波尔定对胶原诱导性关节炎大鼠继发骨微结构的影响

目的:运用双能X线吸收法(DXA)和micro-CT技术评价波尔定对Ⅱ型胶原诱导性关节炎(CIA)大鼠腰椎及股骨近端骨质骨微结构的影响。方法:选用雄性SD大鼠,8只作为空白对照组,其余大鼠制作CIA模型,再随机分为CIA模型组、甲氨蝶呤(MTX)组、波尔定低剂量组和波尔定高剂量组。免疫第15d时开始灌胃给药,连续给药28d后,取大鼠腰椎行骨密度检测,右侧股骨行micro-CT检测并进行三维重建。结果:与CIA模型组比较,波尔定高剂量组大鼠腰椎骨密度显著升高(P<0.01)。股骨近端骨微结构结果:与CIA模型组相比,波尔定高剂量组骨体积分数、骨小梁数量、骨小梁厚度均显著升高(P<0.05,P<0.01),而骨小梁分离度、骨表面积/体积、骨小梁模式因子显著下降(P<0.05,P<0.01)。结论:高剂量波尔定可明显改善CIA大鼠腰椎和股骨近端骨质骨微结构状态,提示其对类风湿关节炎继发的全身性骨质疏松可能具有潜在的预防作用。     

大黄素对泼尼松致大鼠骨丢失的预防作用

目的：观察大黄素对泼尼松致大鼠骨丢失的预防作用。方法将35只3月龄雄性SD大鼠随机分成对照组、模型组、复方钙组、大黄素低剂量组、大黄素高剂量组5组,每组7只。对照组给予溶剂对照溶液,其余4组用泼尼松3 mg／（kg· d）制作骨丢失模型,再分别给予溶剂对照溶液、碳酸钙375 mg／（kg· d）＋维生素D3250 U／（ kg· d）、大黄素90 mg／（ kg· d）、大黄素270 mg／（ kg· d）。大鼠每次按5 mL／kg灌胃给药,连续给药90 d。测定骨重、骨形态指标,用骨组织形态计量学方法测定大鼠胫骨上段松质骨静态参数。结果模型组大鼠体重较对照组降低（P＜0.05）,股骨干重、股骨长度降低（P＜0.05）,伴有骨量的降低,表现为骨静态参数中的骨小梁面积、骨小梁面积百分数、骨小梁宽度下降（ P＜0.05）。与模型组比较,复方钙组以上骨静态参数均升高（ P＜0.05）,大黄素低剂量组以上骨表态参数也有同程度升高（P＜0.05）,但不如复方钙组明显。大黄素高剂量组骨静态参数与模型组相当。结论大黄素90 mg／（ kg· d）用药90 d对泼尼松引起的大鼠骨丢失有预防作用。     

点地梅提取物对大鼠股骨创伤愈合的影响

目的 研究点地梅提取物对大鼠股骨创伤愈合的影响.方法 选取32只雄性Wistar大鼠,构建大鼠股骨骨创伤模型,治疗组(包括点地梅高剂量组和点地梅低剂量组,各8只)给予点地梅提取物,假手术对照组(8只)和骨创伤模型组(8只)大鼠按体质量给予等容量的溶媒,每天1次,连续10d.记录大鼠的体质量增长、伤口愈合等情况,检测血清钙、磷水平及碱性磷酸酶(ALP)活性、骨密度和骨生物力学,通过X线片观察点地梅提取物对大鼠股骨创伤愈合的影响.结果 与骨创伤模型组比较,治疗组血清中钙、磷水平,钙磷乘积及ALP活性明显升高,差异均有统计学意义(P＜0.05);与骨创伤模型组比较,点地梅高剂量组创伤处骨密度明显降低(P＜0.05),点地梅低剂量组弯曲能量明显升高(P＜0.05),其余各项生物力学指标比较差异无统计学意义(P＞0.05);X线片结果显示,点地梅高、低剂量组均比骨创伤模型组愈合效果好.结论 点地梅提取物在所用剂量下具有一定的促进骨创伤愈合的作用.     

复方贞术调脂胶囊对糖皮质激素诱导骨质疏松大鼠骨量和骨转换指标的研究

目的 观察复方贞术调脂胶囊(FTZ)对糖皮质激素诱导骨质疏松大鼠骨密度、生物力学特性和血清骨转换指标的影响.方法 SPF级雄性SD大鼠32只,随机等分为四组:Nrm组为正常对照组,Met组皮下注射甲强龙(Met) 5 mg/kg·d,每周5次,FTZL组和FTZH组在Met组基础上每日分别给予低剂量FTZ (1.5 g/kg)和高剂量FTZ (6 g/kg)灌胃,实验期为12周.QDR4500A型双能X线骨密度测定仪测定股骨和腰椎骨密度,MTS-858型生物力学实验机测定股骨和腰椎生物力学性能.ELISA法测量血清中1型前胶原氨基末端前肽(P1NP)、Ⅰ型胶原羧基端肽(β-CTX)和骨钙素(OC)含量.结果 Met组大鼠股骨和腰椎的骨密度、最大载荷、刚度和血清OC、P1NP均显著低于Nrm组相应指标(Ρ<0.01),血清β-CTX显著高于Nrm组(Ρ<0.01);FTZL组大鼠的最大载荷、刚度和P1NP较Met组有升高趋势,β-CTX有降低趋势,但两组间各指标比较差异均无统计学意义(Ρ>0.05);FTZL组大鼠L5的骨密度和血清OC明显高于Met组(Ρ<0.05);FTZH组大鼠股骨和腰椎的骨密度、最大载荷、刚度、血清OC和P1NP显著高于Met组相应指标(Ρ<0.01),β-CTX明显低于Met组(Ρ<0.05);FTZH组大鼠腰椎的最大载荷、L5的骨密度和血清OC均明显高于FTZL组(Ρ<0.05).结论 FTZ能够改善糖皮质激素诱导骨质疏松大鼠股骨和腰椎的骨密度(BMD)及生物力学特性,改善骨转换指标,效果显著.     

痹痛康丸对胶原免疫性关节炎大鼠免疫功能的影响

[目的]观察痹痛康丸对胶原免疫性关节炎(collagen-Ⅱinduced arthritis,CIA)大鼠免疫功能的影响,探讨其治疗作用机制.[方法]建立Ⅱ型胶原加完全弗氏佐剂诱导的大鼠CIA模型,60只大鼠随机分为6组并灌服,1次／d,连续给药4周.痹痛康丸低、中、高剂量组[0.3、3、30g·(kg·d)-1],白芍总苷组0.3 g·(kg·d)-1,以上各组药物溶解于2ml生理盐水中,正常对照组及模型组灌服生理盐水2 ml/只.观察各组大鼠脾、胸腺重量以及全身免疫指标(外周血T细胞亚群)的变化.[结果]与模型组相比,3组痹痛康丸均能显著降低CIA大鼠胸腺重量指数(P＜0.05),中剂量组痹痛康丸显著降低脾脏重量指数(P＜0.05),痹痛康丸中、高剂量组显著降低CD4+/CD8+的比值(P＜0.05).[结论]痹痛康丸可以改善CIA大鼠免疫的异常状态,从而治疗CIA.     

Effects of Sinomenine on OPG/RANKL and IL-17 in Serum of Collagen-induced Arthritis Rats

目的 探讨青藤碱(SIN)对胶原诱导的关节炎(CIA)大鼠血清骨破坏因子血清骨保护素(OPG)、核周因子κB受体活化因子的配体(RANKL)、白细胞介素17(IL-17)的作用,了解其治疗的骨保护作用.方法 建立CIA大鼠模型,以炎症指标、X线片证实造模成功;分为对照组、模型组、SIN组、MTX组,用ELISA法分析CIA大鼠血清OPG、RANKL、炎性细胞因子IL-17的水平.结果 与正常组比较,模型组大鼠外周血RANKL、IL-17水平明显升高(P＜0.05),OPG水平明显降低(P＜0.05),OPG/RANKL比值下降.与模型组比较,SIN组外周血OPG水平及OPG/RANKL比值明显升高(P＜0.05);与MTX组比较,SIN组OPG、OPG/RANKL比值无明显差异(P＞0.05).结论 在成功建立的CIA大鼠模型中,青藤碱能够提高外周血OPG/RANKL比值,提示青藤碱对类风湿性关节炎有骨保护作用.     

穿山龙总皂苷对CIA大鼠滑膜血管新生的作用

目的:探讨穿山龙总皂苷对胶原诱导性关节炎(collagen-induced arthritis,CIA)大鼠滑膜血管新生及血管内皮生长因子(vascular endothelial growth factor,VEGF)表达的作用.方法:42只Wistar大鼠随机分为7组:正常对照组(A组)、CIA模型组(B组)、雷公藤组(C组)、穿山龙总皂苷高剂量组(D组)、穿山龙总皂苷中剂量组(E组)、穿山龙总皂苷低剂量组(F组)和薯蓣皂苷元组(G组),每组6只大鼠.B-G组大鼠均建立CIA大鼠模型,待模型成功建立后,C-G组大鼠分别给予相应的药物灌胃,连续21d.采用免疫组织化学染色法检测关节滑膜的微血管密度(MVD)和VEGF的表达.结果:CIA模型组大鼠滑膜MVD和VEGF的表达显著高于正常对照组(P＜0.01);C-G组大鼠滑膜MVD和VEGF的表达明显低于模型组(P＜0.01),且各治疗组间比较无显著差异(P＞0.05).结论:穿山龙总皂苷可能通过降低关节滑膜VEGF的表达发挥抑制滑膜血管新生的作用.     

鹿角壮骨胶囊对去卵巢骨质疏松大鼠骨细微结构及骨代谢影响的实验研究

目的 观察鹿角壮骨胶囊对去卵巢大鼠骨细微结构及骨代谢的影响并探讨其机制.方法 120只SD大鼠随机分为假手术组、模型组、仙灵骨葆组,鹿角壮骨胶囊高剂量组、中剂量组、低剂量组,除假手术组外,其余均切除双侧卵巢,干预12周后检测各组血清雌二醇(E2)、抗酒石酸酸性磷酸酶-5b(TRACP-5b)、骨碱性磷酸酶(BALP)、Ⅰ型原胶原N-端前肽(PINP)和Ⅰ型胶原交联C-末端肽(S-CTX)水平,采用双能X线骨密度测量仪测定左侧股骨骨密度;显微镜下观察右股骨小梁的结构变化,并检测右股骨组织形态计量学参数平均骨小梁面积(％Tb.Ar)、骨小梁宽度(Tb.Th)、骨小梁分离度(Tb.Sp)以及骨小梁数目(Tb.N),采用免疫组织化学染色法检测大鼠股骨骨保护蛋白(OPG)及核因子-κ β受体活化因子配体(RANKL)蛋白表达.结果 ①鹿角壮骨胶囊各组血清E2、TRACP-5b及BALP高于模型组(P＜0.01),血清PINP和S-CTX水平低于模型组(P＜0.01);②鹿角壮骨胶囊各组股骨骨密度高于模型组(P＜0.01);③鹿角壮骨胶囊各组Tb.Ar、Tb.Th和Tb.N显著高于模型组(P＜0.01),Tb.Sp显著低于模型组(P＜0.01);④鹿角壮骨胶囊各组股骨OPG蛋白表达高于模型组(P＜0.01),股骨RANKL蛋白表达低于模型组(P＜0.01).结论 鹿角壮骨胶囊不仅能有效地改善去卵巢大鼠激素水平和骨细微结构,而且可提高大鼠骨密度,降低骨转化.     

Effect of Huatan Tongluo Fang on collagen-induced arthritis in rats

目的 观察化痰通络方对胶原诱导性关节炎(CIA)的治疗作用.方法 选择牛Ⅱ型胶原为免疫原,建立CIA模型,选取40只造模成功的大鼠随机分为4组:生理盐水组(A组)、化痰通络方组(B组)、甲胺喋呤组(C组)、化痰通络方+甲胺喋呤组(D组),每组各10只,疗程30 d.采用关节炎指数评分(AI)对大鼠关节炎程度进行评分;采用酶联免疫吸附法(ELISA)测定各组大鼠血清基质金属蛋白酶-3(MMP-3)、血管内皮生长因子(VEGF),根据滑膜病理评估滑膜炎指数积分.结果 AI评分:A组治疗前后AI明显升高(P＜0.01),C组与D组治疗前后AI明显降低(P＜0.01);B组、C组、D组AI均低于A组(P＜0.05,P＜0.01,P＜0.01),D组AI低于B组(P＜0.05).血清VEGF、MMP-3检测结果显示:B、C、D组均显著低于A组(P＜0.01);D组显著低于B组(P＜0.05),而B组与C组、C组与D组差异不显著(P＞0.05).滑膜炎指数积分(SMII)评估结果:B、C、D组SMII均低于A组(P＜0.01);D组SMII低于B组(P＜0.05);D组SMII低于C组,C组SMII低于B组,但差异不显著(P＞0.05).结论 化痰通络方能减轻CIA关节炎症;化痰通络方能明显降低血清VEGF、MMP-3水平;化痰通络方与甲胺喋呤(MTX)联合使用可进一步增强疗效.     

补肾壮骨中药对模拟失重雌性大鼠骨代谢的研究

目的 研究补肾壮骨中药(主要由淫羊藿、续断、补骨脂等组成)对模拟失重雌性大鼠骨丢失的影响.方法 SPF级雌性SD大鼠36只,随机平均分为3组:A组为自由活动对照组,B组和C组为尾吊模拟失重组,C组大鼠给予补肾壮骨中药灌胃,其它2组灌胃等量生理盐水,实验期28 d.采用生化和放免法检测大鼠性激素和骨代谢指标,DEXA测定大鼠右侧股骨的骨密度.结果 B组大鼠血清中骨钙素、碱性磷酸酶、性激素、骨密度水平显著低于A组大鼠相应的指标(P＜0.01,P＜0.05),但血清钙浓度显著高于A组(P＜0.01);C组大鼠骨钙素、碱性磷酸酶、性激素、骨密度,水平均显著性高于B组大鼠(P＜0.01,P＜0.05);而血清钙浓度显著低于B组(P＜0.01).结论 补肾壮骨中药能明显降低模拟失重雌性大鼠的骨丢失.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.