乌司他丁通过抑制Wnt/β-Catenin信号通路活性减轻糖尿病大鼠神经病变性疼痛

目的 探讨乌司他丁减轻糖尿病大鼠神经病变性疼痛（DNP）的效应及相关信号通路。方法 将36只SD大鼠随机分为对照组（Con组）、DNP模型组（DNP组）、乌司他丁治疗组（ULI组）,分别采取不同的干预措施。对大鼠进行机械缩足反射阈值（MWT）测试和热缩足反射潜伏期（TWL）测试。分批处死大鼠,解剖分离L3～5脊髓,采用Western Blot检测Wnt 10a蛋白、β-catenin蛋白的表达水平。采用ELISA法检测瘤坏死因子-α(TNF-α)和白细胞介素-1(IL-1)等炎性因子的表达水平。结果 (1)DNP组各时间点的MWT和TWL值均显著低于Con组。与Con组相比,ULI组的WMT值及TWL值更高（P <0.05）。Western Blot检测显示,与Con组相比,DNP组大鼠脊髓Wnt 10a蛋白和β-catenin蛋白的表达水平增加（P <0.05）,ULI组Wnt 10a和β-catenin蛋白表达水平显著降低（P <0.05）。(2)与Con组相比,DNP组脊髓星形胶质细胞明显激活,Wnt 10a和β-catenin表达增强。ULI组星形胶质细胞的激活受到抑制,Wnt 10a和β-catenin的表达也受到抑制。(3)ELISA检测显示,在注射链脲佐菌素后第39、42、45天,由Wnt 10a/β-catenin信号通路激活的TNF-α和IL-1β水平显著升高,经乌司他丁干预后,显著降低了TNF-α和IL-1β水平。结论 乌司他丁可通过抑制炎症和星形胶质细胞的激活减轻大鼠DNP症状,这可能是通过Wnt 10a/β-catenin信号通路实现的。     

miR-19a对慢性压迫性损伤大鼠神经病理性疼痛的影响及其机制

目的 观察miR-19a对慢性压迫性损伤(chronic constriction injury,CCI)大鼠神经病理性疼痛的作用,并探讨其潜在机制.方法 75只雄性SD大鼠按随机数字表法分为3组:假手术组,行假手术;CCI组,坐骨神经结扎法构建CCI大鼠模型;CCI+inhibitor组,CCI大鼠鞘内注射miR-19a inhibitor.于术前当天(0 d)和术后3、7、14、21 d观察机械缩足反射阈值(mechanical withdrawal threshold,MWT)和热刺激反射潜伏期(thermal withdrawal latency,TWL)的变化.采用RT-qPCR检测腰椎脊髓中促炎因子IL-6、TNF-α、IL-1β mRNA及JAK2和STAT3表达的变化,Western blot检测SOCS3蛋白水平的表达,荧光素酶报告基因技术验证miR-19a的靶基因.结果 与假手术组比较,CCI组大鼠脊髓的miR-19a表达显著上升(P＜0.05),MWT显著降低,TWL显著缩短(P＜0.05).与CCI组比较,CCI+ inhibitor组MWT显著升高,TWL显著延长(P＜0.05).RT-qPCR检测结果表明,CCI可显著促进促炎因子IL-6、TNF-α、IL-1β mRNA的表达;而与CCI组比较,CCI+inhibitor组IL-6、TNF-α、IL-1βmRNA表达水平均显著降低(P＜0.05).另一方面,与假手术组比较,CCI组大鼠术后脊髓中JAK2和STAT3 mRNA水平明显增加;与CCI组比较,CCI+ inhibitor组术后脊髓中JAK2和STAT3的表达显著降低(P＜0.01).荧光素酶报告基因检测结果表明JAK2/STAT3上游的负调控因子SOCS3是miR-19a的靶基因.Western blot检测结果表明CCI组大鼠脊髓中SOCS3水平较假手术组升高,且SOCS3水平在CCI术后第7天达到最高,而后呈下降趋势;与CCI组比较,CCI+inhibitor组SOCS3表达明显上升(P＜0.05).结论 miR-19a inhibitor能缓解CCI大鼠机械性触诱发痛和热痛觉过敏,该作用与SOCS3介导的JAK2/STAT3通路有关.     

神经病理性疼痛大鼠脊髓背角Sirt1与miR-34b表达的变化

目的研究Sirt1与miR-34b在神经病理性疼痛大鼠脊髓背角中表达变化的临床意义。方法将14只雄性SD大鼠随机分为假手术组（Sham组）和坐骨神经慢性压迫性损伤组（CCI组）,每组7只。于模型建立前1d及术后第7、14天,测定大鼠机械缩足反射阈值（MWT）和热缩足反射潜伏期（TWL）。术后第14天取大鼠L4~5节段脊髓进行病理学检查,HE染色后观察脊髓背角运动神经元的数量变化。real-timePCR检测脊髓背角内Sirt1与miR-34b的表达,Westernblot测定大鼠脊髓背角内Sirt1、脑源性神经营养因子（BDNF）和环磷腺苷效应元件结合蛋白（CREB）的表达。结果经MWT和TWL验证,大鼠CCI神经病理性疼痛模型建立成功。HE染色显示,与Sham组比较,CCI组大鼠在手术后7、14d脊髓背角神经元数量显著减少（均P＜0.05）。real-timePCR结果显示,与Sham组相比,CCI组Sirt1表达降低,miR-34b表达升高（均P＜0.05）。Westernblot显示Sirt1与CREB表达降低,pCREB与BDNF表达增加。结论Sirt1与miR-34b的表达变化可能参与坐骨神经慢性压迫性损伤导致的神经病理性疼痛的形成和维持。     

大鼠背根神经节ERK5/CREB信号通路在神经病理性疼痛中的作用

目的:探讨脊髓与背根神经节(DRG)细胞外信号调节蛋白激酶5(ERK5)信号通路在神经病理性疼痛中的作用。方法:SD大鼠坐骨神经结扎(CCI)建立神经病理性模型。应用免疫组化方法检测CCI大鼠DRG磷酸化ERK5(p-ERK5)表达的变化;鞘内注射ERK5反义寡核苷酸对CCI大鼠DRG p-CREB表达以及机械缩足反射阈值(MWT)和热缩足反射潜伏期(TWL)的影响。结果:CCI大鼠同侧DRG p-ERK5标记的神经元数量明显增加;鞘内注ERK5反义寡核苷酸有效抑制DRG ERK5表达的同时,CCI所致的p-CREB表达上调(P<0.05)、机械与热痛觉过敏也明显减轻(P<0.05)。结论:DRG ERK5参与了神经病理性疼痛的信号转导过程,其部分作用是通过激活转录因子CREB实现的。     

姜黄素对神经病理性疼痛大鼠脊髓背角和背根神经节GR和NMDAR-NR1表达的影响

目的探讨姜黄素对神经病理性疼痛大鼠脊髓背角和背根神经节皮质激素受体(GR)和NMDAR-NR1表达的影响。方法将雄性SD大鼠72只(体质量220～250g),随机分成4组:假手术组(Sham组)、慢性坐骨神经结扎损伤组(CCI组)、CCI+溶剂组(SC组)、CCI+姜黄素100mg/kg组(Cur100组)。SC组和Cur100组大鼠在坐骨神经结扎后,分别腹腔注射溶剂或100mg.kg-1.d-1姜黄素,至术后14d。于术前2d和术后1、3、5、7、10、14d测定机械缩足反射阈值(MWT)和热缩足反射潜伏期(TWL);术后3、7、14d取大鼠术侧L4、L5脊髓背角和背根神经节,用免疫组化法检测脊髓背角和背根神经节GR和NMDAR-NR1表达情况。结果与Sham组相比,CCI组术后TWL、MWT明显降低(P<0.01),术侧脊髓背角和背根神经节内GR和NMDAR-NR1表达明显增多(P<0.01)。与CCI组相比,Cur100组大鼠TWL和MWT明显提高(P<0.05),脊髓背角和背根神经节GR和NMDAR-NR1表达明显减少(P<0.05)。结论姜黄素可通过抑制脊髓背角和背神经根节GR和NMDAR-NR1的表达而减轻CCI大鼠神经病理性疼痛。     

蛇床子素对髓核致神经根炎性痛大鼠脊髓背角Wnt3a/β-catenin信号通路的影响

【目的】探讨蛇床子素对髓核致神经根炎性痛大鼠的治疗作用及机制。【方法】将54只SD大鼠随机分为假手术组、模型组和治疗组，每组18只。模型组和治疗组大鼠构建神经根炎性痛模型，假手术组进行假手术处理。术后2 d，治疗组大鼠经硬膜外注射50μL蛇床子素20 g·L-1，假手术组和模型组大鼠经硬膜外注射相同体积二甲基亚砜（DMSO）。术前3、1 d及术后1、3、7、10、14 d测量大鼠50%机械性撤足阈值（MWT）及热伤害性撤足潜伏期（TWL）。于术后7 d，采用定量聚合酶链反应（Q-PCR）检测术侧脊髓背角Wnt3a、β-catenin mRNA表达水平，采用Western Blot法和免疫荧光染色法分别检测术侧脊髓背角Wnt3a、β-catenin蛋白表达水平，采用酶联免疫吸附分析（ELISA）检测术侧脊髓背角白细胞介素18(IL-18)、肿瘤坏死因子α(TNF-α)水平。【结果】模型组术后各时间点50%MWT及TWL较假手术组降低（P<0.05或P<0.01），术后7 d术侧脊髓背角Wnt3a、β-catenin mRNA和蛋白表达水平及IL-18、TNF-α水平均较假手术...     

5-HT3受体在慢性神经病理性疼痛模型脊髓组织中的表达

目的观察慢性神经病理性疼痛大鼠脊髓组织中5-HT,受体的表达变化。方法采用大鼠坐骨神经结扎（慢性压迫性损伤）制备慢性神经病理性疼痛模型。坐骨神经结扎造模后7天,采用测定热缩足反射潜伏期（TWL）和机械缩足反射阀值（MWT）2种行为学方法检测大鼠痛觉闽值变化,免疫组织化学染色法检测大鼠脊髓背角5-HT,受体表达,Westernblot方法检测大鼠脊髓背角中5-HT,受体蛋白水平。结果造模7天后：模型组大鼠的TWL和MWT均低于正常组和假手术组（P〈0．05）,模型组大鼠脊髓背角组织中5-HT,受体表达明显高于正常组和假手术组（P〈0．05）、5-HT,受体蛋白水平高于正常组和假手术组（P〈0．05）。结论在慢性神经病理性疼痛中,脊髓背角组织中5-HT,受体表达增加;脊髓背角组织中5-HT,受体可能参与了慢性神经病理性疼痛的痛觉信息传导过程。     

腹腔注射木犀草素调控sirt1/FOXO1通路对慢性坐骨神经结扎大鼠痛觉敏化的影响

目的探讨腹腔注射木犀草素调控sirt1/FOXO1通路对慢性坐骨神经结扎（CCI）大鼠痛觉敏化的影响。方法将72只SD雄性大鼠按随机数字表法分为假手术组（S组）、慢性坐骨神经结扎组（CCI组）、CCI联合木犀草素腹腔给药组（Lut组）、CCI联合木犀草素和沉默信息调节因子１（sirt1）抑制剂EX725腹腔给药组（Lut+EX组）,每组各18只。S组仅暴露坐骨神经并游离连接组织,不做CCI,其余3组大鼠建立CCI模型。模型建立后,S组和CCI组腹腔注射0.9%氯化钠注射液2.5ml/kg,Lut组腹腔注射木犀草素2.0ml/kg+含1%二甲基亚砜（DMSO）的0.9%氯化钠注射液0.5ml/kg,Lut+EX组腹腔注射木犀草素2.0ml/kg+EX5270.5ml/kg,均连续给药7d。分别在术前1天和CCI模型建立后第1、3、7、14天测定各组大鼠的机械性缩足反射阈值（MWT）和热缩足潜伏期（TWL）。术前1天和CCI后第7、14天提取大鼠脊髓背角组织,测定sirt1、叉头转录因子１（FOXO1）和乙酰化FOXO1蛋白表达。结果各组大鼠CCI前1天MWT和TWL均相近（均P＞0.05）;CCI后第1、3、7、14天,CCI组、Lut组、Lut+EX组MWT和TWL均明显低于S组（均P＜0.05）,但Lut组第7、14天TWL与S组比较差异无统计学意义（P＞0.05）;CCI后第1、3、7、14天,Lut组MWT和TWL均明显高于CCI组（均P＜0.05）,而Lut+EX组与CCI组比较差异均无统计学意义（均P＞0.05）。与S组比较,各组大鼠CCI后第7、14天脊髓背角sirt1蛋白水平均下降（均P＜0.05）,Lut组和Lut+EX组sirt1蛋白水平较CCI组明显增高（均P＜0.05）。与S组相比,各组大鼠在CCI后第7、14天脊髓背角FOXO1和乙酰化FOXO1蛋白水平均上调（均P＜0.05）;与CCI组、Lut+EX组比较,Lut组在CCI后第7天FOXO1蛋白水平升高,第14天FOXO1蛋白水平降低,乙酰化FOXO1水平较前两组降低更明显（均P＜0.05）。结论木犀草素可上调CCI大鼠脊髓背角sirt1蛋白水平,降低FOXO1乙酰化,通过调节sirt1/FOXO1信号通路,降低神经病理性疼痛导致的痛觉敏化。     

COX抑制剂对神经病理性疼痛大鼠镇痛效果及机制

目的观察COX抑制剂对慢性坐骨神经缩窄性损伤(CCI)神经病理性疼痛模型大鼠的镇痛效果及脊髓NR2B亚基表达,探讨其可能的机制。方法健康SD雄性大鼠体质量200~280 g,共36只,随机分为4组:CCI假手术组、CCI对照组、CCI吲哚美辛组、CCI帕瑞昔布组。各组大鼠于术前和用药前、用药后1、3、5、7 d测定机械性缩足反射阈。采用Westernblot方法测定脊髓NR2B亚基的蛋白表达。结果 CCI对照组、CCI吲哚美辛组和CCI帕瑞昔布组大鼠机械性缩足反射阈术后较术前明显降低(P<0.05),帕瑞昔布显著减轻CCI大鼠痛敏状态(P<0.05),吲哚美辛未显示镇痛效果;大鼠脊髓NR2B的表达,CCI吲哚美辛组和CCI帕瑞昔布组与CCI对照组比较无统计学差异(P>0.05)。结论本研究观察到高选择性COX-2抑制剂帕瑞昔布治疗能够改善CCI模型神经病理性疼痛大鼠的机械性缩足反射阈,起到一定镇痛效果,但其机制与脊髓背角NR2B亚基系统可能无关。     

地佐辛对神经病理性疼痛大鼠的镇痛作用及对Toll样受体4/核转录因子-κB信号通路的影响

目的探讨地佐辛对神经病理性疼痛大鼠的镇痛作用及对Toll样受体4(TLR4)/核转录因子-κB(NF-κB)信号通路的影响。方法将90只Sprauge Dawley大鼠随机分为假手术组、模型组、普瑞巴林组及地佐辛低、中、高剂量组,每组15只。模型组、普瑞巴林组及地佐辛低、中、高剂量组大鼠结扎左侧第5腰神经制备神经病理性疼痛模型,假手术组大鼠不结扎第5腰神经。术后第4天开始,普瑞巴林组大鼠腹腔注射普瑞巴林18 mg·kg~(-1)·d~(-1),地佐辛低、中、高剂量组大鼠分别注射地佐辛6、12、24 mg·kg~(-1)·d~(-1),模型组及假手术组大鼠注射等剂量氯化钠溶液;注射量均为1 m L·kg~(-1),连续给药7 d。分别于术前及术后第4、11天测定各组大鼠机械痛阈值(MWT)和热缩足反射潜伏期(TWL);术后第11天处死各组大鼠并取脊髓组织,采用酶联免疫吸附试验法检测脊髓组织中白细胞介素-6(IL-6)、单核细胞趋化蛋白-1(MCP-1)及肿瘤坏死因子-α(TNF-α)水平,Western blot法检测脊髓组织中TLR4、NF-κB蛋白相对表达量。结果各组大鼠术前MWT、TWL比较差异无统计学意义(F=0.261、0.662,P>0.05)。术后第4、11天,模型组、普巴瑞林组及地佐辛低、中、高剂量组大鼠MWT、TWL显著低于术前(P<0.05),模型组、普瑞巴林组及地佐辛低、中、高剂量组大鼠的MWT、TWL显著低于假手术组(P<0.05)。术后第4天,模型组、普瑞巴林组及地佐辛低、中、高剂量组大鼠MWT、TWL比较差异均无统计学意义(P>0.05)。术后第11天,模型组大鼠MWT显著低于术后第4天,普巴瑞林组及地佐辛中、高剂量组大鼠MWT、TWL显著高于术后第4天(P<0.05)。术后第11天,普瑞巴林组及地佐辛低、中、高剂量组大鼠MWT、TWL显著高于模型组(P<0.05),普瑞巴林组及地佐辛中、高剂量组大鼠MWT、TWL显著高于地佐辛低剂量组(P<0.05),普瑞巴林组及地佐辛高剂量组大鼠MWT、TWL显著高于地佐辛中剂量组(P<0.05),地佐辛高剂量组大鼠MWT、TWL与普瑞巴林组比较差异无统计学意义(P>0.05)。模型组、普瑞巴林组及地佐辛低、中、高剂量组大鼠脊髓组织中IL-6、MCP-1、TNF-α水平和TLR4蛋白、NF-κB蛋白相对表达量均显著高于假手术组(P<0.05),普瑞巴林组及地佐辛低、中、高剂量组大鼠脊髓组织中IL-6、MCP-1、TNF-α水平和TLR4蛋白、NF-κB蛋白相对表达量显著低于模型组(P<0.05),普瑞巴林组及地佐辛中、高剂量组大鼠脊髓组织中IL-6、MCP-1、TNF-α水平和TLR4蛋白、NF-κB蛋白相对表达量显著低于地佐辛低剂量组(P<0.05),普瑞巴林组及地佐辛高剂量组大鼠脊髓组织中IL-6、MCP-1、TNF-α水平和TLR4蛋白、NF-κB蛋白相对表达量显著低于地佐辛中剂量组(P<0.05),地佐辛高剂量组与普瑞巴林组大鼠脊髓组织中IL-6、MCP-1、TNF-α水平及TLR4蛋白、NF-κB蛋白相对表达量比较差异无统计学意义(P>0.05)。结论地佐辛可能通过抑制TLR4/NF-κB信号通路的激活而减轻脊髓炎症反应,提高神经病理性疼痛大鼠MWT,延长TWL,发挥镇痛作用。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.