黄芪益母汤治疗慢性肾病蛋白尿30例临床观察

目的:观察黄芪益母汤治疗慢性肾病蛋白尿的临床疗效.方法:将60例慢性肾病蛋白尿患者随机分为两组各30例,均给予基础治疗,治疗组加用黄芪益母汤,对照组加用依那普利,观察2组临床疗效.结果:治疗后2组均能降低24小时尿蛋白(P＜0.05),升高高血浆蛋白(P＜0.05);临床总有效率治疗组93.3%,对照组70.0%,2组比较,差异有显著性意义(P＜0.05).结论:黄芪益母汤对慢性肾病蛋白尿有确切疗效,且安全性较好.     

防己黄芪汤对阿霉素肾病模型大鼠肾组织IL-6、TGF-β1的影响

目的:考察防己黄芪汤干预阿霉素肾病模型大鼠的效应强度,初步探讨其作用机制。方法:按5mg/kg体重给予大鼠尾静脉1次注射阿霉素建立阿霉素肾病模型;检测尿蛋白量,ELISA法检测肾组织IL-6、TGF-β1浓度。结果:模型组大鼠尿蛋白定量升高,肾组织IL-6浓度增加、TGF-β1浓度降低(P<0.05);防己黄芪汤高、中、低剂量组尿蛋白定量明显减少(P<0.05),肾组织IL-6浓度降低、TGF-β1浓度升高(P<0.05)。结论:防己黄芪汤对阿霉素肾病模型大鼠肾功能具有一定的保护作用,可能与其降低肾组织IL-6浓度、提高肾组织TGF-β1浓度有关。     

防己黄芪汤对阿霉素肾病模型大鼠肾组织IL-6、TGF-β1的影响

目的：考察防己黄芪汤干预阿霉素肾病模型大鼠的效应强度,初步探讨其作用机制。方法：按5mg/kg体重给予大鼠尾静脉1次注射阿霉素建立阿霉素肾病模型;检测尿蛋白量,ELISA法检测肾组织IL-6、TGF-β1浓度。结果：模型组大鼠尿蛋白定量升高,肾组织IL-6浓度增加、TGF-β1浓度降低（P〈0.05）;防己黄芪汤高、中、低剂量组尿蛋白定量明显减少（P〈0.05）,肾组织IL-6浓度降低、TGF-β1浓度升高（P〈0.05）。结论：防己黄芪汤对阿霉素肾病模型大鼠肾功能具有一定的保护作用,可能与其降低肾组织IL-6浓度、提高肾组织TGF-β1浓度有关。     

加味黄芪赤风汤对阿霉素肾病大鼠蛋白尿及血清NO、ET-1和TGF-β1的影响

目的探讨加味黄芪赤风汤对阿霉素肾病大鼠蛋白尿及血清NO、ET-1和TGF-β1的影响。方法大鼠尾静脉注射阿霉素制作阿霉素肾病模型,以正常剂量加味黄芪赤风汤、二倍剂量加味黄芪赤风汤和洛丁新灌胃,于实验第2、4、6、8周末收集24h尿液,测24h尿蛋白定量,于实验第8周末取血,进行血清NO、ET-1及TGF-β1的测定。结果模型组与同期空白组相比,大鼠24h尿蛋白定量明显升高(P0.01),血清NO降低(P0.05),血清ET-1及TGF-β1均升高(P0.05)。二倍剂量加味黄芪赤风汤组与同期模型组相比,实验第4、6、8周末24h尿蛋白定量均降低(P0.05),第8周末大鼠血清NO明显升高(P0.01),血清TGF-β1显著降低(P0.01)。正常剂量加味黄芪赤风汤组与同期模型组相比,实验第4周末24h尿蛋白定量减少(P0.05),第8周末大鼠血清ET-1及TGF-β1均显著降低(P0.01)。洛丁新组与同期模型组比,实验第8周末24h尿蛋白定量降低(P0.05),第8周末大鼠血清NO升高(P0.05),血清ET-1显著降低(P0.01)。结论加味黄芪赤风汤能够明显改善阿霉素肾病大鼠蛋白尿及血清NO、ET-1及TGF-β1的含量,对延缓肾小球硬化及肾脏纤维化有积极作用。     

降钙素对激素性骨质疏松大鼠干预作用的实验研究

目的:观察降钙素对糖皮质激素所导致骨质疏松大鼠的干预作用.方法:将30只3月龄SD雄性大鼠随机分为模型组、对照组、密盖息组,每组10只.模型组给予甲泼尼龙3.5 mg/(kg·d);对照组给予生理盐水1.64 mL/(kg·d);密盖息组给予甲泼尼龙3.5 mg/(kg·d) 密盖息2 U/(kg·d).9周后分别测三组大鼠的骨密度(BMD),骨钙素(BGP),尿钙/肌酐,尿磷/肌酐.结果:与对照组比较,模型组BMD,BGP降低(P＜0.05),尿钙/肌酐,尿磷/肌酐增加(P＜0.05).与模型组比较,密盖息组BMD,BGP增加(P＜0.05),尿钙/肌酐,尿磷/肌酐降低(P＜0.05).结论:降钙素可抑制骨吸收,促进骨形成,对预防糖皮质激素所导致的大鼠骨质疏松有显著的作用.     

2型糖尿病大鼠肾脏血管内皮生长因子的表达和黄芪的调节作用

目的观察黄芪对2型糖尿病大鼠肾脏血管内皮生长因子(VEGF)的影响.方法将SD大鼠分为假手术组(Sham组)、糖尿病肾病组(DN组)、黄芪治疗组(DNH组).DN组和DNH组制成糖尿病模型,DNH组予黄芪注射液5 mL/kg灌胃.观察黄芪对糖尿病肾病大鼠肾组织VEGF、尿白蛋白的影响.结果黄芪可明显降低糖尿病大鼠尿白蛋白及肾组织VEGF表达(P＜0.05).结论 2型糖尿病所致糖尿病肾病VEGF表达升高,黄芪可能通过抑制VEGF表达而减少糖尿病肾病损害.     

黄芪注射液在原发性肾病综合征中应用的疗效观察

目的 观察黄芪注射液在原发性肾病综合征(PNS)应用的效果.方法 43例患者随机分为观察组和对照组,在基础治疗的同时,对照组给予强的松1mg/(ks·d),观察组给予强的松1mg/(ks·d),黄芪注射液40ml/d,共用28d.观察两组治疗前后24h尿蛋白定量、血清清蛋白(Alb)、血胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等的变化.结果 观察组与对照组用药28d相比,其24h尿蛋白、血脂固醇、血肌酐、尿NAG酶明显下降(P<0.05),血浆清蛋白明显上升;两组治疗前后组内比较差异有统计学意义(P<0.05).结论 黄芪注射液辅助激素治疗原发性肾病综合征疗效良好.     

黄芪党参水煎剂对阿霉素诱导的大鼠肾病综合征的治疗作用

目的探讨黄芪党参水煎剂对阿霉素诱导的大鼠肾病综合征的治疗作用。方法按6．5mg／kg尾静脉注射阿霉素建立大鼠肾病综合征模型,随机分为三组,对照组、模型组、治疗组。治疗组5周后予以黄芪党参水煎剂每天灌胃,持续2周。观察动物一般情况,检测24h尿量、尿蛋白、血清生化学指标,进行肾脏形态学检查。结果模型组24h尿蛋白增加,血浆清蛋白（ALB）降低、总胆固醇（TC）、三酰甘油（TG）明显升高（P〈0．05,P〈0．01）、肾组织病理学检查异常,治疗组上述指标明显好转。结论黄芪党参水煎剂对阿霉素诱导的大鼠肾病综合征有良好的治疗作用．     

普罗布考对阿霉素肾病大鼠足细胞nephrin和podocin表达的影响

目的 研究普罗布考对阿霉素大鼠足细胞相关分子nephrin及podocin表达的影响.方法 将36只SD大鼠分为正常对照组(12只)、肾病模型组(12只)和普罗布考干预模型组(12只),采用鼠尾静脉注射阿霉素的方法建立阿霉素大鼠肾病模型.4周末检测各组大鼠24 h尿蛋白定量,光镜下观察肾脏病理学改变,Westem blot技术检测nephrin及podocin的表达.结果 肾病模型组和普罗布考干预组24 h尿蛋白定量均高于正常对照组(P＜0.05),但普罗布考干预组24 h尿蛋白定量低于肾病模型组(P＜0.05).肾病模型组和普罗布考干预组肾小球nephrin、podocin的表达均低于正常对照组(P＜0.05),且普罗布考干预组高于肾病模型组(P＜0.05).结论 普罗布考可能通过减轻足细胞损伤实现对阿霉素肾病大鼠肾脏的保护作用.     

二仙汤对更年期肾阳虚大鼠的影响

目的:探讨二仙汤对更年期肾阳虚大鼠模型的治疗作用.方法:将30只符合自然老化的更年期大鼠模型,随机平均分配为对照组、模型对照组和治疗组,3月龄鼠作为青年对照组.模型对照组和治疗组用氢化可的松制造肾阳虚模型成功后,治疗组给予二仙汤灌胃14d.观察二仙汤对大鼠性激素水平的影响.结果:二仙汤能明显减轻肾阳虚症状,体重增加(P＜0.01),治疗组血中的雌二醇(E2)明显高于模型组(P＜0.05),促黄体生成素(LH)和促卵泡刺激素(FSH)低于模型组(P＜0.05).结论:二仙汤对更年期肾阳虚大鼠模型有治疗作用.     

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.     

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.