急性胰腺炎大鼠肺组织内TMF—α mRNA表达的实验研究

目的：了解急性胰腺炎时肺组织中肿瘤坏死因子（TNF）转录水平上调在肺损伤机制中的意义,方法：作者以半定量逆转录聚合酶链反应（RT－PCR）技术检测了急性水肿性胰腺炎（AEP）与急性坏死性胰腺炎（ANP）两种模型的大鼠肺组织的TNFα－mRNA表达的状况,同时观察了它与内毒素（ET）血症的关系。结果：ANP组血TNF－α水平显著高于AEP组,后者又高于对照组（P＜0．05）,诱导AP后1小时肺组织内即出现了TNF－αmRNA的明显表达,在早期（3小时内）两组大鼠的表达水平接近,但随后ANP组TNF－α转录水平明显较AEP组高（P＜0．05）,ANP组ET水平也显示高于AEP组,且当ET含量明显增多时（6小时）,肺内TNF－α基因表达最强,结论：ANP时肺内出现TNF等细胞因子的损害性过度表面可能是发生肺损伤的重要原因,而内毒素血症的刺激是导致TNF过多生成的部分原因。     

巨噬细胞炎症蛋白-2和细胞凋亡在内毒素诱导急性肺损伤发病中的作用探讨

目的探讨巨噬细胞炎症蛋白-2(MIP-2)和细胞凋亡在小鼠内毒素诱导急性肺损伤发病机制中的作用。方法以脂多糖气管内注射建立小鼠急性肺损伤模型,进行肺组织病理、肺水含量、支气管肺泡灌洗液白细胞总数和中性粒细胞分类计数、TNF-α和MIP-2浓度检测,并作肺组织凋亡细胞计数。结果气管内注射LPS后,肺水含量、肺泡灌洗液白细胞总数和中性粒细胞分类计数、TNF-α和MIP-2浓度及肺组织凋亡细胞计数均明显升高,且随时间推移呈逐渐变化的趋势。结论MIP-2是炎症早期的促炎性细胞因子,其在早期短期急剧释放可趋化和激活中性粒细胞并诱导肺组织细胞凋亡,从而启动与维持炎症反应。     

还原性谷胱甘肽对急性坏死性胰腺炎肺损伤的影响

目的:观察急性坏死性胰腺炎(ANP)大鼠肺组织核因子-κB(NF-κB)mRNA,细胞因子(TNF-α,IL-1β,IL-18),髓过氧化物酶(MPO)的变化,探讨还原性谷胱甘肽(GSH)治疗肺损伤的机制. 方法:72只Wistar大鼠随机分成3组: ANP组, GSH组,SO组(假手术组). 于术后6,12,18 h取肺组织供实验用. 免疫组化测定肺中IL-1β,IL-18,TNF-α的表达,比色法测定MPO的活性,RT-PCR检测NF-κB p65 mRNA的表达,胰、肺行组织学观察. 结果:ANP组肺组织NF-κB mRNA,IL-18, IL-1β,TNF-α,MPO的水平升高,NF-κB,IL-1β,TNF-α在12 h达高峰,与SO组相比各时间点均有统计学差异(P＜0.05). GSH治疗后IL-1β,IL-18,TNF-α在各时间点均降低,NF-κB mRNA,MPO在12 h降低(P＜0.05). 结论:ANP时NF-κB,IL-18,IL-1β,TNF-α及MPO均参与了肺损伤,GSH能够抑制肺NF-κB活化,促炎因子的表达及中性粒细胞的聚集,对肺损伤有保护作用.     

热毒宁注射液对兔急性肺损伤的防治作用

目的 研究中药热毒宁(RDN)对于内毒素性急性肺损伤(ALI)兔的肺局部致炎因子及表面活性物质(主要成分为磷脂酰胆碱,PC)的影响及意义.方法 3组健康兔,静脉注射内毒素建立急性肺损伤模型,应用RDN预处理后,不同时间点检测外周血液IL-8、IL-10、TNF-α的含量及支气管肺泡灌洗液(BALF)内的PC和磷脂酰乙醇胺(PE)的含量,并用流式细胞仪测定外周血及BALF内的多核粒细胞(PMN)凋亡、坏死细胞比例及呼吸爆发功能.结果 内毒素诱导的ALI兔血和BALF中的致炎因子含量较对照组显著升高,肺通透指数升高,PC下降,PE增加(均P<0.05).BALF中PMN成活比例增加,凋亡延迟,呼吸爆发明显增强.而RDN的使用均可抑制上述各变化(P<0.05),并明显改善肺病理表现.结论 RDN的预处理可防治内毒素诱导的兔ALI的发生与发展.     

内毒素血症在急性胰腺炎肺损伤中的作用机制

目的：探讨内毒素血症在急性坏死性胰腺炎并发肺损伤过程中的地位及作用机制。材料和方法：将大鼠分三组，水肿性胰腺炎组即制备急性水肿性胰腺炎模型；水肿性胰腺炎 LPS处理，在预定时点测定动物血浆TNF——α的明显表达，血中TNF-α含量显著增加，伴有轻度肺损害的表现。水肿性胰腺炎组动物肺组中也有一定程度TNF-α的表达，如果再合并内毒素血症，则TNF-α的生成大大增加，同时出现严重的肺损伤。结论：急性胰腺炎时内毒素血症可以通过诱导肺内TNF-α等炎症性细胞因子的过度表达而导致肺损伤，研究还提示内毒素血症可能在启动SIRS/MODS及胰腺炎重症化进程中发挥重要作用。     

TNF-α、IL-1β及中性粒细胞凋亡在妊娠家兔羊水栓塞肺损伤中的作用

目的:探讨肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-1β(interleukin-1β,IL-1β)及中性粒细胞凋亡在羊水栓塞(amniotic fluid embolism,AFE)肺损伤发病机制中的作用。方法:20只健康妊娠晚期家兔随机分为对照组及羊水组(n=10),羊水组建立AFE动物模型,监测造模前后动脉血pH值、PaO2及PaCO2变化,1 h后取兔肺组织,计算肺组织湿/干重(W/D)值,ELISA测定肺组织TNF-α、IL-1β含量,Annexin-V/PI双染法测定中性粒细胞凋亡率,并制备肺组织石蜡切片观察肺组织病理学变化。结果:与对照组比较,羊水组造模前后动脉pH、PaO2和PaCO2变化显著(P<0.01),肺组织W/D值,TNF-α和IL-1β含量升高(P<0.01),中性粒细胞凋亡率降低(P<0.01),病理切片见肺组织水肿。结论:TNF-α、IL-1β表达上调及中性粒细胞凋亡延迟与羊水栓塞肺损伤发病有关。     

中性粒细胞在大鼠急性重症胰腺炎肺损伤中的作用机制

目的:探讨急性重症胰腺炎(ASP)合并急性肺损伤时肺泡灌洗液中性粒细胞(PMN)凋亡和坏死的发生规律及可能涉及的作用机制.方法:选取雄性SD大鼠48只,分为ASP实验组(24只)、对照组(24只).实验组大鼠穿刺胰胆管并注入35g/L牛磺胆酸钠制作ASP大鼠模型,分别在制模后3,6,12 h剖杀,于预定时相取支气管灌洗液,密度梯度离心分离PMN,用流式细胞仪测定PMN凋亡、坏死比例,同时测定乳酸脱氢酶(LDH)含量、肺通透指数.结果:ASP组大鼠肺灌洗液中PMN存活细胞比例增加(P＜0.01),凋亡延迟.同时,肺灌洗液LDH明显升高(P＜0.01),肺通透指数显著增加(P＜0.01).结论:ASP合并急性肺损伤时,PMN凋亡延迟,造成PMN持续处于激活状态及毒性内容物的持续释放,与急性肺损伤密切相关.     

TNF-α、IL-8与急性重症胰腺炎肺损伤中PMNs凋亡延迟的相关性研究

目的探讨肿瘤坏死因子-α(TNF-α)和白细胞介素-8(IL-8)在急性重症胰腺炎(acute severe pancreatitis,ASP)合并急性肺损伤中中性粒细胞(polymorphonuclear leukocyte,PMNs)凋亡延迟的相关性及其机制。方法选取雄性SD大鼠48只,穿刺胆胰管并注入3.5%牛磺胆酸钠制作ASP合并急性肺损伤大鼠模型,分为牛磺胆酸钠注射后3、6、12 h及对照组。病理检测胰腺及肺组织;于预定时相取支气管灌洗液,密度梯度离心分离PMNs,流式细胞仪测定PMNs凋亡、坏死比例;ELISA检测灌洗液中TNF-α及IL-8的含量;检测NF-κB在肺组织中的表达。结果 ALI大鼠肺灌洗液中PMNs凋亡、坏死比例增加,凋亡延迟。支气管-肺泡灌洗液中的TNF-α及IL-8的含量较对照组显著增加,灌洗液中细胞TNF-α及IL-8 mRNA表达增加,不同干预时间组间具有显著差异,具有时间依赖效应;肺组织中NF-κB的表达显著增加。结论TNF-α、IL-8在ASP合并急性肺损伤中可能发挥一定的作用。     

外周血中性粒细胞凋亡与急性胰腺炎的关系探讨

目的探讨AP模型中外周血中性粒细胞凋亡与急性胰腺炎的关系。方法sD大鼠90只,随机分为3组,每组30只,分别建立大鼠急性坏死性胰腺炎（ANP）、水肿型胰腺炎（AEP）及对照组模型,在制模后0、3、6、12、24h分期分批处死大鼠,抽取下腔静脉血测定血清淀粉酶含量,作中性粒细胞分离并检测外周血中性粒细胞凋亡。切取胰腺标本组织,病理切片苏木精-伊红染色,并对胰腺组织进行病理评分。结果ANP组PMN凋亡率明显降低,至术后24h降至（1．87±0．41）;AEP组PMN凋亡率则明显升高,术后12h达到峰值（12．33±0．41）;对照组PMN凋亡维持在（6．30±6．57）水平。各时相点组间比较,3、6、12、24hANP组PMN凋亡率低于AEP组（P〈0．05）。结论ANP组外周循环中的中性粒细胞凋亡明显降低,而AEP组外周循环中的中性粒细胞则存在较多的凋亡,提示急性胰腺炎的转归与循环中性粒细胞功能密切相关。     

内镜治疗急性梗阻化脓性胆管炎对外周血中性粒细胞凋亡及细胞因子的影响

目的 研究内镜治疗急性梗阻化脓性胆管炎对患者外周血中性粒细胞凋亡及细胞因子表达的影响.方法 内镜治疗老年急性梗阻化脓性胆管炎,观察治疗前、后外周血中性粒细胞凋亡、细胞因子IL-6、TNF-α、内毒素水平及住院时间变化,以同期青壮年组作对照.结果 在治疗后第5天起.两组IL-6、TNF-α、内毒素水平均明显降低,外周血中性粒细胞凋亡明显增加.青壮年组外周血中性粒细胞凋亡延迟明显改善优于老年组,血浆细胞因子下降明显快于老年组(P<0.05).住院时间明显低于老年组(P<0.05).结论 内镜治疗老年急性梗阻性化脓性胆管炎能改善外周血中性粒细胞凋亡延迟.降低细胞因子、内毒素水平,但比青壮年组恢复时间延迟.     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…