舒脉胶囊对大鼠心肌缺血再灌注损伤的保护作用

目的:研究舒脉胶囊对大鼠心肌缺血再灌注损伤的影响。方法:制备大鼠心肌缺血再灌注损伤模型,用化学比色法测定血清肌酸激酶(CK)、乳酸脱氢酶(LDH)含量及心肌组织匀浆丙二醛(MDA)含量、超氧化物歧化酶(SOD)活性,用放免法测定血浆内皮素(ET)及降钙素基因相关肽(CGRP)含量。结果:大鼠心肌缺血10min,再灌注30min后,血清CK水平明显升高,血浆ET含量增加,心肌组织匀浆SOD活性下降。舒脉胶囊可显著降低缺血再灌注大鼠血中CK、ET水平及心肌组织MDA含量,显著升高血中CGRP水平及心肌组织SOD活性。结论:舒脉胶囊对大鼠心肌缺血再灌注损伤具有保护作用,其作用机制可能与扩张血管、提高氧自由基清除酶活性、抑制脂质过氧化反应有关。     

PCI术后心肌缺血再灌注损伤运用黄芪注射液的临床研究

目的观察黄芪注射液对经皮冠状动脉介入（PCI）术后心肌缺血再灌注损伤的保护作用。方法选取2011年6月-2013年6月我院65例行PCI手术治疗的急性心肌梗死患者,随机分为对照组32例,治疗组33例。治疗组给予黄芪注射液30mL,静滴,7天;对照组仅进行标准化PCI手术治疗。分别于PCI术前、术后第1天、第3天、第7天测定两组患者血清心肌酶学指标：肌钙蛋白（cTnI）、丙氨酸转氨酶（AST）、肌酸激酶（CK）及肌酸激酶-同工酶（CK-MB）、乳酸脱氢酶（LDH）。氧自由基指标：丙二醛（MDA）、超氧化物歧化酶（SOD）活力,以及一氧化氮（NO）活性、cTnI、AST、CK、CK-MB、LDH,氧自由基指标：MDA、SOD以及NO活性等。结果两组患者cTnI在PCI术后各时期均下降,术后第7天与术前比较,AST、CK、CKMB均降低,血清MDA含量降低、SOD及NO活性升高。而PCI术后第1天、第3天与术前比较,两组患者血清MDA含量升高,SOD及NO活性下降,以术后第1天最为显著,反映心肌缺血损伤指标的血清AST、LDH、CK、CKMB活性亦明显升高,说明PCI术后氧自由基及其引发的脂质过氧化作用引起了心肌细胞的损伤。而治疗组给予黄芪注射液治疗后可降低MDA的含量,提高SOD及NO的活性,减少心肌酶的释放,具有保护心肌缺血再灌注损伤的作用。结论黄芪注射液能有效清除氧自由基,减轻脂质过氧化,从而保护心肌缺血再灌注损伤。     

红景天苷对大鼠心肌缺血预处理后血管内皮生长因子表达的影响

目的观察红景天苷对大鼠心肌缺血/再灌注预处理后血管内皮生长因子表达的影响。方法选取16只健康大鼠,随机分为缺血/再灌注组、红景天苷预处理组,其中缺血/再灌注组、红景天苷预处理组经尾静脉注射垂体后叶素制作大鼠急性心肌缺血模型,另设8只为空白对照组。红景天苷预处理组经尾静脉注射1%红景天苷2 m L/(kg·d),每天1次,连续7 d,空白对照组和缺血/再灌注组给予等体积生理盐水预处理。于缺血预处理前及缺血预处理7 d后经眶静脉取血,采用双抗体夹心酶联免疫吸附测定(ELISA)法测定大鼠血清受体胎肝激酶1(FLK-1)及FLK-1 m RNA,缺氧诱导因子-1α(HIF-1α)及HIF-1αm RNA,心肌血管内皮生长因子(VEGF)及m RNA表达;采用测试药盒测定心肌组织中丙二醛(MDA)含量、血清超氧化物歧化酶(SOD)及过氧化氢酶(CAT)活性等指标。结果红景天苷预处理组在缺血预处理7 d后FLK-1及FLK-1 m RNA、HIF-1α及HIF-1αm RNA、VEGF蛋白质及VEGF m RNA的表达均明显增强,与空白对照组、缺血/再灌注组、预处理前比较,差异均有统计学意义(P<0.05)。同时,红景天苷预处理组CAT、SOD活性明显升高,MDA含量明显降低,与缺血/再灌注组及缺血预处理前比较,差异均有统计学意义(P<0.05)。结论红景天苷预处理急性心肌缺血大鼠,可减轻其血管内皮炎症反应及损伤程度,促使大鼠缺血心肌血管内皮新生,增强组织对自由基清除酶活性,抑制脂质过氧化反应,对急性心肌缺血再灌注损伤模型大鼠有保护作用。     

参麦对幼兔未成熟心肌缺血—再灌注损伤的影响

目的 观察参麦对幼兔未成熟心肌缺血—再灌注损伤的影响,并对可能的作用机制进行初步探讨.方法 健康雌性日本大耳白幼兔（兔龄21～28 d）,随机分为缺血—再灌注组（I组）、参麦组（S组）和对照组（C组）3组.结扎冠状动脉左前降支（LAD）制作在体兔心肌缺血—再灌注损伤动物模型,其中C组只穿缝线不结扎动脉,S组于动脉结扎前给予参麦,I、S组结扎LAD 60 min,再灌注120 min时抽取动脉血测血清一氧化氮（NO）和同型半胱氨酸（Hcy）浓度,取缺血区心肌测心肌含水量.同时,心肌组织送检总超氧化物歧化酶SOD （T-SOD）和丙二醛（MDA）.结果 与C组比较,I组血清NO浓度、Hcy浓度、心肌含水量以及心肌MDA浓度均升高,T-SOD浓度则降低,S组血清NO浓度升高.与I组比较,S组血清NO浓度升高,心肌T-SOD浓度升高,心肌MDA浓度、血清Hcy浓度和心肌含水量下降.结论 参麦对幼兔心肌缺血—再灌注损伤有保护作用,其机制与参麦增加血清中的NO浓度、增加心肌SOD并减少MDA发挥其抗氧化作用以及减轻Hcy堆积等有关.     

人参皂苷Rg1和白藜芦醇配伍对心肌缺血再灌注损伤保护作用

目的:观察人参皂苷Rg1和白藜芦醇配伍预处理对大鼠心肌缺血再灌注损伤的影响。方法:75只大鼠分为假手术组、缺血再灌注损伤组(模型组)、人参皂苷加白藜芦醇组(配伍组)、人参皂苷组和白藜芦醇组,每组15只,药物治疗组给予人参皂苷Rg1和白藜芦醇等预处理,制备心肌缺血再灌注损伤模型,观察大鼠血清中IL-17与CK的水平,心肌组织中Bcl-2、Bax的表达水平,ATP、NO、丙二醛(MDA)含量及超氧化物歧化酶(SOD)、诱导型一氧化氮合酶(iNOS)、内皮型一氧化氮合酶(eNOS)活性的变化。结果:与假手术组比较,模型组血清IL-17与CK的水平明显升高;心肌组织Bcl-2表达水平降低、Bax表达水平升高,ATP、NO含量降低;MDA含量升高,SOD活性降低,iNOS活性升高,eNOS活性降低。与模型组比较,人参皂苷加白藜芦醇组大鼠血清IL-17与CK的水平降低;心肌组织Bcl-2表达水平升高、Bax表达水平降低,ATP、NO含量升高;MDA含量降低,SOD活性升高,iNOS活性降低,eNOS活性升高。结论:人参皂苷Rg1与白藜芦醇配伍可能通过抑制心肌细胞凋亡,降低细胞内游离Ca2+浓度,增加自由基清除能力,减低内皮功能及炎症损伤程度等机制对缺血心肌产生一定的保护作用。     

二巯基丙磺酸钠对兔急性心肌缺血再灌注损伤血清ET-1的影响

目的研究兔急性心肌缺血-再灌损伤时血清内皮素-1(ET-1)水平变化及二巯基丙磺酸钠对其的影响。方法新西兰兔20只,随机分成两组:①缺血再灌注组;②二巯基丙磺酸钠保护组。两组分别于缺血前、再灌注后即时及再灌注后0.5h、1h、2h、4h、6h取静脉血。采用放射免疫法分别测定血清ET-1含量。结果缺血再灌注组血清ET-1水平在心肌缺血后明显升高(P<0.05),且于再灌注后1h达高峰(P<0.01),至再灌注后6h仍较缺血前高(P<0.05)。二巯基丙磺酸钠保护组血清ET-1水平于缺血及再灌注的各时间点较缺血前无显著性差异。结论兔急性心肌缺血再灌注损伤时ET-1水平反应性升高,二巯基丙磺酸钠可抑制其分泌而对心肌起保护作用。     

参附注射液对兔心肌缺血再灌注损伤中内皮功能的影响

目的观察实验兔心肌缺血再灌注(I/R)损伤中内皮功能的改变和参附注射液(SFI)对它的影响及作用机制。方法把21只日本大耳白兔随机分为假手术对照组(A组)、心肌I/R模型组(B组)及心肌I/R SFI治疗组(C组),每组7只。检测指标:结扎前、缺血40min、再灌注40min3个时相点血清一氧化氮代谢产物(NOP)和血浆内皮素(ET)的含量;再灌注40min后心肌组织总超氧化物歧化酶(T-SOD)和丙二醛(MDA)的含量;电镜观察心肌的超微结构。结果B组与A组比较,缺血40min、再灌注40min血清NOP明显降低,血浆ET显著增高,且二者呈显著负相关;再灌注40min后心肌组织T-SOD明显降低,MDA明显增高,NOP与T-SOD、ET与MDA均呈显著正相关,NOP与MDA、ET与T-SOD均呈显著负相关;心肌的超微结构发生异常改变。C组与B组比较,缺血40min、再灌注40minNOP水平明显增高;再灌注40minET水平明显降低;再灌注40min后心肌组织T-SOD显著增高,MDA显著降低;心肌超微结构的异常改变明显减轻。结论SFI具有改善兔心肌I/R中自由基介导的内皮功能紊乱作用,可减轻心肌的I/R损伤。     

促红细胞生成素对兔心肌缺血再灌注损伤的保护作用

目的探讨促红细胞生成素(erythropoietin,Epo)对兔心肌缺血再灌注的保护作用。方法建立兔心肌缺血再灌注损伤模型,选用新西兰兔30只随机分为对照组、缺血组、Epo治疗组,检测血浆丙二醛(MDA)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT)和心脏组织匀浆超氧化物歧化酶(SOD)、白介素-6(IL-6)变化。结果 Epo治疗组血浆MDA、CK、CK-MB、cTnT水平较缺血组显著下降(P<0.05);心脏组织匀浆SOD显著升高、IL-6显著降低(P<0.05)。结论 Epo对兔心肌缺血再灌注损伤具有保护作用,这种作用可能与提高心脏组织中SOD水平,降低心脏组织中IL-6水平有关。     

补阳还五汤预处理对MIRI家兔心肌酶及氧化指标的影响

目的观察及探讨补阳五汤对心肌缺血再灌注损伤的保护作用及机制。方法24只家兔随机分为3组：假手术组、模型组、补阳还五汤组。分别预处理1周后,结扎左冠状动脉前降支建立心肌缺血再灌注损伤模型。测定血清中肌酸激酶（CK）、乳酸脱氢酶（LDH）、超氧化物歧化酶（SOD）、丙二醛（MDA）的含量。结果与模型组比较,补阳还五汤组血清CK、LDH及MDA含量明显降低（P〈0．01）,血清SOD的活性显著升高（P〈0．01）。结论补阳还五汤可清除氧自由基,减轻心肌缺血再灌注损伤。     

PCI术后心肌缺血再灌注损伤运用黄芪注射液的临床研究

目的观察黄芪注射液对PCI术后心肌缺血再灌注损伤的保护作用。方法选取2011年6月至2013年6月我院65例行PCI手术治疗的急性心肌梗塞患者,随机分为对照组32人,治疗组33人。治疗组给予黄芪注射液30ml静脉滴注,持续7天,而对照组则仅进行标准化PCI手术治疗。分别于PCI术前、术后第1天、术后第3天、术后第7天测定两组患者血清心肌酶学指标：cTnI、AST、CK、CK-MB、LDH,氧自由基指标：MDA、SOD以及NO活性等。结果两组患者cTnI在PCI术后各时期均下降,术后第7天与术前比较,心肌酶指标AST、CK、CKMB均降低,血清MDA含量降低、SOD及NO活性升高。而PCI术后第1天、第3天与术前比较,两组患者血清MDA含量升高,SOD及NO活性下降,以术后第1天最为显著,反映心肌缺血损伤指标的血清AST、LDH、CK、CKMB活性亦明显升高,说明PCI术后氧自由基及其引发的脂质过氧化作用引起了心肌细胞的损伤。而治疗组给予黄芪注射液治疗后可降低MDA的含量,提高SOD及NO的活性,减少心肌酶的释放,具有保护MIRI的作用。结论本临床研究表明,黄芪能有效清除氧自由基,减轻脂质过氧化,从而保护心肌缺血再灌注损伤。     

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.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

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.