金属硫蛋白对糖尿病大鼠肾脏氧化应激的影响

目的:观察抗氧化剂金属硫蛋白(metallothionein,MT)对糖尿病大鼠肾脏氧化应激指标及NADPH氧化酶的影响,探讨MT对糖尿病大鼠肾脏保护作用的可能机制.方法:雄性SD大鼠随机分为正常对照组(NC,n=8)、糖尿病模型组(DM,n=7)以及糖尿病MT治疗组(DM MT,n=8),糖尿病大鼠腹腔注射链脲佐菌素(60 mg/kg)制备糖尿病大鼠模型,DM MT组大鼠给予10 g/kg体质量MT灌胃.4周后检测各组大鼠24 h尿蛋白(24 h UP)和肾质量/体质量(KW/BW)值,评价肾脏功能,比色法检测肾脏丙二醛(MDA)含量,real-time PCR法检测NADPH氧化酶亚基p47phox、p22phox,蛋白激酶C(PKC)-β和血管紧张素原(Ang)mRNA表达.结果:与NC组相比,DM组24 h UP、KW/BW以及肾皮质MDA水平明显升高(P＜0.05);肾皮质p47phox、p22phox、PKC-β和Ang mRNA表达显著升高(P＜0.05或P＜0.01).与DM组相比,DM MT组24 h UP、KW/BW以及肾皮质MDA水平降低(P＜0.05),p47phox、PKC-β和Ang mRNA的表达水平降低(P＜0.05),而p22phox无明显改变.结论:MT可能通过降低糖尿病大鼠肾脏氧化应激水平,抑制肾皮质PKC-β、Ang以及NADPH氧化酶亚基的表达,从而发挥肾脏保护作用.     

氧化应激对心房颤动犬心房病理组织学及超微结构改变的影响

目的 观察氧化应激对慢性心房快速起搏诱发心房颤动(房颤)犬心房肌钙激活蛋白酶Ⅰ表达及肌细胞超微结构改变的影响.方法 20只犬无菌条件下开胸手术,植入高频起搏器(400次/分),建立房颤犬模型,分为假手术组(不起搏),对照组和普罗布考组心房快速起搏6周.普罗布考组于起搏前1周服用普罗布考(100 mg/kg),至起搏6周结束.采用免疫组化方法和Western印迹法检测各组犬心房肌钙激活蛋白表达情况;分别于起搏前和起搏6周后,记录各组犬房颤诱发情况;比色法检测各组犬心房肌氧化应激相关指标.结果 对照组左、右心房肌肌溶解比率[(53.6±11.8)%,(58.5±9.2)%]比假手术组[(4.4±3.1)%,(4.1±2.9)%]显著增加(P＜0.01);对照组比假手术组心房肌细胞线粒体肿胀伴糖原沉积明显,心房肌钙激活蛋白酶Ⅰ表达显著上调(P＜0.01);普罗布考组左、右心房肌细胞病理组织学和超微结构改变比对照组明显减轻,肌溶解比率明显减少[(12.3±3.2)%,(12.0±2.6)%,P＜0.01],钙激活蛋白酶Ⅰ表达显著下调(P＜0.01).普罗布考组心房肌MDA水平比对照组显著降低(P＜0.01),T-AOC和抗O2-水平明显增加(P＜0.01),房颤诱发率和平均持续时间显著减少(均P＜0.01).心房肌钙激活蛋白酶Ⅰ表达和MDA均与肌溶解程度呈显著正相关(r=0.958,r=0.939,P＜0.01).结论 普罗布考能够通过抑制氧化应激,抑制房颤犬心房肌肌溶解等病理组织学和超微结构变化,防止心房颤动犬心房重构,减少房颤发生.     

胆碱能抗炎通路在参松养心粉剂抑制犬阵发性心房颤动中的作用

目的:探讨参松养心胶囊降低心房颤动(房颤)的发生的具体机制。方法:杂种犬18只,随机分为对照组(n=6)、起搏组(n=6)和参松组(n=6)。对照组植入起搏器后程控关闭起搏器;起搏组植入起搏器后长期间断起搏右房(400次/min,8h/d);参松组植入起搏器后长期间断起搏并每天喂养参松养心,所有犬喂养8周。12周后进行心房电生理和生化指标检测。结果:与对照组相比,起搏组和参松组犬的心房有效不应期(AERP)明显降低,且房颤的诱发次数和持续时间均明显升高;但参松组犬的AERP和房颤诱发明显低于起搏组犬。8周后,起搏组和参松组犬血清和心房肌炎性因子水平和心房交感神经密度明显高于对照组,而乙酰胆碱水平和α7烟碱型乙酰胆碱受体(a7nAChR)蛋白表达低于对照组;但参松组犬的血清和心房肌炎性因子水平和心房交感神经密度明显低于起搏组,而乙酰胆碱水平和a7nAChR蛋白表达高于起搏组。结论:参松养心抑制心房肌电重构和阵发性房颤的诱发可能与其调节胆碱能抗炎通路有关。     

内皮素受体拮抗剂CPU0213和钙拮抗剂CPU86017改善异丙肾上腺素诱导的大鼠心衰的作用机制

为了验证内皮素受体拮抗剂CPU0213和钙拮抗剂CPU86017改善异丙肾上腺素(isoproterenol,ISO)诱导的大鼠心衰的分子生物学机制,将SD大鼠均分为5组:正常组、ISO组、药物治疗组(3组)。除正常组外,其余4组均皮下给予异丙肾上腺素(ISO,1 mg/kg,10 d),其中3个治疗组于第10,11天分别皮下注射:氨基胍(30 mg/kg)、CPU0213(30 mg/kg)和CPU86017(4 mg/kg)。结果发现,ISO组,内皮素受体A(ETA)、iNOS、衰老蛋白p66Shc、ε型蛋白激酶C(PKCε)、瘦素受体(OBRb)、NADPH氧化酶p67phox、瘦素(leptin)mRNA或蛋白表达均上调,药物治疗后对这些异常均有逆转。CPU0213和CPU86017均通过抑制内皮素受体和氧化应激及下调p66Shc和PKCε等相关分子表达,减轻ISO引起的心衰。     

氯沙坦减轻自发性高血压大鼠主动脉重构及其机制

目的：观察氯沙坦治疗对自发性高血压大鼠(SHR)主动脉重构及p22phox表达的影响。方法：36只12周龄SHR连续灌胃给予氯沙坦,剂量分别为0,15,30 mg/(kg·d),每组12只;另取12只WKY大鼠作为非高血压对照组。每周测定尾动脉压。8周后检测主动脉病理结构、血浆过氧化氢（H2O2）水平、过氧化氢酶 (CAT)活力、血浆血管紧张素Ⅱ(Ang II)水平、主动脉p22phox的表达。结果：SHR主动脉血管壁明显增厚,尾动脉压、血浆H2O2和AngⅡ水平及主动脉p22phox的表达均显著增高,而血浆CAT活力明显下降;应用氯沙坦治疗在降低血压的同时,可改善SHRL主动脉结构,降低血浆H2O2水平和主动脉p22phox的表达,升高血浆AngⅡ水平及和CAT活力。结论： SHR主动脉血管重构涉及氧化应激,氯沙坦可改善血管重构,其机制与下调p22phox表达、抑制氧化应激有关。     

通络方剂对糖尿病大鼠肾脏氧化应激的影响

目的:研究两种剂型通络方剂(超微粉和微粉)对糖尿病SD大鼠肾脏氧化应激的影响.方法:链脲佐菌素(60 mg/kg)腹腔注射诱导糖尿病大鼠.1周后测血楮≥16.7 mmol/L为糖尿病,将大鼠随机分为糖尿病对照组(DMC,n=7)、通络方剂超微粉组(DM UT,n=8)和通络方剂微粉组(DM FT,n=8)3组,同时取8只大鼠作为正常对照组(NC).DM UT组和DM FT组按每天1 g/kg UT或FT灌胃,NC和DMC组给予等量的生理盐水溶液.干预4周后,测肾质量/体质量(KW/BW)和24 h尿蛋白(24 h UP),比色法检测肾皮质抗氧化酶和丙二醛(MDA),实时PCR法检测NADPH氧化酶亚基p47phox和p22phox mRNA表达的改变.结杲:与正常大鼠相比,糖尿病大鼠肾皮质MDA含量、24 h UP和KW/BW升高,总超氧化物歧化酶(TSOD)活性降低,谷胱甘肽过氧化物酶(GSH-Px)活性升高,均有统计学意义;正常大鼠与糖尿病大鼠问过氧化氢酶(CAT)活性差异无统计学意义.与DMC组相比,两个通络方剂干预组糖尿病大鼠肾皮质MDA、24 h UP和Kw/BW明显降低;TSOD和GSH-Px活性增强,差异均有统计学意义.DMC组和两个通络方剂组间CAT活性差异无统计学意义.其中DM UT组对24 h UP,KW/BW、MDA、TSOD和GSH-Px的作用较DM FT组更明显,差异有统计学意义.与正常大鼠相比,糖尿病大鼠肾皮质NADPH氧化酶亚基p47phox mRNA表达增强,差异有统计学意义.与DMC组相比,两个通络方剂干预组p47phox mRNA表达降低,差异有统计学意义,但两干预组间差异无统计学意义.在各实验组问NADPH氧化酶亚基p22phox mRNA表达的差异无统计学意义.结论:通络方剂能增强糖尿病大鼠肾脏TSOD和GSH-Px活性,降低NADPH氧化酶p47phox mRNA的表达,可能因此抑制肾脏氧化应激水平,减轻糖尿病大鼠早期的肾脏损伤.     

二十二碳六烯酸下调心房颤动大鼠心房肌细胞双孔内向整流相关性钾通道-1的表达

目的:探讨二十二碳六烯酸(DHA)在大鼠心房颤动(房颤)模型中的作用及其对双孔内向整流相关性钾离子通道1(TREK-1)表达的影响。方法:将乙酰胆碱-氯化钙混合液敏感的雄性SD大鼠随机分为对照组(A组)、对照DHA处理组(B组)、房颤组(C组)、房颤DHA处理组(D组)。分别观察房颤发生时间和心房有效不应期(ERP);应用Western blot测定大鼠心房肌中TREK-1表达及反转录-聚合酶链反应测定大鼠心房肌中TREK-1 mRNA表达。结果:D组较C组大鼠房颤出现时间明显推迟,每天房颤持续时间显著缩短(P0.01);与A组比较,C组大鼠心房ERP明显缩短,D组大鼠心房ERP较C组明显延长(P0.01)。与A组比较,C组TREK-1 mRNA和蛋白表达水平均明显升高(P0.01);与C组比较,D组TREK-1mRNA和蛋白表达均降低(P0.05和P0.01)。结论:DHA具有抗房颤作用,其机制可能与下调双孔钾通道TREK-1表达有关。     

葛根素和丹参酮ⅡA组分配伍对糖尿病肾病大鼠肾组织P27~(kip1)蛋白的调控作用

目的探讨葛根素、丹参酮ⅡA组分配伍对糖尿病肾病大鼠p27kip1表达的影响,为中医药治疗糖尿病肾病提供实验依据。方法单次腹腔注射链脲佐菌素(65 mg/kg)建立糖尿病肾病大鼠模型,实验分为对照组、模型组、葛根素低、高剂量组(50 mg/kg,200 mg/kg)、丹参酮ⅡA低、高剂量组(10 mg/kg,40 mg/kg)、葛根素+丹参酮ⅡA低、高剂量组(葛根素50 mg/kg+丹参酮ⅡA 10 mg/kg,葛根素200 mg/kg+丹参酮ⅡA 40 mg/kg),8周末处死大鼠,测定血糖、24 h尿量及24 h尿蛋白,通过RT-PCR和Western blot法检测各组大鼠肾组织p27kip1mRNA及蛋白的表达。结果葛根素+丹参酮ⅡA高剂量组可明显降低糖尿病肾病大鼠血糖,减少尿量,减轻尿蛋白排泄,抑制糖尿病肾病大鼠肾组织P27~(kip1)蛋白表达(P0.05,P0.01),且优于其他各组。结论葛根素和丹参酮ⅡA组分配伍具有抗糖尿病肾病的作用,其机制可能是通过下调糖尿病肾病大鼠肾组织p27kip1的表达实现的。     

阻塞性睡眠呼吸暂停相关心房颤动模型中Kv1.4钾离子通道表达变化

目的 检测在慢性阻塞性睡眠呼吸暂停(OSA)相关心房颤动(房颤)犬模型及低氧处理HL-1细胞中Kv1.4钾离子通道表达变化，为慢性OSA发生房颤的可能机制提供一定的实验基础。方法 12只健康成年雄性比格犬，分为OSA组、假手术组(Sham组),每组6只，反复夹闭气管插管构建慢性OSA犬模型，每天4 h,每周5 d,持续12周。观察两组犬一般情况，造模前、第4周、第8周、第12周动脉血pH值、氧分压(PaO₂)、二氧化碳分压(PaCO₂)、心房有效不应期(AERP)、房颤诱发率、房颤持续时间。12周造模结束后取两组犬心房肌组织，采用实时荧光定量PCR(RT-qPCR)和Western blotting法检测两组犬心房肌组织中Kv1.4钾离子通道基因及蛋白表达水平。HL-1细胞分为正常氧组(21%氧浓度)、6 h低氧组(3%氧浓度持续6 h)、12 h低氧组(3%氧浓度持续12 h),检测各组HL-1细胞Kv1.4钾离子通道基因及蛋白表达水平。结果 在慢性OSA犬模型中，第4周、第8周、第12周OSA组动脉血pH值、PaO₂...     

血管紧张素-（1-7）对快速心房起搏犬心房重构及p38MAPK蛋白表达的影响

目的:观察快速心房起搏后犬心房重构与p38MAPK蛋白激活的关系,以及血管紧张素（Ang）-(1-7)的干预作用。方法:普通杂种犬15只随机分为3组,假手术组（Sham,S组）、心房起搏组（Pacing,P组）和心房起搏+Ang-(1-7)组（A组）,每组5只,所有犬均安置心房起搏器,除假手术组外,其余两组均给予500次/min持续右心房起搏,A组以6 μg/（kg·h）连续给予Ang-（1-7）,起搏2周后分别测定各组犬的心脏结构变化、心房有效不应期、房颤诱发率及持续时间,HE染色及Masson染色观察心房肌细胞结构变化,Western blot技术测定左心房组织p38MAPK、磷酸化p38MAPK的蛋白表达情况。结果:与假手术组比较,心房起搏组左室射血分数降低,心房有效不应期缩短,房颤诱发率及持续时间升高,心肌细胞排列紊乱,细胞间纤维组织增多,磷酸化p38MAPK水平明显升高（P＜0.05),Ang-(1-7)组较心房起搏组左室射血分数、心房有效不应期、房颤诱发率及持续时间均明显改善,磷酸化p38MAPK蛋白降低（P＜0.05）,但p38MAPK在3组间的差异未达到统计学意义。结论:快速心房起搏导致的心房重构与p38MAPK磷酸化激活有关,Ang-（1-7）可通过降低p38MAPK激活而保护心房重构。     

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…