慢性移植物抗宿主病模型的诱导及补肾清热毒方的疗效观察

目的　观察慢性移植物抗宿主病模型的诱导及补肾清热毒方的疗效。方法　选用 (DBA/ 2×C5 7BL/ 6J)F1小鼠 ,通过尾静脉注射其母鼠DBA/ 2淋巴细胞来诱导模型 ,观察 12周。同时于诱导后第 4周 ,将模型小鼠随机分为中药组 ,强的松组 ,模型组及未诱导的F1对照组 ,用药 8周后处死。观察自身抗体、血肌酐、尿素氮、肾脏病理等指标。结果　注射后 4周的小鼠仅有系膜细胞轻度增生 ,未见间质损害。 12周各项观察指标改变最明显 ,病理改变以内皮下大量嗜复红物质沉积 ,肾小管蛋白管型和肾间质大量炎细胞浸润 ,局灶或节段肾小球出现硬化为主要表现。免疫荧光示IgG、C3沿毛细血管沉积。中药组和强的松组均能降低尿蛋白浓度、自身抗体、血肌酐、尿素氮 ,中药组还有降低胆固醇功效 ,两药对轻度系膜细胞增生有效。结论　慢性移植物抗宿主模型类似人类狼疮性肾炎 ,是良好的狼疮肾炎模型。中药补肾清热毒方在狼疮肾炎发病早期有治疗作用     

一种实用性狼疮样肾炎动物模型--鼠慢性移植物抗宿主病的制备

目的建立一种狼疮样肾炎动物模型，为人类狼疮性肾炎（ＬＮ）实验和临床研究提供基础。方法取雌性亲代ＤＢＡ／２的淋巴细胞分４次经静脉注射雌性子代Ｆ１代杂交鼠（Ｃ５７ＢＬ６× ＤＢＡ２）。注射时间为０，３，７，１０ ｄ。每次注射淋巴细胞数为５０× １０６。结果尿白蛋白于第４次注射后２周开始升高，第１２周达高峰；血抗ｄｓ－ＤＮＡ水平于第４次注射后２周已明显升高，至第４周达高峰，各时点与对照组差异明显。普通光镜（ＰＡＳ、ＰＡＳＭ）示肾小球基底膜增厚，系膜轻度增生，小管间质炎症细胞浸润；免疫荧光示ＩｇＧ沿基底膜呈线状或颗粒状沉积，部分小管基底膜亦可见其沉积；电镜显示膜性肾炎改变，基底膜增宽，内有电子致密物沉积，上皮细胞足交融合。结论本实验所建立狼疮样肾炎动物模型，主要为膜性肾炎。     

紫金狼疮解毒丸GVHR狼疮样小鼠作用的实验研究

目的观察紫金狼疮解毒丸对系统性红斑狼疮动物模型的效果并探讨其作用机理。方法采用同种异体淋巴细胞复制诱导型移植物抗宿主反应（GVHR）狼疮样小鼠模型，研究紫金狼疮解毒丸对GVHR狼疮样小鼠模型的作用。结果显示同种异体淋巴细胞的输入能诱导出dsDNA和抗组蛋白抗体的持续升高。尿蛋白异常并发生免疫复合物介导的肾小球肾炎等SLE样病变；用紫金狼疮解毒丸能显著地控制模型小鼠血清中抗dsDNA和组蛋白抗体的升高（P〈0．05，P〈0．01，P〈0．001）降低尿蛋白的阳转率（P〈0．05）；非常显著地减轻肾小球病理改变。结论紫金狼疮解毒丸能控制SLE样小鼠相关病变的发展。     

白细胞介素Ⅰ受体拮抗剂和抗白细胞介素6抗体对NZB/WF_1小鼠狼疮性肾炎的影响

观察白细胞介素Ⅰ受体拮抗剂（IL-1ra）和抗白细胞介素6抗体（抗IL-6）对9月龄狼疮倾向NZB／WF1小鼠肾脏的形态学表现：IL-1ra组为轻度局灶性系膜增生性肾小球肾炎，病变单一；抗IL-6组呈中度弥漫性系膜增生性肾小球肾炎；盐水对照组为重度弥漫性系膜增生性肾小球肾炎伴明显病变多样性改变。电镜下3组肾小球内均可见多处电子致密物沉积，但IL-1ra组小且少，盐水组则大且多。结果提示，IL-1ra有明显减轻狼疮倾向NZB／WF1小鼠肾小球病理损害作用，从而延缓肾小球硬化，改善肾功能。抗IL-6组亦对小鼠肾小球病变有改善作用。     

同种异体淋巴细胞致狼疮肾炎小鼠模型的研究

目的　制备狼疮肾炎小鼠模型。方法　采用昆明小鼠同种异体脾淋巴细胞经Lectin刺激后输入小鼠腹腔皮下的方法。结果　成功地制备了系膜增生型狼疮肾炎小鼠模型 ,通过光镜、免疫荧光、电镜观察其病理形态、并检测了血清抗ds -DNA抗体、补体以及尿蛋白 ,证实了该模型的可靠性。结论　制备的系膜增生型狼疮肾炎小鼠模型有实用价值     

慢性移植物抗宿主病狼疮小鼠模型免疫学特征分析

目的:诱导及鉴定慢性移植物抗宿主病(cGVHD)狼疮小鼠模型,分析其肾病变特点及狼疮相关免疫学特征.方法:选取6～8周龄(C57BL/10×DBA/2)F1雌性小鼠,随机分为两组,模型组12只,对照组7只,分别于第0、3、8天经尾静脉注射DBA/2雌鼠胸腺和脾的淋巴细胞(模型组)或磷酸盐缓冲液(对照组).利用考马斯亮蓝法监测小鼠尿蛋白变化;检测小鼠血清的抗核抗体(ANA)、抗双链DNA抗体、抗核小体抗体及抗可提取核抗原(ENA)抗体;利用流式细胞技术分析CD4+CD25+调节T细胞的变化;应用实时定量PCR法测定两组小鼠外周血单个核细胞(PBMC)中Foxp3的表达量;于12周末分别用PAMS染色及直接免疫荧光法检测小鼠的肾病理变化.结果:模型组小鼠的尿蛋白自第6周明显增高,与对照组比较差异有统计学意义(P<0.05).模型组小鼠血清中ANA抗体阳性率于第8、12周时明显高于对照组;随小鼠周龄增加,模型组小鼠抗dsDNA抗体及抗核小体抗体的滴度增高,与对照组相比差异有统计学意义(P<0.05).12周时模型组外周血CD4+CD25+调节T细胞的比例明显低于对照组(P=0.002),但两组间外周血PBMC Foxp3的表达量差异无统计学意义(P>0.05).模型组小鼠肾病理的PASM染色可见典型狼疮肾炎病理改变,直接免疫荧光检测可见IgG广泛沉积;而对照组小鼠肾无以上表现.结论:GVHD模型鼠不仅出现了类似人类狼疮肾炎的尿蛋白变化,血清中还出现多种自身抗体,CD4+CD25+调节T细胞明显异常,其肾病理呈典型的狼疮肾炎改变.因此,cGVHD模型鼠可作为一种比较好的系统性红斑狼疮相关基础研究及新疗法的动物模型.     

JNK在cGVHD狼疮样小鼠肾组织表达及在肾纤维化中作用研究

目的:观察c-Jun氨基末端激酶(JNK)在慢性移植物抗宿主病(cGVHD)狼疮样小鼠肾组织中的表达情况,初步探讨其在狼疮肾炎肾脏纤维化中所起的作用.方法:建立cGVHD狼疮样小鼠模型.将小鼠分为12周正常对照组、16周正常对照组、12周模型组及16周模型组4组,每组6只,于12周末处死12周正常对照组和12周模型组小鼠,16周末处死16周正常对照组和16周模型组小鼠,采用双缩脲比色法观察各组小鼠24 h尿蛋白排泄量,HE和Masson染色观察肾间质纤维化程度,免疫组织化学法定位检测JNK、p-JNK在肾组织的表达,RT-PCR法检测各组JNK mRNA表达及Western blotting技术半定量检测JNK、p-JNK蛋白表达水平.结果:12周模型组小鼠24 h尿蛋白排泄量,JNK、p-JNK蛋白及mRNA的表达与正常对照组相比均明显增加(P<0.01),16周模型组更甚(P<0.01).结论:JNK、p-JNK蛋白及mRNA表达在cGVHD狼疮样小鼠肾组织中明显上调,其可能在狼疮肾炎肾纤维化进程中起着重要作用.     

对苯二胺与H2O2混合物诱导小鼠狼疮样改变的作用

目的 了解对苯二胺(PPD)与H2O2混合物诱导BALB/c小鼠产生狼疮样改变的作用.方法 将21只6周龄雌性BALB/c小鼠随机分为高PPD组(n=7,800 mg/kg)、低PPD组(n=7,400mg/kg)和对照组(n=7,生理盐水),经皮染毒.检测小鼠血清抗核抗体(ANA)与抗双链DNA抗体(抗dsDNA抗体)及尿蛋白含量,染毒12周取肾脏组织做病理学检杳,观察HE、PAS染色及电镜下变化.结果 第12周高PPD组ANA(220.89±6.16)和抗dsDNA抗体浓度(34.30±1.29)分别高于低PPD组ANA(169.24±16.12)、抗dsDNA抗体浓度(30.78±0.64)和对照组ANA(92.22±7.94)、抗dsDNA抗体浓度(23.77±0.54),差异均有显著性(P＜0.01).第12周高、低PPD组ANA和抗dsDNA抗体浓度均分别高于染毒前两组ANA和抗dsDNA抗体浓度,差异均有显著性(P＜0.01).自6周开始,各组小鼠尿蛋白差异均有显著性(P＜0.05).光镜下可见肾小球肾炎表现(肾小球系膜细胞增生、系膜区增宽,肾间质炎性细胞浸润;肾小管管腔内有大量分泌物),电镜示足突融合和皮下电子致密物沉积.结论 PPD和H2O2混合物在诱导小鼠产生狼疮样改变中有一定的作用.     

小鼠竹叶青蛇毒素致系膜增生性肾小球肾炎模型的建立

目的：建立小鼠竹叶青蛇毒素（Habu snake venom，HSV）谤发系膜增生性肾小球肾炎（MsGN）模型。方法：动物随机分模型组和对照组。模型组小鼠注射HSV。对照组仅注射等量的生理盐水。定期测定血尿素氮（BUN）的水平，观察肾组织病理改变，并应用免疫组织化学方法测定TGF—β蛋白，作为增值指标观察系膜细胞的增生情况。结果：小鼠注射HSV1天后即BUN升高。第7天达高峰，2周后仍维持在较高的水平。肾组织病理改变表现为不同程度的系膜细胞破坏，系膜区溶解，随后肾小球内有核细胞增多，系膜细胞增生厦系膜区扩张。模型组TGF—B蛋白在肾小球的阳性表达与正常对照组相比均具有显著差异性。结论：竹叶青蛇毒素注射能引起小鼠系膜增生性肾炎的肾脏病变。     

c-Jun氨基末端激酶在慢性移植物抗宿主病狼疮样小鼠肾组织的表达及氟伐他汀的干预作用

建立慢性移植物抗宿主病(cGVHD)狼疮样小鼠模型,观察c-Jun氨基末端激酶(JNK)在狼疮样小鼠肾组织中的表达及氟伐他汀的干预作用。(C57BL/6J×DBA/2)F1代小鼠随机分为正常对照组、氟伐他汀高剂量组(10 mg/kg)、低剂量组(5 mg/kg)和模型组,16周后处死,采用双缩脲比色法观察各组小鼠24 h尿蛋白量,免疫组织化学法定位检测JNK、p-JNK在肾组织的表达,RT-PCR法检测各组JNK mRNA表达及Western blotting半定量检测JNK、p-JNK蛋白表达。结果显示,模型组小鼠24 h尿蛋白量、JNK mRNA及JNK、p-JNK蛋白表达较正常对照组均显著增加(P＜0.01);氟伐他汀干预组较模型组上述指标均明显降低(P＜0.01);高剂量组较低剂量组降低更明显(P＜0.05)。JNK可能参与了狼疮肾炎病情进展,氟伐他汀可能通过影响JNK的表达从而延缓狼疮肾炎肾纤维化进程。     

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…