吡格列酮对动脉粥样硬化大鼠主动脉脂联素受体表达的影响

目的观察动脉粥样硬化（atherosclerosis,AS）大鼠主动脉脂联素受体（adiponectin receptor,AdipoR）的表达,探讨吡格列酮对AS大鼠血管AdipoR表达的影响。方法 Wistar大鼠26只,随机分为正常对照组（n=6）、高脂饮食组（n=20）。高脂饮食组加维生素D3诱导AS模型。AS造模成功后,检测血脂水平。再分AS组即模型组（n=10）和AS＋吡格列酮组即干预组（n=10）。干预组给予吡格列酮溶液10 mg/（kg·d）,连续灌胃4周,对照组和模型组给予等量蒸馏水灌胃4周,检测血脂水平及免疫组织化学检测血管AdipoR变化,Western blotting检测AdipoR蛋白表达。结果高脂饮食喂养后,甘油三酯（triglyceride,TG）、总胆固醇（total cholesterol,TC）、低密度脂蛋白胆固醇（low density lipoprotein cholesterin,LDL-C）明显升高（P〈0.01）;给药4周后,干预组TG、TC明显降低（P〈0.01）;模型组AdipoR蛋白表达明显下降（P〈0.01）。与模型组比较,干预组AdipoR蛋白表达明显升高（P〈0.05）。结论吡格列酮具有降低TG、TC的作用,上调主动脉AdipoR水平。吡格列酮具有抗AS作用,该作用可能与增加血管AdipoR表达有关。     

吡格列酮对高脂血症大鼠主动脉凋亡蛋白Bax、Bcl-2的影响

目的探讨吡格列酮对高脂血症大鼠主动脉凋亡蛋白Bax、Bcl-2表达的影响及保护血管内皮的可能机制。方法清洁型SD大鼠26只,随机分为对照组(n=9)和高脂饮食组(n=17),高脂饮食组喂养12周后再随机分为模型组(n=8)和吡格列酮组(n=9),分别干预4周后,检测各组血脂水平和HE染色观察主动脉病理形态学改变,免疫组织化学法检测主动脉Bax、Bcl-2的表达。结果高脂饮食组喂养12周后,血脂明显升高(P<0.01);给药4周后,与模型组比较,吡格列酮组TG、TC水平明显降低(P<0.01),且主动脉血管内皮基本完好,偶有脱落,平滑肌细胞增殖不明显。与对照组相比,模型组主动脉Bax蛋白表达明显增高(P<0.01),Bcl-2蛋白表达和Bcl-2/Bax比值显著降低(P<0.01);与模型组相比,吡格列酮组主动脉Bax蛋白表达明显降低(P<0.01),Bcl-2蛋白表达和Bcl-2/Bax比值明显升高(P<0.01)。结论高脂饮食可引起主动脉凋亡蛋白Bax、Bcl-2及比值的改变,而吡格列酮可降低血脂,调节Bax、Bcl-2凋亡蛋白表达,抑制内皮细胞凋亡,改善内皮细胞功能和动脉粥样硬化病理进程。     

吡格列酮对2型糖尿病患者血脂的影响

胰岛素抵抗已被认为是糖尿病患者发生脂代谢紊乱的关键，据此推测可改善2型糖尿病患者胰岛素敏感性的药物噻唑烷二酮类（格列酮类）将可能改善患者的血脂水平。盐酸吡格列酮是噻唑烷二酮类的一种。为此我们观察了盐酸吡格列酮治疗前后的血脂变化，报告如下。     

吡格列酮对高脂血症大鼠主动脉PPARγ-NF-kB的影响

目的观察吡格列酮对高脂血症大鼠主动壁过氧化物酶增殖体激活受体（PPAR）γ及核因子（NF）-kB表达的影响。方法清洁级SD大鼠26只,随机分为正常饮食组（对照组,9只）和高脂饮食组（17只）;高脂饮食组喂以高脂饮食12周后检测空腹血脂,造模成功后,分为模型组（8只）和吡格列酮组（9只）;后者给予吡格列酮溶液（0.6mg/ml）连续灌胃4周,对照组和模型组给予等量蒸馏水灌胃4周。用药4周后检测各组血脂、主动脉病理、主动脉一氧化氮、一氧化氮合成酶水平,并通过免疫组织化学法检测PPARγ和NF-kB表达。结果高脂饲料喂养12周后造模成功。给药4周后,吡格列酮组TG、TC明显下降;与对照组比较,模型组主动脉NO、cNOS显著下降（P〈0.01）,吡格列酮可显著提高主动脉NO、cNOS（P〈0.01）;与模型组比较,吡格列酮组PPARγ表达明显升高（P〈0.01）,NF-kB表达明显下降（P〈0.01）。结论吡格列酮具有降低血清TG、TC的作用,升高主动脉NO、cNOS水平;吡格列酮能提高主动脉PPARγ表达,抑制NF-kB表达。     

盐酸吡格列酮对肌肉组织胰岛素抵抗发生的影响

目的:探讨盐酸吡格列酮对饱和脂肪酸诱导的大鼠肌肉组织胰岛素抵抗发生的影响。方法:45只雄性W istar大鼠分为3组。对照组喂饲普通块料,高脂组喂饱和脂肪酸提供59%KJ的高脂饲料,盐酸吡格列酮组在喂饲高脂饲料的同时,灌胃给盐酸吡格列酮10 mg.kg-1.d-1。各组喂饲11周后测定各项指标。结果:与对照组比较,高脂组大鼠体内脂肪相对含量、空腹血糖、血清胰岛素、甘油三酯、胆固醇、胰岛素抵抗指数、肌肉中甘油三酯含量均显著升高;而肌肉组织中胆固醇含量无显著改变,高脂组肌肉胰岛素受体含量、肌肉GLUT4蛋白的相对含量均明显下降。盐酸吡格列酮组体内脂肪相对含量、空腹血糖、甘油三酯、胆固醇、胰岛素和胰岛素抵抗指数、肌肉组织中甘油三酯含量均较高脂组明显降低。肌肉细胞膜胰岛素受体含量和GLUT4蛋白含量与高脂组无显著差异。结论:盐酸吡格列酮干预胰岛素抵抗的作用在肌肉组织主要表现在减轻组织中甘油三酯的沉积。     

吡格列酮和高脂喂养对SD大鼠SIRT6表达的影响

目的观察吡格列酮和高脂喂养对SD大鼠附睾脂肪组织、肝脏和肌肉SIRT6表达的影响。方法 24只雄性SD大鼠随机分为3组:空白对照组(NC)、单纯高脂饮食组(HF)、高脂+吡格列酮组(FP)。RT-PCR及Western blot方法检测附睾脂肪组织、肝脏和肌肉SIRT6表达。结果 (1)与NC组相比,HF组大鼠体重、空腹血糖、胰岛素、甘油三酯、总胆固醇、低密度脂蛋白胆固醇均明显升高(P<0.05),高密度脂蛋白胆固醇则明显下降(P<0.01)。与HF组相比,FP组大鼠体重、空腹血糖、胰岛素、甘油三酯、总胆固醇、低密度脂蛋白胆固醇明显下降(P<0.05)。(2)与正常对照组比较,HF组大鼠附睾脂肪组织、肌肉和肝脏SIRT6 mRNA及蛋白表达轻度下降。吡格列酮治疗后,上述组织SIRT6 mRNA及蛋白表达均显著增高(P<0.05)。结论高脂饮食可诱导大鼠糖脂代谢紊乱,轻度降低SIRT6的表达,吡格列酮改善糖脂代谢紊乱可能通过上调SIRT6的表达。     

小檗碱加吡格列酮对Ⅱ型糖尿病早期胰岛素分泌及脂联素影响

目的观察小檗碱加吡格列酮治疗早期Ⅱ型糖尿病对早期胰岛素分泌及脂联素水平的影响。方法早期Ⅱ型糖尿病患者64例,随机分为治疗组和对照组,治疗组应用小檗碱加吡格列酮,对照组应用吡格列酮,疗程12周。于治疗前后分别行75gOGTT,测定空腹、服糖后30min、120min血糖、胰岛素,治疗前后甘油三酯、脂联素、CRP,计算胰岛素敏感指数。结果两组病例FPG、PPG、TG、CRP、FINS、P120INS均明显下降,治疗组优于对照组(P<0.01),脂联素、IS1、P30INS明显升高,治疗组优于对照组(P<0.01)。结论小檗碱加吡格列酮在明显降低血糖的同时,提高脂联素水平,提高早期Ⅱ型糖尿病患者β细胞早期胰岛素分泌,保护和恢复早期Ⅱ型糖尿病患者β细胞功能。     

盐酸吡格列酮对高脂诱导大鼠胰岛素抵抗的干预作用

目的:探讨盐酸吡格列酮对大鼠胰岛素抵抗(IR)的预防作用。方法:45只雄性wistar大鼠分为对照组、高脂组和吡格列酮组。对照组喂饲普通块料,高脂组喂饱和脂肪酸提供59%热卡的高脂饲料,盐酸吡格列酮组在喂饲高脂饲料的同时,灌胃给盐酸吡格列酮10mg·kg-1·d-1。各组共喂饲11周后测定糖耐量、空腹胰岛素、胰岛素耐量、胰岛素抵抗指数、血脂等。结果:高脂组大鼠从第4周开始体重明显升高,糖负荷30min、60和120min血糖、糖耐量试验中葡萄糖曲线下面积、皮下注射胰岛素后40min、90min、120min血糖和胰岛素耐量试验中葡萄糖曲线下面积、血清胰岛素、胰岛素抵抗指数、血清胆固醇和甘油三酯含量均较正常对照组明显升高。高脂组大鼠内脏脂肪相对含量比正常对照组显著升高(P<0.001)。盐酸吡格列酮组体重、糖负荷后血糖等方面较高脂组明显改善。结论:盐酸吡格列酮能预防高脂诱导IR的发生,其机制与降低血清胆固醇和甘油三酯含量及促使脂肪组织重新分布有关。     

吡格列酮对2型糖尿病患者血浆脂联素水平的影响

目的 观察2型糖尿病患者血浆脂联素水平以及吡格列酮的影响。方法 用ELISA法检测49例2型糖尿病患者和26例非糖尿病对照组的血浆脂联素水平 ,并用随机双盲法比较28例2型糖尿病患者用吡格列酮和安慰剂干预治疗8周后的血浆脂联素、血糖、胰岛素抵抗水平改变。 结果 糖尿病组和非糖尿病对照组血浆脂联素水平无差别[(7.32±3.63)μg/ml和(7.99±3.39)μg/ml,P>0.05]。经吡格列酮治疗后 ,患者血糖、胰岛素抵抗明显改善 ,血浆脂联素水平显著升高[从(8.49±3.67)μg/ml到(16.37±9.86)μg/ml,P<0.05]。结论 吡格列酮除改善血糖及胰岛素抵抗外 ,还可使血浆脂联素水平升高。     

胰岛素抵抗大鼠血管AGEs水平及其损伤机制和吡格列酮的保护作用

目的  探讨胰岛素抵抗大鼠血管AGEs水平及其损伤机制和吡格列酮的保护作用。方法  选6~8 周龄Wistar大鼠随机分为对照组（NC组,n=10）、胰岛素抵抗组(IR组,n=13)和吡格列酮组(PIO组,n=13)。后两组建立胰岛素抵抗模型,模型成功后PIO组给予吡格列酮［10mg/(kg·d)］干预,12周后采用免疫荧光技术检测血管壁AGEs表达;应用RT-PCR法检测RAGE 、NADPH氧化酶 p47phox mRNA 的表达;免疫组织化学技术检测RAGE、磷酸化NF-Кb蛋白的表达。结果  与IR组比较,PIO组AGEs的表达减弱,而两组明显高于NC组;IR组和PIO组RAGE、NADPH氧化酶P47phox mRNA表达较NC组明显升高(P< 0.01),而PIO组上述指标表达较IR组减弱（P<0.05）;PIO组RAGE、磷酸化NF-Кb蛋白表达较IR组减弱（P<0.05）,但两组均明显强于NC组（P<0.01）。结论  胰岛素抵抗大鼠血管AGEs及RAGE表达增多,继而促进氧化应激及炎症反应导致血管损伤;吡格列酮能通过减少AGEs、RAGE生成而抑制氧化应激及炎症反应,改善血管损伤。     

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.     

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…