芹黄素对肾缺血再灌注损伤后Fas/FasL介导凋亡反应的影响

目的 探讨芹黄素抑制大鼠肾缺血再灌注损伤凋亡Fas、FasL基因表达的影响。方法 建立大鼠肾缺血再灌注损伤模型,将60只大鼠分为5组：假手术组、缺血再灌注组、芹黄素低浓度组（2mg/kg）、芹黄素中浓度组（10mg/kg）、芹黄素高浓度组（50mg/kg）,每组大鼠各12只。检测血清肌酐（Cr）和尿素氮（BUN）,测定肾组织氧化损伤和抗氧化指标（SOD、MDA和GSH-Px）含量,观察肾组织病理学变化,免疫组化检测FasL、caspase-3和Bcl-2表达,Western blot法检测Fas、FasL和Bcl-2表达水平。结果 与假手术组比较,缺血再灌注组Cr和BUN水平均明显增高;SOD和GSH-Px含量明显降低,MDA含量显著升高;病理组织显示肾小管损伤严重;免疫组化示FasL、caspase-3蛋白表达增强,Bcl-2表达降低;Western blot法检测结果显示Fas和FasL表达水平明显升高,Bcl-2表达水平明显降低,差异有统计学意义（P<0.01）。与缺血再灌注组比较,芹黄素组Cr和BUN水平均明显降低;SOD和GSH-Px含量明显升高,MDA含量显著下降;病理组织显示肾小管损伤显著改善;免疫组化显示FasL、caspase-3蛋白表达较表达下调,Bcl-2表达上调;Western blot法检测结果显示,Fas和FasL和表达水平明显下降,Bcl-2表达水平明显升高,差异有统计学意义（P<0.05）。结论 芹黄素能减轻肾脏缺血再灌注损伤,其机制可能与其上调Bcl-2基因和阻断Fas/FasL系统有关,从而抑制肾缺血再灌注损伤后所造成的细胞凋亡。     

瑞芬太尼通过激活PI3K/Akt/eNOS通路减轻肾缺血/再灌注损伤

目的 探讨术中应用瑞芬太尼对肾缺血/再灌注损伤的作用及机制。方法 取雄性C57/BL小鼠50只,随机分为5组：假手术组、缺血/再灌注损伤组（I/R组）、缺血/再灌注损伤+磷脂酰肌醇3-激酶（PI3K）抑制剂LY294002处理组（I/R+LY294002组）、缺血/再灌注损伤+瑞芬太尼处理组（I/R+RF组）、缺血/再灌注损伤+LY294002处理+瑞芬太尼处理组（I/R+RF+LY294002组）,每组10只。各组大鼠分别于手术结束6 h后取静脉血或肾脏组织,采用全自动生化分析仪测定静脉血尿素氮（BUN）、血肌酐（SCr）水平,采用蛋白质印迹法检测肾脏组织PI3K/蛋白激酶B（Akt）/内皮型一氧化氮合酶（eNOS）通路相关蛋白的表达,H-E染色观察肾脏组织炎症细胞聚集情况,酶联免疫吸附试验测定肾脏组织中肿瘤坏死因子α（TNF-α）、白细胞介素（IL）-1β、IL-6、IL-10等炎性因子的表达,实时定量PCR测定肾脏组织中抗凋亡因子Bcl2和凋亡因子半胱氨酸蛋白酶3（Caspase-3）的mRNA表达。结果 与假手术组相比,I/R组小鼠静脉血BUN、SCr水平均升高,肾脏组织中PI3K表达及磷酸化Akt（p-Akt）/Akt、磷酸化eNOS（p-eNOS）/eNOS均降低,炎性因子TNF-α、IL-1β、IL-6、IL-10释放均增加,Bcl2 mRNA表达下降而Caspase-3 mRNA表达增高,差异均有统计学意义（P均<0.05）,并且肾脏组织中炎症细胞聚集增多。给予瑞芬太尼处理后,I/R+RF组BUN、SCr水平较I/R组降低,肾脏组织中PI3K表达及p-Akt/Akt、p-eNOS/eNOS均增高,TNF-α、IL-1β、IL-6、IL-10释放均减少,Bcl2 mRNA表达上调、Caspase-3 mRNA表达下调,与I/R组相比差异均有统计学意义（P均<0.05）,炎症细胞募集也减轻。而使用PI3K抑制剂LY294002处理后,I/R+RF+LY294002组BUN、SCr水平升高,肾脏组织中p-eNOS/eNOS降低,IL-1β、L-6释放增加,Caspase-3 mRNA表达上调,与I/R+RF组相比差异均有统计学意义（P均<0.05）,炎症细胞募集也增加。结论 肾缺血/再灌注损伤时,瑞芬太尼通过激活PI3K/Akt/eNOS通路减轻肾脏组织炎症反应和细胞凋亡发挥肾脏保护作用。     

二甲双胍预处理对大鼠肾缺血再灌注损伤模型的影响及机制研究

目的 探讨二甲双胍预处理对大鼠肾缺血再灌注损伤模型的影响及可能的机制。方法 健康清洁级成年雄性SD大鼠体重220~250g,共30只,采用数字表法将其随机分为3组（n=10）：假手术组（Sham组）,缺血再灌注组（I/R组）和二甲双胍组（metformin+I/R组）。metformin+I/R组在建立I/R模型前给予二甲双胍0.125mg/（kg·d）腹腔注射,共14天,Sham组和I/R组给予等容量生理盐水连续14天。给药结束后I/R组和metformin+I/R组采用切除右肾、夹闭左肾动静脉45min后恢复灌注的方法制备大鼠肾缺血再灌注模型,Sham组切除右肾、不夹闭左肾动静脉。分别于再灌注24h时抽取下腔静脉血测定血清肌酐（Cr）和尿素氮（BUN）浓度;然后处死大鼠取肾,光镜下观察肾组织形态学变化,免疫组化法测定Bcl-2、Bax、caspase-3表达,并行Tunel染色评估肾小管上皮细胞凋亡程度。结果 跟Sham组比较,I/R和metformin+I/R组的BUN、Cr均明显升高;同时,相比I/R组,metformin+I/R组的BUN和Cr均明显降低,且差异均有统计学意义（P<0.05）。免疫组化检测结果显示,跟Sham组比较,I/R组和metformin+I/R组Bcl-2、Bax、caspase-3表达明显增高;跟I/R组比较,metformin+I/R组Bax、caspase-3表达明显降低,同时Bcl-2的表达明显强于I/R组。Tunel结果显示,相比Sham组,I/R和metformin+I/R组肾小管上皮细胞凋亡数目明显增多;同时,metformin+I/R组肾小管上皮细胞凋亡数目明显少于I/R组,且差异有统计学意义（P<0.05）。结论 二甲双胍预处理能改善大鼠肾缺血再灌注损伤过程中肾功能损害,其机制可能与抑制肾小管上皮细胞凋亡有关。     

大蒜素抑制人子宫内膜癌Ishikawa细胞生长的实验研究

目的 研究大蒜素抑制人子宫内膜癌Ishikawa细胞生长的作用,并探讨其可能的作用机制。方法 以不同浓度大蒜素（12.5、25、50μg/ml）和顺铂（40μg/ml）分别干预对数生长期Ishikawa细胞,采用MTT法检测Ishikawa细胞增殖抑制;通过流式细胞术检测细胞周期和细胞凋亡状况,采用Western blot法检测Ishikawa细胞中caspase-3蛋白表达,RT-PCR法检测Ishikawa细胞中Bax mRNA、bcl-2 mRNA表达并计算Bax/bcl-2表达比值。结果 大蒜素能够显著提高子宫内膜癌Ishikawa细胞增殖抑制率、阻滞Ishikawa细胞周期于G₂/M期,提高细胞凋亡率、上调caspase-3蛋白和Bax mRNA表达、下调bcl-2 mRNA表达、提高Bax/bcl-2表达比值,且上述作用均具有一定的剂量依赖性。结论 大蒜素对子宫内膜癌Ishikawa细胞增殖具有抑制作用以及促其凋亡的作用,从而表现出其抑制Ishikawa细胞生长的作用;作用机制可能与大蒜素能够改变Ishikawa细胞周期以及调节凋亡相关基因、蛋白表达有关。     

重组胎盘生长因子对大鼠急性心肌梗死后细胞凋亡的影响

目的 研究重组胎盘生长因子（recombinant placental growth factor,rPlGF）对大鼠急性心肌梗死后心肌细胞凋亡的影响并探讨其可能的作用机制。方法 采用结扎冠状动脉的方法建立大鼠急性心肌梗死模型,取40只模型大鼠随机分为模型组和rPlGF治疗组,并设假手术组,尾静脉注射给药。4周后,通过高频率超生影像系统检测舒张末期左心室内径（LVIDd）和收缩末期左心室内径（LVIDs）、短轴缩短率（FS）、射血分数（EF）、每搏排出量（SV）;TTC染色法计算心肌梗死面积,TUNEL法观察心肌细胞凋亡状况,RT-PCR法测定心肌组织bcl-2 mRNA、Bax mRNA表达,Western blot法测定心肌组织caspase-3、NF-κB蛋白表达;比色法测定心肌组织中抗氧化酶活性和丙二醛（MDA）含量。结果 与模型组比较发现经rPlGF 治疗能够显著降低急性心肌梗死大鼠LVIDd和LVIDs,提高FS、EF和SV;降低心肌组织梗死面积,显著降低心肌细胞凋亡指数（apoptosis index,AI）、明显改善心肌细胞凋亡状况,上调bcl-2 mRNA表达并下调Bax mRNA表达、显著提高bcl-2/Bax比值,显著降低caspase-3、NF-κB蛋白表达量,显著提高抗氧化酶（SOD、CAT）活性并显著降低MDA含量,差异均具有统计学意义（P<0.05,P<0.01）。结论 rPlGF具有抑制大鼠急性心肌梗死后细胞凋亡的作用,其机制可能与rPlGF改善心功能、调节凋亡相关基因蛋白表达以及抑制氧化应激损伤有关。     

miR-138在肾脏缺血再灌注损伤中的作用及其机制

目的 观察miR-138在肾脏缺血再灌注损伤中的作用及其机制。方法 60只成年SD大鼠,随机分为假手术组（Sham组）、RIRI组、RIRI+空载体（vector）组、RIRI+miR-138（miR-138）组、RIRI+miR-138 shRNA（sh miR-138）组,每组15只,通过夹闭双侧肾蒂建立肾脏缺血再灌注组损伤模型。采用检测血清中肌酐、尿素氮比较各组肾功能差异、Tunel染色检测细胞凋亡、荧光定量PCR检测p53及下游基因变化等方法研究miR-138对肾脏缺血再灌注损伤的作用及其机制。结果 与假手术组比较,缺血再灌注组的肾脏功能BUN、Cr水平,凋亡水平均显著升高,差异有统计学意义（P<0.05）。上调miR-138后,以上指标均显著升高,且差异有统计学意义（P<0.05）,下调miR-138则保护肾脏缺血再灌注损伤;进一步研究发现miR-138可能通过抑制p53信号通路发挥作用。结论 miR-138对大鼠肾脏缺血再灌注损伤具有明显的加重作用,其机制可能与p53信号通路密切相关。     

水飞蓟素对大鼠肾脏缺血再灌注损伤的保护作用及机制探讨

目的探索水飞蓟素对大鼠肾脏缺血再灌注损伤（IRI）的保护作用及是否与抑制NF-κB 活化有关。方法将30 只成年雄性SD 大鼠随机为假手术组（S 组）、缺血再灌注模型组（IR 组）及药物组（SM 组）。全自动生化分析仪检测血肌酐、血尿素氮,HE 染色检测肾小管损伤程度,免疫组织化学检测肾脏IL-6 及NF-κB p65 表达,酶联免疫吸附法测定肾组织匀浆上清液NF-κB、IL-6 浓度。结果IR组血肌酐、尿素氮、组织匀浆细胞核内NF-κB 及细胞浆中IL-6 水平较S 组升高（P <0.05）,SM 组较IR 组降低（P <0.05）,IR 组肾小管损伤较重,肾脏IL-6、NF-κB p65 表达增强。而给药组肾小管损伤减轻,肾脏IL-6、NF-κB p65 表达减弱。结论水飞蓟素对大鼠肾脏缺血再灌注损伤具有保护作用,其与抑制NF-κB活化有关。     

银杏叶提取物对肾缺血再灌注损伤肾小管细胞凋亡调控基因表达的影响

目的 观察银杏提取物（Egb）对大鼠肾缺血再灌注后肾小管细胞凋亡调控基因bcl-2和bax表达的影响,探讨Egb肾保护作用的分子生物学机制.方法 用动脉夹夹闭大鼠双侧肾蒂45 min再灌注24 h方法制成急性肾缺血再灌注损伤模型.采用脱氧核苷酸末端转移酶介导的DNA原位末端标记技术检测细胞凋亡的情况.免疫组化检测Bcl-2、Bax表达.结果 缺血再灌注组较假手术组肾小管凋亡细胞数明显增多,Bcl-2、Bax表达均增强,Bax/Bcl-2比值增高;银杏叶提取物处理组较缺血再灌注组凋亡细胞数明显减少,Bcl-2表达进一步增强,而Bax表达减弱,Bax/Bcl-2降低.结论 银杏叶提取物可能通过影响Bcl-2、Bax表达,抑制细胞凋亡,从而发挥对缺血再灌注损伤肾脏的保护作用.     

葡萄籽原花青素对大鼠肾缺血再灌注损伤保护作用的研究

目的探讨葡萄籽原花青素(GSPE)对大鼠肾缺血-再灌注损伤的保护作用及其机制。方法选用健康雄性Wistar大鼠36只,随机分为3组:假手术组(Sham组)、肾缺血-再灌注损伤组(RIRI组)、葡萄籽原花青素预处理组(GSPE组),建立大鼠肾缺血-再灌注损伤模型,于肾缺血-再灌注2 h、24 h分别检测血清肌酐(SCr)、血清尿素氮(BUN)含量的变化及血清和组织丙二醛(MDA)的含量及谷胱甘肽光氧化物酶(GSH-Px)活性的变化。结果与Sham组相比,IRIR组和GSPE组血清SCr、BUN含量升高(P<0.01),血清及肾组织MDA含量升高(P<0.01),GSH-Px活性降低(P<0.01);与IRIR组相比,GSPE组的SCr、BUN含量降低(P<0.01),血清及肾组织MDA水平降低(P<0.05),GSH-Px活性升高(P<0.01)。结论在肾缺血-再灌注损伤过程中,葡萄籽原花青素能改善肾功能,其机制可能与抗自由基损伤和减轻脂质过氧化有关。     

hexarelin预处理对小鼠肾脏缺血/再灌注损伤的保护作用

目的 研究生长激素释放肽（GHRP）家族成员hexarelin是否对肾缺血-再灌注损伤具有保护作用及其可能机制。方法 在体情况下结扎C57BL6/J小鼠左侧肾动脉主干2h、松扎0.5h造成急性全肾缺血/再灌注损伤。hexarelin预处理组于结扎肾动脉前2h给予小鼠皮下注射hexarelin （100μg/kg）;单纯肾缺血/再灌注组用生理盐水替代hexarelin;正常对照组仅给予假手术而不结扎肾动脉。肾组织切片TTC染色鉴定肾缺血/再灌注损伤面积。苏木精-伊红染色观察肾组织微观损伤情况。测定肾组织丙二醛（MDA）及总抗氧化能力（T-AOC）含量以判断氧化应激情况。结果 与单纯肾缺血/再灌注组相比,hexarelin预处理使肾缺血/再灌注损伤面积平均减小约49%（P<0.01）;同时,肾缺血/再灌注导致肾组织丙二醛水平升高及总抗氧化能力降低,而hexarelin预处理则可明显改善由缺血/再灌注导致的MDA升高和T-AOC降低。结论 hexarelin对肾缺血/再灌注损伤具有明显的保护作用,其可能机制可能与降低肾组织氧化应激水平并提高总抗氧化能力有关。     

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…     

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.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.