螺旋藻对阿霉素肾硬化大鼠肾脏的保护作用

目的研究螺旋藻对阿霉素肾硬化大鼠肾脏的保护作用及相关机制。方法将32只SD大鼠随机分为4组：假手术组（S组）,阿霉素肾硬化对照组（M组）,螺旋藻组（SP组）,贝那普利治疗组（B组）。8周后观察各组大鼠24 h尿蛋白定量、血尿素氮（BUN）、肌酐（Scr）及肾脏病理改变,免疫组化观察肾脏组织纤连蛋白（FN）、IV型胶原（Col IV）、转化生长因子β1（TGF-β1）的表达。RT-PCR测定肾皮质TGF-β1mRNA的表达。结果螺旋藻能减少尿蛋白、降低BUN和Scr,减轻基质增生和肾小球硬化,且能减少FN、Col IV、TGF-β1的表达。下调肾皮质TGF-β1mRNA的表达。结论螺旋藻能减轻阿霉素肾硬化大鼠肾脏损害,对肾脏有保护作用。     

通络方防治大鼠肾小球硬化的作用机制

目的 观察通络方对肾组织中Ⅳ型胶原(Col Ⅳ)、纤维连接蛋白(FN)、层粘连蛋白(LN)及转化生长因子β1(TGF-β1)表达的影响,探讨通络方防治大鼠肾小球硬化的作用机制.方法 通过光镜观察治疗组肾脏病理学改变,同时应用免疫组化技术及网像采集分析系统测定各组大鼠肾脏组织中Ⅳ-C、FN、LN、TGF-β1表达情况.结果 通络方可明显降低大鼠肾组织中Col Ⅳ、FN、LN、TGF-β1表达(P<0.05或P<0.01),减轻肾脏的病理损害(P<0.01).结论 通络方可能是通过降低肾脏组织中Col Ⅳ、FN、LN及TGF-β1表达起到治疗作用的.     

联合用药延缓阿霉素肾病大鼠肾间质纤维化的研究

目的：探讨贝那普利和蝙蝠蛾拟青酶Cs-4联合应用对阿霉素肾病模型大鼠肾纤维化的保护作用及调节机制。方法：将60只SD大鼠随机分为模型组（M组）、贝那普利组（B组）、联合治疗组（U组）3组，每组20只。8周后观察各组大鼠24h尿蛋白定量、血脂、血浆总蛋白（TP）、血浆白蛋白(ALB)、尿素氮(BUN)、肌酐(Scr)的水平及肾脏病理改变，免疫组化检测肾层粘连蛋白（LN）、肾组织中纤连蛋白(FN)、胶原蛋白Ⅳ(Col Ⅳ)、转化生长因子β1(TGF-β1)的表达，RT PCR方法测定肾皮质转化生长因子β1（TGF-β1）和纤溶酶原激活物抑制物（PAI-1）、组织性金属蛋白酶抑制物1(TIMP 1)mRNA的表达。结果：U组、B组分别和M组相比，24h尿蛋白定量、BUN、Scr、甘油三脂(TG)、总胆固醇(Cho)明显降低（P＜0.01），TP和ALB明显升高（P＜0.01）,U组和B组相比，BUN、Scr、TG、Cho亦明显降低（P＜0.05）；M组肾脏病理肾间质纤维化较重，而B组较轻，U组最轻；免疫组化可见B组和U组中LN、FN、Col Ⅳ、TGF-β1的表达明显低于M组（P＜0.01），并且U组和B组相比，Col Ⅳ、TGF-β1的表达明显降低（P＜0.05）；RT PCR显示B组、U组TGF-1mRNA、PAI-1mRNA、TIMP-1mRNA的表达，均较M组降低（P＜0.01），U组较B组亦明显降低（P＜0.05）。结论：蝙蝠蛾拟青酶Cs-4和贝那普利联合应用有相加作用，能有效的延缓肾间质纤维化。     

缬沙坦及苯那普利对5/6肾切除大鼠血清瘦素水平及肾小球硬化的影响

目的:观察缬沙坦及苯那普利对5/6肾切除大鼠血清瘦素(leptin)水平及其肾小球硬化的影响,探讨其作用机制。方法:选用SD雄性大鼠30只,其中24只通过5/6肾切除法制造慢性肾功能衰竭(CRF)模型,术后2周随机分为模型组、缬沙坦组及苯那普利组,另6只为假手术组。术后第6周末各组大鼠进行肾功能(Scr、BUN)及血清瘦素的测定;处死大鼠,取出肾脏进行病理组织形态学观察,测定肾小球硬化指数(GSI),采用免疫组织化学方法检测肾脏转化生长因子β_1(TGF-β_1)、Ⅳ型胶原(ColⅣ)及纤维连接蛋白(FN)表达。结果:模型组瘦素明显升高,与GSI、TGF-β_1、ColⅣ及FN呈正相关(r值分别为0.871、0.951、0.919、0.913)。与模型组相比,缬沙坦组及苯那普利组血清瘦素水平明显降低,肾功能及GSI明显改善,肾脏转化生长因子TGF-β_1、ColⅣ及FN表达减少(P<0.01)。结论:慢性肾衰存在高瘦素血症,阻断RAS可通过降低瘦素水平改善肾小球硬化。     

壮通饮对糖尿病肾病大鼠肾皮质CTGF、TGF-β_1、PAI-1、FN细胞因子mRNA表达的影响

目的实验性研究壮通饮对糖尿病肾病(DN)大鼠肾皮质结缔组织生长因子(CTGF)、转化生长因子(TGF-β1)、血浆纤溶酶原激活物抑制物(PAI-1)、纤维连接蛋白(FN)细胞因子mRNA表达的影响,并探讨壮通饮对DN大鼠肾脏的保护作用机制。方法采用单肾切除术合并腹腔注射链脲佐菌素(STZ)诱导制备DN大鼠模型,并随机分为空白对照组、假手术组、模型组、卡托普利西药组(1g/kg)和壮通饮低(6.8g/kg)、中(13.6g/kg)、高(27.2g/kg)剂量7个组。于实验给药治疗6周后,用荧光实时定量RT-PCR法检测大鼠肾皮质CTGF、TGF-β1、PAI-1、FN细胞因子mRNA的表达。结果壮通饮可以降低DN大鼠肾皮质CTGF、TGF-β1、PAI-1、FN细胞因子mRNA的表达。结论壮通饮能改善肾皮质CTGF、TGF-β1、PAI-1、FN细胞因子mRNA的表达,以减轻肾脏病理改变,对DN大鼠的肾脏具有一定的保护作用。     

化浊方对肾小球硬化大鼠肾组织细胞因子TGF-β1表达的影响

目的:观察化浊方对肾小球硬化(GS)大鼠模型肾组织TGF-β1表达的影响,探讨其延缓GS的作用机制。方法:72只雄性SD大鼠随机分为正常组、假手术组及模型组、化浊方高、中、低剂量组及厄贝沙坦组。采用尾静脉注射阿霉素、单侧肾脏切除建立肾小球硬化模型,予灌胃治疗8周后处死各组大鼠,检测治疗前后24 h尿蛋白定量、血肌酐(SCr)、尿素氮(BUN),HE染色后光镜下观察肾小球病理改变及肾小球硬化指数(GSI),免疫组化(IHC)检测肾组织TGF-β1的表达。结果:治疗8周后,各治疗组24小时尿蛋白定量、SCr、BUN的水平均低于模型组,肾脏病理显示大鼠肾小球硬化较模型组改善,以化浊方高剂量组明显。高剂量组大鼠肾脏TGF-β1表达明显低于模型组、中低剂量组及厄贝沙坦组。结论:化浊方可能通过抑制大鼠肾脏TGF-β1的表达,改善肾脏病理形态,延缓肾小球硬化。     

曲尼司特对阿霉素肾病大鼠肾脏保护作用的实验研究

目的研究曲尼司特对阿霉素肾病肾小球硬化大鼠的肾脏保护作用,并探讨其可能的机制。方法雄性SD大鼠24只,随机分为正常对照组、模型组、曲尼司特组和安博维组,采用单侧肾切除加尾静脉注射阿霉素5mg/kg的方法建立阿霉素肾病模型。观察各组大鼠24h尿蛋白定量、血尿素氮(BUN)、血肌酐(Scr)及肾脏病理的变化。应用免疫组化方法测定肾组织转化生长因子β1(TGF-β1)和金属蛋白酶组织抑制因子-1(TIMP-1)的表达,应用原位杂交方法测定肾组织α-平滑肌肌动蛋白(α-SMA)mRNA的表达。结果曲尼司特能减少阿霉素肾病大鼠的尿蛋白,延缓Scr上升;减轻基质增生和肾小球硬化;与模型组比较,曲尼司特下调阿霉素肾病大鼠肾组织中TGF-β1〔(0.6927±0.169)vs(0.4540±0.168)〕、TIMP-1〔(0.1615±0.077)vs(0.0869±0.041)〕、α-SMA mRNA〔(0.2693±0.082)vs(0.1407±0.045)〕的表达。结论曲尼司特可能通过下调阿霉素肾病大鼠肾组织中TGF-β1、TIMP-1的表达以及抑制肾脏细胞表型转分化,调节细胞外基质的生成与降解,从而减轻肾脏病理损害,发挥其肾脏保护作用。     

糖尿病大鼠肾间质TGF-β1和α-SMA的表达与细胞外基质沉积的关系

目的：观察糖尿病大鼠肾小管间质中转化生长因子(TGF-β1)、α-平滑肌肌动蛋白(α-SMA)表达与纤维连接蛋白(FN)和胶原Ⅲ型(ColⅢ)沉积的关系。方法：大鼠随机分为正常对照组(A组)，糖尿病1周组(B组)，特尿病2周组(C组)，糖尿病1月组(D组)和糖尿病2月组(E组)。用免疫组化方法检测肾间质TGF-β1、α-SMA、FN和ColⅢ，PAS染色观察肾组织形态学改变，生化法测定大鼠血糖、血脂、血尿肌酐以及尿蛋白。结果：糖尿病2周开始肾小管见TGF-β1表达，并随病程进展而逐渐增多。糖尿病1月肾间质中见FN和ColⅢ沉积开始增多，2月时更多，且可见肾问质中有α-SMA表达；FN和ColⅢ增多与TGF-β1、α-SMA呈正相关。结论：TCF-β1刺激α-SMA的表达，从而促进糖尿病大鼠肾小管问质FN和ColⅢ的沉积。     

萝卜硫素通过TGF-β/Smad3信号通路对肾病综合征大鼠系膜细胞增生的影响

【摘要】 目的 探讨萝卜硫素通过转化生长因子（TGF-β）/smad3信号通路对肾病综合征大鼠系膜细胞增生的影响及其作用机制。方法 采用2μM TGF-β诱导大鼠肾小球系膜细胞（HBZY-1）增生,将细胞分为对照组、TGF-β刺激组、TGF β联合20 μM萝卜硫素组及TGF-β联合40 μM萝卜硫素组。5 mg/kg阿霉素诱导肾病综合征大鼠模型,不同剂量萝卜硫素处理HBZY-1细胞及肾病综合征大鼠,将大鼠分为空白对照组、阿霉素刺激组、阿霉素联合30 mg/kg萝卜硫素组及阿霉素联合60 mg/kg萝卜硫素组,每组各8只;采用CCK8法检测HBZY-1细胞增殖,HE染色分析肾病综合征大鼠肾组织系膜基质沉积,Western Blotting方法检测粘连蛋白（FN）、Ⅳ胶原蛋白（Col4）、TGF-β及p Smad3蛋白表达水平。结果 TGF-β刺激组能明显诱导HBZY-1细胞增生及HBZY-1细胞FN和Col4蛋白表达,与对照组相比差异有统计学意义（P＜0.05）;TGF-β联合20、40 μM萝卜硫组与TGF-β刺激组相比能明显抑制TGF-β诱导的HBZY-1细胞增殖和明显抑制TGF β诱导的FN和Col4蛋白表达（P＜0.05）。阿霉素诱导肾病综合症大鼠肾脏系膜基质沉积增多（P＜0.05）,而不同剂量萝卜硫素治疗后,能显著降低肾脏系膜基质沉积（P＜0.05）。阿霉素刺激组能明显诱导大鼠肌酐、尿素氮及24小时蛋白尿量水平升高和大鼠肾脏组织FN、Col4、TGF-β、p-Smad3蛋白表达,与对照组相比差异有统计学意义（P＜0.05）;与阿霉素刺激组相比,不同剂量萝卜硫素能明显降低大鼠肌酐、尿素氮及24小时蛋白尿量水平、降低肾脏组织FN、Col4、TGF-β、p-Smad3蛋白表达水平（P＜0.05）。结论 萝卜硫素可通过下调TGF-β/Smad3信号传导抑制基质合成相关蛋白表达,进而降低了肾病综合征大鼠肾小球系膜细胞增生。     

肾康丸对糖尿病肾病大鼠肾脏TGF-β1/Smad 7通路的影响

目的探讨肾康丸对糖尿病肾病(DN)大鼠肾脏TGF-β1/Smad 7信号通路的影响。方法用链脲佐菌素(STZ)腹腔注射法诱导建立大鼠糖尿病(DM)模型,模型成功后随机分为3组:模型对照组、开搏通组、肾康丸组,另设正常对照组。治疗8周后,取大鼠肾脏,采用免疫组化法观察各组大鼠肾脏组织纤连蛋白(FN)、转化生长因子-β1(TGF-β1)和Smad 7蛋白表达的情况。结果8周后,DN模型组大鼠与正常大鼠比较,肾脏组织中FN和TGF-β1蛋白表达明显增加,Smad 7蛋白表达明显减少。肾康丸和开搏通都可以减少FN和TGF-β1蛋白的表达,增加Smad 7蛋白的表达。结论肾康丸可以抑制DN大鼠肾脏中TGF-β1/Smad信号传导通路的激活,减少ECM的沉积,从而延缓DN进程。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

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 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.     

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.     

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.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

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.