益心泰颗粒对慢性心力衰竭兔Ca~(2+)-CaN-NFAT_3信号通路的影响

目的探讨益心泰颗粒对慢性心力衰竭(chronic heart failure,CHF)兔Ca2+-CaN-NFAT3信号通路的影响。方法用阿霉素建立CHF兔模型,将造模成功兔分为模型组、益心泰低、中、高剂量组和氯沙坦钾组;另设正常对照组。灌胃4周后观察心肌组织病理结构,并检测心肌细胞内钙离子浓度,心肌组织钙调神经磷酸酶(CaN)、T细胞活化因子3(NFAT3m RNA)及其蛋白和磷酸化水平。结果与正常对照组比较,模型组心肌细胞内[Ca2+]i含量、心肌组织CaN水平、NFAT3、p-NFAT3及NFAT3m RNA表达显著升高(P﹤0.01)。与模型组比较,益心泰低剂量组心肌组织NFAT3、NFAT3m RNA表达降低(P﹤0.05),心肌细胞内[Ca2+]i含量、心肌组织CaN水平及p-NFAT3表达显著降低(P﹤0.01),而益心泰中、高剂量组和氯沙坦钾组心肌细胞内[Ca2+]i含量、心肌组织CaN水平、NFAT3、p-NFAT3及NFAT3m RNA表达显著降低(P﹤0.01)。结论益心泰颗粒抑制慢性心力衰竭时Ca2+-CaN-NFAT3信号通路激活,可能是其治疗慢性心衰的主要机制之一。     

益气温阳活血方对慢性心衰大鼠心室重构钙调磷酸神经酶信号通路的影响研究

目的 探讨中药复方益气温阳活血方对慢性心衰大鼠心室重构钙调磷酸神经酶(CaN)信号通路的影响.方法 体内、外试验应用Fura-2/AM比率荧光成像系统检测心肌细胞内钙离子浓度([Ca2+]i);以RT-PCR法以及Western-blot法检测CaN、活化T细胞核因子3(NFAT3)mRNA及蛋白质表达水平在益气温阳活血方及拆方治疗前后的变化.结果 与正常组比较,模型组[Ca2+] i、心肌组织及心肌细胞CaN、NFAT3mRNA及蛋白质的表达水平均明显明显升高;益气温阳活血方能够明显减少[Ca2+] i、抑制CaN、NFAT3 mR-NA及蛋白质表达水平的升高.结论 CaN信号通路在慢性心衰心室重构机制中起重要作用;益气温阳活血方可能通过抑制CaN信号通路改善心室重构.     

益心泰对心肌梗死大鼠心室重构及CaN、NFAT3蛋白表达的影响

目的探讨钙调神经磷酸酶(CaN)、T细胞活化因子3(NFAT3)蛋白表达对心肌梗死后大鼠心室重构的影响及益心泰对其干预作用。方法制备心肌梗死大鼠模型。随机分成模型组、益心泰组、开博通组、复方丹参滴丸组和假手术组。模型组和假手术组以蒸馏水等量灌胃,其余各组分别给予相应药物灌胃,用药8周后分别检测心室质量指数及CaN、NFAT3蛋白表达情况。结果与假手术组比较,模型组左、右心室质量指数均增加(P<0.01);与模型组比较,益心泰组、复方丹参滴丸组和开博通组左、右心室质量指数均降低(P<0.01)。与假手术组比较,模型组CaN、NFAT3蛋白明显升高,差异有统计学意义(P<0.01);与模型组比较,益心泰组、复方丹参滴丸组和开博通组CaN、NFAT3蛋白均降低,差异有统计学意义(P<0.01);益心泰组与复方丹参滴丸组和开博通组各项指标组间比较,差异无统计学意义(P>0.05)。结论益心泰可能通过抑制CaN、NFAT3蛋白表达,从而在一定程度上干预心肌梗死后心室重构。     

益心泰有效组分对扩张型心肌病心力衰竭兔心肌组织CaN、SERCA2a mRNA及蛋白表达水平的影响研究

背景　扩张型心肌病是心力衰竭的主要病因之一，益心泰具有较好的抗心力衰竭作用，但具体作用机制尚不完全明确。目的　探讨益心泰有效组分（ECYXT）对扩张型心肌病心力衰竭兔心肌组织钙调神经磷酸酶（CaN）、肌浆网钙泵（SERCA2a）mRNA及蛋白表达水平的影响。方法　2018年1月，采用阿霉素耳缘静脉注射+丙基硫氧嘧啶混悬液灌胃复制兔心力衰竭模型。将造模成功的模型兔分为心力衰竭模型组（17只）、ECYXT低剂量组（17只）、ECYXT中剂量组（17只）、ECYXT高剂量组（17只）和氯沙坦钾组（16只），另设正常对照组（20只）。ECYXT各剂量组分别予以浓度2.1 g/kg、4.2 g/kg、8.4 g/kg的ECYXT进行灌胃处理，氯沙坦钾组予以2.75 mg/kg氯沙坦钾悬液进行灌胃处理，心力衰竭模型组和正常对照组予以等量的0.9%氯化钠溶液；6组灌胃量均为每次10 ml/kg，1次/d，连续4周。比较各组兔心肌组织形态学，血清心钠肽（ANP）、脑钠肽（BNP）水平，左心室射血分数（LVEF）、左心室短轴缩短率（LVFS）和E峰与A峰的比值（E/A比值）等心功能情况，心肌细胞［Ca2+］i浓度，心肌组织CaN、SERCA2a mRNA及蛋白表达水平。结果　心力衰竭模型组心肌细胞出现水肿、坏死，胞核皱缩，间质变宽，少许炎细胞浸润，心肌纤维排列紊乱，部分断裂。ECYXT各剂量组和氯沙坦钾组心肌细胞损伤程度均较心力衰竭模型组有所减轻，以ECYXT中剂量组、ECYXT高剂量组、氯沙坦钾组较为明显。与正常对照组比较，心力衰竭模型组血清ANP、BNP水平升高（P<0.01），LVEF、LVFS、E/A比值降低（P<0.01），心肌细胞［Ca2+］i浓度及心肌组织CaN mRNA、蛋白表达水平升高（P<0.01），心肌组织SERCA2a mRNA、蛋白表达水平降低（P<0.01）。与心力衰竭模型组比较，ECYXT各剂量组和氯沙坦钾组血清ANP、BNP水平降低（P<0.01），LVEF、LVFS和E/A比值升高（P<0.01），心肌细胞［Ca2+］i浓度及心肌组织CaN mRNA、蛋白表达水平下降（P<0.01），心肌组织SERCA2a mRNA及蛋白表达水平升高（P<0.01）。与ECYXT低剂量组比较，ECYXT中剂量组、ECYXT高剂量组和氯沙坦钾组血清ANP、BNP水平降低（P<0.01），LVEF、LVFS和E/A比值升高（P<0.01），心肌细胞［Ca2+］i浓度及心肌组织CaN mRNA、蛋白表达水平下降（P<0.01），心肌组织SERCA2a mRNA及蛋白表达水平升高（P<0.01）。ECYXT高剂量组和氯沙坦钾组与ECYXT中剂量组比较，心肌组织SERCA2a mRNA及蛋白表达水平升高（P<0.01），其余指标比较，差异均无统计学意义（P>0.05）。ECYXT高剂量组与氯沙坦钾组比较，以上各指标差异 均无统计学意义（P>0.05）。结论　ECYXT可提高心肌组织SERCA2a mRNA及蛋白表达水平，降低心肌细胞［Ca2+］i浓度，抑制心肌组织CaN mRNA及蛋白表达，提高心功能，改善心力衰竭。     

益心泰方对慢性心力衰竭兔心肌组织β-MHC mRNA及蛋白表达的影响

目的探讨益心泰方对慢性心力衰竭(chronic heart failure, CHF)兔模型心肌组织β-肌球蛋白重链(β-myosin heavy chain,β-MHC) mRNA及其蛋白表达的影响。方法采用缩窄腹主动脉法+丙基硫氧嘧啶灌胃建立CHF兔模型。将成模家兔随机分成模型组、益心泰低剂量组、益心泰中剂量组、益心泰高剂量组及氯沙坦钾组,另设假手术组。每组分别予以相应药物灌胃,模型组及假手术组予以生理盐水灌胃,每日1次,连续灌胃4周。采用ELISA法检测心房钠尿肽(atrial natriuretic peptide, ANP)、脑钠肽(brain natriuretic peptide, BNP)水平;超声心动图仪检测心功能指标;采用Western blot法测检测心肌组织β-MHC蛋白含量;RT-PCR法测定β-MHC mRNA表达,并运用透射电镜观察心肌病理组织结构。结果与假手术组比较,模型组ANP、BNP水平明显升高(P0.01);左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、E峰与A峰的比值(E/A)显著降低(P0.01);β-MHC蛋白及mRNA表达明显升高(P0.01);在电镜下观察,模型组心肌出现水肿、坏死等损伤表现。与模型组比较,各给药组ANP、BNP水平均显著下降(P0.05);各给药组LVEF、LVFS、E/A均显著升高(P0.05);各给药组β-MHC蛋白及β-MHC mRNA水平均显著降低(P0.05);在电镜下观察,各给药组心肌细胞损伤程度均得到改善。与益心泰低剂量组比较,益心泰中、高剂量组及氯沙坦钾组的上述检测指标均优于低剂量组(P0.05)。结论益心泰方可有效抑制心肌组织β-MHC蛋白及mRNA表达,降低ANP及BNP,改善心功能,从而发挥防治CHF的作用。     

线粒体乙醛脱氢酶2通过下调CaN-NFAT3信号通路拮抗高糖引起的乳鼠心肌细胞损伤

目的探讨钙调神经磷酸酶（CaN）-活化的T细胞核因子（NFAT）3通路是否介导乙醛脱氢酶（ALDH）2对高糖处理的乳鼠 心室肌细胞的作用。方法无菌条件下取出生3 d内SD大鼠乳鼠心脏,心尖部剪碎并用胰蛋白酶和胶原酶2混合酶消化成单个 细胞,经差速贴壁后并在培养液中加入5-Brdu进行培养,当其生长呈融合状态时对心室肌细胞进行处理。应用免疫荧光检测培 养的乳鼠心肌细胞内α-SA蛋白以此鉴定原代培养心室肌细胞纯度;实验涉及如下分组：5.5 mmol/L糖对照组（M）、30 mmol/L 高糖组（MH）、30 mmol/L 高糖加乙醛脱氢酶2 激动剂（Alda-1）组(MHA)、30 mmol/L 高糖加乙醛脱氢酶2 抑制剂（Daidzin）组 （MHD）、30 mmol/L高糖加乙醛脱氢酶2激动剂（Alda-1）和NFAT3抑制剂（11R-VIVIT）组（MHAV）;荧光探针检测细胞内钙离 子浓度;ELISA测定细胞内CaN含量;Western blot检测ALDH2、CaN、NFAT3蛋白表达。结果与M组相比,MH组ALDH2蛋 白表达降低（P<0.05）,CaN蛋白表达增高（P<0.05）、NFAT3蛋白表达以及细胞内CaN含量、Ca2+浓度均增高（P<0.01）;与MH组 相比,MHA组Ca2+浓度降低（P<0.05）、细胞内CaN含量降低（P<0.01）、CaN蛋白和NFAT3蛋白表达降低（P<0.05）、ALDH2蛋白 表达增加（P<0.05）,MHD组Ca2+浓度升高（P<0.01）、细胞内CaN含量升高（P<0.05）;与MHA组相比,MHAV组的ALDH2蛋白 表达量无明显变化（P>0.05）,NFAT3蛋白表达量降低（P<0.05）。结论线粒体ALDH2对高糖诱导的乳鼠心肌细胞起保护作用, 其机制可能与ALDH2对Ca2+-CaN-NFAT3信号通路的负调节作用有关。     

M3 受体激动剂对慢性心衰大鼠心肌ICa-L及[Ca2+]i的影响

目的 研究M3 受体激动剂胆碱( choline)对慢性心力衰竭( CHF)大鼠心肌的保护作用及可能的机制. 方法CHF大鼠Ⅱ型胶原酶消化分离单个心肌细胞,全细胞膜片钳技术记录L-型钙电流( ICa-L )变化;激光扫描共聚焦技术观测细胞内钙([Ca2+]i)变化. 结果 膜片钳实验结果显示,与CHF组比较,choline组ICa-L电流密度明显增高( n=6,P<0. 01);预敷U73122后加入choline,与choline组比较, ICa-L电流密度明显下降(n=6,P<0. 01). 共聚焦实验结果显示,与CHF组比较,choline组[ Ca2+] i 明显升高( n=80,P<0. 01);与 choline 组比较,U73122 与 choline 共同孵育组[Ca2+]i 升高幅度不明显(n=80, P<0. 01). 预先给予4-DAMP可部分逆转choline升高ICa-L及[ Ca2+] i 的作用. 结论 M3 受体对CHF大鼠的心肌保护作用可能是通过Gq/11-PLC途径开放L-型钙通道,促进Ca2+内流,使[ Ca2+] i 增加.     

辛伐他汀对血管紧张素Ⅱ诱导的乳鼠心肌细胞肥大的保护作用及机制研究

目的 探讨辛伐他汀(simvastatin,Sim)对血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)诱导的心肌细胞肥大的保护作用及机制.方法 采用原代培养新生SD大鼠心肌细胞,以AngⅡ诱导心肌细胞肥大,观察Sim和环孢素A(cyclosporine A,CSA)对心肌肥厚的影响.应用计算机图像分析系统检测心肌细胞体积;考马斯亮蓝法测心肌细胞总蛋白;Till阳离子测定系统(德国)采用DM3000软件测定胞内[Ca2+]i瞬间变化;Western blotting法检测心肌细胞中钙调神经磷酸酶(calcineurin,CaN)蛋白的含量.结果 与AngⅡ组相比,Sim可以抑制AngⅡ诱导的细胞体积和总蛋白的增加(P＜0.05),抑制心肌细胞内钙离子浓度([Ca2+]i)瞬间变化幅度(P＜0.05),抑制CaN蛋白表达;Sim组与CsA(CaN抑制剂)组相比差异均无统计学意义.结论 Sim抑制AngⅡ诱导的心肌肥厚可能通过调节Ca2+/CaN通路发挥作用.     

神经肽Y诱导大鼠心肌细胞肥大的钙信号机制

目的探讨钙依赖的信号途径在神经肽Y (NPY)诱导心肌肥大中的作用.方法NPY刺激乳鼠心肌细胞,加入钙调神经磷酸酶(CaN)抑制剂环胞素A(CsA)进行干预(5 μg/mL),观察心肌细胞蛋白合成速率(3H-Leu掺入量)、早期肥大反应基因(c-jun mRNA)表达以及胞浆和核内[Ca2+]i的变化.结果经100 nmol/L NPY刺激24 h后,心肌细胞3H-Leu掺入量、c-jun mRNA表达以及胞浆和核内[Ca2+]i均明显高于不加药对照组(P<0.05,P<0.01);而CsA干预后的心肌细胞3H-Leu掺入量和c-jun mRNA表达与对照组比较则无显著差别.结论Ca2+/CaM依赖的CaN信号途径在NPY诱导心肌细胞肥大中起重要作用;NPY刺激细胞内[Ca2+]i增加,可能是活化CaN信号途径的始动环节.     

益心泰有效组分对慢性心力衰竭兔肝脏组织形态的影响

目的 观察益心泰有效组分对慢性心力衰竭（chronic heart failure,CHF）兔肝脏组织形态的影响。方法 采用阿霉素耳缘静脉注射+丙基硫氧嘧啶混悬液灌胃制作兔CHF模型,将模型复制成功的兔分为模型组,益心泰有效组分低、中、高剂量组和氯沙坦钾组,另设正常对照组。干预4周后比较各组兔一般情况,运用超声心动图检测室间隔厚度（interventricular septal thickness,IVST）、左心室后壁厚度（left ventricular posterior wall thickness,LVPWT）,并采集心肌、肝脏组织标本,比较各组兔心脏指数、肝脏指数及肝脏组织形态的变化。结果 与正常对照组比较,模型组IVST、LVPWT均升高（P<0.05）,心脏指数、肝脏指数均上升（P<0.05）。与模型组比较,各给药组兔IVST、LVPWT均降低（P<0.05）,心脏指数、肝脏指数均下降（P<0.05）。与益心泰有效组分低剂量组比较,益心泰有效组分中、高剂量组和氯沙坦钾组IVST、LVPWT均降低（P<0.05）,心脏指数、肝脏指数均下降（P<0.05）。正常对照组肝脏组织形态结构大致正常,各给药组肝脏组织形态改变较模型组有所减轻。结论 益心泰有效组分可改善CHF兔一般情况,降低IVST、LVPWT和心脏指数、肝脏指数,减轻肝脏病理结构损伤,改善心力衰竭。     

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.     

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.     

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.