缺血和再灌注心肌NHE－1mRNA表达的变化

目的探讨缺血再灌注心肌钠氢交换蛋白-1(NHE-1)mRNA表达的变化.方法成年大鼠心脏Langendorff离体灌流,随机分为六组(n=6),给予(1)正常灌流30min;(2)低灌流缺血60min;(3)低灌流缺血60min及再灌注30min;(4)预处理后低灌流缺血60min(5)预处理后低灌流缺血60min再灌注30min;(6)老龄大鼠离体心脏低灌流缺血60min等不同条件处理.保留心肌,使用RT-PCR方法对比不同处理条件下心肌NHE-1表达的变化.结果(1)缺血组心肌(Ⅰ)NHE-1mRNA水平(0.734±0.053)较正常对照组(N)(0.300±0.007)明显升高(P＜0.05),再灌注组心肌(R)NHE-1的mRNA水平(0.281±0.019)较缺血组降低(P＜0.05),与正常组无明显差异(P＞0.05);(2)预处理缺血组心肌(Pi)NHE-1 mRNA水平(0.256±0.011)较缺血组心肌(0.734±0.053)明显降低(P＜0.05),预处理再灌注组心肌(Pr)NHE-1 mRNA水平(0.135±0.011)较再灌注组心肌(0.281±0. 019)降低(P＜0.05);(3)老龄大鼠低灌流缺血心肌(S)NHE-1的mRNA表达(0.787±0.021)与成年大鼠低灌流缺血心肌(Ⅰ)NHE-1的mRNA表达无明显统计学差异.结论低灌流缺血心肌NHE-1表达较正常灌流心肌明显升高,预处理可以明显降低缺血及再灌注心肌NHE-1的表达.     

缺血预处理对大鼠肝缺血再灌注损伤后早期细胞CyclinD1mRNA表达的影响

目的观察缺血预处理对大鼠肝缺血再灌注损伤早期细胞CyclinD1mRNA表达变化的影响.方法采用大鼠原位部分缺血再灌注模型,54只SD大鼠随机分为缺血再灌注组(IR),缺血预处理组(IP)与假手术组(SO组),应用RT-PCR法检测各组复灌后0,1,2,4 h肝组织CyclinD1 mRNA的变化.结果与IR组相比,IP组在复灌早期(0,1 h),肝组织的CyclinD1mRNA表达明显增高.(0.568±0.112 vs 0.274±0.069,0.762±0.164 vs 0.348±0.093,P＜0.01).结论缺血预处理可促进肝细胞在缺血再灌注损伤后早期CvclinD1 mRNA的表达.     

SOD在缺血预处理保护大鼠肝脏缺血再灌注损伤中的作用

目的 :探讨超氧化物歧化酶 (superoxidedismutase ,SOD)在缺血预处理保护肝脏缺血再灌注损伤过程中的作用。方法 :应用大鼠部分肝脏缺血再灌注损伤模型 ,检测缺血预处理组 (IP组 )、缺血再灌注组 (I/R组 )及对照组 (C组 )大鼠血清丙氨酸转氨酶 (alaninetransaminase,ALT) ,门冬氨酸转氨酶 (aspartatetransaminase ,AST)及乳酸脱氢酶 (lactatedehydrogenase ,LDH)水平与肝脏病理组织学改变 ,测定其肝脏组织SOD水平的变化并与单纯缺血预处理组 (OIP组 )大鼠进行比较。结果 :IP组的肝脏损害虽较C组重 ,但明显较I/R组轻 ,其 3种血清生化酶均显著低于I/R组 ;OIP组肝组织的SOD水平 (2 14 .95± 2 4 .38)NU/mgprotein均显著高于IP组 (172 .4 3± 15 .2 3)、I/R组 (16 4 .0 3± 30 .0 8)与C组 (16 7.0 3± 2 7.6 0 )NU/mgprotein (P <0 .0 1)。结论 :缺血预处理对大鼠肝脏缺血再灌注损伤具有保护作用 ,其机制与激活肝组织中的SOD有关     

高铁血红素对大鼠心肌缺血再灌注损伤的保护作用

目的探讨血红素氧合酶-1(HO-1)激动剂高铁血红素对大鼠心肌缺血再灌注损伤的保护作用及机制。方法健康雄性SD大鼠48只,随机分为4组:假手术组(SO)、缺血再灌注组(I/R)、高铁血红素预处理组(HEMI/R)、锌原卟啉IX(ZnPPIX,血红素加氧酶-1抑制剂)+高铁血红素预处理组(ZnPPIX-HEM-I/R),每组12只;后3组建立大鼠I/R模型;检测各组大鼠的心肌梗死范围、心肌酶(CK、LDH)、炎性介质(TNF-α、IL-6)、氧化应激指标(MDA、SOD)并进行比较。结果与S0组比较,I/R组血清LDH、CK、TNF-α、IL-6、MDA水平均升高,而SOD水平降低,差异有统计学意义(P均<0.05)。与I/R组比较,HEM-I/R组大鼠梗死心肌范围(35.8±2.0)%vs(51.0±2.5)%、心肌酶水平[LDH(U/L):1125.0±90.0 vs 1895.6±95.0;CK(U/L):1589.8±70.0 vs 2500.5±150.5]、炎性介质水平[TNF-α(pg/mg):27.00±0.20 vs 40.00±0.20,IL-6(pg/mg):38.80±0.25 vs 61.50±0.10]氧化应激水平[MDA(mmol/mg):7.05±0.50 vs 12.05-0.50,SOD(U/mg):170.50±5.55 vs 95.50±6.55];均显著改善,差异有统计学意义(P均<0.05)。而与HEM-1/R组比较,ZnPPIX-HEM-I/R组上述各项指标的改善均被抑制,差异有统计学意义(P均<0.05)。结论高铁血红素能显著发挥对大鼠缺血再灌注损伤的心肌保护作用,其保护作用机制可能与激动HO-1的过表达相关。     

缺血预处理对大鼠急性肾缺血/再灌注损伤的保护作用及其对细胞凋亡的影响

目的 :观察缺血预处理 (IPC)对大鼠急性肾缺血 /再灌注损伤的保护作用及其对细胞凋亡及凋亡相关蛋白Bcl 2和Bax表达的影响 ,探讨其作用的可能机制 .方法 :双肾动脉缺血 4 5min再灌注 2 4h制备成急性肾缺血 /再灌注动物模型 ,5 0只Wister大鼠随机分为对照假手术组、缺血 /再灌注组、缺血预处理组 (IPC1 ,IPC2 ,IPC3) .原位末端标记法检测细胞凋亡指数 ,免疫组化法测定Bcl 2和Bax表达 .结果 :与对照组比较 ,缺血 /再灌注组凋亡指数增加 (3.1± 2 .3vs 2 8.8± 4 .4 ,P <0 .0 5 ) ,Bax(1 83.0± 1 2 .8vs1 6 3.0± 1 7.1 ,P <0 .0 5 )表达明显增强 ,Bcl 2增加 (1 84 .0± 9.6vs 1 79.0± 1 3.0 ,P <0 .0 5 ) ,Bcl 2 /Bax比值明显降低 (1 .0 0± 0 .0 8vs 1 .1 0± 0 .0 7,P <0 .0 5 ) .缺血 /再灌注组比较 ,IPC3组肾小管凋亡指数明显下降(2 8.8± 4 .4vs 1 5 .6± 3.8,P <0 .0 5 ) ,Bcl 2表达增强 (1 79.0±1 3.0vs1 70 .0± 1 5 .1 ,P <0 .0 5 ) ,Bax表达减弱 (1 6 3.0± 1 7.1vs1 74 .0± 1 3.7,P <0 .0 5 ) ,Bcl 2 /Bax比值增高 (1 .1 0± 0 .0 7vs0 .98± 0 .1 1 ,P <0 .0 5 ) .结论 :缺血预处理 (IPC3)具有抗肾脏缺血 /再灌注损伤作用 ,其作用机制可能是通过调控Bcl 2 /Bax介导的肾脏缺血 /再灌注细胞     

吗啡后处理抑制缺血再灌注损伤大鼠心肌细胞凋亡 及其抗氧化机制

 【目的】 探讨吗啡后处理抑制缺血再灌注损伤大鼠心肌细胞凋亡的作用以及与氧化应激的关系。【方法】 SD大鼠45只随机分成3组,每组15只: S组(假手术,只穿线,不结扎);I/R组(单纯缺血再灌注);M组(吗啡后处理 + 缺血再灌注)。再灌注末,TUNEL染色检测细胞凋亡,检测氧化应激指标和心肌caspase-3的活性。【结果】 再灌注120 min,可在I/R组缺血区心肌检测到大量凋亡心肌细胞(18.0 ± 1.1)%,吗啡后处理显著降低心肌细胞凋亡指数(10.8 ± 1.2)%,P < 0.01)。与I/R组相比,吗啡后处理明显上升了心肌组织超氧化物歧化酶(SOD)活力,降低了心肌组织丙二醛(MDA)含量(P < 0.01)。与假手术的对照组比较,缺血再灌注损伤组caspase-3活性明显增强(P<0.01),而吗啡后处理组明显降低了缺血再灌注损伤所增强的caspase-3活性(P < 0.01)。【结论】 大鼠在体心脏缺血模型,吗啡后处理可通过抗氧化应激,抑制缺血再灌注损伤诱导的心肌细胞凋亡。     

3-硝基丙酸预处理对大鼠局灶性脑缺血再灌注细胞凋亡的影响

目的 研究3-硝基丙酸预处理对大鼠局灶性脑缺血再灌注损伤细胞凋亡的影响。方法 采用线栓法建立大鼠局灶性脑缺血再灌注损伤模型，将20只大鼠随机分成4组，假手术组、缺血组、3-硝基丙酸预处理组、3-硝基丙酸预处理+5-羟癸酸盐组。观察各组凋亡细胞数和凋亡相关蛋白Bcl-2、Bax的变化。结果 与缺血组比较，3-硝基丙酸预处理组使凋亡细胞数明显减少（85.96±11.51） vs( 123.96±13.45）, Bcl-2表达增高(0.18±0.02 )vs (0.13±0.01)，Bax表达下降(0.14±0.02) vs( 0.20±0.03)，差异有显著性（P<0.01）。3-硝基丙酸预处理+5-羟癸酸盐组与缺血组比较差异无显著性（P>0.05）。结论 3-硝基丙酸预处理可通过开放线粒体ATP敏感性钾通道，上调缺血半暗带区Bcl-2蛋白表达，下调Bax蛋白表达，减少神经元凋亡，对脑缺血损伤起保护作用。     

缬沙坦对离体大鼠缺血再灌注心肌保护作用的机制

目的探讨缬沙坦对离体大鼠心肌缺血再灌注(I/R)后心功能保护作用的机制。方法采用Langendorff离体心脏灌流模型,将40只雄性SD大鼠随机等分为5组:对照组用改良Kreb-Henseleit液(K-H液持续灌注110min);I/R组(用K-H液灌流稳定20min后,停灌30min,再灌注60min);HOE140组(K-H液中含缓激肽β2受体拮抗剂HOE1401μmol/L),缬沙坦组(K-H液中含缬沙坦1μmol/L),缬沙坦+HOE140组(K-H液中含缬沙坦1μmol/L+HOE1400·1μmol/L),后3组缺血再灌注过程同I/R组。动态监测左室收缩压(LVSP)、左室压力升高速率(+dp/dtmax)、测定心脏再灌流出液肌酸激酶同工酶(CK-MB)含量变化。实验结束后计算无复流区面积。结果缺血再灌注后,I/R组无复流面积为25·8%±2·7%;与对照组比较,I/R组LVSP及+dp/dtmax降低(LVSP57mmHg±9mmHgvs107mmHg±6mmHg,+dp/dtmax679mmHg/s±177mmHg/svs1892mmHg/s±231mmHg/s,P均<0·01),心肌CK-MB水平增加(210IU/L±48IU/Lvs27IU/L±7IU/L,P<0·01)。单独应用HOE140对I/R心功能、心肌CK-MB及无复流面积无影响(P>0·05)。缬沙坦改善LVSP(85mmHg±7mmHg)和+dp/dtmax(1425mmHg/s±260mmHg/s),缩小无复流区面积(12·9%±2·5%);减少心肌CK-MB释放(103IU/L±24IU/L,与I/R组比P均<0·01);HOE140与缬沙坦合用可部分阻断缬沙坦的上述作用。结论缓激肽β2受体拮抗剂可减弱缬沙坦对离体大鼠缺血再灌注心肌的保护作用,缬沙坦对心肌I/R损伤的保护作用机制部分与缓激肽释放增多有关。     

曲美他嗪对家兔心肌缺血再灌注损伤的保护作用

目的 :探讨曲美他嗪对家兔心肌缺血再灌注损伤的保护作用。方法 :家兔 4 0只 ,随机分为正常对照组、缺血对照组、缺血药物干预组、再灌注对照组、再灌注药物干预组。观察缺血 30 min和再灌注 30 min对血清肌酸磷酸激酶 (CPK)、丙二醛 (MDA)、超氧化物歧化酶 (SOD)的影响 ,心肌三磷酸腺苷 (ATP)含量 ,以及心肌电镜学改变。结果 :1缺血药物干预组与缺血对照组比较 ,除血清 MDA差异有显著性外 [(4 .0 9± 0 .4 0 vs4 .79± 0 .92 ) nmol/ ml,P<0 .0 1],血清 CPK[(132 2± 114 8vs14 98± 190 ) NU/ ml]、SOD[(32 4± 71vs2 88± 5 4) NU/ ml]差异均无显著性(P>0 .0 5 )。 2再灌注药物干预组与再灌注对照组比较 ,血清 CPK[(15 12± 2 2 6 vs190 4± 2 0 3) NU/ ml]、MDA[(6 .0 9± 0 .6 9vs7.4 3± 0 .2 0 ) nmol/ ml]、SOD[(2 13± 71vs119± 5 5 ) NU/ ml],及缺血区心肌 ATP含量 [(1.4 0 1± 0 .2 4 8vs0 .6 2 9± 0 .175 ) μmol/ g]差异均有显著性 (P<0 .0 0 1～ 0 .0 1)。 3电镜显示 :各药物干预组线粒体结构改变分别较各对照组减轻。结论 :曲美他嗪具有改善缺血再灌注损伤心肌线粒体的代谢和清除氧自由基的功能。     

过氧化物酶体增殖物激活受体在实验性大鼠缺血再灌注心肌中的表达

目的研究过氧化物酶体增殖物激活受体(PPAR)在实验性实验性大鼠缺血再灌注心肌中的表达.方法Wistar大鼠66只随机分为三组正常对照组(n=18),假手术组(n=24),缺血再灌注组(n=24).采用鼠心冠状动脉左前降支结扎法制作在体缺血再灌注模型.运用半定量RT-PCR方法对心肌PPAR mRNA的表达情况进行分析,运用Western-blotting方法对检测PPAR蛋白表达情况.并测定各组血清游离脂肪酸的含量.结果缺血再灌注组心肌PPAR mRNA 0.455±0.139较正常对照组及假手术组(分别为 0.711±0.120、0.812±0.148)显著减少(P<0.01);缺血再灌注组心肌PPAR 蛋白表达为67.37±23.46较正常对照组及假手术组(110.49±19.77、102.18±12.56)显著减少(P<0.01).缺血再灌注组游离脂肪酸于再灌注后4 h、6 h显著上升.结论在实验性实验性大鼠缺血再灌注心肌中PPAR 表达减少同时伴有大鼠血液中游离脂肪酸增多.     

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…