血脂康对2型糖尿病糖、脂代谢及血小板活化功能的影响

目的 :探讨血脂康对 2型糖尿病患者血小板活化功能及糖脂代谢的影响。方法 :将 6 5例 2型糖尿病患者分为高脂血症组 (31例 )和正常血脂组 (34例 ) ,测定患者的血小板表面α-颗粒膜蛋白 (GMP - 14 0 )、血小板血栓烷素B2 (TXB2 )及血糖、血清胰岛素水平 ,计算胰岛素敏感指数 (ISI) ,对伴有高脂血症者用血脂康治疗 8周后重复测定上述指标。结果 :伴高脂血症者的GMP - 14 0、TXB2 及血甘油三酯 (TG)、血总胆固醇 (TC)、低密度脂蛋白 -胆固醇 (LDL -C)较正常血脂者明显升高 (P <0 0 5～ 0 0 1) ,ISI及高密度脂蛋白 -胆固醇 (HDL -C)明显降低 (P <0 0 1) ;伴高脂血症者经过血脂康治疗 8周后TG、TC、LDL -C及GMP - 14 0、TXB2 较治疗前降低 (P <0 0 5～ 0 0 1) ,HDL -C及ISI较治疗前明显升高 (P <0 0 5 )。结论 :血脂康对伴高脂血症的 2型糖尿病患者在调脂治疗的同时可降低血小板活性 ,改善胰岛素抵抗     

丹蒌片对高脂血症及血管内皮损伤大鼠的保护作用

目的研究丹蒌片对高血脂症大鼠血脂水平及高脂血症、血管内皮损伤大鼠血管内皮功能相关指标的影响。方法采用高脂饲料喂养所致大鼠高脂血症模型,测定血脂水平相关的指标血清中总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、计算HDL/LDL比值,并测定与血管内皮损伤的相关指标内皮素(ET)、细胞间黏附分子-1(ICAM-1)、一氧化氮(NO)、降钙素基因相关肽(CGRP)、血栓素B2(TXB2)、6-酮-前列腺素F1α(6-keto-PGF1α)。采用机械性(导管牵拉)所致大鼠动脉内皮损伤模型,测定大鼠血清中一氧化氮合酶(NOS)、内皮素(ET)和血管紧张素Ⅱ(AngⅡ)的含量。结果丹蒌片能降低高脂饲料喂养所致高脂血症大鼠的血脂水平,能有效地改善血管内皮细胞功能相关指标;具有明显改善机械性损伤所致动脉内皮损伤大鼠血管内皮细胞功能相关指标的作用。结论丹蒌片能降低高脂血症大鼠血脂水平及改善动脉内皮损伤大鼠血管内皮功能。     

水杉总黄酮对大鼠血小板聚集、血液流变性的作用及机制探讨

目的 观察水杉总黄酮（FMG）对大鼠血小板聚集活性、血小板5－HT释放反应、血浆NO含量及血液流变性的影响。方法 比浊法测定大鼠血小板聚集活性、荧光光度法测定血小板5－HT释放反应、分光光度法测定血浆NO含量、血液流变全自动分析仪检测血液流变性。结果 FMG抑制大鼠血小板聚集活性，抑制血小板5－HT释放，升高血浆NO含量，降低急性血瘀大鼠的全血比粘度、血浆比粘度、红细胞电泳时间、红细胞压积、红细胞计数、血沉方程K值，改善大鼠的血液流变性。结论 FMG有抗血小板聚集活性改善血液流变性的作用。其抗血小板聚集的作用机制可能与抑制血小板释放反应、增加体内NO合成及Ca^2 拮抗作用有关。     

通脉降脂对高胆固醇血症鹌鹑血脂、vWF及GMP-140的影响

目的 :探讨中药通脉降脂对血脂、血浆血管性假血友病因子 (vWF)、血小板α颗粒膜蛋白 140 (GMP 140 )的影响。方法 :建立实验性高胆固醇血症 (HC)鹌鹑动物模型 ,同时用通脉降脂治疗 ,检测血脂 (酶法 )、血浆vWF及GMP 140 (ELISA法 ) ,并与正常、HC及洛伐他汀治疗的鹌鹑进行比较。结果 :通脉降脂治疗后血清总胆固醇 (TC)、低密度脂蛋白 胆固醇 (LDL C)显著下降 (P <0 .0 5 ) ;高密度脂蛋白 胆固醇 (HDL C)明显升高 (P <0 .0 5 ) ;vWF和GMP水平显著降低 (P <0 .0 1)。结论 :通脉降脂具有良好的调节血脂、改善血管内皮功能、抑制血小板活性等作用 ,从而可延缓或逆转动脉粥样硬化病变     

复方丹参滴丸对高脂血症大鼠血小板功能的影响

目的分析高脂血症大鼠血小板功能的变化,探讨复方丹参滴丸对高脂大鼠血小板功能的影响。方法44只Wistar大鼠随机分为正常对照组、高脂模型组、复方丹参滴丸组[160mg/(kg·d)]、阿托伐他汀组[10mg/(kg·d)],分组干预4周后检测血脂水平:总胆固醇(CHO)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)的水平。应用酶联免疫法测定血小板表面α-颗粒膜糖蛋白(CD62P)的浓度,流式细胞术(FCM)检测血浆α颗粒膜蛋白-140(GMP140)浓度。结果高脂血症组CHO、LDL-C显著升高;CD62P及GMP140水平明显升高;复方丹参滴丸组和阿托伐他汀组GMP140及CD62P水平显著降低。结论高脂血症能够促使血小板活化,复方丹参滴丸具有与阿托伐他汀效果相似的抑制血小板活化的作用。     

油茶皂苷对高脂血症大鼠血管内皮细胞的保护作用

目的研究油茶皂苷(SQS)对高脂血症大鼠血管内皮细胞的保护作用。方法 60只SD大鼠,随机分为SQS高、中、低剂量组、氯贝丁酯组、高脂模型组和正常组,建立大鼠高脂血症模型。连续给药14 d后检测大鼠血清血脂、氧化亚氮(NO)、氧化亚氮合酶(NOS)、血管内皮素(ET)、可溶性细胞间黏附分子(ICAM-1)和可溶性血管细胞黏附分子(VCAM-1)水平。结果与高脂模型组比较,SQS可降低高脂血症大鼠血清三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、ICAM-1、VCAM-1、ET,升高NO、cNOS,有效维持NO/ET平衡,对HDL-C、iNOS影响不明显。结论 SQS能调整脂质代谢,抑制炎症反应,并能改善高脂血症大鼠血管内皮细胞功能。     

bFGF在辛伐他汀改善高脂血症大鼠血管内皮功能中的作用研究

目的:研究碱性成纤维细胞生长因子(bFGF)在辛伐他汀改善高脂血症大鼠血管内皮功能中的作用.方法:将30只实验SD大鼠随机分为对照组、高脂血症组和治疗组.观察不同组离体大鼠主动脉环对不同浓度乙酰胆碱(Acetylcholine,Ach)的舒张反应.应用RT-PCR和Western-blotting技术检测主动脉组织bFGF mRNA和蛋白含量表达;应用ELISA方法检测血清bFGF含量;应用硝酸酶还原法检测血清和主动脉组织一氧化氮(NO)的含量.结果:给予高脂血症SD大鼠辛伐他汀20 mg/(kg·d),持续治疗16 W后,血脂总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)浓度降低(P<0.01),高密度脂蛋白(HDL)浓度升高(P<0.01),其主动脉环对不同浓度Ach舒张反应百分率明显升高(P<0.05),主动脉组织中bFGF mRNA、蛋白和NO含量以及血清bFGF和NO含量均升高(P<0.05).结论:bFGF可能参与辛伐他汀保护血管内皮,提高NO含量,改善血管内皮舒张功能的作用.     

非诺贝特对乳源县瑶族高脂血症患者的干预作用及血管内皮功能的影响

目的观察乳源县瑶族人群的血脂水平,运用非诺贝特进行早期干预,探讨对血脂水平及血管内皮功能的影响。方法将符合标准的患者随机分为非诺贝特高、低剂量组,并与正常组对照,干预8周,观察各组治疗前后的血压、血清甘油三酯（TG）、总胆固醇（TC）、空腹血糖（GLU）水平,酶比色法检测NO浓度,酶联免疫吸附法检测血浆可溶性VCAM-1浓度（sVCAM-1）浓度。结果非诺贝特可显著改善高脂血症患者血压、血脂及血糖水平,增加血清NO水平,降低sVCAM-1浓度。结论运用非诺贝特对瑶族人群中高脂血症患者进行早期干预,可显著改善血脂水平、降低血糖,其机制可能通过增加NO释放,抑制sVCAM-1生成,从而改善血管内皮功能实现的。     

心痛灵片对不稳定型心绞痛患者血管内皮功能的影响

目的观察心痛灵片治疗不稳定型心绞痛的临床疗效及对血管内皮功能的影响。方法将64例中医辨证为气虚痰瘀阻络证不稳定型心绞痛患者,随机分为西药常规用药对照组和西药常规用药加心痛灵片治疗组进行临床观察。结果治疗组中医临床证候改善、心绞痛缓解及心电图改善总有效率为90.6%、87.50%和75.0%,中医证候疗效、心绞痛疗效明显优于对照组(P<0.05)。心痛灵能显著升高NO,明显降低ET-1,与对照组比较差异有统计学意义(P<0.05)。结论心痛灵通过改善内皮功能来达到舒张血管,解除冠状动脉痉挛,抑制血小板黏附和聚集,防止血栓形成。     

氯沙坦、福辛普利和硝苯地平控释剂对原发性高血压患者血管内皮功能的保护作用

为评价和比较氯沙坦、福辛普利和硝苯地平控释剂对原发性高血压 (简称高血压病 )患者血管内皮功能的保护作用 ,分别应用以上 3种药物对轻中度高血压病患者进行治疗 ,并与对照组比较。应用放射免疫分析法、酶法及酶联免疫吸附法观察比较治疗前及治疗 4周末对血管内皮功能的影响。结果发现高血压病患者血浆内皮素 (ET)、血小板α 颗粒膜蛋白 (GMP1 4 0 )、血管性假血友病因子抗原 (vWF)显著高于正常对照组 (P <0 .0 5,P <0 .0 1 ) ,一氧化氮(NO)与对照组相比无显著性差异 ,但NO/ET显著低于对照组 (P <0 .0 5)。 3种药物治疗 4周后 ,血浆ET、vWF均较治疗前显著降低 (P <0 .0 5,P <0 .0 1 ) ,但vWF仍高于正常对照组 (P <0 .0 5) ;血浆NO及NO/ET较治疗前及正常对照组显著升高 (P <0 .0 5,P <0 .0 1 ) ;与氯沙坦和福辛普利组相比 ,硝苯地平控释剂组血浆GMP1 4 0治疗后显著降低(P <0 .0 5)。提示以上 3种药均能有效改善高血压病早期的血管内皮功能损害 ,硝苯地平控释剂对GMP1 4 0的改善作用优于氯沙坦组和福辛普利组     

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…