大鼠动脉粥样硬化动物模型的建立和评价

目的 利用免疫损伤和高脂喂养结合的方法建立大鼠动脉粥样硬化(atherosclerosis,AS)动物模型.方法 5周龄Wistar大鼠腹腔注射卵清白蛋白和尾静脉注射牛血清白蛋白佐以灌喂维生素D3,高脂饲料喂养大鼠,FeS04加入到饮水中.检测大鼠不同时间的血脂水平、血液生化指标和病理变化.结果 (1)As模型组的T℃、HDL、LDL显著高于正常对照组(6.1±2.52比1.3±0.10;2.46±1.01比1.02±0.13;3.76±1.67比0.52±0.063;P<0.05).(2)模型组的C反应蛋白(CRP)、心肌激酶(CK)、心肌激酶同工酶(CK-Mb)显著高于正常对照组(4.99±2.26比0.183±0.160;996.3±82.8比293.8±167.1;669.5±128.1比177.5±86.5;P<0.05).(3)采用HE染色发现模型组大鼠的主动脉出现斑块的沉积,而正常大鼠无病变的产生.结论 该方法能够诱导大鼠产生高血脂症状,随着时间的延长心肌发生损伤,同时出现炎症症状,并在动脉壁上形成斑块.     

缬沙坦对动脉粥样硬化大鼠模型主动脉内皮细胞保护作用及对血浆内皮脂肪酶水平影响

目的：通过血管紧张素Ⅱ受体阻断剂（angiotensin Ⅱ receptor blocker,ARB）对动脉粥样硬化性大鼠模型进行治疗,探讨ARB对主动脉内皮细胞保护作用。方法：30只Wistar大鼠随机分为3组,每组10只,模型组通过高脂饲料建立动脉粥样硬化大鼠模型,实验组增加缬沙坦干预,8周后比较各组主动脉内皮一氧化氮（nitric oxide,NO）、内皮素（endothelin,ET）、细胞色素c（cytochrome,Cyt-c）及内皮脂肪酶（endothelia lipase,EL）水平。结果：实验结束时,模型组HE染色可见明显斑块形成并伴有大量脂质细胞浸润,Cyc-c免疫组化染色显示内皮细胞凋亡阳性率（36.85±12.45）,高于对照组（0.81±0.11）和实验组（13.85±6.41）（P=0.000）,平滑肌细胞凋亡阳性率（9.65±2.62）高于对照组（0.06±0.01）（P=0.000）,但与实验组（7.85±1.34）差异无统计学意义（P=0.058）;模型组和实验组总胆固醇（total cholesterol,TC）和低密度脂蛋白-胆固醇（low-density lipoprotein cholesterol,LDL-C）明显增加,与对照组相比差异具有统计学意义（P=0.000）;模型组和实验组相比,TC和LDL-C差异也有统计学意义（P=0.000和0.002）;模型组和实验组大鼠ET-1、NO、EL与对照组相比差异均有统计学意义（P=0.000）,与模型组相比,实验组NO水平升高,ET-1、EL水平降低,差异具有统计学意义（P=0.017、0.008和 0.000）。结论：缬沙坦在细胞损伤期,即具有明显内皮细胞保护功能。对动脉粥样硬化患者早期用药,能够保护细胞完整性,减少凋亡发生,起到疾病预防和治疗的重要意义。     

大鼠动脉粥样硬化和高脂血症一氧化氮特点的比较

目的　研究大鼠动脉粥样硬化时一氧化氮 (NO)的特点并将其与单纯高脂血症进行比较。方法　大鼠分为 3组 :正常对照组 ( 10只 ) ,予普通饲料、饮水 ;高脂血症组 ( 10只 ) ,饲以高脂饲料 (不含维生素D3) ;动脉粥样硬化组 ( 10只 ) :维生素D33× 10 5U/kg 1次肌肉注射、球囊损伤主动脉内皮并饲以含维生素D31.2 5× 10 6U/kg饲料的高脂饲料。 90d后检测血管诱导型 (iNOS)及内皮型一氧化氮合酶 (eNOS)的表达及其活性。 结果　 90d后动脉粥样硬化组大鼠胸主动脉形成了明显的动脉粥样硬化斑块 ,而高脂血症组的大鼠胸主动脉结构未见改变 ;高脂血症组和动脉粥样硬化组血管中 ,eNOS较正常对照组表达减弱、活性下降 (P <0 .0 1) ,但两组间差异无显著性 ;高脂血症组iNOS与正常对照组相比 ,差异无显著性 ,而动脉粥样硬化组则明显升高 (P <0 .0 1)。斑块中iNOS呈强阳性。结论　高脂血症患者的eNOS表达减弱、活性下降 ,并在形成斑块时持续存在 ;iNOS只见于血管壁形成典型的动脉粥样硬化斑块时     

兔动脉粥样硬化模型的建立及其MR检测

目的 探索动脉粥样硬化斑块动物模型的建立；评价MRI检测动脉粥样硬化斑块的能力。方法 成年新西兰大白兔（8周龄以上）15只，随机分成两组，对照组2只，实验组13只。麻醉固定后以相同的方法损伤腹主动脉内膜。实验组兔每日每只喂养胆固醇1．5g加基础饲料，并于术后第11、12周皮下注射维生素D500000 IU／kg。对照组只喂养基础饲料。术后13周所有动物接受T1WI、T2WI、PDWI、TOF序列检查。检查结束后处死实验动物观察其腹主动脉病理变化。结幂实验组动物动脉粥样硬化病变脂质条纹面积和纤维斑块面积的百分比分别为9．64％和1．56％。对照组动脉内膜光滑。全部横断面病理切片共109层，其中实验组动物的86层切片中发现斑块50层，对照组中均未发现斑块层，实验组与对照组相比差异有非常显著性（P〈0．001）。MRI检出纤维斑块11层，检出脂质斑块29层，MR对斑块检测总的阳性率为88％，准确率为80％。结论 采用兔可成功建立动脉粥样硬化斑块模型，MRI可以较准确地对斑块进行定位及定性。     

实验性动脉粥样硬化模型复合建模的方法及评价

目的 建立一种利用复合因素制备兔动脉粥样硬化模型的实验方法.方法 完全随机方法将24只日本大耳白兔分为对照组(8只)和实验组(16只),对照组予普通饲料,实验组用大剂量高脂饲料饲喂加以注射胎牛血清白蛋白和球囊拉伤进行干预,饲养10周.测定血清胆固醇、甘油三酯、低密度脂蛋白含量,主动脉切片进行病理形态学观察,测量斑块面积占内膜的百分比及内膜厚度及内膜面积等.结果实验组血清胆固醇、甘油三酯、低密度脂蛋白水平显著升高(P<0.05或P<0.01).主动脉斑块形成,有典型"纤维帽",斑块面积占内膜面积的53.6%±10.5%,相应的对照组未出现以上类似的变化.其主动脉弓、胸主动脉及腹主动脉的内膜厚度、内膜与中膜厚度比和内膜面积与内膜中膜面积的比值实验组都相应的高于对照组(P<0.05或P<0.01).结论 用高脂饲料加以静脉注射胎牛血清白蛋白和球囊拉伤因素在短时间内可诱发兔动脉粥样硬化,此方法具有一定可行性,可控程度高、易重复.能够更好地模仿人动脉粥样硬化的发病机制,并有助于进一步阐明不稳定斑块的机制.     

叶酸对高同型半胱氨酸血症诱发大鼠动脉粥样硬化的干预研究

目的 探讨叶酸对高同型半胱氨酸血症(HHxy)诱发大鼠动脉粥样硬化的干预效果.方法 健康8周龄雄性SD大鼠26只,体重(200±20)g,适应性喂养一周后随机分为对照组(6只)、模型组(10只)和叶酸干预组(10只).对照组给予普通饲料喂养,模型组在普通饲料喂养的基础上加2%的蛋氨酸,叶酸干预组在普通饲料的基础上加2%的蛋氨酸及0.0003%叶酸.12周后,心脏取血测定血浆同型半胱氨酸(Hcy)浓度,取胸主动脉进行电镜观察和苏木素-伊红(HE)染色、油红O染色.结果 模型组血浆Hcy水平明显高于对照组(P<0.01),叶酸干预组Hcy水平明显低于模型组(P<0.01).电镜观察和HE、油红O染色均可见模型组主动脉内皮下脂质和泡沫细胞沉积,亦即动脉粥样硬化脂纹形成.叶酸干预组与对照组相比无明显改变.结论 HHcy可诱发大鼠主动脉粥样硬化早期病变的形成,叶酸干预可有效预防HHcy引起的血管损伤.     

实验性兔主动脉粥样硬化易损斑块模型的建立与评价

目的 探索建立实验性兔主动脉粥样硬化易损斑块模型的新方法.方法 24只雄性日本大耳白家兔随机分为对照组8只,实验组16只,对照组给予普通饲料;实验组给予高胆固醇饲料、注射牛血清白蛋白及进行腹主动脉球囊拉伤术,分别于0周、3周、6周、10周检测血脂、ox-LDL、TNF-α、IL-1、IL-10,实验结束时取腹主动脉进行病理形态学分析及NF-κBp65亚基免疫组化染色分析.结果 实验组斑块内膜面积比为53.6%,脂核面积与斑块面积比为54.9%,斑块纤维帽厚度与内膜中膜厚度(IMT)比约为8.5%;除甘油三酯变化不大外,实验组TC、LDL-C、HDL-C、LDL-C/ HDL-C、TC/ HDL-C、ox-LDL、TNF-α、IL-1、IL-10均有明显升高趋势,在3周、6周、10周时与对照组比较差异有统计学意义;且NF-κBp65亚基阳性染色面积较对照组高13.5倍.结论 高脂喂养、免疫损伤加球囊拉伤可以成功建立家兔主动脉粥样硬化易损斑块模型.     

脂脉康胶囊对家兔实验性动脉粥样硬化的影响

目的　观察脂脉康胶囊对家兔实验性动脉粥样硬化的治疗作用。方法　以高脂饲料喂养新西兰白兔 12周 ,形成高血脂症 ,造成动脉粥样硬化模型。通过测定主动脉和冠状动脉粥样硬化程度和面积 ,观察脂脉康胶囊对动脉粥样硬化的治疗效果。结果　脂脉康胶囊 0 5、1 0 g/kg灌胃 8周使家兔主动脉粥样斑块面积占主动脉面积的百分率分别由模型组的 (5 2 3±2 2 4) %降至 (10 3± 0 7) %和 (8 1± 0 6) % (均P <0 0 1) ,并显著降低主动脉粥样硬化程度。同剂量的脂脉康胶囊可降低冠状动脉粥样硬化病变发生率 ,同时使冠状动脉斑块阻塞管腔的程度级别分别由 3 4± 0 4降至 1 1± 0 3和 1 0± 0 3 (均P <0 0 1)。结论　脂脉康胶囊能显著抑制主动脉粥样硬化程度和面积 ,降低冠状动脉粥样斑块阻塞程度。提示脂脉康胶囊对家兔实验性动脉粥样硬化具有显著的治疗作用     

小凹蛋白1-NFκB通路介导乙酰水杨酸姜黄素酯的抗动脉粥样硬化作用

目的探讨乙酰水杨酸姜黄素酯对动脉粥样硬化病变的作用及机制。方法 40只7周龄Apo E-/-小鼠,随机分为对照组、高脂组、辛伐他汀组[5 mg/(kg·d)]、乙酰水杨酸姜黄素酯低剂量组[23.8 mg/(kg·d)]和乙酰水杨酸姜黄素酯高剂量组[71.5 mg/(kg·d)],其中对照组给予普通饲料,其他组给予高脂饲料喂养。连续干预4周之后处死动物,检测血清中血脂水平;油红O染色法观察小鼠主动脉斑块;ELISA法或免疫组化法检测血清和肝脏炎症因子TNF-α、IL-6水平;Western blot检测小鼠肝脏中小凹蛋白1和NFκB p65的表达。结果与对照组相比,高脂组血清中TC和LDL-C升高,HDL-C降低,主动脉粥样斑块增多。与高脂组相比,乙酰水杨酸姜黄素酯组小鼠血清中的TC和LDL-C降低,肝脏脂质减少,血清和肝脏炎症因子水平下降,而主动脉粥样硬化斑块减轻;肝脏小凹蛋白1水平升高而NFκB p65水平降低。结论乙酰水杨酸姜黄素酯能抑制高脂喂养所致的Apo E-/-小鼠动脉硬化斑块的形成;机制可能与增加肝脏小凹蛋白1、减少NFκB p65蛋白水平,调节肝脏脂质代谢及炎症反应有关。     

小剂量阿司匹林对动脉粥样硬化兔主动脉MMP-2表达的影响

目的评估小剂量阿司匹林对动脉粥样硬化兔主动脉基质金属蛋白酶-2(MMP-2)的表达及动脉硬化严重程度的影响。方法 24只雄性新西兰兔随机分为对照组(喂食普通兔料)、模型组(喂食高脂饲料)、阿司匹林组(喂食高脂饲料并给予小剂量阿司匹林干预),每组8只。饲养12周后处死动物,取主动脉进行病理学检查,分别应用RT-PCR和Western-bolt分析主动脉病灶中MMP-2 mRNA和蛋白的表达。结果病理学大体观察发现,对照组无动脉粥样硬化斑块形成,模型组和阿司匹林组主动脉斑块最大厚度、平均斑块厚度、管腔狭窄度和斑块所占周径比值等4项指标两两比较均有显著性差异(P<0.01)。对照组中MMP-2蛋白和mRNA呈低水平表达,而在模型组中的表达均明显增高,阿司匹林组MMP-2蛋白和mRNA的表达降低(P均<0.01)。结论 MMP-2在正常血管组织中低水平表达,随血管动脉粥样硬化程度的加重而升高;小剂量阿司匹林可以有效地减少动脉粥样硬化兔主动脉MMP-2表达,减轻动脉硬化的严重程度。     

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…