胰岛素对大鼠缺血性海马CA1区神经元的保护作用

目的：探讨胰岛素对海马ＣＡ１区神经元的保护作用。方法：在造成ＳＤ大鼠短暂全脑缺血后即刻、３０ｍｉｎ及１ｈ分别给予１Ｕ／ｋｇ常规胰岛素及２ｇ／ｋｇ２５％葡萄糖液。缺血７ｄ后，取脑固定染色，于前囟后３．８ｍｍ平面对海马ＣＡ１区１ｍｍ长范围内正常神经元进行了计数。结果：假手术组（ｎ＝６）正常神经元计数为１７４．６±１０．７，缺血后即刻（ｎ＝６）及再灌注３０ｍｉｎ给药组（ｎ＝６）正常神经元计数分别为８７．     

低温盐水局部灌注对脊髓缺血损伤的保护作用

目的 探讨低温生理盐水脊髓灌注对兔主动脉阻断致脊髓缺血的保护作用。方法 ２０只健康成年新西兰白兔,阻断肾动脉水平腹主动脉６０ｍｉｎ建立兔脊髓缺血损伤模型,随机分２组（ｎ＝１０）,Ａ组：缺血对照;Ｂ组：缺血＋脊髓低温盐水灌注。结果 （１）各组血压心率无明显差别;（２）Ｂ组兔下肢功能恢复良好,而Ａ组瘫痪;（３）脊髓形态学显示Ａ组中央灰质聚集性坏死,巨噬细胞浸润,尼氏体消失,核仁模糊,Ｂ组未见Ａ组的形态     

经皮腔内冠状动脉成形术对冠心病患者血、尿TM的影响

目的 观察经皮腔内冠状动脉成形术（ＰＴＣＡ）对冠状动脉硬化性心脏病（简称冠心病）血、尿血栓调节蛋白（ＴＭ）的影响。方法 设ＰＴＣＡ组与冠状动脉造影（ＣＡＧ）组在术前和术后５ｍｉｎ、３０ｍｉｎ、２ｈ、６ｈ、２４ｈ静脉采血,术前、术后６ｈ、２４ｈ留尿;另设对照组空腹采血、尿、用酶联免疫双抗体夹心法测定ＴＭ含量。结果 ＰＴＣＡ组术后５ｍｉｎ、３０ｍｉｎ、及术后６ｈ、２４ｈ血尿ＴＭ均较术前增高（ｔ＝２．３     

预缺血处理对家兔全脑缺血保护效应的实验研究(摘要)

为探讨预缺血处理脑保护效应,以及神经细胞凋亡与缺血性脑损害的关系．用家兔１５只,随机分为３组,对照组（Ａ,ｎ＝５）,缺血组（Ｂ,ｎ＝５）,预缺血处理组（Ｃ,ｎ＝５）．Ａ组只作手术操作;Ｂ组采用二血管夹闭（双侧颈总动脉夹闭,ＭＡＰ＜４０ｍｍＨｇ）全脑缺血１０ｍｉｎ;Ｃ组在缺血前增加预缺血处理２ｍｉｎ,再灌注半小时．对比观察缺血后３ｄ海马ＣＡ１区神经元密度和缺血细胞数变化,同时使用ＴＵＮＥＬ原位标记法,检测缺血３ｄ后海马区的凋亡细胞．结果：（１）Ｃ组神经元密度与Ａ组相比差异无显著性（Ｐ＞００５）,…     

脊髓缺血性二次瘫痪与脊髓血流量

目的：观察脊髓缺血后二次瘫痪与脊髓血流量（ＳＣＢＦ）的关系。方法：以清醒兔肾下主动脉（ＩＲＡ）阻断致腰骶段脊髓缺血为实验模型，采用氢气清除法观测脊髓灰质和白质血流量（ｇＳＣＢＦ和ｗＳＣＢＦ）及Ｔａｒｌｏｖ六级分类法观测脊髓功能变化。结果：ＩＲＡ阻断平均３４ｓ双下肢运动功能完全消失，５５ｓ双下肢感觉功能消失；缺血２０ｍｉｎ再灌流后１～３ｈ内８７％动物的双下肢功能恢复，但再灌流１７～２６ｈ出现二次瘫痪。ＩＲＡ阻断后股动脉血压由１１．３～１６．６ｋＰａ降至２．６２ｋＰａ以下，Ｌ６的ｇＳＣＢＦ由（５１．９４±１３）ｍｌ１００ｇ－１ｍｉｎ－１降至（５．８６±６．０）ｍｌ１００ｇ－１ｍｉｎ－１，Ｌ６的ｗＳＣＢＦ由（３５．８０±７．０）ｍｌ１００ｇ－１ｍｉｎ－１降至（６．７±８．０）ｍｌ１００ｇ－１ｍｉｎ－１；缺血２０ｍｉｎ再灌流即刻（１５ｍｉｎ）股动脉血压和Ｌ６ＳＣＢＦ恢复正常，但再灌流１、３和２４ｈＬ６的ｇＳＣＢＦ和ｗＳＣＢＦ与缺血前相比显著下降，再灌流４８ｈＬ６ｗＳＣＢＦ仍显著下降；但Ｔ１０的ｇＳＣＢＦ和ｗＳＣＢＦ在缺血期和再灌流不同时间均无显著性变化。结论：提示兔脊髓缺血性二次瘫痪可能与继发性ＳＣＢＦ下降有关。     

交感神经兴奋在外伤性脑水肿发生中的作用及机制

目的 探讨交感神经兴奋在外伤性脑水肿发生中的作用。方法 家兔４８只分成Ａ、Ｂ、Ｃ、Ｄ４组,采用自由落体脑损伤模型,致伤前对拟受伤侧颈交感神经进行了不同处理,Ａ组（ｎ＝１２）为假手术对照,仅显露神经;Ｂ组（ｎ＝１２）为神经切断组,切断神经;Ｃ组（ｎ＝１２）为神经刺激组,电刺激神经;Ｄ组（ｎ＝１２）为切断后刺激组,切断神经后刺激该神经头端,于伤后２ｈ观察脑血管变化,２４ｈ观察脑组织Ｅｖｅｎｓｂｌｕｅ（     

再灌注兔脑细胞膜功能的变化

利用“四血管”式造成兔脑完全性缺血３０ｍｉｎ，将动物随机分成未缺血、缺血３０ｍｉｎ后再灌注３０、１８０ｍｉｎ和３６０ｍｉｎ四组（每组ｎ＝８），观察了再灌注时脑细胞膜（ＢＣＭ）上ＡＴＰ酶、磷脂酶Ａ２（ＰＬＡ２）和总磷脂的变化。与未缺血动物相比，Ｎａ＋－Ｋ＋ＡＴＰ酶在再灌注３０、１８０和３６０ｍｉｎ时下降（Ｐ＜０．００１），而ＰＬＡ２升高（Ｐ＜０．００１），总磷脂在再灌注１８０ｍｉｎ和３６０ｍｉｎ时减少（Ｐ＜０．０５），结果提示，完全性缺血后再灌注时ＢＣＭ功能下降和结构受损，如能稳定ＢＣＭ，可望为完全复苏脑细胞提供条件     

PAF受体拮抗剂治疗颈髓损伤的早期观察

目的：探讨全血血小板活化因子（ＰＡＦ）受体拮抗剂ＢＮ５２０２１对颈髓损伤患者早期治疗的效果及其机制。方法：颈髓损伤患者分为地塞米松组和ＢＮ５２０２１组（ｎ＝１８），观察两组颈髓损伤患者ＰＡＦ、血浆血栓素Ｂ２（ＴＸＢ２）、６－酮－前列腺素１α（６－Ｋｅｔｏ－ＰＧＦ１α）含量的变化、多系统器官衰竭（ＭＳＯＦ）发生率及脊髓神经功能恢复状态。结果：ＢＮ５２０２１组血液中ＰＡＦ、ＴＸＢ２含量、Ｔ／Ｋ值、伤后ＭＳＯＦ发生率较地塞米松组明显降低，而脊髓神经功能恢复优于地塞米松组。结论：ＰＡＦ受体拮抗剂对颈髓损伤后神经功能具有较好的保护作用，并且是早期治疗脊髓损伤的潜在理想药物     

艾司洛尔预防气管内插管心血管反应的临床观察

研究艾司洛尔静注预防气管插管时心血管反应的效果。将９０例ＡＳＡⅠ～Ⅱ级择期全麻下手术患者随机分为３组,Ａ组（ｎ＝３０）静注艾司洛尔１ｍｇ．ｋｇ－１,Ｂ组（ｎ＝３０）静注艾司洛尔２ｍｇ．ｋｇ－１,Ｃ组（ｎ＝３０）为对照组,静注同等容量的生理盐水。观察注药前、插管前及插管后１ｍｉｎ、２ｍｉｎ、３ｍｉｎ、５ｍｉｎ、１０ｍｉｎ时,心率、收缩压和舒张压的变化。结果显示：Ａ组和Ｂ组均能较好地缓解窥喉和气管插管时心率增快和血压升高的心血管反应,效果尤以Ｂ组为佳;３组中各有１例发生心动过缓和低血压,未见哮喘和过敏。研究提示：艾司洛尔能安全有效地减轻插管时的心血管反应。     

新生儿缺氧缺血性脑损伤亚低温干预大鼠模型的建立

为探讨不同疗程亚低温对新生儿脑损伤的保护作用,建立新生儿缺血缺氧性脑损伤亚 温干预大鼠模型,先在７日龄清洁级ＳＤ大鼠上以右颈总动脉结扎术和吸入低氧浓度气体法制备缺血缺氧性脑损伤（ＨＩＢＤ）模型,再将其随机分为室温恢复组（ＲｏＴ组,ｎ＝４４）和３种疗程（２４ｈ,４８ｈ,７２ｈ）的亚低温干预组（Ｈｙ２４组,ｎ＝２６,Ｈｙ４８组,ｎ＝１４,Ｈｙ７２组,ｎ＝２０）。亚低温干预期间采用配方奶喂养,并监测脑温     

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…