大黄素维持肝硬化大鼠高动力循环状态下肠屏障完整性实验研究

目的观察大黄素对肝硬化大鼠高动力循环状态下肠屏障完整性的维持作用。方法 SD雄性大鼠25只,随机分为对照组5只、肝硬化模型组10只、大黄素干预组10只,模型组与干预组予500m L/L四氯化碳(3m L/100g)皮下注射复制肝硬化大鼠模型,对照组大鼠给予生理盐水(3m L/100g)皮下注射,均为8周。干预组制模第15天起予大黄素(5mg/m L,5m L/kg)灌胃,对照组和模型组每日给予相当体积的生理盐水灌胃,均1天1次。8周后处死大鼠,行墨汁推进试验测定肠道传输功能,测定门脉压力,血清生化指标测定,取末端回肠组织及肝脏组织观察组织病理学改变,肠黏膜TUNEL凋亡检测。结果 (1)大鼠小肠黏膜损伤:模型组>干预组>对照组(P<0.05)。(2)门脉压力:模型组(13.73±1.81)mm Hg,较对照组(5.64±0.88)mm Hg显著升高(P<0.05),大鼠明显处于高循环状态;干预组门脉压力(10.25±1.47)mm Hg,较模型组明显降低(P<0.05)。(3)血清生化指标(ALT、AST、TB、ALP)水平:模型组[(594.22±317.82)U/L,(1008.33±778.70)U/L,(6.00±5.29)μmol/L,(802.78±396.94)U/L]较对照组[(60.20±21.30)U/L,(149.80±43.03)U/L,(1.00±0.44)μmol/L,(196.20±31.29)U/L]显著升高(P<0.05);干预组[(292.20±140.12)U/L,(350.40±173.35)U/L,(2.49±1.10)μmol/L,(552.20±303.37)U/L]较模型组明显降低(P<0.05);ALB模型组(16.29±1.26)g/L较对照组(23.42±1.56)g/L明显下降(P<0.05),干预组(18.89±1.02)g/L较模型组明显上升(P<0.05)。(4)肠道黑染百分比:模型组(68.05±2.09)%,较对照组(81.68±3.15)%明显减少(P<0.05);干预组(74.50±4.28)%,较模型组明显增加(P<0.05)。(5)肠黏膜凋亡小体:模型组明显多于对照组,而干预组大黄素干预后的小肠上皮细胞凋亡较模型组明显下降。结论大黄素对肝硬化大鼠高动力循环状态下肠屏障完整性有较好的维持作用。     

柴芍承气汤对大鼠肠缺血再灌注后肠组织半胱氨酰白三烯受体1的表达和肠黏膜细胞凋亡的影响

目的：研究中药柴芍承气汤对大鼠肠缺血再灌注（I/R）损伤的保护作用及其机制。方法30只大鼠分为3组,对照组、模型组和中药组各10只。通过免疫组织化学染色方法、Western blot和RT- PCR法检测大鼠肠组织半胱胺酰白三烯受体1（cys-teinyl leukotriene receptor 1,CysLTR1）蛋白和mRNA表达水平,并用光学显微镜观察小肠病理改变,检测小肠重量变化,TUNEL方法检测小肠黏膜细胞凋亡。结果（1）与对照组比较,中药组大鼠肠组织的病理改变均明显减轻（均P＜0.05）;与对照组比较,模型组小肠含水量明显增加（P＜0.05）,而中药组小肠含水量显著降低（P＜0.01）;（2）肠I/R时肠组织CysLTR1蛋白和mRNA表达水平升高;应用中药后,肠组织CysLTR1蛋白和mRNA表达水平均减低（均P＜0.05）;（3）与模型组比较,中药组小肠黏膜细胞凋亡显著减少（P＜0.01）;（4）小肠黏膜中CysLTR1蛋白表达分别与细胞凋亡、黏膜病理损伤、小肠含水量呈正相关（r=0.8463、0.8783、0.7708,均P＜0.05）。结论柴芍承气汤能减轻肠I/R肠组织的病理损害和降低小肠黏膜细胞凋亡,并能抑制肠黏膜组织CysLTR1的表达, CysLTR1的表达可能是柴芍承气汤保护肠黏膜损伤的靶点。     

大黄素对重症急性胰腺炎大鼠肠黏膜细胞凋亡和血清瘦素表达的影响

目的：探讨大黄素对重症急性胰腺炎大鼠肠黏膜屏障的保护机制。方法：60只成年SD大鼠随机分为假手术组、模型组和大黄素组。通过3％牛磺胆酸钠逆行胰胆管注射建立重症急性胰腺炎模型。造模成功后24h门静脉取血,检测血清瘦素含量、淀粉酶活性及血浆内毒素含量。取近回盲部回肠黏膜组织,光学显微镜、电子显微镜下观察肠黏膜病理学改变及超微结构改变;细胞凋亡原位标记法检测回肠黏膜上皮细胞凋亡率,免疫组织化学法检测回肠黏膜组织中Bax蛋白的表达情况。结果：术后模型组血浆内毒素含量、血清瘦素含量、血清淀粉酶活性、Bax蛋白表达及肠黏膜细胞凋亡率均显著高于假手术组（P〈0．01）,而大黄素组血浆内毒素含量、血清淀粉酶活性、Bax蛋白表达和肠黏膜细胞凋亡率则明显低于模型组（P〈0．01）,血清瘦素水平较模型组明显升高（P〈0．05）。模型组胰腺和肠黏膜的病理损害较假手术组加重,而大黄素组病理损害较模型组减轻。结论：大黄素通过抑制肠黏膜上皮细胞过度凋亡,上调血清瘦素水平,达到维持肠黏膜屏障完整性的功效,进而抑制重症急性胰腺炎细菌内毒素移位。     

糖尿病大鼠胃黏膜细胞色素C异常表达及大黄素调控

目的：探讨糖尿病胃病的相关机制及大黄素干预。方法：SD大鼠随机分为对照组（正常组）、实验组（糖尿病组）与大黄素组,实验组应用腹腔一次性注射链脲佐菌素（streptozotocin,STZ）建立糖尿病大鼠模型,造模成功10周后免疫组织化学检测胃黏膜腺细胞细胞色素C（cyt c）的表达情况。结果：①实验组和大黄素组大鼠于造模后均出现多尿、多饮、多食症状,体重减轻,平均体重明显低于对照组（P＜0.05）;平均血糖浓度显著高于对照组（P＜0.05）等糖尿病症状。但应用大黄素干预组大鼠的血糖浓度显著低于实验组。②实验组cyt c蛋白阳性表达的胃黏膜细胞数明显高于对照组（P＜0.05）;大黄素组cyt c蛋白阳性表达的胃黏膜细胞数明显少于实验组（P＜0.05）。结论：糖尿病引起大鼠胃黏膜细胞高表达cyt c蛋白,导致细胞死亡增加,参与糖尿病胃病的发生,而大黄素可降低胃黏膜细胞cyt c蛋白表达,从而缓解糖尿病胃病。     

大鼠哮喘模型气道重塑中细胞增殖和凋亡的变化

目的探讨大鼠哮喘气道重塑中细胞增殖和凋亡的变化,以及地塞米松对其影响.方法将39只大鼠随机等分为正常对照组、哮喘模型组和地塞米松干预组,以卵蛋白致敏制作大鼠哮喘模型,病理观察3组气道壁形态学改变;采用免疫组化方法观察细胞增殖核抗原(PCNA)和Caspase-3在气道壁和肺组织中的表达.结果哮喘模型组气道壁、气道周围及肺泡区细胞PCNA阳性表达(13.00±1.87,20.46±4.16)明显高于正常对照组的(10.00±2.20)及(15.00±4.83)(P＜0.05),且与气道上皮层、黏膜层厚度及胶原沉积面积呈正相关(r=0.67,0.66,0.57;P＜0.05).地塞米松干预组PCNA表达(9.54±2.15,13.08±3.40)明显低于哮喘模型组,Caspase-3表达(5.38±1.45,3.82±1.70)高于哮喘模型组(4.92±1,85,5.62±1.56)(P＜0.05).结论细胞增殖过度和凋亡异常是哮喘气道炎症和重塑反应的重要机制之一,地塞米松可通过调控细胞增殖和凋亡阻止气道重塑发生.     

VEGF、SP在门脉高压大鼠肠黏膜组织的表达

目的：探讨血管内皮生长因子（VEGF）、P物质（SP）在门静脉高压症大鼠肠黏膜中的表达。方法：25只雄性SD大鼠随机分为两组,其中对照组10只,实验组15只。门脉高压模型制备对照组仅暴露并游离门静脉主干及左肾上腺静脉。造模2w后分别检测两组的门静脉压力,采用免疫组织化学SABC法检测肠黏膜组织VEGF、P物质的表达情况。结果：术后2w实验组大鼠腹壁血管、肠系膜血管扩张较对照组明显,实验组大鼠有1只可见腹腔内有少量腹水生成,余大鼠及对照组未见明显腹水生成。实验组大鼠门静脉压力较对照组明显升高（P〈0.05）;免疫组化发现与对照组比较,实验组结肠部位VEGF、P物质的表达及小肠部位P物质的表达明显升高（P〈0.05）,差异有统计学意义;小肠部位VEGF的表达与对照组比较,差异无统计学意义（P〉0.05）。结论：门脉高压症肠黏膜病变（PHE）是多因素共同作用的结果,VEGF、SP可能参与了PHE的发生发展。     

白藜芦醇对梗阻性黄疸大鼠肠黏膜氧化应激损伤的影响

目的 探讨白藜芦醇(resveratrol,Res)对试验性梗阻性黄疸(obstructive jaundice,OJ)大鼠肠黏膜氧化应激损伤的影响.方法 健康雄性Wistar大鼠随机分为5组:假手术组、模型组、溶剂组、Res 10 mg组和Res 20mg组各12只.模型组、溶剂组、Res 10 mg组和Res 20 mg组均结扎胆总管建立梗阻性黄疸大鼠模型,假手术组不结扎胆总管.采用鲎试剂终点显色法检测血浆内毒素含量,HE和透射电镜观察小肠黏膜组织形态学改变,应用比色法检测肠组织丙二醛(malondialdehyde,MDA)含量和超氧化物歧化酶(superoxide dismutase,SOD)活性,TUNEL法检测肠黏膜上皮细胞凋亡.结果 实验处理2周后,模型组血浆内毒素浓度较假手术组明显升高(P＜0.05).HE染色观察模型组大鼠腺体排列紊乱,绒毛变钝、短缩,伴有较多淋巴细胞、炎性细胞浸润.透射电镜示肠黏膜微绒毛明显稀疏,排列紊乱,细胞连接模糊、间隙增宽.肠黏膜组织MDA含量明显高于假手术组,SOD活性明显低于假手术组(P＜0.05).TUNEL法检测示模型组肠黏膜上皮细胞凋亡指数较假手术组明显升高.不同浓度Res干预后上述病理改变得到纠正,大鼠肠黏膜脂质过氧化产物MDA含量较模型组和溶剂组明显降低(P＜0.05),且SOD增加(P＜0.05);大鼠肠黏膜上皮细胞凋亡指数降低(P＜0.05),Res 20 mg组较Res 10 mg组凋亡指数进一步降低(P＜0.05).结论 OJ大鼠存在肠黏膜氧化应激损伤,Res明显改善OJ大鼠高肠源性内毒素血症,提高肠黏膜的抗氧化作用,抑制肠上皮细胞凋亡,具有保护肠黏膜屏障作用.     

基于PI3K/Akt/mTOR信号通路研究南葶苈子水提液对心衰大鼠心室重构的影响

目的：观察南葶苈子水提液对压力后负荷性 心衰大鼠心室重构的影响并探索PI3K/Akt/mTOR信号通路在其中的作用。方法：雄性SD大鼠15只,随机分为正常组、模型组、南葶苈子组。4周后处死大鼠,测定各组大鼠心室肥厚指数;HE染色法和电镜观察心室组织病理变化;Western blot检测各组左室心肌组织Bax、Bcl-2、Cleaved-caspase 3、P-Akt、Akt、P-mTOR、mTOR蛋白表达。结果：南葶苈子组心室肥厚指数为0.0033±0.0002,较模型组0.0037±0.0001降低（P＜0.05）;HE染色和电镜显示南葶苈子组心肌纤维排列不规则和心肌细胞肥厚程度较模型组减轻;Western blot证实,南葶苈子组Bcl-2/Bax蛋白表达灰度值比值0.75±0.20,较模型组0.54±0.18上调（P＜0.05）;Caspase-3/GAPDH蛋白表达灰度值比值1.31±0.22,较模型组1.62±0.26下调（P＜0.05）;而P-Akt/Akt和P-mTOR/mTOR蛋白表达灰度值比值分别为1.50±0.18、1.36±0.32,较模型组1.18±0.21、1.16±0.12上调（P＜0.05）。结论：南葶苈子水提液具有改善压力后负荷性心衰大鼠心室重构的作用,其机制可能与激活PI3K/Akt/mTOR信号通路抑制心肌细胞凋亡有关。     

DEN诱发大鼠肝癌过程中脾脏巨噬细胞变化的研究

目的 探讨在二乙基亚硝胺（DEN）诱发大鼠肝癌过程中大鼠脾脏巨噬细胞（MΦ）结构与功能的变化。方法 SD大鼠50只随机分为正常对照组10只和实验组40只。实验组按DEN腹腔注射加慢性间断自由饮用DEN水溶液的方法制备肝癌肺转移模型,分别在造模的第8、13、16周随机处死大鼠,根据病理结果依次归为为肝硬化组（10只）、肝癌未转移组（10只）、肝癌转移组（10只）。应用透射电镜观察各组大鼠脾脏MΦ超微结构。贴壁法分离纯化MΦ,应用Vybant Phagocytosis Assay试剂盒、MTT法、Rat TNF-αElispot试剂盒、DQTM ovalbuin试剂盒检测脾脏巨噬细胞吞噬、代谢、分泌及抗原呈递功能。结果 MΦ超微结构：肝硬化组和肝癌未转移组MΦ较正常组MΦ表面突起增多,细胞器增多;肝癌转移组MΦ表面突起减少,细胞器较少。MΦ吞噬指数：与正常对照组（75.6±1.7）相比,肝硬化组（84.7±1.9）升高（P＜0.05）;肝癌未转移组（89.5±3.1）显著升高（P＜0.01）;肝癌转移组（36.0±2.6）显著降低（P＜0.01）。MΦ代谢率：与正常对照组（1.41±0.07）相比,肝硬化组和肝癌未转移组代谢率（分别为1.55±0.08,1.60±0.212）增高（P＜0.05）,肝癌转移组（1.25±0.12）代谢率降低（P＜0.05）。TNF-α分泌值：与正常对照组（626.6±24.6）相比,肝硬化组和肝癌未转移组（分别为741±52.9, 1126.2±174.5）升高（P＜0.05）,肝癌未转移组增高更为显著（P＜0.01）,肝癌转移组（313.8±50.8）显著降低（P＜0.01）。抗原呈递阳性细胞比率（%）：与正常组（16.45±1.86）相比,肝硬化组和肝癌未转移组（分别为24.03±1.87、27.95±2.63）显著升高（P＜0.01）;肝癌转移组（10.46±2.16）显著降低（P＜0.01）。结论　在肝硬化及肝癌早期,脾脏MΦ吞噬、代谢、分泌、抗原呈递功能普遍增强;在肝癌晚期,脾脏MΦ吞噬、代谢、分泌、抗原呈递功能普遍减弱。这一结果弥补了脾脏抗肿瘤作用资料的不足,进一步支持脾脏抗肿瘤作用呈双向性和时相性的观点。     

加味四逆散对肝硬化患者肝功能及肠黏膜屏障功能的保护作用

目的 探讨加味四逆散对肝硬化患者肝功能及肠黏膜屏障功能的保护作用.方法 选择72例肝硬化患者,采用随机数字表法将患者均分为观察组和对照组.两组患者予以保肝、利尿和对症等西医常规治疗.观察组患者在西医常规治疗基础上加用加味四逆散.对照组除不使用加味四逆散外余治疗同观察组,疗程均为8周.观察两组患者治疗前后肝功能及血清内毒素、降钙素原（PCT）和D-乳酸水平的变化.结果 治疗8周后,两组患者ALT、AST和TB水平均有明显下降（P ＜0.05或P＜0.01）,且观察组患者的下降值较对照组更明显（P＜0.05）;同时两组患者的血清内毒素、PCT和D-乳酸水平均有明显下降（P ＜0.05或P＜0.01）,且观察组患者的下降值较对照组更明显（P＜0.05）.结论 对肝硬化患者在西医常规治疗基础上予以加味四逆散具有保护肠黏膜上皮细胞、降低肠黏膜的通透性、改善肠黏膜屏障功能和改善患者肝功能的作用,对肝硬化具有良好的辅助治疗作用.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

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…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.     

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.     

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.