葡萄籽原花青素对小鼠脂肪肝模型缺血再灌注造成的急性肝损伤的保护作用

目的 探讨葡萄籽原花青素对脂肪肝缺血再灌注(IR)损伤小鼠模型的保护作用。方法 将30只C57BL/6小鼠随机分为3组。喂食蛋氨酸胆碱缺乏高脂饲料3周后进行非酒精性脂肪肝造模,实验分3组:假手术组、对照组(肝脏缺血再灌注前灌服蒸馏水)、花青素缺血再灌注组(肝脏缺血再灌注前灌服原花青素)。再灌注6 h后处死小鼠,检测血清中丙氨酸转氨酶(AST)和天冬氨酸转氨酶(ALT)含量,观察肝脏组织形态学变化,分析肝脏组织损伤程度,巨噬细胞浸润程度,炎性因子TNF-α、IL-6、iNOS、INFγmRNA表达水平和肝脏组织内p38蛋白表达水平。结果 与对照组相比较,花青素组血清ALT和AST水平较低(P<0.05),巨噬细胞浸润和凋亡细胞明显减少,炎性因子mRNA的表达明显降低。蛋白水平p38基本无变化,磷酸化的p38表达显著升高。结论 花青素能够减轻脂肪肝小鼠肝脏IR损伤,其机制可能与抑制肝脏再灌注后氧化应激反应和炎症反应,促进p-p38的表达升高有关。     

PPARγ激动剂15d-PGJ2对大鼠肝缺血再灌注损伤中细胞凋亡的影响

目的 探讨过氧化物酶体增殖物激活受体γ(PPARγ)激动剂15d-PGJ2对大鼠肝脏缺血再灌注损伤中细胞凋亡的作用及可能的机制.方法 建立70%的大鼠肝脏缺血再灌注损伤模型,40只SD大鼠随机均分为4组:假手术组(SO组)、缺血再灌注损伤组(IK组)、15-脱氧前列腺素J2预处理组(15 d-PGJ2组),15d-PGJ2+GW9662预处理组(15 d-PGJ2+GW9662组).再灌注后,取静脉血栓测肝血清酶(ALT、AST)水平,取肝脏组织TUNEL法检测缺血肝脏细胞凋亡指数(apoptotic index,AI),免疫组化检测Bcl-2、Bax、Caspase-3表达.结果 与SO组相比,其他3组血清ALT和AST水平、肝脏细胞AI、Bax、Bcl-2及Caspase-3均升高(P＜0.05).与IR组相比,15d-PGJ2组血清ALT和AST水平、肝脏细胞AI、Bax及Caspase-3表达降低,Bcl-2表达升高(P＜0.05);而15d-PGJ2+GW9662组与缺血再灌注组相比差异无显著性(P＞0.05).与15d-PGJ2组相比,15d-PGJ2+GW9662组血清ALT和AST水平、肝脏细胞AI、Bax及Caspase-3表达增加,Bcl-2表达减少(P＜0.05).结论 PPARγ激动剂15d-PGJ2对肝脏缺血再灌注损伤有保护作用,其机制可能是通过PPAR γ激活上调Bcl-2、下调Bax的表达和抑制Caspase-3活性实现的.     

异氟醚预处理通过降低肝脏caspase-1/caspase-11的表达减轻肝脏缺血再灌注损伤

目的:通过研究异氟醚预处理对肝脏缺血再灌注损伤小鼠肝脏中caspase-1/caspase-11表达的影响,探究异氟醚预处理对肝脏缺血再灌注损伤保护作用的机制。方法:建立肝脏缺血再灌注损伤模型。将30只雄性C57BL/6小鼠随机分成对照组、异氟醚预处理组和手术组。异氟醚预处理组小鼠吸入1.4%异氟醚30min后,间隔30min进行手术。对组织HE染色切片进行观察及病理评分,检测小鼠血清中ALT/AST水平用以评估异氟醚预处理对肝脏缺血再灌注损伤的保护作用。用Western Blot检测肝脏组织中caspase-1/caspase-11的表达。结果:(1)肝脏组织切片HE染色:对3组小鼠肝脏HE染色切片进行Suzuki’s病理评分,得出手术组评分较对照组明显增高(P<0.05),异氟醚预处理组较手术组明显降低(P<0.05);(2)血清ALT/AST:手术组血清中ALT/AST均较对照组明显增高(P<0.05),异氟醚预处理组较手术组明显降低(P<0.05);(3)Western Blot:手术组小鼠肝脏中caspase-1/caspase-11的表达均显著高于对照组,而异氟醚预处理后caspase-1/caspase-11的表达均较手术组显著降低。结论:异氟醚预处理对肝脏缺血再灌注损伤有保护作用,其机制可能与抑制肝脏caspase-1/caspase-11的表达,从而抑制肝脏与细胞焦亡相关的炎症反应有关。     

异氟烷对大鼠肝脏缺血再灌注损伤时细胞间黏附分子-1表达的影响

目的研究异氟烷对大鼠肝脏缺血再灌注损伤后细胞间黏附分子-1（ICAM-1）的影响，探讨异氟烷肝脏缺血再灌注保护作用的机制。方法将32只SD成年雌性大鼠分为假手术组、缺血再灌注组、异氟烷组、异氟烷．缺血再灌注组。假手术组、异氟烷组作为对照；缺血再灌注组和异氟烷-缺血再灌注组阻断支配大鼠肝脏左叶和中叶的门静脉分支，建立肝脏70％缺血再灌注模型，缺血60min再灌注3h后取材，测定大鼠血清ALT、AST；免疫组织化学方法检测ICAM-1蛋白的表达，HE染色进行病理学检查。结果肝脏缺血60min再灌注3h后肝组织ICAM-1蛋白表达水平增高；血清酶ALT和AST升高；肝组织损害严重。异氟烷抑制ICAM-1表达，降低ALT、AST水平，减轻肝细胞损伤。结论肝脏缺血再灌注损伤程度与肝组织内ICAM-1水平有密切的关系，异氟烷可抑制肝脏缺血再灌注期间肝组织ICAM-1的表达，同时减轻伤肝脏损伤。     

肝脏缺血激活PI3K/p⁃Akt2信号通路并促进库普弗细胞向M1型巨噬细胞转化

目的：研究肝脏库普弗细胞（Kupffer cells,KCs）在肝脏缺血及再灌注过程中的转化转归及其在肝脏缺血再灌注损伤中的作用。方法：制作小鼠肝脏不同缺血时间的模型,用流式细胞术分析缺血后KCs数量,体外培养中用实时荧光定量PCR（qPCR）技术分析炎性细胞因子的表达及巨噬细胞表面标记物的表达水平,免疫印迹（Western blot）技术分析磷脂酰肌醇3?激酶/磷酸化蛋白激酶B?2（PI3K/p?Akt2）信号通路的表达情况。使用qPCR技术分析Akt2抑制剂对KCs炎性细胞因子的表达及其表面标记物表达的影响,另外小鼠肝脏缺血后再灌注6 h,通过肝脏切片HE染色及血清丙氨酸氨基转移酶（alanine aminotransferase,ALT）水平等指标分析肝脏损伤情况。结果：肝脏缺血后KCs数量减少,而存活细胞在体外培养中,脂多糖（lipopolysaccharide,LPS）刺激后促炎性细胞因子的表达明显高于对照组（P < 0.05）,且M1型巨噬细胞的表面标记物诱导型一氧化氮合酶（iNOS）表达水平也高于对照组（P < 0.05）,其细胞内的PI3K/p?Akt2通路被激活,促进KCs向M1型巨噬细胞转化,而Akt2抑制剂可阻断细胞转化过程,减轻肝脏缺血再灌注损伤。结论：小鼠肝脏缺血能激活KCs内PI3K/p?Akt2信号通路,从而在炎性刺激下促进其向M1型巨噬细胞转化,并加重肝脏缺血再灌注损伤。     

缺血后处理对大鼠肝脏一氧化氮合酶表达的影响及意义

目的:探讨缺血后处理(ischemic postconditioning,IPO)对大鼠肝脏一氧化氮合酶(nitric oxide sythase,NOS)表达的影响及意义。方法:建立70%大鼠肝脏缺血再灌注模型,将32只雄性SD大鼠随机分为3组:假手术组(SO组,n=8)、缺血再灌注组(IR组,n=12)、缺血后处理组(IPO组,n=12),IPO组于再灌注恢复血流前,给予多次短暂复灌复停处理。再灌注3h后,比较各组血清谷丙转氨酶(ALT)、谷草转氨酶(AST)变化,硝酸还原酶法测定一氧化氮(NO)含量,逆转录-聚合酶链反应法(RT-PCR)检测肝脏组织内皮型NOS(eNOS)mRNA、诱导型NOS(iNOS)mRNA表达,蛋白免疫印迹法(Western blot)检测肝脏组织eNOS、iNOS蛋白表达,光镜观察组织病理学改变。结果:与SO组相比,其余两组血清ALT、AST、NO含量均明显升高(P<0.01),组织eNOS、iNOS表达均明显增强。与IR组相比,IPO组ALT、AST明显降低(P<0.01),NO明显升高(P<0.01),eNOS、iNOS表达增强。光镜下,IR组、IPO组呈现典型缺血再灌注...     

活化蛋白C对大鼠脂肪肝缺血再灌注损伤的影响

目的 探讨大鼠脂肪肝缺血再灌注损伤过程中炎症变化情况以及活化蛋白C (APC)对大鼠脂肪肝缺血再灌注损伤的影响.方法 清洁级健康雄性Wistar大鼠60只,制备成脂肪肝模型后,随机分为假手术组、对照组和APC组.APC组和对照组行部分肝缺血50 min,各组于再灌注6 h和24 h两个时间点,分别对10只大鼠取材,观察各组ALT、AST、TNF-α、肝组织MPO含量、肝组织ICAM-1免疫组化染色和肝脏组织病理学改变等指标.结果 APC组与对照组的ALT、AST、TNF-α、MPO和ICAM-1表达在各个时间点上均明显高于假手术组.再灌注6 h后与对照组比较,APC组ALT、AST、TNF-α水平和MPO含量明显降低,ICAM-1的表达明显减弱.光镜下观察肝形态学变化,对照组损伤甚为明显,APC组和假手术组损伤程度较对照组轻,假手术组更轻.再灌注24 h后,与对照组比较,APC组TNF-α水平明显降低,APC组与对照组其余各项指标间差异无统计学意义.结论 APC通过抗炎和减少内皮细胞损伤,对大鼠脂肪肝缺血再灌注损伤起保护作用.     

PPARγ激动剂罗格列酮在大鼠肝缺血再灌注损伤中的作用及机制探讨

目的:探讨过氧化物酶体增殖物激活受体γ(PPARγ)激动剂罗格列酮在大鼠肝脏缺血再灌注损伤中的作用及机制.方法:建立70%的大鼠肝脏缺血再灌注损伤模型,SD大鼠随机分为6组,对照组(control,C),假手术组(sham,S),缺血再灌注损伤(ischemia-reperfusion,IR)组,罗格列酮(rosiglitazone,Ros)预处理组,GW9662预处理组,以及Ros GW9662预处理组.再灌注后,取静脉血检测肝血清酶(ALT、AST)水平,取肝脏组织TUNEL法检测缺血肝脏细胞凋亡指数(apoptotic index,AI),免疫组化检测Bcl-2,Bax,Caspase-3表达.结果:IR组和Ros组与假手术组相比肝脏细胞凋亡指数、Bax、Bcl-2及Caspase-3均升高.Ros处理组与IR组相比肝脏细胞凋亡指数、Bax及Caspase-3表达降低,Bcl-2表达升高,GW9662能阻断Ros的保护作用.单独应用GW9662时肝脏细胞凋亡指数、Caspase-3以及Bax表达比IR组升高,而Bcl-2降低.结论:PPARγ激动剂罗格列酮对肝脏缺血再灌注损伤有保护作用,它可能是通过上调Bcl-2表达,下调Bax和Caspase-3表达,抑制肝脏细胞凋亡而起作用的.     

JAK2/STAT3信号通路在白藜芦醇抗肝脏缺血再灌注损伤中的作用及机制研究

目的：：探讨JAK2/STAT3信号通路在白藜芦醇抗肝脏缺血再灌注损伤中的作用及机制。方法：健康雄性SD大鼠40只随机分为4组,假手术对照(SC)组、肝脏缺血再灌注(HIR)组、白藜芦醇处理(Res+HIR)组、JAK2/STAT3通路阻断剂AG490(Res+AG490+HIR)组。建立急性肝脏缺血再灌注损伤模型,于再灌注6h后收集动物血液和肝脏标本。检测血清谷丙转氨酶(ALT)、谷草转氨酶(AST)和碱性磷酸酶(AKP)及炎症因子IL-6、TNF-α、IL-10、TGF-β的变化。肝脏组织HE染色,光镜下观察肝组织形态学变化。结果：与HIR组相比,Res+HIR组大鼠肝组织病理学变化明显改善,血清中反映肝脏功能学的指标ALT、AST及AKP的浓度明显降低,同时血清中抗炎因子IL-10和TGF-β含量升高,而促炎因子IL-6和TNF-α含量降低;使用JAK2/STAT3通路阻断剂AG490后,肝组织病理学改变明显,ALT、AST及AKP的浓度明显升高,IL-10和TGF-β含量降低,而IL-6和TNF-α含量明显升高。结论：白藜芦醇对肝脏缺血再灌注损伤的保护作用可能是通过激活JAK2/STAT3信号通路,改变再灌注过程中炎性反应实现的。     

HSP 72 mRNA的表达在肝脏热缺血-再灌注损伤中的意义

目的研究大鼠肝脏热缺血—再灌注中热休克蛋白(HSP 72)mRNA表达的意义。方法40只SD大鼠随机分成亚砷酸钠组(SA组)和对照组(NS组)。前者预先外周静脉给予SA每千克体质量6 mg,后者给予生理盐水。24 h后阻断肝脏中、左叶血供90 m in,再灌注3、6 h,分别采用RT-PCR、W estern b lot方法检测肝脏中HSP 72 mRNA和HSP 72的表达;外周血测定血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和乳酸脱氢酶(LDH);观察7 d存活率。结果肝脏热缺血90 m in再灌注3、6 h后,SA组和对照组均有强HSP 72 mRNA表达;SA组有强HSP 72表达,对照组则弱表达;对照组血清ALT、AST、LDH显著高于SA组(P<0.01);SA组7 d生存率显著高于对照组(P<0.05)。结论肝脏热缺血—再灌注可诱导肝脏产生热休克反应,HSP72 mRNA的表达反映了肝脏的损伤程度;预先诱导肝脏产生热休克反应,HSP 72 mRNA的表达则反映了肝脏提前出现应激反应,HSP 72的产生直接对肝脏热缺血—再灌注损伤提供细胞保护作用。     

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…