阿托伐他汀对高脂大鼠血小板功能的干预研究

目的：分析高脂血症大鼠血小板功能的变化,探讨阿托伐他汀对高脂血症大鼠血小板功能的影响。方法：34只Wistar大鼠随机分为正常对照组、高脂血症模型组和阿托伐他汀（10mg/kg）干预组,4周后检测3组大鼠的血脂：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。应用流式细胞术检测血小板表面α-颗粒膜蛋白（CD62P）的表达、酶联免疫法测定血浆中α颗粒膜蛋白-140（GMP-140）浓度。结果：与正常对照组相比,高脂血症组CHO、LDL水平显著升高、HDL/CHO明显降低,CD62P及GMP140水平明显升高。阿托伐他汀干预组在降低CHO、LDL水平的同时,显著降低了GMP140及CD62P水平。结论：高脂血症能够促使血小板活化,阿托伐他汀在调脂治疗的同时,抑制了血小板的活化。     

高脂血症大鼠血小板活化功能分析

目的分析高脂血症大鼠血小板功能的变化。方法24只Wistar大鼠随机分为正常对照组、高脂血症模型组，4周后检测两组大鼠的血脂：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）水平。应用流式细胞术检测血小板表面a-颗粒膜糖蛋白（CD62P）的表达、酶联免疫法测定血浆中α颗粒膜蛋白．140（GMP140）浓度。所有数据采用Excel软件建库，SPSS11．5统计软件进行分析。结果正常对照组与高脂血症组CHO、TG、LDL-C、HDL-C，CHO分别是1．846mmol／L VS 13．779mmol／L、0．999mmol／L vs 0．746mmol／L、0．164mmol／L vs 10．680mmol／L、0．583mmol／L vs 0．195mmol／L。CD62P、GMP140水平分别为10．089％ vs 25．169％、10．665ng/mL vs 27．045．g／mL。结论高脂血症能够促使血小板活化。     

阿托伐他汀对高脂血症患者血小板CD62p的影响

目的 :探讨阿托伐他汀对高脂血症患者血小板活化功能的影响。方法 :测定 3 0例高胆固醇血症和混合性高脂血症患者 (治疗组 )降脂治疗前和治疗 (阿托伐他汀 2 0mg/d) 4周、8周后及 3 0例健康者 (对照组 )的总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及血小板表面激活标记物CD62p。结果 :治疗组患者CD62p较对照组明显增高 (P <0 .0 1) ,阿托伐他汀治疗 4周、8周后CD62p较治疗前明显下降 (P<0 .0 1)。结论 :阿托伐他汀治疗高胆固醇血症患者 ,在降脂的同时 ,可抑制血小板活性     

瑞舒伐他汀与阿托伐他汀对不稳定型心绞痛患者内皮功能和GMP140的影响

目的 观察瑞舒伐他汀与阿托伐他汀治疗对不稳定型心绞痛患者内皮功能和血小板活化的影响.方法 入选不稳定型心绞痛患者67例,分为瑞舒伐他汀组(34例)和阿托伐他汀组(33例).两组患者均常规使用抗心肌缺血和抗凝、抗血小板药物治疗,瑞舒伐他汀组加用瑞舒伐他汀钙10 mg/晚;阿托伐他汀组加用阿托伐他汀20 mg/晚,均连续服用1个月.另入选健康成人30例作为对照组.用酶联免疫吸附法(ELISA)检测治疗前后血清GMP140和采用超声检测肱动脉血流介导的内皮舒张功能(FMD)的变化.结果 与对照组相比,两组不稳定型心绞痛患者血清中GMP140水平均显著增高,FMD明显降低(P＜0.01).经治疗1个月后,两组不稳定型心绞痛患者低密度脂蛋白和GMP140显著下降,FMD明显改善.同阿托伐他汀组患者相比,瑞舒伐他汀组GMP140降低更明显[(7.73±4.62)vs(5.62±3.26) pg/mL,P ＜0.05].结论 瑞舒伐他汀和阿托伐他汀均可降低不稳定型心绞痛患者血小板的活化,改善肱动脉内皮功能,但瑞舒伐他汀降低血小板活化更显著.     

阿托伐他汀对改善陈旧心肌梗死患者血管内皮功能的研究

目的研究阿托伐他汀对陈旧性心肌梗死(OMI)患者血管内皮的作用。方法将60例OMI患者随机分为安慰剂(C)组和阿托伐他汀(P)组,分别测定血总胆固醇(TC)、三酰甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血管内皮素(ET)及一氧化氮(NO)浓度的变化,比较血小板表面α颗粒膜蛋白(GMP-140)的表达及内皮依赖性扩张百分率(FMD%),和非内皮依赖性百分率(GTN%)。结果P组阿托伐他汀治疗6周后,TC含量较治疗前下降29%,LDH-C下降35%,HDL-C升高3%,但甘油三酯(TG)水平无明显变化,内皮功能得到了明显的改善,GMP-140表达受到抑制,而这种表达抑制与血胆固醇水平的改变无关。结论阿托伐他汀可以通过调脂及抑制血小板的活性参与血管内皮功能的改善,老年急性心肌梗死(AMI)患者服用阿托伐他汀可能通过改善内皮功能达而到降低心脑血管事件发生率的目的。     

阿托伐他汀联合非诺贝特治疗混合性高脂血症大鼠的疗效及其安全性

目的 探讨阿托伐他汀与非诺贝特联合应用治疗混合性高脂血症大鼠的疗效及安全性.方法 将大鼠随机分为N组(正常对照组)、C组(高脂对照组)、A组[阿托伐他汀1.8 mg/(kg·d)]、AFF组[阿托伐他汀0.9 mg/(kg·d)+非诺贝特18 mg/(kg·d),早晚分开灌胃]、AFHX组[阿托伐他汀0.9 mg/(kg·d)+非诺贝特9 mg/(kg·d)]及AFHD组[阿托伐他汀0.9 mg/(kg·d)+非诺贝特18 mg/(kg·d)],造模4周,用药4周.分别检测血脂、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、肌酸激酶(CK)及肝脏病理学检查.结果 ①各用药组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)及脂蛋白(a)均降低(P＜0.01),而联合用药组更加有效的升高高密度脂蛋白胆固醇(HDL-C)水平(P＜0.01)和降低TG水平(P＜0.01);②各用药组CK水平升高(P＜0.05),但以AFHD组升高的最为显著;③各用药组ALT和AST的水平均升高(P＜0.01),以AFHD组较为显著,AFHX组次之(P＜0.05),但仍较C组降低(P＜0.05);④AFHD组和AFF组可以更加有效的控制肝指数、肝脏脂肪变性和炎症活动度评分(P＜0.05).结论 阿托伐他汀与非诺贝特联合可增强全面调脂疗效、控制肝脏脂肪变性和非酒精性脂肪性肝炎的发生;二者联合应用时采用合适剂量,并早晚分开给药,可以减少药物性肝损害和骨骼肌损害的发生.     

阿托伐他汀对高脂蛋白血症患者血小板活性因子的影响

目的 探讨阿托伐他汀对高脂蛋白血症患者血小板活性CD63、CD62P表达和动脉粥样硬化的影响及机制. 方法 测定60例高脂蛋白血症在常规治疗基础上,服用阿托伐他汀20 mg,治疗12周前后血小板活性CD63、CD62P水平的变化. 结果 60例患者经阿托伐他汀治疗12周后血小板CD63、CD62P测定值显著低于治疗前水平(P＜0.05). 结论 阿托伐他汀通过抗血小板活化、抗炎等机制对防治动脉粥样硬化及稳定斑块起着重要的作用.     

阿托伐他汀 瑞舒伐他汀治疗冠心病伴高脂血症临床疗效分析

目的比较阿托伐他汀、瑞舒伐他汀在治疗冠心病伴高脂血症方面的临床疗效。方法选择2009年8月—2010年10月在我院心内科住院的150例冠心病伴高脂血症患者,随机分为观察组(瑞舒伐他汀组)和对照组(阿托伐他汀组)2组,比较2组患者治疗前后总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TC)的变化。结果观察组患者TC、TG、LDL-C下降幅度比对照组更大,观察组HDL-C升高幅度较对照组大,2组比较差异显著(P<0.01)。结论阿托伐他汀、瑞舒伐他汀治疗冠心病伴高脂血症,同等剂量下,瑞舒伐他汀的调脂作用比阿托伐他汀更明显。     

阿托伐他汀改善高LDL-C相关血小板活化异常的临床研究

 目的  探讨口服阿托伐他汀对高LDL-C血症相关的血小板异常活化功能的改善作用,阐明他汀类药物降低临床事件的新机制。方法  从2012年11月至2013年7月于华山医院门诊就诊人群中,纳入LDL-C≥4.14 mmol/L同时三酰甘油(triglycerides,TG) <1.7 mmol/L且未经调脂治疗和抗血小板治疗者作为研究对象,作为阿托伐他汀治疗组(AT组),从体检中心招募健康志愿者作为对照组。测定血小板最大聚集率(maximal platelet aggregation,MPAG),全血流式细胞检测法测定血小板活化标志物CD62p (P-选择素)和PAC-1 (GpⅡbⅢa)水平。对患者予以标准他汀治疗(阿托伐他汀20 mg/天),并于治疗后1个月、2个月随访检测以上指标。结果  AT组共纳入40例,其中33例完成研究;对照组纳入并完成35例。两组人群基线资料(年龄、性别、BMI、吸烟史、血压、冠心病家族史、血糖)无明显差异;AT组患者服用阿托伐他汀治疗后,TC、TG、LDL-C均明显下降(P<0.05);基线时AT组血小板最大聚集率与对照组相似(33.03%±15.87% vs.29.05%±17.75%,P=0.102),采用他汀治疗2个月后,AT组患者血小板最大聚集率较基线显著下降但差异无统计学意义(P=0.073)。治疗前AT组CD62p和PAC-1均高于对照组(1.72±0.96 vs.0.90±0.77,P<0.001;4.33±2.42 vs.2.63±2.03,P<0.01);阿托伐他汀治疗2个月后,CD62p和PAC-1分别为0.85±0.72和1.50±1.07,与治疗前比较,两者表达均明显下降(P<0.05)。结论  临床上阿托伐他汀可以改善高LDL-C相关的血小板活化。     

阿托伐他汀对老年冠心病患者血小板α颗粒膜蛋白GMP-140的影响

目的探讨阿托伐他汀对老年冠心病患者血小板α颗粒膜蛋白（GMP-140）的影响。方法80例老年冠心病患者服用阿托伐他汀8周。测定冠心病患者和正常对照者的GMP-140含量并比较冠心病患者服用阿托伐他汀前后总胆固醇、甘油三脂、低密度脂蛋白、血小板α颗粒膜蛋白（GMP-140）的变化。结果发现冠心病患者治疗后总胆固醇、低密度脂蛋白、GMP-140浓度均明显降低，高密度脂蛋白浓度增高。结论阿托伐他汀治疗老年冠心病患者能有效地降低胆固醇。抑制血小板活性。     

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…