利拉鲁肽对脊髓损伤修复作用的探讨

目的探讨利拉鲁肽对大鼠脊髓损伤(SCI)神经的修复作用及机制。方法将雌性大鼠分为利拉鲁肽干预组、正常对照组,每组24只。采用大鼠脊髓动脉瘤夹夹伤法建立大鼠脊髓损伤模型。术后分别给予利拉鲁肽(0.12 mg/kg,0.5 m L)、生理盐水(0.5 m L)。术后2 d应用细胞凋亡技术检测神经细胞损伤程度,术后3 d采用Western blotting蛋白印迹技术检测损伤脊髓组织中白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)表达水平,术后14 d对损伤脊髓组织行HE染色观察组织形态变化并计算损伤空洞面积,术后3 d至28 d定期记录大鼠后肢行为学BBB评分。结果 SCI后利拉鲁肽干预组细胞凋亡、炎性因子表达、空洞面积计算均较正常对照组降低(P<0.05),利拉鲁肽干预组双后肢BBB评分同期较正常对照组高(P<0.05)。结论脊髓损伤后给予利拉鲁肽可降低细胞凋亡及急性炎症反应,有利于后期神经组织修复以及运动功能恢复。     

脊髓损伤大鼠细胞凋亡、自噬程度的评估及阿魏酸的干预作用研究

目的:研究脊髓损伤大鼠细胞凋亡、自噬程度的评估及阿魏酸的干预作用。方法:选择成年雄性SD大鼠并分为假手术组(Sham组)、脊髓损伤组(SCI组)、阿魏酸干预组(FA组),通过动脉夹夹持的方法建立脊髓损伤模型,给予100mg/kg的阿魏酸灌胃、2次/日干预。干预后7、14d时,测定脊髓组织中凋亡分子、凋亡抑制分子、细胞自噬分子的表达量。结果:SCI组大鼠脊髓组织中PARP-1、AIF、ASK-1、mTOR、PI3K、Akt、Beclin1、LC3-Ⅱ的蛋白表达量显著高于Sham组,Survivin、NAIP、Bcl-2的蛋白表达量显著低于Sham组;FA组大鼠脊髓组织中PARP-1、AIF、ASK-1、mTOR、PI3K、Akt、Beclin1、LC3-Ⅱ的蛋白表达量显著低于SCI组,Survivin、NAIP、Bcl-2的蛋白表达量显著高于SCI组。结论:阿魏酸对脊髓损伤过程中的细胞凋亡、自噬具有抑制作用。     

脊伤颗粒对大鼠急性脊髓损伤后运动功能及Caspase-3表达的影响

目的 研究脊伤颗粒对大鼠脊髓损伤(spinal cord injury,SCI)后运动功能及半胱氨酸蛋白酶-3(Caspase-3)表达的影响.方法 随机抽取大鼠32只作为假手术组,其余118只大鼠采用改良Allen'S打击器制作大鼠SCI模型,将造模成功的96只大鼠随机分为模型组、甲基强的松龙组(下称甲强龙组)、脊伤颗粒组.分别给予假手术组、模型组生理盐水灌胃,甲强龙组尾静脉注射药物,脊伤颗粒组予以相应药物灌胃.在给药后1、3、7、14 d的4个不同时间点采用BBB行为学功能评分;再分批处死大鼠,取出SCI组织用HE染色观察其病理变化,用免疫组化染色检测Caspase-3表达阳性细胞,原位末端标记法(TUNEL法)标记凋亡细胞.结果 (1)BBB运动功能评分方面,与假手术组比较,模型组评分低(P＜0.01);与模型组比较,脊伤颗粒组、甲强龙组评分高(P＜0.05);与甲强龙组比较,SCI后1、3d,脊伤颗粒组评分偏低,(P＜0.05),SCI后7、14 d脊伤颗粒组评分偏高(P＜0.05).(2)在平均积分光密度值和细胞凋亡率方面,与假手术组比较,模型组数值偏高(P＜0.01);与模型组比较,甲强龙组、脊伤颗粒组平均数值低(P＜0.05);与甲强龙组比较,SCI后1、3d,脊伤颗粒组平均数值偏高(P＜0.05),SCI后7、14 d,脊伤颗粒组平均数值偏低(P＜0.05).结论 脊伤颗粒能部分恢复SCI后模型大鼠的运动功能并可明显抑制细胞Caspase-3表达和细胞凋亡.     

脊髓损伤对下丘脑c-Fos表达及神经细胞凋亡的影响

目的 探讨脊髓损伤后下丘脑神经细胞凋亡情况,确认脊髓损伤导致大脑损害的特点及其在相关并发症发生发展中的可能机制。方法 18 只SD 大鼠随机分为两组：假模组（Sham 组）和脊髓损伤组（SCI 组）,以改良的Allen’s 撞击法制作脊髓损伤动物模型,常规饲养,分别于8 周取大鼠下丘脑组织,应用免疫荧光染色法观察脊髓损伤大鼠下丘脑组织c-Fos 表达,TUNEL 法观察两组下丘脑神经细胞凋亡情况,应用ELISA 法检测两组大鼠下丘脑炎症因子（TNF-α、IL-1β、IL-6）表达。结果 脊髓损伤后8 周,SCI 组较Sham 组下丘脑c-Fos 表达明显增加（P＜0.05）,同时下丘脑可见明显凋亡细胞,主要表现为胞浆减少,细胞核深染、固缩在一边;SCI 组TUNEL 阳性细胞数比Sham 组明显增多,差异有统计学意义（P＜0.01）;SCI 组大鼠下丘脑包括TNF-α、IL-1β、IL-6 等多种炎症因子水平较Sham 组明显升高,差异有统计学意义（P＜0.01）。结论 脊髓损伤可对下丘脑造成损害,表现为下丘脑神经细胞凋亡及炎症反应明显增加,其可能与c-Fos 表达有关,脊髓损伤后对下丘脑的损害可能是某些并发症发生发展的发病机制。     

补阳还五汤对脊髓损伤大鼠脊髓组织 Caspase －3表达的影响

目的：观察补阳还五汤对脊髓损伤（SCI）后大鼠脊髓神经细胞凋亡相关蛋白 Caspase －3及 mRNA表达的影响,初步探讨补阳还五汤抑制脊髓神经细胞凋亡的作用机制。方法Wistar 大鼠40只,随机分为正常对照组、SCI 模型组、补阳还五汤组和阳性药物对照（MP）组,每组10只。各组分别于建立 SCI 模型后1、7、14、21、28 d 观察大鼠后肢运动功能恢复情况并进行 BBB 功能评分,观察大鼠 SCI 模型建立及恢复情况,并于第28天处死各组大鼠,采用 real －time PCR 法检测脊髓组织 Caspase －3 mRNA 的表达情况,Western blot 法检测脊髓组织 Caspase－3蛋白的表达情况。结果大鼠麻醉清醒后,SCI 模型组大鼠损伤平面以下完全瘫痪。 BBB 评分结果显示：术后第1～28天,与正常对照组比较,SCI 模型组 BBB 评分明显降低（P ＜0．05）;术后第7～28天,与 SCI 模型组比较,补阳还五汤组和 MP 组大鼠 BBB 评分明显增高（P ＜0．05）;补阳还五汤组和 MP 组大鼠 BBB 评分差异无统计学意义。 Real －time PCR 和 Western blot 结果显示：与正常对照组比较,SCI 模型组 Caspase －3蛋白及 mRNA 表达明显升高（P ＜0．05）;与 SCI 模型组比较,补阳还五汤组和 MP 组大鼠脊髓组织 Caspase －3蛋白及 mRNA 表达明显降低（P ＜0．05）。补阳还五汤组和 MP 组大鼠脊髓 Caspase －3蛋白及 mRNA 表达差异无统计学意义。结论补阳还五汤可改善 SCI 大鼠后肢运动功能,通过下调 Caspase －3的表达,从而抑制 SCI 大鼠脊髓神经细胞的凋亡,对脊髓神经细胞有保护作用。     

利拉鲁肽对匹罗卡品致痫大鼠海马各区神经元凋亡的影响

目的探讨利拉鲁肽对大鼠癫痫持续状态后海马各区神经元凋亡的影响。方法将雄性SD大鼠(n=54)随机分为空白对照组(n=6)、匹罗卡品模型组(SE组,n=24)、利拉鲁肽干预组(Liraglutide组,n=24);并根据发作终止后的时间点(12 h,1 d,3 d,7 d)将SE组和Liraglutide组各分为4个亚组(n=6)。采用免疫组化技术检测海马CA3和DG区BCL2和BAX蛋白的表达。结果与SE组相比,Liraglutide组在SE后12 h、1 d、3 d时CA3区BCL2表达水平升高(P0.05),而在SE后7 d时BCL2水平与SE组无差异(P0.05);在DG区,Liraglutide组在SE后1 d BCL2表达升高(P0.05),在SE后3 d时表达无差异(P0.05)。Liraglutide组相较SE组,在SE后12 h,DG区BAX表达开始明显降低(P0.01);在SE后1 d,CA3区BAX表达降低(P0.01);且在SE后3 d,Liraglutide组DG区和CA3区BAX表达都高于空白对照组(P0.05)。结论利拉鲁肽通过抑制癫痫持续状态后海马CA3区和DG区神经元凋亡发挥神经保护作用。     

褪黑素对大鼠慢性压迫脊髓损伤Caspase-3表达及细胞凋亡的影响

目的:探讨褪黑素(MT)对大鼠慢性压迫脊髓损伤半胱-天冬氨酸蛋白酶3(Caspase-3)表达和细胞凋亡的影响.方法:将70只大鼠建立慢性压迫损伤动物模型,随机分为MT治疗组(A 组)和含50 mL/L无水乙醇的生理盐水对照组(B 组),于损伤1,4,11,21,35,60和90 d取材,采用HE染色观察慢性压迫脊髓损伤脊髓组织病理变化,用免疫组化法染色检测Caspase-3表达阳性细胞,原位末端标记法(TUNEL法)标记凋亡细胞,并用改良的Tarlov评分法和斜板实验观察大鼠脊髓神经功能变化情况.结果:HE染色光镜下观察脊髓组织病理学改变A组明显轻于B组.A,B两组均发现Caspase-3表达及TUNEL标记阳性凋亡细胞,Caspase-3表达和神经细胞凋亡指数均B组＞A组(P＜0.05),与大鼠脊髓神经功能变化有平行的变化趋势.结论:MT能抑制大鼠慢性压迫脊髓损伤Caspase-3表达和神经细胞凋亡.     

维格列汀对大鼠脊髓损伤后神经细胞凋亡及运动功能恢复的影响

目的：探究维格列汀（Vilda）对大鼠脊髓损伤（SCI）后神经细胞凋亡及运动功能恢复的影响。方法：雌性SD大鼠随机分成3组（n=16）：Sham组、SCI组、SCI+Vilda组;采用血管夹压迫法建立大鼠SCI模型,成模后SCI+Vilda组按10 mg·kg-1·d-1的剂量灌胃给药,SCI组大鼠给予等量0.9%氯化钠溶液;在术后第1、第3、第7、第14、第21、第28天进行后肢运动功能恢复情况评估（BBB评分）;术后第3天提取脊髓组织进行组织免疫荧光染色检测Cleaved Caspase 3,提取组织蛋白进行Western blot检测Bcl-2、Bax、Cleaved Caspase 3蛋白的表达情况;术后第7天提取脊髓组织进行尼氏染色检测存活神经元;术后第28天,对各组大鼠进行足印迹步态分析。结果：与Sham组比较,SCI组BBB评分显著降低,步态不一致,脊髓前角运动神经元数量减少,免疫荧光显示Cleaved Caspase 3表达增强,Western blot显示Bax、Cleaved Caspase 3表达上升,Bcl-2表达下降（P＜0.05）;与SCI组比较,SCI+Vilda组BBB评分明显提升,步态一致性更好,脊髓前角运动神经元数量增加,Cleaved Caspase 3荧光表达减弱,Bax、Cleaved Caspase 3表达下降,Bcl-2表达上升（P＜0.05）。结论：Vilda可抑制SCI大鼠脊髓神经细胞的凋亡,从而促进大鼠SCI后运动功能的恢复。     

黄芪注射液对大鼠急性脊髓损伤的神经保护作用及机制研究

  目的  基于细胞凋亡Fas和TRAIL死亡受体信号通路探讨黄芪注射液对大鼠急性脊髓损伤(SCI)的神经保护作用及机制。  方法  40只健康的雄性SD大鼠随机分为假手术组,SCI模型组, 黄芪注射液低、中、高剂量(1、2、4 mL · kg-1)组, 每组8只。采用改良的重物打击法构建大鼠急性SCI模型; 按照BBB评分和Rivlin斜板实验评价大鼠运动功能; 苏木精-伊红(Hematoxylin-eosin, HE)染色检测脊髓组织病理变化; 尼氏染色法检测脊髓神经元细胞损伤程度; 高通量转录组测序分析差异表达基因; qPCR验证基因转录水平的表达量; 利用TUNEL试剂盒检测各组脊髓细胞凋亡情况; Western blot检测凋亡通路关键蛋白表达水平。  结果  BBB评分和斜板试验结果显示, 与假手术组比较, 模型组大鼠表现出明显的运动功能障碍; HE染色显示模型组脊髓组织病理病变严重; 模型组尼氏染色着色较浅, 神经元细胞损伤严重; 与假手术组比较, 模型组脊髓中4 597个基因差异表达, Fas、TRAIL、Caspase-3、Caspase-8、Caspase-9和Bax蛋白表达显著上调(P < 0.01), Fas凋亡抑制分子FAIM和抗凋亡因子Bcl-2的蛋白表达量显著降低(P < 0.01)。与模型组比较, 黄芪注射液组的BBB评分、Rivlin斜板度数显著升高(P < 0.05, P < 0.01), 组织病变程度较小, 尼氏染色着色程度随剂量升高而变深, 黄芪注射液高剂量组脊髓神经细胞损伤和凋亡得到显著缓解(P < 0.01)。转录组测序和qPCR结果显示: 与模型组比较, 黄芪注射液中、高剂量组中参与细胞凋亡调控的FAIM和TRAIL mRNA差异表达(P < 0.01), 黄芪注射液高剂量组Fas、TRAIL、Caspase-3、Caspase-8、Caspase-9和Bax蛋白表达被剂量依赖性地抑制(P < 0.05,P < 0.01), FAIM和Bcl-2的蛋白表达上调(P < 0.01)。  结论  黄芪注射液可能通过对死亡受体途径Fas和TRAIL蛋白的抑制, 进而调控神经元细胞的程序性凋亡, 发挥对SCI的神经保护作用, 改善脊髓组织损伤病变程度, 加速后期神经运动功能障碍的恢复。      

丁咯地尔对大鼠坐骨神经损伤后背根神经元凋亡及Caspase-3、Bcl-2表达的影响

目的:研究丁咯地尔对大鼠坐骨神经损伤后背根神经元凋亡及天冬氨酸特异性半胱氨酸蛋白酶3(Caspase-3)、Bcl-2表达的影响.方法:将48只成年健康SD大鼠随机分为正常组、模型组、丁咯地尔组,预处理14 d后制作坐骨神经损伤动物模型,分别在模型制备后12,24,72 h与7 d各组提取L1～5背根神经节,用原位末端脱氧核糖核酸转移酶介导的脱氧尿苷三磷酸标记法(TUNEL法)检测神经细胞的凋亡水平和用免疫组化方法计数Caspase-3、Bcl-2阳性细胞表达数,并加以组间比较.结果:正常组大鼠背根神经细胞凋亡和Caspase-3阳性细胞较少;而模型组在坐骨神经损伤后12 h,神经细胞凋亡及Caspase-3阳性表达数明显增多,72 h达高峰,7 d表达减弱;丁咯地尔组在坐骨神经损伤后12 h,神经细胞凋亡及Caspase-3阳性表达数也增多,但较模型组减少(P＜0.05),24 h至7 d均较同期模型组明显减少(P＜0.01);丁咯地尔组于模型制备后12 h Bcl-2即有明显表达,72 h达高峰,7 d时与模型组比较仍有明显差异(P＜0.05).结论:坐骨神经损伤后背根神经元存在广泛的细胞凋亡现象,丁咯地尔通过抑制Caspase-3蛋白表达,上调Bcl-2表达,从而抑制细胞凋亡来发挥其神经保护作用.     

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.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

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.