复发性实验性自身免疫性葡萄膜炎小鼠模型的诱导及其特点

目的 诱导复发性实验性自身免疫性葡萄膜炎(experimental autoimmune uveoretinitis,EAU)小鼠模型,评价其发生过程及特点.方法 完全弗氏佐剂(CFA)乳化的光感受器间维生素A类结合蛋白(IRBP) 161-180肽段免疫B10.RⅢ小鼠作为诱导组(35只),用CFA-PBS免疫小鼠作为对照组(6只).小鼠免疫后7、14、21、28、35 d裂隙灯显微镜和光学显微镜观察及评价眼部炎症发生、眼部表现和病理学变化;待炎症完全消失时,再次免疫小鼠,评价小鼠眼部炎症复发.结果 诱导组首次免疫后7d出现初发炎症,14 d炎症达高峰,随后炎症消退,至35 d完全消失.第35天进行再次免疫,36 d出现复发炎症,42 d达炎症高峰,随后炎症消退,但至观察期第96天部分鼠(1/5)仍维持炎症.眼部表现为睫状充血、前房渗出、瞳孔受损.病理学表现为视网膜和脉络膜炎性细胞浸润,血管炎、肉芽肿性炎,光感受器细胞层破坏,视网膜下渗出.对照组未见明显炎症.结论 建立的EAU呈现慢性复发性病程,其眼部表现和病理学特征与人类葡萄膜炎相似,可作为葡萄膜炎研究的新型动物模型.     

获得性自身免疫性重症肌无力患者胸腺组织Bcl—2和Fas表达水平的研究

为探讨胸腺组织中凋亡相关基因Bcl-2和Fas表达水平与获得性自身免疫性重症肌无力的关系,将31例重症肌无力患者的胸腺标本作为观察组,25例先天性心脏病患者的胸腺标本作为正常对照组,以免疫组化法检测胸腺组织中Bcl-2及Fas基因的蛋白表达水平。结果观察组Bcl-2表达明显高于对照组(P<0.01)而Fas表达却与对照组无明显差异(P>0.05),观察组Bcl-2与Fas表达水平无相关性。因此,胸腺组织中存在的细胞凋亡异常可能是获得性自身免疫性重症肌无力发生的重要机制之一,凋亡相关基因Bcl-2和Fas的作用可能是相互独立的。     

大鼠肝脏癌前病变肝细胞凋亡及Fas/FasL的表达

目的探讨肝脏癌前病变过程中肝细胞凋亡的变化及Fas和FasL的表达,以期为肝脏疾病防治提供实验依据。方法将大鼠随机分为对照组和模型组,模型组采用腹腔注射二乙基亚硝胺(DEN)制备大鼠肝脏癌前病变模型,生化检查血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)、α-L-岩藻糖苷酶(AFU)、甲胎蛋白(AFP)和癌胚抗原(CEA)。光镜下观察肝脏组织病理学改变;使用DNA电泳法检测肝细胞的凋亡情况;应用免疫组织化学法检测Fas和FasL的表达与分布。结果对照组大鼠光镜下肝组织结构正常,模型组大鼠肝细胞肿胀,肝小叶内可见灶性坏死伴炎性细胞浸润,同时逐渐出现纤维组织增生及肝细胞再生。模型组1～8周和9～12周大鼠血清ALT、AST、γ-GT和AFU活性均高于对照组,差别有统计学意义(P<0.01);模型组9～12周大鼠血清ALT、AST、γ-GT和AFU活性高于1～8周,差别有统计学意义(P<0.05),2组AFP和CEA均正常。对照组无细胞凋亡,模型组大鼠肝脏细胞呈明显的DNA梯状条带。对照组大鼠肝组织中未见Fas和FasL表达,模型组Fas和FasL主要表达在肝脏细胞胞浆。结论大鼠肝脏癌前病变时,肝细胞凋亡增加可能与凋亡相关基因Fas和FasL表达增加有关。肝脏癌前病变大鼠肝细胞凋亡增加,可能是肝损伤加重的原因。     

重症肌无力胸腺细胞凋亡与Fas基因表达的研究

目的探讨胸腺细胞凋亡及相关基因Fas/FasL在MG发病中的作用和意义.方法采用脱氧核糖核酸末端转移酶介导的缺口末端标记(TUNEL)技术检测胸腺组织中凋亡细胞,免疫组织化学S-P法与原位杂交组织化学检测Fas/FasL及其mRNA的表达.结果重症肌无力胸腺中细胞凋亡数与Fas、Fas mRNA表达阳性率均显著低于正常胸腺.Fas阳性表达与重症肌无力胸腺组织中细胞凋亡数呈负相关.胸腺切除术后有效组的胸腺细胞凋亡数显著低于无效组.结论胸腺细胞凋亡减少及相关基因Fas表达异常可能与重症肌无力的发病有关,胸腺细胞凋亡水平可作为反映术后疗效的客观指标.     

iNOS与IFN-γ参与EAU发病机制的研究

目的建立大鼠EAU模型,探讨iNOS与IFN-γ参与EAU发病及其相互作用的机制。方法用视网膜S抗原与Freund完全佐剂免疫大鼠诱导EAU模型。观察EAU发作时间、EAU临床评分及组织病理学改变;并采用免疫组织化学SP法,检测EAU组和对照组动物眼后部葡萄膜视网膜iNOS、IFN-γ的表达。结果EAU组动物的眼睛在免疫后不同时间发生不同程度的炎症（发病率为100%）,临床评分为3.14±0.61,具有阳性体征者均有葡萄膜视网膜组织病理学改变,模型建立成功。经免疫组织化学染色发现,EAU组iNOS、IFN-γ表达阳性率分别为93%、93%。结论iNOS与IFN-γ在Th1细胞参与EAU的发病机制中发挥一定作用。     

口腔鳞癌细胞Fas/FasL的表达及对癌细胞凋亡的影响

目的:研究凋亡相关蛋白Fas、FasL在口腔鳞状细胞癌组织中的表达及对癌细胞凋亡的影响。方法:采用免疫组织化学方法检测10例正常口腔黏膜、38例不同分化程度口腔鳞癌组织Fas、FasL的表达;脱氧核糖核酸末端转移酶介导的原位末端标记(TUNEL)技术,检测鳞癌细胞的凋亡。结果:Fas在正常口腔黏膜中广泛表达,鳞癌组织表达明显下调(P<0.05);FasL在正常口腔黏膜不表达,鳞癌组织表达明显上调(P<0.01);Fas、FasL表达与口腔鳞癌分化程度无关;口腔鳞癌细胞Fas表达阴性组癌细胞凋亡指数(Apop-toticIndex,AI)明显低于Fas表达阳性组(P<0.01),Fas表达阳性组中,随Fas表达的下降,癌细胞AI逐步降低,各组间AI差异有显著性(P<0.01);口腔鳞癌细胞FasL表达阳性组癌细胞AI明显低于FasL表达阴性组(P<0.01);不同程度FasL表达间的癌细胞凋亡指数有差异。结论:口腔鳞癌细胞Fas、FasL的表达与癌细胞的凋亡及肿瘤的形成有密切关系。     

Fas,Fas-L,Bcl-2基因家族凋亡相关基因在葡萄膜炎发病机制中的作用研究进展

葡萄膜炎病因复杂，发病机制至今不明，许多研究表明可能与免疫因素及炎症细胞有关。近来研究又发现相关基因Fas、Fas—L和Bcl-2家族在葡萄膜炎的发生发展中发挥了重要作用。本文对Fas，Fas—L及Bcl-2凋亡相关基因与葡萄膜炎的发病关系作一综述。     

纳洛酮对大鼠缺血再灌注心肌细胞凋亡及Fas?FasL表达的影响

目的:观察纳洛酮(naloxone,Nal)对大鼠缺血再灌注心肌细胞凋亡及Fas、FasL蛋白表达的影响并探讨其机制。方法:SD大鼠24只,随机分成假手术组(Sham组)、缺血再灌注组(IR组)和纳洛酮处理组(Nal组)。原位末端标记法(TUNEL)检测心肌细胞凋亡情况;蛋白免疫印迹法(Western blotting)检测Fas、FasL蛋白表达;光镜下观察心肌组织病理学的改变。结果:与Sham组相比,IR组可见大量心肌细胞凋亡,Fas、FasL蛋白表达显著增加(P<0.01)。与IR组相比,Nal组心肌细胞凋亡显著减少,Fas、FasL蛋白表达明显降低(P<0.01)。IR组见心肌组织呈大小不等的灶性坏死,Nal组心肌坏死不明显。结论:心肌缺血再灌注时Fas、FasL表达介导心肌细胞凋亡,纳洛酮通过抑制Fas、FasL蛋白的表达而减少细胞凋亡从而起到保护心肌的作用。     

肺纤维化鼠细胞凋亡及Fas/Bcl-2动态变化

目的 探讨细胞凋亡及Fas/Bcl-2在肺纤维化发病中的作用. 方法 选取SD大鼠48只,随机分为对照组、模型组,每组各24只,应用博莱霉素(5 mg/kg)气管内注入建立实验性大鼠肺纤维化模型,对照组注入等量生理盐水,各组动物于7、14、28天随机处死8只,取肺组织采用HE染色观察病理变化,TUNEL法检测肺组织细胞凋亡、RT-PCR和免疫组织化学法分别检测肺组织Fas/Bcl-2 mRNA以及蛋白的表达. 结果 实验性大鼠肺纤维化发病过程中,呈现典型的肺泡炎(7天)、肺泡炎与纤维化并存(14天)及稳定的肺纤维化(28天)等表现;同时间段模型组肺组织细胞凋亡指数、Fas mRNA及蛋白表达均显著高于对照组(P＜0.01).Bcl-2 mRNA及蛋白表达显著低于对照组(P＜0.01);模型组细胞凋亡从7天开始逐步升高,第28天达最高峰,Fas蛋白与Fas mRNA表达趋势与细胞凋亡相同;模型组Bcl-2蛋白与Bcl-2 mRNA表达在第7天开始下降,第14天达最低峰,第28天略有回升(P＜0.05),但仍低于对照组(P＜0.01). 结论 肺泡及支气管上皮细胞凋亡与肺纤维化的形成有关,可能是肺纤维化的发病机制之一;Fas mRNA及蛋白表达上调和Bcl-2 mRNA及蛋白表达下调,可能引起肺上皮细胞的凋亡从而导致肺纤维化增生.     

口腔鳞癌肿瘤浸润淋巴细胞的Fas/FasL表达

目的研究口腔鳞状细胞癌肿瘤浸润淋巴细胞(TIL)Fas/FasL的表达及其临床病理学意义。方法采用免疫组织化学方法和脱氧核糖核酸末端转移酶(TDT)介导的原位末端标记(TUNEL)技术,对38例口腔鳞癌TIL的Fas/FasL表达及TIL和癌细胞的凋亡进行检测,观察TIL的Fas/FasL表达与TIL和癌细胞凋亡的关系。结果TIL的Fas和FasL均有广泛的表达,TILFas表达阳性组的TIL凋亡指数(AI)明显高于Fas表达阴性组(P<0.05),TILFasL表达阳性组的癌细胞凋亡指数与FasL表达阴性组差异无显著性(P>0.05)。结论口腔鳞癌TIL的Fas阳性表达与其凋亡有密切关系,而FasL的阳性表达则与癌细胞凋亡无关。癌细胞可能通过Fas凋亡系统诱导TIL的凋亡并通过某种机制逃避TIL的杀伤。     

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.