妊高征患者母血及胎盘组织中卵泡休止素水平变化的研究

目的 :研究妊高征患者母血及胎盘组织中卵泡休止素 (FS)水平变化的临床意义。方法 :采用固相双夹心酶联免疫吸附 (ELISA)法测定妊高征组 (轻度 4例、中度 4例、重度 12例 )及正常妊娠组 (34例 )孕妇血清以及胎盘组织 (两组各 10例 )FS含量。结果 :妊高征组血清FS水平低于正常妊娠组 (P <0 .0 0 1) ;重度妊高征组血清FS水平低于轻中度妊高征组 (P<0 .0 5 ) ;妊高征组胎盘组织FS含量低于正常妊娠组 (P<0 .0 0 1) ;两组血清FS水平与胎盘组织FS含量呈显著的直线相关关系 (P <0 .0 5 )。结论 :FS下降可能参与妊高征的发生、发展。血清FS值可与其它指标相结合用于胎盘功能的评价     

妊娠高血压综合征患者硫酸镁治疗前后血浆内皮素含量的变化

目的 :测定妊娠高血压综合征 (妊高征 )患者血浆内皮素含量的变化 ,探讨硫酸镁治疗妊高征的机制。方法 :采用放射免疫测定法观察 36例妊高征患者 (妊高征组 )血浆内皮素水平和硫酸镁治疗 4h时内皮素的变化 ,并以 14例同期正常妊娠妇女作对照。结果 :中、重度妊高征组患者血浆内皮素水平比同期正常妊娠妇女高 (P <0 .0 5 ) ,硫酸镁治疗 4h后血浆内皮素含量较治疗前显著降低 (P <0 .0 5 ) ,而轻度妊高征患者硫酸镁治疗后血浆内皮素较治疗前差异无显著性(P >0 .0 5 )。结论 :硫酸镁可以通过调节妊高征患者血浆内皮素含量而起到治疗妊高征的作用。     

重度妊娠高血压综合征患者胎盘表皮生长因子受体的表达

测定 2 1例重度妊高征患者胎盘EGFR的表达 ,分 2组 ,其中重度妊高征合并胎儿宫内发育迟缓 (IUGR)组 9例和重度妊高征未合并IUGR组 12例 ,并与 15例正常妊娠者 (对照组 )比较。与对照组相比 ,重度妊高征患者胎盘EGFR蛋白及其mRNA的表达显著降低 (P <0 .0 1) ,重度妊高征合并IUGR组与重度妊高征未合并IUGR组之间胎盘EGFR的表达无显著性差异 (P >0 .0 5 )。胎盘滋养层细胞EGFR表达显著降低 ,可能是重度妊高征发病的重要因素     

妊娠高血压综合征与脂类、载脂蛋白、血浆蛋白代谢的关系

目的　探讨妊娠高血压综合征 (妊高征 ,PIH )患者脂类、载脂蛋白、血浆白球蛋白代谢在其发病中的作用及临床意义。方法　中、重度妊高征 (中、重度组 ) 3 4例 ,轻度妊高征 (轻度组 ) 40例 ,正常妊娠 (正常组 ) 44例 ,测定其血脂、脂蛋白、蛋白质浓度。结果　中、重度组的胆固醇 (TC)、甘油三酯 (TG)明显高于正常组 (P <0 .0 0 1)和轻度组 (P <0 .0 5 ) ;高密度脂蛋白 (HDL)各组无差异性 (P >0 .0 5 ) ,中、重度组低密度脂蛋白 (LDL)明显高于正常组 (P <0 .0 1) ;中、重度组载脂蛋白A1(Apo A1)低于正常组 (P <0 .0 1) ,载脂蛋白B(Apo B)则高于正常组 (P <0 .0 0 1) ;中、重度组白蛋白(ALB)低于正常组 (P <0 .0 0 1) ,而球蛋白 (GLB)则高于正常组 (P <0 .0 5 ) ;中、重度组动脉粥样硬化“危险因子”(LDL/HDL)明显高于正常组 (P <0 .0 5 ) ,动脉粥样硬化指数 [(TC -HDL) /HDL]亦然 (P <0 .0 0 1)。结论　中、重度妊高征患者存在明显的脂类和蛋白质代谢异常     

血清封闭抗体及HLA抗体与妊高征发病关系探讨

目的 :探讨封闭抗体及人类白细胞抗原 (HLA)抗体与妊娠高血压综合征 (妊高征 )发病的关系。方法 :应用微量淋巴细胞毒试验 ,检测 5 4例妊高征患者 (妊高征组 ) (其中轻度 12例、中度 15例、重度 2 7例 )及 40例正常妊娠妇女 (对照组 )血清封闭抗体及HLA抗体水平。结果 :封闭抗体阳性率妊高征组 (特别是中、重度妊高征组 )极显著低于对照组 (P <0 .0 1) ;与对照组相比 ,重度妊高征组HLA Ⅰ、Ⅱ类抗体阳性率均极明显降低 (P <0 .0 1、P <0 .0 0 1) ,中度妊高征组HLA Ⅰ类抗体阳性率无显著差异 ,而HLA Ⅱ类抗体阳性率下降有显著差异 (P <0 .0 5 )。上述抗体在妊高征各组间比较 ,仅发现轻 重度妊高征组间封闭抗体阳性率有显著差异 (P <0 .0 5 )。结论 :封闭抗体及HLA抗体 (尤其是HLA Ⅱ类抗体 )下降或缺乏可能在妊高征的发病及病情进展中起着较重要的作用。     

神经肽Y与妊娠高血压综合征发病的关系

目的　探讨神经肽Y(NPY)与妊娠高血压综合征 (妊高征 )发病的关系。方法　采用放射免疫法测定 3 4例妊高征患者 (妊高征组 ,轻度 10例 ,中度 10例 ,重度 14例 )产前及产后的血浆NPY水平 ,以同期 2 0例正常孕妇(正常妊娠组 )和 10例正常非孕妇女 (正常非孕组 )为对照。结果　正常妊娠组产前血浆NPY水平 (82 .60±2 7.5 9)ng/ml稍低于正常非孕组 (85 .94± 2 8.12 )ng/ml,两组比较 ,差异无显著性 (P >0 .0 5 )。妊高征组产前血浆NPY水平为 (148.79± 64 .3 2 )ng/ml,明显高于正常妊娠组和正常非孕组 (P均 <0 .0 1)。轻度妊高征组血浆NPY水平高于正常妊娠组和正常非孕组 ,但差异无显著性 (P均 >0 .0 5 ) ;轻、中、重度妊高征三组间血浆NPY水平差异显著 (P均 <0 .0 1)。产后 3天血浆NPY水平下降到非孕水平。结论　妊高征患者血浆NPY水平升高 ,在妊高征的发生、发展中有一定作用     

内皮素/一氧化氮系统失调在妊高征发病中的作用

目的 :观察妊高征患者血浆一氧化氮 (NO)和内皮素 (ET)含量的变化并探讨其在妊高征发病中的意义。方法 :应用镉柱比色法和放射免疫法分别对 43例妊高征患者 (妊高征组 )、36例正常妊娠妇女 (对照组 )和 19例正常非孕妇 (正常组 )血浆中NO代谢产物亚硝酸盐 /硝酸盐 (NO-2 /NO-3 )及ET - 1含量进行了检测。结果 :正常妊娠妇女血浆中NO-2 /NO-3 含量 (34.2 9± 10 .15 ) μmol/L明显高于非孕正常组妇女 (11.98± 3 .99)μmol/L ,并随孕周的增加而增加 ,孕中期达高峰 (39.45± 9.16 ) μmol/L ,到孕晚期有所下降 (31.42± 7.86 5 )μmol/L。血浆中ET的含量有所上升 ,但与非孕正常组妇女相比则没有显著差异 (P >0 .0 5 ) ;与正常晚期妊娠对照组相比 ,轻、中度妊高征妇女血浆中NO-2 /NO-3 含量虽有所上升 ,但没有明显差异 (P >0 .0 5 ) ,而重度妊高征妇女则有明显上升 (P <0 .0 5 )。妊高征妇女血浆ET含量 (96 .0 5± 13 .5 7)ng/L与正常晚期妊娠妇女(36 .48± 6 .17ng/L)相比有极显著的上升 (P <0 .0 1) ,并且与妊高征的严重程度成正比 (r =0 .5 2 ,P <0 .0 1) ,ET/NO比值 (2 .47)明显大于正常晚期妊娠对照组妇女 (1.13,P <0 .0 5 )。结论 :妊高征患者内皮细胞损伤导致ET/NO系统平衡失调可能在妊高征的发病机     

瘦素与妊娠高血压综合征患者发病的相关研究

目的　探讨妊娠高血压综合征与瘦素的关系。方法　采用放射免疫分析法 ,测定 38例妊娠高血压综合征孕妇 (妊高征组 )和正常孕妇 37例 (对照组 )瘦素的含量 ,并进行比较。结果　妊高征组瘦素与对照组比较有显著差异 (P <0 .0 1) ,中、重度妊高征组血浆瘦素与轻度妊高征组比较 ,差异有显著性 (P <0 .0 5 )。结论　血浆中的高瘦素血症在妊高征的发病中可能起重要作用。     

妊高征病人Lp(a)及Fn水平变化的研究

目的 :探讨妊高征病人母血、脐血中脂蛋白 (a) [Lp(a) ]及纤维结合蛋白 (Fn)水平变化在妊高征发生、发展中的作用。方法 :用免疫比浊法检测妊高征 30例 (中度 16例 ,重度 14例 )及正常足月妊娠 2 0例 (对照组 )的母血、脐血中的Lp(a)和Fn含量。 结果 :中、重度妊高征组母血中Lp(a)均较对照组极显著升高 (P <0 0 1) ;重度妊高征组脐静脉血Lp(a)含量较对照组和中度妊高征组显著升高 (P <0 0 5 )。中、重度妊高征组母血Fn含量均较对照组显著增高 (P <0 0 5 ) ;重度妊高征组脐静脉血Fn含量较对照组显著增高 (P <0 0 1)。结论 :血清中Lp(a)、Fn水平升高参与了妊高征的血管内皮损伤 ,观测这两项指标可以预测妊高征的严重程度及愈后。     

血管内皮生长因子与妊娠高血压综合征的关系研究

目的　探讨血管内皮生长因子 (VEGF)在妊娠高血压综合征 (妊高征 )发病中的作用。方法　采用酶联免疫吸附法测定 3 5例妊高征患者 (妊高征组 ,其中轻度 10例 ,中、重度 2 5例 )的外周血及其新生儿脐静脉血VEGF水平 ,用免疫组化法测定胎盘中的VEGF水平 ,并以正常晚期妊娠妇女 (正常妊娠组 ) 2 0例和正常未孕妇女 (正常未孕组 )10例为对照。　结果 ( 1)妊高征组外周血VEGF水平为 ( 2 8 66± 9 98)ng/ml,明显高于正常妊娠组 [( 13 15± 8 46)ng/ml,P <0 0 1]和正常非孕组 [( 5 47± 3 5 2 )ng/ml ,P <0 0 1] ;轻度妊高征组血清VEGF水平为 ( 16 75± 7 2 4)ng/ml ,与正常妊娠组比较 ,差异无显著性 (P >0 0 5 ) ;中、重度妊高征组血清VEGF水平为 ( 3 5 43± 9 0 2 )ng/ml,明显高于对照组和轻度妊高征组 (P均 <0 0 1)。产后三天下降到非孕水平。 ( 2 )妊高征组的新生儿脐血VEGF水平为 ( 4 8 3 5±9 64 )ng/ml ,低于正常妊娠组 ( 5 7 62± 11 19)ng/ml,其差异无统计学意义。两组孕妇的新生儿脐血VEGF水平均高于其母血清 (P均 <0 0 1)。 ( 3 )妊高征组胎盘VEGF轻度表达为 71 4%,中度为 2 8 6%,无重度表达 ;正常妊娠组胎盘VEGF轻度表达为 3 0 %,中度为 45 %,重度为 2 5 %。妊高征组胎盘VEGF表达显著低于     

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…