GM-CSF在小鼠放射性复合切割伤中的异常表达及干预治疗实验

目的 对比观察小鼠放射性复合切割伤与单纯切割伤愈合过程中粒细胞-巨噬细胞集落刺激因子(granulocytemacrophage colony stimulating factor,GM-CSF)动态表达水平的差异以及GM-CSF对小鼠放射性复合切割伤的干预治疗效果,进一步探讨GM-CSF对放射性复合切割伤愈合的影响.方法 56只雌性昆明种小鼠(20～22 g)随机分为辐照组和对照组,各28只,辐照组小鼠在6 Gy 60Co γ射线全身一次性均匀辐照后,即刻于背部皮肤制作全层缺损伤口,构建放射性复合切割伤模型;对照组小鼠伤口制备部位、方法同实验组,但小鼠不作辐照处理.伤后1、3、5、7d时分别处死小鼠7只,取创面周围皮肤及下方的薄层肌肉组织,通过Real-time PCR和免疫组化方法检测伤口愈合过程中GM-CSF的mRNA及蛋白表达水平.另将40只同品系、同体质量小鼠随机分为两组(实验组和对照组,各20只),均按上述相同方法构建放射性复合切割伤小鼠模型,于伤后0、1、3、4、5、7、9、11、14 d时分别给予rhGM-CSF(6 000 ng/mL)凝胶或空白凝胶涂抹,通过检测创面残余面积与胶原纤维水平,评价rhGM-CSF凝胶对放射性复合切割伤口的治疗效果.结果 致伤后1～3 d辐照组GM-CSF的mRNA及蛋白水平均低于对照组(P＜0.05或P＜0.01);5～7 d时,对照组GM-CSF的mRNA及蛋白表达逐渐下降,而辐照组GM-CSF水平无明显改变.凝胶涂抹4～11 d内,rhGM-CSF凝胶治疗组中小鼠皮肤伤口残余面积低于空白凝胶组(P＜0.05或P＜0.01);Masson染色显示:与空白凝胶组相比,rhGMCSF凝胶治疗后放射性复合切割伤口中可见显著增生、广泛分布,排列紧密的胶原纤维.结论 放射性复合切割伤口早期愈合过程中GM-CSF的mRNA及蛋白表达水平较正常伤口低,而持续给予6 000 ng/mL rhGM-CSF刺激可明显加快放射性复合切割伤的愈合进程.     

罗哌卡因对皮肤损伤愈合及GM-CSF表达的影响

摘要：目的  观察罗哌卡因对皮肤损伤小鼠皮肤愈合及粒细胞-巨噬细胞集落刺激因子（GM-CSF）表达的影响。方法  将小鼠随机分为实验组（罗哌卡因）和对照组（生理盐水）,两组小鼠创面进行Masson染色,测定GM-CSF浓度和羟脯氨酸水平,记录创面的愈合率和愈合时间。结果  第5天,实验组绿染胶原纤维沉积量较对照组多;第10天,实验组较对照组创缘上皮增生明显。实验组小鼠第5天GM-CSF含量高于对照组（P < 0.05）。实验组小鼠创面愈合时间短于对照组（P <0.05）。实验组大鼠第5天和第10天创面愈合比例高于对照组（P <0.05）。实验组大鼠第5天和第10天创面羟脯氨酸水平高于对照组（P <0.05）。结论  罗哌卡因局部浸润可以促进小鼠全层皮肤损伤的愈合,其机制可能与局部浸润罗哌卡因能够促进GM-CSF的表达有关。

     

外用重组人表皮生长因子凝胶对供皮区创面愈合作用疗效观察

目的：观察外用重组人表皮生长因子凝胶在供皮区创面愈合中的作用。方法：供皮区创面60例随机分为重组人表皮生长因子外用组（实验组,30例,用重组人表皮生长因子凝胶均匀涂抹）和空白凝胶组（对照组,30例,用空白凝胶均匀涂抹）,观察创面愈合情况。术后3个月随访瘢痕增生情况。结果：实验组创面愈合时间明显短于对照组（P〈0．05）,瘢痕增生也较对照组轻（P〈0．05）。结论：外用重组人表皮生长因子凝胶能缩短供皮区创面愈合时间,减少近期瘢痕增生。     

糖尿病创面愈合与GM-CSF关系的研究

目的探讨糖尿病创面愈合与粒细胞巨噬细胞集落刺激因子（GM-CSF）的关系。方法70只C 57B L/6小鼠分为野生小鼠组（对照组,n=35）和糖尿病模型组（DM组,n=35）。腹腔麻醉后在背部中线两侧各制作0.8cm×0.8cm创面。创面动态摄像并于相应时间段取标本,观察创面组织愈合情况,同时计算创面愈合率;EL ISA法测定创面GM-CSF表达。结果创面形成后第3天起,DM组小鼠创面愈合率较对照组明显下降,以创面形成后7 d内变化最为明显;创面形成后第1天,两组小鼠创面GM-CSF表达均明显增高;创面形成后第1天和第3天,对照组小鼠创面GM-CSF表达显著高于DM组。结论GM-CSF的低表达可能与创面愈合早期炎症细胞浸润减少有关。     

粒细胞巨噬细胞集落刺激因子对糖尿病小鼠创面愈合的作用

目的 探讨粒细胞巨噬细胞集落刺激因子(GM-CSF)对糖尿病小鼠创面愈合的作用.方法 C57BL/6小鼠42只,链脲佐菌素(STZ)诱导建立糖尿病小鼠模型.腹腔麻醉后在糖尿病小鼠背部中线两侧各制作0.8cm×0.8cm创面,左侧创面外用GM-CSF凝胶(GM-CSF处理组),右侧创面则给予不含药物的凝胶(对照组).在创面形成后不同时相点,分别测量计算两组糖尿病小鼠创面的愈合率;组织Masson染色观察创面再上皮化程度和胶原纤维的沉积情况;碱性水解法测定反映局部胶原蛋白合成量的指标羟脯氨酸水平.结果 GM-CSF处理组创面愈合率较对照组明显增加,从创面形成后3d起两组差异显著(P＜0.01);Masson染色组织学观察显示,GM-CSF处理组创面形成后不同时相点的再上皮化速率和胶原纤维沉积均较对照组明显加快;创面形成后3 d起,GM-CSF处理组羟脯氨酸水平较对照组明显增高.结论 糖尿病小鼠创面外用GM-CSF凝胶,可诱导创面再上皮化和胶原蛋白合成,从而促进创面愈合.     

粒细胞巨噬细胞集落刺激因子对糖尿病小鼠创面愈合的作用

目的探讨粒细胞巨噬细胞集落刺激因子(GM-CSF)对糖尿病小鼠创面愈合的作用。方法C57BL/6小鼠42只,链脲佐菌素(STZ)诱导建立糖尿病小鼠模型。腹腔麻醉后在糖尿病小鼠背部中线两侧各制作0.8 cm×0.8 cm创面,左侧创面外用GM-CSF凝胶(GM-CSF处理组),右侧创面则给予不含药物的凝胶(对照组)。在创面形成后不同时相点,分别测量计算两组糖尿病小鼠创面的愈合率;组织M asson染色观察创面再上皮化程度和胶原纤维的沉积情况;碱性水解法测定反映局部胶原蛋白合成量的指标羟脯氨酸水平。结果GM-CSF处理组创面愈合率较对照组明显增加,从创面形成后3 d起两组差异显著(P<0.01);Masson染色组织学观察显示,GM-CSF处理组创面形成后不同时相点的再上皮化速率和胶原纤维沉积均较对照组明显加快;创面形成后3 d起,GM-CSF处理组羟脯氨酸水平较对照组明显增高。结论糖尿病小鼠创面外用GM-CSF凝胶,可诱导创面再上皮化和胶原蛋白合成,从而促进创面愈合。     

芦荟凝胶对大鼠Ⅱ度放射性皮炎创面愈合部位新血管生成及VEGF、VEGFR表达的影响

目的:探讨芦荟凝胶对大鼠模型中Ⅱ度放射性皮炎所致创面愈合处新血管生成以及血管内皮生长因子(VEGF)及其受体(VEGFR)表达的影响。方法:采用6mev电子线在大鼠背部建立10%Ⅱ度放射性皮炎模型,制备芦荟凝胶。将实验大鼠分为两组:创面自然愈合组(对照组)和创面外涂芦荟组(实验组)。HE染色观察创面新生血管数量;应用免疫组化染色,后行图像分析,分别测定损伤后2、6、10、18、24d的创面组织中VEGF和VEGFR的表达。结果:实验组在伤后10、18、24d创面组织中微血管数量明显大于对照组(P<0.05);实验组和对照组从伤后第2²4天创面组织中VEGF、VEGFR的表达均逐渐增高,而实验组从伤后第1024天创面组织中VEGF、VEGFR的表达均逐渐增高,而实验组从伤后第10²4天创面组织中VEGF、VEGFR表达的增高幅度明显大于对照组(P<0.05)。结论:芦荟凝胶能够提高放射性皮炎创面组织中VEGF、VEGFR的表达,促进新血管生成,增加局部血运,促进创面愈合。     

芦荟凝胶对大鼠Ⅱ度放射性皮炎发生中ICM-1和EGF的影响

目的在分子水平探讨芦荟凝胶抑制大鼠Ⅱ度放射性皮炎发生的机制。方法首先建立SD大鼠裸露背部10％Ⅱ度放射性皮炎模型，随机分成两组，对照组为自然愈合组，实验组为芦荟外涂组，实验组每天进行鲜芦荟凝胶对辐射伤口区的外涂，每天2次。辐射伤后2、6、10、18和24d各活杀大鼠10只，每组各5只。采用免疫组织化学方法并利用图像分析技术，分别记录创面发生率及伤口局部ICAM-1、EGF的表达量。结果实验组ICAM-1的表达总体均数低于对照组的表达，差异有显著性，以早期明显。实验组EGF的表达总体均数高于对照组的表达，差异有显著意义，以中期明显。实验组创面发生率较对照组低。两组间差异有显著性。结论芦荟凝胶对大鼠Ⅱ度放射性皮炎的发生有抑制作用。机制与ICAM-1分泌的抑制及EGF分泌的促进相关。     

新型双组分交联封闭聚合物水凝胶促进大鼠创面愈合的研究

目的探讨新型双组分交联封闭聚合物水凝胶对大鼠创面愈合的作用。方法采用背部皮肤打孔法构建SD大鼠创面模型,再按随机数字表法分为水凝胶组、硫酸庆大霉素组、对照组,每组6只。水凝胶组每天在创面处涂抹植物纤维素衍生物水溶液25μL,同时喷涂氧化淀粉水溶液25μL;硫酸庆大霉素组每天在创面处涂抹硫酸庆大霉素50μL;对照组不作任何处理。药物干预期间记录每天创面愈合情况并测量创面面积;药物干预10d后麻醉大鼠,取创面组织测量创面肉芽组织面积,并检测组织中IL-6、TNF-α、转化生长因子β（TGF-β）mRNA相对表达量。结果从药物干预第4天起,水凝胶组和硫酸庆大霉素组大鼠创面面积均明显小于对照组（均P＜0.05）,而水凝胶组与硫酸庆大霉素组比较差异均无统计学意义（均P＞0.05）。水凝胶组、硫酸庆大霉素组创面肉芽组织面积均明显小于对照组,组织中IL-6、TNF-αmRNA相对表达量均明显低于对照组,TGF-βmRNA相对表达量明显高于对照组,差异均有统计学意义（均P＜0.05）;而水凝胶组与硫酸庆大霉素组创面肉芽组织面积以及组织中IL-6、TNF-α、TGF-βmRNA相对表达量比较,差异均无统计学意义（均P＞0.05）。结论新型双组分交联封闭聚合物水凝胶可加速大鼠创面愈合,减少炎症反应。     

干扰素-γ对皮肤创伤愈合的影响

目的：探讨干扰素-γ（IFN-γ）对皮肤伤口愈合的影响。方法：选取40只雄性小鼠,制备机械性创伤小鼠模型,随机分为实验组和对照组。实验组给予肌肉注射IFN-γ100万IU/支,隔日1次,每次1支,连续治疗14 d,对照组不做处理。观察两组小鼠的愈合情况。结果：实验组20只小鼠,伤口愈合时间为14～20 d,平均（16.08±1.73）d,对照组为10～15 d,平均（12.75±1.54）d,差异有统计学意义（P〈0.05）。第14天时,实验组动物伤口愈合1只,对照组18只,后者明显多于前者（P〈0.05）。结论：IFN-γ可减慢皮肤创面愈合时间,从而影响创面愈合。     

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…