美洛宁对大鼠脑缺血再灌注后海马区神经细胞凋亡及学习记忆功能的影响

①目的 研究美洛宁对大鼠脑缺血再灌注后海马区神经细胞凋亡及学习记忆功能的影响。②方法 选用成年Wistar大鼠制成大脑中动脉缺血模型,将大鼠随机分为脑缺血组、美洛宁治疗组、假手术组。每组又分别划分成缺血再灌注后1、3、6、12、24、48、72及168h等8个时相组,另取12只作为正常对照组。美洛宁治疗组经致伤后,给予腹腔注射美洛宁30mg/(kg·d),直至各时相点处死;脑缺血组、假手术组及正常对照组在相同时间给予等量的生理盐水腹腔注射作为对照。各组均在相应的时间点处死取材进行原位细胞凋亡检测;另取48只大鼠随机分为脑缺血组、美洛宁治疗组、假手术组及正常对照组,进行水迷宫测试。③结果 美洛宁能够使海马区神经细胞凋亡的高峰明显下调,使水迷宫测试的潜伏期明显缩短。④结论 美洛宁能够有效抑制大鼠脑缺血再灌注后海马区神经细胞凋亡,明显改善学习记忆功能障碍。     

促红细胞生成素对大鼠全脑缺血再灌注后海马蛋白激酶B表达的影响

目的观察促红细胞生成素(EPO)对大鼠全脑缺血再灌注后海马CA1区蛋白激酶B表达的影响,进一步探讨EPO脑保护作用的机制.方法采用改良的Pulsinelli四血管阻断方法制作大鼠全脑缺血再灌注模型.将SD大鼠随机分为4组:正常组、假手术组、缺血再灌注组和EPO治疗组.各组动物分别于缺血15min再灌注6h、24h、48h、72h、7d断头取脑.鼠脑灌注及固定后制作石蜡切片,HE染色观察海马的病理变化,用TUNEL方法检测海马CA1区神经细胞凋亡,免疫组织化学SP法观察磷酸化蛋白激酶B(p-PKB)表达.另外再取24只大鼠分为4组:正常组、假手术组、缺血再灌注组和EPO治疗组,应用Y型迷宫法对缺血再灌注7 d的大鼠进行缺血后学习和记忆功能的测定.结果 (1)TUNEL染色:假手术组48 h、72h可见个别阳性细胞.缺血再灌注组于再灌注24h可见少量阳性细胞;再灌注48h可见较多TUNEL阳性细胞,72h出现大量TUNEL阳性细胞,7d明显减少.EPO治疗组TUNEL阳性细胞在各时间点明显少于缺血再灌注组[(948.6±91.0)个vs(502.7±97.3)个,P＜0.01].(2)认知功能变化:全脑缺血再灌注后7 d大鼠学习能力降低,尝试次数明显增多(P＜0.01).EPO治疗组尝试次数减少,有显著性差异(P＜0.01).学习能力测试后24h记忆功能测定,结果发现缺血再灌注组成绩明显低下,EPO处理组可改善缺血造成的大鼠记忆功能障碍[(20.06±3.85)s vs(12.93±3.04)s,P＜0.01].(3)p-PKB免疫组化染色:缺血再灌注组于再灌注6h即出现p-PKB明显表达增高,72h达高峰,7 d明显下降.EPO治疗组于再灌注6h、48h、72h、7 d,p-PKB蛋白表达较缺血再灌注组增高[(25.42±3.86)vs(11.64±2.13),P＜0.01].(4)相关分析:TUNEL阳性细胞与p-PKB蛋白表达则呈负相关,而大鼠学习能力与海马CA1区存活神经细胞数呈正相关趋势.结论 EPO能减少大鼠脑缺血再灌注损伤后海马CA1区神经细胞的坏死和凋亡,减轻脑缺血再灌注损伤后大鼠学习、记忆功能障碍.EPO可能通过增强海马神经细胞p-PKB的表达,发挥神经细胞保护作用.     

促红细胞生成素对大鼠全脑缺血再灌注后海马蛋白激酶B表达的影响

目的观察促红细胞生成素(EPO)对大鼠全脑缺血再灌注后海马CA1区蛋白激酶B表达的影响,进一步探讨EPO脑保护作用的机制。方法采用改良的Pulsinelli四血管阻断方法制作大鼠全脑缺血再灌注模型。将SD大鼠随机分为4组:正常组、假手术组、缺血再灌注组和EPO治疗组。各组动物分别于缺血15min再灌注6h、24h、48h、72h、7d断头取脑。鼠脑灌注及固定后制作石蜡切片,HE染色观察海马的病理变化,用TUNEL方法检测海马CA1区神经细胞凋亡,免疫组织化学SP法观察磷酸化蛋白激酶B(p-PKB)表达。另外再取24只大鼠分为4组:正常组、假手术组、缺血再灌注组和EPO治疗组,应用Y型迷宫法对缺血再灌注7d的大鼠进行缺血后学习和记忆功能的测定。结果(1)TUNEL染色:假手术组48h、72h可见个别阳性细胞。缺血再灌注组于再灌注24h可见少量阳性细胞;再灌注48h可见较多TUNEL阳性细胞,72h出现大量TUNEL阳性细胞,7d明显减少。EPO治疗组TUNEL阳性细胞在各时间点明显少于缺血再灌注组[(948.6±91.0)个vs(502.7±97.3)个,P<0.01]。(2)认知功能变化:全脑缺血再灌注后7d大鼠学习能力降低,尝试次数明显增多(P<0.01)。EPO治疗组尝试次数减少,有显著性差异(P<0.01)。学习能力测试后24h记忆功能测定,结果发现缺血再灌注组成绩明显低下,EPO处理组可改善缺血造成的大鼠记忆功能障碍[(20.06±3.85)svs(12.93±3.04)s,P<0.01]。(3)p-PKB免疫组化染色:缺血再灌注组于再灌注6h即出现p-PKB明显表达增高,72h达高峰,7d明显下降。EPO治疗组于再灌注6h、48h、72h、7d,p-PKB蛋白表达较缺血再灌注组增高[(25.42±3.86)vs(11.64±2.13),P<0.01]。(4)相关分析:TUNEL阳性细胞与p-PKB蛋白表达则呈负相关,而大鼠学习能力与海马CA1区存活神经细胞数呈正相关趋势。结论EPO能减少大鼠脑缺血再灌注损伤后海马CA1区神经细胞的坏死和凋亡,减轻脑缺血再灌注损伤后大鼠学习、记忆功能障碍。EPO可能通过增强海马神经细胞p-PKB的表达,发挥神经细胞保护作用。     

大鼠全脑缺血再灌注损伤后神经元凋亡及认知功能的研究

目的探讨大鼠脑缺血再灌注海马神经元凋亡及认知功能变化。方法雄性SD大鼠60只,随机分成假手术组（SH组）、模型组（IR组）。模型组采用4-VO法建立SD大鼠全脑缺血模型,不同时间点进行水迷宫测试。TUNEL法检测海马CA1区凋亡细胞。结果尼氏染色显示,与假手术组间比较,缺血组海马CA1区神经元数量显著下降（P〈0.01）;TUNEL法检测显示：与假手术组相比,凋亡指数显著增加（P〈0.01）。Morris水迷宫检测,与假手术组相比,模型组大鼠学习阶段寻台时间明显延长,而其记忆测试潜伏期也明显长于假手术组。结论大鼠全脑缺血再灌注损伤后神经元凋亡显著增加,认知功能明显下降。     

电针对脑缺血再灌注大鼠海马神经细胞凋亡的影响

目的观察电针对脑缺血再灌注后大鼠海马神经元损伤的保护作用。方法将SD大鼠随机分为正常组、假手术组、模型24 h组、模型48 h组、模型72 h组、电针治疗24 h组、电针治疗48 h组、电针治疗72 h组。采用改良线栓法制备局灶型脑缺血(MCAO)再灌模型,电针大椎、双侧内关穴。观察各组大鼠缺血侧海马神经元TUNEL阳性细胞数的变化、神经体征的改变。结果模型组缺血侧海马CA1区神经细胞凋亡数随再灌注时间延长而增加,48 h达高峰并持续至72 h,电针治疗可明显减少神经细胞凋亡数,与同时相模型组比较一有显著性差异(P<0.01,P<0.05),并以72 h电针治疗组尤为明显。同时,电针可明显改善脑缺血再灌注大鼠的神经功能缺损,与模型组比较有显著性差异(P<0.05、P<0.01)。结论电针对脑缺血再灌注损伤后的神经细胞凋亡有一定的拮抗作用,对脑缺血再灌注后大鼠海马神经元有保护作用。     

促红细胞生成素对慢性脑缺血大鼠空间学习记忆能力的影响

目的:观察大鼠慢性脑缺血所致的空间学习记忆功能损害及促红细胞生成素(EPO)对其认知功能的影响。方法:结扎大鼠双侧颈总动脉建立慢性脑缺血模型,治疗组术后给予EPO1000U/kg,持续5d。术后第8周时3组大鼠Morris水迷宫测试后断头取脑做组织学和流式细胞术检测。结果:缺血组水迷宫表现同假手术组和EPO治疗组相比有显著差异(P<0.05)。EPO能改善慢性脑缺血大鼠的空间学习记忆能力(P<0.05)。EPO组神经细胞病理改变较轻,海马细胞凋亡率较低(P<0.01)。结论:EPO可能通过减少海马CA1区神经元的损害以及抗凋亡作用改善慢性脑缺血大鼠空间学习记忆障碍。     

孕酮对大鼠脑损伤后海马CA_1区神经细胞凋亡及学习记忆功能的影响

目的:探讨孕酮对大鼠创伤性脑损伤后海马CA1区细胞凋亡及学习记忆功能的影响。方法:将雄性SD大鼠随机分为假手术组,损伤组,孕酮治疗组。按照改进的Feeney自由落体损伤装置制作大鼠脑损伤模型。利用TUNEL法观察大鼠海马CA1区细胞凋亡,Morris水迷宫测试大鼠学习记忆功能。结果:孕酮治疗组各时间点凋亡细胞数较损伤组减少,脑损伤后24h、48h和72h凋亡细胞数治疗组和损伤组之间存在显著性差异(P<0.05)。孕酮治疗组大鼠学习记忆能力潜伏期较损伤组缩短。结论:孕酮可以减轻脑损伤后海马神经细胞凋亡,促进大鼠学习记忆功能的恢复。     

神经生长因子预处理对大鼠脑缺血再灌注损伤保护作用机制的研究

目的:探讨神经生长因子(NGF)预处理对大鼠脑缺血再灌注损伤保护作用的机制.方法:采用四动脉阻断(4VO)法制作大鼠全脑缺血模型.18只大鼠随机分为3组,每组6只.对照组:只分离翼小孔和颈总动脉,未予脑缺血处理;缺血组:未行NGF预处理,只行脑缺血再灌注处理;NGF预处理组:全脑缺血前12 h脑室内注射NGF 20 U,所有大鼠缺血20 min再灌注24 h后取脑组织.采用TUNEL法原位标记DNA片段,观察海马CA1区神经细胞凋亡的变化.结果:NGF预处理组海马CA1区TUNEL阳性神经细胞为(10.83±2.84)细胞/视野,与缺血组(17.69±3.79)细胞/视野比较显著减少(P＜0.05).结论:NGF预处理通过抑制神经细胞凋亡对大鼠全脑缺血再灌注损伤有保护作用.     

七氟醚预处理对局灶性脑缺血再灌注后大鼠空间学习与记忆能力的影响

目的:目前,对七氟醚的脑保护功能研究较多,其对认知功能方面的研究相对较少,文中观察七氟醚预处理对局灶性脑缺血再灌注后大鼠空间学习与记忆的影响. 方法:雄性SD大鼠24只,随机分成假手术(C)组,缺血再灌注组(I/R)和七氟醚预处理组(S),每组8只.采用线栓法大脑中动脉阻断前脑血供1h,拔出栓线给予再灌注,七氟醚预处理组术前吸入七氟醚1h,呼气末七氟醚浓度维持在1.0(2.4%)肺泡最低有效浓度(MAC).再灌注72h后利用Morris水迷宫测量术后大鼠空间学习与记忆的能力,用免疫组织化学法测定大鼠海马CA1区胆碱乙酰转移酶(ChAT)的变化. 结果:七氟醚预处理组大鼠逃避潜伏期明显短于缺血再灌注组(P<0.05),在记忆保留实验中七氟醚预处理组大鼠穿越平台次数和平台所在象限探索时间明显多于缺血再灌注组(P<0.05),海马CA1区ChAT阳性细胞的数目七氟醚预处理组也明显多于缺血再灌注组(P<0.05). 结论:1.0 MAC七氟醚预处理1h可能通过保护CA1区胆碱能神经元,对局灶性缺血再灌注大鼠的空间学习与记忆有明显的改善作用.     

血管性痴呆动物模型中应用补肾健脑汤对大鼠海马神经元谷氨酸转运体的影响研究

目的 观察补肾健脑汤对血管性痴呆大鼠海马细胞神经元谷氨酸转运体(excitator aminoacid transporters,EAATs)的影响.方法 将30只SD大鼠随机分为假手术组、模型组及药物组,采用双侧颈总动脉反复3次缺血-再灌注方法,制备小鼠血管性痴呆模型,各组大鼠按照分组原则进行处理,8周后通过Morris水迷宫试验、跳台试验进行学习和记忆成绩测试评估大鼠认知功能,同时采用苏木精-伊红染色法观察海马组织病理改变,采用免疫组织化学的方法观察海马CA1区神经细胞膜上 EAAT1和EAAT2的表达量.结果 通过跳台实验可见,与假手术组比较,模型组学习和记忆测试明显下降.与模型组比较,药物组学习和记忆测试明显改善,Morris水迷宫实验同样得出相同趋势的结果.形态学观察显示,模型组大鼠海马CA1区神经细胞排列紊乱、数量较少,甚至坏死、凋亡.而药物组大鼠海马CA1区神经元数目、形态较模型组有明显改善.免疫组化结果显示,与假手术组比较,模型组大鼠海马CA1区神经细胞膜上EAAT1和EAAT2表达明显下降,而药物组大鼠海马CA1区神经细胞膜上EAAT1和EAAT2表达则明显改善.结论 补肾健脑汤能明显改善血管性痴呆大鼠学习和记忆障碍,机制可能与其有效调节海马CA1区内EAATs的的表达有关.     

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…