T淋巴细胞在异种鼠肝移植免疫排斥反应中的作用

目的：探讨Ｔ淋巴细胞是否参与了异种肝移植免疫排斥反应。方法：建立仓鼠到大鼠原位肝移植模型,用免疫组织化学染色方法检测异种肝移植免疫排斥反应中Ｔ淋巴细胞浸润情况及其Ｆａｓ抗原配体（Ｆａｓ－Ｌ）的表达,并用普通组织学及原位末端标记方法检测移植肝中细胞凋亡。结果：异种肝移植免疫排斥过程中,移植肝中Ｔ淋巴细胞,包括ＣＤ４,ＣＤ８亚型大量浸润,术后第４天开始表达Ｆａｓ－Ｌ,随着排斥反应的加重,Ｆａｓ－Ｌ表达越高,细胞凋亡数量也越多。结论：Ｔ淋巴细胞参与了异种肝移植免疫排斥反应。     

慢性重型乙型肝炎肝移植围手术期凝血功能的调控

目的探讨慢性重型乙型肝炎肝移植围手术期凝血功能障碍的防治.方法回顾性分析我院2003年11月至2004年11月收治的7例慢性重型乙型肝炎肝移植病例围手术期凝血功能的调控方法.结果 7例患者有1例患者因病情极重,并发多器官功能衰竭,在术前死亡,其余6例经围手术期积极调控出凝血功能,均接受背驮式同种异体肝移植.6例患者术后均未出现出血及血栓形成.结论慢性重型乙型肝移植围手术凝血功能的调控对肝移植手术及术后患者恢复有重要意义,良好的凝血功能调控能减少术中出血,减轻全身病理生理紊乱,提高机体对手术的耐受,降低术后血栓形成的危险.     

内皮素与猪原位肝移植术循环功能损害的关系

目的：为探讨ＥＴ与猪原位肝移植（ＯＬＴ）术循环功能损害的关系，方法：观察了一组１２例ＯＬＴ术的猪血浆ＥＴ的变化，同时测定血流动力学指标的变化，结果：ＥＴ在猪ＯＬＴ术的无肝缺血期开始升高，再灌注后进一步升高；血浆ＥＴ水平与再灌注后心肌损害和血流动力学紊乱有关（ＥＴ与ＭＡＰ，ＳＶＲ，ＰＶＰ，ＰＡＷＰ／ＣＯ，ＳＶ）等呈正（负）相关关系。结论：提示ＥＴ参与了猪ＯＬＴ术缺血再灌注引起的心血管功能紊乱的病理过程     

内皮素与猪原位肝移植术循环功能损害的关系

目的：为探讨ＥＴ与猪原位肝移植（ＯＬＴ）术循环功能损害的关系，方法：观察了一组１２例ＯＬＴ术的猪血浆ＥＴ的变化。同时测定血流动力学指标的变化，结果：ＥＴ在猪ＯＬＴ术的无肝缺血期开始升高，再灌注后进一步升高，血浆ＥＴ水平与再灌注后心肌损害和血流动力学紊乱有关（ＥＴ与ＭＡＰ，ＳＶＲ，ＰＶＰ，ＰＡＷＰ／ＣＯ，ＳＶ）等呈正（负）相关关系，结论：提示Ｅ参与了猪ＯＬＴ术缺血－再灌注引起的心血管功能紊乱的病理过     

犬冠脉周期性血流减少时血小板α颗粒膜蛋白140的变化及其意义

目的：观察犬冠脉发生周期性血流减少（ＣＦＲｓ）期间血小板α颗粒膜蛋白１４０（ＧＭＰ１４０）及ＴＸＢ２的变化，分析ＧＭＰ１４０在诊断ＣＦＲｓ中的意义．方法：开胸分离犬冠脉前降支（ＬＡＤ）２～３ｃｍ用血管钳钳夹方法损伤冠脉内膜后放置血管缩窄环，使冠脉至临界狭窄，缩窄环近端置电磁流量计，诱发ＣＦＲｓ．在诱发ＣＦＲｓ前及ＣＦＲｓ出现后４０ｍｉｎ冠状窦采血，用放免方法测ＧＭＰ１４０及ＴＸＢ２血浆浓度．结果：ＣＦＲｓ出现后４０ｍｉｎ，ＧＭＰ１４０及ＴＸＢ２显著升高［ＧＭＰ１４０从（４．２９±０．９９）μｇ／Ｌ升至（６．８２±１．１２）μｇ／Ｌ，Ｐ＜０．０１；ＴＸＢ２从（７５．６２±４１．８７）ｎｇ／Ｌ升至（１０９．９２±４５．９７）ｎｇ／Ｌ，Ｐ＜０．０１］；ＧＭＰ１４０与ＴＸＢ２有很好的正相关性（ｒ＝０．７３，Ｐ＜０．０１）．结论：ＧＭＰ１４０可能是ＣＦＲｓ中的一种重要介质，ＧＭＰ１４０有望成为诊断ＣＦＲｓ的一个较特异的指标．     

T淋巴细胞在异种鼠肝移植免疫排斥反应中的作用

目的 探讨Ｔ淋巴细胞是否参与了异种肝移植免疫排斥反应。方法 建立仓建到大鼠原全肝移植模型,用免疫组织化学染色方法检测异种肝移植免疫排斥反应中Ｔ淋巴细胞浸润情况及其Ｆａｓ抗原配体（Ｆａｓ－Ｌ）的表达,并用普通组织学及原位末端标记方法检测移植肝中细胞凋亡。结果 异种肝移植免疫排斥过程中,移植肝中Ｔ淋巴细胞,包括ＣＤ４、ＣＤ８亚型大量浸润,术后４天开始表达Ｆａｓ－Ｌ,随着排斥反应的加重,Ｆａｓ－Ｌ表达越     

四道生理记录仪在心脏收缩时间间期测定中的应用

目的：探讨心脏收缩时间间期测定方法,为评价心室收缩功能提供客观指标。方法：用四道生理记录仪通过颈动脉搏动图法测定２０例正常人心脏收缩时间间期的四项指标ＬＶＥＴ、Ｑ－Ｓ２、ＰＥＰ、ＰＥＰ／ＬＶＥＴ。结果：ＬＶＥＴ＝０．２８４ｓ,Ｑ－Ｓ２＝０．３７３ｓ,Ｑ－Ｓ２＝０．３７３ｓ,ＰＥＰ＝０．０９１ｓ,ＰＥＰ／ＬＶＥＴ＝０．３２。结论：利用四道生理记录仪测定收缩时间间期方法简便,结果可靠。     

小儿心力衰竭定量诊断标准的研究

用多普勒超声心动图测定２８６名正常儿童和４１例心衰患儿的５８项心脏血流参数，选出主动脉峰值流速（ＰＦＶＡ）、肺动脉峰值流速（ＰＦＶＰ）、二尖瓣Ｅ峰峰值流速（ＰＦＶＭＥ）、三尖瓣Ｅ峰流速（ＰＦＶＴＥ）、心脏指数（ＣＩ）等５项作为心衰定量诊断标准。这５项指标为ＰＦＶＡ：６个月以下＜７３．１ｃｍ／ｓ，６个月～＜８７．１ｃｍ／ｓ，４岁～＜１０１．９ｃｍ／ｓ，１０～１４岁＜１１０ｃｍ／ｓ；ＰＦＶＰ：６个月以下＜６９．２ｃｍ／ｓ，６个月～１４岁＜８２．４ｃｍ／ｓ；ＰＦＶＭＥ：６个月以下＞７８．５或＜５０．１ｃｍ／ｓ，６个月～１４岁＞１０１．６或＜７５．２ｃｍ／ｓ；ＰＦＶＴＥ：６个月以下＞６５．９或＜３７．１ｃｍ／ｓ，６个月～１４岁＞６７．１或＜４３．１ｃｍ／ｓ；ＣＩ＜２．６Ｌ／ｍ~２·ｍｉｎ~（－１）。     

卡托普利对先天性心脏病肺动脉高压的血液动力学作用

目的：了解卡托普利对左向右分流先天性心脏病肺动脉高压患者的血液动力学影响。方法：心内左向右分流肺动脉平均压＞ ２７ ｋ Ｐａ 的患者３０ 例,卡托普利０４ ～０６ ｍｇ／ｋｇ（ ≯１２５ ｍｇ） ,每日３ 次,服药前及３ ～５ ｄ 后用多普勒超声心动图观察血液动力学指标。结果：发现用药后出现两种不同的血液动力学变化,肺／ 体循环总阻力比值（ Ｔ Ｐ Ｒ／ Ｔ Ｓ Ｒ） 较低的 Ａ 组用药后主动脉压及体循环总阻力下降,肺动脉压及肺总阻力不变, Ｔ Ｐ Ｒ／ Ｔ Ｓ Ｒ 升高,肺／ 体循环血流量比值（ Ｑｐ／ Ｑｓ） 减少;而 Ｔ Ｐ Ｒ／ Ｔ Ｓ Ｒ较高的 Ｂ 组主动脉及肺动脉压均降低,体循环总阻力无明显变化,肺总阻力降低, Ｔ Ｐ Ｒ／ Ｔ Ｓ Ｒ 下降, Ｑｐ／ Ｑｓ 增高。临床上 Ａ 组比 Ｂ组症状改善更明显。结论：卡托普利降低先天性心脏病患者肺动脉压的同时,有可能出现 Ｑｐ／ Ｑｓ 增加这一不利的血液动力学变化。应将 Ｑｐ／ Ｑｓ 列为常规观察指标之一,特别是对于大分流量有症状的患者。     

60例消化道溃疡大出血患者手术治疗后引发血小板减少的原因及其临床意义

目的： 分析消化道溃疡大出血手术治疗后引发血小板减少症（ＴＣＰ） 的原因及临床意义。方法： 分析１９８６ 年３ 月～１９９５ 年１２ 月间因上消化道出血入住日本医科大学急救中心、并接受紧急手术治疗的６０ 例患者出现ＴＣＰ 的原因。结果： 经历大量输血或休克后的患者,术后ＴＣＰ 的发生明显增高; 术后ＴＣＰ 的严重程度与继发感染、多脏器功能衰竭及死亡相关。结论： 上消化道溃疡大出血患者手术止血后普遍存在ＴＣＰ, 其原因主要有大量输血和休克;术后ＴＣＰ 的程度与患者的预后有关, 术后血小板水平可做为预后指标。     

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…