粉防己碱对肾性高血压大鼠血压及抗氧化作用影响研究

目的：探讨粉防己碱对肾血管性高血压大鼠血压及血清抗氧化能力的影响。方法：采用两肾一夹（2K1C）法建立大鼠肾血管性高血压病模型,术后2周,选择50只尾动脉血压升高超过130 mmHg的大鼠按照随机数字表法分为3组,每组10只,分别为空白对照组、高血压模型组、粉防己碱高剂量治疗组、粉防己碱高剂量治疗组及氯沙坦组。在对大鼠应用药物治疗后的第4、5、6周,测定2组大鼠的尾动脉血压、血清中超氧化物歧化酶（SOD）活性、一氧化氮（NO）以及丙二醛（MDA）的含量,同时测定总抗氧化能力（T-AOC）;应用estern blotting方法检测大鼠腹主动脉中的内皮素-1（ET-1）蛋白表达。结果：治疗4周后,粉防己碱高、低剂量能显著降低肾血管性高血压大鼠的尾动脉血压（P≤0.01,P≤0.05）,且降压作用维持至第6周;与模型组相比较,粉防己碱高、低剂量治疗组使肾血管性高血压大鼠血清中MDA含量、ET-1表达值、T-AOC显著降低（P≤0.01,P≤0.05）,使肾血管性高血压大鼠血清中NO含量与SOD活性显著增高（P≤0.01,P≤0.05）。结论：粉防己碱能够显著的降低肾血管性高血压大鼠尾动脉收缩压,同时对大鼠的血清具有很强的抗氧化能力,主要的作用机理可能与其增加一氧化氮的释放及产生以及降低ET-1的蛋白在血管中的表达相关。     

葡萄籽原花青素对肾血管性高血压大鼠血管内皮细胞功能的影响

目的 观察葡萄籽原花青素(GSP)对肾血管性高血压(RH)大鼠血管内皮细胞(VEC)功能的影响.方法 采用两肾一夹(2K1C)法复制RH大鼠模型,并设假手术组(control,n=8).术后2周,选取鼠尾动脉收缩压升至130 mmHg以上的大鼠32只为RH大鼠,随机分为4组(n=8):高血压模型组(RH model)、GSP低剂量治疗组[low GSP,50 mg/(kg·d)]、GSP高剂量治疗组[high GSP,200 mg/(kg·d)]和卡托普利阳性对照治疗组[captopril,30 mg/(kg·d)].治疗6周后,分别测定各组大鼠尾动脉收缩压、血清中内皮素(ET)、前列环素(PGI2)和血管紧张素Ⅱ(AngⅡ)含量,Western blotting法检测腹主动脉中内皮型一氧化氮合酶(eNOS)的蛋白表达.结果 治疗6周后,与control组相比,RH model组大鼠的尾动脉收缩压、血清中ET和AngⅡ含量明显升高,而血清中PGI2含量和腹主动脉中eNOS的蛋白表达明显降低；与RH model组相比,GSP各剂量治疗组和captopril治疗组大鼠的尾动脉收缩压、血清中ET和AngⅡ含量显著降低,血清中PGI2含量和腹主动脉中eNOS的蛋白表达显著升高.结论 GSP能降低RH大鼠尾动脉收缩压、减少RH大鼠血清中缩血管物质ET和AngⅡ含量、增加舒血管物质PGI2含量及增强腹主动脉中eNOS的蛋白表达进而发挥保护VEC功能的作用.     

葡萄籽原花青素对肾血管性高血压大鼠血管重塑保护作用机制的研究

目的 探讨葡萄籽原花青素(GSP)对肾血管性高血压大鼠血管重塑保护作用机制.方法 采用两肾一夹(2K1C)法,复制肾血管性高血压(RH)大鼠模型,并设立假手术组(control,n=7).术后2周,选取鼠尾动脉收缩压(SBP)升至130mmHg以上的大鼠28只为RH大鼠,并随机分为4组(n=7):高血压模型组(RHmodel)、GSP低剂量治疗组[low GSP,50mg/(kg·d)]、GSP高剂量治疗组[high GSP,200mg/(kg·d)]和卡托普利阳性对照治疗组[(captopril,30mg/(kg·d)].治疗6周后,分别测定各组大鼠尾动脉SBP、胸主动脉中膜厚度(MT)及管腔内径(LD);ELISA法测定腹主动脉中超氧化物歧化酶(SOD)活性、总抗氧化能力(T-AOC)、丙二醛(MDA)及一氧化氮(NO)含量;Western blotting法检测腹主动脉中白介素-10(IL-10)的蛋白表达.结果 治疗6周后,与control组比较,RH model组大鼠尾动脉SBP、MT及MDA含量明显升高,而腹主动脉中SOD活性、T-AOC、NO含量、LD和IL-10的蛋白表达明显降低.与RH model组比较,GSP能显著降低大鼠尾动脉SBP、MT及MDA含量,升高腹主动脉中SOD活性、T-AOC、LD和IL-10的蛋白表达.NO含量虽然增多,但无统计学意义.结论 GSP能显著降低RH大鼠的尾动脉SBP,同时可以通过增强大鼠抗氧化能力,增加腹主动脉中NO含量及抑炎因子IL-10的蛋白表达来发挥保护血管重塑的作用.     

两肾一夹高血压大鼠肾脏损伤及血管改变动态观察

目的探讨不同高血压维持时段对肾脏和肾脏血管的影响。方法 5周龄的雄性WKY大鼠36只作为实验动物,夹住左侧肾动脉,使其缩窄约3/4左右,制作两肾一夹高血压动物模型（2K1C）,监测术后8、16和24周2K1C高血压大鼠血压和肾脏相对重量的变化;光学显微镜动态观察肾脏损伤,观测肾脏各级小动脉血管重构情况。结果 2K1C高血压大鼠术后血压明显升高（P〈0.05）,肾脏相对重量没有随血压和周龄改变发生明显变化（P〉0.05）;随高血压维持周龄增加,肾小球损伤指数、肾间质炎症改变和管型逐渐增加（P〈0.01）。2K1C高血压试验组肾脏动脉丛管壁增厚,中层平滑肌层数增多,并可见弹力纤维断裂现象,部分肾入球小动脉玻璃样变性。与同龄对照组相比,2K1C组中型动脉和细小动脉中膜厚度/管腔直径比值（S）均增大,病变以细小动脉更明显。术后16周2K1C组中型动脉S值高于8周2K1C组（P〈0.05）。2K1C组细小动脉S值随高血压大鼠周龄增大明显增加（P〈0.01）。结论随高血压状态的维持,2K1C高血压大鼠模型肾脏损害、肾脏血管构型改变逐渐加重。     

原发性高血压大鼠动脉血管重构的形态学研究

目的探讨自发性高血压大鼠(SHR)大动脉及肾小、细动脉血管重构(VR)的形态学改变,为进一步明确高血压状态下动脉VR的分子机制奠定基础。方法将4、16、24周龄组雄性SHR作为实验组,同周龄雄性Wistar大鼠(WKY)作为对照组,各组5只大鼠。进行主动脉和肾小、细动脉组织学测量和弹性纤维染色观察,高血压动脉VR情况。结果 SHR组主动脉中膜血管平滑肌细胞(VSMC)总数多于同周龄WKY组。24周龄SHR主动脉管壁中层弹性膜排列紊乱、松散、厚薄不均、断裂。SHR组肾小动脉相对内径随周龄增加逐渐减小,相对中膜厚度随周龄增加逐渐增加。24周龄SHR肾小动脉管壁纤维化,肾细动脉未见明显纤维化改变。结论 SHR各组动脉VR的形态学表现不一致,可能其具有不同的分子机制。     

EFFECTS OF PERIVASCULAR ADIPOSE TISSUE ON VASCULAR REMOLDING IN RENAL HYPERTENSION

目的:探讨血管周围脂肪组织(PVAT)与肾性高血压血管重构的相关性及其可能的机制.方法:用两肾一夹型(左侧肾动脉狭窄,右侧肾保留,2k1c)建立肾性高血压大鼠模型,将30只SD大鼠随机分为假手术组(SH)和肾性高血压组(RH),术前及术后12周末检测大鼠尾动脉血压、心率.放射免疫法检测脂肪组织血管紧张素Ⅱ(AngⅡ)水平.采用实时荧光定量PCR检测血管紧张素原(AGT)和血管紧张素酶(ACE)mRNA表达.采用western blot检测血管紧张素受体1(AT1)和受体2(AT2)蛋白表达.并检测PVAT过氧化氢(H2O2)含量.结果:2k1c术后12周RH组大鼠胸主动脉发生血管重构,AngⅡ水平、AGT、ACE mRNA表达均高于SH组,AT1蛋白表达量和H2O2含量也高于SH组,而AT2蛋白量表达两组差异无统计学意义(P＞0.05).结论:PVAT与肾性高血压血管重构相关,活性氧(ROS)可能参与其发生机制.     

两肾一夹高血压大鼠肾脏损伤及血管改变动态观察

目的探讨不同高血压维持时段对肾脏和肾脏血管的影响。方法 5周龄的雄性WKY大鼠36只作为实验动物,夹住左侧肾动脉,使其缩窄约3/4左右,制作两肾一夹高血压动物模型(2K1C),监测术后8、16和24周2K1C高血压大鼠血压和肾脏相对重量的变化;光学显微镜动态观察肾脏损伤,观测肾脏各级小动脉血管重构情况。结果 2K1C高血压大鼠术后血压明显升高(P<0.05),肾脏相对重量没有随血压和周龄改变发生明显变化(P>0.05);随高血压维持周龄增加,肾小球损伤指数、肾间质炎症改变和管型逐渐增加(P<0.01)。2K1C高血压试验组肾脏动脉丛管壁增厚,中层平滑肌层数增多,并可见弹力纤维断裂现象,部分肾入球小动脉玻璃样变性。与同龄对照组相比,2K1C组中型动脉和细小动脉中膜厚度/管腔直径比值(S)均增大,病变以细小动脉更明显。术后16周2K1C组中型动脉S值高于8周2K1C组(P<0.05)。2K1C组细小动脉S值随高血压大鼠周龄增大明显增加(P<0.01)。结论随高血压状态的维持,2K1C高血压大鼠模型肾脏损害、肾脏血管构型改变逐渐加重。     

结缔组织生长因子 肝细胞生长因子与肾血管性高血压大鼠血管重塑的相关性研究

目的:探讨结缔组织生长因子(CTGF)和肝细胞生长因子(HGF)在肾血管性高血压大鼠血管重塑中的作用。方法:采用"两肾一夹"肾血管性高血压大鼠模型,构建成功的30只Wistar大鼠随机分为对照组(n=15)、高血压组(n=15),每周测量1次各组大鼠尾动脉收缩压(SBP)。HE染色观察血管结构变化,并计算颈总动脉血管中膜厚度与内径比值(MT/LD)及血管中膜平滑肌细胞层数,免疫组织化学染色法检测颈总动脉CTGF和HGF的表达水平。结果:①模型组大鼠尾动脉SBP较对照组明显升高(P<0.01)。②模型组大鼠颈总动脉MT/LD及血管中膜细胞层数较对照组显著增加(P<0.01)。③模型组大鼠颈总动脉CTGF蛋白的表达水平明显高于对照组(P<0.01),HGF蛋白的表达水平明显低于对照组(P<0.01)。④CTGF蛋白的表达水平与血压、MT/LD、血管中膜平滑肌细胞层数呈显著正相关(P<0.01),与HGF呈显著负相关(P<0.01);HGF与血压、MT/LD、血管中膜平滑肌细胞层数、CTGF均呈显著负相关(P<0.01)。结论:在2K1C高血压大鼠模型中,CTGF、HGF均参与了肾血管性高血压血管重塑,CTGF是促血管重塑因子,而HGF是少有的抑制血管重塑因子。     

磷酸化细胞外信号调节激酶和P21ras在高血压血管平滑肌细胞中表达增强

目的探讨高血压血管平滑肌细胞增生和ERK激活的机制。方法采用免疫组织化学和Westernblotting技术,对比观察肾血管性高血压和自发性高血压大鼠肾细小动脉平滑肌细胞中磷酸化细胞外信号调节激酶1/2(ERK1/2)和P21ras表达。结果实验期间,Wistar肾血管性高血压组动脉血压从(104±18)mmHg升高到实验结束时的(198±33)mmHg,自发性高血压大鼠16周龄时的血压为(163±23)mmHg。肾血管性高血压组肾小球发生了明显的纤维化(P<0.05),自发性高血压大鼠肾小球纤维化等与对照组无显著性差异。肾血管性高血压组入球动脉、小叶间动脉、叶间动脉和弓形动脉血管平滑肌细胞中磷酸化ERK1/2染色阳性率分别为7.09%、14.57%、29.44%和13.63%,均明显高于对照组(P<0.01)。自发性高血压大鼠入球动脉、小叶间动脉、叶间动脉和弓形动脉血管平滑肌细胞中磷酸化ERK1/2染色阳性率分别为16.09%、24.17%、32.44%和18.61%,均明显高于对照组(P<0.01);肾血管性高血压组和16周龄自发性高血压大鼠入球动脉、小叶间动脉和弓形动脉平滑肌细胞中P21ras的阳性率明显高于对照组(P<0.01);Westernbloting检测可见高血压组和16周龄自发性高血压大鼠肾组织磷酸化ERK1/2和P21ras蛋白含量明显高于对照组(P<0.01)。结论在大鼠两肾一夹型高血压和自发性高血压时,P21ras基因表达增加使部分血管平滑肌细胞丝裂原激活蛋白激酶系统激活,导致部分小动脉血管平滑肌细胞增生。     

牛磺酸对高血压大鼠心肌肥厚、心肌细胞凋亡、NO及血管紧张素Ⅱ含量的影响

目的探讨牛磺酸对肾血管性高血压大鼠心肌肥厚、心肌细胞凋亡、一氧化氮（NO）及血管紧张素Ⅱ（Ang Ⅱ）含量的影响。方法采用两肾一夹（2K1C）型肾血管性高血压大鼠模型。所有大鼠被随机分为3组（每组20只）：假手术对照组、高血压对照组、牛磺酸治疗组。于术后第5周开始给予牛磺酸50mg·kg^-1·d^-1。采用标准尾套法间接检测清醒大鼠血压。给药8周后,大鼠处死,分离其左室心肌以用于检测左室质量/体质量比、心肌细胞凋亡指数（AI）、NO和Ang Ⅱ含量。结果与假手术组大鼠相比,未给药2K1C高血压大鼠血压明显升高,左室质量体质量比、心肌AI和Ang Ⅱ含量均升高,心肌NO含量降低。应用牛磺酸治疗则明显降低了肾动脉狭窄术后大鼠的血压、左室质量/体质量比、心肌Ai和Ang Ⅱ含量;同时也升高了2K1C高血压大鼠心肌NO含量。结论长疗程牛磺酸治疗可抑制高血压大鼠心肌肥厚和心肌细胞凋亡发生,其作用机制与药物调控心源性活性物质分泌水平有关。     

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…