星状神经节阻滞术对大鼠急性心肌梗死后炎症反应的影响

目的 探讨星状神经节阻滞术（SGB）对大鼠急性心肌梗死（AMI）后心肌细胞炎症的保护作用。方法 选取8周龄雄性SPF级Wistar大鼠60只,体重200～250 g,随机分为假手术组、AMI组和SGB组,每组20只。假手术组只打开胸腔暴露心脏,不结扎冠状动脉;AMI组结扎冠状动脉左前降支复制AMI模型;SGB组在AMI模型复制成功后行SGB。模型复制成功后1周采集各组大鼠血清及心脏组织,qRT-PCR检测各组大鼠心肌组织中炎症因子（IL-6、IL-1β及TNF-α）mRNA;酶联免疫吸附试验检测各组大鼠血清中炎症因子（IL-6、IL-1β及TNF-α）,全自动生化分析仪检测各组大鼠血清中心肌酶（AST、LDH和CK-MB）。结果 各组大鼠心肌组织中炎症因子IL-6、IL-1β及TNF-α mRNA相对表达量比较,差异有统计学意义（P <0.05）,SGB组IL-6、IL-1β及TNF-α mRNA的相对表达量均较AMI组降低（P <0.05）。各组大鼠血清中炎症因子IL-6、IL-1β及TNF-α表达水平比较,差异有统计学意义（P <0.05）,AMI组、SGB组IL-6、IL-1β及TNF-α表达水平较假手术组升高（P <0.05）,SGB组IL-6、IL-1β及TNF-α表达水平较AMI组降低（P <0.05）。各组大鼠血清AST、LDH及CK-MB表达水平比较,差异有统计学意义（P <0.05）,AMI组、SGB组AST、LDH及CK-MB表达水平较假手术组升高（P <0.05）,SGB组AST、LDH和CK-MB表达水平较AMI组降低（P <0.05）。结论 SGB对大鼠AMI后心肌细胞炎症有一定的保护作用。     

注射用炎琥宁对实验性急性咽炎动物模型的疗效与作用机制研究

目的 探讨注射用炎琥宁对大鼠实验性急性咽炎动物模型的疗效及作用机制。方法 采用乙型溶血性链球菌直接注射于SD大鼠咽部黏膜建立急性咽炎动物模型,并给予注射用炎琥宁药物进行治疗,观察该药物对模型动物血清IL-1β、IL-6β、肿瘤坏死因子-α（TNF-α）的表达以及对病理形态学的影响。结果 高、中（53、26.7 mg/kg）剂量组药物对模型动物血清中的IL-1β、IL-6β有明显的抑制作用,同时能不同程度改善急性咽炎的病理变化;高剂量组药物能有效抑制模型组动物TNF-α的表达。结论 注射用炎琥宁对急性咽炎有较好的治疗作用,其作用机制可能与调节细胞因子的表达和抑制咽部病理改变的发生有关。     

积雪草苷对平阳霉素诱导的大、小鼠肺纤维化的保护作用

  目的：观察积雪草苷对平阳霉素诱导的大、小鼠肺纤维化的保护作用,并探讨其作用机制。  方法：①小鼠实验:将KM小鼠随机分为对照组、模型组、阳性对照(醋酸泼尼松,5 mg/kg)组和积雪草苷低剂量(40 mg/kg)、高剂量(80 mg/kg)组,每组10只。除对照组外,其他各组小鼠采用一次性气管注入平阳霉素(5 mg/kg)的方法诱导肺纤维化模型。造模次日,各组灌胃给予相应的药物干预,连续28 d。末次给药后,分离肺组织;测定肺指数;ELISA检测肺组织白介素(IL)-6、肿瘤坏死因子-α(TNF-α)、IL-1β含量;PCR检测肺组织转化生长因子-β₁(TGF-β₁)mRNA表达。②大鼠实验:将SD大鼠随机分为对照组、模型组、阳性对照(醋酸泼尼松,4 mg/kg)组和积雪草苷低剂量(20 mg/kg)、高剂量(40 mg/kg)组,每组10只。除对照组外,其他各组大鼠采用一次性气管注入平阳霉素(5 mg/kg)的方法诱导肺纤维化模型。造模次日,各组灌胃给予相应的药物干预,连续28 d。末次给药后,分离肺组织;测定肺指数;HE染色后光镜下观察各组大鼠肺组织形态学变化;ELISA检测肺组织IL-6、TNF-α、IL-1β含量;PCR检测肺组织TGF-β₁mRNA表达。  结果：①小鼠实验:模型组小鼠肺指数,肺组织IL-6、TNF-α、IL-1β含量及TGF-β₁ mRNA表达均较对照组显著升高(P<0.01)。与模型组相比,阳性对照组与积雪草苷低、高剂量组小鼠的肺指数及肺组织IL-6、TNF-α、IL-1β含量显著降低(P<0.05,P<0.01),积雪草苷低、高剂量组小鼠肺组织TGF-β₁ mRNA表达水平显著降低(P<0.05)。②大鼠实验:模型组大鼠肺指数,肺组织IL-6、TNF-α、IL-1β含量及TGF-β₁ mRNA表达均较对照组显著升高(P<0.01)。与模型组相比,阳性对照组与积雪草苷低、高剂量组大鼠肺指数显著降低(P<0.05,P<0.01),肺组织TGF-β₁ mRNA表达水平显著降低(P<0.01);阳性对照组和积雪草苷高剂量组大鼠肺组织IL-6、TNF-α、IL-1β含量较模型组显著降低(P<0.05,P<0.01),积雪草苷低剂量组TNF-α、IL-1β含量较模型组明显降低(P<0.05)。③HE染色观察显示,模型组大鼠肺泡结构破坏,成纤维细胞增生,伴有大量炎症细胞浸润;积雪草苷低、高剂量组和阳性对照组大鼠上述病变均有改善,炎症细胞浸润和肺泡萎陷减轻。  结论：积雪草苷对平阳霉素诱导的大、小鼠肺纤维化具有保护作用,其机制可能与下调TGF-β₁mRNA表达、抑制炎症细胞因子激活有关。     

肺炎支原体肺炎患儿血清IL-1R1、HMGB1、炎症细胞因子水平及其临床意义

目的 探讨肺炎支原体肺炎患儿血清白细胞介素-1受体1型（IL-1R1）、高迁移率族蛋白1（HMGB1）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平及其临床意义。方法 选取2017年1月—2018年12月南通大学第二附属医院儿科收治的肺炎支原体肺炎患儿90例作为观察组,另取同期该院健康体检儿童90例作为对照组。采用酶联免疫吸附试验测定两组血清IL-1R1、HMGB1、IL-1β、IL-6、TNF-α水平。结果 观察组血清IL-1R1、HMGB1、IL-1β、IL-6、TNF-α水平高于对照组（P <0.05）。重症患儿血清IL-1R1、HMGB1、IL-1β、IL-6、TNF-α水平高于轻症患儿（P <0.05）。轻症患儿恢复期血清IL-1R1、HMGB1、IL-1β、IL-6、TNF-α水平低于急性期（P <0.05）。重症患儿恢复期血清IL-1R1、HMGB1、IL-1β、IL-6、TNF-α水平低于急性期（P <0.05）。肺炎支原体肺炎患儿血清IL-1R1与IL-1β、IL-6和TNF-α呈正相关（r =0.576、0.617和0.598,均P <0.05）;肺炎支原体肺炎患儿血清HMGB1与IL-1β、IL-6和TNF-α呈正相关（r =0.543、0.571和0.623,均P <0.05）。结论 肺炎支原体肺炎患儿血清IL-1R1、HMGB1及炎症细胞因子水平升高,其水平高低可反应病情严重程度。     

电针对睡眠剥夺大鼠行为学和脾脏IL-1β、IL-6和TNF-α的影响

[目的] 观察电针对睡眠剥夺大鼠行为学和脾脏白细胞介素(IL)-1β、IL-6和肿瘤坏死因子-α(TNF-α)mRNA表达的影响。[方法] 将32只Wistar雄性大鼠随机分为空白对照组、模型组、安定组和电针组。对照组未做任何处理,其余3组给予注射氯苯丙氨酸(PCPA)睡眠剥夺后,安定组给予腹腔注射安定,电针组给予电针百会、神庭,每组每日治疗1次,连续5 d后行旷场实验并采用逆转录-聚合酶链反应(RT-PCR)检测大鼠脾脏IL-1β、IL-6和TNF-α。[结果] 与对照组相比,模型组大鼠旷场实验水平得分、垂直得分和中央格停留时间明显升高,差异具有统计学意义(P<0.05);与模型组相比,安定组和电针组旷场实验水平得分、垂直得分和中央格停留时间明显降低,差异具有统计学意义(P<0.05)。与对照组相比,模型组IL-1β和TNF-α含量显著升高,差异具有统计学意义(P<0.01),IL-6无统计学差异(P>0.05);与模型组相比,安定组和电针组IL-1β和TNF-α含量显著降低,差异具有统计学意义(P<0.05),IL-6无统计学差异(P>0.05)。[结论] 电针百会、神庭既能明显改善睡眠剥夺症状,又能很好控制IL-1β、IL-6和TNF-α的表达,解除失眠对机体的损害。     

中药咽炎饮抗大鼠急性咽炎的实验研究

目的:评价中药咽炎饮对急性咽炎的药效作用,并对其机制进行初步探讨。方法:采用15%浓氨水向咽部喷雾制备大鼠急性咽炎模型,以双黄连口服液作为药物对照,分为双黄连组给予双黄连口服液8ml/(kg·d);咽炎饮高、低两个剂量组分别给予7.2,3.6g/(kg·d)的咽炎饮,正常组、模型组,分别给予等量生理盐水,灌胃,每天2次,连续7d。实验处理完成后,取血检测白细胞计数及白细胞分类计数。取咽部组织观察病理改变。离心取上清用酶联免疫法(ELISA)检测肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)。结果:咽炎饮可抑制急性咽炎大鼠血中白细胞异常升高,减轻咽部组织的炎细胞浸润,减少TNF-α、IL-1β分泌。结论:咽炎饮可有效治疗大鼠急性咽炎,其机制可能与抑制TNF-α、IL-1β分泌有关。     

六灵解毒丸对急性咽炎的治疗作用研究

目的 研究六灵解毒丸对急性咽炎的治疗作用。方法 采用向幼龄大鼠咽部喷雾15%氨水的方法制备大鼠急性咽炎模型。将造模成功的大鼠随机分为5组,即模型组、蓝芩口服液组、六灵解毒丸3个剂量组（4.375、8.75、17.5 mg/kg）,每天灌胃给药1次。空白组与模型组大鼠每天用生理盐水灌胃1次。各组均连续灌胃7 d。实验期间观察大鼠体质量、咽喉红肿等体征。给药结束后,用HE染色法观察大鼠咽部病变情况,取血清和咽黏膜下的结缔组织检测炎症因子的表达情况。采用小鼠毛细血管通透性与耳肿胀实验研究六灵解毒丸的抗炎作用。结果 与空白组相比,模型组大鼠时常抓挠口咽部且体质量增长缓慢,咽部明显红肿,组织结构异常,有大量结缔组织增生和炎症细胞浸润。给予大鼠六灵解毒丸后,大鼠体质量增长加快,咽部红肿程度下降,组织结构有明显改善,黏膜下层腺体结构正常,未见结缔组织增生与炎症细胞浸润。六灵解毒丸能明显下调大鼠血清与组织中的IL-1β、IL-6、TNF-α水平（P<0.05~0.01）。另外,六灵解毒丸对二甲苯所致小鼠耳肿胀和乙酸所致的小鼠腹腔毛细血管通透性升高均有显著的抑制作用（P<0.05~0.01）,其中六灵解毒丸中、高剂量组抑制耳肿胀作用明显优于蓝芩口服液。结论 六灵解毒丸对于急性咽炎具有良好的治疗作用,其机制可能与下调IL-1β、IL-6、TNF-α水平相关。在临床等效剂量下,六灵解毒丸的作用略优于蓝芩口服液,表明六灵解毒丸有较好的治疗急性咽炎的作用。      

HO-1减轻大鼠颈动脉球囊损伤后的内膜增生

目的 探讨血红素加氧酶-1（HO-1）能否减轻大鼠颈动脉球囊损伤后的内膜增生。方法 20只雄性SD大鼠随机分为正常并注射生理盐水组、球囊损伤并注射生理盐水组,球囊损伤并注射氯化血红素组、球囊损伤并注射锌原卟啉组。建立大鼠颈动脉球囊损伤模型,14天后取各组大鼠的颈动脉。弹力蛋白染色并计算各组大鼠颈动脉的内膜面积与中膜面积的比值（i/m）。Western blot法检测各组大鼠颈动脉内HO-1、NF-κB、IL-1β、IL-6、TNF-α的表达情况。结果 球囊损伤能够明显诱导大鼠颈动脉i/m值的增加（P<0.01）。球囊损伤并注射氯化血红素组的颈动脉i/m值明显低于球囊损伤并注射生理盐水组（P<0.01）。球囊损伤并注射锌原卟啉组的颈动脉i/m值明显高于球囊损伤并注射生理盐水组（P<0.01）。球囊损伤并注射生理盐水组颈动脉的NF-κB、IL-1β、IL-6、TNF-α的表达明显高于正常并注射生理盐水组。球囊损伤并注射氯化血红素组NF-κB、IL-1β、IL-6、TNF-α的表达明显低于球囊损伤并注射生理盐水组（P<0.05）。球囊损伤并注射锌原卟啉组NF-κB、IL-1β、IL-6、TNF-α的表达明显高于球囊损伤并注射生理盐水组（P<0.01）。结论 球囊损伤能够诱导大鼠颈动脉的炎性反应及内膜增生,HO-1能够减轻大鼠颈动脉球囊损伤后的内膜增生。     

白藜芦醇促进巨噬细胞M2极化并缓解小鼠急性痛风性关节炎

目的 观察白藜芦醇对小鼠急性痛风性关节炎的预防效果,并探讨巨噬细胞M2极化是否介导白藜芦醇的作用。方法 18只C57BL/6小鼠随机分为3组,每组6只：假手术组、造模+溶剂对照组、造模+白藜芦醇组。假手术组用无菌生理盐水处理小鼠右侧后肢踝关节,造模+溶剂对照组小鼠右侧后肢踝关节给予单钠尿酸盐（MSU）晶体构建急性痛风性关节炎模型,造模+白藜芦醇组提前给予DMSO溶解的白藜芦醇干预再进行MSU晶体造模。测定各组小鼠双侧足掌厚度,采用H-E染色观察各组小鼠足掌关节滑膜组织炎症情况。分离、提取正常小鼠腹腔原代巨噬细胞,给予白藜芦醇干预后以MSU晶体刺激,用蛋白质印迹法检测巨噬细胞M1极化标志物诱导型一氧化氮合酶（iNOS）的表达,用实时荧光定量PCR检测巨噬细胞中炎症指标肿瘤坏死因子α（TNF-α）、白细胞介素1β（IL-1β）mRNA的表达水平,用流式细胞术检测M2型巨噬细胞标志物F4/80、CD163的表达。结果 成功构建小鼠急性痛风性关节炎模型。造模前给予白藜芦醇干预后,小鼠右侧后肢足掌厚度明显低于溶剂对照组[（1.98±0.02）mm vs（2.49±0.12）mm,P<0.01],小鼠足掌关节炎滑膜组织中中性粒细胞浸润面积减少。体外实验中,白藜芦醇显著抑制了小鼠腹腔原代巨噬细胞中iNOS蛋白和TNF-α、IL-1β mRNA的表达水平（P均<0.01）,提高了F4/80⁺CD163⁺细胞比例（P<0.01）。结论 白藜芦醇可能通过促进巨噬细胞M2极化,抑制炎性因子的产生,从而有效缓解小鼠急性痛风性关节炎。     

金水宝胶囊对尘肺模型大鼠的改善作用及其机制

通过建立大鼠尘肺模型,探讨金水宝胶囊改善呼吸功能及肺组织病变的相关机制。通过气管注射石英粉尘建立大鼠慢性尘肺模型。造模成功后,治疗组灌胃给予金水宝胶囊600、300 mg/kg,每天1次,连续6个月。给药的第1、3、6月,各组分别取6只大鼠,进行血液流变学、血管内皮功能、免疫炎症因子、氧化应激等指标检测。结果显示,在6个月试验期间,金水宝胶囊高剂量对于各时间点血浆黏度具有明显的改善作用(P<0.05),对全血黏度有部分改善作用。金水宝胶囊可降低血清TGF-β、TNF-α和IL-6等炎症因子水平(P<0.05,P<0.01),高剂量能显著降低血清CD4⁺/CD8⁺水平(P<0.05,P<0.01)。金水宝胶囊可明显降低模型大鼠血清MDA水平,并升高SOD活力(P<0.05),具有剂量相关性。金水宝胶囊剂量依赖性降低模型大鼠支气管肺泡灌洗液中白细胞数量(P<0.05,P<0.01)。金水宝胶囊高剂量全部试验周期内对支气管肺泡灌洗液ET、NO和PC水平均有明显改善作用(P<0.05,P<0.01),而低剂量第1月具有部分改善作用,而3月后具有统计学显著差异的改善作用。阳性药汉防己甲素片对炎症相关指标具有较好改善作用,但对于血流变和氧化应激指标则未见明显影响。实验结果表明,金水宝胶囊对于尘肺模型大鼠的改善作用涉及血液黏度、全身及肺组织炎症反应、血管内皮损伤、机体氧化应激状态、肺组织纤维化等多方面的作用机制。     

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.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

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.