琼脂糖微囊化猪胰岛移植治疗糖尿病的实验研究

对微囊化猪胰岛的体外、体内功能进行研究。方法采用经胰导管连续灌注胶原酶技术分离和纯化猪胰岛。国产琼脂糖作为制备微包囊的免疫隔离材料，用“相分离”方法包被成年猪胰岛。２１只糖尿病大鼠用于实验，对照组６只，移植组１５只。其中６只腹腔内植入微囊化胰岛，６只腹腔内植入未包囊胰岛，３只肾包膜下植入未包囊胰岛。数据做组间比较，用ｔ检验。结果微囊化胰岛在１个月的培养期间可持续分泌胰岛素。囊内细胞生长良好，微囊没有溶解和破碎。培养２天的微囊化胰岛对高糖与茶碱刺激有明显反应，胰岛素释放量分别为低糖的１．８３倍和２．２８倍（Ｐ＜０．０１）。对６只糖尿病大鼠施行腹腔内植入微囊化胰岛手术，２０００～３０００个／只。不用任何免疫抑制剂。移植后第４天血糖明显下降，第７天时血糖降至正常范围，维持３０天。结论琼脂糖微囊具有较好的免疫隔离作用。     

大鼠胰岛微囊化技术和微囊化胰岛同种移植

用改良胶原酶消化技术和聚蔗糖密度梯度离心方法将大鼠胰岛从胰腺分离,按Sun等的方法用海藻酸和聚赖氨酸等予以微囊化。每个微囊化和未微囊化胰岛体外培养每24h释放的胰岛素分别为63±42μu和69±42μu。7只链脲霉素诱发糖尿病大鼠不使用免疫抑制剂,接受一次性腹腔内移植(4.0～4.5)×10~3个微囊化胰岛后血糖恢复正常或接近正常(由19.4±1.6mmol/L降至7.9±3.4mmol/L)。每只受鼠每天的饮水量及尿量也明显下降。移植后血糖恢复正常的最长时间已超过222d,仍在继续随访。     

微胶囊对大鼠糖尿病异种胰岛组织移植免疫隔离作用的实验研究

目的　观察微胶囊 (海藻酸钠 多聚赖氨酸 海藻酸钠 )对大鼠糖尿病异种胰岛组织移植的免疫隔离作用。方法　糖尿病大鼠 30只。随机分为 5组 :( 1)微囊组 ;( 2 )未包囊组 ;( 3)空囊移植组 ;( 4 )生理盐水组 ;( 5 )糖尿病组。每组各 6只。微囊组用微囊化的小鼠胰岛细胞注入糖尿病大鼠腹腔内。未包囊组用纯化后的胰岛细胞注入糖尿病大鼠腹腔内。空囊移植组用与微囊组数量相同的空微囊注入糖尿病大鼠腹腔内。生理盐水组用等量的生理盐水注入糖尿病大鼠的腹腔内。糖尿病组对糖尿病大鼠不行移植操作。各组大鼠分别于移植后 2h、4h测量血糖 ,以后每天测定血糖 1次 ,1周后改为每 10d测 1次 ;同时称量体重 ,观察饮水量及尿量 ,直至空腹血糖高于 19.3mmol/l定为胰岛移植物排斥。结果　糖尿病组、空囊移植组及生理盐水组大鼠血糖无明显变化 ;微囊组糖尿病大鼠异种胰岛移植 2h后血糖明显低于未包裹组 ,下降幅度为 8～ 12mmol /L ,有显著性差异 (P <0 .0 1) ;未包裹组血糖下降仅维持 2～ 3d ,微胶囊组血糖下降可持续 5 6～ 12 0d ,两组持续天数比较 ,有显著性差异 (P <0 .0 1)。移植后 1个月从腹腔回收的微囊胰岛呈圆型、表面光滑 ,无明显纤维组织包绕。囊内胰岛DTZ染色呈桔黄色。结论　微胶囊制作技术可明显延长小     

猪胰岛移植治疗小鼠糖尿病

目的:探讨猪胰岛纠正糖尿病小鼠的高血糖作用.方法:用链尿佐菌素腹腔注射诱发小鼠糖尿病.用胶原酶分离成年猪胰岛,Ficoll液密度梯度离心纯化后腹腔内移植.测定血糖,观察移植效果.结果:在移植后第3天开始,小鼠血糖明显下降,移植物存活有效时间5～12天,平均功能存活时间7.1±1.87天.胰岛移植组血糖下降为5.77±1.38mmol/L,对照组注射Hanks液后血糖为26.19±3.05 mmol/L.结论:猪胰岛能有效纠正糖尿病小鼠高血糖状态,异种胰岛移植对糖尿病小鼠有治疗作用.     

微囊包膜猪胰岛移植治疗糖尿病大鼠获得成功

胰岛移植治疗胰岛素依赖型糖尿病,其疗效不够满意的主要原因是:受者产生排异反应及移植的是胰腺组织碎片而非纯化胰岛。 重庆医科大学人工细胞研究室舒昌达教授等在糖尿病小鼠腹腔内移植免疫隔离膜包裹大鼠胰岛(中华内分泌代谢杂志(1991;7(2):101)工作的基础上;发现微囊包膜猪胰岛在体外培养时,能稳定地分泌胰岛素,故将微囊包膜纯化初生猪胰岛移植至糖尿病大鼠腹腔内,进行异种胰岛移植研究。     

微囊化胰岛移植联合肾动脉重建缓解糖尿病肾病大鼠早期肾脏病变

目的：建立微囊化胰岛移植联合肾动脉重建大鼠模型,并观察该模型对糖尿病肾病（DN）大鼠早期肾脏病变的疗效。方法：SD大鼠单次大剂量腹腔注射链脲佐菌素建立糖尿病模型。实验分为3组：①DN组;②微囊组（采用微囊化胰岛腹腔移植）;③联合组（进行微囊化胰岛移植联合肾动脉重建）。各组观察4周后,收集24 h内所有尿液,检测尿蛋白总量,并随机检测各组血糖。收集各组肾脏和肾动脉分别进行PAS染色和HE染色,并观察结果。结果：微囊化胰岛移植联合肾动脉重建可以降低大鼠血糖,明显减少尿蛋白。肾脏PAS染色提示联合组和微囊组均可以减轻肾小球硬化,但2组差异无统计学意义。联合组和微囊组肾动脉内膜增厚不显著。结论：微囊化胰岛移植联合肾动脉重建可以显著减轻早期DN病变。     

微囊化新生猪胰岛异种移植治疗小鼠实验性糖尿病的研究

用一步法微囊包膜技术包裹新生猪胰岛，移植于８只糖尿病小鼠腹腔后约１周，小鼠血糖由移植前的＞１６．６７ｍｍｏｌ／Ｌ降至＜８．３３ｍｍｏｌ／Ｌ。然后将维持疗效１３０天以上小鼠的移植物取出作组织学检查。结果显示微囊内仍见边缘清晰的完整胰岛，且微囊胰岛无纤维包绕；而移植无微囊胰岛的对照组，正常血糖仅维持２周，移植物即被排斥。提示采用微囊化的胰岛异种移植，能有效地纠正糖尿病模型动物的高血糖，并明显地延长小鼠的存活期。说明此微囊具有免疫隔离作用，且有良好的生物膜性，能有效地避免宿主抗移植物的排异反应。     

微囊内胰岛数量对实验性糖尿病模型鼠疗效的影响

用一步法微囊技术包裹新生猪胰岛 ,并控制微囊内胰岛数量 ,分别移植于链脲霉素 (STZ)制备的糖尿病模型大鼠 ,每组 10只 ,对照组微囊内 3～ 4个胰岛 ,实验组微囊内含一个胰岛。植入胰岛数量均为2 0 0 0个 /鼠 ,移植后的第 10天各组大鼠均停用胰岛素。结果表明 :实验组大鼠血糖值为 (6 .6 4± 1.10 )mmol/L。半数以上血糖在正常范围并存活达 147d以上。对照组为 (9.83± 1.33)mmol/L。血糖维持该水平70余天后逐渐上升 ,其中 3只血糖高水平情况下存活 98d。两组相比有非常显著差异 (P <0 .0 1)。结果表明 :减少微囊内胰岛数量 ,可提供足量营养 ,是提高疗效的有利措施。     

骨髓基质干细胞移植对糖尿病大鼠血糖的影响

目的研究骨髓基质干细胞移植对糖尿病大鼠的降血糖作用。方法单次链脲霉素腹腔注射建立糖尿病大鼠模型;糖尿病大鼠分为对照组和移植组,对照组腹腔注射等体积培养液,移植组将骨髓基质干细胞移植至糖尿病大鼠胰腺组织中,测定大鼠血糖变化,评价骨髓基质干细胞移植对大鼠血糖的影响。结果骨髓基质干细胞移植后,糖尿病大鼠血糖水平明显下降,由17.58±2.46 mmol/L降至5.94±2.25 mmol/L,移植组和对照组大鼠血糖水平差异有显著性(P<0.01)。结论骨髓基质干细胞移植后可降低糖尿病大鼠血糖。     

微囊化新生猪胰岛细胞异种移植生物相容性和疗效的研究

目的:研究微囊化新生猪胰岛细胞异种移植影响生物相容性的因素以及对1型糖尿病的疗效。方法:注射链脲霉素诱发糖尿病大鼠模型后,将不同组微囊化新生猪胰岛细胞、未微囊化新生猪胰岛细胞及空微囊,经腹腔植入1型糖尿病大鼠体内,移植后不应用任何免疫抑制剂,测量移植后大鼠血糖、体重、胰岛素C肽的变化。结果:移植后6~8周实验组、对照组3糖尿病大鼠血糖、体重逐渐恢复正常水平;移植后实验组、对照组1、2、3血清C肽水平升高,对葡萄糖刺激实验反应明显;胰岛素释放试验显示葡萄糖可刺激胰岛细胞释放胰岛素实验组与对照组比较有统计学意义(p0.01)。结论:微囊周围细胞过度增生是导致移植物功能丧失的主要原因;微囊化新生猪胰岛细胞可以纠正糖尿病大鼠高血糖状态,在体内可以生长、分化,并增加胰岛素分泌水平。     

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.