芪归糖痛宁颗粒对糖尿病大鼠坐骨神经AGEs、PARP mRNA表达的影响

目的 探讨芪归糖痛宁颗粒对糖尿病周围神经病变(Diabetic Peripheral Neuropathy,DPN)的作用机制。 方法 大鼠高脂饲料喂养4周后,空腹12h进行链脲佐菌素(STZ)60 mg/kg一次性腹腔注射复制DPN大鼠模型,将成模的大鼠分组,分别予以相应药物灌胃,正常对照组和模型组实验期间予以生理盐水灌胃,疗程12周,实验结束后,分别对大鼠FPG、神经传导速度、血清SOD、MDA、NGF水平及坐骨神经AGEs、PARP mRNA的表达进行检测。 结果 与模型组比较,芪归糖痛宁颗粒高、低剂量组均能降低糖尿病大鼠血糖(P<0.01或P<0.05),改善神经传导速度(P<0.01或P<0.05),均降低血清MDA水平(P<0.05),均降低坐骨神经AGEs、PARP mRNA的表达(P<0.01)。芪归糖痛宁颗粒高剂量组升高血清SOD水平(P<0.01),降低血清NGF水平(P<0.01)。 结论 芪归糖痛宁颗粒通过抑制氧化应激与AGEs、PARP途径的相互作用,从而防治和延缓糖尿病周围神经病变的发生。     

芪归糖痛宁颗粒对大鼠糖尿病周围神经病变的影响

目的观察芪归糖痛宁颗粒对大鼠糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的疗效,并探讨其作用机制。方法以链脲佐菌素(streptozotocin,STZ)一次性腹腔注射复制DPN大鼠模型。于模型复制第3天起,各治疗组分别灌胃给予相应的受试药物,正常组和模型组灌胃给予等容量溶媒,疗程8周。实验结束后,测定大鼠热痛阈值、血液流变学指标、血清神经生长因子(nerve growth factor,NGF)、髓磷脂碱性蛋白(myelin basic protein,MBP)的含量,同时取固定部位坐骨神经,用苏木精-伊红染色观察坐骨神经组织病理学变化。结果与模型组比较,芪归糖痛宁颗粒组能明显改善DPN大鼠坐骨神经病理组织学损伤程度,同时降低大鼠热痛阈(P<0.05),降低大鼠全血黏度低切、中切、高切,血浆黏度,红细胞聚集指数及MBP含量(P<0.05,或P<0.01),升高血清NGF含量(P<0.05)。结论芪归糖痛宁颗粒对大鼠DPN具有一定的治疗作用。     

温针灸、谢氏点穴及其联合治疗对高脂饮食诱导的膝骨关节炎大鼠的作用机制研究

目的 探讨温针灸、谢氏点穴及其联合治疗对肥胖大鼠膝骨关节炎的治疗效果与作用机制。〖JP1〗方法 采用高脂饮食诱导肥胖大鼠膝骨关节炎,检测温针灸、谢氏点穴以及温针灸+谢氏点穴治疗后肥胖大鼠体质量,血清总胆固醇（total cholesterol,TC）、三酰甘油（total triglyceride,TG）、高密度脂蛋白（high-density lipoprotein,HDL）与低密度脂蛋白（low-density lipoprotein,LDL）,膝关节病变,关节滑液中白细胞介素1β（interleukin 1β, IL-1β）、肿瘤坏死因子α（tumor necrosis factor α,TNF-α）、单核细胞趋化蛋白1（monocyte chemoattractant protein-1,MCP-1）和血管内皮生长因子（vascular endothelial growth factor,VEGF）的含量以及膝关节软骨层中基质金属蛋白酶-1（matrix metalloproteinases-1,MMP-1）和MMP-13表达的水平。结果 与对照组比较,模型组大鼠体质量,血清TC、TG、LDL水平,膝关节Mankin得分,关节滑液中IL-1β、TNF-α、MCP-1、VEGF水平及膝关节软骨层中MMP-1与MMP-13的表达水平均显著升高（P<0.05）,血清HDL水平显著降低（P＜0.05）。与模型组比较,各治疗组大鼠血清TC、TG水平,膝关节Mankin得分,关节滑液中MCP-1、VEGF水平及膝关节软骨层中MMP-13表达水平均显著下降（P<0.05）。谢氏点穴疗法、温针灸+谢氏点穴疗法显著升高大鼠血清HDL水平,降低关节滑液中TNF-α含量和膝关节软骨层中MMP-1表达水平（P<0.05）;温针灸+谢氏点穴疗法显著降低大鼠血清LDL水平、关节滑液中IL-1β含量（P<0.05）;温针灸+谢氏点穴疗法降低大鼠血清TC、TG、LDL水平,膝关节Mankin得分及膝关节软骨层中MMP-1、MMP-13表达水平显著优于温针灸治疗组和谢氏点穴治疗组（P<0.05）。结论 温针灸联合谢氏点穴能够调节脂质代谢,减少关节滑液中VEGF与MCP-1的分泌,从而缓解高脂饮食诱导的膝骨关节炎。     

芪蛭皱肺颗粒对慢性阻塞性肺疾病大鼠模型气道炎症的影响

目的 观察芪蛭皱肺颗粒对慢性阻塞性肺疾病（COPD）大鼠血清、支气管肺泡灌洗液（BALF）中白细胞介素-8（IL-8）和肿瘤坏死因子-α（TNF-α）水平的影响.方法 采用香烟烟熏加气管内注入脂多糖的复合因素造模法建立COPD大鼠模型,于造模第15天,空白组、模型组给予等体积中剂量颗粒辅料溶液灌胃4周,其他各药物干预组给予芪蛭皱肺颗粒小剂量、中剂量、大剂量和阳性药物（固本咳喘片）溶液灌胃4周,末次用药后取肺组织HE染色,取血清和BALF采用放免法检测IL-8和TNF-α的含量.结果 采用香烟烟熏加气管内注入脂多糖的方法成功复制了COPD大鼠模型,病理观察显示大鼠支气管及肺血管壁炎细胞浸润,分泌物明显增多,肺泡扩张.与空白组比较,模型组血清IL-8与TNF-α含量均升高（P＜0.01或＜0.05）;BALF IL-8与TNF-α含量亦均升高（P＜0.05或＜0.01）;与模型组比较,芪蛭皱肺颗粒各剂量组及固本咳喘片组血清及BALF中IL-8和TNF-α含量均降低（P＜0.05）,以芪蛭皱肺颗粒大剂量组降低更明显（P＜0.01）.结论 芪蛭皱肺颗粒有可能是通过减少炎症因子的生成和释放,从而有效调节肺炎症损伤时IL-8和TNF-α水平的升高,对大鼠模型气道炎症具有一定的干预作用.     

益气活血通络方对高糖诱导的人脐静脉内皮细胞炎性因子表达的影响

目的 研究益气活血通络方含药血清对高糖诱导的人脐静脉内皮细胞(human umbilical vein endothelial cells, HUVECs)炎性因子白细胞介素-1β（interleukin-1 beta, IL-1β）、肿瘤坏死因子-α（tumor necrosis factor alpha, TNF-α）、单核细胞趋化蛋白-1（monocyte chemoattractant protein-1, MCP-1）及金属基质蛋白酶-1（metal matrix proteinase-1, MMP-1）表达的影响,探讨益气活血通络方对脐静脉内皮细胞的保护作用。方法 选择SD大鼠30只,中药灌胃,制备含药血清。体外培养HUVECs,MTT法检测不同时间点、不同浓度葡萄糖对细胞存活率的影响;将HUVECs随机分为5组,即空白对照组,模型组,益气活血通络方低、中、高浓度组,高糖刺激后,分别加入不同浓度益气活血通络方含药血清干预,收集上清及细胞,ELISA法检测IL-6的表达,Western Blot法测定IL-1β、TNF-α、MCP-1及MMP-1蛋白的表达。结果 细胞培养48 h 后,33.3 mmol/L高糖组（模型组）细胞活力显著降低（P＜0.05）;高糖刺激可引起IL-6、IL-1β、TNF-α、MCP-1及MMP-1蛋白的高表达(P＜0.05）,益气活血通络方含药血清显著抑制IL-6、IL-1β、TNF-α、MCP-1及MMP-1蛋白的高表达（P＜0.05)。结论 益气活血通络方可抑制炎性因子的高表达,对高糖损伤的HUVECs有一定的保护作用。     

姜黄素增强糖皮质激素对慢性阻塞性肺疾病大鼠抗炎作用的研究

目的探讨在慢性阻塞性肺疾病（简称慢阻肺）大鼠模型中姜黄素增强糖皮质激素抗炎作用的效果和机制。方法将24只sD大鼠随机分为慢阻肺组、姜黄素组、布地奈德组和姜黄素＋布地奈德组。所有大鼠均采取单纯香烟烟熏法复制慢阻肺大鼠动物模型。实时定量PCR检测大鼠肺组织中的白细胞介素8（IL-8）、单核细胞趋化蛋白1（MCP-1）、肿瘤坏死因子α（TNF-α）、基质金属蛋白酶9（MMP-9）、组蛋白脱乙酰化酶2（HDAC2）的mRNA表达,酶联免疫吸附试验（ELISA）检测大鼠肺组织中的IL-8、MCP-1、TNF-α表达,蛋白免疫印迹（Western）检测大鼠肺组织中MMP-9、HDAC2的蛋白表达,染色质免疫沉淀（CHIP）检测IL-8、MCP-1、TNF-α、MMP-9启动子区与HDAC2的结合水平。结果与慢阻肺组、姜黄素组、布地奈德组比较,姜黄素＋布地奈德组大鼠肺组织中IL-8、MCP-1、TNF-α、MMP-9的mRNA和蛋白表达量均降低,HDAC2的表达量升高。CHIP结果显示,与慢阻肺组、姜黄素组、布地奈德组比较,姜黄素＋布地奈德组大鼠肺组织的IL-8、MCP-1、TNF-α、MMP-9启动子区与HDAC2的结合水平升高。结论姜黄素和布地奈德合用大鼠肺组织中IL-8、MCP-1、TNF-α、MMP-9的表达量明显降低,并与HDAC2的表达量呈负相关,这种相关性可能与大鼠肺组织的IL-8、MCP-1、TNF-α、MMP-9启动子区与HDAC2的结合水平有关。说明姜黄素可能通过升高HDAC2的表达量和活性,增强慢阻肺大鼠对糖皮质激素的敏感性及抗炎作用。     

宁痫颗粒联合卡马西平对难治性癫痫大鼠血清IL-1β、IL-6、TNF-α影响的实验研究

目的：观察宁痫颗粒联合卡马西平对海人酸难治性癫痫大鼠血清IL-1β、IL-6、TNF-α水平的影响,探讨其作用机制.方法：Wistar雄性大鼠42只,按体质量随机分为假手术组、模型组、卡马西平＋宁痫颗粒高（0.03＋4.80/g·kg-1·d-1）、中（0.03＋2.40/g·kg-1·d-1）、低剂量组（0.03＋ 1.20/g·kg-1·d-1）、宁痫颗粒组（2.40/g· kg-1·d-1）和卡马西平组（0.03/g· kg-1·d-1）,每组6只.采用海马CA3局部注射海人酸制作大鼠癫痫模型,术后第二天予苯妥英钠药物筛选14d后成功制作难治性癫痫模型.各组分别灌胃2周后股动脉采血,收集各实验组大鼠血清,采用免疫酶联法（Elisa法）,测定各实验组大鼠血清IL-1β、IL-6、TNF-α水平.结果：与卡马西平组比较,宁痫颗粒低剂量联合卡马西平组大鼠血清IL-1β、IL-6含量显著降低（P＜0.05）,宁痫颗粒中、高剂量组联合卡马西平大鼠血清IL-1β、IL-6含量极显著降低（P＜0.01）;宁痫颗粒低、中、高剂量联合卡马西平组大鼠血清TNF-α含量极显著降低（P＜0.01）.结论：IL-1β、IL-6、TNF-α共同参与了免疫反应,其水平的变化间接反映了脑组织损伤程度.表明宁痫颗粒联合卡马西平具有一定的免疫抑制作用,比单用卡马西平疗效显著,说明两者联合具有协同作用,其机制可能是通过抑制炎症反应从而阻断癫痫发作,达到治疗癫痫目的.     

芪归糖痛宁颗粒对糖尿病大鼠坐骨神经糖基化终末产物、聚ADP核糖聚合酶基因表达的影响

目的探讨芪归糖痛宁颗粒对糖尿病周围神经病变(DPN)的作用机制。方法 SD大鼠65只,随机留取10只为空白对照组,其余55只给予高脂饲料喂养4周后,空腹12h链脲佐菌素(STZ)60mg/kg一次性腹腔注射复制DPN大鼠模型,将42只成模大鼠分为模型组(M组)9只、芪归糖痛宁颗粒高剂量组(QTG高组)、芪归糖痛宁颗粒低剂量组(QTG低组)和甲钴胺片组(J组)组各11只,分别予以相应药物灌胃,空白对照组(Con组)和模型组实验期间予以生理盐水灌胃,疗程12周,实验结束后,分别对大鼠空腹血糖(FPG)、神经传导速度、血清超氧化物歧化酶(SOD)、丙二醛(MDA)、神经生长因子(NGF)水平及坐骨神经糖基化终末产物(AGEs)、聚ADP核糖聚合酶(PARP)基因的表达进行检测。结果治疗后,与模型组(M组)比较,芪归糖痛宁颗粒高(QTG高组)、低剂量(QTG低组)组均能降低糖尿病大鼠血糖[(14.08±3.54)mmol/L、(16.11±2.95)mmol/L比(20.41±2.25)mmol/L,P0.01或P0.05)],改善神经传导速度(49.16±5.37)m/s、(43.76±3.93)m/s比(39.66±3.65)m/s,P0.01或P0.05)],降低血清MDA水平(14.91±1.23)nmol/L、(15.22±0.55)nmol/L比(16.75±1.67)nmol/L,P均0.05)],降低坐骨神经AGEs m RNA的表达(0.572±0.021,0.983±0.013比1.088±0.032,P均0.01),降低PARP m RNA的表达(0.677±0.035、0.829±0.015比1.113±0.024,P0.01);与模型组(M组)比较,芪归糖痛宁颗粒高剂量组升高血清SOD水平(112.87±4.98)U/m L比(97.55±4.93)U/m L,P0.01),升高血清NGF水平[(37.38±4.51)ng/L比(26.06±4.41)ng/L,P0.01)]。结论芪归糖痛宁颗粒通过抑制氧化应激与AGEs、PARP途径的相互作用,从而防治和延缓大鼠糖尿病周围神经病变的发生。     

黄芪桂枝五物汤对糖尿病周围神经病变大鼠血清IL-1β、TNF-α、NGF和坐骨神经NGF mRNA的影响

目的 通过建立糖尿病周围神经病变（diabetic peripheral neuropathy,DPN）大鼠模型,研究黄芪桂枝五物汤对DPN大鼠血清白细胞介素1β（interleukin-1β,IL-1β）、肿瘤坏死因子α（tumor necrosis factor-α,TNF-α）、神经生长因子（nerve growth factor,NGF）和坐骨神经组织NGF mRNA的影响,探讨黄芪桂枝五物汤治疗DPN的可能机制。方法 连续4周以高脂饮食加腹腔注射链脲佐菌素诱导模型法复制DPN大鼠模型,自第5周开始,黄芪桂枝五物汤高、中、低剂量组每日分别采用黄芪桂枝五物汤19.40、4.85、2.43 g/kg灌胃,连续给药12周;甲钴胺组每日采用甲钴胺0.25 mg/kg灌胃。采用RT-PCR技术检测大鼠坐骨神经中NGF mRNA表达水平,采用酶联免疫吸附法检测血清IL-1β、TNF-α、NFG水平。结果 与空白对照组比较,模型组大鼠血清IL-1β、TNF-α水平显著升高（P＜0.05）,NGF水平显著降低（P＜0.05）,坐骨神经中NGF mRNA表达水平下降（P＜0.05）。黄芪桂枝五物汤呈剂量依赖性降低血清IL-1β、TNF-α水平,升高血清NGF水平和坐骨神经中NGF mRNA表达水平。结论 黄芪桂枝五物汤可减轻周围神经组织炎症损伤,促进损伤神经的修复与再生,其机制可能与降低糖尿病大鼠血清IL-1β、TNF-α水平,上调坐骨神经NGF mRNA的表达水平有关。     

小檗碱对2型糖尿病周围神经病变大鼠IL-1β、TNF-α的影响

目的:通过观察小檗碱(Ber)对糖尿病周围神经病变(DPN)模型大鼠血清、脊髓及坐骨神经内白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)的浓度的影响,探讨小檗碱治疗DPN作用机制。方法:以链脲佐菌素(STZ)腹腔注射诱导形成DPN模型,以不同剂量100mg/kg、187.5mg/kg的Ber灌胃治疗,每天1次,持续8周。用酶联免疫吸附测定(ELISA)法分别测定各组大鼠血清、脊髓及坐骨神经内IL-1β、TNF-α的浓度。结果:Ber对DPN大鼠痛阈、坐骨神经传导速度(NCV)有明显改善(P<0.05),与对照组比较,DPN模型组大鼠的IL-1β、TNF-α含量显著增高(P<0.05),Ber治疗8周后,与DPN模型组比较IL-1β、TNF-α含量明显降低(P<0.05)。结论:抑制细胞炎症因子IL-1β、TNF-α的释放,可能是小檗碱改善DPN的机制之一。     

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.