糖化和氧化产物修饰的蛋白质促进兔主动脉粥样斑块形成

目的:探讨晚期糖基化终产物(AGE)和晚期蛋白质氧化产物(AOPP)对动脉粥样硬化斑块形成的影响.方法:50只12周龄新西兰白兔被随机分为5组(每组10只),除对照组外均以高胆固醇饲料喂养并分别注射或不注射兔血清白蛋白及AGE或AOPP修饰的兔血清白蛋白.10周后处死动物,取血清测血脂、AGE和AOPP水平;取主动脉全段,以苏丹Ⅳ染色,PHOTOSHOP R 软件分析粥样斑块占主动脉壁的相对面积;显微镜下测量粥样斑块的平均厚度.结果:(1)AGE和AOPP组主动脉全段的动脉粥样斑块相对面积(50.1%±7.4%和62.4%±8.8%)均明显大于单纯胆固醇喂饲组(29.8%±6.3%)和白蛋白组(20.9%±6.4%)(P均＜O.05).(2)AGE和AOPP组胸主动脉段粥样斑块的平均厚度[(147.7±13.1)μm和(138.1±13.0)μm]均明显大于单纯胆固醇喂饲组[(85.7±15.0)μm和白蛋白组[(95.5±15.7)μm](P均＜O.05);(3)4个喂饲高胆固醇饲料组的血脂水平无明显差异,注射AGE或AOPP的动物血清中AGE或AOPP水平明显增高,且与斑块相对面积呈正相关(AGE与斑块相对面积:r=0.408,P=0.005;AOPP与斑块相对面积:r=0.595,P=0.000).结论:AGE和AOPP促进高胆固醇动物动脉粥样斑块形成,这类尿毒症毒素可能参与了慢性肾功能衰竭加速型动脉粥样硬化的发生、发展.     

罗格列酮对动脉粥样硬化大鼠血清晚期糖基化终产物的影响及可能机制

目的:观察晚期糖基化终产物在动脉粥样硬化大鼠血清中的水平,以及应用胰岛素增敏剂罗格列酮对其的影响,并探讨其可能机制。方法:通过一次性维生素D3注射+高脂喂养法建立动脉粥样硬化模型。动物分组:A组:动脉粥样硬化模型组,B组:罗格列酮治疗组,C组:正常对照组,24周后处死全部大鼠,测定大鼠血清晚期糖基化终产物(AGE)、丙二醛(MDA)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、总胆固醇(TC)、甘油三脂(TG)水平。计算血浆致动脉硬化指数(AIP)。取主动脉全段,HE染色分析大鼠主动脉病变,PHOTOSHOP系统测定粥样斑块面积占内膜面积的百分比。免疫组化法观察主动脉丙二醛修饰低密度脂蛋白(MDA-LDL)的沉积。结果:大鼠血清AGE水平A组>B组>C组(P均<0.01)。MDA血清水平亦有A组>B组>C组(P值分别<0.05和0.01)。AIP数值A组>B组>C组(P均<0.01)。TC、LDL血清水平A组和B组均高于C组(P均<0.01),A组和B组之间无统计学差异。除C组外,其他两组大鼠主动脉均见粥样斑块形成,A组动脉粥样斑块面积/内膜面积百分比(38%±6%)高于B组(26%±8%)(P<0.05),A组粥样斑块病变部位MDA-PLDL的沉积面积较B组大(P<0.01,AGE与AIP值呈正相关(r=0.698,P<0.01),AGE与血清MDA呈正相关(r=0.514,P<0.05)。结论:血清AGE增高是动脉粥样硬化的危险因素之一。应用罗格列酮可以降低AGE水平,改善动脉损伤。AGE导致动脉粥样硬化的机制可能与增加氧化应激和增高血浆致动脉硬化指数有关。     

动脉粥样硬化的实验研究 Ⅰ.中药有效成份8501的抗动脉粥样硬化作用

本文采用48只雄性新西兰纯系家兔,分成4组,观察中药有效成分8501在实验性动脉粥样硬化形成过程中降低胆固醇和预防斑块形成的作用。结果表明,8501可以明显降低血清胆固醇、主动脉组织胆固醇酯(CE)及总胆固醇(TC)含量,对抗高脂饲料,降低血清α-脂蛋白比例的作用,并可使主动脉粥样硬化斑块面积明显小于高脂组。阿斯匹林虽有降低血清胆固醇含量、轻度升高α-脂蛋白比例的作用,但主动脉组织TC、CE含量及斑块形成面积与高脂组无明显差异。     

实验性兔主动脉粥样硬化易损斑块模型的建立与评价

目的 探索建立实验性兔主动脉粥样硬化易损斑块模型的新方法.方法 24只雄性日本大耳白家兔随机分为对照组8只,实验组16只,对照组给予普通饲料;实验组给予高胆固醇饲料、注射牛血清白蛋白及进行腹主动脉球囊拉伤术,分别于0周、3周、6周、10周检测血脂、ox-LDL、TNF-α、IL-1、IL-10,实验结束时取腹主动脉进行病理形态学分析及NF-κBp65亚基免疫组化染色分析.结果 实验组斑块内膜面积比为53.6%,脂核面积与斑块面积比为54.9%,斑块纤维帽厚度与内膜中膜厚度(IMT)比约为8.5%;除甘油三酯变化不大外,实验组TC、LDL-C、HDL-C、LDL-C/ HDL-C、TC/ HDL-C、ox-LDL、TNF-α、IL-1、IL-10均有明显升高趋势,在3周、6周、10周时与对照组比较差异有统计学意义;且NF-κBp65亚基阳性染色面积较对照组高13.5倍.结论 高脂喂养、免疫损伤加球囊拉伤可以成功建立家兔主动脉粥样硬化易损斑块模型.     

瑞舒伐他汀对载脂蛋白E基因敲除小鼠动脉粥样硬化的治疗作用及其机制

目的: 探讨瑞舒伐他汀对载脂蛋白E基因敲除(ApoE^-/-)小鼠动脉粥样硬化模型血脂水平、动脉粥样硬化斑块及斑块内细胞凋亡的影响,阐明瑞舒伐他汀抑制动脉粥样斑块进展及斑块内细胞凋亡的机制。方法: 选取健康6周龄雄性ApoE^-/-小鼠30只,随机分为高脂饮食组、高脂+他汀组和普通饮食对照组,每组10只。前2组小鼠给予高脂饮食,普通饮食对照组小鼠给予普通饲料,喂养4周后,3组小鼠分别给予0.9%生理盐水、瑞舒伐他汀(10mg·kg^-1·d^-1)和0.9%生理盐水灌胃8周,ELISA法检测各组小鼠血清血脂水平,HE染色观察小鼠动脉粥样硬化斑块大小,TUNEL法检测斑块内细胞凋亡,免疫组织化学染色法检测凋亡相关基因Bax蛋白表达。结果: 高脂+他汀组小鼠血清总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平明显低于高脂饮食组(P<0.05或P<0.01),高脂+他汀组高密度脂蛋白胆固醇(HDL-C)水平明显高于高脂饮食组(P<0.01)。高脂饮食组小鼠主动脉粥样斑块呈巨块型,斑块内可见大量泡沫细胞、胆固醇结晶、坏死细胞及炎性细胞;高脂+他汀组小鼠主动脉粥样斑块较小,泡沫细胞、坏死细胞和炎性细胞均较少;高脂+他汀组小鼠主动脉粥样斑块面积明显小于高脂饮食组(P<0.01);高脂+他汀组小鼠主动脉粥样斑块内细胞凋亡指数明显低于高脂饮食组(P<0.01)。与高脂饮食组比较,高脂+他汀组小鼠Bax蛋白表达明显降低。结论: 瑞舒伐他汀可以抑制动脉粥样斑块进展,抑制斑块内细胞凋亡,其作用机制可能与线粒体途径有关。     

正脂丸抗氧化、保护血管内皮功能作用的研究

目的：观察正脂丸防止动脉粥样硬化(As)形成的作用并探讨其可能的作用机制，方法：18例家兔随机分为3组（空白对照组、模型组、正脂丸组），分别于实验前、实验8w后测定血清总胆固醇（TC）、氧化低密度脂蛋白(ox-LDL)和NO含量，8w后处死动物，测定主动脉粥样硬化斑块面积，主动脉分支开口处斑块形成率及心壁内冠状动脉分支狭窄程度，结果：8w后正脂丸组血清TC，ox-LDL水平明显低于模型组，NO高于模型组（P＜0．05），主动脉斑块面积，心壁内冠状动脉分支狭窄程度均明显小于模型组。，结论：正脂丸有较好的防止As形成的作用，作用机制除降低血清TC含量处，还与其防止LDL氧化，保护血管内皮功能有关。     

高胆固醇血症患者缺血修饰白蛋白、血脂与炎症标志物水平关系的研究

目的 考查高胆固醇血症患者缺血修饰白蛋白(IMA)、血脂及炎症标志物水平之间关系,以及IMA在动脉粥样斑块形成和氧化应激中的作用.方法 检测37例动脉粥样硬化患者及37例健康志愿者血清中葡萄糖、总胆固醇、高密度脂蛋白(HDL)胆固醇、低密度脂蛋白(LDL)胆固醇、甘油三酯、氧化修饰LDL(ox-LDL)、抗ox-LDL自身抗体、高灵敏度C反应蛋白(hs-CRP)及IMA浓度.结果 高胆固醇血症患者组总胆固醇、LDL胆固醇、甘油三酯、ox-LDL、抗ox-LDL自身抗体、hs-CRP及IMA水平较对照组显著增高(P＜0.05),而HDL胆固醇水平较对照组显著降低(P＜0.05).IMA水平与总胆固醇、LDL胆固醇、抗ox-LDL自身抗体及hs-CRP水平之间有显著相关性.另外,hs-CRP与总胆固醇、HDL胆固醇、LDL胆固醇、甘油三酯、ox-LDL及抗ox-LDL自身抗体之间亦有显著相关性.结论 高胆固醇血症与炎症标志物及氧化应激标志物的表达增高相关,并降低血清白蛋白结合钴的能力,从而导致IMA水平增高.IMA与氧化应激及动脉粥样斑块的形成有相关性,证明了其在疾病发生、发展中可能起到重要作用.     

正加速度对家兔实验性动脉粥样硬化形成的影响

正加速度能使喂饲胆固醇家兔的血清总胆固醇含量升高得更多(P<0.01)。但主动脉弓内膜粥样斑面积,两组相差不显著。对照组的胸主动脉内膜粥样斑面积大于腹主动脉,实验组则相反。实验组冠状动脉口形成粥样斑和脂肪肝的例数比对照组多,相差显著(P<0.05)。     

高脂饮食对慢性肾脏病进展的影响

目的:探讨高脂饮食对5/6肾切除大鼠的肾损害及机制。方法:30只SD大鼠随机分为三组,高脂饮食组:喂饲高胆固醇饲料;手术对照组:喂饲普通鼠饲料;假手术组:喂饲普通鼠饲料。5个月后取肾组织,观察肾小球硬化及肾间质损害程度。同时检测血脂、血清肌酐、尿素氮、24h尿蛋白定量丙二醛(MDA)、氧化修饰低密度脂蛋白(ox-LDL)水平。结果:与对照组相比,高脂饮食组大鼠血脂水平显著升高,肾功能明显下降,24h尿蛋白定量显著升高;肾小球硬化及肾间质损害半定量积分明显升高;同时血清丙二醛与氧化修饰低密度脂蛋白水平均也显著升高。结论高脂饮食加速5/6肾切除大鼠肾损害,其机制可能与增强氧化应激反应有关。     

罗格列酮、辛伐他汀对动脉粥样硬化兔内皮功能的影响

目的探讨罗格列酮辛伐他汀对动脉粥样硬化兔内皮功能的影响。方法40只日本大耳白兔随机分为五组,正常对照组、高脂模型组、罗格列酮组、辛伐他汀组、联合用药组,每组8只。A组(正常对照组):普通颗粒饲料喂饲150g,日二次,10周。B组(高脂模型组):高脂饲料(1%胆固醇+8%猪油+普通颗粒饲料)150g,日二次,10周。C组(罗格列酮组):高脂饲料喂饲10周,从喂饲高脂饲料起,给予口服罗格列酮0.5mg/kg/日。D组(辛伐他汀组):高脂饲料喂饲10周,从喂饲高脂饲料起,给予口服辛伐他汀2.0mg/kg/日。E组(联合用药组):高脂饲料喂饲10周,从喂饲高脂饲料起,给予口服罗格列酮0.5mg/kg/日+辛伐他汀2.0mg/kg/日。实验结束后获取血浆和主动脉全长标本进行生化和病理分析。结果高脂模型组、各用药组与正常对照组相比血清血脂、内皮素(ET-1)水平增高,一氧化氮(NO)浓度降低,主动脉内膜不同程度脂质斑块形成,模型组最明显。罗格列酮组、辛伐他汀组、联合用药组三组ET-1浓度明显低于高脂模型组,NO水平高于高脂模型组,P<0.01,联合用药组效果最显著;四组主动脉可见不同程度的脂质斑块形成,其斑块/内膜面积比高脂模型组>罗格列酮组>辛伐他汀组>联合用药组,P<0.01。结论罗格列酮、辛伐他汀通过改善内皮功能、调脂等各自不同途径防治动脉硬化的发生发展,并具有协同作用。     

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.