血栓通注射液联合贝那普利对糖尿病肾病大鼠UAER及TGF-β1的影响

目的 观察血栓通注射液联合贝那普利对糖尿病肾病(DN)大鼠肾脏的保护作用,并进一步探讨其作用机制. 方法 健康SD大鼠60只,按照随机数字表分为空白组(N组)、模型组(DN组)、贝那普利组(B组)、贝那普利+血栓通组(XB组).用高糖高脂饲料加小剂量STZ制备DN大鼠模型.于实验12周末检测各组尿蛋白排泄率(UAER),观察肾脏组织转化生长因子β1(TGF-β1)的表达变化. 结果 与N组相比,DN组UAER明显增高(P＜0.01),肾小管上皮细胞及肾小球脏层上皮细胞TGF-β1的表达阳性表达显著增加(P＜0.01);与DN组相比,XB组UAER降低显著(P＜0.05),肾小管上皮细胞及肾小球脏层上皮细胞TGF-β1的阳性表达受到明显的抑制(P＜0.01);与B组相比,XB组的UAER降低更显著(P＜0.05);肾小管上皮细胞及肾小球脏层上皮细胞TGF-β1的阳性表达受到更显著的抑制(P＜0.01). 结论 血栓通注射液联合贝那普利对DN大鼠有明显的保护作用,其机制可能与降低尿白蛋白排泄率,并可一定程度地抑制TGF-β1在肾小管及肾小球的表达有关.     

脂多糖通过上调热休克蛋白27的表达减轻小鼠肾缺血再灌注损伤

目的 探讨热休克蛋白27 (heat shock protein-27,HSP27)在脂多糖(lipopolysaccharide,LPS)减轻小鼠肾缺血再灌注(ischemia-reperfusion,IR)损伤中的作用.方法 雄性C57BL/6小鼠随机分为4组:假手术组、LPS+假手术组、肾IR组和LPS+肾IR组,每组又分为槲皮素(quercetin,200mg/kg)亚组和溶剂对照亚组.采用右肾切除+左肾肾蒂夹闭25 min后再灌注建立肾IR模型,在肾IR前3d腹腔注射LPS(3mg/kg)进行预处理,采用槲皮素(200 mg/kg)灌胃抑制HSP27的表达.再灌注后24 h,各组小鼠经腹主动脉采血检测血清肌酐(Cr)、尿素氮(BUN)水平评估肾IR损伤模型,取左肾评估炎症反应程度、HSP27蛋白表达水平及凋亡相关蛋白easpase-3的活性.结果 LPS预处理可明显降低肾IR后的血清Cr、BUN水平,并减少肾小管损伤程度,同时能提高肾内HSP27的表达水平(P＜0.05);槲皮素能明显抑制肾内HSP27的表达水平,且能明显削弱LPS预处理对肾脏IR的减轻作用,包括升高Cr、BUN水平和造成更严重的炎症反应(P＜0.05).另外,LPS能明显降低肾脏IR后肾内caspase-3的活性,但槲皮素能明显削弱这种作用(P＜0.05).结论 LPS通过上调HSP27的表达减轻小鼠肾脏IR损伤.     

尿激酶热敏脂质体体内外溶栓效果的研究

目的 研究尿激酶热敏脂质体(UKTsL)的体内外溶栓效果.方法 在简易体外溶栓装置上研究了UKTsL的体外靶向溶栓效果;在兔颈动脉血栓模型上观察了UKTsL的体内靶向溶栓能力.结果 体外溶栓实验显示,UKTsL组的血凝块溶解率达(50.41±4.04)%,和2倍尿激酶(UK)剂量的UK组相近,与磷酸盐缓冲液(PBS)组及尿同UK剂量的尿激酶脂质体(UKL)组相比差异有显著性(P＜0.01).体内实验显示UKTsL组(UK总量75 000u/mL)各时段血压变化及血栓形态学改变与UK组(150 000 u/mL)相近(P＞0.05).结论 UKTsL具有较好的热靶向溶栓能力,能减少尿激酶的毒副作用.UKTsL用于溶栓还有待深入研究.     

敲除Vanin-1促进肾缺血再灌注损伤后功能恢复的作用及机制

目的 探讨血管非炎症分子1(vascular noninflammatory molecule-1,Vanin-1)在缺血再灌注损伤后肾组织的表达水平及其与肾脏功能恢复的关系.方法 选取8周龄BALB/c野生型、Vanin-1基因敲除雄鼠,采用完全随机法分为假手术组、缺血再灌注组、敲除组、敲除+缺血再灌注组,每组6只.缺血再灌注组、敲除+缺血再灌注组分离双侧肾蒂后夹闭35 min,后松开夹闭,恢复血流;假手术组、敲除组仅暴露肾蒂,不夹闭.术后0、3、14d,留取血清、尿液、肾组织标本,检测血清肌酐、尿素氮水平,检测尿液TGF-β水平,PAS染色明确肾组织损伤严重程度,免疫组化检测肾组织Vanin-1表达水平.提取野生型和Vanin-1基因敲除鼠原代肾小管上皮细胞,传代至第2代,设置对照组、对照+损伤组、敲除组、敲除+损伤组,损伤条件为缺氧(1％O2,94％N2,5％CO2,48 h)、复氧(5％CO2,95％空气,24 h),模拟体内缺血再灌注损伤模型,收取肾小管上皮细胞和上清,检测Vanin-1蛋白和上清中TGF-β表达水平.结果缺血再灌注损伤后第3天,与假手术组相比,缺血再灌注组、敲除+缺血再灌注组血清肌酐、尿素氮水平明显升高(P＜0.05),PAS染色提示肾组织损伤明显;但缺血再灌注组与敲除+缺血再灌注组小鼠比较,血清肌酐、尿素氮水平无明显差异,PAS染色提示两组肾组织损伤无明显差异.缺血再灌注后第14天,该两组血清肌野、尿素氮、PAS肾组织损伤均比缺血再灌注后第3天显著恢复,敲除+缺血再灌注组的恢复速度均明显快于缺血再灌注组,PAS肾组织慢性化改变明显轻于缺血再灌注组(P＜0.05),且敲除+缺血再灌注组尿中TGF-β水平明显低于缺血再灌注组(P＜0.05).免疫组化结果提示:损伤后第14天,肾组织 Vanin-1表达明显升高(P＜0.01),且主要表达于受损肾小管上皮细胞.细胞实验结果显示:予以缺氧-复氧损伤后,对照+损伤组肾小管上皮细胞Vanin-1蛋白表达明显升高(P＜0.01),上清中TGF-β 水平明显高于敲除+损伤组(P＜0.05).结论Vanin-1可促进缺血再灌注损伤后肾小管上皮细胞TGF-β分泌,延缓肾脏功能恢复,促进急性肾损伤向慢性肾脏病进展.     

磷酸化膜突蛋白与大鼠肾脏缺血再灌注损伤的关系

目的 研究磷酸化膜突蛋白( phosphorylated moesin,p-Moesin)与大鼠肾脏缺血再灌注损伤的关系.方法 2.5月龄Wistar雄性大鼠15只.随机选取5只行假肾脏缺血再灌注手术,即打开腹腔后未进行肾脏动静脉夹闭(假手术组);10只行肾脏缺血再灌注手术(行双侧肾脏动静脉夹闭45 min再灌注24h),其中5只未给予治疗(手术组),其他5只在手术后给予盐酸法舒地尔治疗(治疗组).留取肾组织免疫组化法观察p-Moesin在肾组织的表达情况.结果 p-Moesin定位于大鼠肾脏肾小管上皮细胞胞浆和胞核.手术组大鼠肾脏p-Moesin的表达(阳性着色面积评分)(3.55±0.04)较假手术组(1.04±0.08)增多(P＜0.05);治疗组大鼠肾脏p-Moesin的表达(1.86±0.09)较手术组减少(P＜0.05).结论 p-Moesin在大鼠肾脏定位于肾小管上皮细胞胞浆与胞核,其表达与大鼠肾脏缺血再灌注损伤有关.     

不同浓度七氟烷后处理对大鼠肾脏缺血/再灌注损伤的影响

目的 探讨不同浓度七氟烷后处理对大鼠肾脏缺血/再灌注损伤的影响,评价七氟烷后处理对大鼠肾脏缺血/再灌注损伤后肾内皮型一氧化氮合成酶(eNOS)、诱导型一氧化氮合成酶(iNOS)的影响.方法 SD雄性大鼠60只,随机分为5组(每组12例):假手术组、缺血/再灌注组[建立肾脏缺血/再灌注(I/R)模型]、不同浓度七氟烷后处理组[(1.2%七氟烷为S1.2组,1.8%七氟烷为S1.8组和2.2%七氟烷为S2.2组):先建立I/R模型,在缺血后再灌注的同时用不同浓度的七氟烷处理2 h.测定再灌注24 h时血清肌酐(Cr)、尿素氮(BUN)浓度;大体标本观察再灌注肾横切面坏死情况;光镜下观察肾皮质肾小管坏死百分率].为探讨七氟烷后处理作用机制,采用免疫组化法测假手术组,缺血/再灌注组,S1.8组肾组织eNOS、iNOS的表达.结果 再灌注24 h时,与假手术组相比,其余4组血清Cr、BUN、肾小管坏死率明显升高(P<0.05);与缺血/再灌注组相比,S1.2组、S1.8组、S2.2组血清Cr、BUN、肾小管坏死率明显下降(P<0.05);S1.2组、S1.8组、S2.2组之间上述各指标差异无统计学意义(P>0.05).与假手术组相比,缺血/再灌注组肾eNOS、iNOS的表达明显增强(P<0.05);与缺血/再灌注组相比,S1.8>组肾eNOS、iNOS的表达明显下降(P<0.05).结论 七氟烷后处理可以减轻大鼠肾缺血/再灌注损伤;七氟烷3种不同浓度(1.2%,1.8%,2.2%)后处理对减轻大鼠缺血/再灌注损伤无明显差别;七氟烷后处理可抑制肾eNOS、iNOS的表达.     

门冬氨酸钾镁对尿激酶静脉溶栓治疗急性心肌梗死的影响

目的研究门冬氨酸钾镁对尿激酶(UK)静脉溶栓治疗急性心肌梗死(AMl)的影响.方法98例AMI住院患者,随机分为门冬氨酸钾镁+尿激酶组和UK组,前者在静滴UK前后加门冬氨酸钾镁静滴.结果两组血管再通率分别为74.0%和70.8%,无显著性差异(P＞0.05),但门冬氨酸钾镁+尿激酶组的再灌注心律失常(RA)发生率,5周病死率显著低于UK组(P＜0.01,P＜0.05);开始治疗前后并发的严重心律失常(SA)、心力衰竭(HF)及梗塞后心绞痛(PIA)的发生率显著低于UK组(P均＜0.05),再梗塞(RI)及梗塞延展(IE)的发生率也低于UK组.结论UK静脉溶栓前后加用门冬氨酸钾镁,可提高UK溶栓疗效,缩小梗塞面积,减少并发症,并有益于缺血--再灌注损伤防治.     

尿α1-微球蛋白测定对糖尿病肾病早期诊断的价值

目的:探讨尿α1-微球蛋白与糖尿病肾脏损害的关系及早期诊断的价值.方法:用放免法同时检测30例正常人和60例2型糖尿病(DM)患者的α1-微球蛋白.结果:患者组α1-微球蛋白显著高于正常组(P＜0.01).糖尿病组与对照组的α1-MG/Cr(P＜0.01)和TRF/Cr(P＜0.05)均有明显差异.DM1组Alb/Cr、β2-MG/Cr与对照组无明显差异,而α1-MG/Cr、TRF/Cr有显著差异(α1-MG/Cr,P＜0.01;TRF/Cr,P＜0.05),三组α1-MG/Cr、TRF/Cr排泄率都明显高于健康对照组,且DM2组和DM2组明显高于DM1组(P＜0.01).结论:尿α1-微球蛋白可作为糠尿病肾病早期诊断指标之一,近曲小管病变甚至早于肾小球病变.     

Expression and significance of Trps1 in rat kidney repair after ischemia/reperfusion injury

目的 观察大鼠缺血再灌注损伤肾组织Trps1的表达变化及其与肾组织病变的关系,探讨Trps1在肾脏修复再生中的作用.方法 42只雄性SD大鼠分为假手术组、缺血再灌注组.经腹正中切口分离大鼠双侧肾蒂,用无损动脉夹夹闭60 min后恢复灌注,假手术组仅暴露肾蒂不夹闭.于再灌注后1、3、7、14、21 d取大鼠动脉血及肾组织标本,采用自动生化分析仪检测大鼠血肌酐、尿素氮水平,PAS染色检测肾组织损伤情况,免疫组化和Western blot检测肾组织Tprs1表达变化.结果 假手术组大鼠血肌酐和尿素氮分别为(30.12±2.95) μmol/L、(5.89±0.67) mmol/L.与假手术组相比,大鼠肾脏缺血再灌注后1、3、7d血肌酐[(319.25±25.49)、(338.20±22.70)、(216.07±18.54)μmol/L]及尿素氮[(33.53±8.06)、(78.05±7.13)、(42.61±11.87) mmol/L]显著升高(P＜0.05),14、21 d血肌酐[(33.33±6.46)、(32.06±8.74)μmol/L]及尿素氮[(6.02±1.27)、(6.93±3.28) mmol/L]与假手术组相比无显著差异(P＞0.05).PAS 染色显示肾组织在再灌注1d时即出现损伤,3d时损伤最重,7d时损伤开始修复,至第21天修复完全.免疫组化及Western blot显示,假手术组Trps1主要在皮质肾小管上皮细胞表达,缺血再灌注后1d肾组织Trps1表达显著下降(P＜0.05),3d仅见微弱表达(P＜0.05),7、14 d表达开始上升,但仍有显著差异(P＜0.05),21 d与假手术组水平无显著差异(P＞0.05).相关性分析显示Trps1表达变化与肾小管急性损伤评分呈负相关(r=-0.81,P＜0.05).结论 Trps1在AKI肾脏损伤修复期表达上调,与肾组织损伤指标呈负相关,提示其可能具有促进肾脏修复再生的作用.     

姜黄素通过TGF-β/Smads信号通路对肾缺血再灌注后肾小管间质纤维化抑制作用

目的:探究姜黄素通过TGF-β/Smads信号通路对肾缺血再灌注后肾小管间质纤维化的抑制作用.方法:将40只健康SD大鼠按随机数字表法平均分为假手术组、模型组、低剂量组和高剂量组.使用夹闭法松开肾蒂的方法复制肾缺血再灌注大鼠模型.检测血清中血清肌酐(serum creatinine,Scr)和尿素氮(urea nitrogen,BUN)水平、肾组织胶原含量、肾组织的病理变化以及肾脏中转化生长因子-β1 (transforming growth factor β1,TGF-β1)、Smad3和Smad7蛋白表达水平.结果:假手术组肾小管形态正常,模型组肾小管间质呈现明显的病理变化,低剂量组和高剂量组肾小管间质纤维病理变化明显改善,且高剂量组改善程度高于低剂量组;模型组的肾小管间质纤维化评分、Scr、BUN、胶原含量、TGF-β1和Smad3明显高于假手术组,Smad7明显低于假手术组(P＜0.05);低剂量组和高剂量组肾小管间质纤维化评分、Scr、BUN、胶原含量、TGF-β1和Smad3均明显低于模型组,Smad7明显高于模型组(P＜0.05);高剂量组肾小管间质纤维化评分、Scr、BUN、胶原含量、TGF-β1和Smad3评分明显低于低剂量组,Smad7明显高于低剂量组(P＜0.05).结论:姜黄素对肾缺血再灌注后肾小管间质纤维化具有抑制作用,其作用机制可能为抑制TGF-β/Smad信号转导通路.     

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…     

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.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.