NLRP3炎症小体及其下游炎症因子在动脉粥样硬化炎症反应中的作用

目的：探讨NLRP3炎症小体及其下游炎症因子在动脉粥样硬化炎症反应中的作用。方法选择氧化低密度脂蛋白(ox-LDL)作用于人单核细胞系THP-1,经Western blot法检测NLRP3及其下游炎症因子半胱天冬酶-1(Caspase-1)、白介素-1β(IL-1β)和白介素-18(IL-18)的表达;并采用SiRNA技术下调空白处理组(Blank组)和ox-LDL处理组NLRP3基因表达,分别检测以上指标。结果与空白处理组相比,50 mg/L、100 mg/L、150 mg/L的ox-LDL作用于单核细胞后可促进NLRP3的表达,NLRP3下游的Caspase-1、IL-1β和IL-18表达水平与NLRP3表达一致,表达也均明显升高,差异均具有统计学意义(P<0.05)。NLRP3小干扰RNA (SC-45469)转染后,Blank组与ox-LDL组的NLRP3及其下游炎症因子Caspase-1、IL-1β和IL-18的表达均有显著下降(P<0.05);而转染后Blank组与ox-LDL组各指标下降率组间比较差异均无统计学意义(P>0.05)。结论 NLRP3炎症小体参与动脉粥样硬化发生发展的过程,其可能通过改变ox-LDL的表达水平,诱发炎症相关因子Caspase-1、IL-1β和IL-18的分泌来调节, NLRP3炎症小体具有成为临床上防治动脉粥样硬化的新靶点的重要潜力。     

卡维地洛对ox-LDL诱导内皮细胞中NLRP3炎症小体介导焦亡及炎症的影响

目的研究卡维地洛对氧化型低密度脂蛋白(ox-LDL)诱导内皮细胞中NLRP3炎症小体介导焦亡及炎症的调控作用。方法人脐静脉内皮细胞(HUVEC)分为对照组、ox-LDL组、低剂量组(0.01 mmol/L)、高剂量组(0.1 mmol/L);转染阴性对照腺病毒(Ad-NC)或过表达NLRP3腺病毒(Ad-NLRP3)后分为Ad-NC组、Ad-NC+ox-LDL组、Ad-NC+高剂量组、Ad-NLRP3+高剂量组。检测各组细胞活力和白细胞介素(IL)-1β、IL-18含量,以及GSDMD-N、NLRP3、Cleaved Caspase-1表达水平。 结果ox-LDL组细胞活力低于对照组,IL-1β、IL-18及GSDMD-N、NLRP3、Cleaved Caspase-1均高于对照组(P＜0.05)。低剂量组和高剂量组细胞活力高于ox-LDL组,IL-1β、IL-18及GSDMD-N、NLRP3、Cleaved Caspase-1均低于ox-LDL组(P＜0.05)。转染NLRP3腺病毒后,Ad-NLRP3+高剂量组和Ad-NC+ox-LDL组细胞活力低于Ad-NC+高剂量组,IL-1β、IL-18及GSDMD-N、NLRP3、Cleaved Caspase-1均高于Ad-NC+高剂量组(P＜0.05)。 结论卡维地洛显著抑制ox-LDL诱导HUVEC中NLRP3炎症小体介导的细胞焦亡及炎症反应。     

黄芪甲苷通过NLRP3炎性小体调节糖尿病动脉粥样硬化早期大鼠血脂及炎症因子的研究

目的  探讨黄芪甲苷调节糖尿病动脉粥样硬化早期大鼠血脂及炎症因子的作用及机制。方法  将48只GK大鼠随机分为模型组、阳性药(格列喹酮片联合盐酸贝那普利片)组、黄芪甲苷低剂量组和黄芪甲苷高剂量组,每组12只,均为高脂饲料饲养。12只Wistar大鼠作为空白对照。给药组分别灌胃格列喹酮片(10 mg/kg)及盐酸贝那普利片(10 mg/kg)和黄芪甲苷(20、40 mg/kg),对照组及模型组灌胃生理盐水,每日1次,连续6周。动物体质量及血糖被监测。采用生化法测定大鼠血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)的含量;HE染色法观察大鼠腹主动脉病理形态;ELISA法测定大鼠腹主动脉IL-6、IL-10、CRP、TNF-α的含量;Western blot法检测大鼠腹主动脉NLRP3、ASC、Caspase-1蛋白的表达。结果   与模型组相比,黄芪甲苷高、低剂量组均可明显改善大鼠腹主动脉病变, 降低大鼠血糖及血清TC、TG、LDL水平,升高HDL水平,降低腹主动脉IL-6、CRP、TNF-α水平,提高IL-10水平, 下调NLRP3、ASC、Caspase-1蛋白的表达(P＜0.05~0.000 1)。结论   黄芪甲苷可调节糖尿病动脉粥样硬化早期大鼠的血脂及炎症状态,机制与调控NLRP3炎性小体相关蛋白的表达密切相关。      

大鼠动脉粥样硬化痰瘀互结病证结合模型的建立及方药干预研究(中医药实验与动物模型专栏)

目的 建立大鼠动脉粥样硬化痰瘀互结病证结合模型,并观察模型大鼠炎症因子的变化以及方药（丹蒌片）的干预作用。方法 32只雄性SD大鼠随机分为正常组、模型组、阿托伐他汀钙组(ATV组)、丹蒌组（DLP组）,每组8只。正常组大鼠喂食基础饲料,余3组均采用高脂饮食 维生素D3腹腔注射联合颈动脉球囊损伤的方法复制痰瘀互结型AS模型。模型组、ATV组、DLP组分别给予生理盐水、阿托伐他汀钙混悬液、丹蒌片混悬液灌胃干预4周。干预结束后,HE染色观察大鼠胸主动脉病理学改变,检测大鼠血清中血脂、hs-CRP、IL-6、TNF-α和LP-PLA2水平,RT-PCR法检测大鼠胸主动脉组织内IL-6、TNF-α和LP-PLA2 mRNA表达。结果 ①与正常组比较,模型组大鼠血清中TC、LDL-C、hs-CRP、IL-6、TNF-α和LP-PLA2水平升高（P<0.05）,HDL-C下降（P<0.05）,血管组织中IL-6、TNF-α和LP-PLA2表达升高（P<0.05）,HE染色光镜下观察,模型组大鼠胸主动脉内皮细胞排列不完整,内膜明显不规则增厚,内皮下间隙增宽,泡沫细胞聚集,脂质沉着,形成了典型的AS斑块。②与模型组比较,ATV组与DLP组大鼠血清TC、LDL-C和hs-CRP、IL-6、TNF-α和LP-PLA2水平降低（P<0.05）,胸主动脉组织内IL-6、TNF-α和LP-PLA2的表达下降（P<0.05）,ATV组与DLP组两组间比较差异无统计学意义（P>0.05）。HE染色光镜下观察,ATV组与DLP组大鼠胸主动脉内膜增生明显减轻,斑块面积减小,动脉粥样硬化的程度减轻。结论 采用高脂饮食 维生素D3腹腔注射联合颈动脉球囊损伤的方法可以建立AS痰瘀互结证的大鼠模型,并且痰瘀同治方药（丹蒌片）可以改善该模型大鼠的AS和炎症反应。     

黄芪甲苷通过NLRP3炎性小体调节糖尿病动脉粥样硬化早期大鼠血脂及炎症因子的研究

目的探讨黄芪甲苷调节糖尿病动脉粥样硬化早期大鼠血脂及炎症因子的作用及机制。方法将48只GK大鼠随机分为模型组、阳性药(格列喹酮片联合盐酸贝那普利片)组、黄芪甲苷低剂量组和黄芪甲苷高剂量组,每组12只,均为高脂饲料饲养。12只Wistar大鼠作为空白对照。给药组分别灌胃格列喹酮片(10 mg/kg)及盐酸贝那普利片(10 mg/kg)和黄芪甲苷(20、40 mg/kg),对照组及模型组灌胃生理盐水,每日1次,连续6周。动物体质量及血糖被监测。采用生化法测定大鼠血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)的含量;HE染色法观察大鼠腹主动脉病理形态;ELISA法测定大鼠腹主动脉IL-6、IL-10、CRP、TNF-α的含量;Western blot法检测大鼠腹主动脉NLRP3、ASC、Caspase-1蛋白的表达。结果与模型组相比,黄芪甲苷高、低剂量组均可明显改善大鼠腹主动脉病变,降低大鼠血糖及血清TC、TG、LDL水平,升高HDL水平,降低腹主动脉IL-6、CRP、TNF-α水平,提高IL-10水平,下调NLRP3、ASC、Caspase-1蛋白的表达(P0.05～0.000 1)。结论黄芪甲苷可调节糖尿病动脉粥样硬化早期大鼠的血脂及炎症状态,机制与调控NLRP3炎性小体相关蛋白的表达密切相关。     

大鼠动脉粥样硬化痰瘀互结病证结合模型的建立及方药干预研究

目的 建立大鼠动脉粥样硬化痰瘀互结病证结合模型,并观察模型大鼠炎症因子的变化以及方药(丹蒌片)的干预作用。方法 32只雄性SD大鼠随机分为正常组、模型组、阿托伐他汀钙组(ATV组)、丹蒌组(DLP组),每组8只。正常组大鼠喂食基础饲料,余3组均采用高脂饮食+维生素D3腹腔注射联合颈动脉球囊损伤的方法复制痰瘀互结型AS模型。模型组、ATV组、DLP组分别给予生理盐水、阿托伐他汀钙混悬液、丹蒌片混悬液灌胃干预4周。干预结束后,HE染色观察大鼠胸主动脉病理学改变,检测大鼠血清中血脂、hs-CRP、IL-6、TNF-α和LP-PLA2水平,RT-PCR法检测大鼠胸主动脉组织内IL-6、TNF-α和LP-PLA2 mRNA表达。结果 ①与正常组比较,模型组大鼠血清中TC、LDL-C、hs-CRP、IL-6、TNF-α和LP-PLA2水平升高(P<0.05),HDL-C下降(P<0.05),血管组织中IL-6、TNF-α和LP-PLA2表达升高(P<0.05),HE染色光镜下观察,模型组大鼠胸主动脉内皮细胞排列不完整,内膜明显不规则增厚,内皮下间隙增宽,泡沫细胞聚集,脂质沉着,形成了典型的AS斑块。②与模型组比较,ATV组与DLP组大鼠血清TC、LDL-C和hs-CRP、IL-6、TNF-α和LP-PLA2水平降低(P<0.05),胸主动脉组织内IL-6、TNF-α和LP-PLA2的表达下降(P<0.05),ATV组与DLP组两组间比较差异无统计学意义(P>0.05)。HE染色光镜下观察,ATV组与DLP组大鼠胸主动脉内膜增生明显减轻,斑块面积减小,动脉粥样硬化的程度减轻。结论 采用高脂饮食+维生素D3腹腔注射联合颈动脉球囊损伤的方法可以建立AS痰瘀互结证的大鼠模型,并且痰瘀同治方药(丹蒌片)可以改善该模型大鼠的AS和炎症反应。     

慢性牙周炎牙龈卟啉单胞菌感染患者NLRP3炎症小体与炎症反应及焦亡指标的相关性

目的研究慢性牙周炎牙龈卟啉单胞菌感染患者NLRP3炎症小体与炎症反应及焦亡指标的相关性。 方法选择300例慢性牙周炎患者,按照牙龈卟啉单胞菌感染情况分为阳性组和阴性组。比较两组牙周健康指标、牙周组织NLRP3、凋亡相关斑点样蛋白(ASC)、Caspase-1 mRNA和GSDMD-N蛋白表达水平,以及龈沟液白细胞介素(IL)-1β、IL-18、肿瘤坏死因子-α(TNF-α)水平。采用Pearson检验进行相关性分析。 结果阳性组菌斑指数(PLI)、牙龈指数(GI)、附着丧失(AL)、牙周袋深度(PD)、牙周组织NLRP3、ASC、Caspase-1 mRNA、GSDMD-N蛋白,以及龈沟液IL-1β、IL-18、TNF-α水平均高于阴性组(P＜0.05)。NLRP3、ASC、Caspase-1 mRNA表达水平与PLI、GI、AL、PD、GSDMD-N蛋白、IL-1β、IL-18、TNF-α水平均呈正相关(P＜0.05)。 结论慢性牙周炎患者牙龈卟啉单胞菌感染加重病情、炎症反应及细胞焦亡,其作用可能与激活NLRP3炎症小体有关。     

刺甘草查尔酮调节自噬和NLRP3炎症小体减轻脓毒症心肌损伤

目的 探究刺甘草查尔酮对自噬、NLRP3炎症小体和脓毒症大鼠心肌损伤的影响。方法 将大鼠按照随机数表法分为Col、LPS、Ech L、Ech M、Ech H、阳性对照组。检测大鼠心功能指标（LVEDD、LVESD、FS、EF）；ELISA检测血清中炎症因子（TNF-α、IL-1β）水平和心肌损伤标志物（cTnΙ、CK-MB）含量；HE染色检测心肌组织病理学变化；TUNEL检测心肌细胞凋亡率；蛋白质印迹检测心肌组织中自噬相关蛋白及炎性小体相关蛋白表达。结果 和Col组相比，LPS组大鼠心功能指标LVEDD、LVESD和血清中TNF-α、IL-1β、cTnΙ、CK-MB水平明显升高，FS、EF明显降低，心肌组织中p62、NLRP3、ASC、cleaved caspase-1蛋白表达和心肌细胞凋亡率均明显升高，组间差异有统计学意义（P<0.05）；和LPS组相比，Ech L、Ech M与Ech H组心功能指标LVEDD、LVESD和血清中TNF-α、IL-1β、cTnΙ、CK-MB水平明显降低，FS、EF明显升高，心肌组织中LC3Ⅱ/LC3 Ι比值、Becline-1、p62均逐渐升高，NLRP3、ASC、cleaved caspase-1蛋白表达和心肌细胞凋亡率均逐渐降低，组间差异有统计学意义（P<0.05），且呈剂量依赖。结论 刺甘草查尔酮可减轻脓毒症大鼠心肌损伤，其可能和促进心肌组织中自噬和抑制NLRP3炎症小体激活有关。     

核苷酸结合寡聚化结构域样受体蛋白3介导细胞焦亡在痛风性关节炎中的作用机制研究

目的:探讨血清核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎症小体活化Gasdermin D(GSDMD)蛋白介导的细胞焦亡在痛风性关节炎中的作用及其机制。方法:分别收集40例急性痛风性关节炎患者(试验组)和40例健康体检者(对照组);采用血常规检测仪和全自动生化分析仪检测两组血清中生化指标(肾功、血脂)及白细胞计数(WBC)、血沉(ESR)、C反应蛋白(CRP)等炎性指标的含量。采用免疫印迹法检测法(Western blot)分别检测两组外周血单个核细胞中NLRP3、GSDMD、白介素1β(IL-1β)蛋白的表达量。通过酶联免疫吸附法(ELISA)检测两组血浆中IL-1β和白介素18(IL-18)的表达量。结果:与对照组相比,试验组中WBC、ESR、CRP水平较高,差异具有统计学意义(均P<0.05);试验组细胞焦亡相关蛋白NLRP3、GSDMD、IL-1β及IL-18表达显著增加(均P<0.05);试验组血尿酸水平、NLRP3、GSDMD与炎性因子(IL-1β及IL-18)表达量呈线性正相关(均P<0.05)。结论:NLRP3可能通过激活的GSDMD蛋白介导的...     

血浆IL-6、CRP和TNF-α水平在主动脉夹层患者病程中的变化及意义

目的通过检测主动脉夹层患者血浆中白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)和C-反应蛋白(CRP)3种炎症介质的浓度,探讨其在病程中的变化及临床意义。方法分别使用ELISA法检测68例主动脉夹层患者、50例单纯原发性高血压患者及50例健康成人血浆中的IL-6、CRP、TNF-α浓度,将主动脉夹层组按照病程不同分为包含急性期到慢性期的9个时间段组别进行统计,分析夹层组炎症介质与另两组的差异及其随时间的变化趋势。结果主动脉夹层患者血浆中IL-6、CRP、TNF-α浓度均比正常人组、单纯原发性高血压组高(P<0.05),3种炎症因子浓度峰值均出现于主动脉夹层病程急性期内,在亚急性期、慢性期逐渐降低。结论主动脉夹层患者血浆中IL-6、CRP和TNF-α在病程中扮演重要角色,炎症因子可作为评估主动脉夹层患者全身炎症反应的强度、辅助诊断及评估早期预后的指标。     

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.