重组血管活性肠肽基因质粒治疗大鼠胶原性关节炎的研究

目的：观察重组血管活性肠肽（pcDNA3．1＋／VIP）质粒治疗胶原诱导的大鼠关节炎（CIA）对血清TNF—α、IL～2、IL-4表达的影响和病理变化，探讨VIP基因治疗类风湿性关节炎的效果及可能机制。方法：以Ⅱ型胶原诱导的大鼠关节炎作为CIA模型，重组血管活性肠肽质粒关节腔内注射治疗CIA，以双抗体夹心酶联免疫吸附法（ABC—ELISA）检测血清TNF—α、IL-2和IL-4的表达，观察病理变化和整体疗效。结果：①病理切片显示CIA模型组炎性细胞浸润明显，并存在骨和软骨破坏，VIP治疗组可显著减轻关节炎性病理改变；②细胞因子测定显示：与正常组相比，各对照组血清TNF—α、IL-2水平显著升高（P〈0．05），IL-4水平减低（P〈0．05）；与各对照组相比，各重组VIP质粒治疗组血清TNF—α和IL-2表达水平均明显降低（P〈0．05），IL-4表达则升高（P〈0．05）。结论：血管活性肠肽基因质粒关节腔内注射治疗大鼠CIA具有显著的疗效，有望成为RA的有效治疗手段。     

雷公藤内酯醇对胶原诱导的大鼠关节炎关节腔和外周血清中细胞因子的影响

目的:观察雷公藤内酯醇对Ⅱ型胶原诱导的关节炎(CIA)大鼠外周血清和关节腔中IL-6、IL-10、TNFα的影响,探讨雷公藤内酯醇治疗CIA的可能机制。方法:以胶原诱导的W istar大鼠关节炎为动物模型,将模型复制成功的20只大鼠随机分为模型组和雷公藤内酯醇组。雷公藤内酯醇按40μg/kg BW肌注给药,每3 d 1次,31 d处死动物,采用酶联免疫吸附法(ELISA)检测大鼠血清和膝关节腔液中TNFα、IL-6和IL-10含量。结果:与正常对照组大鼠相比,CIA模型大鼠关节腔液和血清中TNFα、IL-6含量升高IL-10含量降低(P<0.01),经过雷公藤内酯醇治疗后,关节腔液和血清中TNFα、IL-6含量降低,IL-10含量升高,模型组与治疗组相比,差异有显著性(P<0.01)。结论:雷公藤内酯醇可能通过调节细胞因子变化而达到治疗CIA,这也可能是雷公藤治疗类风湿关节炎的机制之一。     

紫草素对晚期胶原性关节炎的作用研究

目的 研究紫草素对晚期Ⅱ型胶原诱导的关节炎小鼠的抗炎症、免疫调节作用.方法 紫草素(5 ms/kg)每日1次腹腔注射已经成模胶原性关节炎(collagen.induced arthritis,CIA)小鼠,连用10天,用关节炎评分评估CIA小鼠关节炎病情;用逆转录聚合酶链反应测定CIA小鼠髌骨及邻近滑膜组织的细胞因子表达水平;用组织学染色评价膝关节的软骨和骨破坏.结果 紫草素降低了晚期Ⅱ型胶原诱导的关节炎小鼠的关节炎评分,阻止了软骨破坏,髌骨及邻近滑膜组织的Th1型细胞因子(TNF-α和IL-12)和炎症性细胞因子IL-6的mRNA水平与对照组相比均显著被抑制.结论 紫草素免疫干预已发病的CIA小鼠,降低了关节炎评分阻止了软骨破坏,其机制可能为紫草素通过抑制了Th1细胞因子的表达发挥了抗炎症的作用.     

雷公藤甲素对CIA大鼠γδT细胞胞内细胞因子表达的影响

目的观察雷公藤甲素对II型胶原诱导的关节炎(CIA)大鼠外周血γδT细胞表达细胞因子TNF-α和IL-10的影响,探讨γδT细胞在CIA中的作用机制和雷公藤甲素对γδT细胞的免疫调节作用.方法 Wistar大鼠背部及尾根部多点皮内注射牛Ⅱ型胶原诱导CIA动物模型,大鼠经雷公藤甲素治疗后,取外周血分离淋巴细胞,用流式细胞仪,通过直接荧光标记的抗TNF-α和抗IL-10抗体来检测单个细胞水平γδT细胞胞内细胞因子的表达.结果 CIA模型大鼠外周血中γδT细胞与正常大鼠相比较,所占淋巴细胞的百分比显著下降(6.96±0.74) %,γδT细胞胞内 TNF-α(2.22±0.36)%和IL-10(1.00±0.20)%的表达均明显降低(P<0.01).通过雷公藤甲素治疗后,γδT细胞的数量和TNF-α与IL-10的表达均恢复至正常水平.结论雷公藤甲素可调节CIA大鼠外周血γδT细胞的数量和TNF-α及IL-10表达水平,而达到治疗类风湿性关节炎的目的.     

黄芪多糖对细菌脂多糖诱导大鼠腹腔巨噬细胞释放TNFα、NO及IL-1的影响

目的研究黄芪多糖(APS)对细菌脂多糖(LPS)诱导大鼠腹腔巨噬细胞释放肿瘤坏死因子α(TNFα)、白细胞介素-1(IL-1)及一氧化氮(NO)的影响.方法 10 mg/L LPS体外诱导大鼠腹腔巨噬细胞,小鼠成纤维细胞瘤株(L929)杀伤法检测TNFα的含量、小鼠胸腺细胞增殖法检测IL-1的活性、Griess法检测NO的水平.结果 APS能不同程度地抑制激活巨噬细胞对TNFα、NO与IL-1的分泌.结论 APS抑制巨噬细胞的分泌功能可能是其保肝作用的机制之一.     

桂枝芍药知母汤对Ⅱ型胶原诱导性关节炎大鼠IFN-γ及IL-4水平的影响

目的研究桂枝芍药知母汤对Ⅱ型胶原诱导性关节炎大鼠的治疗作用,并探讨其作用机制。方法采用牛Ⅱ型胶原诱导的关节炎模型(Collagen-induced arthritis,CIA),灌胃给药21 d后观察大鼠体重变化、足肿胀度;采用ELISA法测定大鼠滑膜和血清中的白细胞介素4(IL-4)水平,小鼠巨噬细胞NO2-释放法测定大鼠滑膜和血清中干扰素γ(IFN-γ)活性。结果桂枝芍药知母汤能改善CIA大鼠体重变化,降低原发性和继发性足肿胀度,下调CIA大鼠滑膜和血清IFN-γ、IL-4水平。结论CIA大鼠滑膜中IFN-γ、IL-4水平均升高,血清中以IFN-γ升高为主。桂枝芍药知母汤抗风湿作用,可能通过下调CIA大鼠滑膜和血清IFN-γ、IL-4水平,从而调节Th1/Th2平衡。     

实验性关节炎大鼠外周血CD4+T细胞固有胆碱能系统研究

目的　探索胆碱能系统在关节炎模型大鼠外周血CD4 T淋巴细胞表达状态及其在关节炎中的免疫调节作用。方法　Ⅱ型胶原乳剂多点皮内注射, 建立胶原性关节炎 (CIA) 大鼠模型, 根据关节炎严重程度将大鼠分为 CIAⅠ和CIAⅡ组。运用流式细胞术和双标记免疫荧光技术检测烟碱样乙酰胆碱受体α7亚单位 (nAChRα7) 及胆碱乙酰转移酶 (ChAT) 在CIA大鼠外周血CD4 T淋巴细胞中的表达, 分析其与外周血 CD4 T淋巴细胞活化 (表达 CD71)的关系。结果　CIA 大鼠外周血 CD71 /CD4 T 淋巴细胞明显多于对照组 (P< 0. 01); CD4 T 淋巴细胞表达nAChRα7和ChAT明显低于对照组 (P< 0 01), CIAⅡ组又明显低于 CIA Ⅰ组 (P< 0 01)。nAChRα7 /CD4 与CD71 /CD4 T淋巴细胞呈负相关关系 (P< 0 05); ChAT /CD4 与 CD71 /CD4 T 淋巴细胞无相关关系 (P>0. 05)。结论　nAChRα7和ChAT在正常大鼠外周血 CD4 T淋巴细胞中表达, 并参与免疫细胞活性的抑制性调节,CIA大鼠外周血CD4 T淋巴细胞胆碱能系统功能减弱, 胆碱能系统在自身免疫性疾病中起重要调节作用。     

通络止痛胶囊对佐剂性关节炎大鼠血清IL-1β、TNF-α的影响

目的观察通络止痛胶囊对佐剂性关节炎（AA）大鼠血清白细胞介素-1（IL-1β）、肿瘤坏死因子α（TNF—α）的影响。方法将50只Wistar大鼠随机分为正常对照组、模型对照组和通络止血胶囊高、中、低剂量组,每组10只,用ELISE法测定大鼠外周血细胞因子IL-1β,放射免疫法测定TNF-α的表达情况。结果与正常组相比,AA大鼠外周血中IL-1β、TNF—α显著升高（P〈0．01）;通络止痛胶囊低、中、高剂量组大鼠血清IL-1β、TNF—α水平显著低于模型组,尤以高剂量组最显著（P〈0．01）。结论通络止痛胶囊可能通过降低IL—1β和TNF-α,抑制AA大鼠骨与软骨的破坏,减轻滑膜炎症。     

蜂毒肽对胶原诱导关节炎大鼠模型Th17/Treg平衡及炎症的影响

目的探讨蜂毒肽干预胶原诱导关节炎大鼠模型后对Th17/Treg平衡调控及关节炎症的影响。方法将30组SD大鼠随机分为正常对照组6只,其余24只SD大鼠于第1天尾根部注射牛II胶原,第10天再次注射II胶原建立胶原诱导关节炎模型,第14天淘汰6只未建模成功的大鼠,筛选出18只建模成功的大鼠按随机数字表法分为模型组、蜂毒肽组、甲氨蝶呤组,每组6只。第14天蜂毒肽组腹腔注射蜂毒肽(0. 5 mg/kg,隔日1次),甲氨蝶呤注射组注射甲氨蝶呤(每只1 mg,每周1次,共3次),模型组、正常组腹腔注射等量灭菌注射用水,第32天麻醉处死后,收集血清,ELISA法检测血清中TNF-α、IL-10、IL-17 A浓度,分离大鼠脾脏,提取淋巴细胞,MTS检测单个核细胞活性,流式细胞术检测Th17、Treg细胞的比例,HE染色观察踝关节病理变化。结果蜂毒肽、甲氨喋呤降低血清中TNF-α、IL-17 A浓度(P0. 01,P0. 05),升高IL-10浓度(P0. 05);蜂毒肽、甲氨喋呤抑制淋巴细胞活性(P0. 05);蜂毒肽、甲氨喋呤能下调Th17细胞比例(P0. 05),上调Treg细胞比例(P0. 01,P0. 05);蜂毒肽、甲氨喋呤组减少滑膜增生,抑制炎性细胞浸润,延缓骨和关节软骨破坏。结论蜂毒肽能调节胶原诱导关节大鼠模型Th17/Treg平衡,抑制关节的炎症。     

芍甘附子汤加味对CIA大鼠关节滑膜病理及血清IL-2、IL-17A与TNF-α表达水平的影响

[目的]研究芍甘附子汤加味对胶原诱导性关节炎(CIA)大鼠模型关节滑膜病理及血清白细胞介素(IL)-2、IL-17A及肿瘤坏死因子-α(TNF-α)的干预作用,并探讨其作用机制。[方法]随机将24只大鼠分为正常组、模型组、雷公藤组及芍甘附子汤组。除正常组外,其余各组均用胶原乳液多点皮内注射建立关节炎动物模型。模型建立后分别进行灌胃:模型组予蒸馏水2 mL/(kg·d)灌胃,雷公藤组给予雷公藤多苷片6.25 mg/(kg·d)灌胃,芍甘附子汤组予芍甘附子汤加味12.5g/(kg·d)灌胃,苏木精-伊红(HE)染色观察各组大鼠踝关节及滑膜病理改变,酶联免疫吸附(ELISA)法测定大鼠血清IL-2、IL-17A及TNF-α水平。[结果]HE染色结果发现芍甘附子汤加味可改善CIA大鼠模型关节滑膜炎症,抑制关节软骨破坏。与正常组比较,模型组IL-2水平增高(P<0.01),与模型组比较,雷公藤组及芍甘附子汤组IL-2水平均下降(P<0.01)。模型组IL-17A水平较正常组增加(P<0.01),与模型组比较,雷公藤组及芍甘附子汤组IL-17A水平均下降(P<0.01)。与正常组比较,模型组TNF-α水平增高(P<0.05),与模型组比较,雷公藤组TNF-α有下降趋势,但差异无统计学意义(P>0.05),芍甘附子汤组TNF-α水平下降(P<0.01),芍甘附子汤组与雷公藤组比较差异有统计学意义(P<0.01)。[结论]芍甘附子汤加味可改善CIA大鼠关节滑膜炎症,抑制关节软骨破坏,同时可降低血清中IL-2、IL-17A及TNF-α的表达水平。     

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.     

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.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…