薯蓣粥对2型糖尿病大鼠肝脏糖异生的影响

目的观察薯蓣粥对2型糖尿病(type 2 diabetes mellitus,T2DM)大鼠磷酸烯醇式丙酮酸羧激酶(phosphoenolpyruvate carboxykinase,PEPCK)、葡萄糖-6-磷酸酶(glucose-6-phosphatase,G6Pase)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、C-反应蛋白(C-reactive protein,CRP)和脂联素(adiponectin,APN)等与肝脏糖异生相关指标的变化,从肝脏糖异生角度探讨薯蓣粥的降糖机制,为薯蓣粥的临床应用提供科学依据。方法60只Wistar大鼠随机分为空白组10只和造模组50只。造模组采用高糖高脂饲料联合腹腔注射小剂量链脲佐菌素(streptozotocin,STZ)制备T2DM大鼠模型,将造模成功的40只大鼠随机分为模型组、薯蓣粥组、二甲双胍组和联合治疗组,各组10只。每组给予相应药物连续灌胃给药6周后,全自动生化分析仪检测空腹血糖(fasting blood glucose,FBG);ELISA检测血清TNF-α、IL-6、CRP和APN含量;RT-qPCR检测PEPCK和G6Pase基因(mRNA)表达;免疫组化检测PEPCK和G6Pase蛋白表达。结果与空白组比较,模型组大鼠FBG显著升高(P<0.01);血清TNF-α、IL-6、CRP水平上升,APN水平下降(P<0.01);肝组织PEPCK、G6Pase mRNA及蛋白表达均增加(P<0.01)。与模型组比较,薯蓣粥组、二甲双胍组和联合治疗组FBG显著降低(P<0.01);血清TNF-α、IL-6、CRP水平下降,APN水平上升(P<0.05);肝组织PEPCK、G6Pase mRNA及蛋白表达均减少(P<0.01);且联合治疗组较薯蓣粥组应用效果更优(P<0.05)。结论薯蓣粥能够降低T2DM大鼠FBG水平,其作用机制可能与下调T2DM大鼠血清TNF-α、IL-6、CRP水平和上调APN水平,进而减少肝组织PEPCK、G6Pase mRNA及蛋白的表达,减弱肝脏糖异生有关。     

健脾清化方对糖尿病大鼠血糖波动和胰岛分泌功能的影响

目的观察中药复方健脾清化方干预糖尿病模型大鼠血糖波动及改善胰岛细胞分泌功能的作用。方法小剂量链脲佐菌素联合高脂高糖饲料诱导Wistar大鼠糖尿病模型。随机分为健脾清化方组(JPQ组)、正常组(NOR组)和模型组(CON组)。分别给予生药含量1. 3 g/ml健脾清化方10 ml/kg和等剂量蒸馏水灌胃,干预4周。葡萄糖氧化酶法观察健脾清化方对模型大鼠糖代谢(IPGTT)、血糖波动水平[平均血糖波动幅度(Mean amplitude of glycemic excursions,MAGE)、葡萄糖曲线下面积(Area under curve of glucose,AUCg)]、Elisa法检测胰岛细胞功能[I/G、胰岛素原(Proinsulin,PI)、真胰岛素(True insulin,TI)、PI/TI]的影响,并行HE染色光镜下观察胰岛细胞形态变化。结果健脾清化方组大鼠的腹腔糖耐量血糖水平显著降低(P 0. 05),MAGE和AUCg降低(P 0. 05),健脾清化方组PI显著下降(P 0. 05),TI显著上升(P 0. 05),PI/TI显著下降(P 0. 05),I/G显著上升(P 0. 05)。HE染色光镜下可见健脾清化方组胰岛细胞数量增多,形态改善。结论健脾清化方能有效改善糖尿病模型大鼠的糖代谢和血糖波动,并对糖尿病模型大鼠的胰岛素分泌功能和胰岛细胞形态有一定的改善作用。     

小檗碱对2型糖尿病中国地鼠肝脏葡萄糖激酶、葡萄糖-6-磷酸酶和磷酸烯醇式丙酮酸羧激酶mRNA表达的影响

目的研究小檗碱对2型糖尿病中国地鼠肝脏葡萄糖激酶（GcK）、葡萄糖-6-磷酸酶（G6P）和磷酸烯醇式丙酮酸羧激酶（PEPCK）mRNA表达的影响,探讨小檗碱影响糖代谢的分子机制。方法以高脂高热量饲料喂养结合腹腔注射小剂量链脲佐菌素（STZ）的方法制作2型糖尿病中国地鼠模型,成模后随机分成模型组、小檗碱组、二甲双胍组,各药干预9周。同时设立对照组。观察小檗碱疗效及对肝脏GcK、G6P、PEPCK mRNA表达的影响。结果与模型组相比,小檗碱增强胰岛素敏感性,降低血糖血脂,增高肝脏GcK的mRNA表达,降低肝脏G6P、PEPCK mRNA的表达。结论小檗碱降低2型糖尿病血糖的作用机制可能与提高肝脏GcK mRNA的表达和降低G6P、PEPCK mRNA的表达有关。     

健胰方拆方对糖尿病大鼠胰高血糖素样肽-1的调节作用

目的:从胰高血糖素样肽-1(glucagon like peptide-1,GLP-1)代谢环节探索比较健胰方拆方"清化组"和"健脾组"对胰岛细胞功能的作用差异。方法:雄性Wistar大鼠150只,采用高脂高糖饲料联合链脲佐菌素(STZ)方法诱导建立糖尿病大鼠模型。采用随机数字表法和析因分析模型,将造模成功的大鼠分为清化组、健脾组、拆方合用组、模型对照组,每组30只。予相应药液灌胃;模型对照组给予同体积的0.9%生理盐水灌胃,1次/d。连续干预4周后检测血糖、血浆GLP-1和胰岛素(Ins)水平,实时荧光定量PCR方法检测胰腺组织胰岛—十二指肠同源盒基因-1(pancreatic duodenal homeobox-1,PDX-1)mRNA表达,免疫组化法检测回肠L细胞合成GLP-1水平。结果:清化组和健脾组分别具有降糖作用(P0.05,P0.01),两因素之间有交互作用(P0.01);清化组对糖负荷后各时间点Ins浓度都有影响(P0.01),健脾组仅对5 min、10 min的Ins浓度有影响(P0.05,P0.01),与模型对照组比较,上述影响体现在促进胰岛素释放方面;清化组对PDX-1 mRNA表达有影响(P0.01),健脾组没有类似作用;两组拆方对GLP-1浓度都无影响;两组拆方对肠道L细胞内GLP-1颗粒的阳性反应面积及累积光密度均具有增强作用(P0.01),从数值上比较,前者两种因素之间有协同作用(P0.05)。结论:健胰方两组拆方均可改善胰岛β细胞功能、降低大鼠血糖,其中"清化组"可影响GLP-1合成和分泌,"健脾组"对GLP-1无明显影响,可能存在其他机制。     

衍生物Fla-CN的抗糖尿病作用及其作用机制研究

目的:体内外研究黄酮衍生物Fla-CN的抗糖尿病作用及其机制。方法:体外实验以人肝HepG2细胞为研究对象,不同浓度Fla-CN孵育后,利用荧光标记 2-脱氧葡萄糖（2-NBDG）,通过检测HepG2 细胞内2-NBDG的荧光强度,观察Fla-CN对肝细胞葡萄糖摄取的影响;采用硫酸-蒽酮比色法检测HepG2细胞内糖原含量;通过检测一定时间内葡萄糖生成量,观察Fla-CN对肝细胞糖异生过程的影响。体内实验采用2型糖尿病模型db/db小鼠为研究对象,给予Fla-CN和二甲双胍干预4 周后,测定db/db小鼠空腹血糖、糖耐量以及胰岛素耐量,计算糖耐量、胰岛素耐量实验血糖-曲线下面积（AUC）。通过Western印迹法检测化合物干预后小鼠肝组织中磷酸化AMP活化蛋白激酶 (AMPK)、糖异生关键酶磷酸烯醇式丙酮酸羧激酶（PEPCK）、葡萄糖-6-磷酸酶（G6Pase）及转录调控因子过氧化物酶体增殖物激活受体γ协同刺激因子1α（PGC-1α）的表达。进一步通过Western 印迹检测AMPK抑制剂Compound C或AMPK激动剂AICAR 与Fla-CN联用后,HepG2细胞内PEPCK、G6Pase、PGC-1α的蛋白表达。结果:Fla-CN能够促进HepG2细胞对葡萄糖的摄取（F=33.50,P<0.01）和糖原合成（F=93.63,P<0.01）,抑制糖异生（F=44.19,P<0.01）。同时,Fla-CN显著降低2型糖尿病db/db小鼠空腹血糖以及时间-血糖曲线下面积（F=98.40,P<0.05）。Western印迹显示Fla-CN能够激活db/db小鼠肝组织中 AMPK,抑制PEPCK、G6Pase 以及PGC-1α 的表达,并呈现一定剂量依赖性。Compound C能在一定程度上阻断Fla-CN对AMPK的激活和对PEPCK、G6Pase 以及PGC-1α的抑制作用。结论:黄酮衍生物Fla-CN通过激活AMPK,有效调节肝 HepG2 细胞糖代谢,抑制肝糖异生,降低2型糖尿病db/db小鼠空腹血糖,改善其受损的糖耐量,提高胰岛素敏感性。     

同型半胱氨酸对小鼠糖异生作用的影响

目的研究高同型半胱氨酸血症中肝脏组织葡萄糖-6-磷酸酶（G6Pase）和磷酸烯醇式丙酮酸羧激酶（PEPCK）的表达,探讨
同型半胱氨酸对糖异生作用的影响。方法50 只小鼠随机分为高同型半胱氨酸血症（HHcy）组和正常对照组,每组25 只;含
1.5%的蛋氨酸饮水3个月制造高同型半胱氨酸动物模型。3个月后,各组测定空腹血糖、空腹胰岛素,计算胰岛素抵抗指数;利
用逆转录PCR（RT-PCR）和Western blot方法检测肝脏的G6Pase和PEPCK表达的变化。结果与正常对照组比较,HHcy组空腹
血糖、空腹胰岛素和胰岛素抵抗指数增加（P<0.05）;RT-PCR发现HHcy组肝脏的G6Pase和PEPCK的mRNA水平明显增加（P<
0.05）;Western blot表明HHcy组肝脏的G6Pase和PEPCK的蛋白质表达水平明显增加（P<0.05）。结论同型半胱氨酸可能通过
增强糖异生作用,导致肝糖的输出增多,与胰岛素抵抗的发生有关。
     

桦褐孔菌水提取物对STZ诱导的糖尿病大鼠肝脏磷酸化腺苷酸蛋白激酶表达的影响

[目的]探讨桦褐孔菌水提取物对STZ诱导的糖尿病大鼠肝脏磷酸化腺苷酸蛋白激酶(P-AMPK)表达的影响.[方法]制作STZ诱导的糖尿病大鼠模型,随机分为糖尿病模型组、阳性对照组、桦褐孔菌水提取物高、中、低剂量组.阳性对照组给予200mg/kg盐酸二甲双胍,桦褐孔菌水提取物各剂量组分别灌胃给予900,600,300mg/kg桦褐孔菌水提取物,正常对照组和糖尿病模型组灌胃给予等体积纯净水,每日1次,连续8周.测定实验前后空腹血糖(FBG)、糖化血红蛋白、糖耐量等指标,检测肝组织中磷酸烯醇式丙酮酸羧化激酶(PEPCK)和P-AMPK表达水平.[结果]与糖尿病模型组比较,桦褐孔菌各剂量组FBG值显著降低(P<0.05),肝脏PEPCK表达明显降低(P<0.05),P-AMPK表达显著升高(P<0.05),且均表现出剂量依赖性.[结论]桦褐孔菌水提取物对STZ诱导的糖尿病大鼠具有较好的降低血糖作用,机制认为可能与上调腺苷酸蛋白激酶(AMPK)信号通路中P-AMPK表达,减少PEPCK表达,继而降低糖异生过程有关系.     

表没食子儿茶素没食子酸酯对大鼠胰岛素抵抗的影响

目的 研究表没食子儿茶素没食子酸酯(EGCG)对自发性2型糖尿病GK大鼠的胰岛素抵抗的影响及作用机制.方法 自发性2型糖尿病GK大鼠40只,同系健康对照Wistar大鼠10只,大鼠随机分为:正常对照组、2型糖尿病对照组、2型糖尿病低剂量EGCG( 50 mg/kg)治疗组、中剂量(100 mg/kg)组、高剂量EGCG( 300 mg/kg)组.干预6周后,分别检测葡萄糖耐量试验、胰岛素耐受试验、肝脏GcK、G6P以及PEPCKmRNA表达情况,以及骨骼肌细胞膜GLUT4含量的变化.结果 各剂量治疗组的糖耐量均得到明显改善(P＜0.05),胰岛素耐量在240 min时较模型对照组有明显差异(P＜0.05).与模型组比较,低剂量和中剂量治疗组均能提高肝脏葡萄糖激酶(GcK) mRNA的表达(P＜0.05),同时抑制葡萄糖-6-磷酸酶(G6P)和磷酸烯醇式丙酮酸激酶(PEPCK) mRNA的表达(P＜0.05);高剂量治疗组肝脏三类酶mRNA的表达与模型对照组相比无明显差异.各剂量治疗组GK大鼠的骨骼肌细胞膜GLUT4的含量较模型对照组均具有明显上调(P＜0.05).结论 中低剂量EGCG可以改善GK大鼠胰岛素抵抗,其作用机制可能与抑制肝脏糖异生作用以及骨骼肌GLUT4的转位水平有关,并且EGCG具有代偿胰岛素的作用.     

健脾清化方对糖尿病模型大鼠血糖波动的影响

目的:观察中药复方健脾清化方对糖尿病模型大鼠血糖波动幅度和糖脂代谢的影响。方法:实验分为正常组、模型组和健脾清化方组,除正常组外均采用小剂量链脲佐菌素联合高脂高糖饲料诱导建立Wistar大鼠糖尿病模型。健脾清化方组以13 g·kg-1·d-1的剂量灌胃,正常组和模型组分别给予同体积的蒸馏水灌胃,共干预4周。采用葡萄糖氧化酶方法检测大鼠血清葡萄糖,快速血糖仪测定大鼠尾尖血糖;通过公式计算血糖波动相关指数,包括平均血糖波动幅度(mean amplitude of glycemic excursions,MAGE)、最大血糖波动幅度(largest amplitude of glycemic excursions,LAGE)及M值;腹腔糖耐量检测糖代谢,包括腹腔糖耐量(IPGTT)、曲线下面积(AUCg)、平均血糖;ELISA法测定脂代谢,包括总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、三酰甘油(TG)。结果:与模型组比较,健脾清化方能明显降低糖尿病大鼠IPGTT各时间点血糖、平均血糖和AUCg(P0.05,P0.01);健脾清化方能有效改善糖尿病大鼠血糖波动,降低MAGE、M值(P0.05,P0.01);健脾清化方能有效改善脂代谢,降低糖尿病大鼠的TG水平(P0.05)。结论:健脾清化方能有效改善糖尿病模型大鼠的血糖波动,并对糖尿病模型大鼠的糖脂代谢也具有一定的改善作用。     

宫内发育迟缓胎鼠肝脏PGC-1和PEPCK基因的表达变化

目的宫内发育迟缓(IUGR)是胰岛素抵抗的独立危险因素,通过检测IUGR胎鼠肝脏糖代谢相关酶的表达,探讨IUGR个体发生胰岛素抵抗的分子机制。方法通过孕期蛋白质营养不良法建立大鼠IUGR模型,孕21天时剖宫产,测量胎鼠的体重和肝重,采用RT-PCR和蛋白印迹技术检测胎鼠肝脏PGC-1和PEPCK的mRNA及蛋白表达的变化。结果与正常对照相比,IUGR胎鼠肝脏PGC-1的mRNA和蛋白表达水平明显增高(P<0.01),肝中PEPCKmRNA的表达也明显增高(P<0.01)。结论IUGR胎鼠肝脏PGC-1表达增加诱导了糖异生关键酶PEPCK的表达,促进肝脏糖异生,这是IUGR鼠成年后发生胰岛素抵抗的原因之一。     

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.     

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…