2型糖尿病大鼠肾脏血管内皮生长因子的表达和黄芪的调节作用

目的观察黄芪对2型糖尿病大鼠肾脏血管内皮生长因子(VEGF)的影响.方法将SD大鼠分为假手术组(Sham组)、糖尿病肾病组(DN组)、黄芪治疗组(DNH组).DN组和DNH组制成糖尿病模型,DNH组予黄芪注射液5 mL/kg灌胃.观察黄芪对糖尿病肾病大鼠肾组织VEGF、尿白蛋白的影响.结果黄芪可明显降低糖尿病大鼠尿白蛋白及肾组织VEGF表达(P＜0.05).结论 2型糖尿病所致糖尿病肾病VEGF表达升高,黄芪可能通过抑制VEGF表达而减少糖尿病肾病损害.     

黄芪卫矛合剂调节糖尿病肾病大鼠HGF和TGF-β1平衡研究

目的探讨黄芪卫矛合剂对糖尿病肾病大鼠的干预作用。方法用单侧肾切除并链脲佐菌素尾静脉注射建立大鼠糖尿病肾病模型,随机分为假手术组、糖尿病肾病组、糖尿病肾病+黄芪卫矛合剂组和糖尿病肾病+氯沙坦钾组。共持续12周,蛋白印迹法检测各组大鼠肾组织中肝细胞生长因子(HGF)和转化生长因子-β1(TGF-β1)蛋白表达。结果糖尿病肾病模型组HGF表达减少,TGF-β1蛋白表达增多,与假手术组比较均有非常显著性差异(P0.01),两治疗组可增加HGF蛋白表达,降低TGF-β1蛋白表达,与模型组比较有显著性或非常显著性差异(P0.01或P0.05)。结论黄芪卫矛合剂能够通过增加糖尿病肾病大鼠肾组织中HGF蛋白表达,抑制TGF-β1蛋白表达,起到防治糖尿病肾病的作用。     

黄芪汤剂对阿霉素肾病模型大鼠肾组织中Smad4表达的影响

目的：观察黄芪汤剂对阿霉素大鼠肾病模型中Smad4表达的影响,探讨其对阿霉素病大鼠肾脏的防治作用及其机制。方法：建立阿霉素肾病模型,灌服黄芪汤剂（0.28g/mL）治疗,空白组和对照组灌服蒸馏水,连续三周后检测生化指标和肾组织病理变化,免疫印迹（western blot）检测肾组织Smad4蛋白定位表达。结果：黄芪组生化指标和病理均优于造模组,Smad4较造模组表达明显减弱。结论：黄芪汤剂可能参与下调转化因子β1下游因子Smad4的高表达从而延缓肾脏纤维化。     

愈肾合剂对糖尿病模型大鼠肾脏细胞TGG-β1、PDGF-B表达的影响

目的 观察中药方剂愈肾合剂对糖尿病大鼠肾脏细胞转化生长因子β1(TGF-β1)、血小板衍化生长因子B(PDGF-B)表达的影响,探讨其治疗糖尿病肾病的作用机制.方法 诱发糖尿病肾病大鼠模型,设假手术组、模型组、对照组、治疗组.采用免疫组织化学方法 检测肾脏细胞TCF-β1、PDGF-β的表达.结果 愈肾合剂可降低模型大鼠尿蛋白,改善肾功能,下调TGF-β1、PDGF-B的蛋白表达.结论 愈肾合剂可通过下调TGF-β1、PDGF-B的蛋白表达,进而改善肾功能,延缓疾病进展.     

糖肾汤对糖尿病大鼠肾保护作用的实验研究

目的 研究糖肾汤对糖尿病大鼠肾保护作用.方法 采用四氧嘧啶造成实验性糖尿病大鼠模型,随机分为模型组、糖肾汤治疗组、卡托普利对照组,连续灌胃给药4周,观察治疗前后血糖变化,尿微量白蛋白的排泄,尿α1-微球蛋白水平,血液流变学变化,肾脏组织形态学改变及肾内血流的彩色多普勒超声(color Doppler flow imaging,CDFI)血流参数的变化.结果 糖肾汤降低了糖尿病大鼠肾重与体重比值,并可使糖尿病模型大鼠尿微量白蛋白排泄量及尿α1-微球蛋白含量明显减少,改善糖尿病模型大鼠血流变异常,减轻/延缓光镜下肾脏结构损害,控制和纠正糖尿病模型大鼠肾血管阻力增高,改善其肾内血流灌注的状况.结论 糖肾汤具有延缓实验性糖尿病肾病的作用,明显改善早期糖尿病肾病肾内血流状况,控制肾小球滤过率的改变.     

加味消渴康对糖尿病肾病大鼠丝裂原活化蛋白激酶P38及转化生长因子-β1表达的影响

目的:探讨加味消渴康对糖尿病肾病(DN)大鼠肾组织丝裂原活化蛋白激酶P38(P38 MAPK)及转化生长因子-β1(TGFβ1)表达的影响.方法:采用单侧肾切除加链脲佐菌素诱导的DN模型,分为正常组、模型组、中药组和西药组.中药组予加味消渴康灌胃,西药组予氯沙坦灌胃,正常组及模型组每日灌服等量蒸馏水,共灌胃12周.各组大鼠于第12周末处死取出肾脏,观察肾组织病理学改变以及P38MAPK和TGF-β1的表达.结果:加味消渴康对DN大鼠肾组织病理损伤有较好的改善作用,并能降低肾组织P38MAPK及TGF-β1的表达.结论:加味消渴康对DN有一定的治疗作用.     

黄芪甲苷经 TGF －β／Smad 信号通路对糖尿病肾病大鼠肾脏的影响

目的：观察黄芪甲苷干预链脲佐菌素（STZ）诱导糖尿病肾病大鼠模型氧化损伤的影响及相关的分子机制研究。方法健康成年雄性SD大鼠80只,体重（2.54±0.45）kg,其中10只作为空白对照组,10只作为空白加高剂量黄芪甲苷组,其余60只则用于STZ模型。糖尿病肾病大鼠模型以60 mg／kg一次性腹腔注射诱导,造模后1周开始测血糖,剔除血糖低于13.9 mmol／L的大鼠。造模成功的大鼠随机选取10只作为模型对照组和模型加黄芪甲苷高中低（120 mg／kg、60 mg／kg、30 mg／kg）治疗组。每2周收集代谢数据,给药6周后处死。测定体重肾脏指数,血糖情况以及大鼠血清ROS及SOD情况,观察患侧肾脏组织病理,采用蛋白质免疫印迹法（ Western blot）检测TGF－β／Smad信号通路相关信号分子的表达。结果模型组大鼠肾重及肾脏指数最大,而治疗组大鼠肾重及肾脏指数明显减小（P＜0.05）,但仍高于对照组大鼠（P＜0.05）。实验各组大鼠血糖在0周时无明显差别。黄芪甲苷治疗组血糖值低于模型组,但差异无统计学意义（P＞0.05）。黄芪甲苷可降低模型大鼠患侧肾脏组织纤维化病变,呈剂量依赖性下调TGF－β1、TβRⅠ、TβRⅡ、Smad4、Smad2／3、P－Smad2／3、α－SMA、Collagen Ⅰ、Ⅲ、Ⅳ的蛋白表达水平,呈剂量依赖性上调Smad7的蛋白表达。结论（1） SD大鼠单次腹腔大剂量注射STZ建立致糖尿病肾病模型;（2）黄芪甲苷可通过降低ROS水平,升高SOD活性对糖尿病肾病大鼠的氧化损伤起到一定的缓解;（3）黄芪甲苷可通过下调大鼠肾脏TGF－β／Smad信号通路的表达而改善大鼠的胞外基质堆积而保护肾脏。     

愈肾合剂对糖尿病模型大鼠肾脏细胞TGF-β1、PDGF-B表达的影响

目的观察中药方剂愈肾合剂对糖尿病大鼠肾脏细胞转化生长因子β1(TGF-β1)、血小板衍化生长因子B(PDGF-B)表达的影响,探讨其治疗糖尿病肾病的作用机制。方法诱发糖尿病肾病大鼠模型,设假手术组、模型组、对照组、治疗组。采用免疫组织化学方法检测肾脏细胞TGF-β1、PDGF-B的表达。结果愈肾合剂可降低模型大鼠尿蛋白,改善肾功能,下调TGF-β1、PDGF-B的蛋白表达。结论愈肾合剂可通过下调TGF-β1、PDGF-B的蛋白表达,进而改善肾功能,延缓疾病进展。     

凉血化瘀法和补肾法对肾小球肾炎大鼠血液流变学的影响

采用大鼠肾毒血清性实验模型，分为凉血化瘀治疗组、补肾治疗组和空白对照组，各灌服８周后杀检，测定各组血液流变学指标并进行组间比较。结果表明：凉血化瘀治疗组各项血液流变学指标（全血粘度、血浆比粘度、红细胞压积、纤维蛋白原含量）均明显优于病理组，组间比较具有显著性差异；补肾组和病理组之间相比无显著性差异。说明凉血化瘀法对于实验性肾小球肾炎大鼠血液流变学指标的改善作用强于补肾法。     

曲尼司特对马兜铃酸肾病大鼠肾纤维化防治作用的初步研究

目的观察曲尼司特干预治疗对马兜铃酸肾病大鼠肾纤维化防治作用,以探讨其可能的机制。方法雄性SD大鼠24只,随机分为4组。对照组予灌服饮用水10mL.kg-1.d-1,模型组、曲尼司特治疗组及安博维治疗组均予关木通水煎剂灌胃共12周建立马兜铃酸肾病模型。12周时观察各组大鼠血红蛋白(Hb)、肌酐(Cr)、转化生长因子β1(TGF-β1)、肝细胞生长因子(HGF)和原位杂交骨成形蛋白7(BMP-7)的表达。结果曲尼司特能延缓血红蛋白降低及血清肌酐(Scr)上升;减轻肾小管上皮细胞空泡变性、小管萎缩及间质纤维化;曲尼司特能下调马兜铃酸肾病大鼠肾组织中的TGF-β1,上调HGF、BMP-7的表达。结论曲尼司特可能通过下调马兜铃酸肾病大鼠肾组织中TGF-β1,上调HGF、BMP-7的表达以抑制肾小管上皮细胞表型转分化,从而减轻肾纤维化,发挥其肾脏保护作用。     

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.     

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…