早期抑制TLR4对新生大鼠HIBD后青春期脑海马免疫功能的影响

目的 探讨Toll样受体4(TLR4)早期抑制在调节新生大鼠缺氧缺血性脑损伤(HIBD)后青春期脑海马免疫功能中的作用。方法 生后7 d新生大鼠随机分为Control组、缺氧缺血(HI)组及HI+TLR4抑制剂TAK-242组(TAK-242组)。HI后3 d免疫组化检测大鼠脑海马TLR4表达;HI后21 d免疫荧光检测大鼠脑海马CA1区Iba-1⁺、GFAP⁺、CD161⁺、MPO⁺及CD3⁺细胞的数量变化;免疫组化检测大鼠脑海马CA1区黏附因子ICAM-1、补体C3a表达;Western blot检测大鼠脑海马IL-1β、TNF-α、IL-10表达。结果 HI后3 d大鼠脑海马CA1、CA3及DG区TLR4表达,HI组较Control组升高(P<0.01或P<0.05),而TAK-242组较HI组降低(P<0.05)。HI后21 d大鼠脑海马CA1区GFAP⁺细胞数量,TAK-242组较HI组降低(P<0.05);CD3     

Toll样受体4抑制剂联合雷帕霉素对小鼠移植心脏存活的影响

目的 探讨Toll样受体4(TLR4)抑制剂TAK-242对小鼠心脏移植后移植物存活的影响.方法 采用小鼠腹部异位心脏移植模型,供者为BALB/C小鼠,受者为C57BL/6小鼠.受者分为4组:对照组、雷帕霉素(Rapa)组、TAK-242组及Rapa+TAK-242组,术后移植后观察移植物存活情况;部分受者于术后7 d或15 d获取移植心脏用于组织病理学检测.结果 TAK组移植心脏平均生存时间稍延长但未达到统计学意义[(8.2±0.2)d vs(7.6±0.2)d,P=0.086].Rapa+TAK-242组移植心脏平均生存时间较对照组显著延长[(56.1±3.7)d vs(7.6±0.2)d,P<0.001],并且优于Rapa组[(56.1±3.7)d vs(19.2±1.5)d,P<0.001].组织病理学结果 提示Rapa+TAK-242组移植物排斥反应最轻,组织中CD11c阳性树突状细胞减少,CD3阳性淋巴细胞浸润减少,C4d沉积减轻.结论 TAK联合Rapa能够减少移植心脏组织内炎症细胞浸润,减轻排斥反应,延长移植心脏存活.     

右美托咪定通过调控TLR4表达对神经细胞氧糖剥夺损伤保护作用的机制研究

目的探讨右美托咪定调控TLR4表达对神经细胞氧糖剥夺损伤的保护作用及其机制。方法体外培养PC12神经细胞,复制氧糖剥夺细胞模型,以低(0. 1μmol/L)、中(1. 0μmol/L)和高剂量(10. 0μmol/L)右美托咪定作用24 h后,CCK-8法检测细胞存活率,Western blot检测Bcl-2相关X蛋白(Bax)、B细胞淋巴瘤/白血病-2(Bcl-2)和Toll样受体4(TLR4)蛋白的表达,RT-PCR法检测TLR4 mRNA的表达,ELISA法检测肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)含量。在复制氧糖剥夺细胞模型中,以TLR4抑制剂TAK-242抑制TLR4表达后,给予右美托咪定作用,观察细胞存活率、Bax蛋白、Bcl-2蛋白、TLR4蛋白、TNF-α含量和IL-6含量的变化。结果低、中和高剂量右美托咪定作用后,PC12细胞存活率升高,Bax和TLR4蛋白表达、TLR4 mRNA表达以及TNF-α和IL-6含量降低,而Bcl-2蛋白表达升高(P0. 05),且表现出浓度依赖性。TAK-242处理后,TLR4表达降低,PC12细胞存活率升高,Bax蛋白表达以及TNF-α和IL-6含量降低,而Bcl-2蛋白表达升高(P0. 05);给予右美托咪定作用后,TAK-242的上述作用明显增强(P0. 05)。结论右美托咪定可通过抑制TLR4表达保护神经细胞氧糖剥夺损伤。     

TLR4/MyD88/NF-κB 信号通路对甲基苯丙胺依赖CPP大鼠海马的影响

  目的  研究TLR4/MyD88/NF-κB信号通路对甲基苯丙胺（methamphetamine,MA）依赖的条件性位置偏好（conditioned place preference,CPP）大鼠海马的影响,同时采用特异性抑制剂TAK-242抑制Toll样4受体（Toll-like receptor 4,TLR4）,减轻MA依赖诱导的海马神经炎症。  方法  建立MA（10 mg/kg,ip,14 d）依赖大鼠CPP模型,分别为生理盐水组、MA组、TAK-242组、MA+TAK-242组。TAK-242组和MA+TAK-242组先分别腹腔注射抑制剂TAK-242（3 mg/kg）,1h后MA+TAK-242组再腹腔注射MA（10 mg/kg）。采用Western Blot实验和采用荧光定量PCR实验检测MA依赖CPP大鼠海马中TLR4、MyD88、TRAF6、IκB-α、p-IκB-α、NF-κBp65、p-NF-κBp65蛋白的表达和mRNA表达。  结果  与生理盐水组相比,MA组TLR4、MyD88、TRAF6、NF-κBp65的蛋白和mRNA表达均升高（P < 0.001或P < 0.01）,IκB-α的蛋白和mRNA表达下降（P < 0.01）,p-IκB-α、p-NF-κBp65的表达升高（P < 0.01或P < 0.05）;与MA组相比,MA+TAK-242组TLR4、MyD88、TRAF6、NF-κBp65的蛋白和mRNA表达均下降（P < 0.001、P<0.01或P < 0.05）,IκB-α的蛋白和mRNA表达升高（P < 0.01）,p-IκB-α、p-NF-κBp65表达下降（P < 0.01或P < 0.05）。  结论  MA依赖可通过激活TLR4/MyD88/NF-κB信号通路,诱导CPP大鼠海马神经炎症的发生,采用特异性TLR4抑制剂可以减轻MA诱导的神经炎症。     

TLR4/NF-κB对哮喘大鼠气道平滑肌细胞增殖、凋亡的影响

目的 探讨Toll样受体4(Toll like receptors4,TLR4)/核因子-κB(Nuclear Factor Kappa B,NF- κB)对哮喘大鼠气道平滑肌细胞增殖、凋亡的影响.方法 体外培养哮喘大鼠气道平滑肌细胞,将细胞分为空白对照组、TNF-α组、(TNF-α+PDTC)组和(TNF-α+TLR4)抗体组.用四甲基偶氮唑蓝(MTT)微量比色法检测ASMCs增殖反应,用TUNNEL法检测ASMCs凋亡情况,用ELISA检测细胞培养上清液中NF-κB的蛋白含量,用RT-PCR、Westem blot检测各组细胞TLR4的mRNA和蛋白表达水平.结果 TNF-α组ASMCs的增殖反应与对照组相比增加,差异有显著性(P＜0.05),(TNF-α +PDTC)组、(TNF-α +TLP4)抗体组ASMCs增殖反应显著低于TNF-α处理组(P＜0.01),(TNF-α+PDTC)组与对照组相比差异无显著性(P＞0.05),(TNF-α +TLR4)抗体组ASMCs增殖反应显著低于对照组(P＜0.01);TNF-α处理组细胞凋亡率与对照组相比差异无显著性(P＞0.05),(TNF-α+PDTC)组和(TNF-α +TLP4)抗体组细胞凋亡率显著高于TNF-α处理组(P＜0.01)及对照组(P＜0.01);TNF-α组NF- κB含量显著高于对照组、(TNF-α+PDTC)组及(TNF-α+TLR4)抗体组(P＜0.01);(TNF-α +PDTC)组与(TNF-α +TLR4)抗体组之间差异无显著性(P ＞0.05);TNF-α组TLR4mRNA表达水平明显高于对照组及(TNF-α +TLR4)抗体组(P＜0.05);(TNF-α +TLR4)抗体组TLR4mRNA表达水平与对照组之间差异无显著性(P＞0.05);TNF-α组TLR4蛋白表达水平显著高于对照组及(TNF-α+TLR4)抗体组(均P＜0.01);对照组TLR4蛋白表达水平显著高于TNF-α+TLR4抗体组(P＜0.01).结论 TLR4可能通过NF-κB参与哮 喘大鼠气道平滑肌细胞增殖凋亡.     

以树突状细胞为主的免疫细胞对慢性再生障碍性贫血患者外周血IFN-γ及TNF-α表达的影响

目的 观察以树突状细胞为主的免疫细胞治疗前后慢性再生障碍性贫血患者外周血干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)的表达水平的变化,探讨以树突状细胞为主的免疫细胞治疗慢性再障的作用机制.方法 流式细胞仪检测14例正常对照组和14例慢性再障患者治疗前及治疗10个月后外周血CD3+细胞、CD8+细胞内IFN-γ,TNF-α的表达水平,ELISA法检测血浆中IFN-γ,TNF-α的分泌水平.结果 慢性再障患者血浆中及CD3+细胞内、CD8+细胞内IFN-γ,TNF-α的水平显著高于对照组(P<0.05).经以树突状细胞为主的免疫细胞治疗10个月后,IFN-γ,TNF-α的表达水平明显下降,与治疗前相比差异有显著性(P<0.05),与正常对照组相比较差异无显著性(P>0.05).结论 以树突状细胞为主的免疫细胞能下调慢性再障患者CD3+,CD8+细胞内IFN-γ,TNF-α的表达,降低血浆IFN-γ,TNF-α的水平,对慢性再障有较好的疗效.     

Electroacupuncture Attenuates Immune-Inflammatory Response in Hippocampus of Rats with Vascular Dementia by Inhibiting TLR4/MyD88 Signaling Pathway

Objective:To investigate whether electroacupuncture(EA)alleviates cognitive impairment by suppressing the toll-like receptor 4(TLR4)/myeloid differentiation factor 88(MyD88)signaling pathway,which triggers immune-inflammatory responses in the hippocampus of rats with vascular dementia(VaD).Methods:The experiments were conducted in 3 parts and in total the Sprague-Dawley rats were randomly divided into 8 groups by a random number table,including sham,four-vessel occlusion(4-VO),4-VO+EA,4-VO+non-EA,sham+EA,4-VO+lipopolysaccharide(LPS),4-VO+LPS+EA,and 4-VO+TAK-242 groups.The VaD model was established by the 4-VO method.Seven days later,rats were treated with EA at 5 acupoints of Baihui(DV 20),Danzhong(RN 17),Geshu(BL 17),Qihai(RN 6)and Sanyinjiao(SP 6),once per day for 3 consecutive weeks.Lymphocyte subsets,lymphocyte transformation rates,and inflammatory cytokines interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)were measured to assess immune function and inflammation in VaD rats.Transmission electron microscopy was used to observe the ultrastructure of nerve cells in the hippocampus.The levels of TLR4,MyD88,IL-6,and TNF-αwere detected after EA treatment.TLR4/MyD88 signaling and cognitive function were also assessed after intracerebroventricular injection of TLR4 antagonist TAK-242 or TLR4 agonist LPS with or without EA.Results:Compared with the 4-VO group,EA notably improved immune function of rats in the 4-VO+EA group,inhibited the protein and mRNA expressions of TLR4 and MyD88 in the hippocampus of rats,reduced the expressions of serum IL-6 and TNF-α(all P<0.05 or P<0.01),and led to neuronal repair in the hippocampus.There were no significant differences between the 4-VO+LPS+EA and 4-VO+EA groups,nor between the 4-VO+TAK-242 and 4-VO+EA groups(P>0.05).Conclusions:EA attenuated cognitive impairment associated with immune inflammation by inhibition of the TLR4/MyD88 signaling pathway.Thus,EA may be a promising alternative therapy for the treatment of VaD.     

Adiporedoxin对TNFα诱导血管内皮细胞Integrin α4和Integrin β1表达的影响

目的研究脂过氧化物酶(adiporedoxin,Adrx)对肿瘤坏死因子-α(TNF-α)诱导血管内皮细胞整合素α4(Integrin α4)和整合素β1(Integrin β1)表达的影响。方法过表达实验分为空载体组、空载体+TNF-α组、Adrx+TNF-α组;si-RNA干扰实验分为si-Control组、TNF-α组、si-Adrx+TNF-α组。将Adrx质粒和si-Adrx分别转染HUVEC细胞后,用TNF-α处理细胞,Real-time PCR和Western blotting分别检测Integrin α4和Integrin β1 mRNA和蛋白水平。结果TNF-α上调Integrin α4、Integrin β1表达;与单用TNF-α处理组比较,Adrx+TNF-α组细胞Integrin α4和Integrin β1 mRNA和蛋白水平均显著降低;而用si-RNA下调Adrx表达后,TNF-α诱导的Integrin α4和Integrin β1 mRNA和蛋白水平均明显升高。结论Adrx负调控TNF-α诱导的HUVEC细胞Integrin α4和Integrin β1表达。     

HBV无症状携带者树突状细胞的分化及功能研究

目的 研究HBV无症状携带者树突状细胞的分化及功能.方法 抽取健康对照者(A组)、HBV无症状携带者(B组)外周静脉血,经密度梯度离心法分离获得PBMC,用TNF-α、IL-10分别和rhIL-4、rhGM-CSF刺激培养,获得:成熟树突状细胞(mDC)、不成熟树突状细胞(imDC).rhIL-4、rhGM-CSF刺激培养获得树突状细胞(DC)作组内对照.imDC组加入TNF-α刺激,检验imDC的稳定性.流式细胞仪检测各组反映树突状细胞成熟度的各种分子.结果 A、B组内mDC细胞膜表达HLA-DR,HLA-ABC分子,分泌的IL-12p70与imDC、DC、imDC+TNF-α组相比明显增加;A、B组间mDC的HLA-DR,HLA-ABC表达无显著性差异,IL-12p70分泌差异有统计学意义(P<0.01).imDC的HLA-ABC、HLA-DR低表达,IL-12p70分泌也较低,与本组内DC比较结果差异有统计学意义(P<0.01);A、B组间imDC的HLA-DR,HLA-ABC低表达,IL-12p70分泌差异无统计学意义.imDC加入TNF-α后HLA-ABC、HLA-DR仍低表达,IL-12p70分泌低于本组内DC,结果差异有统计学意义(P<0.01);A、B组间结果无显著性差异.结论 在A、B组,TNF-α均有效促进DC成熟为mDC,IL-10均抑制DC的成熟,不受A、B组细胞来源影响.mDC分泌大量IL-12p70,并在B组低于A组,说明B组mDC存在一定的功能不足.     

TAK-242 对Aβ25-35 诱导大鼠海马神经元损伤的作用及其机制研究

目的 探讨TAK-242 对β- 淀粉样蛋白25-35（Aβ25-35）诱导的大鼠海马神经元损伤的作用及其相关机制。方法 用Aβ25-35 注射大鼠双侧海马复制阿尔兹海默病的动物模型,TAK-242 腹腔注射进行治疗,Nissl 染色观察大鼠海马CA3 区神经元的形态和数量,Western blot 检测大鼠海马Toll 样受体4（TLR4）和髓样分化因子88（MyD88）蛋白的表达,酶联免疫吸附法检测大鼠海马白细胞介素1β（IL-1β）和肿瘤坏死因子α（TNF-α）表达水平。结果 大鼠海马注射Aβ25-35 后引起大鼠海马CA3 区神经元破坏和数量减少,而TAK-242 可以抵抗Aβ25-35 所造成的神经毒性并保护海马神经元,同时TAK-242 可降低Aβ25-35 所引起的海马组织内TLR4、MyD88、IL-1β 和TNF-α 表达升高。结论 TAK-242 可以通过抑制TLR4/MyD88信号通路,降低炎症因子IL-1β 和TNF-α 水平,从而保护大鼠海马神经元抵抗Aβ25-35 诱导的神经毒性。     

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…