牛颈静脉带瓣管道重建犬右室-肺动脉连接后的钙化研究

目的研究牛颈静脉用于重建右室-肺动脉连接后的钙化情况。方法以戊二醛鞣制的牛颈静脉带瓣管道为研究对象,建立犬重建右心室-肺动脉连接动物模型,观察9￣10个月,通过原子光谱吸收法测定组织钙含量,以评价在体内循环系统中与血流接触的情况下,牛颈静脉带瓣管道的钙化情况。结果管壁钙含量为(22.05±10.78)μg/mg,瓣膜钙含量为(0.88±0.69)μg/mg,后者仅为前者的3.99%,经配对t检验分析,在统计学上差异均有显著性(P<0.001)。瓣下管壁钙含量为(16.04±4.25)μg/mg,瓣上管壁钙含量为(28.07±17.98)μg/mg,配对t检验显示二者在统计学上差异无显著性(P>0.05);瓣膜的基底部、交界部及游离缘3者之间的钙含量在统计学均无显著性差异,配对t检验显示P>0.05;结论牛颈静脉带瓣管道重建右室-肺动脉连接后,血管壁远较瓣膜容易钙化;瓣上管壁和瓣下管壁钙化程度无明显差异,瓣膜各部分钙化程度无明显差异。     

戊二醛固定的牛颈静脉带瓣管道的钙化实验研究

目的检测戊二醛固定的牛颈静脉带瓣管道的在体钙化程度,评价用戊二醛固定牛颈静脉带瓣管道的可行性,为寻找最佳的固定方法提供基础资料.方法将戊二醛处理后的牛颈静脉管壁及瓣叶组织用肝素进行处理,植入脱乳的SD大鼠背部皮下,60 d后取出,进行自身对照,采用原子吸收分光光度法检测组织钙含量,HE染色、Von-Kossa染色进行形态学检测,透射电镜观察超微结构变化.结果包埋前的牛颈静脉瓣膜、管壁试片平均钙含量分别为(1.84±0.75)、(0.53±0.22)μg/mg干重,包埋后的牛颈静脉瓣膜、管壁试片平均钙含量分别为(16.23±8.32)、(151.00± 23.78)μg/mg干重,两组相比有显著差别(P＜0.001).光镜及电境下显示包埋前的牛颈静脉瓣膜、管壁内皮保存完整,组织结构紧凑,胶原纤维结构保持良好;包埋后的牛颈静脉瓣膜、管壁则内皮残缺,结构疏松,胶原纤维破坏严重.结论戊二醛交联的牛颈静脉带瓣管道,可见明显钙化.瓣膜钙化较轻,管壁钙化严重.     

醇对戊二醛鞣制的牛心包防钙化改性的实验研究

目的本实验采用几种醇改性戊二醛处理后的牛心包,希望寻找一种理想的生物瓣处理方法。方法分为五组,即新鲜对照组及戊二醛、2,3-丁三醇、1,3-丙二醇、1,2-丙二醇组。分组将牛心包试片植入SD大鼠背部皮下60d后,行组织钙定量测定及组织学检测。结果2,3-丁二醇改性后的牛心包试片钙平均含量为3.99±0.96ug/mg干重,与GA组、1,2-丙二醇,1,3-丙二醇试片的钙平均含量(241.89±7.79、244.26±6.39、167.32±12.29ug/mg干重)相比,钙化,钙化明显减轻(均P＜0.01),但与对照组(4.11±2.23ug/mg干重)相比无显著性差异(P＞0.05)。病理组织学检查显示2,3-丁二醇组和1,3-丙二醇组试片仅有轻度形态学改变。而GA组和1,2-丙二醇组试片有严重的胶原变性,大片钙化。结论戊二醛鞣制的生物材料经2,3-丁二醇改性后,可显著减轻钙化。     

戊二醛鞣制的牛颈静脉带瓣管道钙化的实验研究

目的探讨戊二醛鞣制的牛颈静脉带瓣管道是否易于钙化。方法本研究以戊二醛鞣制的牛颈静脉作为研究对象,通过建立大鼠皮下包埋动物模型11例加速体内钙化的方法,应用原子吸收光谱法测定组织钙含量。结果血管壁和瓣膜钙含量分别为(211.00±25.83)μg/m g和(4.218±3.879)μg/m g,后者为前者的2%,统计学上差异有显著性(P<0.001)。结论戊二醛交联鞣制的牛颈静脉血管壁较易发生钙化,与之相比瓣膜较不易钙化。     

戊二醛结合肝素鞣制牛颈静脉带瓣管道抗钙化的实验研究

目的用动物皮下包埋的模型,用戊二醛鞣制的牛颈静脉带瓣管道(VBJVC)作为对照,来研究戊二醛结合肝素鞣制的牛颈静脉带瓣管道是否具有更好的抗钙化能力和抗衰老能力。方法把牛颈静脉带瓣管道分为两组,实验组(戊二醛结合肝素组)和对照组(戊二醛组),分别包埋在两组实验兔的皮下。90d后取出牛颈静脉带瓣管道片,进行钙的定量分析和形态学检查。形态学分析包括光镜下HE染色和Von-Kossa染色,进行钙化程度的比较。结果比较戊二醛结合肝素鞣制的VBJVC(A组)较之传统的单纯的用戊二醛鞣制的VBJVC(B组),其结果有明显的统计学意义。(1)标本用原子分光光度计测量组织钙含量,A组(13.92±5.03)mg/g,B组(34.99±12.33)mg/g,A组的组织钙化明显低于B组;(2)光镜下用Von-Kossa钙染色,按照Carpentier的分级方法,A组,0度2个,Ⅰ度3个,Ⅱ度1个。B组,0度1个,Ⅰ度1个,Ⅱ度2个,Ⅲ度2个,A组的组织钙化明显低于B组。结论经过戊二醛结合肝素鞣制的VBJVC,较之单纯用戊二醛鞣制的VBJVC,有较好的抗钙化能力。     

2,3-丁二醇改性处理的鞣制牛颈静脉带瓣管道血流动力学研究

目的观察2,3丁-二醇改性处理的鞣制牛颈静脉带瓣管道(BJVC)重建猪右心室流出道后的血流动力学性能。方法应用戊二醛固定(A组)和戊二醛固定、2,3丁-二醇改性处理(B组)的牛颈静脉带瓣管道分别进行猪肺动脉与右心室连接,行超声心动图检测牛颈静脉带瓣管道血流动力学指标。结果重建术后3个月16头猪均存活,A组跨瓣压差、牛颈静脉反流量及远端吻合口压差显著大于B组,差异有统计学意义(P<0.05)。结论2,3丁-二醇改性处理的鞣制牛颈静脉可能是一种更好的重建右室流道材料,但远期效果需进一步研究。     

辛醇对戊二醛鞣制的牛心包抗钙化改性的实验研究

目的:探索戊二醛鞣制牛心包生物瓣膜新的处理方法,以延缓其钙化进程,从而延长牛心包生物瓣使用寿命。方法:用辛醇对戊二醛鞣制的牛心包进行改性处理,通过建立大鼠皮下包埋动物模型加速体内钙化的实验方法;应用原子吸收光谱法测定组织钙含量,以评价辛醇化学改性对戊二醛鞣制的牛心包钙化的影响。结果:辛醇组和戊二醛牛心包钙含量分别为(113．19±14．86)μg／mg和(256．16±21．52)μg／mg(P< 0．001),辛醇组牛心包试片钙含量明显低于戊二醛组。结论:在戊二醛鞣制的基础上通过辛醇对牛心包进行进一步的化学玫性处理,可显著延缓牛心包的钙化进程,可望成为一种增强牛心包生物瓣耐久性的有效方法。     

牛颈静脉带瓣管道结构特性及流体动力学的实验研究

目的 :探讨牛颈静脉带瓣管道结构形态及其流体动力学特性。方法 :取新鲜牛颈静脉带瓣管道 ,应用自制的流量测定装置 ,在相同压力下测定其在一定时间内顺行和逆行灌注量 ,根据逆行与顺行流量的百分比将瓣膜功能分级。重复测量以 0 .6 2 5 %戊二醛液固定的牛颈静脉管道的顺逆行灌注流量 ,观察静脉瓣膜解剖结构。结果 :牛颈静脉管道常有 2～ 3组瓣膜 ,瓣叶菲薄、透明。每组瓣可为三叶或两叶 ,少数为四叶。各组瓣叶发育程度不一 ,发育良好的组瓣呈散在分布。瓣膜抗返流功能和瓣膜与瓣窦高度之比值呈正相关 (r =0 .70 9,P <0 .0 0 1 ) ;瓣膜抗返流功能与瓣叶数和管径之间不相关 (P >0 .0 5 )。固定前后其逆行与顺行灌注流量百分比差异有显著性 (P<0 .0 5 )。结论 :部分牛颈静脉具有发育良好的瓣膜 ,抗返流特性好。常用的戊二醛固定处理降低了牛颈静脉管道的抗返流性能     

光氧化反应处理牛颈静脉带瓣管道的形态学与理化性能研究

目的：探讨光氧化反应处理后的牛颈静脉带瓣管道的外观形态、组织稳定性及流体物理性能的特征。方法：取新鲜牛颈静脉带瓣管道24根，分为光氧化处理组、戊二醛处理组及新鲜对照组。分别观察和测量各组处理前后的管壁的厚度、管腔外径及各组管道瓣膜的抗返流功能的变化，测定处理前后的组织含水量、热皱缩温度、最大应力，并作各组的组织蛋白提取分析以了解组织稳定性。结果：光氧化组与对照组相比管壁厚度、管腔外径、瓣膜抗返流功能、组织含水量及热皱缩温度差异无统计学意义（P>0.05）,与戊二醛组相比差异有统计学意义（P<0.05）。光氧化组最大应力大于对照组，低于戊二醛组。光氧化组和戊二醛组的组织蛋白提取量均少于对照组。结论：光氧化方法处理后的牛颈静脉带瓣管道能较好地保持原有的管壁及瓣膜结构的完整性，并可提高组织的稳定性和组织的断裂强度。     

去细胞处理对牛颈静脉带瓣管道细胞外基质骨架的影响

目的:探讨去细胞处理对牛颈静脉带瓣管道细胞外基质骨架成分及组织稳定性的影响,为确立构建组织工程化的人工血管技术提供依据.方法:采集新鲜牛颈静脉,筛选瓣膜功能良好的血管,采用曲那通X-100、胰蛋白酶/EDTA和DNase-I/RNase-A三步法去细胞处理,组织化学染色和透射电镜观察细胞外基质骨架成分(胶原和弹力蛋白)的变化.对新鲜和去细胞处理的牛颈静脉血管壁(n=10)分别进行弹力蛋白(Fastin弹性蛋白法)和羟脯氨酸(碱水解、分光光度法)含量测定;并测定处理前后的热皱缩温度和抗张强度以比较组织稳定性.结果:去细胞处理牛颈静脉血管壁光镜和透射电镜检测提示细胞及其成分完全去除,组织间隙增宽,但胶原成分较好保留,弹力蛋白部分减少及断裂.与新鲜组织比较,去细胞组羟脯氨酸含量相对增加[(25.73±2.97)mg/g vs.(29.25±2.99)mg/g,P＜0.05],弹力蛋白含量相对减少[(159.71±21.06)ng/g vs.(134.91±35.40)mg/g,P＜0.05],热皱缩温度降低[(72.50±0.53)℃ vs.(69.75±0.54)℃,P＜0.05],抗张强度也下降明显[(5.19±0.65)MPa vs.(3.13±0.94)MPa,P＜0.05].结论:去细胞处理对牛颈静脉细胞外基质骨架有一定损害,牛颈静脉的组织稳定性有所下降,得到的细胞外基质基本成分需经进一步交联处理才可以作为组织工程支架材料.     

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…