祛风通络方对系膜增生性肾小球肾炎大鼠肾组织α-SMA的影响

目的：通过观察肾脏组织形态学及肾小球α-SMA表达的变化,探讨祛风通络方防治大鼠系膜增生性肾小球肾炎的可能机制,为祛风通络方的临床应用提供理论依据.方法：采用免疫法制备MsPGN大鼠模型,光镜下观察各组大鼠肾小球系膜区（GMC）及细胞外基质（ECM）积聚变化.采用免疫组织化学法检测各组大鼠肾组织中α-SMA的表达,并用图像分析系统对免疫组织化学结果进行灰度值分析.结果：肾小球及肾小管α-SMA灰度值病理组为167.91±6.16,空白对照组为195.88±3.49,两者相比较差异具有统计学意义（P〈0.05）;肾小球及肾小管α-SMA灰度值祛风通络方组为200.71±2.29,蒙诺组为201.68±1.37,与病理组相比,2组灰度值明显升高（P〈0.05）,2治疗组与空白对照组相比灰度值虽有所升高但差异无显著性.肾组织形态学观察显示,祛风通络方组个别区域肾小球系膜细胞轻度增生,系膜区轻度增宽,管腔无挤压现象,较模型组明显改善.结论：祛风通络方能够抑制肾组织α-SMA的表达,影响肾小球系膜细胞的重塑,该方可减轻MsPGN模型大鼠肾组织病理损害,延缓肾小球硬化的进展.     

肾疏宁对系膜增生性肾炎模型大鼠肾小球固有细胞表型转化的影响

目的:观察肾疏宁对系膜增生性肾炎(MsPGN)模型大鼠肾小球系膜细胞(MC)表型转化的作用,探讨肾疏宁防治肾小球硬化的作用机制。方法:在建立MsPGN大鼠模型基础上,延长造模时间至12～16周,使其向肾小球硬化进展,观察肾疏宁对肾小球α平滑肌肌动蛋白(α-SMA)表达的影响,并设苯那普利为阳性对照组。结果:12、16周末造模各组α-SMA表达量明显高于正常组(P<0.01)。16周末肾疏宁组α-SMA表达量明显优于苯那普利组(P<0.01)。结论:肾疏宁能抑制MC表型转化,减少肾小球内固有细胞α-SMA的表达,可能是防治肾小球硬化的部分作用机制。     

肾疏宁对肾小球硬化大鼠肾小球系膜细胞表型转化的作用

目的观察中成药复方肾疏宁对肾小球硬化模型大鼠肾小球系膜细胞表型转化的作用,探讨肾疏宁防治肾小球硬化的作用机制。方法采用单侧肾切除并阿霉素尾静脉注射的方法建立大鼠肾小球硬化模型。用数字表法将SD大鼠随机分为假手术组、模型组、模型组+肾疏宁治疗组和模型组+苯那普利治疗组,共观察8周。用免疫组织化学染色法观察大鼠肾小球内α-平滑肌肌动蛋白(alpha smooth muscle actin,α-SMA)和转化生长因子-β1(transforming growth factor-β1,TGF-β1)的表达,用病理图像分析软件检测肾小球内α-SMA和TGF-β1染色阳性面积/肾小球毛细血管襻面积的改变。同时观察肾疏宁对肾小球硬化大鼠体质量、尿蛋白、血白蛋白、尿素氮、肌酐的影响。结果假手术组大鼠肾小球内未见α-SMA表达,可见TGF-β1少量表达;模型组大鼠肾小球内α-SMA和TGF-β1显著表达,与假手术组比较,差异有统计学意义(P<0.01);血白蛋白、总蛋白明显降低,与假手术组相比,差异有统计学意义(P<0.01);尿蛋白、血尿素氮、肌酐明显升高,与假手术组相比,差异有统计学意义(P<0.01)。肾疏宁治疗组和苯那普利治疗组24h尿蛋白排泄量、血尿素氮、肌酐明显降低,与模型组相比,差异有统计学意义(P<0.01)。肾小球内α-SMA阳性面积/肾小球毛细血管襻面积和TGF-β1阳性面积/肾小球毛细血管襻面积显著减少,与模型组比较差异有统计学意义(P<0.01)。相关性分析显示α-SMA和TGF-β1呈显著正相关(r=0.637,P<0.01)。结论肾疏宁可抑制肾小球系膜细胞表型转化,减少肾小球内固有细胞α-SMA和TGF-β1的表达,降低24h尿蛋白、血尿素氮和血肌酐,可能是防治肾小球硬化的部分作用机制。     

厄贝沙坦对肾小球硬化大鼠肾组织肝细胞生长因子的调节

目的 :探讨厄贝沙坦对肾切除加重复阿霉素注射的方法复制的肾小球硬化模型大鼠肾组织肝细胞生长因子 (HGF)分泌的调节。方法 :将肾小球硬化大鼠分为厄贝沙坦治疗组和对照组 ,设假手术组为正常对照。检测厄贝沙坦治疗 8周后的肾功能和组织病理改变 ,用免疫组化方法检测肾小球和肾小管 间质中HGF的表达 ,并用ELISA法比较各组大鼠肾组织分泌的HGF。结果 :厄贝沙坦治疗组较对照组肾组织HGF的表达增加 ,肾组织分泌的HGF含量增加。结论 :厄贝沙坦可以上调肾组织HGF的分泌 ,加强HGF的肾保护作用 ,延缓肾小球硬化 ,减轻肾小管 间质纤维化。     

滋阴清热活血方联合激素对系统性红斑狼疮肾纤维化干预机制的研究

目的 研究滋阴清热活血方联合激素对MRL/lpr狼疮小鼠肾纤维化的影响，揭示该方抗狼疮肾纤维化效应机制。方法 将MRL/lpr自发性狼疮小鼠按尿蛋白水平平均分为5组:模型组、醋酸泼尼松组、滋阴清热活血方组、滋阴清热活血方加激素全量组、滋阴清热活血方加激素半量组。药物干预4周后，H＆E染色和Masson染色分别检测狼疮小鼠肾组织病理学改变和肾纤维变化情况；免疫荧光法检测肾脏IgG免疫复合物沉积；Western blot法测定模型肾脏Smad4和Smad7蛋白表达水平。结果 与模型组比较，各治疗组小鼠肾脏病理损伤显著减少；Masson染色结果显示，与模型组比较，滋阴清热活血方组和醋酸泼尼松组胶原沉积减少；与滋阴清热活血方组比较，滋阴清热活血方加激素全量组和滋阴清热活血方加激素半剂量组胶原沉积面积均减少。免疫荧光染色检测结果显示，与模型组比较，滋阴清热活血方组和醋酸泼尼松组肾脏免疫复合物沉积减弱；与滋阴清热活血方组比较，滋阴清热活血方加激素全量和半量组肾脏IgG免疫复合物荧光显著减少。与模型组比较，滋阴清热活血方组、滋阴清热活血方加激素全量组和激素半剂量组肾组织Smad4蛋白显著下降；滋阴清热活血方组、滋阴清热活血方加激素全量组和激素半剂量组肾组织Smad7显著增加，其中，中药联合激素的2组尤为显著。结论 滋阴清热活血方联合激素对MRL/lpr小鼠肾组织肾纤维化具有较好的改善作用，其作用机制可能与抑制Smad4表达、上调Smad7蛋白表达有关，该研究为临床滋阴清热活血方联合激素治疗系统红斑狼疮肾纤维化提供了生物学依据。     

黄芪对IgA肾病大鼠肾组织α-SMA和FN的影响

目的：探讨黄芪对IgA肾病大鼠肾组织α-平滑肌肌动蛋白（α-SMA）、纤维连接蛋白（FN）表达的影响,以观察黄芪对对IgA肾病的治疗作用及抗肾间质纤维化的机理。方法：复制IgA肾病大鼠模型,并给予黄芪治疗,分析肾脏病理改变,采用免疫组织化学技术检测各组大鼠肾组织中α-SMA、FN的表达情况。结果：IgA肾病模型组大鼠肾小球系膜区、肾小管、肾间质病理损害较正常对照组和黄芪治疗组明显加重,模型组大鼠肾小球系膜区IgA免疫荧光明显增强,与正常对照组（P〈0．001）和黄芪治疗组（P〈0．001）比较均有统计学意义。正常组肾组织有少量α-SMA和FN的表达,而IgA肾病模型组大鼠肾组织中α-SMA和FN表达明显增强,与正常对照组和黄芪治疗组α-SMA（P〈0．05）和FN（P〈0．05）比较差别有统计学意义。结论：黄芪可以抑制IgA肾病大鼠肾组织中α-SMA和FN的表达,从而干预肾间质纤维化,减轻肾脏病理改变,延缓IgA肾病的发生发展。     

黄芪对UUO模型大鼠肾脏肝细胞生长因子表达的影响

目的 动态观察黄苠(AM)对单侧输尿管梗阻(UUO)所致大鼠肾小管间质纤维化的拈抗作用和肝细胞生长因子(HGF)表达的影响.方法 SD大鼠随机分为假手术组(SOR组)、UUO组和UUO+AM治疗组(AM组).在造模后3、7、14 d处死动物,观察肾脏病理改变.采用免疫组化方法检测肾组织中α-平滑肌肌动蛋白(α-SMA)、HGF表达.实时荧光定量RT-PCR检测大鼠.HGF mRNA和α-SMA mRNA表达量.Western blot检测大鼠HGF及其受体C-met蛋白表达量.结果 与SOR组相比,各时间点UUO大鼠肾脏病理损害进行性加重,AM治疗后可明显减轻UUO大鼠肾小管损伤及肾间质纤维化程度(P<0.05).随着梗阻时间的延长,UUO大鼠肾组织α-SMA表达逐渐增加;HGF及其受体C-met呈现先升高后下降的表达规律,在UUO术后第7 d达高峰,此后大幅回落;与UUO组各对应时间点比较,AM治疗后可使肾组织中的HGF及其受体C-met表达显著增高,α-SMA表达明显降低(P<0.05).结论 AM可能通过诱导HGF及其受体C-met的表达,负性调控肾小管上皮细胞转分化,减轻肾间质纤维化.     

补肾化瘀汤对肾纤维化大鼠肾组织中α-SMA表达的影响

目的:探讨补肾化瘀方对肾纤维化大鼠肾组织中α-平滑肌肌动蛋白(α-SMA)表达的影响。方法:将24只大鼠随机分为假手术组、模型组、补肾化瘀方组和代文组,采用单侧输尿管结扎(UUO)的方法建立肾纤维化大鼠模型;分别于UUO术后28天采用免疫组化方法观察模型大鼠肾组织α-SMA的表达变化。结果:与假手术组相比,模型组大鼠肾组织α-SMA表达于28天出现明显增高(P<0.01);用药后,补肾化瘀汤组和代文组α-SMA表达与模型组相比均明显降低(P<0.01);补肾化瘀汤组和代文组无明显差异(P>0.05)。结论:补肾化瘀汤组能够通过降低肾组织中α-SMA表达防治肾纤维化。     

益气活血法对肾间质纤维化影响的实验研究

目的 观察益气活血中药拮抗肾间质纤维化的作用及对转化生长因子β1mRNA表达的影响.方法 将30只大鼠随机分假手术组(对照组)、模型组和治疗组(中药组),采用单侧输尿管梗阻(UUO)模型,术后第14天观察梗阻肾组织病理改变,应用免疫组织化学方法检测转化生长因子β1(TGF-β1)、α-平滑肌肌动蛋白(α-SMA)和Ⅰ型胶原的表达.结果 模型组TGF-β1、α-SMA、Ⅰ型胶原的表达增加,肾间质病变加重,与对照组相比有显著差异(P＜0.05);治疗组与模型组相比,TGF-β1、α-SMA、Ⅰ型胶原的表达下调,肾间质病变面积明显缩小,差异有显著性(P＜0.05).结论 益气活血中药可能通过下调TGF-β1、α-SMA、Ⅰ型胶原的表达,从而阻抑肾间质纤维化的进展.     

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…