黄芪多糖对NOD小鼠1型糖尿病的预防作用

目的 探讨黄芪多糖对NOD小鼠1型糖尿病的预防作用。方法 比较APS预免疫组NOD小鼠和NS对照组NOD小鼠DM发病率、血清C-P和GAD-Ab水平、脾脏T细胞亚群比例、胰岛组织病理学和免疫组化。结果 APS组与NS组比较,DN发病率显著降低,血清C-P水平显著增高,胰岛炎症程度减轻,CD8T细胞亚群比例显著增高,CD4/CD8比值显著降低。结论 早期应用黄芪多糖预免疫可以预防或延缓NOD小鼠1型糖尿病的发病。     

双歧杆菌对NOD小鼠1型糖尿病的免疫干预作用

目的 了解早期应用双歧杆菌对非肥胖糖尿病（NOD）小鼠糖尿病发病的影响.方法 将4周龄雌性NOD小鼠随机分为两组：实验组（20只）给予双歧杆菌0.25 mg/g体重/天（制备成活菌悬液0.5ml）,对照组（20只）给予等量的磷酸盐缓冲液（PBS）.4周龄开始给药至30周龄,每周测体重,于15周龄时各组分别处死6只小鼠,取胰腺组织HE染色进行胰岛炎评分;其余小鼠30周龄时观察发病率,同时观察胰岛炎,脾脏T细胞亚群变化.结果双歧杆菌组糖尿病发病率28.57%,明显低于对照组78.57%（P＜0.05）,发病时间也显著延缓,胰岛炎程度明显减轻,残存胰岛数目高于对照组;脾CD4^＋、CD8^＋T细胞亚群双歧杆菌组明显低于对照组（CD4^＋T细胞P＜0.01,CD8^＋T细胞P＜0.05）.结论 双歧杆菌对NOD小鼠1型糖尿病发病有预防和延迟的作用,其机制可能与调节小鼠CD4^＋、CD8^＋T细胞亚群有关。     

1型糖尿病的分子免疫学研究进展

1型糖尿病是一种T细胞介导的器官特异性自身免疫性疾病。在其发病中有许多免疫细胞参与，包括CD4^ 和CD8^ T淋巴细胞、B淋巴细胞等，其中CD4^ T淋巴细胞起中心性作用，按其分泌细胞因子的不同大致分为Th1和Th2两亚群。许多研究表明，在胰岛B细胞的损伤、胰岛炎的加重、糖尿病的发生过程中，Th1细胞及细胞因子和Th2细胞及细胞因子起了重要的作用。     

结核性及恶性肿瘤性胸腔积液淋巴细胞亚群比例以及Th1/Th2免疫平衡研究

目的探讨Th1／Th2免疫应答平衡在结核性和恶性肿瘤性胸腔积液病理生理过程中的可能作用。方法对24例治疗前结核性胸腔积液以及28例患者恶性胸腔积液患者胸液标本进行有核细胞计数、分类和流式细胞仪检测淋巴细胞亚群,检测CD3^＋,CD3^＋CD4^＋、CD3^＋CD8^＋T淋巴细胞亚群比例,并计算CD4^＋／CD8^＋值;利用夹心酶联免疫吸附测定（ELISA）法检测胸液标本中INF-γ、IL-18、TNF-α以及IL-10的浓度。结果结核性胸腔积液患者胸水中T辅助淋巴细胞以CD3^＋CD4^＋细胞为主,其CD3^＋细胞比例、CD3^＋CD4^＋细胞比例以及CD4^＋／CD8^＋值均高于恶性肿瘤性胸腔积液组（P〈0．01）。2组研究对象INF-γ、IL-18、TNF-α以及IL-10的浓度分别是（中位数）：结核性胸腔积液组942．0、1526、62pg／ml和153pg／ml;恶性胸腔积液组10．35、1763、8．85pg／ml和66．85pg／ml。结核性胸腔积液中INF-γ、TNF—α以及IL-10均明显高于恶性肿瘤性胸腔积液中的水平（P〈0．01）,且平均分别高约90倍、7倍和2倍。IL-18在2组胸腔积液中的含量无显著性差异（P〉0．05）。结核性胸腔积液IL-18／IL-10明显低于恶性肿瘤性胸腔积液组（P〈0．01）。结论结核性胸腔积液表现为Th1免疫应答为主;而恶性肿瘤性胸腔积液患者存在明显的细胞免疫功能低下。这种低下可能主要以T辅助淋巴细胞受损、Th1免疫应答降低以及Th2免疫应答升高为主。IFN-γ可作为鉴别结核性胸腔积液和恶性肿瘤性胸腔积液特异性和敏感度较高的指标。     

异基因骨髓干细胞移植后重建NOD小鼠T淋巴细胞亚群比值的研究

目的：探讨骨髓干细胞移植对NOD小鼠免疫系统重建和预防糖尿病发生的机制。方法：①21只6周龄NOD雌性鼠接受9．5cGy全身照射后随机分为两组,移植组10只,对照组11只;②每周监测血常规和血糖的变化;③小鼠饲养至发生糖尿病时或至30周龄时处死,摘取脾脏分离淋巴细胞,通过流式细胞术检测移植鼠与非移植鼠脾脏CD3^＋、CD4^＋、CD8^＋、CD4^＋／CD8^＋淋巴细胞;采用ELISA法测定血清中IFN-γ水平;吉姆萨染色法计数小鼠骨髓分裂相中Y染色体所占比例,检测嵌合程度并作为细胞植活标记。结果：①移植后NOD受鼠经骨髓细胞的性别染色体检测显示均植入成功;②实验组糖尿病发病率显著低于对照组（P〈0．05）,且发病时间与对照组比较明显延缓（P〈0．05）;③实验组和对照组CD3^＋T细胞、CD4^＋T细胞比较差异无统计学意义（P〉0．05）,但实验组CD8^＋T细胞显著高于对照组（P〈0．05）。实验组的CD4^＋／CD8^＋比值显著低于对照组（P〈0．05）,血清IFN7数值也显著低于对照组水平（P〈0．01）。结论：NOD鼠在通过异基因骨髓干细胞移植后,能降低糖尿病的发生率和延缓糖尿病的发生,可能与移植后免疫重建,下调CD4^＋／CD8^＋T细胞的比值,使Th1／Th2极化向Th2偏移等机制相关,异基因骨髓干细胞移植可能成为防治1型糖尿病的新途径。     

黄芪多糖对NOD鼠胰岛细胞因子基因表达的影响

目的　探讨黄芪多糖 (APS)以NOD小鼠 1型糖尿病免疫干预的分子机制。方法　应用RT CPR技术分别检测APS处理组和对照组NOD小鼠所有胰腺组织内 15条细胞因子mRNA的表达水平。结果　与对照组相比 ,APS组IL 1β、IL 2、IL 6、IL 12、TNF α、INF γ、Fas、iNOS的mRNA表达水平明显下调 ,IL 4、IL 5、IL 10、TGF β、Bcl 2、SOD的mRNA表达水平明显上调。结论　APS能纠正NOD小鼠Th1/Th2型细胞 /细胞因子的免疫失衡状态 ,预防或延缓 1型糖尿病的发生     

卡介菌多糖核酸对尖锐湿疣患者外周血T细胞亚群及其细胞因子表达的影响

目的 研究卡介菌多糖核酸（BCG-PSN）对尖锐湿疣（CA）患者外周血T淋巴细胞亚群及胞内细胞因子表达的影响，探讨BCG-PSN对尖锐湿疣可能的免疫调节机制。方法 采用三色和双色荧光抗体染色技术经流式细胞仪检测18例CA患者在BCG-PSN治疗前后外周血T淋巴细胞亚群及CD4^＋T细胞、CD8^＋T细胞内IL-2、IL-4、IL-12、IFN-γ染色阳性细胞百分率。结果 在BCG-PSN治疗前，CA患者CD3^＋T细胞、CD4^＋T细胞、CD4^＋／CD8^＋比值明显低于对照组（均P〈O．01），CD4^＋T细胞和CD8^＋T细胞内IL-2、IL-12、IFN-γ阳性细胞百分率较对照组明显下降（均P〈0．01），IL-4阳性细胞百分率与对照组比较差异无显著性意义（P〉0．05）；而治疗后CA患者CD3^＋T细胞、CD4^＋T细胞、CD4^＋／CD8^＋比值明显高于治疗前（均P〈O．01）；CD4^＋T细胞和CD8^＋T细胞内IL-2、IL-12、IFN-γ阳性细胞百分率较治疗前升高（均P〈0．01）。结论 BCG-PSN可通过调节尖锐湿疣患者T细胞亚群，纠正患者Th1／Th2模式及Tc1／Tc2模式失衡现象，起到治疗尖锐湿疣的作用。     

多巴胺D1样受体在介导调节CD4^＋T淋巴细胞功能中的作用

目的：从分子水平揭示CD4^＋ T淋巴细胞表达D1受体和D5受体mRNA的现象,探讨这些受体在调节CD4^＋ T淋巴细胞功能中的作用.方法：采用免疫磁珠分离和纯化小鼠淋巴结CD4^＋ T淋巴细胞.用抗CD3/CD28抗体刺激活化CD4^＋ T淋巴细胞,并用D1样受体激动剂SKF38393、拮抗剂SCH23390分别作用于CD4^＋ T淋巴细胞,然后采用real-time PCR法检测CD4^＋ T淋巴细胞上D1受体和D5受体mRNA的表达,Th1细胞特异性转录因子（T-box expressed in T cells,T-bet）和细胞因子干扰素γ（interferon-γ,IFN-γ）的表达,Th2细胞特异性转录因子GATA binding protein 3（GATA 3）和细胞因子白细胞介素-4（interleukin-4,IL-4）的表达,Th17细胞特异性转录因子（retinoid acid-related orphan receptor gammat,RoR γt）和细胞因子IL-17、IL-22的表达.结果：D1样受体激动剂SKF38393（10^-8和10^-7 mol/L）作用于CD4^＋ T淋巴细胞后,CD4^＋ T淋巴细胞表达D1样受体mRNA增高,IFN-γ的表达降低,GATA 3、IL-4的表达增高,但T-bet、RoR γt、IL-17和IL-22的表达没有变化,SCH23390（10^-7 mol/L）能阻断SKF38393的这些作用.结论：CD4^＋ T淋巴细胞能表达多巴胺D1样受体,CD4^＋ T淋巴细胞上D1样受体的激活可促进CD4^＋ T淋巴细胞向Th2细胞分化、抑制Th1细胞功能及增强Th2细胞功能.     

吸毒人群中HIV、TB感染者免疫细胞和细胞因子监测

目的测定吸毒人群外周血中T细胞亚群、Th1—Th2细胞因子,评价HIV、TB感染后免疫学指标的变化。方法对吸毒人群中9例HIV阳性者、5例患活动性结核病者、40例吸毒人群中健康者及40例正常人群,应用流式细胞技术（FCM）分别检测CD3^＋、CD3^＋CD4^＋．CD3^＋CD8^＋细胞百分率,计算CD3^＋CD4^＋／CD3^＋CD8^＋即Th细胞与Ts细胞的比值,采用酶联免疫吸附法（ELISA）检测Th1（IL-2、IFN-γ）/Th2（IL-4、IL-6）细胞因子浓度。结果HIV感染组、TB感染组及吸毒者健康组、正常人组各项指标间差异有统计学意义,CD3^＋CD4^＋／CD3^＋CD8^＋即Th细胞与Ts细胞的比值及Th1（IL-2、IFN-1）浓度均明显低于对照组,HIV〈TB〈吸毒人员健康者〈正常人群（P〈0．05）。而Th2（IL-4、IL-6）细胞因子浓度则明显高于正常人群。结论CD3^＋CD4^＋／CD3^＋CD8^＋即Th细胞与Ts细胞的比值及Th1（IL-2、IFN-γ）/Th2（IL-4、IL-6）细胞因子浓度的检测在评价HIV、TB感染者的免疫状况、进展和预后判断等方面具有重要作用。     

Th1/Th2亚群失衡与自身免疫性糖尿病

自身免疫性糖尿病 (autoimmunediabetes )是 1型糖尿病的一个亚型 ,是指有一定的遗传基础 ,并在多种因素的共同作用下 ,由T淋巴细胞介导的以胰岛 β细胞损害为主要特征的器官特异性自身免疫性疾病。在其发病中有许多免疫细胞参与 ,包括CD4+ 和CD8+ T淋巴细胞、B淋巴细胞、单核细胞、巨噬细胞 (MΦ)、树突状细胞等 ,这些细胞对胰岛的浸润引发胰岛的炎症 ,并致胰岛 β细胞的损伤 ,使胰岛素分泌减少或缺乏 ,糖尿病发生。其中CD4+ T淋巴细胞起中心性作用[1] 。按其分泌细胞因子的不同大致分Th1和Th2两亚群。Th1/Th2亚群失衡与自身免疫性糖…     

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.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

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.