COPD 大鼠气道上皮 CC16 mRNA的表达及意义

目的：探讨CC16在慢性阻塞性肺病（ COPD）发病机制中的作用。方法：将雄性SD大鼠随机分为健康对照组、COPD模型组（烟熏＋内毒素）和噻托溴铵药物干预组,每组10只。 RT-PCR检测各组大鼠气道上皮中CC16 mRNA的表达;免疫组化检测各组大鼠肺组织中CC16的蛋白表达;酶联免疫吸附试验（ ELISA ）检测各组大鼠血清中CC16、PLA2、IL8、TNFα的含量以及肺组织中PLA2、IL8、TNFα的含量。结果：大鼠气道上皮CC16 mRNA表达,COPD模型组较健康对照组显著减少,药物干预组较COPD模型组显著增加;血清及肺组织中CC16含量, COPD模型组较健康对照组显著减少,药物干预组较COPD模型组显著增加;血清及肺组织中PLA2、IL8、TNFα的含量,COPD模型组较健康对照组显著增多,药物干预组较COPD模型组显著减少（差异均有统计学意义,P＜0.05）。结论：在COPD大鼠形成过程中,气道上皮CC16 mRNA表达及肺组织CC16蛋白表达显著减少,这一改变可能是其小气道损伤的组织学标志,且与COPD的发生与发展有关。     

烟熏联合脂多糖制备大鼠慢性阻塞性肺疾病动物模型

目的通过动态观察大鼠慢性阻塞性肺疾病(COPD)动物模型制备过程中肺组织及小支气管的病理改变,以期进一步了解COPD疾病的发展过程。方法采用2次气道内注入细菌内毒素脂多糖和连续被动吸烟4周的方法建立COPD大鼠模型。造模过程中取第7、14、21、28、42天大鼠肺组织进行病理HE染色。结果造模28dCOPD大鼠模型均符合人类COPD的病理形态学特点,模型组大鼠在造模过程中逐渐出现肺气肿表现。结论气道内注入脂多糖与烟熏的复合方法能成功制备较稳定大鼠COPD动物模型。     

白介素10对急性肺损伤保护作用的实验研究

目的：探讨白介素10（IL－10）对急性肺损伤（ALI）的保护作用。方法：气道内滴注内毒素（LPS，10mg/kg）建立大鼠AIL模型。54只雄性SD大鼠随机分为对照组、内毒素组、内毒素加IL－10组，每组18只（2h 、6h、24h各6只）。按时相处死并采集标本，观察大鼠体重、动脉血气分析、肺系数、支气管肺泡灌洗液（BALF）总蛋白水平、BALF细胞总数及分类计数、血清及BALF中TNF－α水平、肺病理。结果：内毒素组大鼠体重、动脉血氧分压（PaO2）进行性降低，肺系数、BALF总蛋白水平、BALF细胞总数均明显增加，分类以中性粒细胞（PMN）为主，血清及BALF中TNF－α水平明显升高，肺病理示肺内PMN大量浸润伴出血、透明膜形成。IL－10组的各项指标均较内毒素组减轻。结论：①气道内滴注内毒素可成功复制ALI模型。②BALF的TNF－α水平比血中TNF-α水平与肺损伤具有更好的相关性。③IL－10可减轻LPS诱导的ALI。     

慢性阴塞性肺疾病大鼠模型体内TNFα及P65含量变化及意义

目的:探讨下NFα及P65在慢性阻塞性肺病(COPD)大鼠肺组织中的含量变化及其在发病中的作用.方法:香烟熏吸复合脂多糖(LPS)气道内滴注法复制COPD模型.将20只雄性清洁级Sprague-Dawley大鼠随机分为对照组和COPD模型组,每组各10只.肺组织切片行苏木精-伊红染色,测定两组支气管肺泡灌沈液(BALF)中TNFα含量,免疫组化法测定两组大鼠气道上皮中P65表达,运用Image-Proplus6.0软件行半定量分析.结果:模型组大鼠BALF中TNFα及肺组织中P65表达较对照组明显升高(P<0.05).结论;TNFα及P65参与了大鼠COPD的发病过程且在炎症反应中起重要作用.     

噻托溴铵对慢性阻塞性肺疾病大鼠血清、肺泡灌洗液及肺组织中IL-8、TNF-α、PLA2的影响

目的研究噻托溴铵对慢性阻塞性肺疾病（简称慢阻肺）大鼠血清、肺泡灌洗液及肺组织中炎症因子水平及肺组织病理结构的影响,以证实噻托溴铵治疗慢阻肺的抗炎作用。方法采用烟熏加气管内注入内毒素法建立大鼠慢阻肺模型。将雄性SD大鼠随机分为对照组、慢阻肺组和噻托溴铵干预组,每组10只。HE染色观察大鼠肺、支气管的病理改变,测定肺平均内衬间隔（MLI）及平均肺泡数（MAN）。行支气管肺泡灌洗液（BALF）细胞计数及分类。酶联免疫吸附试验检测各组大鼠血清、BALF及肺组织中IL-8、TNF-α、磷脂酶A2（PLA2）的含量。结果慢阻肺组大鼠肺、支气管HE染色符合慢阻肺的病理改变;慢阻肺组大鼠出现明显肺气肿,噻托溴铵组也出现肺气肿,但程度较轻。慢阻肺组大鼠BALF中细胞总数、中性粒细胞及淋巴细胞比例,血清、BALF及肺组织中炎症因子水平较对照组均明显升高（P〈0.01）;噻托溴铵干预组与慢阻肺组相比,BALF中细胞总数、中性粒细胞及淋巴细胞比例,血清、BALF及肺组织中炎症因子水平均显著降低（P〈0.01）,但仍明显高于对照组（P〈0.01）。结论噻托溴铵可以通过减少炎症细胞渗出降低慢阻肺大鼠血清、BALF及肺组织中IL-8、TNF-α、PLA2水平,减轻气道及肺组织炎症,发挥抗炎作用。     

芪蛭皱肺颗粒对慢性阻塞性肺疾病大鼠模型气道炎症的影响

目的 观察芪蛭皱肺颗粒对慢性阻塞性肺疾病（COPD）大鼠血清、支气管肺泡灌洗液（BALF）中白细胞介素-8（IL-8）和肿瘤坏死因子-α（TNF-α）水平的影响.方法 采用香烟烟熏加气管内注入脂多糖的复合因素造模法建立COPD大鼠模型,于造模第15天,空白组、模型组给予等体积中剂量颗粒辅料溶液灌胃4周,其他各药物干预组给予芪蛭皱肺颗粒小剂量、中剂量、大剂量和阳性药物（固本咳喘片）溶液灌胃4周,末次用药后取肺组织HE染色,取血清和BALF采用放免法检测IL-8和TNF-α的含量.结果 采用香烟烟熏加气管内注入脂多糖的方法成功复制了COPD大鼠模型,病理观察显示大鼠支气管及肺血管壁炎细胞浸润,分泌物明显增多,肺泡扩张.与空白组比较,模型组血清IL-8与TNF-α含量均升高（P＜0.01或＜0.05）;BALF IL-8与TNF-α含量亦均升高（P＜0.05或＜0.01）;与模型组比较,芪蛭皱肺颗粒各剂量组及固本咳喘片组血清及BALF中IL-8和TNF-α含量均降低（P＜0.05）,以芪蛭皱肺颗粒大剂量组降低更明显（P＜0.01）.结论 芪蛭皱肺颗粒有可能是通过减少炎症因子的生成和释放,从而有效调节肺炎症损伤时IL-8和TNF-α水平的升高,对大鼠模型气道炎症具有一定的干预作用.     

益肾通肺汤对COPD大鼠血清IL-8、TNF-α的影响

目的:观察益肾通肺汤对实验性慢性阻塞性肺疾病(COPD)大鼠血清白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α)及肺组织形态学的影响,探讨其防治COPD的机理。方法:将36只雄性W istar大鼠随机分为空白组、模型组、治疗组。两次气管内注射脂多糖加烟熏造模后,治疗组予中药益肾通肺汤灌胃1个月。支气管肺泡灌洗并计数灌洗液中细胞数及分类,放射免疫法测定各组大鼠血清IL-8、TNF-α的含量,肺组织切片行苏木素-伊红(HE)染色观察形态学改变。结果:模型组大鼠血清IL-8、TNF-α较空白组明显升高(P<0.01),治疗组大鼠血清IL-8、TNF-α较模型组明显下降(P<0.05)。结论:益肾通肺汤能降低COPD大鼠血清IL-8、TNF-α水平,对COPD有一定的防治作用。     

慢性阻塞性肺疾病大鼠血清及肺组织中肺表面活性蛋白D的水平变化及意义

目的通过测定肺表面活性蛋白D（SP-D）在慢性阻塞性肺疾病（COPD）大鼠肺组织及血清中的含量变化,探讨SP-D与COPD发病的关系。方法采用烟熏加气管内注入内毒素脂多糖（LPS）的方法建立大鼠COPD模型。将雄性SD大鼠随机分为对照组、内毒素组和COPD组,每组10只。HE染色观察大鼠肺、支气管的病理改变,定量检测肺平均内衬间隔（MLI）及平均肺泡数（MAN）以评估肺气肿程度。酶联免疫吸附实验（ELISA）检测大鼠血清SP-D含量。Western-blot及免疫组化方法检测大鼠肺组织SP-D含量变化。结果 COPD组大鼠肺、支气管的HE染色下病理变化符合COPD的典型病理改变。COPD组大鼠MLI较对照组明显增宽[（80±5）μm/个比（49±2）μm/个,P〈0.05],MAN较对照组明显减少[（274±13）个/mm2比（406±12）个/mm2,P〈0.01）;内毒素组MLI、MAN与对照组比较无显著差异（P〉0.05）。对照组、内毒素组和COPD组大鼠血清SP-D含量分别为（42.14±2.52）ng/mL、（49.59±2.81）ng/mL和（53.21±4.17）ng/mL,肺组织SP-D含量分别为0.39±0.01、0.56±0.01和0.63±0.01。内毒素组及COPD组大鼠血清和肺组织中SP-D含量均较对照组明显升高（P〈0.05）,而COPD组又显著高于内毒素组（P〈0.05）。3组血清SP-D水平与肺组织中SP-D含量均呈正相关（r值分别为0.93、0.94和0.93,P〈0.01）。结论 COPD组大鼠血清及肺组织中SP-D含量明显升高,并且血清及肺组织中SP-D水平呈显著正相关。COPD大鼠血清及肺组织中SP-D水平的研究为将SP-D作为COPD的生物标记物提供一定依据。     

改良吸烟复合气道内注入LPS法COPD大鼠模型的建立

目的对大鼠被动吸烟复合气道内注入脂多糖（lipopolysaccharide,LPs）法建立慢性阻塞性肺病（COPD）模型进行改良,通过比较模型大鼠肺功能、肺组织病理学改变、支气管肺泡灌洗液细胞分类计数及TNFα浓度、模型制作成功率和死亡率等指标评价改良烟熏复合气道内注入LPS法COPD大鼠模型的有效性。方法30只SD大鼠随机分为正常组、模型组和改良模型组三组,予正常组大鼠常规喂养,模型组采用第1及第15天气道内注入1g／ml LPS0.2ml（当天不行香烟熏染）,第2-28天行每日3次（每次间歇2h）,每次10支香烟熏染30min。改良模型组除调整第15天气道内注入LPS剂量为0.1ml,第2-7天每次香烟熏染剂量为5支外,其余同对照组。于第29天比较三组大鼠的肺功能、肺组织病理学改变及支气管肺泡灌洗液TNFα浓度、模型制作成功率。结果与正常组比较,模型组、改良模型组COPD模型大鼠气道阻力、支气管肺泡灌洗液TNF仪浓度明显高于正常组,两者肺顺应性明显低于正常组,结果有显著统计学差异（P〈0.05）。结论改良大鼠被动吸烟复合气道内注入LPS法是更为经济、稳定和可靠的大鼠COPD造模方法。     

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…