高热惊厥大鼠血红素氧合酶-1/一氧化碳体系的变化

目的:研究血红素氧合酶-1(heme oxygenase-1,HO-1) /一氧化碳(carbon monoxide,CO)体系与高热惊厥(febrile convulsion, FC)的关系.方法:采用热水浴诱导大鼠FC,隔日诱导惊厥1次,共诱导10次.发育期大鼠随机分为2组:37.0 ℃水浴正常对照组(n=12),高热处理(44.5 ℃热水浴)组(n=33),高热处理组又分出高热未惊厥组(FC=0,n=13)和FC组(FC≥6次,n=16).用组织原位杂交技术观察大鼠海马CA1区、CA3区和齿状回HO-1 mRNA的变化,用分光光度计检测大鼠左侧颞叶皮层和海马组织匀浆及血浆中CO含量.结果: FC组海马CA1区、CA3区和齿状回HO-1 mRNA表达明显高于正常对照组及高热未惊厥组(P<0.01),FC组脑组织匀浆及血浆中CO含量亦明显高于正常对照组及高热未惊厥组(P<0.05,P<0.01).结论:热水浴诱导大鼠FC可导致HO-1 mRNA表达的增高,并使CO产生增多.     

大鼠海马神经元血红素氧合酶-1在发育期及高热惊厥时的表达变化

目的:探讨大鼠海马神经元血红素氧合酶-1(heme oxygenase-1,HO-1)在正常发育期的表达及在高热惊厥时的变化.方法:发育期大鼠随机分为2组:正常组(n=6)和高热处理组,根据大鼠是否惊厥,后者又分为高热未惊厥组(n=6)和高热惊厥组(n=6).利用热水浴模型诱导大鼠高热惊厥,选择不同鼠龄的发育期大鼠,利用免疫组织化学方法,观察大鼠海马神经元HO-1表达的变化.结果:(1)出生3 h的新生大鼠海马HO-1未见表达,生后1周表达水平较高,生后2周达高峰,3周表达降低,生后6周表达明显降低,成熟后(2月)表达维持在较低水平.(2)海马CA1、CA3和门区神经元HO-1表达光密度的比较:高热惊厥组HO-1表达增加,与正常组及高热未惊厥组比较,差异均有显著性(P＜0.01),高热未惊厥组与正常组比较差异无显著性(P＞0.05).结论:不同鼠龄的发育期大鼠,海马神经元HO-1表达水平不同;发育期大鼠高热惊厥诱导海马神经元HO-1表达显著增加,这种表达增加可能与高热惊厥脑损伤有关.     

高热惊厥大鼠脑病理变化及超微结构的实验研究

目的：探讨反复高热惊厥（febrile seizure，FS）是否能引起发育期大鼠脑损伤。方法：51只雄性SD大鼠随机分为正常对照组（NC组，n=14）、高热对照组（HC组，n=19）及高热惊厥组（FS组，n=18）。水浴法建立FS模型，每日诱导2次，共10次。采用HE染色观察FS大鼠海马神经元病理形态，TUNEL染色观察神经元凋亡，电镜观察海马CA1区神经元、突触、穗鞘、胶质细胞、缝隙连接、毛细血管等超微结构变化。结果：HE染色可见FS组海马神经元发生变性和坏死。TUNEL染色可见FS组凋亡指数明显增高。电镜观察可见FS组神经元出现胞膜皱缩，细胞体积缩小，胞浆密度增加，核膜内陷，胞核深染；线柱体肿胀、脊断裂甚至空泡化，粗面内质网、游离核糖体肿胀，密度低；突触间隙增宽；髓鞘松解；胶质细胞水肿；毛细血管周围水肿。结论：频繁的FS发作可导致发育期大鼠海马神经元损伤。     

反复热性惊厥前后硫化氢/胱硫醚-β-合成酶体系表达的改变

目的:研究反复热性惊厥(febrile seizures,FS)对发育期大鼠脑内硫化氢(hydrogen sulfide,H2S)/胱硫醚-β-合成酶(cystathionine-β-synthase,CBS)体系表达的影响.方法:采用热水浴诱导大鼠反复热性惊厥.隔日诱导惊厥1次,共诱导10次.发育期大鼠随机分为对照组(N组, n=8)及10次热性处理组(n=22).10次热性处理组依其是否出现惊厥又分为10次高热组(H组, n=9)及10次热性惊厥组(FS组,n=8).10次热性处理组中虽出现惊厥但不足10次者用于其他实验.用亚甲基蓝法测定大鼠血浆H2S含量;用原位杂交和免疫组化法分别观察CBS基因和蛋白表达情况.结果:FS组大鼠血浆H2S含量明显高于对照组和高热组,FS组大鼠海马CBS基因和蛋白表达明显高于对照组和高热组.结论:反复热性惊厥可使大鼠血浆H2S含量升高,并可使大鼠海马CBS基因和蛋白表达增强.     

发育期大鼠高热惊厥前后海马γ-氨基丁酸B受体亚基表达的变化

目的：研究高热惊厥(febrile seizures，FS)对发育期大鼠脑内γ-氨基丁酸(γ-aminobutyric acid，GABA)B受体亚基GABABR1与GABARR2蛋白表达的影响。方法：采用热水浴诱导大鼠高热惊厥模型。隔日诱导惊厥1次，共诱导10次，末次惊厥后24h处死大鼠。发育期大鼠随机分为3组：对照组(n＝24)，1次高热处理组(n＝28)，10次高热处理组(n＝40)。高热处理组根据是否出现惊厥再分为1次高热惊厥组(FS1，n＝16)与1次高热未惊厥组(F1，n＝12)，10次高热惊厥组(FS10，n＝15)与10次高热未惊厥组(F10，n＝13)。采用免疫组化方法观察不同次数高热惊厥大鼠脑内GABABR1与GABABR2蛋白表达的变化。结果：FS10大鼠海马齿状回、CAl-CA3区GABABRl和GABABR2蛋白表达明显低于F10、F1、FSl和对照组；F10大鼠上述脑区GABABRl和GABABR2蛋白表达低于F1、FS1和对照组；F1及FS1大鼠与对照组相比差异无显著性；海马各区GABABR1与GABABR2表达的改变大部分平行，但10次高热惊厥后GABABR2在CA1—CA3区下降更明显，而GABABR1在齿状回下降更明显。结论：反复高热惊厥及反复高热均可使发育期大鼠脑内GABABR亚基蛋白表达降低，高热惊厥的影响较单纯高热更为明显，提示GABABR亚单位与发育期大鼠高热惊厥及其脑损伤密切相关。GABABR1与GABABR2改变的不平行可能与受体亚单位组合的可塑性改变有关，这种改变可能导致抑制功能的改变。     

薄盖灵芝对大鼠热性惊厥的防治研究

[目的]探讨薄盖灵芝对大鼠热性惊厥及反复热性惊厥大鼠海马神经元的影响。[方法]18只21日龄雄性SD大鼠随机均分为热性惊厥组(FS),盐水对照组(NS)及薄盖灵芝干预组(G)。采用热水浴诱导大鼠热性惊厥。G组于每次水浴前2h腹腔注射薄盖灵芝;而NS组腹腔注射相同体积的0.9%氯化钠溶液。观察各组大鼠惊厥表现,采用电镜观察海马CA1区神经元超微结构的损伤性变化。[结果]G组大鼠惊厥潜伏期较FS组和NS组长(P<0.05),惊厥持续时间较FS组和NS组缩短(P<0.05),惊厥级别较FS组和NS组下降(P<0.05)。电镜标本观察发现G组大鼠海马CA1区神经元变性坏死百分比明显低于FS组及NS组(P<0.05)。[结论]薄盖灵芝可使大鼠惊厥潜伏期延长、惊厥持续时间缩短、惊厥严重程度下降,对反复热性惊厥大鼠海马神经元有保护作用。     

发育期大鼠惊厥后血清丙二醛、促红细胞生成素及髓鞘碱性蛋白的变化及意义

目的 探讨发育期大鼠惊厥发作后血清丙二醛(MDA)、促红细胞生成素(EPO)及髓鞘碱性蛋白(MBP)的变化及意义.方法 发育期大鼠64只随机分为正常对照组(n=15)和高热组(n=49).高热组又随机分为3个亚组:高热未惊厥组(惊厥次数＜1,n=15)、一般惊厥组(1≤惊厥次数≤5,n=17)、反复惊厥组(惊厥次数＞5次,n=17).采用热水浴法反复诱导发育期大鼠惊厥,记录每组惊厥潜伏期、惊厥开始发作时肛温、惊厥持续时间及惊厥发作级别;采用ELISA分别测定各组大鼠丙二醛、促红细胞生成素、髓鞘碱性蛋白的表达水平.结果 一般惊厥组发育期大鼠惊厥后24 h血清MDA水平高于正常对照组及高热未惊厥组(P＜0.05);一般惊厥组发育期大鼠惊厥后12 h、24 h、48 h、72 h血清EPO水平高于正常对照组及高热未惊厥组(P＜0.05);反复惊厥组发育期大鼠惊厥后12 h、24 h、48 h、72 h血清MDA、EPO水平均高于一般惊厥组(P＜0.05);髓鞘碱性蛋白表达水平变化各组之间比较无明显变化(P＞0.05).结论 血清丙二醛、促红细胞生成素是发育期惊厥脑损伤的敏感指标,反复惊厥更容易造成脑损伤,可通过其观察生化指标的动态变化来了解发育期脑损伤情况.     

纳洛酮对幼年大鼠反复热惊厥后远期惊厥易感性的影响

目的:探讨纳洛酮对幼年大鼠反复热惊厥后远期惊厥易感性的影响.方法: 用热水浴惊厥模型诱导生后15 d的SD大鼠发生7次热性惊厥,期间两治疗组大鼠(各13只)每次惊厥一出现立即腹腔注射低剂量纳洛酮(分别为1 mg/kg和2 mg/kg),而惊厥对照组大鼠(n=13)仅腹腔注射相同体积的生理盐水.间隔2个月再热水浴1次,观察比较治疗组和惊厥对照组大鼠远期惊厥发生率、惊厥潜伏期、惊厥持续时间及惊厥程度的差异.采用Timm染色观察神经元海马齿状回苔藓纤维发芽状况.结果: 未接受纳洛酮治疗的有幼年反复热性惊厥史的对照组大鼠,2个月后再次接受热刺激时,惊厥发生率为84.6%, 惊厥潜伏期(3.65±0.77) min,惊厥持续时间(21.18±4.06) min,惊厥级别评分(4.54±0.78), 5级惊厥发生率达69.3%,且有2只大鼠出现惊厥持续状态, 其中1只抽搐后死亡;而接受纳洛酮治疗的实验组大鼠,2个月后再次接受热刺激时,惊厥发生率、惊厥潜伏期、惊厥持续时间、惊厥级别评分分别为57.7%、(3.78±0.69) min、(5.66±2.78) min、(2.97±1.18), 5级惊厥发生率仅为19.3%, 无1只出现惊厥持续状态.比较两组惊厥发生率、惊厥潜伏期差异均无显著性,但惊厥持续时间、惊厥级别评分、5级惊厥发生率两组相比差异均有显著性.惊厥对照组Timm染色显示大鼠海马区有明显苔藓纤维发芽现象,评分达(2.33±1.03);而治疗组大鼠Timm染色示海马区苔藓纤维发芽现象明显减轻,评分为(0.92±0.79);两者比较差异有显著性, 提示治疗组大鼠远期惊厥脑损伤较未治疗组明显减轻.结论:应用低剂量纳洛酮对反复热性惊厥的幼年大鼠进行早期干预治疗,可以降低远期惊厥易感性,减轻成年后再次惊厥所造成的神经元损伤.     

托吡酯对动物反复热性惊厥脑损伤的干预作用观察

目的 探讨托吡酯对大鼠反复热性惊厥造成的脑损伤有无保护或改善作用.方法 利用热水浴方法诱导热性惊厥(FC)大鼠模型后进行水迷宫试验,并对大鼠海马组织进行HE组织化学染色及电镜观察,然后测定血清神经元特异性烯醇化酶(NSE)浓度.结果 托吡酯可以改善反复热性惊厥大鼠的学习记忆能力,并减轻海马神经元损伤的程度,明显降低血清NSE浓度.结论 托吡酯对反复热性惊厥造成的大鼠脑损伤具有保护作用,可以改善热性惊厥性脑损伤的程度.     

鹿石合剂对缺氧缺血脑损伤新生大鼠海马神经元超微结构的影响

目的 探讨中药鹿石合剂对缺氧缺血脑损伤新生大鼠海马CA1区神经元超微结构的影响.方法 结扎右侧颈总动脉及缺氧2 h,建立缺氧缺血新生大鼠模型,以西药"洛斯宝"为阳性对照,鹿石合剂灌胃,分别以透射电镜和光镜尼氏染色观察海马CA1区神经元超微结构及尼氏小体的变化.结果 大鼠海马CA1区神经元核膜不清晰,染色质边集,大部分线粒体膜损伤,线粒体肿胀、空泡变性,线粒体嵴断裂、模糊或消失,粗面内质网数量减少、排列紊乱;鹿石合剂高剂量组粗面内质网丰富,细胞器结构接近假手术组,尼氏小体呈块状或颗粒状,染色比假手术组浓密.鹿石合剂高剂量组疗效优于"洛斯宝"组.结论 鹿石合剂可改善缺氧缺血脑损伤大鼠海马CA1区神经元超微结构的变化.     

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…