益肾保真方对肾性贫血大鼠血清促红细胞生成素表达的影响

目的 探讨益肾保真方对慢性肾衰竭大鼠贫血的干预作用及疗效机制。 方法 采用二步5/6肾切除的方法复制慢性肾衰竭大鼠贫血模型,将造模成功的43只大鼠随机分为正常组（n=9）、模型组（n=8）、益肾保真方高剂量组[n=9,46.5 g/（kg·d）]、益肾保真方低剂量组[n=9,15.6 g/（kg·d）]及尿毒清组[n=8,2.5 g/（kg·d）]。灌胃给药,每日1次,连续6周,测定各组大鼠血肌酐（SCr）、尿素氮（BUN）、血红蛋白（Hb）、红细胞计数（RBC）、平均红细胞容积（MCV）及血清促红细胞生成素（EPO）含量。 结果 益肾保真方高、低剂量组Hb、RBC及EPO水平均较模型组和尿毒清组升高（P<0.05）,MCV在组间的差异无统计学意义;与模型组比较,益肾保真方高、低剂量组BUN、SCr水平均降低（P<0.01）,但与尿毒清组比较差异无统计学意义。 结论 益肾保真方对肾性贫血有干预作用,其机制可能与降低氮质潴留、减轻毒素对造血的抑制、提高红细胞刺激因子EPO水平有关。     

二黄益肾汤调控TGF-β1/Smad信号通路治疗慢性肾功能衰竭研究

[目的] 观察二黄益肾汤对5/6肾切除大鼠肾组织血清尿素氮（BUN）、血清肌酐（Scr）、转化生长因子-β1（TGF-β1）、Smad3、Smad4、Smad7 mRNA及蛋白表达的影响。[方法] 健康SPF级雄性SD大鼠,采用5/6肾切除方式建立慢性肾功能衰竭模型。造模成功后,随机分为模型组、尿毒清组和二黄益肾汤组,各给药组分别给予相应药物进行灌胃治疗,时间为12周。实验结束后,检测BUN、Scr含量,苏木精-伊红（HE）染色分析病理改变。采用实时定量-聚合酶链反应（RT-PCR）和蛋白免疫印迹（Western Blot）方法检测TGF-β1、Smad3、Smad4和Smad7 mRNA及蛋白表达量。[结果] 5/6肾切除方法可以成功建立慢性肾功能衰竭动物模型。与模型组比较,二黄益肾汤组与尿毒清组能够降低Scr、BUN含量,差异具有统计学意义（P<0.01）。二黄益肾汤组和尿毒清组肾间质内有少量炎性细胞浸润及纤维组织增生,纤维化面积缩小,能够改善肾功能衰竭肾纤维化病变程度。基因和蛋白表达量分析结果显示,与模型组比较,二黄益肾汤组和尿毒清组TGF-β1、Smad3、Smad4表达呈降低趋势,差异有统计学意义（P<0.05）,Smad7的表达呈升高趋势,差异有统计学意义（P<0.05）。[结论] 二黄益肾汤能够改善慢性肾功能衰竭大鼠肾脏纤维化程度,抑制TGF-β1、Smad3、Smad4的基因和蛋白表达量,促进Smad7的表达量增多,可能通过调控TGF-β1/Smad信号通路而发挥相关治疗作用。     

益肾排毒方对腺嘌呤致慢性肾衰竭大鼠肾间质纤维化的影响

目的 探讨益肾排毒方抗肾纤维化的机制,为中药复方防治肾纤维化提供依据.方法 采用益肾排毒方和尿毒清颗粒,分别干预腺嘌呤导致的肾间质纤维化模型Wistar大鼠.分6组:正常组、模型组、对照组(尿毒清颗粒)、治疗组(益肾排毒方低、中、高剂量).检测大鼠TGF-β1、ColⅣ、SOD.结果 益肾排毒方可以降低TGF-β1、ColⅣ水平,增高SOD水平,与模型组比较,差异均有统计学意义(P<0.05).结论 益肾排毒方具有抗腺嘌呤致慢性肾衰竭大鼠肾纤维化的作用.     

肾衰胶囊延缓大鼠慢性肾功能衰竭的实验研究

目的：探讨肾衰胶囊对慢性肾功能衰竭(CRF)大鼠肾组织及肾脏转化生长因子(TGF-β1)表达的影响。方法：用Wistar大鼠灌服腺嘌呤造模，分高、低剂量组及尿毒清组治疗，检测肾功能指标，观察肾脏病理及超微结构，免疫组化检测肾内TGF-β1的表达水平。结果：高剂量组肾功能指标改善与尿毒清组比较，差异均有显著性，同时能抑制CRF大鼠肾小球系膜细胞及基质增生，改善病理状态，减轻肾小管-间质损害，抑制肾内TGF-β1的表达水平。结论：肾衰胶囊能明显改善CRF大鼠病理状态，明显抑制TGF-β1表达，提示这可能是其延缓慢性肾功能衰竭进展的主要作用机理。     

肾衰胶囊对慢性肾功能衰竭大鼠肾组织的影响

目的　探讨肾衰胶囊对慢性肾功能衰竭 (CRF)大鼠肾组织的影响。方法　用Wistar大鼠灌服腺嘌呤造模 ,分高、低剂量组及尿毒清组治疗 ,检测肾功能指标 ,观察肾脏病理及超微结构。结果　高剂量组肾功能多项指标的改善与尿毒清组比较 ,差异均有统计学意义或高度统计学意义 (P <0 0 5或 <0 0 1) ,显微镜检及电镜检查发现 ,同时能抑制CRF大鼠肾小球系膜细胞及基质增生 ,改善病理状态 ,减轻肾小管 -间质损害。结论　肾衰胶囊能改善CRF大鼠肾功能衰竭的病理状态。     

尿毒清胶囊及其拆方对5/6肾切除大鼠肾组织TGF-β_1 mVRNA表达的影响

【目的】观察尿毒清胶囊及其拆方对慢性肾功能哀竭（CRF）模型大鼠肾组织转化生长因子β1（TGF-β1）mRNA表达的影响。【方法】采用5/6肾切除法复制CRF大鼠模型,造模成功的SD大鼠随机分为模型组、黄芪组（剂量1.5 g&#183; kg^-1&#183; d^-1）、丹参组（剂量为1 g&#183; kg^-1&#183; d^-1）、大黄组（剂量为1 g&#183; kg^-1&#183; d^-1）、黄芪丹参大黄组（剂量为1 g&#183; kg^-1&#183; d^-1）、尿毒清组（剂量为1 g&#183; kg^-1&#183; d^-1）;各给药组灌胃给药6周后,检测各组大鼠血清尿素氮（BUN）、肌酐（SCr）水平,并采用逆转录聚合酶链反应检测各组大鼠肾组织TGF-β1mRNA的表达水平。【结果】各给药组均可降低血清BUN、SCr水平,与模型组比较均有显著性差异（P〈0.05或P〈0.01）,其中尿毒清组降低SCr水平作用优于大黄组（P〈0.05）;TGF-β1mRNA在各组肾组织中均有不同程度的表达,其中模型组表达最强烈,尿毒清组和黄芪丹参大黄组表达最轻。【结论】尿毒清治疗CRF的作用与其能下调TGF-β1mRNA在肾组织中表达有关,且中药复方作用优于单味中药。     

补肾生血颗粒对实验性慢性肾衰大鼠血EPO及TNF的影响

目的探讨补肾生血颗粒对慢性肾功能衰竭大鼠改善肾性贫血作用及血EPO、TNF的影响.方法采用腺嘌呤建立大鼠贫血模型,随机分为模型对照组、中药治疗组(补肾生血颗粒)、西药治疗组(促红素EPO)、中西药联合治疗组(补肾生血颗粒、EPO联用).测血RBC、Hb、HCT、肾功、EPO及肿瘤坏死因子(TNF)的指标.结果与中药组及中西药联合应用组相比,补肾生血颗粒治疗肾性贫血的效果与EPO无明显差异(P＞0.05),稍逊于中西药联合应用组(P＜0.05),并能明显降低血BU、CR的含量(P＜0.01),减轻肾组织病理损害,还可降低血TNF,提高血EPO的水平.结论补肾生血颗粒能有效治疗肾性贫血并能明显改善肾功能,提高血EPO含量,还有降低血TNF的作用.     

开结汤对腺嘌呤所致慢性肾功能衰竭模型大鼠影响

目的:研究开结汤对腺嘌呤所致慢性肾功能衰竭模型大鼠的影响。方法:选取大鼠60只,按体重随机分为6组:正常组,模型组,开结汤低剂量治疗组、中剂量治疗组、高剂量治疗组,尿毒清治疗组,除正常组外,其余5组用250 mg/(kg·d)腺嘌呤连续灌胃21 d复制慢性肾功能衰竭模型,造模成功后分别给药开结汤和尿毒清治疗30 d,治疗结束后,大鼠心脏取血检测常规生化指标;肾组织做病理切片,观察肾小球、肾小管的病理变化。结果:开结汤3个剂量组、尿毒清治疗组与模型组比较大鼠血清中Scr、BUN、P的含量均有明显降低(P0.05),Ca的含量未见明显改变;病理组织观察结果显示,开结汤低、中剂量组中大鼠肾间质纤维化及炎性细胞浸润明显减少。结论:开结汤通过降低炎性细胞浸润,改善肾功能,从而延缓慢性肾功能衰竭进程。     

促红细胞生成素联合左卡尼汀治疗血透患者贫血的疗效观察

目的观察联合应用促红细胞生成素﹙EPO﹚与左卡尼汀和单纯应用EPO治疗慢性肾功能衰竭行维持性血液透析患者贫血的疗效。方法将43例行维持性血液透析治疗的慢性肾功能衰竭并发贫血患者分为治疗组22例和对照组21例,在血透结束前将治疗药物直接注射到透析器的静脉端,治疗组予EPO和左卡尼汀、对照组单纯予EPO,根据患者贫血改善情况调整药物用量;疗程3个月。结果用药后,两组患者血生化指标均较治疗前有所改善,其中治疗组Hb、Hct、Alb水平均较治疗前明显升高,TC和TG水平明显下降,差异均有统计学意义（P〈0.01）,而且与对照组比较差异亦均有统计学意义（P〈0.05）;但对照组治疗前后血生化指标差异无统计学意义（P〉0.05）。治疗后,两组患者的心率、平均动脉压均较治疗前下降;乏力、食欲不振、心前区不适等临床表现均较治疗前明显好转。治疗组EPO用量较对照组明显减少,差异有统计学意义（P〈0.01）。结论联合应用EPO与左卡尼汀可明显提高慢性肾功能衰竭并发行贫血患者的维持性血液透析治疗效果。     

药物治疗肾功能衰竭合并肾性贫血透析患者的临床护理

目的总结药物治疗肾功能衰竭合并肾性贫血透析患者的临床护理体会。方法选择慢性肾功能衰竭并肾性贫血的血液透析患者60例,对其进行促红细胞生成素（EPO）及静脉补铁等治疗,同时给予严密的病情观察及用药、饮食等精心护理。结果本组患者血常规指标均转为正常,贫血等症状明显改善,未发生透析治疗相关并发症。结论药物治疗肾功能衰竭透析治疗中的肾性贫血,同时给予相关护理干预,能明显改善患者贫血状况,提高患者生活质量。     

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…