预处理早发和延迟时相重叠保护心脏的实验研究

目的探讨以单磷酯A预处理的延迟时相与以腺苷预处理的早发时相重叠对心脏保护效果的影响.方法大白兔以单磷酯A预处理24 h后制成离体心脏,再以腺苷预处理(MA)组,4℃改良St.Thomas液诱导心脏停搏低温保存4 h,复灌1 h.观察心功能恢复率、心肌ATP和MDA含量、Ck-mb释放量等.另设单磷酯A预处理延迟时相(M组)、腺苷预处理早发时相(A组)、单纯改良St.Thomas液保护(C)组.结果MA、A、M、C组的心功能恢复率( 10-3μmol/wet·g max,%)分别为(70.97±17.92),(64.36±16.10),(65.54±22.62)和(39.07±13.78),MA组高于A、M、C组,并与C组的差异有显著性(P＜0.01).MA组心肌ATP含量(10-3Llmol/wet g)为(5.46±1.37),高于M组(3.97±1.04)、C组(2.07±0.74)和A组(4.45±1.29),差异有显著性(P＜0.05或P＜0.01).结论以腺苷预处理的早发时相与单磷酯A预处理的延迟时相重叠可以部分增强心脏保护作用.     

腺苷A1受体激动剂预处理延迟效应保护大鼠心脏的实验研究

目的探讨腺苷A1受体激动剂预处理延迟效应对大鼠心脏的保护效果.方法A组以高选择性A1受体激动剂CCPA预处理Wistar大鼠24 h后制成离体心脏,4℃改良St.Thomas液,诱导心脏停搏,并放入该液中低温保存4 h,再灌注1 h.观察心功能恢复率、心肌ATP、Ck-Mb释放量.另设单纯改良St.Thomas液保存对照组(C).结果A组左室内压上升与下降最大速率恢复率(±dp/dtmax,%)为(62.83±17.27),(66.81±18.99),心肌ATP含量10-3μmol/wet·g(3.67±1.42);而B组分别为(40.41±18.29),(44.70±25.14),(1.46±0.54).A组都明显高于B组,差别均有显著性(P＜0.01或P＜0.05).结论以腺苷A1受体激动剂预处理延迟效应能改善离体大鼠心脏的保存效果.     

腺苷A1受体激动剂延迟预处理保存大鼠心脏的实验研究

目的本研究探讨腺苷A1受体激动延迟预处理对大鼠心脏的保护效果.方法P组以高选择性A1受体激动剂CCPA预处理Wistar大鼠24h后制成离体心脏,4℃改良St.Thomas液,诱导心脏停搏,并放入该液中低温保存4h,再灌注1h.观察心功能恢复率、心肌ATP、Ck-mb释放量.另设单纯改良St.Thomas液保存对照(C).结果P组左室内压上升与下降最大变化速率恢复率(±dp/dtmax,%)为62.83±17.27,66.81±18.99,心肌ATP含量(10-3μmol/wet.g)3.67±1.42;而C组分别为40.41±18.29,44.70±25.14,1.46±0.54.P组都明显高于C组,差别均有显著性(P＜0.01或P＜0.05).结论高选腺苷A1受体激动剂延迟预处理能改善离体大鼠心脏的保存效果.     

腺苷受体激动剂预处理对保存大鼠心脏的影响及其与NF-κB的关系

目的　探讨腺苷A1受体激动剂预处理延迟效应对低温St Thomas液保存大鼠心脏的影响及其与心肌核转录因子 κB(nuclearfactorkb ,NF κB)的关系。方法　Wistar大鼠随机分6组:A、C、D组以高选择性A1受体激动剂CCPA(2 chloro N6 cyclopen tyladenosine)预处理,其中D组在预处理前15min注射NF κB抑制剂(pyrrolidindiethyldithiocarbamate ,PDTC) ;B、E组仅注射生理盐水;F组注射PDTC后再注射生理盐水。2 4h后A、B组4℃St.Thomas液保存4h ,复灌1h ,而另4组低温缺血3h ,复灌1h。观测心功能、磷酸肌酸激酶同工酶(CK MB)、三磷酸腺苷(ATP)等。结果　A组左室内压上升与下降最大速率恢复率(±dp dtmax)为(62 83±17 2 7) %、(66 81±18 99) % ,心肌ATP含量(3 67±1 42 )×10 - 3μmol g ;而B组±dp dtmax分别为(4 0 41±18 2 9) %、(4 4 70±2 5 14 ) % ,ATP含量(1 46±0 5 4)×10 - 3μmol g ;A组明显高于B组,差异有显著性(P <0 0 1,P <0 0 5 )。C组±dp dtmax恢复率、ATP都明显高于D、E、F组(P <0 0 1,P <0 0 5 ) ,而D、E、F组间无明显差异。结论　以腺苷A1受体激动剂能诱导预处理的延迟效应,改善低温St .Thomas液保存离体大鼠心脏的保存效果,而该效应的信号传递与心肌核转录因子 κB的活化有关。     

核转录因子-kB在腺苷A1受体激动剂预处理中的作用

目的了解核转录因子-kB(NF-kB)与腺苷A1受体激动剂(CCPA)预处理延迟阶段中的作用.方法健康雄性Wistar大鼠随机分组.A组以CCPA预处理;K组在CCPA处理前15min注射NF-kB抑制剂;C组对照组仅用CCPA溶剂注射.24h后制成离体心脏,作离体灌注心,12～15℃缺血180min,间断灌注4℃改良st.Thomas心麻液,再灌注60min.观察心功能,心肌Mn-SOD、MDA和ATP等指标.结果A组左心压力上升最大速度的恢复率、心肌Mn-SOD、ATP都明显高于K、C组;MDA为15.78±2.39(nmol/mg蛋白质)低于K、C组,差别均有显著性(P＜0.05或P＜0.01).结论NF-kB在腺苷A1受体激动剂(CCPA)预处理延迟阶段中起着信号传递的关键作用.     

腺苷A1受体介导的预处理延迟效应对低温心麻液保护作用的影响

目的 利用大鼠离体心脏缺血-再灌模型,了解腺苷A1受体介导的大鼠心脏预处理延迟效应对低温心麻液保护作用的影响以及与肿瘤坏死因子表达的关系。方法 雄性Wistar大鼠随机分为正常对照组(Z)、缺血对照组(C)、CCPA预处理组(A)。离体心脏低温缺血180min、复灌60min。观察左室压力变化最大速率恢复率、心肌同功酶漏出量,并以免疫组织化学、原位杂交或逆转录、PCR技术观察TNF-α mRNA和蛋白质的表达水平。结果 A组左室压力变化最大速率恢复率明显高于C组(P＜0．05),心肌同功酶漏出量明显低于C组(P＜0．05)。A组TNF-α表达水平虽然高于Z组,但明显低于C组,差异有显著性(P＜0．01)。结论 腺苷A1受体介导的预处理延迟效应能增强低温心麻液的保护效果,进一步减轻心肌缺血．再灌注损伤;同时下调心脏TNF-α的表达可能是其机制之一。     

腺苷A1受体激动剂延迟预处理保存大鼠心脏的实验研究

目的 :探讨腺苷A1受体激动剂延迟预处理对大鼠心脏的保护效果。方法 :实验组 (P组 )以高选择性A1受体激动剂CCPA预处理Wistar大鼠 2 4h后处死 ,分离心脏并置于 4℃改良St.Thomas液中诱导心脏停搏 ,然后放入该液中低温保存 4h ,再灌注 1h。观察心功能恢复率、心肌ATP、Ck mb释放量。另设单纯改良St.Thomas液保存对照组 (C组 )。结果 :P组左室内压上升与下降最大速率恢复率 (±dp/dtmax,% )为 62 .83± 17.2 7,66.81± 18.99,心肌ATP含量 (10 -3 μmol/g) 3 .67± 1.42 ;而C组分别为 40 .41± 18.2 9,44 .70±2 5 .14 ,1.46± 0 .5 4。P组都明显高于C组 ,差异均有显著性 (P <0 .0 1或P <0 .0 5 )。结论 :以腺苷A1受体激动剂延迟预处理能改善离体大鼠心脏的保存效果     

腺苷A1受体激动剂预处理对心脏肿瘤坏死因子-α表达的影响

目的了解腺苷A1受体激动剂预处理能否诱发大鼠心脏延迟保护效应,并对其缺血-再灌注过程中肿瘤坏死因子-α(TNF-α)表达的影响. 方法 雄性Wistar大鼠随机分为正常对照组(Z)、缺血对照组(C)和腺苷A1受体激动剂预处理组(A).体外心脏低温缺血180 min,复灌60 min,观察左心室压力变化最大速率(±dp/dtmax)恢复率、心肌同工酶漏出量,并以免疫组化、原位杂交或逆转录-PCR技术观察TNF-α mRNA和蛋白质的表达水平. 结果 A组±dp/dtmax恢复率明显高于C组(P<0.05),心肌同工酶漏出量明显低于C组(P<0.05).A组TNF-α表达水平虽高于Z组,但明显低于C组,差异有显著性意义(P<0.01). 结论 腺苷A1受体激动剂预处理可诱导大鼠心肌延迟保护效应, 同时下调心脏TNF-α的表达.     

腺苷A1受体诱导心脏预处理延迟保护及其机制的探讨

目的了解腺苷A1受体诱导心脏预处理延迟保护效应对心肌再灌注损伤的影响及其与核转录因子-κB(NF-κB)的关系. 方法将Wistar大鼠随机分组,A组以腺苷A1受体激动剂二氯环戊腺苷(CCPA)预处理; K组在CCPA处理前15 min注射NF-κB抑制剂四氢吡咯二硫代氨基甲酸酯(DDTC);C组对照组,仅注射等渗盐水;D组仅注射DDTC.24 h后制成体外灌注心脏,低缺血180 min,间断灌注4℃心脏停搏液,再灌注60 min.观察心功能、心肌ATP等指标. 结果A组心功能恢复率、心肌ATP含量都明显高于Κ、C、D组,差异均有显著性意义(P<0.05或P<0.01). 结论腺苷A1受体诱导预处理延迟效应可减轻心肌再灌注损伤,而NF-κB可能起信号传递的作用.     

阿片δ受体诱导大鼠心脏预处理延迟保护效应及其机制的探讨

目的探讨以阿片δ受体激动剂能否诱导心脏缺血预处理的延迟保护效应及其保护机制.方法 健康成年雄性大鼠随机分4组,A和B组以阿片δ受体激动剂DADLE处理(2 mg/kg),C和D组注射生理盐水,24 h后4组都制成离体心脏,低温缺血3 h,复灌1 h.观测心功能、ATP等.其B和D组在缺血前以优降糖阻止心肌ATP敏感性钾通道的开放.结果 A左室压力变化最大速率恢复率和心肌ATP含量都高于B,C和D组,差异有显著性(P＜0.01 or P＜0.05),而B,C和D组间无明显差异.A组心肌丙二醛含量与CK-MB漏出活性明显低于B,C和D组(P＜0.01 or P＜0.05).结论阿片δ受体可以诱导健康成年大鼠产声预处理延迟保护效应,而ATP敏感性钾通道参与介导其效应机制.     

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…