大鼠全脑缺血再灌注后脑组织一氧化氮合酶的变化

目的 观察全脑缺血再灌注后神经元型一氧化氮合酶(neuronal nitric oxide synthese，nNOS)与诱导型一氧化氮合酶(inducible nitric oxide synthase，iNOS)的变化，从而探讨一氧化氮在脑缺血再灌注损伤中的作用。方法 实验分为正常组、假手术组、缺血组，采用大鼠4血管夹闭方法制作全脑缺血再灌注模型，观察nNOS、iNOS在缺血20min再灌注2h、6h、1d、3d、5d、7d时的变化及大脑皮层、海马、丘脑的组织病理学改变。结果 nNOS在缺血再灌注后2h开始升高，1d达高峰，3d开始下降，iNOS在再灌注2h开始表达，3d达高峰，5d开始下降，并持续至7d。结论 脑缺血再灌流时nNOS和iNOS表达增强，尤其是iNOS在灌注后期表达，提示N0生成增多可能与缺血后迟发性神经元死亡有关。     

局灶性脑缺血再灌注时诱导型一氧化氮合酶在大鼠脑组织的分布特点

目的观察大鼠脑缺血再灌注时诱导型一氧化氮合酶（inducible nitric oxide synthase,iNOS）在脑组织的分布特点,及其在缺血性脑损伤中的作用。方法阻断大鼠大脑中动脉（middle cerebral artery,MCA）血流2h。再灌注3-120h制成脑缺血再灌注模型。苏木精-伊红染色评价缺血性脑损伤的组织学特点,免疫组织化学（immunohistochemistry,IHC）染色观察iNOS在脑组织的分布特点。结果再灌注12h组开始出现神经元不可逆变性,24h梗死形成。正常组和假手术组、再灌注3h组无iNOS阳性的细胞。再灌注12～120h过程中,脑组织iNOS阳性细胞在再灌注12h开始表达,24h达到高峰,后逐渐下降。再灌注12～120h各组与正常组、假手术组、3h组比较P〈0．01。再灌注各组与24h组比较P〈0．01。结论iNOS在脑缺血再灌注后12h开始表达,24h达高峰,后逐渐下降,其细胞定位以小胶质细胞为主。iNOS与脑缺血再灌注后期神经元损伤有明显关联。为临床早期使用iNOS抑制剂减少脑损害,提供了一定的参考价值。     

肾脏缺血再灌注损伤后一氧化氮合酶的变化

目的　研究大鼠肾脏缺血再灌注损伤 (IRI)过程中一氧化氮合酶 (NOS)的变化规律。方法　制作SD大鼠单侧肾脏IRI动物模型 ,用同位素法测定正常及IRI肾组织的NOS活性 ;用Western印迹和逆转录PCR法分析eNOS和iNOS在IRI过程中蛋白和基因表达的变化。结果　单纯热缺血 1h对肾脏NOS活性无明显影响 ,再灌注30min后NOS活性即开始升高 ,2～ 6h到达高峰 ,持续到 6h ,此后迅速下降 ,2 4h降低到正常以下 ,2 1d时恢复至正常水平。Western印迹显示IRI早期eNOS蛋白表达升高 ,12h后开始逐步降低 ,3d后明显低于正常对照组 ,以后逐步恢复正常。iNOS的变化与eNOS明显不同 ,正常肾脏iNOS表达微弱 ,IRI可诱导iNOS表达 ,12h开始表达 ,并逐渐升高 ,3d后达到高峰 ,以后逐步恢复正常。RT PCR分析发现eNOS及iNOSmRNA的变化与其蛋白变化相一致。结论　单纯缺血并不引起NOS活性的明显变化 ,再灌注损伤使NOS的mRNA表达增加 ,酶的合成增多 ,活性增高。正常肾脏iNOS的表达微弱 ,IRI可诱导iNOSmRNA表达 ,使iNOS合成增加     

大鼠局灶性脑缺血再灌注后P-erk表达及神经元凋亡的变化

目的 研究磷酸化细胞外信号调节激酶(phospho-excelluar signal-regulated kinase,P-erk)在局灶性脑缺血再灌注中的作用. 方法 建立局灶性脑缺血再灌注大鼠模型;HE染色观察脑组织形态病理学变化;免疫组化法检测大鼠脑缺血再灌注不同时间磷酸化ERK的表达;TUNEL染色检测神经元凋亡. 结果在脑缺血再灌注大鼠检测到磷酸化ERK在梗死中心灶和缺血半暗带都存在阳性表达,于再灌注6 h达到峰值,12 h后逐渐下降;而凋亡细胞于再灌注24 h开始有明显的阳性细胞增加,48 h细胞凋亡达到高峰(P<0.01). 结论 局灶性脑缺血再灌注后磷酸化ERK表达增加,提示缺血再灌注损伤可能导致ERK活性上调,参与缺血后神经细胞凋亡和非程序性死亡过程.     

一氧化氮合酶在大鼠急性肾缺血后的表达

目的：探讨一氧化氮合酶（NOS）在大鼠急性肾缺血后的表达及意义。方法：将18只雄性SD大鼠随机分成对照组、缺血后5min组、缺血后15min组。将实验组大鼠夹闭双侧肾动脉5min、15min，然后处死大鼠取肾，提取总RNA，采用逆转录－聚合酶链反应（RT－PCR）定量检测大鼠肾组织内nNOSRNA、eNOSmRNA、iNOSmRNA的表达水平。结果：nNOSmRNA在急性缺血后明显下降；eNOSmRNA在急性缺血后5min、15min无显著变化；iNOSmRNA在急性缺血后5min、15min表达上调。结论：急性缺血可导致大鼠肾nNOSmRNA表达下调，iNOSmRNA表达上调。     

大鼠局灶性脑缺血再灌注后Bcl-2和Bax的表达

目的：研究大鼠脑缺血再灌注后凋亡相关基因Bcl-2和Bax在缺血皮层表达的变化。方法：线栓法制作大鼠局灶性脑缺血再灌注模型，免疫组化法观察Bcl-2和Bax的表达变化。结果：再灌注2h后皮层神经元Bcl-2表达开始明显上调，为高峰，之后开始下降。缺血再灌注后早期Bax在皮层神经元的表达明显增强，随着再灌注时间的延长，其表达不断增加，24－48h达高峰。Bcl-2／Bax的比率在再灌注开始时升高，再灌注6h达高峰，随后开始下降。结论：Bcl-2和Bax的比率改变与缺血再灌注后的神经元存亡相关。     

大脑中动脉缺血再灌注后nNOS的表达

①目的 探讨神经元型一氧化氮合酶(nNOS)与脑缺血的关系。②方法 制备Wistar大鼠大脑中动脉缺血再灌注模型，用苏木精-伊红染色观察缺血后脑组织的形态学改变，用免疫组织化学法显示nNOS的变化。③结果 缺血再灌注后皮质及壳尾核nNOS免疫阳性神经元细胞表达增多，以再灌注3h最多，6h开始下降。组织学观察可见缺血区内有神经元的变性、肿胀及坏死。④结论 在局灶性脑缺血再灌注早期nNOS表达增多，并可能参与急性期神经毒性作用。     

局灶性脑缺血/再灌注时大鼠脑皮质GFAP及c-fos的表达变化

目的 研究大鼠局灶性脑缺血／再灌注时皮质区星形胶质细胞胶质纤维酸性蛋白（GFAP）与神经元c-fos的表达变化。方法70只大鼠，随机分成缺血组及假手术组，缺血组再根据再灌注时间的不同，分别分为再灌注2、4、6、12、24、48、72h7个亚组，应用免疫组织化学单标记法、蛋白印迹法观察缺血皮质区各时间点GFAP和c-fos表达，用免疫组织化学双重染色法显示2组再灌注4、24、48hGFAP和c-fos表达的相互关系。结果大鼠脑缺血2h再灌注2h神经元c-fos的表达增加，4h达高峰，随之下降，2组间各时间点均有差异（P〈0．05）；于再灌注4h星形胶质细胞被激活、GFAP表达增加，随时间延长而逐渐升高，于48h达高峰，随后下降，2组间6、12、24、48、72h5个时间点具有差异（P〈0．05）；且在同一部位，c-fos阳性神经元周围伴有激活的星形胶质细胞表达GFAP。结论脑缺血／再灌注时皮质区星形胶质细胞及神经元均被激活，并伴有GFAP、c-fos的不同的时程规律表达变化。     

成年大鼠局灶性脑梗死后神经元前体细胞的迁移研究

目的探讨成年大鼠大脑中动脉栓塞缺血再灌注后梗死灶周神经元前体细胞的迁移特征. 方法建立一侧大脑中动脉栓塞缺血再灌注模型,应用免疫组化及细胞记数检测缺血再灌注后1、7、14、21 d梗死灶周神经元前体细胞的变化. 结果各个时相点的梗死灶周均可见神经元前体细胞;在缺血再灌注后第7天阳性细胞的数量达到高峰,随后逐渐下降;但在梗死区域的镜像区域未见到阳性细胞的表达. 结论成年大鼠大脑中动脉栓塞缺血再灌注可激活神经元前体细胞的发生,并诱导神经元前体细胞朝着梗死区域迁移.     

褪黑素对缺血再灌注后大鼠肝脏NF-κB表达及iNOS的影响

目的探讨褪黑素对缺血再灌注后大鼠肝脏NF—κB表达及iNOS的影响。方法采用大鼠部分肝缺血再灌注模型，将健康雄性SD大鼠78只随机分为假手术组（S）、缺血再灌注组（I／R）、褪黑素处理组（Mel）3组．分别检测标本中NF—κB表达和iNOS含量。结果S组无NF-κB阳性表达；I／R组和Mel组经历单纯的肝脏缺血后，NF—κB的表达与S组无差异（P〉0．05），而再灌注后两组均有不同程度的NF—κB表达增加，并均于6h时点处达到各自峰值，Mel组于再灌注后各相应时点NF—κB的阳性表达率显著低于I／R组（P〈0．01）。再灌注后0～1h，3组iNOS活力无差异（P〉0．05），此后，I／R组iNOS活力随再灌注时间的延长而较S组显著上升（P〈0．01），其高峰亦在9h时点处出现，Mel组再灌注1h后各时点iNOS活力均较I／R组显著下降（P〈0．01）。结论褪黑素可以有效下调肝脏I／R过程中NF—κB的表达，抑制iNOS的活力，发挥其对肝脏缺血再灌注损伤的保护作用。     

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…