缺氧诱导因子-1 α、VEGF在脑出血灶周的表达研究

目的探讨缺氧诱导因子-1α(hypoxia inducible factor--1α,HIF-1α)、(vascular endothelialgrouth foutor,VEGF)在脑出血灶周中的表达,并探讨其表达的意义.方法应用免疫组织化学技术检测37例脑出血灶周脑组织中HIF-1α、VEGF的表达.结果37例脑出血灶周脑组织中HIF-1α阳性率为40.6%,HIF-1α在出血量＞60mL时高表达,其阳性率为88.9%,与其他出血量(30～45mL,45～600mL)阳性率的表达比较有显著意义(P＜0.05).HIF-1α表达与手术时间明显相关,随着手术时间的推迟而增加,差别有显著性意义(P＜0.05).HIF-1与VEGF的表达呈正相关(n=15,r=0.79)(P＜0.01).结论脑出血后HIF-1α的表达与出血量及手术时间相关,为判断脑出血灶周缺血半暗带的存在提供了依据;HIF-1 α与脑出血后微循环的重建有关.     

大鼠脑出血灶周HIF-1α和COX-2的动态变化

目的观察大鼠脑出血后血肿灶周脑组织中HIF-1α、COX-2蛋白的动态表达,探讨二者与脑水肿的关系,以及HIF-1α和COX-2蛋白的表达在血肿灶周脑组织损伤中的作用机制。方法 SD大鼠35只,随机分为假手术组、脑出血6h、1、3、7、14、21天组,每组5只。采用自体血体内注射法建立脑出血动物模型,用免疫组化法检测脑出血后血肿灶周脑组织中HIF-1α和COX-2蛋白的动态表达,并用干/湿比重法测定脑含水量。结果脑出血后6h HIF-1α、COX-2蛋白的表达和脑水含量明显升高,3～7天达到高峰,第14天明显降低,COX-2及脑水含量在21天基本降至正常。HIF-1α在21天仍有较高水平的表达。造模后6h,脑出血组与假手术组相比,HIF-1α及COX-2蛋白的表达和脑水含量明显增高,其差异有统计学意义(P<0.05)。脑出血组的各时间点间比较,其差异均有统计学意义(P<0.05)。HIF-1α蛋白的表达与脑水含量呈正相关(r=0.636,P<0.01);COX-2蛋白的表达与脑水含量呈正相关(r=0.927,P<0.01)。结论大鼠脑出血后血肿灶周HIF-1α、COX-2蛋白的表达呈一定的变化规律。随着脑出血时间的延长HIF-1α蛋白、COX-2蛋白的表达程度和脑组织水肿程度呈正相关。     

脑出血灶周缺氧诱导因子-1α和血清促红细胞生成素表达的相关研究

目的探讨脑出血灶周缺氧诱导因子-1α(HIF-1α)和血清促红细胞生成素(EPO)的表达及意义。方法采用免疫组化法、放射免疫法分别检测观察组患者31例脑出血灶周脑组织中HIF-1α及血清EPO的表达,并与正常对照组17例比较。结果观察组患者脑出血灶周HIF-1α表达率(41.94%)与对照组(0%)比较差异有统计学意义(P<0.01);HIF-1α随出血量增加表达随之升高,大、中量组与对照组及大量组与小量组比较差异有统计学意义(P<0.05或P<0.01)。EPO随出血量增加表达随之降低,但均高于对照组,且差异有统计学意义(P<0.05或P<0.01);大、中量组与小量组比较差异有统计学意义(P<0.01)。HIF-1α随手术时间推迟表达升高,而EPO表达和病程无相关性。HIF-1α和EPO呈负相关(r=-0.432,P<0.05)。结论脑出血后HIF-1α、EPO的表达有明显改变,在灶周低氧所致血管新生过程中可能起重要作用,可作为判断缺血半暗带存在的重要指标。     

大鼠脑出血后HIF-1α表达与血脑屏障通透性相关分析

目的 探讨血肿周边脑组织中HIF-1α蛋白的表达变化与血脑屏障(BBB)通透性之间的关系.方法 SD大鼠56只随机分假手术对照组(sham组)和脑出血组(ICH组).ICH组又分为6h组、24h组、3d组、7d组和14d组,每组8只.采用自体血脑内注射法建立脑出血动物模型,测定血肿周边脑组织中伊文思蓝(EB)外渗量,以EB外渗量反映BBB通透性的变化,以免疫组化方法检测脑出血后不同时间血肿周边脑组织中HIF-1α蛋白表达情况,并应用干湿比重法测定脑组织含水量.结果 脑出血后3d内,BBB通透性和脑组织含水量均呈进行性增加,并于出血后第3d达到高峰,此后逐渐下降,对照组与出血组脑组织含水量及BBB通透性比较差异均有统计学意义(P<0.05);脑出血组HIF-1 α蛋白阳性表达率60.42%(29/48),对照组HIF-1 α蛋白阳性表达牢为0％,二者相比差异有统计学意义(P<0.05);脑出血后,HIF-1 α蛋白表达于出血后3d达到高峰并维持到第7d,脑出血后不同时间阳性率比较差异有统计学意义(P<0.05).HIF-1α的表达变化与BBB通透性和脑组织含水量均呈正相关(P<0.05).结论 HIF-1 α在血肿周边脑组织中的表达与BBB通透性改变及脑水肿的形成和发展密切相关.     

胰岛素样生长因子-1对大鼠血肿周围缺氧诱导因子及脑水肿动态观察的影响

目的研究重组人胰岛素样生长因子(rhIGF-1)对大鼠血肿周围缺氧诱导因子(hypoxia inducible factor-1α,HIF-1α)在21d内变化的影响。方法采用自体鼠尾血脑内注射法建立动物模型,动物的实验脑出血模型,应用免疫组化方法检测脑出血后的HIF-1α蛋白表达情况,并应用干湿比重法测定脑组织含水量。结果出血后,HIF-1α蛋白阳性表达率随时间逐渐增加,72h达高点,此后逐渐下降,脑出血后各时间点阳性率比较差异有统计学意义(P<0.05),脑出血IGF-1干预组较脑出血组及假手术组各时间点脑组织含水量低,HIF-1α蛋白阳性率较低。结论胰岛素样生长因子能显著降低HIF-1α表达,对脑出血后脑组织有良好的保护作用。     

脑出血大鼠细胞凋亡与缺氧诱导因子HIF-1α的相关性及促红细胞生成素对其影响

目的：研究脑出血大鼠细胞凋亡与缺氧诱导因子HIF-1α的相关性以及重组人促红细胞生成素（rhEPO）对脑出血后脑水肿及缺氧诱导因子的影响.方法：采用自体血脑内注射法建立脑出血动物模型,应用免疫组化方法检测脑出血后不同时间血肿周边脑组织中HIF-1α蛋白表达情况,并应用干湿比重法测定脑组织含水量,应用TUNEL法测凋亡细胞.结果：出血后,HIF-1α蛋白阳性表达率随时间进行性增加,并于出血后72h达到高峰且维持到第7日,此后HIF-1α蛋白表达阳性率逐渐下降,脑出血后不同时间阳性率比较具有显著性差异（P〈0.01）;脑出血后3d内,脑组织含水量进行性增加,此后逐渐下降,脑出血EPO干预组较脑出血组及对照组各时间点脑组织含水量降低,HIF-1α蛋白阳性率减少.结论：缺血半暗带区脑组织中HIF-1α与细胞凋亡和脑水肿表达具有相关性.rhEPO能显著降低脑出血后脑组织含水量,减少HIF-1α表达,对脑出血后脑组织有良好的保护作用.     

大鼠脑出血后HIF-1α表达与血脑屏障通透性相关分析

目的探讨血肿周边脑组织中HIF-1α蛋白的表达变化与血脑屏障（BBB）通透性之间的关系。方法SD大鼠56只随机分假手术对照组（sham组）和脑出血组（ICH组）。ICH组又分为6h组、24h组、3d组、7d组和14d组,每组8只。采用自体血脑内注射法建立脑出血动物模型,测定血肿周边脑组织中伊文思蓝（EB）外渗量,以EB外渗量反映BBB通透性的变化,以免疫组化方法检测脑出血后不同时间血肿周边脑组织中HIF-1α蛋白表达情况,并应用干湿比重法测定脑组织含水量。结果脑出血后3d内,BBB通透性和脑组织含水量均呈进行性增加,并于出血后第3d达到高峰,此后逐渐下降,对照组与出血组脑组织含水量及BBB通透性比较差异均有统计学意义（P〈0.05）;脑出血组HIF-1α蛋白阳性表达率60.42%（29/48）,对照组HIF-1α蛋白阳性表达率为0%,二者相比差异有统计学意义（P〈0.05）;脑出血后,HIF-1α蛋白表达于出血后3d达到高峰并维持到第7d,脑出血后不同时间阳性率比较差异有统计学意义（P〈0.05）。HIF-1α的表达变化与BBB通透性和脑组织含水量均呈正相关（P〈0.05）。结论HIF-1α在血肿周边脑组织中的表达与BBB通透性改变及脑水肿的形成和发展密切相关。     

肝细胞癌中缺氧诱导因子-1α、热休克蛋白70的表达及其与癌转移关系的实验研究

<0.05).患者癌转移者与无癌转移者HIF-1α、HSP70比较有显著性差异(P <0.01),HIF-2α表达与肝细胞癌恶性程度呈正相关(rr=0.726,, P <0.05).HSP70与HIF-2α表达呈正相关( r=0.726,P <0.05).结论 HIF-2α与HSP70表达有相关性,HIF-1α、HSP70与癌转移有关, HIF-α与HSP70联合检测有助于判断肝细胞癌患者的预后.     

HIF-1α蛋白在脑出血患者中的表达及其临床意义

目的观察脑出血患者HIF-1α蛋白的表达情况,探讨HIF-1α蛋白在脑出血患者中表达特点与脑出血时间的关系和意义。方法应用免疫组化方法检测65例脑出血患者出血灶周围脑组织HIF-1α蛋白的表达。结果65例脑出血灶周边脑组织标本中,HIF-1α蛋白阳性表达率为61．5％（40／65）,10例正常脑组织中HIF-1α蛋白阳性表达率为0（0／10）,两者比较有显著性差异（P〈0．01）。HIF-1α蛋白在脑出血后不同时间阳性表达率分别为：出血后〈6h20％（3／15）,出血后6～24h62．5％（20／32）,出血后〉24h9414％（17／18）,出血组之间比较（P〈0．05）。结论HIF-1α在脑出血患者神经组织中有表达。且HIF-1α表达的程度与出血时间呈正相关,说明HIF-1α蛋白有助于缺血脑组织神经细胞的保护。     

宫颈癌组织HIF-1α和IGF-2表达及意义

目的 探讨缺氧诱导因子-1α(HIF-1α)及胰岛紊样生长因子-2(IGF-2)在宫颈癌(ICC)发生、发展中表达及意义.方法 应用免疫组织化学S-P方法,检测20例正常宫颈(NCE)、28例宫颈上皮内瘤变(CIN)、70 例ICC组织 HIF-1α和IGF-2蛋白表达.结果 NCE、CIN、ICC组织 HIF-1α蛋白的表达阳性率分别为0、32.14%、72.86%,IGF-2 蛋白表达的阳性率分别为10.oo%、28.57%、68.57%,各组间比较差异均有显著性(Hc=39.487,q=5.782～35.582,P<0.01;χ2=25.570,P<0.01).ICC组织中 HIF-1α和IGF-2表达呈正相关(r=0.629,P<0.01).结论 HIF-1α及IGF-2的表达与宫颈癌的发生发展密切相关,二者在ICC发展中可能起协同作用.     

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…