维拉帕米对家兔血管成形术后血浆纤维蛋白原和再狭窄的影响

目的：探讨血浆纤维蛋白原（Fb)在血管成形术后的变化，研究维拉帕米（Verapamil)对血管成形术后再狭窄的预防作用及可能机制，方法：将24只家兔随机分为假手术组，对照组（单纯血管成形）和维拉帕米干预组，对后两组家兔以球囊导管损伤腹主动脉内膜，喂养4周后，对腹主动脉狭窄部位行血管成形术，其中干预组于术前及术后给予维拉帕米肌注（剂量0．5mg.kg^-1.d^-1)，分别于术前，术后48小时，1周及4周抽取静脉血测定三组家兔血浆Fb 含量。血管成形术后4周处死动物，对成形术部位动脉标本作病理形态学检查和免疫组化检查，结果：血管成形术后血浆Fb含量明显增高，而干预组术后48小时和1周血浆F水平低于同期对照组，其差异有显著性（分别P＜0．01和P＜0．05）病理形态学检查显示：干预组管腔面积和内弹力板围绕面积均大于对照组，其差异均有高度显著性（P均＜0．01），而新生内膜面积和增殖细胞核抗原（PCNA）增殖指数干预组均小于对照组（P均＜0．05）。结论：血管成形术后血浆Fb明显增高，而维拉帕米可抑制血浆Fb水平的升高，可抑制新生内膜增殖，促进代偿性血管扩张，从而可减轻血管成形术后再狭窄的程度。     

西洛他唑对家兔血管成形术后内膜增殖和血管重构的影响

目的:探讨西洛他唑对家兔血管成形术后内膜增殖的抑制作用和血管重构的影响.方法:日本雄性大耳白兔60只,随机分成3组:对照组,高脂组,西洛他唑组.采用高胆固醇(1.5g/(kg·d)加腹主动脉内皮剥脱制作血管狭窄模型,之后行血管球囊扩张成形术.于术后4周处死动物,取血管成形术部位血管标本,进行光镜、电镜及免疫组化染色.结果:高脂组内膜增生最明显,内膜面积最大而管腔面积最小;西洛他唑组内膜面积较高脂组明显减小,管腔面积明显扩大,两组相比P＜0.05.电镜结果:高脂组见大量泡沫细胞,合成型平滑肌细胞多,而西洛他唑组泡沫细胞少见,收缩型平滑肌细胞多并可见凋亡细胞.PCNA免疫组化染色:高脂组PCNA阳性细胞面积百分比明显高于西洛他唑组,主要分布于内膜和内弹力板区域(P＜0.05).结论:新型抗血小板制剂西洛他唑能够抑制家兔血管成形术后的内膜增殖,促进有益的血管重构.     

内皮素抗血清抑制动脉损伤后内膜增生的实验研究

目的通过兔颈总动脉球囊损伤模型,观察内皮素(ET)抗血清对损伤动脉内膜增生的影响,以寻找预防动脉损伤后内膜增生的新途径.方法设立假手术组、对照组、ET抗血清组.ET抗血清 组术后按0.5ml/kg/d自耳缘静脉给予ET抗血清,假手术组及对照组给同等量的正常兔血清,观察术后2周各组血浆6-keto-PGF1α、TXB2水平、血管增殖指数及血管内膜厚度和管腔狭窄度.结果1.血浆6-keto-PGF1α水平ET抗血清组显著高于对照组(P＜0.01),2.血浆TXB2水平ET抗血清组显著低于对照组(P＜0.01).3.损伤侧血管增殖指数各组均显著高于假手术组(P＜0.01),ET抗血清组显著低于对照组(P＜0.01).4.对照组损伤侧血管内膜厚度、截面积、管腔狭窄度均显著高于假手术组(P＜0.01),而ET抗血清组上述指标均低于对照组(P＜0.01).结论ET抗血清抑制动脉内膜的增生.     

Captopril对家兔动脉损伤后内膜增生的影响

在家兔颈总动脉球囊损伤模型上,观察卡托普利（Captopril）对术后2周血浆内皮素（ET1）、血管内膜增殖细胞核抗原（PCNA）阳性表达率、血管内膜厚度的影响。结果表明：Captopril能显著降低球囊损伤后家兔血浆ET1水平及血管内膜PCNA阳性表达率（P＜0.01);与剥脱对照组相比,Captopril组血管内膜厚度及管腔狭窄明显降低（P＜0.01)。提示：Captopril能抑制血管损伤后内膜的增生,可能是通过降低ET1水平及抑制平滑肌细胞增殖实现的,为Captopril应用于动脉粥样硬化及经皮冠装动脉成形术后再狭窄的治疗提供一定的依据。     

吲哚-3-甲醇对大鼠动脉损伤后内膜增殖的影响

目的 观察吲哚-3-甲醇对大鼠损伤动脉内膜增生的影响并探讨可能机制.方法 采用球囊扩张方法,建立大鼠颈总动脉损伤模型.20只 Sprague-Dawley大鼠,随机分为单纯球囊扩张组(对照组)和球囊扩张 吲哚-3-甲醇治疗组(治疗组),其中治疗组又分为3个亚组,在球囊扩张术后灌胃给予吲哚-3-甲醇7 d,剂量分别为12.5、25、50 mg/d,2周后取损伤段血管用于病理组织学检查和免疫组化染色检查.结果 ①治疗组内膜厚度、内膜面积均显著小于对照组 (P＜0.05);管腔狭窄程度较对照组分别降低25.2%、29.9%、48.5%.②PCNA阳性细胞表达在治疗组明显低于对照组.③各治疗组细胞凋亡率与对照组比较均明显增高(P＜0.01).结论 口服适宜剂量吲哚-3-甲醇可抑制血管内膜增生及血管再狭窄,并可能与其抑制平滑肌细胞增殖并诱导其凋亡有关.     

纳豆激酶对兔血管成形术后再狭窄的影响

目的 研究纳豆激酶对血管成形术后再狭窄的防治作用及机制.方法 采用56只新西兰兔,随机分为7组:溶剂对照组、模型组、纳豆激酶(粗)灌胃组、纳豆激酶(精)灌胃组、纳豆激酶(精)注射组、硫酸氯吡格雷组、硫酸氯吡格雷与阿司匹林组.用球囊导管自股动脉插管建立家兔主动脉球囊损伤模型,检测各组血小板数目及聚集情况、腹主动脉组织病理学改变,并采用免疫组化法对MMP.2、9表达情况进行检测.结果 与模型组相比.3个纳豆激酶给药组血小板数目及聚集情况均无明显改变(P＞0.05);狭窄指数均显著提高,内膜增殖指数均降低(P＜0.01或0.05);MMP-2、9表达均无明显改变.结论 纳豆激酶可抑制血管成形术后再狭窄,但不是通过作用于血小板和影响MMP-2、9表达发挥作用的.     

PDGF-β mRNA反义寡核苷酸抑制兔血管内膜损伤后血管平滑肌细胞增生

目的 以PDGF-β的反义寡核苷酸作为药物抑制血管平滑肌细胞表达PDGF-βmRNA和增生,为反义药物预防经皮血管内膜成形术后再狭窄提供实验依据.方法 用球囊导管损伤兔髂动脉内膜建立再狭窄模型,于内膜损伤后1周观察血管平滑肌细胞表达PDGF-β mRNA和增殖细胞核抗原的情况.结果 计数200个内膜细胞中的PCNA阳性反应的细胞数,与对照组相比,反义药物显著抑制内膜平滑肌细胞表达PCNA,抑制率为93.44%(P＜0.001).显微镜高倍视野下(400X)计数血管内膜每平方毫米中的PDGF-βmRNA阳性细胞的平均数,与对照组相比,反义药物显著抑制内膜平滑肌细胞表达PDGF-β mKNA,抑制率为88.40%(P＜0.001).结论 根据不同种属PDGF-β的同源性设计的反义药物显著下调血管内膜表述PDGF-β mRNA并可抑制血管内膜增生,这为临床应用反义寡核苷酸防治经皮血管内膜成形术后再狭窄提供实验依据.     

2,5-MC抑制支架植入术后内膜增殖的实验研究

目的评估酪氨酸蛋白激酶抑制剂2,5-MC抑制支架植入术后内膜增殖的效果.方法将含2,5-MC的F-127凝胶包裹于新西兰兔支架植入段颈动脉腔外,对侧包裹空白F-127凝胶作对照.通过RT-PCR、免疫组化染色检测核内癌基因c-myc和细胞核抗原Ki67的表达;通过三色染色观察内膜增厚情况,检测2,5-MC抑制内膜增殖的效果.结果2,5-MC治疗组核内癌基因c-myc mRNA和Ki67抗原的表达均显著低于对照组(P＜0.05,P＜0.01).组织学检测显示治疗组内膜增生厚度明显低于对照组;植入术后3个月,治疗组内膜/中膜比为0.92±0.10,血管腔狭窄率(51.0±5.58)%;对照组内膜/中膜比为1.30±0.39,血管腔狭窄率(73.01±5.94)%,二组比较有显著差异(P＜0.05,P＜0.01).结论腔外包裹酪氨酸蛋白激酶抑制剂2,5-MC具有抑制支架植入术后内膜增殖的效果.     

水蛭素样肽对兔颈动脉成形术后再狭窄的干预作用

目的研究水蛭素样肽(HLP)对兔粥样硬化颈动脉成形术后再狭窄的干预作用.方法 14只雄性新西兰大白兔,经氮气干燥法损伤颈动脉内皮后给予3周高脂饮食.于血管成形术术前30 min,连续4 h经耳静脉分别给予HLP(1.6 mg·kg-1·h-1,n=7)和生理盐水(对照组,n=7),检测出血时间(BT)和活化部分凝血激酶时间(APTT).术后4周取手术血管进行组织学观察,免疫组化检测组织因子(TF)和转化生长因子β(TGF-β)的表达.结果两组BT和APTT无明显差异.与对照组比较,HLP治疗组的新生内膜面积、新生内膜面积/中层面积比值和管腔狭窄率分别降低了62%、59%和39%(P<0.05),同时其新生内膜的TF、TGF-β表达量显著降低(P<0.05,P<0.01).结论 HLP通过下调TF和TGF-β因子的表达,防止血管成形术后再狭窄的发生,且不增加出血倾向.     

颜氏益心方对球囊损伤后大鼠颈总动脉血管内膜的影响

目的 探讨颜氏益心方对实验性球囊损伤后大鼠颈总动脉血管内膜的影响.方法 利用SD大鼠颈总动脉球囊损伤法造成颈动脉狭窄,观察颜氏益心方对颈动脉狭窄血管内膜厚度及管腔面积的影响.结果 与假手术组比较,模型组管腔面积明显缩小(P＜0.05),内膜显著增生(P＜0.05);与模型组比较,益心方低、高剂量组管腔面积及内膜增生程度均明显改善(P＜0.05).结论 颜氏益心方可改善球囊损伤后大鼠颈动脉血管内膜的厚度及管腔面积,从而抑制其内膜增生,减少其再狭窄程度.     

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.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

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.