不同剂量脂多糖对大鼠急性肺损伤效应的观察

目的观察脂多糖(LPS)诱导的急性肺损伤(ALI)大鼠血浆IL-4含量变化,探讨其在ALI发生发展过程中的意义.方法 120只Wistar大鼠根据注射LPS剂量随机分为2、4、6和8 mg/kg组,并设立生理盐水对照组(NS组),伤后1、2、4和6 h观察大鼠的一般情况、动脉血氧分压(PaO2)、肺组织湿质量/干质量比值、肺组织病理改变,并检测血浆IL-4含量.结果①梯度剂量LPS可以引发程度不同的大鼠ALI;当LPS≥6 mg/kg时,发生急性呼吸窘迫综合征(ARDS).②LPS可以诱导大鼠血浆IL-4含量升高;当LPS≥6 mg/kg时,血浆IL-4含量峰值显著提高.结论①尾静脉注射LPS可以复制出大鼠ALI模型.②LPS≥6 mg/kg是大鼠发生ARDS的临界剂量.③LPS诱导大鼠血浆IL-4含量升高可能与ARDS发生有关.     

硫辛酸对急性肺损伤大鼠IL-10的影响

目的探讨硫辛酸(LA)对内毒素(脂多糖,LPS)诱导的急性肺损伤(ALI)大鼠白细胞介素(IL)-10含量的影响。方法72只大鼠随机分为4组,对照组、LPS组LPS+LA30mg干预组。LPS+LA100mg干预组。各实验组舌下静脉注射LPS诱导大鼠ALI模型,30min后2个干预组分别给予LA30mg/kg和100mg/kg舌下静脉注射,对照组给予等体积生理盐水。LPS注射1、3、6h后测定血清及肺组织中IL-10浓度。结果各实验组血清及肺组织中IL-10分别在不同时间点显著高于对照组(P<0.01)。2个干预组血清及肺组织中IL-10水平在3h、6h明显升高,均显著高于LPS组(P<0.01),且LPS+LA100mg组显著高于LPS+LA30mg组(P<0.05)。结论LPS可导致ALI的发生,LA可提高IL-10水平,改善肺损伤。     

安宫牛黄丸对脂多糖致急性肺损伤大鼠肺组织Nrf2蛋白表达的影响

目的 探讨安宫牛黄丸对脂多糖引起的急性肺损伤的保护机制.方法 将40只SD大鼠按随机数字表法分为对照组(Control组,n=10)、脂多糖组(LPS组,n=10)、脂多糖+安宫牛黄丸组(LPS+AG组,n=10)和安宫牛黄丸组(AG组,n=10).采用一次性腹腔注射脂多糖30 mg/kg建立大鼠急性肺损伤模型.分别检测各组大鼠肺湿重/干重比、支气管肺泡灌洗液蛋白浓度和白细胞计数、肺组织超氧化物歧化酶(SOD)活性、丙二醛(MDA)和肿瘤坏死因子α(TNF-α)含量、肺组织内转录因子NF-E2相关因子2(Nrf2)水平.结果 LPS+AG组肺组织SOD活性为(325.67±7.85)kU/g,明显高于LPS组的(298.75±6.25)kU/g,差异有统计学意义(P<0.05).MDA、INF-α含量分别为(1.89±0.35)μmol/L、(35.21±3.12)ng/g,均低于LPS组的(2.78±0.41)μmol/L、(41.52±4.87)ng/g,差异均有统计学意义(P<0.05).LPS+AG组肺组织Nrf2蛋白表达为(0.87±0.19),明显高于LPS组的(0.34±0.11),差异有统计学意义(P<0.05).结论 安宫牛黄丸对脂多糖诱发的急性肺损伤具有保护作用,可能与其能激活肺组织Nrf2表达有关.     

高温复合脂多糖应激大鼠血浆TNF-α、IL-6含量的变化规律

目的探讨高温与脂多糖(lipopolysaccharide,LPS)复合应激大鼠血浆TNF-α、IL-6含量等指标的变化规律.方法雄性SPF级Wistar大鼠随机分为:常温生理盐水组(C组)、高温生理盐水组(H组)、常温脂多糖组(L组)、高温脂多糖组(HL组).持续监测动物肛温(rectal temperature,Tr)、心率(heat rate,HR)、平均动脉压(mean arterial pressure,MAP)以及呼吸频率(respiratory rate,RR),并检测动物应激0、40、80、120 min时血浆TNF-α、IL-6含量.结果①复合应激120 min,HL组Tr上升到(43.04±0.11)℃,HR加快到(660±42)次/min,RR加快到(150±11)次/min,MAP下降到(49.0±3.5)mmHg;HR、MAP与同时相各组之间存在显著性差异;②HL组于应激40min时血浆TNF-α、IL-6水平即显著升高,TNF-α峰值(80 min)显著高于各组TNF-α水平,IL-6表达水平极度升高,显著高于同时相各组.结论高温与LPS复合应激可能促发、扩大全身炎症反应综合征.     

大鼠急性肺损伤时肺组织激活蛋白-1活性变化的研究

目的探讨脂多糖(LPS)致伤大鼠后肺组织激活蛋白-1(AP-1)活性与肺组织损害及功能障碍程度的关系.方法经Wistar大鼠尾静脉注射不同剂量(2、4、6及8 mg/kg)LPS复制急性肺损伤(ALI)模型,以注射生理盐水为对照,观察致伤后不同时相点(1、2、4及6 h)大鼠的呼吸频率及死亡情况;检测动脉血氧分压(PaO2)和肺湿重/干重(W/D)值,并行组织学检查;采用凝胶迁移率分析法(EMSA)检测肺组织AP-1活性.结果LPS 2 mg/kg即可致大鼠呼吸频率增快,LPS≥6 mg/kg时出现呼吸困难或呼吸窘迫,死亡率为60%(36/60);各剂量组PaO2均较对照组低,以LPS≤6 mg/kg组降低显著(P＜0.01);肺组织W/D值从LPS 2 mg/kg、2 h时显著升高,LPS≥4 mg/kg各-时相均显著升高(P＜0.05);肺大体观察LPS剂量越大,肺水肿及炎症反应越严重;LPS致伤后肺组织AP-1活性均升高,剂量越大,AP-1活性越高,不同剂量组均在2 h点达到高峰,且以LPS≥6 mg/kg组升高显著(P＜0.01).结论①LPS≥6 mg/kg是介导大鼠发生ALI和ARDS的临界剂量;②肺组织AP-1活性升高水平与肺组织损伤和功能障碍程度密切相关.     

水通道蛋白-1在急性肺损伤中的表达及意义

[目的]探讨水通道蛋白1(AQP-1)在脂多糖(LPS)所致的急性肺损伤(ALI)中的作用。[方法]根据是否腹腔注射脂多糖(LPS)将实验动物分为脂多糖组(LPS组)及生理盐水对照组(Con组),对比两组动物组织病理学改变、动脉血气、肺湿/干重比及AQP-1表达的差异。[结果]光镜下见LPS组肺组织水肿,大量炎性细胞浸润;LPS组PO2(55.07±17.02)mmHg明显低于Con组(97.35±9.37)mmHg,差异有显著性意义,P<0.05;LPS组肺湿/干重比(4.93±0.16)明显高于Con组(4.11±0.69),差异有显著性意义,P<0.05;免疫组化染色显示:LPS组的AQP-1蛋白表达减弱,荧光实时定量PCR证实LPS组的AQP-1 mRNA表达较对照组明显下降(P<0.01)。[结论]AQP-1参与了急性肺损伤的形成。     

热射病合并细菌内毒素感染大鼠动物模型的复制

目的复制热射病合并细菌内毒素感染的动物模型,为进一步探讨重度热射病的发病机制奠定基础。方法雄性SPF级Wistar大鼠随机分为:常温生理盐水组(C组)、高温生理盐水组(H组)、常温细菌内毒素组(L组)、高温细菌内毒素组(HL组)。持续监测动物肛温(Tr)、心率(HR)、平均动脉压(MAP)、呼吸频率(RR)的动态变化,观察致伤0、40、80、120min的外周血白细胞计数、肺湿质量/干质量比值(W/D)以及肺病理改变。结果(1)HL组Tr上升到(43.04±0.11)℃,HR加快到(660±42)次/min,RR加快到(150±11)次/min,MAP下降到(49.0±3.5)mmHg;其中Tr、HR、RR、MAP与L组之间存在显著性差异,HR、MAP与H组之间存在显著性差异。(2)L组、HL组WBC显著下降而H组WBC显著上升,L组、HL组WBC计数与H组之间存在显著性差异。(3)HL组动物W/D显著性升高,肺急性微血管损伤改变显著。结论本研究模拟了临床热射病合并内毒素感染发展为重度热射病的过程,是用于重度热射病多器官损伤肺启动机制研究较好的模型。     

脂多糖致大鼠急性肺损伤早期转化生长因子β1的表达

目的:观察转化生长因子β1(TGF-β1)在脂多糖(LPS)致大鼠急性肺损伤(ALI)早期模型肺组织的表达情况,探讨其在ALI发病机制中的作用。方法:将27只SD大鼠随机分成3组,其中NS对照组为气管内滴注生理盐水12 h后取材,LPS1组、LPS2组为气管内滴注LPS 1.0 ml/kg(浓度为100μg/ml)后分别于12 h,24 h取材。用免疫组织化学方法测定肺组织TGF-β1的表达。结果:LPS2组大鼠肺组织TGF-β1的表达(140.081±21.854)较LPS1组(45.157±29.443)明显升高(P<0.05),并且两个损伤组(LPS1组、LPS2组)TGF-β1的表达均显著高于NS对照组(7.175±3.686)(P<0.05)。肺组织HE染色显示肺损伤24 h与12 h相比肺泡间隔增厚,间质增生,淋巴细胞、巨噬细胞及成纤维细胞浸润等表现明显增强。结论:ALI早期,TGF-β1诱导胶原合成可能在ALI发病机制中扮演重要角色。     

内毒素诱导大鼠急性肺损伤中凋亡相关基因bcl-2及fas的表达观察

【目的】探讨bcl-2及fas在内毒素诱导大鼠急性肺损伤(ALI)中的表达。【方法】Wistar大鼠随机分为正常对照组及脂多糖(LPS)股静注后30、60、120 min组,检测肺损伤指标(肺系数、PMN百分比、蛋白含量、肺泡通透指数)、观察病理形态、免疫组化染色检查。【结果】表征损伤的各生化指标对照组均较损伤组轻;其中LPS 120 min变化组最为显著,各项生化指标均较对照组明显升高(P<0.001);肺组织各蛋白LPS致伤后较正常组表达增高(P<0.01)。【结论】Bcl-2和fas系统参与了LPS致ALI时的肺损伤,并在ALI发病机制中起着一定的作用。     

外源性硫化氢在脂多糖致老年大鼠急性肺损伤中的作用

目的:探讨外源性硫化氢(H2S)在脂多糖(LPS)致老年大鼠急性肺损伤(ALI)中的作用并初探其机制.方法:将48只SD老年大鼠随机分为对照组、LPS组(经气管内滴注LPS复制ALI模型)和NaHS+LPS组(LPS滴注前10 min腹腔注射NaHS),每组16只.分别于给药后4及8 h取8只动物处死,测定肺系数;光镜下观察肺组织形态学改变;检测血浆H2S、NO和CO含量,肺组织丙二醛(MDA)含量.胱硫醚-γ-裂解酶(CSE)、诱导型-氧化氮合酶(iNOS)和血红素加氧酶(HO)活性;用免疫组织化学法检测肺组织iNOS及HO-1蛋白的表达.结果:给药后4及8 h,LPS组肺系数及IQA大于对照组和NaHS+LPS组,NaHS+LPS组大于对照组(P均<0.001).与对照组比较,LPS组肺组织MDA含量增加;血浆H2S含量和肺组织CSE活性下降;肺组织iNOS活性和iNOS蛋白表达增强,血浆N0含量增加;肺组织HO活性和HO-1蛋白表达增强,血浆CO含量增加(P均<0.05).与LPS组比较,NaHS+LPS组上述措标均有所改香(P均<0.01).结论:CSE/H2S体系的卜调是LPS致老年大鼠ALI发病的机制之一,外源性H2S可通过抗氧化和下调iNOS/NO体系、上调HO-1/CO体系对肺组织发挥保护作用.     

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…