蕈样肉芽肿患者外周血单个核细胞LFA—1及ICAM—1分子表达的研究

目的：研究白细胞功能相关抗原－１（ＬＦＡ－１）及细胞间粘附分子－１（ＩＣＡＭ－１）分子在蕈样肉芽肿（ＭＦ）患者外周血中的异常表达及意义。方法：应用间接荧光抗体标记及流式细胞术对１０例蕈样肉芽肿（ＭＦ）患者外周血进行检测。结果：ＭＦ患者外周血ＬＦＡ－１＋单个核细胞为（７９．３１±６．９９）％，高于正常对照的（６８．０３±８．６２）％，差异非常显著（Ｐ＜０．０１）；患者外周血ＩＣＡＭ－１＋单个核细胞为（４６．１６±３．２３）％，高于正常对照的（３１．６９±１１．５６）％，差异非常显著（Ｐ＜０．００１）。结论：ＭＦ患者体内粘附机制存在异常，与其发病有关。     

急性心肌梗死前48小时心绞痛对近期预后的影响

目的探讨急性心肌梗死（ＡＭＩ）前心肌缺血对ＡＭＩ的预后有无影响。方法总结ＡＭＩ前４８ｈ有心绞痛（ＡＰ）患者６８例及无ＡＰ患者２７例在ＡＭＩ后近期并发症及心肌酶和心梗面积的情况。结果有梗死前心绞痛者比无梗死前心绞痛者梗死范围小（３６．８％±９．７％；５０．１％±１２．１％，Ｐ＜０．０１），心肌酶峰值低（肌酸激酶２９１５６±５４５１ｎｍｏｌ·ｓ－１·Ｌ－１；３９１９１±５６０１ｎｍｏｌ·ｓ－１·Ｌ－１，Ｐ＜０．０１。乳酸脱氢酶２９±２μｍｏｌ·ｓ－１·Ｌ－１；３５±２μｍｏｌ·ｓ１·Ｌ１，Ｐ＜０．０１。谷草转胺酶５５８４±１０１７ｎｍｏｌ·ｓ－１·Ｌ－１；７２０１±９５０ｎｍｏｌ·ｓ－１·Ｌ－１，Ｐ＜０．０１）。梗死后并发严重心律失常及心力衰竭发生率低（Ｐ＜０．０５）。结论梗死前无心绞痛患者较有心绞痛患者预后差，应引起重视。     

蒺藜总皂甙抑制培养的牛脑微血管内皮细胞表达E选择素

目的：观察蒺藜总皂甙（ＧＳＴＴ）对牛脑微血管内皮细胞（ＢＣＭＥＣ）表达Ｅ选择素的影响。方法：流式细胞仪测定白细胞介素１β（ＩＬ－１β）诱导ＢＣＭＥＣ粘附大鼠血单核细胞（ＭＮＣ）和中性粒细胞（ＮＴＰ）的数目；应用ＥＬＩＳＡ法检测ＢＣＭＥＣ表达Ｅ选择素的量。结果：ＢＣＭＥＣ经ＩＬ－１β诱导后，明显增加细胞表面Ｅ选择素的表达；ＢＣＭＥＣ与白细胞的粘附率亦明显增加，对ＭＮＣ的粘附率从（１２．９±０．４）％增至（４５．７±０．６）％，对ＮＴＰ的粘附率从（１４．７±０．３）％增至（４４．９±０．６）％。抗Ｅ选择素单克隆抗体（ＡＥｍＡｂ）能显著降低ＩＬ－１β的诱导作用。在ＩＬ－１β处理前，用ＧＳＴＴ（０．０１～１．００ｇ／Ｌ）与ＢＣＭＥＣ共孵育，则ＧＳＴＴ可浓度依赖性地抑制ＩＬ－１β的诱导作用，降低Ｅ选择素的表达量。结论：ＧＳＴＴ能抑制ＢＣＭＥＣ表达Ｅ选择素     

大肠癌细胞体外培养的化疗药敏检测研究

应用四甲基偶氮唑盐（ＭＴＴ）比色法进行大肠癌细胞体外培养的化疗药敏检测，结果显示可检测到的２０例大肠癌标本中以５－Ｆｕ最为敏感（ＩＲ＝５４．７％±１４．１％），ＭＭＣ（ＩＲ＝４３．０％±１１．４％，Ｐ＜０．０５）和ＡＤＭ（ＩＲ＝４２．０％±１１．１％，Ｐ＜０．０５）次之，ＤＤＰ为不敏感（ＩＲ＝２５．９％±１２．８％，Ｐ＜０．０１），各药物组间的化疗影响药敏存在显著性差异，Ｐ＜０．００１。研究结果证实ＭＴＴ比色法是一种快速、准确地检测实体瘤化疗药材的有效方法，检测中预防细胞体外培养的微生物污染和增加瘤细胞的获得率是实验成功的关键。同时也为临床选择合适的大肠癌化疗药物提供了可靠的依据。     

1,6—二磷酸果糖抗失血性休克实验研究

本实验观察了ＦＤＰ抗失血性休克作用。３组失血性休克大鼠分别接受５％ＦＤＰ溶液（Ａ组）、５％葡萄糖溶液（Ｂ组）和生理盐水（Ｃ组）静注。给药６０ｍｉｎ后，Ａ组ＭＡＰ为１０．４±２．１ｋＰａ，与Ｂ、Ｃ组７．９±２．４和７．７±２．６ｋＰａ间均有差异（Ｐ＜０．０１）；Ａ组动物存活率７５％，而Ｂ、Ｃ组分别为２５％和１５％（Ｐ＜０．０１）；Ａ组动脉血ｐＨ和ＰａＯ２分别为７．２４±０．１４和１３．４６±１．２２ｋＰａ，与Ｂ、Ｃ组７．１４±０．１４和１０．２９±３．８４ｋＰａ与７．０２±０．１０和７．２５±２．１２ｋＰａ间有显著差异（Ｐ＜０．０１）；Ａ组回输血液再灌流后血浆ＳＯＤ和ＭＤＡ分别为１２００±１２６Ｕｍｌ－１和０．４７±０．２５ｎｍｏｌｍｌ－１，同Ｂ、Ｃ组１０８１±１１９Ｕｍｌ－１和０．９１±０．２９ｎｍｏｌ－１与８３５±９Ｕｍｌ－１和１．１３±０．１６ｎｍｏｌ－１间均有显著差异（Ｐ＜０．０１）。结果表明ＦＤＰ保护组织损伤而产生抗休克作用。     

肥胖和高血压病患者胰岛素敏感性的变化

探讨高血压病与肥胖患者胰岛素抵抗现象。方法用正常血糖胰岛素钳夹技术测定３６例正常血压者，２３例单纯肥胖患者，５１例高血压非肥胖患者及５４例高血压合并肥胖患者的葡萄糖代谢率（Ｍ值），同时做口服葡萄糖耐量试验和胰岛素释放试验。结果发现（１）肥胖、高血压非肥胖和高血压合并肥胖患者口服葡萄糖７５ｇ后，６０和１２０分钟血糖及不同时间点胰岛素值均比正常血压者高（Ｐ＜０．０１）；（２）Ｍ值：正常人、高血压非肥胖患者、单纯肥胖者、高血压合并肥胖患者分别为９．２±１．０、７．６±２．０、６．７±１．５、５．２±１．８ｍｇ·ｋｇ－１·ｍｉｎ－１，差异均有显著意义（Ｐ＜０．０５）；胰岛素敏感性降低在高血压病合并肥胖组为８７．０％，单纯肥胖为６９．６％，高血压非肥胖为４１．１％，正常人为２．８％，差异有显著意义（Ｐ＜０．０５）；（３）多因素回归分析，发现性别、年龄、舒张压对Ｍ值无明显影响，而体重指数每增加１ｋｇ／ｍ２，Ｍ值减少０．４２ｍｇ·ｋｇ－１·ｍｉｎ－１，收缩压每增加１０ｍｍＨｇ，Ｍ值减少０．２０ｍｇ·ｋｇ－１·ｍｉｎ－１。结论胰岛素敏感性降低可能是肥胖与高血压病的发病因素。肥胖对胰岛素敏感性的影响比血压的影响更明显。     

－80℃低温冷冻保存人外周血造血干细胞

采用６％羟乙基淀粉（ＨＥＳ）和５％二甲基亚砜（ＤＭＳＯ）为冷冻保护剂，不用程控降温装置和液氨，直接于一８０℃冰箱中冻存外周血造血干细胞（ＰＢＳＣ）。于冻存前和冻存后１周、１个月、２个月和３个月分别取样分析。冻存３个月后，外周血单核细胞（ＭＮＣ）回收率为８９．８±６．６％；胎盼蓝拒染存活率为８０．２±５．４％；粒一单系造血祖细胞（ＣＦＵ一ＧＭ）回收率为７１．１±８．２％。说明冻存效果好，ＤＭＳＯ用量减少，为ＰＢＳＣ的冷冻提供了一种简单而有效的方法。     

自发狼疮肾炎鼠细胞间粘附分子的变化及黄芪的作用

利用计算机图象分析系统及免疫荧光技术研究了自发狼疮小鼠（ＭＲＬｌｐｒ／ｌｐｒ）肾脏组织中细胞间粘附分子（ＩＣＡＭ－１）的分布及表达，同时对肾组织中免疫球蛋白及补体Ｃ３的沉积进行了定量分析，结果发现ＭＲＬｌｐｒ／ｌｐｒ小鼠肾组织中ＩＣＡＭ－１可在毛细血管袢及系膜区有明显沉积。经用中药黄芪治疗后ＩＣＡＭ－１在肾组织中分市及沉积均明显减弱，治疗１组６．２５±４．３７％，治疗２组５．３３±２．０８％，狼疮组２０．８５±１．２６％。同时免疫球蛋白及补体Ｃ３的沉积也明显减弱。结果提示ＩＣＡＭ－１在自发狼疮小鼠肾脏病变中起重要作用，黄芪通过免疫调节作用可以减轻自发狼疮小鼠的肾脏病变。     

20例垂体微腺瘤MRI和CT的对比分析

对２０例病理证实为垂体微腺瘤患者进行ＭＲＩ和ＣＴ表现的对比观察。ＭＲＩ显示所有２０个病灶，ＣＴ发现１９个。增强前，在Ｔ＿１加权像上，９０％病变为低信号；ＣＴ片上，８５％为低密度。增强后，ＭＲＩ和ＣＴ各有４５％的肿瘤显示更加清晰。ＭＲＩ与ＣＴ相比，在判断垂体微腺瘤的位置、大小（５．１±２．０／５．２±１．９ｍｍ）、鞍隔上抬（１５／１６例）、垂体柄偏位（９／１０例）以及有无垂体增大（１６／１７例）上，两者结果相似。明确有无鞍底骨质侵蚀ＣＴ明显优于ＭＲＩ，二者有明显差异（Ｐ＜０．０５）。认为高分辨率ＣＴ是垂体微腺瘤的首选影像检查方法。     

充血性心力衰竭大鼠肾脏Aquaporin 2水通道蛋白基因的表达

目的探讨Ａｑｕａｐｏｒｉｎ２水通道蛋白（ＡＱＰ２）基因与心力衰竭时水潴留的关系。方法雄性ＳＤ大鼠（２００～２５０ｇ）分别行左冠状动脉结扎术。５周后分别进行颈动静脉插管，测量平均动脉压和心排血量。根据左心室心肌梗塞面积（ＬＶＭＩ）的不同，将冠状动脉结扎大鼠分为两组。应用Ｎｏｒｔｈｅｒｎｂｌｏｔ和Ｗｅｓｔｅｒｎｂｌｏｔ测定肾脏ＡＱＰ２基因的ｍＲＮＡ和蛋白质表达的变化。结果对照组、ＬＶＭＩ＜２０％组、ＬＶ－ＭＩ≥２０％组，ＡＱＰ２／ＧＡＰＤＨｍＲＮＡ吸光度比分别为１．３８５±０．０２３，１．５２３±０．０３６，１．７７９±０．０７２（Ｐ＜０．０１）；ＡＱＰ２蛋白表达量吸光度分别为１００％±１０％，１５７％±１３％，２０２％±２５％（Ｐ＜０．０１）。结论提示ＡＱＰ２ｍＲＮＡ和蛋白质的表达在充血性心力衰竭大鼠是明显增加的。ＡＱＰ２基因表达的增加可能在充血性心力衰竭时水潴留的发生中起作用。     

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…