勃起功能障碍糖尿病大鼠模型的建立

目的 建立勃起功能显著低于正常水平的糖尿病(DM)大鼠模型.方法 30只10周龄SD雄性大鼠随机分成对照组(n=12)和实验组(n=18).实验组大鼠腹腔注射链脲佐菌素(STZ)溶液60 mg/kg,对照组腹腔注射相应剂量的0.1 M pH4.5枸椽酸钠溶液.注射后3 d,于尾静脉采血测血糖,后每2 wk测血糖1次.STZ注射后10 wk,测定两组大鼠体重和基础阴茎内压(ICP)及神经刺激诱导ICP.结果 (1)一般情况STZ注射后第5 wk有1只大鼠死亡.2只大鼠于第8、10 wk血糖未达糖尿病标准,糖尿病表现不明显,判为STZ抵抗.18只大鼠中DM模型制作成功15只(定为DM组),成功率83.3%;(2)血糖、体重DM组STZ注射后各时间点的血糖水平均显著高于对照组(P＜0.001);STZ注射前DM组和对照组的体重无显著性差异(P＞0.05),而注射后10 wk DM组的体重显著低于对照组(P＜0.001),平均体重较对照组低31.9%;(3)两组大鼠间ICP比较STZ注射后10 wk,DM组的基础ICP和神经刺激诱导ICP分别为8.9±3.5和56.3±15.8 cmH2O,分别显著低于对照组的36.8±11.2和156.3±38.4 cmH2O(P＜0.001),DM组的基础ICP和神经刺激诱导ICP较对照组分别低75.8%和64.0%.结论 以STZ60 mg/kg腹腔注射建立DM大鼠模型操作方便、成功率高,而且所制作的DM大鼠模型阴茎的基础ICP和神经刺激诱导ICP均显著低于正常大鼠,能成为理想的DMED研究的动物模型.     

大明胶囊对STZ诱导的1型糖尿病大鼠胰腺microRNA表达谱的影响及其靶点分析

目的 研究大明胶囊(Daming capsule,DM)对链脲佐菌素(streptozocin,STZ)诱导的1型糖尿病大鼠胰腺microRNA (miRNA)表达谱的影响,预测miRNA的靶点并进行分析.方法 将45只成年雄性Sprague-Dawley大鼠随机分为3组:空白组、模型组及DM组.DM组大鼠灌胃给予200 mg/(kg·d)的DM,空白组和模型组给予同等体积的生理盐水,每天2次.2周后,模型组及DM组腹腔注射STZ 65mg/kg建立1型糖尿病模型,注射STZ后DM组大鼠按上述剂量继续给予DM,空白组和模型组给予同等体积的生理盐水,每天2次.STZ注射后3天、7天检测大鼠空腹血糖,并于STZ注射后7天取大鼠胰腺组织.microRNA芯片技术检测各组大鼠胰腺组织miRNA表达,实时荧光定量PCR(real-time PCR,RT-PCR)验证miRNA芯片结果.Targetscan数据库预测miRNA靶点.结果 大鼠腹腔注射STZ 3天和7天后,大鼠空腹血糖值由(6.1±0.6)上升至(21.9±3.1)和(24.6 ±2.4) mmol/L(P ＜0.01).DM组大鼠的空腹血糖为(6.5±0.8) mmol/L,STZ后3天和7天的血糖分别为(14.1±5.1)和(12.4±4.8)mmol/L(P ＜0.01),明显低于同期模型组血糖水平(P＜0.01).在STZ大鼠胰腺,有47个miRNAs表达上调大于2倍,32个miRNAs表达下调大于2倍;DM大鼠胰腺组织,有35个miRNAs表达上调大于2倍,34个miRNAs表达下调大于2倍.其中在STZ大鼠胰腺组织表达上调的21个miRNAs及下调的8个miRNAs的表达被DM逆转;随机选择miR-200b、let-7b和miR-375进行RT-PCR验证的结果显示,这些miRNAs的表达与芯片结果一致;对DM纠正的miRNAs靶点分析发现这些靶点参与了胰腺β细胞胰岛素的生成、分泌和葡萄糖代谢及胰岛细胞凋亡.结论 DM降低了STZ诱导的1型糖尿病大鼠的空腹血糖,并改变了大鼠胰腺组织miRNA表达谱;miRNAs通过调节胰岛素生成、分泌、葡萄糖代谢和胰岛细胞的凋亡参与了DM的降血糖作用.     

早期大鼠实验性糖尿病视网膜病变模型的建立及观察

目的建立链脲佐菌素（STZ）诱导的糖尿病大鼠视网膜病变病理模型并评价其应用价值.方法34只封闭群Wistar大鼠分为正常对照组（CON）、糖尿病3个月组（DM3）和糖尿病6个月组（DM6）,采用化学药物STZ大剂量一次性腹腔注射建立糖尿病大鼠模型,观察各组大鼠一般生理指标,并对糖尿病模型大鼠进行视网膜组织病理学检查及血管内皮生长因子（VEGF）免疫组化检测.结果STZ腹腔注射大鼠成模率100%,DM3组及DM6组大鼠视网膜均出现程度不等的水肿、血管扩张和细胞排列紊乱等改变,DM6组更加显著.视网膜VEGF表达阳性细胞率在DM3组为38%,DM6组为89%.结论STZ诱导的糖尿病大鼠在病程6个月以上时可作为早期类似人类背景型糖尿病视网膜病变的模型.     

缺氧诱导因子1-α在不同血糖浓度糖尿病大鼠视网膜组织中的表达

目的 检测缺氧诱导因子-1α(HIF-1α)在不同血糖浓度组糖尿病视网膜组织中的表达变化,探讨其在糖尿病视网膜病变(DR)发生发展中的作用.方法 将SD大鼠随机分为对照组(CON)和糖尿病(DM)组.其中糖尿病组采用STZ一次性尾静脉注射建立糖尿病模型,制模成功后用胰岛素使其血糖分别控制在＜10、10～14、＞16.7mmol/L 3个不同水平(分别作为DM1、DM2和DM3组), 8周后处死大鼠,取眼球组织,应用免疫组化法检测各组大鼠视网膜组织中HIF-1α的表达变化.结果 免疫组织化学染色显示正常对照组大鼠视网膜几乎不表达HIF-1α,DM1组有少量表达,DM2组阳性细胞数量增多,DM3组表达更强,各组之间比较差异有统计学意义(P＜0.05).结论 血糖升高会引起HIF-1α的表达增强,提示HIF-1α参与了DR的发生、发展过程.     

生长抑素对糖尿病大鼠早期视网膜电图的影响

目的：探讨生长抑素对糖尿病(DM)大鼠早期视觉电生理改变的影响,阐明生长抑素对DM大鼠早期视网膜病变的治疗作用。方法：选取20只Wistar雄性大鼠作为研究对象,腹腔注射链脲佐菌素（STZ）诱导建立DM大鼠模型后,随机分为生长抑素治疗组和模型对照组,每组10只。生长抑素治疗组大鼠腹腔注射生长抑素10 μg/kg/d,连续8周,模型对照组大鼠给予同体积生理盐水。另取Wistar雄性大鼠10只作为正常对照组。分别测定各组大鼠血糖及视网膜电图改变,并对各指标进行统计学分析。结果：与模型对照组比较,生长抑素治疗组大鼠8周时血糖水平下降 (P<0.05)。与正常对照组比较,生长抑素治疗组与模型对照组大鼠1、2、4、6和8周时杆细胞反应、最大反应的a波和b波的潜伏期均延长(P<0.05),幅值于第6和8周时下降(P<0.05);与模型对照组比较,生长抑素治疗组大鼠8周时杆细胞反应、最大反应的a波和b波的潜伏期缩短(P<0.05),生长抑素治疗组各观察时间点幅值均无改变(P>0.05)。结论：生长抑素对于DM大鼠早期视网膜病变具有治疗作用。     

早期糖尿病周围神经病变大鼠模型的建立

目的 旨在建立早期糖尿病周围神经病变(diabetic peripheral neuropathy, DPN)大鼠模型。方法 26只雄性SD大鼠经过适应性喂养1周后,分为对照组(n=6)和模型组(n=22)。模型组给予D12451高糖高脂饲料(碳水化合物的热量占比35%,脂肪的热量占比45%)喂养6周诱导胰岛素抵抗,对照组给予普通饲料。随后模型组按体质量给予35 mg/kg的链脲佐菌素(streptozocin,STZ)缓冲液腹腔注射诱导胰腺特异性损伤,对照组给予等量的缓冲液,48 h后测定模型组大鼠的随机血糖,大于16.7 mmol/L即认为2型糖尿病(type 2 diabetes mellitus,T2DM)造模成功。评价T2DM大鼠的一般特征,包括体质量、空腹血糖、糖耐量及胰岛素耐量。定期监测其热痛阈的变化,判断早期DPN出现的时间,最后测定大鼠的坐骨神经传导速率。结果 模型组大鼠经过高糖高脂饮食喂养6周联合STZ腹腔注射后,T2DM造模成功。T2DM组与对照组相比,空腹血糖明显升高(P<0.001),糖耐量及胰岛素耐量均明显受损(分别为P<0.001,P=0.002)。模型建立成功后第17天,T2DM组与对照组相比表现出明显的热痛觉过敏(P=0.004),两组的坐骨神经传导速率差异无统计学意义(P=0.196)。结论 高糖高脂饮食喂养大鼠6周联合35 mg/kg的STZ腹腔注射可成功诱导T2DM模型,表现为一定程度的胰岛素抵抗与胰岛素缺乏,此模型在第17天左右出现早期DPN,其中小纤维的损害早于大纤维。     

链脲佐菌素诱导的糖尿病大鼠模型稳定性观察

目的:观察链脲佐菌素(STZ)诱导的1型糖尿病(TIDM)大鼠模型的稳定性,并探讨有关建模成功的标准.方法:模型组采用STZ按50mg/kg的剂量进行腹腔注射复制T1DM大鼠模型,对照组SD大鼠则腹腔注射等量的pH4.2、0.1mol/L柠檬酸-柠檬酸钠缓冲液,分别在腹腔注射后72h、1周、2周、3周、4周、5周、6周、7周、8周时检测各组大鼠的空腹血糖.结果:参照目前常用的腹腔注射STZ 72h后空腹血糖值≥16.7mmol/L即表示建模成功的标准,腹腔注射STZ后72h、1周、2周、3周、4周、5周、6周、7周、8周的建模成功率分别是100％、80％、75％、70％、70％、70％、70％、70％、70％.结论:如果采用目前常用的建模成功的标准,实际上在TIDM组中有30％的大鼠是未建模成功的,因此建议采用腹腔注射STZ后第3周空腹血糖值≥16.7mmol/L作为建模成功的标准.     

糖尿病性白内障动物模型的建立与评价

目的比较多种大鼠糖尿病性白内障模型,建立发病过程类似人类糖尿病性白内障、便于实验研究的动物模型。方法雄性SD大鼠完全随机分为正常组、链脲佐菌素(STZ)诱导组、特殊膳食诱导组、小剂量STZ加特殊膳食诱导组。各组使用不同方法造模成功后,比较大鼠血糖、尿糖、体质量的变化,并在裂隙灯下观察大鼠晶状体混浊的进展。结果STZ诱导组70%(14/20)血糖明显升高(空腹血糖>14mmol/L),5周后出现晶状体混浊,14周后大鼠晶状体完全混浊。特殊膳食诱导组40%(8/20)血糖明显升高,8周后出现晶状体混浊,20周后大鼠晶状体完全混浊。小剂量STZ加特殊膳食诱导组85%(17/20)血糖明显升高,6周后出现晶状体混浊,20周后大鼠晶状体完全混浊。与其他各组糖尿病大鼠相比,小剂量STZ加特殊膳食诱导组死亡率明显降低(P<0.05)。结论小剂量STZ腹腔注射加膳食诱导是安全而有效的糖尿病性白内障模型制作方法,它诱导的糖尿病大鼠白内障进展缓慢,类似人类糖尿病性白内障,便于研究和观察。     

抗CXCR4单克隆抗体对糖尿病大鼠视网膜血管内皮生长因子表达的影响

目的:探讨抗CXCR4单克隆抗体对糖尿病大鼠视网膜血管内皮生长因子表达的影响。方法:选取64只健康雄性SD大鼠,用链脲佐菌素(STZ)制造糖尿病大鼠模型。治疗组用抗CXCR4单克隆抗体玻璃体注射,对照组和未治疗组只给予等量生理盐水。注射1周后,摘取眼球,做视网膜HE染色切片观察各组大鼠视网膜结构,ELISA定量检测各组视网膜VEGF含量。结果:视网膜HE染色示CON组视网膜未见明显异常,DM未治疗组视网膜各层结构排列紊乱,视网膜内皮组织水肿,可见大量新生血管及突破基底膜的血管芽细胞核,DM治疗组视网膜内皮组织水肿减轻、新生血管减少。ELISA结果显示DM未治疗组VEGF含量(194.91±2.18)pg/ml,显著高于正常组VEGF含量(122.43±1.62)pg/ml,DM治疗组VEGF含量(143.65±1.46)pg/ml,3组比较均有统计学意义(P<0.05)。结论:抗CXCR4单克隆抗体能够抑制糖尿病大鼠视网膜VEGF的表达。     

高糖高脂饲料诱导的肥胖大鼠和糖尿病大鼠糖脂代谢对比分析

目的 对比分析高糖高脂饲料诱导的肥胖大鼠和相同饲料联合小剂量链脲佐菌素(STZ)制备的糖尿病大鼠糖脂代谢特点。方法 雄性SD大鼠随机分为正常组(NC组)和高脂组(HF组)分别给予正常饲料或高糖高脂饲料喂养8周,8周后HF组中选取肥胖大鼠再次随机两组,一组为糖尿病组(DM组),注射小剂量STZ 30 mg/kg;另一组为肥胖组(OB组)。各组继续原饲料喂养并观察4周。测定大鼠体质量、血糖、三酰甘油、总胆固醇、空腹胰岛素、胰岛素敏感性,并进行腹腔内糖耐量试验和胰岛素释放试验。结果 高脂联合注射STZ后,DM组逐渐出现了多饮、多食、多尿和体质量减轻的特点。第12周末,DM组空腹血糖高于OB组(P<0.01),胰岛素敏感性低于OB组(P<0.01),葡萄糖耐量、胰岛素分泌功能受损程度大于OB组,血清总胆固醇、三酰甘油水平高于OB组(P<0.01)。结论 持续高糖高脂饮食能够诱导大鼠出现糖调节受损、胰岛分泌功能减退以及脂代谢紊乱。高脂联合注射STZ后,糖尿病大鼠的上述受损幅度明显加大。     

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.