一种快速建立小鼠心肌缺血再灌注模型的方法

目的: 探讨一种快速高效且不需要借助呼吸机和开胸操作的方法,建立小鼠心肌缺血再灌注模型。方法: 取40只雄性昆明小鼠（6~8周龄,体重18~25 g）,随机分为假手术组、缺血15 min+再灌注24 h组、缺血30 min+再灌注24 h组和缺血45 min+再灌注24 h组,每组10只。给予2%异氟烷气体麻醉,分离胸大肌和胸小肌,于左侧第3、4肋间隙挤出心脏,迅速定位,假手术组仅穿线不结扎,手术组分别结扎冠状动脉左前降支（LAD）15、30和45 min后,松开结扎线24 h以建立心肌缺血再灌注模型。同时在结扎前、结扎后5 min及再灌注24 h后进行心电图检测。再灌注24 h后在结扎部位再次进行结扎,进行伊文思蓝-TTC染色,垂直于心脏长轴切片,检测心肌缺血区和梗死区面积。结果： 至再灌注24 h后,小鼠生存率为90%,心肌缺血再灌注造模成功率86.7%。心电图检测显示LAD结扎5 min后均出现T波高耸,ST段抬高,QRS波增宽。随着再灌注时间延长,ST段逐渐回落。结扎LAD 5 min后,肉眼可见结扎线以下心室壁呈现灰白色,再灌注24 h后可见与周围组织区分明显的白色梗死区,心脏搏动频率和幅度较结扎前明显减弱。心肌组织切片经伊文思蓝-TTC染色呈现界限明显的缺血区、梗死区和正常心肌组织区。缺血45 min+再灌注24 h组小鼠（切片缺血区面积+梗死区面积）/左室总面积比值为（63.8±6.36）%,梗死区面积/(梗死区+缺血区面积)比值为（46.7±5.77）%。结论： 该方法建立小鼠心肌缺血再灌注模型,减少了呼吸机使用所需要的时间,操作快速便捷,造模成功率大于85%。     

热休克因子1基因剔除对小鼠生长繁殖的影响

目的采用左冠状动脉结扎法,建立和评价大鼠心肌缺血再灌注损伤模型。方法麻醉大鼠21只,开胸,穿线结扎左冠状动脉造成缺血45min、松解造成再灌注180min;记录标准Ⅱ导联心电图、MAP和心肌收缩功能、心肌缺血／坏死面积以及大鼠存活时间变化。结果左冠状动脉结扎后,QRS波增宽、增高,ST段上移,T波增高,与缺血前有非常显著差别（P〈0．01）;再灌注后,QRS波宽和波高、ST段和T波非常显著下降（P〈0．01）,但仍高于缺血前水平。与缺血前比较,缺血后MAP、HR、LVSP、＋dp／dtmax、-dp／dtmax非常显著下降（P〈0．01）,LVEDP非常显著升高（P〈0．01）,再灌注后变化趋势相同。180min后,缺血区／左室、坏死区／缺血区的的平均面积比分别为34．3％、49．6％,存活率为52．4％。结论采用左冠状动脉结扎法,复制大鼠心肌缺血再灌注损伤模型,心电图、MAP和心肌收缩功能、心肌缺血／坏死变化明显,成功率较高,是一种较好的建模方法。     

硒与丹参酮ⅡA磺酸钠合用对兔心肌缺血再灌注心电图变化及血浆CK LDH的影响

目的：观察硒与丹参酮ⅡA磺酸钠合用对兔心肌缺血再灌注心电图变化和血浆CK、LDH的影响。方法：将18只家兔随机分成3组，即假手术组、缺血再灌注组、硒＋丹参酮ⅡA磺酸钠（DS-201）组。兔冠状动脉左旋支结扎40min再灌注60rain。记录标准ⅡA导联心电图变化。再灌注60min后取血，测定血浆中肌酸激酶（CK）、乳酸脱氢酶（LDH）的含量。结果：缺血再灌注组结扎后心电图PP间期明显延长（与结扎前相比，P〈0．01），sT段抬高与T波融合成单项曲线；再灌注期间PP间期进一步显著延长，ST段进一步显著抬高；血浆CK、LDH含量显著高于假手术组（P〈0．01）。硒＋DS-201组在结扎期间PP间期和sT段的变化与缺血再灌注组相同；再灌注期间与结扎期间相比PP间期无明显延长，与缺血再灌注组相比无显著性差异；再灌注期间ST段显著回落（与缺血再灌注组相比，P〈0．01）。硒＋DS-201组血浆CK、LDH含量显著低于缺血再灌注组（P〈0．01）。结论：硒与丹参酮ⅡA磺酸钠合用对兔心肌缺血再灌注具有保护作用。血浆cK、LDH含量和再灌注后心电图sT段的变化可作为观察药物对心肌缺血再灌注保护作用的重要指标。     

心血通干预内皮素对急性心肌缺血再灌注性心律失常的预防作用

目的：探讨心血通对兔急性心肌缺血再灌注性心律的失常及其血浆内皮素浓度的影响，方法：27只兔了胡机分为对照组，治疗组和预防组，3组兔均用乙醚麻醉，开胸结扎左前降支冠状动脉（LAD）60min，然后松开LAD再灌注120min，用心电监护仪观察心律失常发生情况，在LAD结扎前，及LAD结扎后10min,20min,40min,60min，及再灌注后10min,20min,40minm,60min,120min，采血测定ET浓度，结果：预防组显著降低各相同时相点血浆ET浓度（P＜0．01），显著降低缺血再灌注性心律失常发生率，而治疗组和对照组作用不明显，。结论：心血通对再灌注心律失;常有预防作用，而无治疗作用，其机制与ET浓度下降有关。     

宽胸逐瘀汤对家兔心肌缺血再灌注损伤保护作用的实验研究

目的：探讨宽胸逐瘀汤对离体和在体家兔心肌缺血再灌注损伤的保护作用。方法：32只在体家兔结扎冠状动脉造成心肌缺血再灌注损伤模型，随机分为假手术组、缺血再灌注组、宽胸逐瘀汤组和复方丹参片组。每组动物均在末次给药后1h开胸，暴露心脏，于冠状动脉左室支中1／2处穿线，放置硅胶管后，以备一起结扎，假手术组不结扎．放置60min，其余各组均结扎30min，解除结扎再灌注30min。实验过程中动态观察心电图（ECG），以结扎后出现心电图ST段呈弓背向上抬高，T波高耸，放松结扎后拾高的sT段下降1／2以上为缺血再灌注成功。记录心电图肢体Ⅱ导联ST段抬高情况，并检测各组血清中超氧化物歧化酶（SOD）和肌酸激酶（cK）的活性。结果：宽胸逐瘀汤和复方丹参片均可降低心电图Ⅱ导联抬高的ST段，与缺血再灌注组比较，ST段抬高程度较轻（P〈0．01），宽胸逐瘀汤的作用优于复方丹参片（P〈0．01）；宽胸逐瘀汤和复方丹参片均可降低血清CK含量，升高血清SOD含量，与缺血再灌注组比较有显著性差异（P〈0．01，P〈0．05），且宽胸逐瘀汤的作用优于复方丹参片（P〈0．05）。结论：宽胸逐瘀汤具有保护心肌缺血再灌注损伤的作用，其机制可能与改善心肌能量代谢，减轻氧自由基损伤有关。     

心肌缺血-再灌注模型血流动力学的实验研究

目的：制备大鼠心肌缺血-再灌注模型，观察血流动力学变化及其与心肌酶谱、心电图变化的关系，探讨在该模型上研究血流动力学的可行性。方法：20只成年SD大鼠随机分为心肌缺血-再灌注组和假手术组。结扎或旷置冠状动脉左前降支（LAD）后，置测压管于左心室，生理记录仪记录左心室压变化率、左心室压峰值（LVSP）等，心电图仪记录ST段变化，实验末取血测定心肌酶谱值作对比研究。结果：缺血-再灌注组较假手术组左心室压变化率减少，左心室压峰值下降，心电图ST段抬高，心肌酶谱值升高。结论：以大鼠心肌缺血-再灌注模型进行血流动力学研究是可行和稳定的。     

高氧液对家兔心肌缺血再灌注损伤的保护作用

目的：观察高氧液对家兔心肌缺血再灌注损伤的保护作用。方法：结扎兔冠状动脉左室支段，40min后解除结扎，制成心肌急性缺血再灌注模型。于缺血前10min、再灌注前10min，静滴平衡盐液（对照组）、高氧平衡盐液（高氧液组），观察在急性缺血及再灌注状态下心电图、血浆肌酸磷酸激酶（CK）、丙二醛（MDA）和超氧化物歧化酶（SOD）的变化。结果：高氧平衡盐液能使抬高的心电图S－T段明显下降，缺血再灌注心肌CK活性明显降低；并能保护SOD的活性，降低脂质过氧化反应代谢产物MDA的含量。结论：高氧平衡盐液对家兔在体心肌缺血再灌注损伤具有保护作用。     

犬心肌缺血再灌注损伤心电图Ⅱ导联QRS波群的演变

目的观察杂种犬心肌缺血再灌注损伤过程心电图(ECG)的动态变化规律,为研究干细胞移植对犬心肌缺血再灌注损伤后的治疗作用提供基础。方法选用杂种犬24只,结扎冠状动脉左前降支中远1/3处,分3组分别于30min、60min、90min后松开。应用MPA-2000生物信号分析系统,在结扎前后及松开后连续动态记录ECGII导联QRS波群的变化。结果在开始结扎阻断冠状动脉血流时,QRS主波向上Rs型;重新开放血流血管再通之初,83.3%(20/24)的犬QRS波表现为主波向下rS型或QS型,伴QRS波增宽,然后r波波幅逐渐增大,逐渐演变成主波向上的Rs型,QRS时程恢复正常。15min、30min和大于30min的演变率分别为25.00%(6/24)、41.7%(10/24)和16.7%(4/24);且演变率与冠脉阻断时间相关。结论犬心肌缺血再灌注后ECG变化有一定规律,QRS波群变化趋势有可能作为心肌细胞功能恢复程度以及心肌保护效果较为直观的判断指标。     

刺五加叶皂苷对大鼠心肌缺血再灌注心律失常的影响

目的：观察刺五加叶皂苷（ASS）对大鼠心肌缺血再灌注心律失常的保护作用。方法：Wistar大鼠开胸结扎冠状动脉左室支30 min后松扎,再灌注60 min建立心肌缺血再灌注模型,以心电图监测心律失常情况,并测定心肌组织超氧物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)活性,丙二醛（MAD）及Ca²⁺浓度变化。 结果：ASS 50和100 mg•kg^-1能防止缺血再灌注室性心律失常的发生,缩短心律失常的维持时间,降低ST段抬高的程度,可明显增加再灌注心肌组织中SOD及GSH-Px活性,降低MAD及Ca²⁺浓度。结论：ASS对大鼠心肌缺血再灌注心律失常具有明显保护作用,主要与增强心肌组织的抗氧化酶活性,减少自由基及Ca²⁺超负荷对心肌的氧化损伤有关。     

黄芩茎叶总黄酮预处理对心肌缺血再灌注大鼠心功能的影响

目的:探讨黄芩茎叶总黄酮(Scutellaria Baicalensis stem-leafTotal Flavonoid,SSTF)预处理对心肌缺血再灌注大鼠心功能的影响.方法:40只SD大鼠随机分为假手术组、缺血再灌注组、SSTF预处理组(SSTF组).SSTF组大鼠于术前1周灌胃不同剂量的SSTF(17.5mg/kg/d、35mg/kg/d、70mg/kg/d).采用结扎大鼠左冠状动脉前室间支的方法制备心肌缺血再灌注大鼠模型,缺血30min、再灌注2h,术后观察大鼠心电图的变化以及心律失常的发生情况.结果:SSTF预处理可抑制缺血再灌注大鼠心电图T波的升高、降低心律失常的发生率(P＜0.05,P＜0.01).结论:SSTF预处理对缺血再灌注大鼠心肌细胞具有保护作用.     

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…     

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.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.