板蓝根抗内毒素作用研究

１％板蓝根氯仿提取物溶液（药液）有抗大肠杆菌（Ｅ．Ｃｏｌｉ）Ｏ１１１Ｂ４内毒素（内毒素）作用。家兔热原法实验结果显示：实验组（药液２ｍｌ／ｋｇ＋内毒素４０ＥＵ／ｋｇ）、阳性对照组（内毒素４０ＥＵ／ｋｇ）、阴性对照组（药液２ｍｌ／ｋｇ）平均升温分别为０．０８，０．７７，０．１０℃。用电子显微镜观察内毒素结构形态，发现经药液作用后的内毒素由链状变为片状。鲎试验法证实，该药液稀释３２倍仍有抗内毒素作用。     

石楠藤提取物对急性出血坏死性胰腺炎大鼠治疗作用的实验研究

作者报道中药石楠藤提取物对急性出血坏死性胰腺炎（ＡＨＮＰ）大鼠治疗作用的实验研究。将１００只ＳＤ大鼠随机分为三组：①假手术组（ＳＯ组）；②ＡＨＮＰ组（ＡＰ组），该组动物在ＡＨＮＰ诱发后，不做特殊治疗；③石楠藤提取物治疗组（ＳＮ组）。该组动物在ＡＨＮＰ诱发后１０分钟经腹腔内注射石楠藤提取物（１％石楠藤提取物５ｍｌ／ｋｇ体重）。结果表明：ＳＮ组血清淀粉酶值明显下降（ＳＮ组１６１３０±５０３０Ｕ／Ｌ６ｈ、１９２９０±５３８０Ｕ／Ｌ１２ｈｖｓＡＰ组２３７８０±３９６０Ｕ／Ｌ、２８４７０±４１５０Ｕ／Ｌ，Ｐ＜０．０１）。血中ＰＡＦ含量明显降低（ＳＮ组１．３±０．３０ｎｇ／ｍｌ１ｈ、２．０±０．３４ｎｇ／ｍｌ６ｈ、２．１±０．３２ｎｇ／ｍｌ１２ｈｖｓＡＰ组２．２±０．２５ｎｇ／ｍｌ、６．１±０．４２ｎｇ／ｍｌ、１０．１±０．５３ｎｇ／ｍｌ，ｐ＜０．０１）。血浆内毒素含量明显下降（ＳＮ组６９．９±７．２ＥＵ／Ｌ、６ｈ、９１．１±８．４ＥＵ／Ｌ、１２ｈｖｓＡＰ组９８．４±６．９ＥＵ／Ｌ、１５１．７±９．１ＥＵ／Ｌ，Ｐ＜０．０１）。石楠藤提取物治疗组术后平均存活时间明显长于ＡＰ组（ＳＮ组：４３．５ｈ，ＡＰ组１１．５ｈ，ｐ＜０     

恶性梗阻性黄疸内、外引流术后血浆内毒素含量变化与死亡率的关系

目的：了解内、外引流在治疗恶性阻梗性黄疸的疗效。方法：对１５０例恶性梗阻性黄疸患者分为内引流组１１０例,外引流组１０例,比较两组在引流术后７０天内血浆内毒素的变化和死亡率关系。结果：内引流组在术后血浆内毒素与术前相比有下降趋势,内毒素值从（０．６０±０．２２）Ｅｕ／ｍｌ下降到（０．２１±０．０３）Ｅｕ／ｍｌ,病死率１．８％（２／１１０）。而外引流组结果则相反,术后血浆内毒素与术前相比呈上升趋势,内毒素值从（０．６１± ０．２０）Ｅｕ／ｍｌ上升到（１．１９±０．０８）Ｅｕ／ｍｌ,病死率７０％（２８／４０）。结论：内毒素血症在恶性阻梗性黄疸引流术后早期是导致死亡的主要原因,对恶性梗阻性黄疸患者应尽可能施行胆管内引流术。     

内毒素和内皮细胞的结合能力及对a-Catenin的影响

寻找内毒素和培养的内皮细胞直接结合的证据及对胞内连接蛋白α－Ｃａｔｅｎｉｎ的影响,观察内毒素对内皮细胞的损伤特性。方法：（１）荧光标记的内毒素（２μｍ／ｍｌ）和培养的内皮细胞在无血清下共同孵育后用荧光分光光度计进行检测;（２）内毒素（２μｇ／ｍｌ）刺激无血清培养的内皮细胞后用ＥＬＩＳＡ测定内皮细胞胞内连接蛋白α－Ｃａｔｅｎｉｎ表达的变化。结果：内皮细胞和内毒素孵育１０、２０、４０和６０分后荧光强度分别为对照组的１．８７、３．９７、３．４１（Ｐ＜０．０１）和２．０２（Ｐ＜０．０５）倍;胞内连接蛋白的表达各时相点和对照组比均明显降低（ Ｐ＜０． ０５和＜０． ０１）。结论：内毒素在无血清情况下可以和内皮细胞结合,同时可以影响胞内连接蛋白α－Ｃａｔｅｎｉｎ的表达状态,并不依赖是否有血清的存在。     

清热解毒药体外抗内毒素的鲎试验研究

「目的」探讨清热解毒药的抗内毒素作用。为临床寻找高效低毒的抗内毒素药物。「方法」选１０种清热解毒分别经鉴别、提取、浓缩。配成含原生药４００ｍｇ／ｍｌ、２０ｍｇ／ｍｌ,１０ｍｇ／ｍｌ,５ｍｇ／ｍｌ的药液,分别与等体积１Ｅｕ／ｍｌ细菌内毒素作用２小时,然后再分别为特异性鲎试剂进行试验,「结果」具有抗内毒素作用的药物及浓度分别为：金银花、玄参、苦参、黄柏（５ｍｇ／ｍｌ）;黄芩、黄连、七叶一枝花（１０ｍｇ／ｍｌ）;连,鱼腥草,生地（２０ｍｇ／ｍｌ）。「结论」金银花、玄参、苦参、黄柏等有较强抗内毒素活性。     

免疫吸附清除肿瘤坏死因子对内毒素休克兔肾脏的作用

应用抗肿瘤坏死因子（ＴＮＦ）单克隆抗体免疫吸附方法，特异性清除循环ＴＮＦ，观察对内毒素休克肾脏的作用。方法以致死剂量内毒素（８×１０９ｃｆｕ／ｋｇ）制成内毒素休克动物模型，１小时后开始体外循环免疫吸附，监测平均动脉压（ＭＡＰ）变化，循环ＴＮＦ及尿素氮（ＢＵＮ）、肌酐（Ｃｒ）水平。６小时后活杀动物，留取肾脏行组织病理检查。结果（１）免疫吸附组血液灌流后３０分钟ＭＡＰ开始回升（１１．６±１．４ｋＰａ），明显高于对照组（８．８±２．３ｋＰａ，Ｐ＜０．０１）；（２）免疫吸附组２小时的ＴＮＦ活性（４４±１０Ｕ／ｍｌ）较对照组（１４４８±２２６Ｕ／ｍｌ）明显降低（Ｐ＜０．０５）；血清ＢＵＮ、Ｃｒ水平较对照组降低（Ｐ＜０．０５）；（３）免疫吸附组肾小球充血，白细胞浸润及肾小管坏死程度和线粒体的损害均较对照组明显减轻。结论抗ＴＮＦ单克隆抗体特异性免疫吸附方法，能有效清除血循环ＴＮＦ。早期降低ＴＮＦ水平，有效地缓解内毒素休克时的低血压状态，减轻肾脏病理损害，改善肾功能     

内毒素、烫伤血清对培养的大鼠心脏微血管内皮细胞间连接的影响

目的：探讨内毒素、烫伤血清对培养的心脏微血管内皮细胞（ＣＭＥＣ）间连接成分ＶＥ－钙粘附分子表达的影响，研究内毒素对严重烧伤后内皮细胞的损伤机制。方法：①ＣＭＥＣ的分离培养；②烫伤血清和内毒素刺激培养的ＣＭＥＣ后ＥＬＩＳＡ测定内皮细胞间连接成分ＶＥ－钙粘附分子的表达。结果：ＣＭＥＣ经２０％的烫伤血清刺激后，６ｈ开始ＶＥ－钙粘附分子的表达即有明显减少，是正常对照组的６５％，到２４ｈ仍在低的水平（Ｐ＜０．０１）；经内毒素（２ｍｇ／Ｌ）刺激，从１ｈ开始即有显著降低，是对照组的８０％，６ｈ降低到最低点，是对照组的５６％，后仍在低的水平（Ｐ＜０．０１）。不同浓度的内毒素（０．５、１．０、１．５和２．０ｍｇ／Ｌ）对培养的ＣＭＥＣ进行刺激，作用１２ｈ后，与正常对照组相比差异显著（Ｐ＜０．０５和Ｐ＜０．０１），分别为对照组的８８％、８３％、８０％和４７％，且２．０ｍｇ／Ｌ刺激组有更明显的降低；相同浓度的内毒素（均为２．０ｍｇ／Ｌ）刺激，有血清和不含血清组差异不明显（Ｐ＞０．０５）。结论：烫伤血清和内毒素可以影响内皮细胞中ＶＥ－钙粘附分子的表达，内毒素的影响有剂量的依赖关系，有无血清的存在对ＶＥ－钙粘附分子表达的影响差异不明显     

肝素对小鼠实验性内毒素血症的保护作用

本文采用ＬＤ＿（７５）的Ｏ＿（１１１）Ｂ＿４大肠杆菌内毒素建立小鼠实验性内毒素血症模型，观察肝素对内毒素血症的保护作用。结果，生理盐水对照组存活率为３３．３３％，肝素对小鼠内毒素血症有显著保护作用，５．５Ｕ／２０ｇ小鼠组存活率６３．６４％（Ｐ＜０．０５）；３．０Ｕ／２０ｇ小鼠组为７９．１７％（Ｐ＜０．００５）；１．５Ｕ／２０ｇ小鼠组７５．００％（Ｐ＜０．００５）。肝素注射时间对小鼠内毒素血症保护作用依次为肝素与内毒素同时注射（７９．１７％）；内毒素注入后３０ｍｉｎ（７５．００％）；内毒素注入前３０ｍｉｎ（７０．８３％）和注入前６０ｍｉｎ（５８．３３％）。注射途径依次为静脉注射（７９．１７％）、皮下注射（７７．２７％）、腹腔注射（７５．００％）、肌肉注射（７０．８３％），统计学上无明显差异。表明中小剂量肝素对小鼠内毒素血症有明显保护作用，早期使用、静脉和皮下注射疗效明显。     

大鼠内毒素性休克肺ET—1mRNA和bcl—2的表达及山莨菪碱,地 …

目的 探讨内皮素（ＥＴ）－１ｍＲＮＡ和原癌基因ｂｃｌ－２在大鼠内毒素性休克肺损伤中的作用及山莨菪碱、地塞米松对肺的保护作用。方法 ２４只ＳＤ大鼠随机分为４组（ｎ＝６）：Ⅰ组（对照组）静注等量生理盐水;Ⅱ组（休克组）静脉注射脂多糖（ＬＰＳ）５ｍｇ／ｋｇ;Ⅲ组静注山莨菪碱４ｍｇ／ｋｇ后０．５ｈ再静注ＬＰＳ５ｍｇ／ｋｇ;Ⅳ组静注地塞米松４ｍｇ／ｋｇ后０．５ｈ再静注ＬＰＳ５ｍｇ／ｋｇ。观察５ｈ后取肺组织测     

复方紫归对烫伤大鼠肠道免疫功能的影响

目的：研究ＺＧ对烧伤后肠道免疫功能的调节。方法：４０％体表面积（ＴＢＳＡ）Ⅲ度烫伤大鼠灌喂复方紫归（ＺＧ）３ｇ／ｋｇ，２／ｄ，共３ｄ（ＺＧ组），灌喂０．９％生理盐水８ｍｌ／ｋｇ，２／ｄ，共３ｄ（对照组）。结果：ＺＧ组肠道内容物ＩｇＡ含量明显高于对照组（Ｐ＜０．０５）；ＺＧ组肠固有层ＣＤ３＋Ｔ淋巴细胞活性明显增强（Ｐ＜０．０５）；ＺＧ组血浆ＬＰＳ、ＭＤＡ明显低于对照组（Ｐ＜０．０５）。结论：复方紫归对烫伤大鼠肠道免疫功能有一定的保护作用，可减轻肠道缺血再灌注损伤和肠源性内毒素血症。     

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.