疏阳化痰方对焦虑女性痤疮(阳郁痰凝证)患者疗效及血清炎性因子的影响

[目的]观察疏阳化痰方治疗焦虑痤疮女性患者80例疗效及对血清炎性因子影响。[方法]纳入2017年1月-2018年1月期间治疗的焦虑女性痤疮患者80例,随机分为治疗组和对照组,每组各40例,对照组常规给予丹参酮胶囊口服,治疗组在对照组基础上给予疏阳化痰方治疗,连续治疗12周;观察治疗前后两组治疗有效率、焦虑评分量表（SAS）、皮肤病生活质量指数（DLQI）、血清炎性因子[白介素-1α（IL-1α）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）]、血清激素水平黄体激素水平（LH）与雌二醇（E₂）、中医证候量表不良反应。[结果]1）治疗后治疗组缓解率为92.5%,对照组缓解率为85.0%,两组在缓解率方面对比无统计学意义（P>0.05）;2）两组治疗后痤疮国际改良分级等级分级比较无统计学差异（P>0.05）;3）两组治疗后DLQI评分、中医证候量表评分、SAS评分对比具有统计学差异（P<0.05）;4）两组治疗前后血清炎性因子（IL-1α、IL-6、TNF-α）、血清激素水平LH与E₂水平变化比较具有统计学差异（P<0.05）;两组治疗前后均未出现不良反应。[结论]疏阳化痰方联合丹参酮胶囊治疗焦虑女性患者痤疮（阳郁痰凝证）效果显著,值得临床应用推广。     

痤疮颗粒对痤疮患者血清中白细胞介素-8和肿瘤坏死因子-α水平的影响

[目的] 探讨痤疮颗粒对痤疮患者血清中细胞因子变化。[方法] 采用放射性免疫学方法检测痤疮颗粒对痤疮患者血清中白细胞介素-8(IL-8),肿瘤坏死因子-α(TNF-α)水平的影响。[结果] 应用痤疮颗粒治疗痤疮患者后,其血清中的IL-8和TNF-α水平均较用药前有显著变化(P<0.01);并且疗后患者血清中IL-8和TNF-α水平与正常对照组无差异(P>0.05)。[结论] 痤疮颗粒能够改变痤疮患者血清中细胞因子水平。     

参芪山腊梅叶汤对慢性肾功能衰竭患者微炎症因子的影响

[目的]观察参芪山腊梅叶汤治疗慢性肾功能衰竭的临床疗效及微炎症因子的影响。[方法]将80例慢性肾功能衰竭患者随机分为观察组40例与对照组40例,对照组给予西医常规治疗。观察组在对照组基础上给予参芪山腊梅叶汤治疗,每日1剂。两组均以3个月为1个疗程。治疗2个疗程后观察两组临床疗效,比较治疗前后中医证候积分、肌酐（Scr）、尿素氮（BUN）、肌酐清除率（CCr）、血清白蛋白（ALB）及超敏C反应蛋白（hs-CRP）、白细胞介素6（IL-6）、肿瘤坏死因子-α（TNF-α）的变化。[结果]观察组总有效率为82.50%,对照组总有效率为57.50%,两组比较差异有统计学意义（P<0.05）.治疗后两组Scr、BUN、IL-6、hs-CRP、TNF-α、中医证候积分均下降（P<0.05或P<0.01）,观察组明显低于对照组（P<0.05）.治疗后两组CCr、ALB上升（P<0.05或P<0.01）,观察组明显高于对照组（P<0.05）.[结论]参芪山腊梅叶汤有效改善慢性肾功能衰竭的临床症状、肾功能和营养状况。降低hs-CRP、IL-6和TNF-α是其可能作用机制。     

通肺化痰汤加减对痰热郁肺型COPD急性加重期患者血清LCN1和LCN2水平的影响

[目的] 观察通肺化痰汤加减对痰热郁肺型慢性阻塞性肺疾病急性加重期（AECOPD）患者的临床疗效及对血清LCN1和LCN2水平的影响。[方法] 选取痰热郁肺型AECOPD患者80例,应用随机数字表法分为对照组和治疗组（每组40例）,两组患者均应用吸氧、抗感染等基础治疗,对照组使用茶碱缓释片、沙美特罗替卡松粉吸入剂,治疗组在对照组基础上加用通肺化痰汤加减,治疗结束后比较两组患者临床疗效、肺功能、肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-8及脂质运载蛋白（LCN）1、LCN2水平的变化。[结果] 治疗后,治疗组总有效率（90%）高于对照组总有效率（72.5%,P<0.05）,两组肺功能水平较治疗前升高,治疗组高于对照组（P<0.05）;治疗后TNF-α、IL-8水平较治疗前降低,治疗组低于对照组（P<0.05）;治疗后LCN1、LCN2水平较治疗前降低,治疗组低于对照组（P<0.05）,治疗过程中未发生不良反应。[结论] 通肺化痰汤对治疗痰热郁肺型AECOPD患者疗效显著,安全性高,可明显改善患者肺功能,降低血清TNF-α、IL-8、LCN1、LCN2水平,提高临床疗效。     

增强型体外反搏对69例冠心病患者的血清炎性因子的影响探讨

目的 分析增强型体外反搏冠心病患者的血清炎性因子的影响,探讨冠心病治疗的新靶点。方法 将69例冠心病采用数字表法将患者随机分为观察组和对照组,观察组35例,对照组34例,对照组患者接受常规药物治疗;观察组在对照组治疗基础上接受反搏治疗,两组治疗时间均为6周,比较两组患者疗效;采集患者治疗前后外周血,采用ELISA法对患者血清中炎性因子CRP、hsCRP、TNFα以及IL-6水平进行检测。结果 观察组患者治疗总有效显著高于对照组 (P<0.05),对照组患者治疗前后血清炎性因子水平变化差异无统计学意义(P>0.05),观察组患者治疗后血清炎性因子水平显著低于治疗前(P<0.05)。结论 体外反搏治疗冠心病患者临床疗效显著,治疗后患者血清炎性因子降低显著,值得临床进一步推广应用。     

针刺对局灶性脑缺血大鼠缺血脑组织及血清白介素-8的影响

[目的]观察针刺对局灶性脑缺血大鼠脑组织及血清白介素8(IL-8)含量的影响。[方法]以热凝法阻断一侧大脑中动脉造成大鼠局灶性脑缺血模型,采用放免法测定大鼠脑组织及血清IL-8含量。[结果]脑缺血后各时段模型组与同时段假手术组及正常组比较脑组织及血清IL-8显著升高(P<0.05,P<0.01);治疗后6、12、24、48h各时段针刺组与同时段模型组比较脑组织IL-8含量明显降低(P<0.01),6、12及48h针刺组血清IL-8含量显著低于同时段模型组(P<0.05,P<0.01)。[结论]针刺可能通过抑制缺血区脑组织IL-8的合成和分泌,调节血清IL-8的含量,抑制炎性细胞的黏附及浸润,从发挥脑保护作用。     

分泌性中耳炎患者血清及耳积液IL-8 IL-10 IL-1β水平及意义

目的 探究分泌性中耳炎（SOM）患者血清与耳积液中白介素8（IL-8）、IL-10、IL-1β水平变化及其临床意义。方法 以南阳市中心医院2017年12月至2018年12月收治的97例SOM患者（观察组）和同期97例健康体检者（对照组）为研究对象,观察组依据病程、临床症状以及检查结果分为急性组（n=30）、亚急性组（n=33）以及慢性组（n=34）等亚组。比较观察组患者血清与耳积液、对照组血清炎症因子水平,观察组各亚组患者血清中、耳积液中炎症因子水平,分析血清及耳积液炎症因子水平与病程的相关性。结果 观察组患者血清中IL-8、IL-10、IL-1β水平高于对照组,差异有统计学意义（P<0.05）,观察组患者耳积液中IL-8、IL-10、IL-1β水平高于观察组血清中水平（P<0.05）;急性组SOM患者血清与耳积液中IL-8、IL-10、IL-1β水平低于亚急性组和慢性组,亚急性组上述指标水平低于慢性组,差异有统计学意义（P<0.05）;SOM患者血清与耳积液中IL-8、IL-10、IL-1β等炎症因子水平与患者病程之间均呈正相关性（r_血清=0.856,0.763,0.925;r_耳积液=0.776,0.849,0.927;P均<0.05）。结论 SOM患者血清中IL-8、IL-10、IL-1β水平异常上升,而这种异常上升状态在患者耳积液中更显著,炎症因子水平与患者病程关系密切。     

针刺对慢性疲劳大鼠血清IL-2及TNF-α的影响

[目的]观察针刺对慢性疲劳大鼠血清白细胞介素-2(IL-2)及肿瘤坏死因子-α(TNF-α)的影响。[方法]采用慢性束缚和冷水游泳制备慢性疲劳大鼠模型。随机将大鼠分为正常对照组、模型组、针刺组和人参皂苷组。针刺组选百会、肾俞、后三里穴,针刺1次/d。人参皂苷组给予人参皂苷水溶液[70mg/(kg·d)]灌胃治疗,1次/d。正常对照组和模型组进行与针刺组和人参皂苷组相同时间、相同程度的捉抓。连续治疗2周断头取血。采用放射免疫分析法检测大鼠血清IL-2及TNF-α的水平。[结果]模型组大鼠血清IL-2、TNF-α水平均降低,针刺后两者均明显升高。[结论]针刺可以升高慢性疲劳大鼠血清IL-2、TNF-α水平,这可能是针刺治疗慢性疲劳综合征的作用机制之一。     

早期肠内营养混悬液营养支持联合生长抑素对ICU重症胰腺炎患者血清PCT、PA、TF、AMY水平变化及预后的影响

目的 探究早期肠内营养混悬液营养支持联合生长抑素对ICU重症胰腺炎患者血清降钙素原（PCT）、前白蛋白（PA）、转铁蛋白（TF）、淀粉酶（AMY）水平变化及预后的影响。方法 选取2014年7月~2016年11月首都医科大学附属北京同仁医院ICU重症胰腺炎患者66例,依据治疗方案分为对照组（n=33）与治疗组（n=33）。对照组予以早期肠外营养支持+生长抑素治疗,治疗组予以早期肠内营养混悬液营养支持+生长抑素治疗。统计两组并发症发生情况,并对比两组治疗前后预后相关评分（APACHEⅡ、SOFA及改良Marshall评分）、血清PCT、PA、TF、AMY水平及血清相关炎性因子[白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）]水平。结果 两组治疗前APACHEⅡ、SOFA及改良Marshall评分差异均无统计学意义（P>0.05）;治疗后与对照组相比,治疗组APACHEⅡ、SOFA及改良Marshall评分均较低,差异有统计学意义（P<0.05）;两组治疗前血清PCT、PA、TF、AMY水平差异均无统计学意义（P>0.05）;治疗后与对照组相比,治疗组血清PCT、AMY水平均较低,血清PA、TF水平较高,差异有统计学意义（P<0.05）;两组治疗前血清TNF-α、IL-6及IL-10水平比较差异均无统计学意义（P>0.05）;治疗后与对照组相比,治疗组血清TNF-α、IL-6水平均较低,血清IL-10水平较高,差异有统计学意义（P<0.05）;治疗组并发症发生率15.15%（5/33）低于对照组42.42%（14/33）,差异有统计学意义（P<0.05）。结论 早期肠内营养混悬液营养支持联合生长抑素治疗ICU重症胰腺炎患者,可有效提高血清PA、TF及IL-10水平,降低PCT、AMY、TNF-α、IL-6水平,改善预后且安全性较高。     

针刺对局灶性脑缺血大鼠缺血脑组织及血清IL-6的影响

[目的]观察针刺对局灶性脑缺血大鼠脑组织及血清白介素-6(IL-6)含量的影响。[方法]以热凝法阻断一侧大脑中动脉造成大鼠局灶性脑缺血模型,采用放免法测定大鼠脑组织及血清IL-6含量。[结果]脑缺血后3、6、12、24 h缺血组脑组织IL-6含量与正常组比较均显著增高(P<0.01),针刺后3、6、12 h脑组织中IL-6含量较同时段缺血组显著降低(P<0.01),并明显低于正常对照组(P<0.01)。脑缺血后血清中IL-6含量3 h急剧升高,3、6、12 h段缺血组血清IL-6含量与同时段假手术及正常组比较显著升高(P<0.01),治疗后3、6、12 h针刺组血清IL-6含量较同时段缺血组显著降低(P<0.01),24及48 h针刺组血清IL-6含量明显升高,与正常组及假手术组比较均有显著差异(P<0.01)。[结论]通过对IL-6的调节,发挥其抗炎、神经保护作用,促进受损神经元修复,可能针刺治疗缺血性脑卒中的作用机制之一。     

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…