保心汤治疗冠心病心绞痛气虚血瘀证的临床观察

目的观察保心汤对冠心病心绞痛 (气虚血瘀证 )的疗效。方法采用随机对照方法 ,将 62例病人随机分为保心汤组和西药对照组 ,观察两组心绞痛发作情况及心电图、血脂、临床症状等的变化。结果两组在心绞痛、心电图疗效上无显著性差异 (P >0 .0 5 ) ,但在改善症状和对血脂的影响方面保心汤组优于对照组(P >0 .0 5 )。结论保心汤能有效改善心肌缺血和临床症状 ,对血脂有良性影响     

临床医师处方抗菌药物前需思考的几个问题

2001年和2003年卫生部全国医院感染监测网调查结果均显示,医院横断面抗菌药物的平均使用率在54%以上,联合用药较为普遍.国内监测结果也表明细菌耐药性日益严重.针对上述问题,提出临床医师在面对病人开处方抗菌药物之前,须思考的问题:是否有使用抗菌药物的适用症?是否了解选用的抗菌药物,选用何种药物?是否有联合使用抗菌药物的指征?采用何种给药途径、给药剂量、给药时间?是否属于特殊宿主或针对特殊病原体的感染使用抗菌药物?密切观察抗菌药物治疗是否有效?针对局部感染是否需要穿刺或外科手术引流病灶?是否已出现抗菌药物的不良反应?是否存在药物相互作用?是否存在不合理使用抗菌药物情况?并且针对每个问题提出了建议.     

Presence of immunoglobulin M antibodies around the glomerular capillaries and in the mesangium of normal and passive Heymann nephritis rats

Summary Diffuse distribution of small, faintly staining, beaded deposits of rat immunoglobulin M (IgM) around the glomerular capillary blood vessels, and a more intensely staining larger deposition in the mesangium, were observed on the kidney sections of normal rats. As glomerular-fixed nephritogenic antigens are known to be present on the epithelial aspect of the glomerular basement membrane (GBM), especially at the soles of foot processes and at the slit pores, it was assumed that the IgM antibodies were directed against these antigens. Investigation by immunofluorescent antibody double-staining techniques of rat kidney sections obtained from normal and rabbit anti-FX1A-injected rats stained for the nephritogenic antigen showed that a number of antigenic sites in the glomeruli and in the mesangium shared antibody hits by heterologous rabbit IgG and autologous rat IgM antibodies. Most sites in the glomeruli stained specifically for rat IgM or rabbit IgG, but preferentially for the latter. The intensely fluorescent mesangial deposits stained mainly for rat IgM, indicating that at these sites the antigenic material was virtually saturated, while areas at the entry to the mesangial space also stained for rabbit IgG, indicating that at these locations free nephritogenic epitopes were still available for reaction with the anti-FX1A antibody. Western blot analysis have shown that the rabbit anti-rat FX1A IgG and the rat anti-rat KF3 IgM antibodies are directed against the same renal tubular-derived antigen with a molecular weight of 70,000. These experimental findings collectively demonstrate that the heterologous IgG and autologous IgM antibodies are directed against the same nephritogenic antigen, which is found in the glomeruli, the mesangium and the proximal convoluted tubules. Thus, the IgM autoantibody has a possible physiological role but, in addition, there is evidence of active immunophagocytic events, manifested in a rapid and continuous entrapment and expulsion of macromolecules after their processing by the mesangial cells of normal and passive Heymann nephritis rats.     

肾炎益气液对肾毒血清性肾炎大鼠肾脏超微结构的影响

目的:观察肾毒血清性肾炎大鼠肾组织超微结构变化及肾炎益气液对该变化的影响。方法: 采用大鼠肾毒血清性肾炎模型,常规电镜制片、染色,观察肾组织超微结构的变化。结果: 注射肾毒血清(NTS)后,病理组大鼠电镜下可见明显的系膜细胞增生,系膜基质增多,毛细血管腔闭塞及上皮下、内皮下电子致密物沉积等多种病理损伤性变化。而肾炎益气液组上述病变有所减轻。结论: 肾炎益气液有不同程度减轻肾小球电镜下病变的作用。     

Fate-Mapping of GM-CSF Expression Identifies a Discrete Subset of Inflammation-Driving T Helper Cells Regulated by Cytokines IL-23 and IL-1β

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The beta1 adrenergic effects of antibodies against the C-terminal end of the ribosomal P2beta protein of Trypanosoma cruzi associate with a specific pattern of epitope recognition

BALB/c mice immunized with recombinant Trypanosoma cruzi ribosomal P2beta protein (TcP2beta) develop a strong and specific antibody response against its 13 residue-long C-terminal epitope (peptide R13: EEEDDDMGFGLFD) that has a concomitant beta1-adrenergic stimulating activity. However, other animals that undergo similar immunizations seem tolerant to this epitope. To evaluate further the antibody response against the ribosomal P proteins, 25 BALB/c and 25 Swiss mice were immunized with TcP2beta. From the 50 animals, 31 developed a positive anti-R13 response, whereas 19 were non-responsive. From the 31 anti-R13 positive mice, 25 had anti-R13 antibodies that recognized the discontinuous motif ExDDxGF, and their presence correlated with the recording of supraventricular tachycardia. The other six had anti-R13 antibodies but with a normal electrocardiographic recording. These anti-R13 antibodies recognized the motif DDxGF shared by mammals and T. cruzi and proved to be a true anti-P autoantibody because they were similar to those elicited in Swiss, but not in BALB/c mice, by immunization with the C-terminal portion of the mouse ribosomal P protein. Our results show that the recognition of the glutamic acid in position 3 of peptide R13 defines the ability of anti-R13 antibodies to react with the motif AESDE of the second extracellular loop of the beta1-adrenergic receptor, setting the molecular basis for their pathogenic beta1 adrenoceptor stimulating activity.     

黄芪-当归药对益气活血作用的药效物质基础

目的：探讨黄芪-当归药对（3∶1）对气虚血瘀模型大鼠的益气活血作用,从特征图谱、药效物质辨识、入血成分对比三方面入手,为临床合理用药及复方药效物质辨识与质量控制提供理论依据。方法：使用高效液相色谱法（HPLC）建立黄芪-当归（3∶1）指纹图谱,采用超高效液相色谱-四级杆-静电场轨道阱联用技术（UPLC-Q-Exactive Orbitrap-MS）分析水煎液成分;选用SPF级成年雄性Wistar大鼠,随机分为空白组、模型组、黄芪-当归3∶1组及黄芪-当归5∶1组,每日通过控制食量及凉水游泳制备气虚血瘀模型,同时各组每天给药（水）1次,给药组剂量10.2 g·kg-1,模型组和空白组给予等量的蒸馏水,连续15 d。观察大鼠一般状况;记录各组大鼠体质量,全血及血浆黏度,胸腺指数和脾脏指数,血清中三磷酸腺苷（ATP）、二磷酸腺苷（ADP）、大鼠血管性血友病因子（vWF）水平及ATP/ADP值;苏木素-伊红（HE）及扫描电镜观察血管内皮形态;UPLC-QExactive Orbitrap-MS分析血清中的原型及代谢成分。结果：建立了黄芪-当归（3∶1）指纹图谱;UPLC-Q-Exactive ...     

基于“阴火”理论探讨内皮细胞代谢重塑与肿瘤血管化关系及中医药干预思考

血管内壁的内皮细胞借助调节血管稳态、血管张力、细胞黏附、细胞增殖、凝血抗性、炎症因子等来响应机体的物理和化学信号,进而维持血管处于衡动稳定的状态。血管生成是肿瘤发生发展所需的关键条件,肿瘤血管化的病理模式为瘤体生长提供所需的营养和氧气,以促进其增殖。近年来,内皮细胞参与肿瘤血管渗入,驱动血管生成被认为是促进肿瘤转移的关键环节。血管内皮细胞可通过调控代谢重塑以满足肿瘤血管化过程中对物质和能量的需要,其异常的代谢特征使得其能更好地适应肿瘤微环境的变化,这种代谢的改变常被看作是肿瘤血管化进程的重要基础。中医“阴火”理论源自《黄帝内经》,原指“阴虚生内热”,属内伤之火范畴,后经历代医家推演变化,逐步形成“脾胃气虚-阴火上乘-气火失调”的病机认识。内皮细胞代谢重塑的发病过程是“阴火”病理表征的客观体现,而阴火造化生息、燔灼妄动之性又与肿瘤新生血管增生无制、亢变为害的疾病状态相吻合。脾胃亏虚与气机失衡的改变可致水谷精微不得布散,发生代谢障碍,停久为痰为瘀,与血脉相搏结,致使局部环境异化（肿瘤微环境形成）、脉道不利（内皮细胞代谢失衡）,异变形成肿瘤新生血管。在“阴火”证候要素指导下,围绕气与火的相关性,运用“扶正调气”的治法遣方用药,可调节内皮细胞代谢功能,达到机体相对平衡状态,进而抑制肿瘤血管新生。基于以上认识,该文围绕内皮细胞代谢重塑与阴火相关理论,阐发学术微旨,以期为中医药干预肿瘤血管化进程提供一定的理论支持。