苓甘五味姜辛汤合止嗽散加减治疗慢性咳嗽的疗效观察

目的:探讨苓甘五味姜辛汤合止嗽散加减治疗慢性咳嗽的疗效。方法:选取2019年1—9月我院收治的50例慢性咳嗽患者作为研究对象,以等距抽样法分为对照组(25例,西药治疗)与观察组(25例,止嗽散联合苓甘五味姜辛汤加减治疗)。比较两组用药反应、用药效果与咳嗽评分。结果:观察组用药后的咳嗽评分(0.40±0.05)分低于对照组(P0.05);观察组用药后嗜睡、头晕等不良反应发生率(8.00%,2/25)低于对照组(P0.05);观察组用药有效率(88.00%,22/25)高于对照组(P0.05)。结论:应用止嗽散联合苓甘五味姜辛汤加减治疗慢性咳嗽,可减少用药不良反应,减轻咳嗽症状。     

RNAi靶向沉默c-FLIP(L)基因对大肠癌细胞凋亡的影响

目的应用RNAi技术将c-FLIP(L)对应的SiRNA片段对大肠癌细胞株SW480凋亡的影响,明确RNAi靶向沉默c-FLIP基因在TRAIL介导的凋亡途径中的作用。方法与c-FLIP(L)对应的SiRNA片段转染入细胞,半定量RT-PCR法判断干扰前后FLIPmRNA水平的变化,Westernblot分析FLIP蛋白水平变化,比较分析干扰前后细胞对介导的凋亡敏感性的改变及转染前后TRAIL诱导的细胞凋亡的情况。结果 c-FLIP(L)可以减低SW480中FLIPmRNA和蛋白水平(P0.01),转染FLIP-siRNA后,TRAIL对大肠癌胞株SW480的遏制作用显著加强(P0.05),TRAIL介导凋亡明显增高(P0.05)。结论 RNAi靶向沉默c-FLIP(L)并能提高SW480对TRAIL灵敏度并诱使SW480凋亡。     

慢性间歇低氧大鼠的血压变化及其颈动脉体中还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶的表达

目的 探讨慢性间歇低氧(chronic intermittent hypoxia,CIH)大鼠的血压变化及其颈动脉体中还原型烟酰胺腺嘌呤二核苷酸磷酸(NADPH)氧化酶的表达情况,以明确CIH致血压升高的可能机制.方法 清洁级雄性SD大鼠30只按随机数字表法分为CIH组、慢性持续缺氧组及对照组.尾袖法测量大鼠尾动脉收缩压,采用RT-PCR法检测大鼠颈动脉体中NADPH氧化酶各亚基gp91 phox、p22phox及p47phox mRNA的表达,对颈动脉体行免疫组织化学染色,并对p22phox的表达情况行半定量分析.结果 CIH组大鼠的尾动脉收缩压为[(145±11)mm Hg,1 mm Hg=0.133kPa],较CIH组(129±9)mm Hg及对照组(124±7)mm Hg显著升高(F值为19.895,P＜0.01),CIH组gp91phox、p22phox及p47phox mRNA的表达(分别为2.82±0.51、2.74±0.45和2.88±0.47)较慢性持续缺氧组(分别为2.35±0.42、2.25±0.38和2.41±0.43)及对照组(分别为2.23±0.35、2.16±0.30和2.30±0.36)显著升高(F值分别为5.794、6.854和7.163,P＜0.01)免疫组织化学检查结果显示CIH组p22phox蛋白相对表达量(99±12)较其他两组(分别为38±7和34±8)增多.结论 CIH可刺激大鼠颈动脉体中NADPH氧化酶的表达上调并使血压升高,NADPH氧化酶在颈动脉体中的过度表达可能与OSAHS患者发生高血压病存在相关联系.

Abstract：

Objective Chronic intermittent hypoxia (CIH) occurs in patients with obstructive sleep apnea-hyponea syndrome (OSAHS) and has adverse effects on multiple physiological functions. Previous studies have shown that reflexes arising from carotid bodies mediate CIH evoked circulation-respiratory responses, and reactive oxygen species (ROS) play important roles in eliciting systemic responses to CIH.But very little is known about the molecular mechanisms underlying CIH. NADPH oxidase is the most important sources of ROS. In the present study we examined changes of blood pressure and expression of NADPH oxidase in carotid body in rats exposed to intermittent hypoxia. Methods Thirty healthy male SD rats were randomly divided into 3 groups, a CIH group, a chronic continuous hypoxia group and a control group. The systolic blood pressure (SBP) was measured with tail-cuff method. RT-PCR was used to examine mRNA expressions of NADPH oxidase subunit gp91phox, p22phox, p47phox. Immunohistochemistry and semiquantitative analysis of NADPH oxidase subunits p22phox were done in the carotid body sections of all rats. Results Compared with normal group [ ( 124 ± 7 ) mm Hg, 1 mm Hg = 0. 133 kPa ] and chronic continuous hvpoxia group[ (129 ± 9) mm Hg], the SBP in CIH group [( 145 ± 11 ) mm Hg] was significantly higher( F = 19. 895, P ＜0. 01 ＝, and the expression of NADPH oxidase subunits gp91phox,p22phox,p47phox mRNA in CIH group ( 2. 82 ± 0. 51, 2. 74 ± 0. 45, 2. 88 ± 0. 47, respectively ) were significantly higher than those in chronic continuous hypoxia group ( 2. 35 ± 0. 42, 2. 25 ± 0. 38, 2. 41 ±0. 43, respectively)and normal group(2. 23 ±0. 35, 2. 16 ±0. 30, 2. 30 ±0. 36, respectively) ( F =5.794,6. 854, 7. 163, respectively, P ＜ 0. 01 ). The Immunohistochemistry and semiquantitative analysis showed that the expression of NADPH oxidase subunit p22phox in the carotid body in CIH group ( 99 ± 12 ) were more than those in chronic continuous hypoxia and control groups ( 38 ± 7 and 34 ± 8, P ＜ 0. 05 ).Conclusion CIH upregulates the expression of NADPH oxidase in rat carotid body and elevates the rat SBP. These results indicate that NADPH oxidase up-expression is closely associated with OSAHS patients with hypertension.     

吸入一氧化氮辅助治疗急性低氧性呼吸衰竭的效果分析

目的探讨吸入一氧化氮辅助治疗急性低氧性呼吸衰竭的效果分析。方法将130例急性低氧性呼吸衰竭新生儿根据治疗方法不同分为治疗组和对照组,每组65例,两组均给予常规机械通气与药物治疗,在此基础上治疗组给予吸入一氧化氮治疗。比较两组疗效、氧合指数、动脉与肺泡氧分压比值;治疗后随访6个月,观察预后情况,包括死亡、并发症等。结果治疗组总有效率明显高于对照组[95．4％（62／65）比84．6％（55／65）],差异有统计学意义（P〈0．05）。治疗组治疗后氧合指数和动脉与肺泡氧分压比值明显优于对照组[（365．38±45．27）mmHg（1mmHg=0．133kPa）比（267．77±50．33）mmHg、0．38±0．12比0．27±0．10],差异有统计学意义（P〈0．05）。所有新生儿治疗后随访6个月,治疗组与对照组病死率比较差异无统计学意义（P〉0．05）。治疗组并发症发生率明显低于对照组[7．7％（5／65）比21．5％（14／65）],差异有统计学意义（P〈0．05）。结论吸入一氧化氮辅助治疗急性低氧性呼吸衰竭能有效提高疗效,改善预后,其机制可能与改善血气指标有关。     

噻托溴铵联合布地奈德治疗轻中度支气管哮喘的疗效观察

目的观察噻托溴铵联合布地奈德治疗轻中度支气管哮喘的临床疗效。方法选择我院2011年11月—2012年12月诊治的轻中度支气管哮喘患者60例,随机分为观察组和对照组,每组30例。对照组患者吸入布地奈德,观察组吸入布地奈德+噻托溴铵。检测两组患者治疗前及治疗后8周第一秒用力呼气容积(FEV1)、呼气峰流速(PEF);记录两组患者治疗后8周支气管哮喘急性发作次数及治疗期间不良反应情况。结果两组患者治疗前FEV1及PEF比较,差异均无统计学意义(P0.05);两组患者治疗后FEV1及PEF高于治疗前,且观察组患者治疗后FEV1及PEF高于对照组(P0.05)。治疗组患者治疗后8周支气管哮喘急性发作次数为(2.3±0.2)次,低于对照组的(9.2±0.3)次(P0.05)。观察组患者治疗期间出现口干2例,对照组患者治疗期间出现失眠1例,两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论噻托溴铵联合布地奈德治疗轻中度支气管哮喘疗效确切,可有效改善患者肺功能,减少支气管哮喘急性发作次数。     

噻托溴铵对支气管哮喘患者血清及诱导痰中IL-13水平的影响

目的：通过噻托溴铵对支气管哮喘患者干预,明确其对哮喘患者血清及诱导痰中IL-13水平的影响及其可能作用机理。方法60例哮喘患者随机分成两组各30例。对照组给予布地奈德吸入,观察组给予布地奈德＋噻托溴铵吸入,分别于治疗前、8周时检测血清及诱导痰中IL-13水平。结果治疗后两组血清及诱导痰中IL-13均明显下降（P 〈0.01）,观察组血清及诱导痰IL-13水平与对照组相比有显著差异（P 〈0.05）。结论噻托溴铵可降低哮喘患者血清及诱导痰中IL-13水平,具有抗炎作用。