青蒿琥酯对佐剂性关节炎大鼠血清TNF-α、IL-1β含量的影响

目的：观察青蒿琥酯对大鼠佐剂性关节炎(ajuvant arthritis,AA)的治疗作用及其对 AA 大鼠血清 TNF-α、IL-1β含量的影响。方法：选择体重150～180g 的雄性 Wistar 大鼠,测量双侧足爪容积后,右后足跖部皮内注射完全弗氏佐剂(0.1mL/只)建立 AA 模型,于造模后第19天,将出现二次反应的大鼠随机分成模型组、青蒿琥酯治疗组80mg/(kg·d)、雷公藤多甙组8mg/(kg·d),每组8只;并随机取8只正常 Wistar 大鼠为空白对照组。治疗各组连续灌胃给药14d。于给药第15天测量各组大鼠足爪容积后采血,放射免疫分析法测量大鼠血清中 TNF-α及 IL-1β含量。结果 ：(1)青蒿琥酯对大鼠 AA 有显著的治疗作用。给药第 15天各组造模侧足爪平均肿胀度(%)分别为:模型组177.00±37.5、青蒿琥酯组为68.81±28.19、雷公藤多甙组为66.00±30.78、空白对照组为27.25±4.20;青蒿琥酯组抑制率为61.1%,雷公藤多甙抑制率为63%。在抑制 AA 大鼠造模侧足爪肿胀方面,青蒿琥酯、雷公藤多甙组和空白对照组与模型组比较差异有统计学意义 (p<0.05);青蒿琥酯和雷公藤多甙组比较差异无统计学意义(P>0.05)。各组非造模侧平均肿胀度(%)分别为: 模型组83.25±21.47、青蒿琥酯组为34.50±10.23、雷公藤多甙组为35.974±10.82、空白对照组为28.00±7.76,青蒿琥酯组抑制率为58.6%,雷公藤多甙的抑制率为56.8%。在抑制 AA 大鼠非造模侧足爪肿胀方面,青蒿琥酯、雷公藤多甙和空白对照组与模型组比较差异有统计学意义(p<0.05);青蒿琥酯和雷公藤多甙组比较差异无统计学意义(p>0.05)。（2）放射免疫分析法检测大鼠血清 TNF-α、IL-1β含量(χ±S,ng/mL)分别为: 模型组8.762±34、0.10±0.03,空白对照组5.40±1.15、0.05±0.01,青蒿琥酯组5.79±1.56、0.06±0.01,雷公藤多甙组6.16±0.945、0.058±0.015。青蒿琥酯、雷公多甙和空白对照组与模型比较差异有统计学意义(p<0.05);青蒿琥酯组与雷公多甙组比较差异无统计学意义(p>0.05),且该二组与空白对照组比较亦差异无统计学意义 (p>0.05)。结论：青蒿琥酯对大鼠 AA 具有良好治疗作用,作用机制与其下调 AA 大鼠外周血 TNF- α、IL-1β水平有关。     

丹参与雷公藤多甙联合治疗急性坏死性胰腺炎的实验研究

目的　探讨丹参与雷公藤多甙联合应用对急性坏死性胰腺炎 (acutenecrotizingpancreatitis,ANP)的治疗作用。 方法　采用单次过量 2 0 %L 精氨酸 (10 0 0mg/ 10 0g大鼠体重 )皮下注射建立ANP动物模型。测定血清淀粉酶、TNF α、IL 1β水平 ,并观察胰腺组织的病理变化。根据血清淀粉酶、TNF α、IL 1β水平及胰腺组织的变化来评价胰腺炎的严重程度。 结果　大鼠皮下注射过量L 精氨酸后 ,血清淀粉酶、TNF α、IL 1β水平升高 ,胰腺变性坏死。丹参与雷公藤多甙联合治疗ANP ,可显著降低血清淀粉酶、抑制炎症细胞因子的过度生成 ,组织受损程度明显减轻。结论　丹参与雷公藤多甙联合应用对ANP动物模型具有很好治疗效果 ,可能具有临床应用价值     

牛膝醇提物对佐剂性关节炎模型大鼠滑膜病理的影响

目的观察牛膝醇提物（alcohol extractive of Achyranthis Bidentatae，AEAB）对佐剂性关节炎（Adjuvant Arthritis，AA）大鼠的治疗作用及对关节滑膜病理的影响。方法20只大鼠随机分为正常对照组、AA模型组、雷公藤多甙（Tripterygium Wilfordii Hook F，TWH）治疗组和AEAB治疗组。除正常组外，用氟氏完全佐剂（Freund＇s Complete Adjuvant，FCA）0.2ml诱发关节炎，以TWH为阳性对照药，用AEAB灌胃治疗，观察各组大鼠足跖关节肿胀度、关节炎症指数（AI）及滑膜病理变化。结果TWH和AEAB治疗组关节肿胀度、AI均低于模型组；滑膜病理学较模型组明显改善。结论AEAB能显著减轻AA大鼠关节肿胀，降低AI，能有效抑制关节滑膜增生。     

高三尖杉酯碱对大鼠佐剂性关节炎SP及IL-1β、TNF-α影响的实验研究

[目的]观察高三尖杉酯碱对大鼠佐剂性关节炎模型(AA)的作用.[方法]采用大鼠佐剂性关节炎模型,以雷公藤多甙作为阳性药物对照,观察高三尖杉酯碱对大鼠佐剂性关节炎模型SP及IL-1β、TNF-α的影响.[结果]经高三尖杉酯碱,雷公藤多甙干预后,AA大鼠血清与滑膜中TNF-α、IL-1β含量,以及血浆,滑膜中SP含量均明显下降.[结论]高三尖杉酯碱有与雷公藤多甙相类似的抗炎作用,可能是通过明显抑制AA大鼠血清与滑膜中TNF-α、IL-1β含量,以及血浆、滑膜中SP含量的分泌和释放,起到治疗AA大鼠关节炎作用的.     

痹速清合剂对佐剂性关节炎大鼠血清细胞因子水平的影响

目的 :观察痹速清合剂对佐剂性关节炎的治疗作用及对细胞因子系列 (IL 1β、TNF α、IL 4、IL 10 )的影响。方法 :将 4 0只雄性Wistar大鼠随机分为正常对照组、模型对照组、消炎痛治疗组及痹速清合剂治疗组 ,采用佐剂性关节炎 (AA)大鼠模型 ,观察各组对AA大鼠足肿胀、血清细胞因子含量及体重的影响。结果 :痹速清合剂与消炎痛均能显著抑制AA大鼠原发性及继发性关节肿胀 ,显著降低AA大鼠血清IL 1β、TNF α水平 ,升高IL 4、IL 10水平。在降低IL 1β、TNF α水平 ,增加AA大鼠体重方面作用优于消炎痛 (P <0 .0 5 )。结论 :痹速清合剂对佐剂性关节炎大鼠有明显的治疗作用 ,其作用机制可能是通过下调致炎因子 (IL 1β、TNF α)水平、上调抗炎因子 (IL 4、IL 10 )水平、抑制致炎效应、增强抗炎效应而实现的。     

苗药方四大血对佐剂性类风湿关节炎大鼠TNF-α及IL-1β表达的影响

目的：研究苗药方四大血对佐剂型类风湿关节炎大鼠（AA）的作用及其机制。方法：建立类风湿性关节炎的动物模型——AA;将大鼠分成空白对照组及AA模型对照组（均采用生理盐水灌胃治疗）、四大血高、中、低剂量治疗组（生药浓度：40g／kg、20g／kg、lOg／kg）和阳性治疗对照组（40mg／kg雷公藤多甙片）。观察各组大鼠左、右足跖外观变化,测量各组原发侧足跖肿胀度,ELISA检测各组血清中炎性因子白细胞介素-1β（IL-1β）、肿瘤坏死因子α（TNF-α）表达水平。结果：与AA模型对照组相比,四大血高、中剂量治疗组及阳性治疗对照组大鼠足肿消散;与AA模型对照组比较,四大血下调了IL-1β、TNF-α的表达。结论：四大血能拮抗AA病情发展,其机制可能其与下调相关炎性因子表达有关。     

益肾清络活血方对佐剂性关节炎大鼠的抗炎作用研究

[目的]研究益肾清络活血方对佐剂性关节炎(adjuvant arthritis,AA)模型大鼠的抗炎作用。[方法]取70只SD大鼠,除正常组10只大鼠外,剩余60只大鼠给予右后足趾皮内注射弗氏完全佐剂复制AA大鼠模型,造模成功后随机分为模型组、雷公藤多苷片组、益肾清络活血方低、中、高剂量组,致炎第12d开始连续每天给药28d。检测并计算各组大鼠给药前、后足跖肿胀度和关节炎指数,于末次给药24h后采用ELISA法检测各组大鼠血清中白细胞介素1β(interleukin-1β,IL-1β)、肿瘤坏死因子α(tumor necrosis factor alpha,TNF-α)水平,Western Blot法检测大鼠踝关节滑膜组织中TNF-α蛋白表达水平。[结果]与模型组比较,给药后益肾清络活血方低、中、高剂量组AA大鼠关节炎指数下降(P0.05),大鼠足跖肿胀度减轻(P0.05),血清中IL-1β、TNF-α水平降低(P0.05),大鼠踝关节滑膜组织中TNF-α蛋白表达水平下调(P0.01)。给药后益肾清络活血方高、中、低剂量组关于降低AA大鼠各炎性指标呈剂量依赖关系。在血清IL-1β、TNF-α水平比较中,益肾清络活血方高、中、低剂量组疗效弱于雷公藤多苷片组(P0.05);在炎症指数、足跖肿胀度与蛋白表达中,益肾清络活血方高剂量组与雷公藤多苷片组疗效相当(P0.05),益肾清络活血方中、低剂量组疗效弱于雷公藤多苷片组(P0.05)。[结论]益肾清络活血方高、中、低剂量组对AA大鼠均有抗炎作用,益肾清络活血方高剂量组对AA大鼠抗炎作用优于益肾清络活血方中、低剂量组,其作用机制可能与抑制炎性因子IL-1β、TNF-α水平及降低关节滑膜组织中TNF-α蛋白表达水平有关。     

黄芪和雷公藤多甙对大鼠肾小球系膜细胞增殖及分泌IL-6影响的比较

[目的]观察比较黄芪和雷公藤多甙对’肾小球系膜细胞增殖及其分泌白细胞介素6(IL-6)水平的影响【方法】应用细胞培养技术进行肾小球系膜细胞培养,采用血清药理学方法,制备黄芪舍药血清、雷公藤多甙含药血清．并分为低、中、高3个剂量梯度(5％、10％、20％),观察含药血清对过度增殖状态下肾小球系膜细胞增殖和分泌IL-6的影响．应用四甲基偶氮唑盐(MTT)法测定系膜细胞增殖,酶标记免疫吸附分析法(ELISA)测定细胞IL-6含量。【结果】黄芪、雷公藤多甙含药血清各剂量组均可抑制大鼠肾小球系膜细胞的增殖,并能抑制肾小球系膜细胞产生IL-6,其抑制作用呈剂量效应关系,其中尤以雷公藤多甙高、中剂量组及黄芪高剂量组作用显著。【结论】在体外培养的肾小球系膜细胞处于过度增殖的状态下．黄芪能抑制肾小球系膜细胞增殖及分泌IL-6,其作用与雷公藤相仿,两药合用可减少雷公藤用量,可能具有增效减毒的作用。     

黄芩甙、地塞米松对大鼠感染性脑水肿细胞因子的影响

目的 :探讨黄芩甙、地塞米松对大鼠感染性脑水肿白细胞介素 1(IL 1β)、肿瘤坏死因子α(TNF α)的影响。方法 :应用大鼠感染性脑水肿模型 ,采用干湿法、原子吸收分光光度法、ELISA测定各组脑组织水含量、钠离子含量及脑匀浆上清液中IL 1β,TNF α水平的变化 ;在光镜下观察各组脑组织的细胞形态学改变。结果 :在大鼠感染性脑水肿(感脑 )组脑水含量、钠离子、IL 1β、TNF α含量均比生理盐水 (对照 )组明显增高 (P <0 .0 1)。在黄芩甙和地塞米松两组则上述指标均下降 ,低于感脑组 (P <0 .0 5 ) ;而两组间各指标比较差异无显著性 (P >0 .0 5 ) ;脑组织水含量与IL 1β ,TNF α含量成正相关 (r分别为 0 9381,0 8349,P <0 .0 1)。对照组脑组织结构正常 ,感脑组织脑组织可见弥漫的灶性水肿区 ;黄芩甙和地塞米松组水肿明显减轻。结论 :黄芩甙、地塞米松对大鼠感染性脑水肿有保护作用 ,效果相近 ;作用机制与抑制IL 1β ,TNF α过度产生有关     

雷公藤多苷对佐剂性关节炎大鼠P 物质表达的影响

目的:探讨雷公藤多苷对佐剂性关节炎(AA)大鼠P物质(SP)的干预作用.方法:以AA大鼠为研究对象,以肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)作为炎症活动的指标,造模成功后,予雷公藤多苷片混悬液灌胃治疗30天,分别在治疗前后用放射免疫法测定各组大鼠血液、滑膜中的TNF-α、IL-1β、SP以及脊髓后角中的SP水平,以观察雷公藤多苷治疗后各组织SP的变化.结果:与正常组比较,模型组大鼠血液和滑膜中的SP、TNF-α、IL-1β和脊髓后角中的SP水平明显增高(P<0.05);与模型组比较,给药30天后,给药组大鼠的右足趾肿胀较模型组减轻(P<0.05),给药组大鼠血液、滑膜中TNF-α、SP及滑膜中IL一1β水平都显著降低(P<0.05),而脊髓后角中SP水平未见明显下降(P>0.05).结论:雷公藤多苷具有抗炎镇痛免疫抑制作用,其作用机制除降低血清和滑膜中的TNF-α、IL一1β水平外,还可能与降低佐剂性关节炎大鼠外周的SP水平有关,但对中枢SP无影响.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.