A型肉毒毒素局部注射治疗原发性头痛80例疗效观察

目的 探讨原发性头痛应用A型肉毒毒素局部注射的疗效和不良反应。方法 对80例原发性头痛患者予颅周肌肉多点注射BTX—A，观察治疗前及治疗后6个月三种原发性头痛的发作情况及疗效持续时间。结果治疗后各时段头痛发作严重程度均较治疗前明显下降（P〈0．01），各时段内相比，无明显差异性（P〉0．05）。治疗后第6个月时，三种原发性头痛的疗效无差异性（P〉0．05）。结论 BTX—A治疗原发性头痛疗效显著，不良反应短暂、轻微。治疗剂量及注射位点应个体化，值得临床进一步研究。     

A型肉毒毒素注射联合功能训练对痉挛型脑瘫患儿运动能力的影响

目的研究A型肉毒毒素注射联合功能训练对痉挛型脑瘫患儿运动能力的影响。方法选取2014年1月-2015年1月该院收治的痉挛型脑瘫患儿120例为研究对象,按照随机数字表法将患者分为研究组和对照组,每组60例,对照组给予功能训练,研究组在对照组的基础上给予A型肉毒毒素注射治疗,比较治疗前后2周、1个月、3个月以及6个月应用综合痉挛量表(CSS)评分和粗大运动功能量表(GMFM)评分。结果研究组治疗2周后CSS评分开始降低,对照组治疗1个月后CSS评分开始降低,研究组治疗后与治疗前比较差异均有统计学意义(均P0.05);两组治疗2周、1个月、3个月及6个月CSS评分比较,差异有统计学意义(P0.05)。研究组治疗1个月后GMFM评分显著升高,对照组治疗6个月后GMFM评分显著提高,研究组治疗后与治疗前比较差异均有统计学意义(均P0.05),两组治疗1个月、3个月及6个月GMFM评分比较差异均有统计学意义(均P0.05)。结论 A型肉毒毒素注射联合功能训练治疗痉挛型脑瘫患儿能有效缓解肢体痉挛,提高患儿粗大运动能力。     

A型肉毒毒素联合红外偏振光治疗带状疱疹后遗神经痛的临床观察

目的观察A型肉毒毒素联合红外偏振光治疗带状疱疹后遗神经痛的临床疗效。方法选取87例带状疱疹后神经痛患者,采用随机数字表法分为3组。红外偏振光治疗组（A组）运用红外偏振光治疗仪照射治疗带状疱疹后神经痛,肉毒素治疗组（B组）应用A型肉毒毒素进行疼痛点皮下注射治疗疱疹后神经痛,联合治疗组（C组）同时应用红外偏振光治疗仪照射患部和肉毒素疼痛点皮下注射治疗带状疱疹后神经痛,调查每例带状疱疹后神经痛患者治疗前3个月、治疗后1个月、治疗后3个月、治疗后6个月带状疱疹后神经痛发作情况,并行简式McGill疼痛问卷表及生活质量评价量表评分,比较带状疱疹后神经痛发作严重程度及其带状疱疹后神经痛恢复状况,观察不良反应。结果A组、B组与C组治疗后1个月、治疗后3个月、治疗后6个月简式McGill疼痛问卷表评分显著低于治疗前评分（P〈0．01）,生活质量评价量表评分显著高于治疗前评分（P〈0．01）,差异均有统计学意义。C组在治疗后1个月、治疗后3个月、治疗后6个月,SF-MPQ及SF-36评分分别与A组、B组治疗后1个月、治疗后3个月、治疗后6个月相应评分比较差异有统计意义（P〈0．01）。结论A型肉毒毒素疼痛点皮下注射联合红外偏振光治疗带状疱疹后神经痛发作临床疗效显著,不良反应轻微。     

A型肉毒毒素注射在临床脑卒中偏瘫患者中的临床应用及疗效评价

目的通过对脑卒中偏瘫患者给予A型肉毒毒素注射屈肘肌与肩后伸肌群并进行康复训练,观察该治疗对中风偏瘫患者上肢功能的影响,探究A型肉毒毒素部位联合注射对改善脑卒中患者上肢功能的效果及临床治疗意义。方法选取2016年8月15日-2018年5月15日期间我院康复医学科收治的脑卒中偏瘫患者98例,按入院时间顺序分为两组,对照组(46例)给予单纯屈肘肌A型肉毒毒素注射,观察组(52例)在对照组治疗基础上另给予肩后伸肌群肉毒素注射。两组患者注射后均进行物理康复训练。在治疗1、2、3个月时进行改良Ashworth痉挛量表评分、Fugl-Meyer上肢运动功能评分及Barthel指数评分综合分析患者痉挛及运动状态,综合评价A型肉毒毒素的治疗效果及两种注射方式的临床疗效。结果两组患者在治疗1、2、3个月时Ashworth评分均显著降低,且观察组患者各时间点Ashworth评分均低于对照组;两组患者治疗后Fugl-Meyer评分显著增加,且在治疗3个月时观察组患者Fugl-Meyer量表评分显著高于对照组;两组患者治疗后日常生活能力Barthel评分均显著增加,在治疗3个月时观察组Barthel评分显著高于对照组,显示出良好的预后。结论 A型肉毒毒素可显著缓解脑卒中偏瘫患者的肌肉痉挛状态,提高患者日常生活能力,且屈肘肌与肩后伸肌群联合注射较单独屈肘肌注射表现出更好的临床疗效。     

长期家庭无创辅助通气对稳定期慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的疗效分析

目的 探讨长期家庭无创辅助通气对稳定期慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者的治疗效果.方法 确诊稳定期COPD合并Ⅱ型呼吸衰竭患者共78例,按患者意愿分为治疗组26例和对照组52例,对照组予以常规治疗,包括吸入沙美特罗/氟替卡松+长期家庭氧疗(LTOT);治疗组在常规治疗基础上加用无创辅助通气治疗,每日6～8h,疗程12个月,观察两组血气分析指标[pH值、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)]、肺功能指标[第1秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1％)]、6 min步行试验(6-MWT)距离、圣乔治呼吸问卷(SGRQ)评分及急性发作住院次数.结果 随访12个月,治疗组无一例因急性发作行气管插管,无一例死亡.对照组有5例因急性发作行气管插管、有创机械通气,其中1例死亡.治疗后两组肺功能指标(FEV1、FEV1％)较治疗前均有改善(P＜0.05).但治疗组治疗后FEV1、FEV1％显著高于同期对照组(P＜0.05).治疗组治疗后血气分析指标(pH值、PaCO2、PaO2)较治疗前显著改善(P＜0.05).对照组治疗后PaO2较治疗前显著改善(P＜0.05),但对照组治疗后pH值、PaCO2与治疗前比较差异无统计学意义(P＞0.05).两组患者治疗后6-MWT距离、SGRQ评分较治疗前均有改善,差异有统计学意义(P＜0.05),治疗组治疗后6-MWT距离显著高于同期对照组、SGRQ评分显著低于同期对照组,差异均有统计学意义(P＜0.05).随访12个月,治疗组平均每人急性发作次数(0.84±0.16)次,对照组(1.49±0.78)次,差异有统计学意义(t=-3.65,P＜0.05).结论 家庭无创辅助通气治疗可以改善稳定期COPD合并Ⅱ型呼吸衰竭患者的肺功能、血气分析,增加运动耐量,提高生活质量,减少急性发作次数及插管率.     

贲门失弛缓症内镜下治疗的探讨

目的 探讨内镜下治疗贲门失弛缓症的方法,并观察其疗效.方法 选取60例贲门失弛缓症患者,按随机数字表法分成单纯扩张组、单纯肉毒杆菌毒素注射组和扩张联合肉毒杆菌毒素注射组,每组20例,术后定期观察患者病情的缓解情况及并发症.结果 三组患者治疗后吞咽困难、胸痛、呕吐较前缓解,单纯扩张组有17例疗效明显,单纯肉毒杆菌毒素注射组有15例疗效明显,扩张联合肉毒杆菌毒素注射组20例疗效均显著.结论 内镜下扩张联合肉毒杆菌毒素注射治疗贲门失弛缓症疗效优于单纯扩张和单纯肉毒杆菌毒素注射治疗,值得在临床中推广.     

肌电图神经传导速度测定对A型肉毒毒素注射治疗面肌痉挛疗效判定的研究

目的 以肌电图神经传导速度测定作为客观评价指标,评定面肌痉挛患者面神经受损的程度、部位及A型肉毒毒素注射治疗后的恢复情况.方法 68例面肌痉挛患者随机分为A型肉毒毒素治疗组(34例)和传统治疗组(34例);分别于治疗前,治疗后1周、1个月、3个月进行肌电图神经传导速度测定.结果 A型肉毒毒素治疗组治疗后1周、1个月、3个月完全缓解率明显高于传统治疗组(P<0.01).治疗后3个月A型肉毒毒素治疗组34例患者自发放电均消失,仅有5例遗留有动作电位波幅降低,潜伏期延长.而传统治疗组中只有5例自发放电消失.结论 A型肉毒毒素早期治疗面肌痉挛,并以肌电图神经传导速度作为测定指标,使面肌痉挛从诊断到治疗形成一个完整体系,明显提高疗效,且无明显不良反应.     

超声定位引导A型肉毒毒素注射联合常规康复训练治疗痉挛型脑瘫儿童下肢肌张力障碍的疗效观察

目的 观察超声定位引导A型肉毒毒素(BTX-A)注射联合常规康复训练治疗痉挛型脑瘫儿童下肢肌张力障碍的疗效,为临床康复治疗提供依据。方法 选择2014年9月-2015年8月于安徽省儿童医院康复科住院治疗的双下肢痉挛的脑瘫患儿42例作为研究对象,随机分为对照组(21例)和治疗组(21例),对照组给予常规康复训练(运动疗法+物理治疗),治疗组在超声定位引导下予BTX-A注射,次日行常规康复训练。所有患儿分别在治疗前及治疗1、3、6个月采用改良Ashworth修正量表(MAS)和粗大运动功能量表(GMFM)行双下肢肌肉痉挛程度和粗大运动功能的评价。结果 两组在治疗1、3、6个月后MAS及GMFM评分均优于治疗前(P<0.05);同时间点治疗组痉挛程度的缓解及运动功能的提高均较对照组明显改善(P<0.05);治疗组MAS评分在3个月与6个月比较差异无统计学意义(P＞0.05),BTX-A疗效有一定的时限性。结论 运用超声定位引导BTX-A注射治疗痉挛型脑瘫患儿能更好的缓解其双下肢痉挛性肌群的肌张力,改善其运动功能。     

丹珍头痛胶囊合盐酸氟桂利嗪胶囊治疗偏头痛的效果分析

目的:本文探讨丹珍头痛胶囊联合盐酸氟桂利嗪胶囊治疗偏头痛的临床效果.方法:选择我院2015年01月至2016年12月期间收治的68例偏头痛患者,按照随机数字表法分组,观察组(n=34)与对照组(n=34),我院予以对照组盐酸氟桂利嗪胶囊治疗,予以观察组丹珍头痛胶囊治疗,治疗疗程后对比2组患者的偏头痛积分、发作次数与持续时间以及治疗总有效率.结果观察组治疗总有效率为94.12％高于对照组82.36％,P＜0.05.观察组偏头痛积分、发作次数与持续时间等指标均优于对照组,P＜ 0.05.结论:针对于偏头痛患者采用丹珍头痛胶囊治疗,能改善临床治疗效果,促进患者恢复健康.     

氟替卡松/沙美特罗复合制剂治疗中度持续支气管哮喘临床疗效观察

[目的]探讨中度持续支气管哮喘患者使用氟替卡松/沙美特罗复合干粉吸入剂的临床疗效和安全性.[方法]对60例中度持续支气管哮喘患者随机分为治疗组和对照组,治疗组采用氟替卡松/沙美特罗复合干粉吸入剂(舒利迭)(英国葛兰素威康公司生产),250/50μg,1吸/次,2次/d;对照组采用BDP(必可酮)(英国葛兰素威康公司生产)吸入剂,250μg,2吸/次,2次/d.所有患者按需加用SABA(特布他林).治疗3个月、6个月根据GINA标准已达完全控制后两组患者均开始减量,用最小治疗置维持,治疗1个月、3个月和6个月观察日间症状、夜间症状、SABA使用次数、肺功能及不良反应,1年内因哮喘急性发作再次住院率.[结果]第1个月两组日间症状及夜间症状无明显差异,P值>0.05;第3个月、第6个月治疗组日间症状及夜问症状均较对照组减少,两组比较其P值均<0.05;1年内因哮喘急性发作而再次住院率;治疗组较对照组低,P值<0.05;治疗组按需使用特布他林的次数均较对照组减少,P值<0.05;治疗6个月后肺功能改善率:FEV1实测值/预计值%及FEV1/FVC治疗组:均较对照组提高,P值<0.05.治疗组无1例发生不良反应,对照组4例口咽真菌感染,6例有不同程度的声音嘶哑、口干.[结论]绝大多数中度持续哮喘患者使用氟替卡松/沙美特罗复合干粉吸入剂治疗即可达到满意的疗效,且安全性高,可提高患者使用的方便程度和依从性,不良反应少.     

缬沙坦/氨氯地平和依贝沙坦/双氢克尿噻联合治疗老龄高血压疗效的研究

Objective To compare the clinical effect of valsartan/amlodipine combination or irbesartan/hydrochlorothiazide(HCTZ)combination in very elderly hypertensives.Methods After a 4-week placebo period,94 hypertensives,aged 75-89 years were random given valsartan 160 mg/amlodipine 5 mg or irbesartan 300 mg/HCTZ 12.5 mg for 24 weeks according to a rospective study.After 4 weeks,amlodipine or HCTZ was doubled in non-responders.Patients were checked every 4 weeks.At each visit,sitting,lying and standing blood pressure(BP),systolic BP(SBP)and diastolic BP(DBP)were measured. At the end of placebo period and treatment period,electrolytes and uric acid were evaluated.Results Blood pressure was significantly decreased in both treatment groups,however,there was no statistical significance between two groups.BP changes from lying to standing position were significantly greater in the irbosartan/HCTZ group(-17.2/-9.1 mmHg)than that in the valsartan/amlodipine group(-10.1/-1.9 mmHg,t=2.14,P＜0.05 for SBP and t=3.11,P＜0.01 for DBP vs.irbesartan/HCTZ).Potassium significantly decreased and uric acid significantly increased(-0.4 mmol/L,t = 2.33,P＜ 0.05 and+29.7μ mol/L,t =2.54,P＜0.05 vs.baseline,respectively)only in the irbesartan/HCTZ group.Conclusions Both combinations had similarly effective in reducing clinical BP in very elderly hypertensives.However,valsartan/amlodipine offered some advantage and less pronounced BP orthostatic changes and absence of metabolic adverse effects.     

乙酰半胱氨酸对肥胖哮喘小鼠气道炎症和重建的作用

目的探讨乙酰半胱氨酸对哮喘气道炎症和重建的影响。方法60只雌性C57／6J小鼠按随机数字表法分为哮喘组（A组）,肥胖哮喘组（B组）,治疗组（C组）,对照组（D组）,每组15只。经腹腔注射与雾化吸入卵蛋白（OVA）制作慢性哮喘模型,高脂饮食制造肥胖模型。计数支气管肺泡灌洗液（BALF）中细胞总数及分类,ELISA法测定肺组织匀浆中IL-6和8-异前列腺素F2α（8-iso-PGF2α）水平,肺组织切片观察各组小鼠病理变化,并测定气管壁面积（WAt）、气管平滑肌面积（WAm）、管腔基底膜周长（Pbm）。结果,A组、B组小鼠BALF中白细胞总数及嗜酸性粒细胞比例、肺组织IL-6水以及病理切片中气管壁厚度（WAt／Pbm）、气管平滑肌厚度（WAm／Pbm）均较D组明显增加,且B组IL-6和WAt／Pbm较A组进一步增加（P〈0．05）。C组小鼠BALF中白细胞总数、IL-6和WAt／Pbm均较B组明显下降（P〈0．05）。四组小鼠肺组织匀浆8-iso—PGF2α水平按D组、C组、A组、B组依次升高,各组差异有统计学意义（F=101．8,P〈0．01）。Pearson相关分析表明,8-iso—PGF2α水平与肺组织IL-6水平和WAt／Pbm和呈正相关（r=0．817、0．737,P〈0．01）。结论乙酰半胱氨酸能够通过抑制氧化应激反应,抑制哮喘小鼠的气道炎症和气道重建。     

脂多糖对人皮肤成纤维细胞胶原代谢的影响

目的探讨脂多糖（1ipopolysaccharide,LPS）对人皮肤成纤维细胞胶原代谢的影响,以了解LPS在增生性瘢痕形成中的生物学作用。方法取正常皮肤行成纤维细胞培养后,分为1个对照组及6个实验组。实验组分别与终浓度为0．005、0．010、0．050、0．100、0．500和1．000μg／ml大肠杆菌LPS（Ecoli055：B5）培养,对照组DMEM培养。用逆转录-聚合酶链反应（RT-PCR）法测定成纤维细胞Ⅰ、Ⅲ型前胶原mRNA及胶原酶mRNA的表达,并以同一个体相同代数的瘢痕组织成纤维细胞做对照。结果与对照组比较,LPS刺激浓度在0．005-0．1μg／ml时,促进正常皮肤成纤维细胞Ⅰ、Ⅲ型前胶原mRNA表达（0．323±0．041,0．303±0．063,0．391±0．071,0．344±0．086,0．488±0．059,0．401±0．087,0．616±0．107,0．434±0．084,0．823±0．092,0．542±0．082）,抑制胶原酶mR-NA表达（0．598±0．068,0．556±0．049,0．441±0．043,0．372±0．083,0．260±0．027）,且呈一定的剂量依赖性;当LPS刺激浓度为0．5μ／ml,上述作用下降（0．451±0．063,0．374±0．072,0．360±0．062）;而当LPS刺激浓度到达1．0μg/ml时,抑制正常皮肤成纤维细胞Ⅰ、Ⅲ型前胶原mRNA表达（0．162±0．025,0．171±0．061）,促进胶原酶mRNA表达（0．444±0．114）。LPS刺激浓度在0．1μg／ml时,成纤维细胞（0．823±0．092,0．542±0．082,0．260±0．027）Ⅰ、Ⅲ型前胶原mRNA和胶原酶mRNA表达与同一个体增生性瘢痕组织成纤维细胞（0．829±0．049,0．569±0．038,0．277±0．059）近似。结论LPS对人皮肤成纤维细胞Ⅰ、Ⅲ型前胶原mRNA和胶原酶mRNA的表达,其直接调节可能是参与增生性瘢痕形成的重要机制。     

异丙酚对大鼠肺缺血/再灌注损伤的保护作用

Objective To study the protective effects of propofol against ischemia/reperfusion injury in rat lung. Methods Rat model of pulmonary ischemia/reperfusion injury was used in this study. Rats were randomly divided into three groups, including sham opera-tion group (group A), iachemia/reperfusion group (group B) and propofol group (group C), 15 rats in each group. The concentration of tumor necrosis factor -α and interleukin-6 in bronchoalveolar lavage fluid (BALF) were measured by enzyme linked immunosorbent assay (ELISA). Then blood gas analysis, lung wet/dry (W/D) weight ratio were detected in each group. Results Propofol could significantly improve PaO2, reduce the W/D value and the contents of TNF-α and IL-6 in BALF. Conclusion Propofol effectively suppressed the pro-duction and release of inflammatory cytokine, therefore it can protect the lung from isehemia/reperfusion injury.     

降钙素对大白兔糖尿病骨质疏松模型假体骨密度及生物力学的影响

Objective To investigate the influence of calcitonin on bone mineral density and biomechanics around the artificial pros-thesis in ovariectomized diabetic rabbit model. Methods Fourteen femina New Zealand white rabbits at the age of 5 months old were select-ed, which weight 2.24 -2.65kg, averaging 2.26kg. First, the model of rabbit with diabetic osteoporosis was successfully established by the compound method of ovariectomy plus streptozotocin. Osteotomy in the middle part of femur was performed in both groups, fixation of artifi-cial prosthesis was done with 3.0 kirschner wire. After that, Rabbit models with diabetic osteoporosis were randomly divided into experimen-tal group and control group. Rabbits in the experimental group were treated with calcitonin 6U intramuscular injection once every other day. In control group, intramuscular injection of normal saline solution 1.5ml once every three days. Rabbit models of two groups were sacrificed in the 24th week. The BMD of the region of interest (ROI) around the prosthesis were detected before experiment and 8, 16 and 24 weeks after injection. After rabbits were killed, experimental femurs in both groups were complete removal and soft tissues were rejected. Determi-nation of the pull-out and torsion bone biomechanics experiments of prosthesis was done in both groups respectively. Results The BMD of ROI in the experimental group before operation was (0.1863±0.004)g/cm2 and (0.1753±0.005)g/cm2 in 24 weeks after operation, in control group before operation was (0.1865±0.002)g/cm2 and (0.1638±0.005)g/cm2 in 24 weeks after operation. There were significant difference between the two groups(P < 0.05). Biomechanical show that the pull-out strength in the experimental group was (312.68±8.73 )N/cm2 and (205.43±12.45 ) N/cm2 in control group. There were significant difference between the two groups(P < 0.05). The tor-sion strength in experimental group was (80.47±2.51) N/cm2 and (38.52±0.64) N/cm2 in control group. There were significant differ-ence between the two groups(P < 0.05). Conclusion Salmon calcitonin can reduce the bone turnover rate around prosthesis and decrease bone absorption in the rabbit of diabetic osteoporosis models, accelerate the bone formation around prosthesis, and increase the BMD. It can ameliorate the quality of bone around prosthesis, improve its biomechanics property, and increase the holding power between prosthesis and body mass. It is of clinical significance for the prevention and treatment of aseptic loosening artificial prosthesis.     

蝶鞍结构与垂体瘤生长方式关系的影像学研究

目的 从影像学角度探讨蝶鞍相关解剖对垂体腺瘤生长方式的潜在影响.方法 按照常用蝶窦分类方法,共收集83例蝶窦气化类型为全鞍型和20例鞍前型正常头颅的影像学资料;同时收集45例影像学提示为侵入蝶窦生长的垂体腺瘤临床资料进行分析.结果 （1）正常鞍底形态与蝶窦气化程度的关系：全鞍型蝶窦更易导致凹陷型鞍底（98.8%）.（2）正常鞍底形态与垂体上缘形态的关系：凹陷型垂体上缘更易伴随凹陷型鞍底（93.8%）.（3）根据正常头颅正中矢状位鞍窝骨性上口前后径与鞍窝前后最大径之间的关系,对蝶鞍形态提出初步分型：囊袋型、炒锅型、直筒型及筛型.（4）所有向蝶窦生长的垂体腺瘤患者蝶窦均为全鞍型.结论 鞍底形态、蝶窦气化程度及蝶鞍形态等综合因素能够解释垂体腺瘤向鞍底蝶窦生长的现象;结合文献,蝶鞍的相关形态学基础应该是影响垂体腺瘤生长方式的主要因素.     

强直性脊柱炎合并骨质疏松的临床研究

Objective To investigate the incidence of osteoporosis (OP) in patients with ankylosing spondylitis and the relationship between OP and the clinical data. Methods Serum levels of bone alkaline phosphatase (BALP) and tartrate resistant acid phosphatase 5b (TRACP5b) were detected by enzyme linked immunosorbent assay ( ELISA ) in 60 cases with ankylosing spondylitis, and it was compared with normal controls. Bone mineral density (BMD) was measured through dual-energy X-ray absorptiometry ( DXA), including lumbar ( L2 - L4), bilateral femoral neck and greater trochanter. Some clinical data was collected and analyzed at the same time. Results The incidence of OP in AS patients was 35%, and the incidence of OP in the femoral proximal end was higher than that in lumbar. Compared with normal controls[ ( 1.06 ±0. 18 )U/L ], the levels of serum TRACP5b in AS[ (1.31 ± 0. 82 )U/L] patients was significantly higher ( P <0. 05 ). The levels of serum BLAP in OP combined AS group[ ( 21.65 ± 5.41 ) U/L]were significantly lower than non-OP group[ (32. 37 ± 16. 5 ) U/L] ( P <0. 05 ). The disease duration was negatively correlated with the BMD of femoral neck ( P < 0. 01 ). Conclusions There was higher incidence of OP in AS patients, which were related with the abnormality of bone metabolism and the disease duration.Multiple factors participated in the regulation of bone metabolism of AS.     

关节腔内注射洛伐他汀预防骨关节炎软骨退变

目的 研究洛伐他汀关节腔内注射对骨关节炎(OA)模型关节软骨退变及对基质金属蛋白酶(matrix metalloprotein-ase-1,3)mRNA表达的影响.方法 30只6个月龄新西兰大白兔行右膝关节前交叉韧带切断术.手术后将动物随机分为实验组和对照组,实验组术后立即给予关节腔内注射0.5 mg/ml洛伐他汀0.2 ml/kg,每周1次,连续6周;对照组则关节腔内注射等容量的生理盐水.术后6周处死动物.在解剖镜下观察股骨内髁关节软骨的大体形态学改变并评分.用反转录-聚合酶链式反应检测软骨及滑膜中MMP-1,3 mRNA的表达.结果 解剖镜下实验组软骨退变程度较对照组明显减轻;实验组关节液中IL-1水平较对照组明显降低;实验组滑膜中MMP-1,3 mRNA的表达水平显著低于对照组(P<0.05),而软骨中的MMP-1,3 mRNA的表达较对照组差异无统计学意义(P>0.05).结论 在OA早期关节腔内注射L洛伐他汀能够明显降低MMP-1,3 mRNA的表达,减轻骨关节炎软骨的退变.     

利尿剂在三聚氰胺及三聚氰酸致大鼠急性肾损伤中的治疗作用

Objective To investigate the effect of diuretic (furosemide) therapy on kidney injury induced by melamine and cyanuric acid in rats. Methods 36 male Spragne Dawley rats were random disided into 3 groups. Group A was treated with 2mL of water daily, group B was treated with melamine and cyanuric acid ( each 100 mg/kg) daily for 4 days and then 2ml of water daily, group C was treated with the same as group B at the first 4 days and then treatment with furosemide (20mg/kg) daily. Samples of blood and 24h urine were collected to detective biochemical indexes, and kidney sections were performed on days 4 and 11 ( each end point, n = 6). The kidneys were observed with histopathology and renal crystal deposition scores were determined. Results On the 4th day, group B and group C were resulted in acute kidney injury such as oliguria [ ( 3. 39 ± 1.02 ) ml, ( 3. 20 ± 0. 86 ) ml ] and high serum creatinine [ ( 153.54 ±27. 08)μmol/L, (160. 11 ± 19. 55)μmol/L] and renal melamine cyanurate crystal were found in the renal tissues. On the 11th day, the renal crystal deposition score in the rats was reduced by 9. 52% ( P >0. 05). Compared with those of the 4th day in group B, it reduced by 63.63%( P <0.05) in group C. Urine volume were increased significantly compared with those of the 4th day( P < 0. 05 ) in group C [ from (3.20±0. 86)ml to (25.96 ±5.97)ml] and group B [ from(3. 39 ± 1.02)ml to (8. 57 ± 1.66)ml] , and Urine volume in group C was increased significantly more than that in group B ( P < 0. 05 ). The serum creatinine was obviously reduced as compared with those of the 4th day in group B and C( P <0.05), from[ (153. 54±27.08) μmol/L] to [ ( 106. 10 ±5.53) μmol/L] in group B and from [ ( 160. 11 ± 19. 55) μmol/L] to [ (67. 17 ± 12. 80 ) μmol/L] in group C, but the serum creatinine in group B was still higher than that in group A and C ( P < 0. 05). Conclusions Furosemide can attenuate the damage of acute kidney injury induced by melamine and cyanuric acid.     

脓毒症血清对大鼠小肠微血管内皮细胞ICAM-1的影响及肾上腺髓质素的干预作用

Objective To observe the levels of intercellar adhesion molecule-1(ICAM-1)of rat intestinal mucosa microvascular endothelial cells in sepsis rat,and to investigate the possible protective effect of adrenomedullin on the expression of intercellar adhesion molecule-1(ICAM-1)of rat intestinal mucosa microvascular endothelial cells,and to confirm whether adrenomedullin can decrease released inflammatory factors to slow down or inhibit the occurrence and development of sepsis.Methods The rat intestinal mucosa microvascular endothelial cells were isolated and cultured in vitro,and it was divided into sham operated(sham operated serum),sepsis serum(with addition of sepsis serum)and ADM serum(with 0.lng/kg adrenomedullin 6h after sepsis treatment)groups.The soluble ICAM-1(sICAM-1)content in RIMMVECs culture supernatant was measured by ELISA at the 24th hour after serum stimulation.Results The ICAM-1 content in the supernatant of sepsis group [(0.33 ±0.04)ng/L] was obviously higher than that in sham operated [(0.15 ± 0.02)ng/L] and ADM [(0.17 ± 0.04)ng/L] group(P ＜ 0.05),but ADM group was no significantly different compared with sham operated group(P ＞ 0.05).Conclusions ADM could decrease the expression of ICAM-I in RIMMVECs,and the low level of ICAM-1 could suppress its downstream inflammation factors and inhibit the occurrence and development of sepsis.