补阳还五汤作用机制研究进展

补阳还五汤是治疗气虚血瘀证的代表方剂,且越来越广泛地被应用于心脑血管等各系统疾病。从改善血液流变学、抗血栓形成、抗动脉粥样硬化、抗脑缺血及再灌注损伤等方面来阐述补阳还五汤在心脑血管疾病中的作用机制。     

补阳还五汤对动脉粥样硬化大鼠模型血脂的影响

目的利用高脂饲料加维生素D3诱发的动脉粥样硬化(AS)模型,观察益气活血代表方剂补阳还五汤对AS模型血脂的影响,探讨其治疗作用及可能机制。方法大鼠动脉粥样硬化造模成功后,随机分为4组。补阳还五汤治疗组:造模成功后给予补阳还五汤17.5g/(kg·d)灌胃;川芎嗪治疗组:造模成功后给予川芎嗪0.2g/(kg·d)灌胃;正常对照组一直饲喂普通饲料;模型组造模成功后改喂普通饲料。灌胃30d。用药一月后测定血脂水平。结果高脂饮食加维生素D3可诱导大鼠形成动脉粥样硬化模型,模型组的血脂明显高于正常组。补阳还五汤治疗组的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)水平均显著低于川芎嗪治疗组、模型组。结论益气活血的代表方剂补阳还五汤具有抗动脉粥样硬化作用,下调血脂水平可能是其作用机制之一。     

补阳还五汤对脑损伤大鼠脑组织凋亡信号通路的影响

目的探究补阳还五汤对脑出血大鼠脑组织PI3K/AKT信号转导通路的影响及可能机制。方法 SD大鼠随机分为假手术组、模型组、补阳还五汤组、银杏叶片组,其中模型组、补阳还五汤组、银杏叶片组采用Rosenberg法复制脑出血大鼠模型。免疫组化法检测PI3K、AKT、Bcl-2、BAX蛋白的表达,TUNEL法检测细胞凋亡变化,干湿重法检测脑组织水含量,甲酰胺法检测血脑屏障(BBB)通透性。结果与模型组比较,补阳还五汤组、银杏叶片组PI3K、AKT蛋白表达、Bcl-2/BAX值均显著增高(P0.05),脑组织含水量、伊文思蓝含量、细胞凋亡数量显著降低(P0.05)。结论补阳还五汤对脑出血的保护作用机制可能是其不但降低了BBB通透性,而且激活了PI3K/AKT信号通路,介导Bcl-2、BAX蛋白表达变化,调节二者之间的比值。     

补阳还五汤抗家兔动脉粥样硬化形成及机制

为了观察补阳还五汤抗动脉粥样硬化的作用及机制 ,给予家兔高脂饮食和补阳还五汤 ,用组织学方法观察动脉壁病理形态学改变 ,并测定血清中总胆固醇、甘油三酯、内皮素、一氧化氮及FⅦ促凝活性水平。结果显示 ,与高脂组相比 ,补阳还五汤组血清总胆固醇和甘油三酯明显降低 (P <0 .0 1) ;血浆FⅦ促凝活性和一氧化氮水平明显降低 (P <0 .0 1) ;主动脉、腹主动脉和冠状动脉粥样斑块面积显著减少 (P <0 .0 1)。提示补阳还五汤具有抗动脉粥样硬化形成的作用 ,其机制可能与降低血脂和FⅦ促凝活性有关     

补阳还五汤对动脉粥样硬化大鼠细胞间黏附分子-1表达的影响

目的研究补阳还五汤对动脉粥样硬化(AS)大鼠细胞间黏附分子-1(ICAM-1)表达的影响。方法采用高胆固醇饲料喂饲建立大鼠AS模型并予补阳还五汤干预。测定各组内膜增生情况,免疫组化观察内膜粥样硬化斑块中ICAM-1的表达。结果补阳还五汤组内膜增生较模型组明显减轻(P0.05)。补阳还五汤组ICAM-1表达较模型组明显减少(P=0.019)。结论补阳还五汤能显著改善大鼠AS水平;可明显抑制ICAM-1表达,此可能为其防治AS的机制之一。     

补阳还五汤提取物灌胃对脑出血大鼠脑组织中PI3K、AKT、Caspase-3表达的影响

目的 观察补阳还五汤提取物对脑出血大鼠脑组织磷脂酰肌醇3激酶(PI3K)、丝/苏氨酸蛋白激酶(AKT)、半胱氨酸天冬氨酸蛋白水解酶3(Caspase-3)表达的影响,探讨其对脑组织的保护作用机制。方法 将72只SD大鼠随机分为假手术组、模型组、补阳还五汤组、银杏叶片组各18只,后4组采用Rosenberg法建立脑出血大鼠模型后,分别给予生理盐水、补阳还五汤提取物、银杏叶片连续灌胃35 d。用免疫组化法检测PI3K、AKT、Caspase-3蛋白表达,TUNEL法检测脑组织细胞凋亡情况,干湿重法检测脑组织含水量,甲酰胺法检测血-脑脊液屏障通透性。结果 与模型组比较,补阳还五汤组、银杏叶片组PI3K、AKT蛋白表达水平升高,Caspase-3蛋白表达水平降低,脑组织含水量、凋亡细胞数减少,血-脑脊液屏障通透性降低(P均<0.05)。结论 补阳还五汤提取物可能通过激活PI3K/AKT信号通路,降低血-脑脊液屏障通透性来保护脑出血大鼠脑组织。     

补阳还五汤对线栓大鼠模型脑损伤和血脑屏障通透性的影响

目的:观察补阳还五汤对线栓大鼠模型脑损伤和血脑屏障通透性的影响。方法:通过线栓法建立大脑中动脉栓塞(MCAO)模型,分为MCAO组(生理盐水)、补阳还五汤组(灌胃补阳还五汤)、血塞通组(尾静脉注射血塞通)及联合组(补阳还五汤+血塞通),另设假手术组(生理盐水)。评估大鼠行为学,检测血清中枢神经特异性蛋白(S-100β)、神经元特异性烯醇化酶(NSE)及脑组织伊文思蓝(EB)含量、Wnt3a、β-连环蛋白(β-catenin)、水通道蛋白-4(AQP-4)、紧密连接相关蛋白(Claudin-5)mRNA和蛋白表达。结果:与MCAO组比较,补阳还五汤组、血塞通组及联合组神经功能评分、贴纸去除时间及S-100β、NSE、EB含量、AQP-4 mRNA和蛋白表达量均降低,且联合组最低,Wnt3a、β-catenin、Claudin-5 mRNA和蛋白表达量均升高,且联合组最高(P<0.05)。结论:补阳还五汤可减轻MCAO大鼠脑损伤,降低血脑屏障通透性,其机制可能与抑制Wnt/β-catenin信号通路有关。     

补阳还五汤合六味地黄汤对局灶性脑缺血大鼠脑组织bFGF表达的影响

目的观察补阳还五汤合六味地黄汤对局灶性脑缺血大鼠脑组织碱性成纤维细胞生长因子（bFGF）表达的影响及反方是否有协同作用。方法采用改良Haruo Nagasawa法复制老龄大鼠脑缺血模型,随机分为补阳还五汤合六味地黄汤组（即健脑通络汤组）、六味地黄汤组、补阳还五汤组、模型组、假手术组,观察各组术后24 h、72 h、7 d后脑组织bFGF的表达。结果六味地黄汤和补阳还五汤合用能协同提高急性持续脑缺血大鼠bFGF的表达,其作用优于单用,其中单用补阳还五汤优于单用六味地黄汤。结论通过诱导内源性bFGF的表达,可能是健脑通络汤进行脑保护的机制,补阳还五汤与六味地黄汤合用优于单用补阳还五汤。     

补阳还五汤抑制大鼠肺纤维化及对肺组织TGF-β/Smads信号通路的影响

目的 观察补阳还五汤对大鼠肺纤维化的抑制作用,并通过转化生长因子β(TGF-β)/Smads通路变化探讨其机制.方法 将36只SD大鼠随机分为三组各12只,模型组、干预组气管内注入博来霉素诱导肺纤维化模型,造模后分别予以补阳还五汤、生理盐水灌胃2次/天;对照组气管内注入生理盐水,给予生理盐水灌胃2次/天.灌胃1周后处死...     

Rho/Rho激酶信号通路与缺血性脑血管病

Rho/Rho激酶信号通路是体内普遍存在的一条信号通路,它通过调节细胞内肌动蛋白骨架的聚合状态而扮演着"分子开关"角色,参与多种细胞功能.Rho/Rho激酶信号通路在缺血性脑血管病的危险因素、发病机制和病理生理学过程中发挥着重要作用,抑制Rho/Rho激酶信号通路能够取得显著的神经保护作用.     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.