芪龙方防治大鼠胃癌癌前疾病的作用

目的 :研究经验方芪龙方防治胃癌癌前疾病及其在胃癌发生发展中的作用。方法 :用 N-甲基 - N′-硝基 -N-亚硝基胍 ( MNNG)诱发新生大鼠胃癌癌前疾病及胃癌的动物模型 ,观察芪龙方对模型动物的病理组织学作用。结果 :芪龙方能显著减少 MNNG诱发的大鼠胃粘膜慢性萎缩性胃炎、胃粘膜异型增生和胃腺癌的发生率 ,与单纯病理模型组比较 P <0 .0 5 ,并呈现一定的剂量效应关系。结论 :芪龙方有较强的防治胃癌癌前病变和胃癌发生发展的作     

曲美他嗪对慢性心力衰竭病人心功能、脑钠肽和心肌肌钙蛋白Ⅰ的影响

目的观察曲美他嗪对慢性心力衰竭（CHF）病人心功能、脑钠肽（BNP）和心肌肌钙蛋白Ⅰ（cTnⅠ）的影响。方法60例病情稳定的CHF病人。随机分为治疗组及对照组。每组30例。对照组病人采用心力衰竭常规药物治疗，治疗组在对照组治疗的基础上加用曲美他嗪20mg，每日3次。两组均连续治疗4周。观察治疗前后两组NYHA分级、心功能、BNP和cTnⅠ等指标的变化。结果与治疗前相比，两组治疗后NYHA分级及心功能均得到显著改善，血浆BNP及cTnⅠ水平显著降低（P〈0．05或P〈0．01）；与对照组治疗后相比，曲美他嗪组显著缩小病人左室舒张末内径（LVEDD，P〈0．05），显著减小左室质量指数（LVMI，P〈0．05），显著增加左室射血分数（LVEF。P〈0．05）；血浆BNP（P〈0．05）和cTnⅠ（P〈0．01）显著降低。结论曲美他嗪能降低血浆BNP及cTnⅠ水平，改善CHF病人的心功能。     

辛伐他汀联合曲美他嗪治疗慢性心力衰竭的疗效观察

目的 探讨辛伐他汀与曲美他嗪联合治疗慢性心力衰竭（CHF）的疗效.方法 采用随机数字表法将76例CHF患者分为对照组和观察组,对照组（38例）给予抗心力衰竭常规治疗,治疗组（38例）在上述基础上加用辛伐他汀与曲美他嗪联合治疗,比较两组治疗前后心功能各指标改善情况以及血浆高敏C反应蛋白（hs-CRP）的变化情况.结果 观察组的治疗总有效率明显高于对照组,差异有统计学意义（P＜0.05）;治疗后左心室射血分数（LVEF）、左心室收缩末期内径（LVESD）以及左心室舒张末期内径（LVEDD）改善情况优于对照组,差异具有统计学意义（P＜0.05）;血浆hs-CRP水平下降程度较对照组明显,治疗后6min步行试验行走距离亦明显长于对照组,差异均有统计学意义（P＜0.05）.结论 辛伐他汀与曲美他嗪联合治疗CHF,在抗炎的同时能够改善患者心功能,降低心肌耗氧,提高心力衰竭患者运动耐量.     

Famotidine Prevents Deep Histologic Lesions Induced by 0.6N HCl in Rat Gastric Mucosa: Role of Parietal Cells

The assessment of the protective actions of H₂-receptor antagonists against gastric mucosal lesions by necrotizing agents relies on the gross observation of the gastric mucosa only. We examined the activity of famotidine against 0.6 N HCl-induced damage and the role of parietal cells by light and transmission electron microscopy. Rats received famotidine 0.3–10 mg/kg intragastrically. Sixty minutes later 0.6 N HCl (1 ml/rat) was given and after an additional 30 min the stomachs were removed. Macroscopically visible lesions were measured. Histologic lesions were scored on the basis of the depth. The ultrastructure of parietal cells in the isthmus–neck region was examined. Pretreatment with famotidine resulted in a slight increase of macroscopically visible gastric lesions in response to HCl. While the extent of total histologic damage was not modified, the antisecretory dose significantly reduced only lesions deep within the mucosa. Famotidine alone determined the dose-dependent occurrence of a distinct parietal cell morphological state, suggestive of inhibition of the secretory system. A causal link between the protective effect on the region where parietal cells are located, the percentage of cells shifting to the inhibited morphological state, and the inhibitory effect on acid secretion is proposed.     

Replacement of conventional glucocorticoids by oral pH-modified release budesonide in active and inactive Crohn's disease: results of an open,prospective, multicenter trial

Glucocorticosteroids (GCS) are established in the treatment of active Crohn's ileitis and ileocolitis. Recently, the topical steroid budesonide was found to be effective in untreated patients with Crohn's disease (CD) causing less side effects than conventional GCS. No clinical data have been reported about the effects of switching from conventional GCS to budesonide in terms of side effects and disease activity. The primary aim of this study was to evaluate the development of side effects after switching from conventional GCS treatment to Eudragit L-coated budesonide (pH-modified release formulation) in patients taking 5–30 mg prednisolone equivalent per day for at least two weeks. In all, 178 patients with active CD (N = 88) or CD in remission during GCS treatment (N = 90) were included. Conventional GCS treatment was tapered down during a maximum of three weeks, with simultaneous intake of 3 × 3 mg budesonide. Thereafter, patients received 3 × 3 mg budesonide alone for six weeks. GCS-related side effects, disease activity and adverse events were documented at study entry and after 0, 2, 4, and 6 weeks of budesonide treatment. The percentage of patients with GCS-related side effects decreased from 65.2% (intention-to-treat-population) at entry to 43.3% (P < 0.0001) at the end of the trial. The total number of GCS-related side effects decreased significantly from 269 to 90. Of the patients who entered the study with active disease under conventional GCS therapy, 38.6% were in remission at the end of the study. Of the patients who entered the study with CD in remission, 78% stayed in remission after switching from conventinal GCS to budesonide. In conclusion, switching from conventional GCS treatment to budesonide leads to a significant reduction of GCS related side effects in patients with CD without causing rapid deterioration of the disease.     

Homogeneity and Diameter of Linear Lesions Induced With Multipolar Ablation Catheters: In Vitro and In Vivo Comparison of Pulsed Versus Continuous Radiofrequency Energy Delivery

Background: For invasive treatment of atrial fibrillation, linear lesions induced with multipolar ablation catheters (MAC) are needed to prevent recurrence. The aim of the study was to compare the efficacy of pulsed versus continuous radiofrequency (RF)-energy delivery using MAC. Methods: In vitro tests were performed using endomyocardial preparations of fresh pig hearts in a 10-liter-bath of physiologic saline solution (37°C) at constant flow conditions (1.5[emsp4 ]l/min). The MAC were placed with a constant pressure of 20 ponds onto the endocardium. The energy (generator: Osypka HAT 200 S) was delivered either pulsed (4 electrodes simultaneously, 5[emsp4 ]ms duty-cycle) or continuously (each electrode separately). In vivo experiments were performed in 6 anesthetized pigs using fluoroscopic positioning of MAC at 40 different intracardial positions and with similar conditions as in vitro experiments. Lesion volume (LV) was calculated after measuring lesion diameter with a microcaliper. The homogeneity of the lesions (LH) was classified from 1–4; with 1 as highest homogeneity. Results: Pulsed energy delivery produced more homogeneous linear lesions in significantly less time. There was no difference in electrode temperature values (50.2±0.8 and 51.3±1.4°C) in vitro and in vivo. In the in vivo experiments, lesion depth and calculated lesion volume were less in both modes of energy delivery but pulsed energy delivery was superior regarding lesion depth and homogeneity. Conclusion: With pulsed energy delivery it is possible to create linear lesions of significantly greater homogeneity. Moreover, larger lesions are induced in less time by pulsed energy delivery in vitro and in vivo.     

Effects of Alpha Adrenergic Stimulation and Blockade on Early Afterdepolarizations Induced by Cesium in Canine Cardiac Purkinje Fibers

Alpha Adrenergic Stimulation and EADs. The effects of alpha adrenergic stimulation and three alpha adrenoceptor blockers on early afterdepolarizations (EADs) were examined in canine card diac Purkinje fibers. In the first group of 18 preparations, EADs were induced by superfusion with 7.5 mM cesium (Cs) dissolved in low potassium (2.7 mM KCl) Tyrode's solution. During alpha adrenoceptor stimulation (norepinephrine 1 μM and propranolol 1 μM) to enhance EADs, the effects of phentotamine and two new alpha 1 adrenoceptor antagonists, benoxathian and WB 4101 (1, 3, and 10 μM), were examined. WB 4101 (1 μM) suppressed EADs in all six preparations. Benoxathian required 3 μM in five preparations and 10 μM in one to suppress EADs. Phentolamine (10 μM) suppressed EADs in two of six preparations. In the second group of 21 preparations, the effects on cesium-induced EADs of the three alpha adrenoceptor hlockers (10 μM) were examined without alpha adrenoceptor stimulation. WB 4101 (10 μM) suppressed EADs in seven of seven preparations, while benoxathian (10 μM) suppressed EADs in five of seven. Phentolamine (10 μM) enhanced EADs in six of seven preparations. In the third group of 24 Purkinje fibers, the direct effects (without alpha adrenoceptor stimulation) of these three antagonists on the characteristics of normal Purkinje fiber action potentials superfused with normal Tyrode's solution were examined. Phentolamine (1, 3, and 10 μM, n = 8) prolonged action potential duration at 90% repolarization (APD90) by 5.3%± 1.3%, 10.0%± 1.8%, and 14.3%± 2.7%, respectively. Benoxathian (n = 8) and WB 4101 (n = 8) shortened APD90 equally: 6.8%± 1.1% vs 7.7%± 1.3% at 1 μM, 13.6%± 1.0% vs 14.5%± 1.6% at 3 μM, and 21.1%± 1.2% vs 20.8%± 2.1% at 10 μM, respectively. We conclude that in cesium treated Purkinje fibers: (1) Alpha adrenoceptor stimulation enhanced EADs; (2) Phentolamine was least effective in suppressing EADs, probably because of a direct effect that prolonged MM)90,: and (3) Although benoxathian and WB 4101 had similar etTects on APD90, WB 4101 was more effective in suppressing EADs at lower concentrations than henoxathian.     

血府逐瘀口服液对大鼠缺氧-再给氧损伤心脏微血管内皮细胞黏附分子表达的影响

目的 观察血府逐瘀口服液对心脏微血管内皮细胞缺氧／复氧损伤中黏附分子表达的影响。方法 通过心脏微血管内皮细胞体外培养技术，建立缺氧／复氧损伤模型，模拟心肌缺血再灌注损伤。用免疫细胞化学法和图像定量分析系统，观察心脏微血管内皮细胞的细胞间黏附分子-1（ICAM-1）和血管细胞黏附分子-1（VCAM-1）的表达变化。结果大鼠心脏微血管内皮细胞缺氧4h后ICAM-1和VCAM-1的蛋白表达较对照组升高，但无统计学意义（P〉0．05），再给氧6h、12h后ICAM-1和VCAM一1的表达较对照组明显增高（P〈0．01）。血府逐瘀口服液能显著降低ICAM-1和VCAM-1的蛋白表达，这种作用随着剂量的增加而增强。结论 血府逐瘀口服液可通过降低心脏微血管内皮细胞的ICAM-1和VCAM-1表达，减少白细胞浸润，从而减轻缺血再灌注损伤中的炎性反应对心功能造成损害。     

Protective Effects of Nafamostat Mesilate on Liver Injury Induced by Lipopolysaccharide in Rats: Possible Involvement of CD14 and TLR-4 Downregulation on Kupffer Cells

Nafamostat mesilate (NM) is a synthetic protease inhibitor with various biological effects. To determine its effect on liver injury related to sepsis, we investigated the effects of NM on lipopolysaccharide (LPS)-induced liver injury. Wistar rats were allocated into two groups; the NM group underwent intraperitoneal NM administration 30 min before LPS administration, and the control group underwent PBS administration. Serum AST and ALT levels were significantly decreased in NM-treated rats. Reduced levels of TNF-α, IL-1β, and IFN-γ were observed after LPS administration in NM-treated rats. No significant differences were observed in IL-6 levels between the NM and the control group. In contrast, HGF levels were significantly increased only in control rats. NM treatment decreased protein and mRNA levels of TLR-4 and CD14. Our data suggest that NM treatment has protective effects against LPS-induced hepatotoxicity through downregulation of TLR4 and CD14 in liver, which decreased TNF-α, IL-1β, and IFN-γproduction in liver.     

Linear Lesion Radiofrequency Ablation in Canine Vagal Atrial Fibrillation: Effects of Special Catheters Designed for Efficiency, and the Critical Role of Lesions from the Crista Terminalis to the Superior Vena Cava

Objective: To determine whether specially devised catheters could be used to place radiofrequency (RF) linear lesions quickly and efficiently for termination and/or prevention of atrial fibrillation (AF). Methods: Two versions of 2 different types of ablating catheters were used in 12 canines with AF induced by rapid pacing during vagal stimulation. 1) Modified basket catheters in two versions, one designed to produce caudo-cranial linear lesions through extended bare electrode-splines in contact with the atrial wall; and the other designed to produce horizontal linear lesions by revolving within the atrium. Together these would form longitude and latitude grids in the atrium. 2) The second catheter type was 2 versions of coil electrodes with thermocouples centered under each of the large-area coil electrodes. One version of these deflectable coil electrodes was intended to produce lesions in the tricuspid valve annulus-inferior vena cava (IVC) isthmus; and along the crista terminalis from the superior vena cava (SVC) to the IVC. A different type of deflection angulation on the second version was intended to produce more horizontal lesions from the crista to the tricuspid annulus. Guidance was fluoroscopic, and by electrograms and transesophageal echo. Gross pathologic examinations followed each experiment. Prior to use in canines, all electrode configurations were tested in vitro on fresh bovine preparations suspended in saline at 37[emsp4 ]°C. Results: The bare spline and coil electrode catheter configurations produced discrete non-perforating non-charring lesions in the in vitro preparations. One dog died of exsanginating hemorrhage. Post mortem examination revealed the lesions to be extremely variable, ranging from no evidence of effective RF delivery to deep lesions with perforation. Seven clinical successes were achieved (6 complete), with the coil electrode catheters accounting for 5 of the 7, although the procedure times were shorter with the baskets. Critical lesions were those from the crista to the SVC. Planned trans-isthmus lesions were not done, but may be needed to prevent atrial flutter not seen prior to effective AF ablation. Conclusions: Special basket and coil-electrode catheters may be useful but require refinement. The finding that lesions between the crista terminalis and the SVC were critical to success may be applicable to some cases of AF in humans.     

Evaluation of the Protective Effects of Histamine and 5-hydroxytryptamine Receptor Antagonists Against the Lethal Toxicity Induced by Oxygen Free Radicals in Rats

Generation of oxygen free radicals (OFR) via intravenous administration of xanthine plus xanthine oxidase [X + XO], to Inactin® anesthetized rats produced intense respiratory distress. This effect led to death of more than 90% of the animals within a 120 min observation period. Several reports documented that the two autocoids, 5-hydroxytryptamine (5-HT) and histamine (H), can induce pulmonary and bronchiolar constriction and pulmonary edema. Hence, our present studies were conducted to investigate whether antagonists of 5-HT and histamine could provide protection from the lethal toxicity of the free radicals. Pretreatment of the rats with pyrilamine and cimetidine, H1 and H2 receptor antagonists, respectively, prolonged the duration of survival, but it failed to enhance net survival rate. In contrast, pretreatment of the rats with nonspecific 5-HT antagonists, methysergide and cyproheptadine, and a selective 5-HT₂ receptor antagonist, ketanserin, markedly enhanced the survival rate to 80–90%. These observations are consistent with data showing that 5-HT levels in the systemic arterial blood doubled within 5–10 min after administration of [X + XO]. These studies support the view that OFR-mediated respiratory distress is caused predominantly by 5-hydroxytryptamine and to a lesser extent by histamine.     

运动锻炼与多因素评估及干预对老年人预防跌倒效果的Meta分析

目的 评价运动锻炼、多因素评估与干预措施在预防老年人跌倒发生中的效应.方法 通过Medline、Cochrance Cochrane Register of Controlled Trials,<中国生物医学文献数据库>(CBMdisc)与其他数据库以及追溯相关参考文献收集研究预防老年人跌倒的随机对照试验,按入选的标准逐步筛选文献后提取文献中的数据进行Meta分析.结果 共有29篇文献收录.Meta分析的结果显示,运动锻炼在预防老年人跌倒的发生上,总效应RR为0.79,95%CI为0.72～0.87;多因素评估及干预在预防老年跌倒上,总效应相对危害度(RR)为0.86,95%CI为0.78～0.94.结论 运动锻炼、多因素评估及干预可减少老年人跌倒的发生.     

Effect of Moxibustion at Acupoints Ren-12 (<Emphasis Type="Italic">Zhongwan</Emphasis>), St-25 (<Emphasis Type="Italic">Tianshu</Emphasis>), and St-36 (<Emphasis Type="Italic">Zuzanli</Emphasis>) in the Prevention of Gastric Lesions Induced by Indomethacin in Wistar Rats

This study was aimed at assessing the physical characteristics underlying the action of moxibustion at acupoints Ren-12 (Zhongwan), St-25 (Tianshu), and St-36 (Zuzanli) in preventing acute injuries of the gastric mucous membrane induced by indomethacin in Wistar rats. Induction of gastric lesions, by means of intragastric administration of indomethacin (100 mg/kg), in adult male Wistar rats was followed by treatment with moxibustion using Artemisia vulgaris dried leaves at 60 or 45C, heating with Artemisia vulgaris charcoal at 50C, heating with a regular tobacco cigar at 50C, and heating with a regular water pad at 50C, The effects of the different heating protocols over the gastric lesions were then compared. In addition, another group of animals was pretreated with capsaicin (100 mg/kg, s.c.), in order to lesion C fibers and, 15 days later, subjected to indomethacin administration and moxibustion treatment. Moxibustion was significantly more efficient at 60C than at 45C in preventing gastric lesions triggered by indomethacin. Moxibustion applied in acupoints provided a significant reduction of the lesion area, which was two times less than that of animals stimulated in a nonacupoint (sham group). Comparing the therapeutic effects provided by different forms of heating over the gastric lesions, the burning of dry leaves of Artemísia vulgaris was significantly more efficient in preventing gastric lesions than moxibustion made with Artemísia charcoal or tobacco (cigar) or by heating the animal with a water pad. Desensitization of the afferent sensory C fibers by capsaicin significantly diminished the ability of moxibustion to block the lesions in the gastric mucous membrane. Moxibustion can efficiently prevent indomethacin-induced gastric lesions in rats and this effect is dependent on the temperature, the material used for moxibustion, the use of acupuncture points, and the integrity of C fibers.     

Electroacupuncture Elicits Dual Effects: Stimulation of Delayed Gastric Emptying and Inhibition of Accelerated Colonic Transit Induced by Restraint Stress in Rats

Acupuncture has been used for treating functional gastrointestinal (GI) disorders. Animal studies have demonstrated that acupuncture antagonized various stress-induced responses. We investigated the effects of electroacupuncture (EA) at ST-36 (Zusanli; lower limb) on stress-induced alteration of GI motor activities. Solid gastric emptying was significantly delayed by restraint stress (29.6±2.4%; n=7) compared to that of controls (60.0±2.5%; n=8). Delayed gastric emptying was significantly improved by EA at ST-36 (47.2±1.8%). Intracisternal (IC) injection of corticotropin releasing factor (CRF; 1 μg) delayed gastric emptying to 25.4±3.1%, which was also improved by EA at ST-36, to 53.0±7.1% (n=8). The stimulatory effect of EA on stress-induced delayed gastric emptying was abolished by atropine (17.6±1.9%) but not by guanethidine (42.2±2.3%). Colonic transit was significantly accelerated by restraint stress (GC=7.2±0.3; n=8) compared to that of controls (GC=5.2±0.2; n=8). Accelerated colonic transit was significantly reduced by EA at ST-36 (GC=4.9±0.3). IC injection of CRF accelerated colonic transit (GC=6.9±0.2), which was also normalized by EA at ST-36 (GC=4.7±0.2). The inhibitory effect of EA on stress-induced acceleration of colonic transit was not affected by guanethidine (GC=4.6±0.3). In conclusion, EA at ST-36 showed dual effects: stimulation of stress-induced delayed gastric emptying and inhibition of stress-induced acceleration of colonic transit. The stimulatory effect of EA on stress-induced delayed gastric emptying is mediated via cholinergic pathways. The inhibitory effect of EA on stress-induced acceleration of colonic transit is independent of the sympathetic pathway.