参芪复方对实验性2型糖尿病大血管病变胰岛素抵抗的干预作用

目的：观察参芪复方对2型糖尿病（T2DM）大血管病变大鼠胰岛素抵抗的干预作用。方法：GK大鼠连续腹腔注射L-N-硝基精氨酸甲酯（L-NAME）,同时喂饲高脂饮食,复制2型糖尿病大血管病变模型。入选大鼠随机分为正常Wistar对照、模型、雷米普利（阳性对照）及参芪复方低、高剂量5个组。造模同时开始给药,连续28 d。实验结束时放射免疫法测血清胰岛素（INS）;免疫印迹（Western Blot）法测骨骼肌葡萄糖转运蛋白4（GLUT4）水平。结果：参芪复方高剂量可降低GK大鼠空腹血糖（P〈0.05）,参芪复方低、高剂量和雷米普利均可改善胰岛素抵抗,增加胰岛素敏感性（P〈0.01）。雷米普利、参芪复方高剂量可上调GLUT4蛋白水平（P〈0.05）。结论：参芪复方具有改善胰岛素抵抗作用,上调骨骼肌GLUT4蛋白水平可能为其机制之一。     

复方苦荞麦对糖尿病大鼠血管并发症早期防治的研究

目的:观察复方苦荞麦对糖尿病大鼠症状、血糖及血管内皮细胞分泌功能的影响,以阐明其降糖效果及对血管并发症的防治作用.方法:雄性Wistar大鼠56只,随机选取10只作为正常对照组,余46只造模,造模成功后再随机分为复方苦荞麦高剂量组、复方苦荞麦低剂量组,消渴丸组,病理对照组4组,连续治疗4周,治疗期间观察各鼠体重、进食、饮水量、尿量等一般情况,治疗期满摘除眼球采血,测血糖、内皮素及血清一氧化氮合酶.结果:复方苦荞麦能明显改善糖尿病大鼠症状,降低糖尿病大鼠血糖;显著降低糖尿病大鼠血浆内皮素水平,提高血清一氧化氮合酶水平,高剂量作用显著优于低剂量.结论:复方苦荞麦降糖效果显著,对血管内皮细胞具保护作用,对糖尿病血管并发症的早期防治具有较好疗效.     

罗格列酮、胰岛素对Ⅱ型糖尿病大鼠脑内TIPE2的表达和细胞凋亡的影响

目的探讨罗格列酮、胰岛素干预下Ⅱ型糖尿病大鼠脑内肿瘤坏死因子α诱导蛋白8样因子2(TIPE2)表达与细胞凋亡的变化,以及它们之间的相关性。方法选取3月龄Wistar大鼠(n=5,3Wistar组)和3月龄GK大鼠(n=5,3GK组);4月龄GK大鼠喂养至6月龄,根据期间的不同处理分为6月龄GK大鼠(n=5,6GK组)、罗格列酮干预6月龄GK大鼠(n=5,RSG+6GK组)、胰岛素干预6月龄GK大鼠(n=5,INS+6GK组)。采用免疫组化法检测各组大鼠脑内TIPE2的表达部位及特征,运用RT-PCR法和Western blotting法检测各组大鼠脑内TIPE2 mRNA和蛋白的表达,采用免疫荧光法检测各组大鼠脑内细胞凋亡的情况。结果 3GK组在染色强度、阳染细胞数、阳染血管数、mRNA、蛋白水平均较3 Wistar组有明显增加(P<0.05),6GK组较3GK组有明显增加(P<0.05),RSG+6GK组、INS+6GK组均较6GK组有明显减少(P<0.05)。大鼠脑内细胞凋亡数目与TIPE2的表达呈正相关性(r=0.981 6,P<0.05)。结论Ⅱ型糖尿病可促进大鼠脑内TIPE2的表达和细胞凋亡,随年龄的增长和糖尿病病程的进展,TIPE2的表达和细胞凋亡数目相应增加,罗格列酮、胰岛素干预可减少糖尿病大鼠脑内TIPE2的表达并抑制细胞凋亡。在糖尿病大鼠脑内细胞凋亡的进程中,TIPE2能够发挥促凋亡作用。     

参芪复方合剂对胰岛素抵抗大鼠的治疗作用及机制

目的 观察参芪复方合剂对胰岛素抵抗大鼠的治疗作用及机制。方法 雄性SD大鼠建立胰岛素抵抗大鼠模型。参芪复方组给予参芪复方合剂，8周后检测空腹血糖（FBG）、空腹血清胰岛素（FINS）和瘦素（LP），计算稳态模型抵抗指数（HOMA—IR）值。结果 高脂肪饲料组较对照组FINS、LP和HOMA—IR显著升高，FBG无明显变化；高脂肪饲料组大鼠LP与FINS、HOMA—IK显著正相关；参芪复方组大鼠HOMA—IR、FINS和LP显著降低；参芪复方组较二甲双胍组胰岛素、IR值和瘦素差异无显著性。结论 高脂肪饲料喂养SD大鼠4周能形成IR大鼠模型，并伴有高瘦素血症。参芪复方合剂能有效改善大鼠IR。     

高脂饲料喂养的GK大鼠血糖水平与饮水量的相关性分析

目的:观察中、西药干预分别对糖尿病大鼠血糖、饮水量、体质量和摄食量的影响,同时分析糖尿病多饮症状与血糖水平的相关性。方法:自发性2型糖尿病GK大鼠50只,随机分为5组:模型组(M)、参芪复方高剂量组(SH)、参芪复方中剂量组(SM)、参芪复方低剂量组(SL)、格华止组(G)。连续12 w以高脂饲料喂养,诱导并维持高血糖状态。另设正常Wistar大鼠10只,作为空白组(C),予普通饲料喂养,平行对照。12 w后进行药物干预,SH、SM、SL组分别予高剂量、中剂量、低剂量参芪复方汤剂,G组予格华止,C组及M组予生理盐水灌胃。干预疗程16 w。监测大鼠饮水量、摄食量、体质量和空腹血糖,并对饮水量和血糖值进行相关分析。结果:随病程延长,GK大鼠逐渐出现血糖、体质量、摄食量、饮水量不断升高,干预16 w后,SH、SM、SL、G组动物饮水量、摄食量和血糖水平均较M组显著下降(P0.05);从数值上可以发现,中药各组改善多饮的程度高于G组,而G组大鼠的血糖水平低于各中药组。饮水量与血糖水平呈较弱正相关的关系(r=0.399,P=0.000)。结论:口渴和血糖升高都是糖尿病的客观表现,分别反应同一疾病的不同侧面,血糖并不是糖尿病最核心的指标,也不应作为唯一的控制目标。中、西医由于理论体系的不同,在治疗时各有侧重。     

参芪注射液对大鼠失血性休克再灌注肠粘膜糖皮质激素受体的调节作用

目的 探讨参芪注射液对大鼠失血性休克-再灌注后肠粘膜组织糖皮质激素受体的影响.方法 雄性SD大鼠72只,随机分成:正常组、模型组、参芪低剂量组(参芪注射液10g/kg)和参芪高剂量组(参纸注射液20g/kg).对SD大鼠静脉使用肝素后缓慢放血,建立重度血失性休克及复苏的动物模型;参芪注射液于再灌注前静脉注入.造模完成后观察各组动物肠粘膜病理学变化,动态观察2,6、12 h肠粘膜、GR的结合活性和GRRNA的表达水平.结果 正常组肠粘膜无明显改变,模型组肠粘膜重度损伤,参芪高剂量组轻度损伤,低剂量组中度损伤;参芪高剂量组与低剂量组比较,肠粘膜损伤减轻程度更明显.模型组与正常组比较,2、6、12 h肠粘膜GR结合活性和GRmRNA表达明显降低(P<0.01);参芪注射液高低剂量组与模型组比较,2、6、12h肠粘膜GR结合活性和GRmRNA表达明显升高(P<0.01,P<0.05);参芪高剂量组与低剂量组比较,2、6、12h肠粘膜GR结合活性和GRmRNA表达升高更明显(P<0.05).结论 参芪注射液能有效地减轻大鼠失血性休克再灌注肠粘膜损伤,提高肠粘膜GR结合活性和GRmRNA的表达水平.     

复方三七纳米颗粒对颅脑损伤大鼠TNF-α、IL-2及IL-6的影响

目的:探讨复方三七纳米颗粒对颅脑损伤大鼠血清TNF-α、IL-2及IL-6的影响,验证复方三七纳米颗粒对颅脑损伤后机体的保护作用。方法:将96只大鼠随机分为假手术组、创伤模型组、复方三七纳米颗粒组和尼莫地平组,分别予生理盐水、生理盐水、复方三七纳米颗粒、尼莫地平灌胃5d,于造模后第1、3、5d腹主动脉穿刺取血留取标本,观察四组血清TNF-α、IL-2及IL-6含量。每组每个时相点随机选8只完成检测。结果:四组血清TNF-α、IL-2及IL-6比较,时间主效应和干预主效应差异有统计学意义(P<0.05)。结论:复方三七纳米颗粒可降低颅脑损伤大鼠血清中TNF-α、IL-6含量,增加IL-2的表达。     

参芪和胃颗粒对鼠胃肠功能影响的实验研究

目的:观察参芪和胃颗粒对大小鼠胃肠功能的影响.方法:将实验大小鼠动物按高、中、低剂量将参芪和胃颗粒分为3组,与蒸馏水组作阴性对照、多潘立酮组作阳性对照,采用灌胃给药方式,计算大鼠的胃排空率、小鼠的小肠推进率.结果:参芪和胃颗粒可显著增加大鼠胃排空率,3.5 g/kg(中剂量组)、1.75 g/kg(低剂量组)的鼠排空率...     

参芪复方对糖尿病血管氧化应激相关蛋白表达的影响

目的 观察参芪复方对糖尿病病变血管的保护性作用,并探讨其部分作用机理.方法 选取5月龄无特定病原体（SPF）级别雄性GK大鼠55只,随机分为空白组、模型组、西药组、中药组,另设15只Wistar大鼠为正常组;采用一氧化氮合成酶（eNOS）抑制剂Nw-硝基-L-精氨酸甲酯（L-NAME）诱导糖尿病血管并发症,并连续给药4周后,观察大鼠血糖、腹主动脉病理学改变、腹主动脉组织P38丝裂原活化蛋白激酶（p38MAPK）及血红素氧合酶-1（HO-1）蛋白表达.结果 中药组大鼠腹主动脉病理学病变程度较其他组轻,氧化应激损伤呈低水平,腹主动脉组织中HO-1蛋白高表达,而p38MAPK蛋白呈低表达.结论 参芪复方对糖尿病血管有保护性作用,其机理可能是通过降低血管组织p38MAPK 蛋白表达和升高HO-1蛋白表达,调整氧化应激水平,减少氧化应激血管损伤,进而对糖尿病血管起到保护性作用.     

南苜蓿总皂苷改善2型糖尿病大鼠糖代谢的作用机制

目的 探讨南苜蓿总皂苷(TSMP)对2型糖尿病(T2DM)大鼠糖代谢的作用及其可能的机制.方法 采用高脂加小剂量链脲佐菌素诱导T2DM大鼠模型,将大鼠分为对照组、模型组、二甲双胍组(0.2 g/kg)、TSMP高剂量组(1.4 g/kg)、TSMP低剂量组(0.7 g/kg),连续给药4周,末次给药后测定胰岛素抵抗指数(IRI)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、肝糖原、白细胞介素(IL)-1β、肿瘤坏死因子-α(TNF-α)、游离脂肪酸(FFA)、瘦素(Leptin)水平,以及丙酮酸激酶(PK)、已糖激酶(HK)、葡萄糖-6-磷酸酶(G-6-Pase)、果糖-1,6-二磷酸酶、葡萄糖激酶(GK)的活性;检测肝脏组织中G-6-Pase、磷酸烯醇式丙酮酸羧激酶(PEPCK)蛋白的表达.结果 与模型组比较,给予高剂量(1.4 g/kg) TSMP能降低T2DM大鼠IRI、FBG、HbA1c、IL-1β、TNF-α、FFA、Leptin水平,升高肝糖原水平,提高PK、HK、GK的活性,降低G-6-Pase、果糖-1,6-二磷酸酶的活性,并下调肝脏组织中G-6-Pase、PEPCK蛋白表达水平,差异均有统计学意义(P＜0.05).结论 TSMP可以改善T2DM大鼠的糖代谢紊乱,可能与其促进葡萄糖的利用,减轻炎性反应和改善胰岛素抵抗有关.     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.