缺血性脑卒中中药治疗进展

中药及其活性成分通过减少炎症介质的释放,减轻白细胞浸润和保护血脑屏障,对脑缺血后的炎症反应进行干预发挥药理作用。中药单片及其有效成分能够直接透过血脑屏障,促进其他药物的渗透,同时在血脑屏障受损时降低其通透性,修复损伤,保护脑组织。通过抑制缺血诱导的小胶质细胞激活和其介导的促炎细胞因子在缺血区产生微粒,生成促炎介质,增加黏附分子的表达;同时,中药可抑制血管瘤,改善缺血性脑卒中的神经功能损伤,调节转录因子NF-κB。中药对缺血性脑卒中具有良好的抗炎药效,但目前对于中药作用机制的阐述尚不明确,对炎症作用的靶点研究不足,对中药主要有效成分的研究较为片面,今后需进一步加强运用生物技术研究中药的化学成分,明确其活性成分,阐明中药对缺血性脑卒中介导炎症反应的精确机制。     

黄蜀葵花总黄酮对缺血性损伤保护作用的实验研究进展

黄蜀葵花总黄酮是中药黄蜀葵花的主要有效成分,实验研究显示其对缺血性疾病有较好的药理作用,对心脑缺血性损伤有明确的保护作用,其机制主要与抗脂质过氧化、减少自由基生成、抑制细胞凋亡相关。     

丹参有效成分丹参酮IIA和丹酚酸A药理学研究进展

丹参具有抗氧化,抗凝血,抗肿瘤等作用,含有多种有效成分,目前国内外对丹参单体的研究已较为深入,利用先进的现代生物学技术对单体药物的作用机制及作用靶点进行研究的报道也较为多见。丹参有效成分主要分为脂溶性的丹参酮类和水溶性的丹酚酸类,本文将对丹参脂溶性有效单体丹参酮II A和水溶性有效单体丹酚酸A的近期药理作用研究进展进行综述。     

血清药物化学在中药领域应用研究进展

血清药物化学已成为近年来研究中药药效物质基础较为科学且迅速发展的方法之一,利用该法可从复杂的中药成分中筛选和明确与功能主治相吻合的物质,对有效成分进行分离纯化,阐明药效作用的物质基础,说明中药复方配伍的意义和作用机制,能有效反应中药多成分、多靶点协同发挥药效的作用特点,同时通过分析研究血清移行成分,寻找体内直接作用物质,有助于快速、准确地对中药药效物质进行研究。     

中医药防治肾纤维化的研究现状及实践

肾纤维化是各种慢性肾脏病进展至终末期肾病的病理基础,可危及生命。其发病机制较为复杂,由多种细胞因子和信号通路共同参与。目前尚无有效治疗药物。近年来基于肾纤维化的中医理论及其分子机制,通过随机多中心临床研究以及体内外基础研究,证实多种中药及其有效成分有延缓肾纤维化的疗效,并明确了作用靶点。继续寻找有效的延缓肾纤维化的中药,证实其疗效,明确作用机制尤为重要。<     

小续命汤有效成分组的高通量筛选研究

目的:应用高通量筛选技术,建立新型的中药复方活性成分和作用机制研究模式,探讨中药复方小续命汤发挥药理作用的物质基础。方法:观察中药复方小续命汤240个连续组分的抗氧化、抗过氧化氢损伤、抗谷氨酸损伤活性以及对神经细胞内钙离子的影响。结果:中药复方小续命汤多模型筛选结果显示,连续组分L1~L40和A100~A120的综合作用效果较好。因此,可将这两部分的连续组分重新组合,作为小续命汤抗脑缺血损伤的有效成分组。结论:中药复方小续命汤可通过多组分、多靶点途径发挥其药理作用。     

中药黄芩的药理及应用

黄芩及其有效成分黄酮类化合物具有广泛的药理活性,除了传统意义上的抗炎、抗变态、抗病毒以及解热和保肝等生物活性之外,近年来对其抗氧化、抗肿瘤和抗HIV21病毒的研究日趋深入,开发黄芩及其活性成分作为抗血栓,降血压、治疗冠心病和糖尿病以及防治肿瘤和艾滋病药物的前景十分广阔。在黄芩成分药理作用的研究方面,得到系统研究并得以应用的多是黄芩中含量较高的黄酮类化合物,而大部分含量相对较低的黄酮类化合物,其药理特性未能得到充分的研究,其潜在的独特的药理作用也没有被发现利用。研究报道最多的都是正品黄芩,其他种类黄芩的研究报道很少,这些都可作为今后黄芩研究工作的方向。在充分发掘黄芩潜在药理作用的同时,还应注重研究黄芩黄酮类化合物所具有的药理活性的化学理论基础及其作用机制。     

中药有效成分治疗脓毒症急性肺损伤作用机制研究进展

目前针对脓毒症急性肺损伤的治疗尚无推荐的药理干预措施,皮质类固醇仍然是治疗该病的主要手段,但其副作用不容忽视。中药有效成分作为天然药物的提取物,在炎症反应、氧化应激、细胞凋亡方面对该病的治疗具有潜在的研究价值,具有多途径、多靶点、不良反应小的特点。通过回顾总结中药有效成分治疗脓毒症急性肺损伤实验研究,以期梳理明确其机制和特点,为下一步研发治疗用药提供思路与方向。     

当归有效成分及抗老年痴呆药效特点探析

通过查阅近几年来国内外的对于老年痴呆治疗的相关文献,将其中关于老年痴呆分子机制的文献进行分析与总结,以求通过这些归档与整理能够促进老年痴呆的治疗研究.研究当归的有效成分,针对这些有效成分分析老年痴呆的分子机制及药理作用,并据此提出适当的治疗老年痴呆的有效措施以及针对老年人痴呆的作用机制、作用谱和药效特点,提出创新药物的研发思路.研究发现,老年痴呆由于病因较为复杂,因而西医暂无针对性的治疗方法,中药当归由于其药理作用及有效成分,可以针对老年痴呆进行治疗,为老年痴呆的临床治疗提供了新的思路.由于目前研究当归治疗老年痴呆的药理作用以及分子机制的研究主要见于单一成分上,而对于研究多分子间的相互作用相对较少,本文就此基础上对其机制及药效进行分析,加强对分子间相关性的研究,为更好地治疗老年痴呆提供依据.     

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.     

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.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

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.