三七保肝作用及其机理研究进展

概述了近几年三七抗急性肝损伤、抗酒精性肝损伤、抗肝纤维化、改善肝脏微循环、抗肝癌、利胆等作用及保肝作用机理研究。     

Ursodeoxycholic acid and F(6)-D(3) inhibit aberrant crypt proliferation in the rat azoxymethane model of colon cancer: roles of cyclin D1 and E-cadherin.

We have previously demonstrated that ursodeoxycholic acid(UDCA) and a fluorinated analogue of vitamin D(3), F(6)-D(3),inhibited colonic carcinogenesis in the azoxymethane (AOM) model. Generalized colonic mucosal hyperproliferation and aberrant crypt foci (ACF) are intermediate biomarkers of colon cancer. Using these biomarkers, in this study we examined the anticarcinogenic mechanisms of these chemopreventive agents. Rats were maintained on AIN-76A chow or supplemented with 0.4% UDCA or F(6)-D(3) (2.5 nmol/kg chow) and treated weekly with AOM 20 mg i.p./kg wt or saline x 2 weeks. F(6)-D(3) was continued for an additional 2 weeks and UDCA for the duration of the study. At 40 weeks, animals received bromodeoxyuridine (BrdUrd) i.p. 2 h before sacrifice. A portion of each tumor was fixed in formalin and the remainder flash frozen. Colons were divided longitudinally and half-fixed in formalin and half in ethanol. The size and location of methylene blue-stained ACF were recorded. Cell proliferation (BrdUrd labeling) and apoptosis (terminal deoxynucleotidyl transferase-mediated nick end labeling assay) were measured in colonic crypts and tumors. Protein expression levels of several regulators of cell proliferation were analyzed by immunostaining and Western blotting. Colonic crypt cyclin D1 and E-cadherin mRNA levels were measured by real-time PCR. In saline injected controls, neither UDCA nor F(6)-D(3) alone had any effect on cytokinetic parameters or on the expression of mitogenic regulators. AOM significantly increased the proliferation (percentage of BrdUrd-positive cells) of both ACF (23.1 +/- 1.7%) and non-ACF crypts (17.6 +/- 1.6%), compared with normal colonic crypts (4.5 +/- 0.8%; P < 0.05). This hyperproliferation was accompanied by a 5-fold increase in cyclin D1 and >50% decrease in E-cadherin protein (P < 0.05) in ACF, both of which are predicted to be growth-enhancing alterations. UDCA and F(6)-D(3) significantly (P < 0.05) inhibited AOM-induced crypt cell hyperproliferation, ACF development, and tumor burden. These chemopreventive agents also significantly blocked AOM-induced alterations in cyclin D1 and E-cadherin protein in ACF and tumors. In ACF, changes in mRNA levels of cyclin D1, but not E-cadherin, paralleled alterations in protein expression. Cyclooxygenase-2 and inducible nitric oxide synthase were increased in AOM tumors but not in ACF, and these changes were blocked by UDCA and F(6)-D(3). UDCA and F(6)-D(3) significantly inhibited ACF development and hyperproliferation, in part, by preventing carcinogen-induced alterations in cyclin D1 and E-cadherin. In established tumors, UDCA and F(6)-D(3) also limited inductions of cyclooxygenase-2 and inducible nitric oxide synthase, which together with their effects on cyclin D1 and E-cadherin, contribute to their chemopreventive actions.     

突发性耳聋的疗效探索

目的 探索突发性耳聋的有效治疗方案。方法 将我科近年来收治的394例突聋患者分为5组。第一组中西医结合治疗40例。在此基础上，第二组加体外反搏治疗44例，第三组加高压氧舱治疗46例，第四组加光量子血液疗法46例；第五组加声信息治疗52例。与之比较相应各组的中西医结合组分别为42例、44例、40例和40例。结果 第一组有效率70．0％，第二组有效率86．4％，第三组有效率89．1％，第四组有效率93．5％，第五组有效率88．5％。第一组与其余4组的疗效差异有显著性意义（P＜0．05）。结论 药物治疗的同时加用各种特殊治疗，均将取得更好的疗效。     

血小板因子4对环磷酰胺损伤小鼠骨髓细胞增殖能力的影响

目的 探讨血小板因子4(PF4)对环磷酰胺(CTX)诱导的化学损伤小鼠骨髓细胞增殖能力的影响. 方法 36只小鼠随机分为PF4组、CTX组和对照组.小鼠腹腔注射CTX 200 mg/kg制备化学药物损伤小鼠模型.在注射CTX前26 h和20 h,PF4组和CTX组各注射PF4(40μg/kg)和等体积的PBS缓冲液,对照组只注射等体积的PBS缓冲液.通过体外双层琼脂培养法测定PF4对CTX损伤小鼠骨髓细胞粒一巨噬细胞集落(CFU-GM)形成的影响,流式细胞仪测定细胞周期的变化.结果 注射CTX后第5天CTX组骨髓细胞数(BMK)较对照组显著减少(P<0.01);第8天PF4组BMK较CTX组显著增多(P<0.01).注射CTX后第5天CTX组骨髓CFU-GM数量较对照组和PF4组显著减少(P<0.01);第8天PF4组与CTX组的骨髓CFU-GM数量均有不同程度的上升,但两组间差异仍有统计学意义(P<0.05).注射CTX后第5天PF4组骨髓有核细胞GO/G1期细胞百分率比CTX组显著提高,且细胞坏死、凋亡率显著下降(P<0.01),而与对照组相比差异无统计学意义(P>0.05).第8天各组间G0/G1期细胞百分率、细胞坏死/凋亡率差异均无统计学意义(P>0.05). 结论 PF4使处于G0/G1期的骨髓细胞数增多,降低了其坏死和凋亡率,增加骨髓细胞CFU-GM集落形成率.     

非上皮来源外阴肿瘤的临床病理分析

目的 探讨非上皮来源的少见外阴肿瘤的临床和病理特点.方法 回顾性分析1986年至2007年,北京协和医院住院治疗的42例非上皮来源外阴肿瘤患者的临床病理资料.结果 42例患者的平均发病年龄44.1岁;临床表现为外阴肿物者有32例,占76%;有伴随症状者21例,占50%.肿瘤直径1～15 cm不等.治疗主要以手术治疗为主,其中行外阴病灶切除术40例,外阴单纯切除术1例,外阴广泛性切除术1例.术中见肿物直径>10 cm有2例,均为侵袭性血管黏液瘤患者.手术切缘干净者41例,1例未切净者为侵袭性血管黏液瘤,第2次手术切净.术后组织病理学诊断中,最常见的类型,良性肿瘤依次为汗腺瘤(7例,17%)和血管瘤(5例,12%);恶性肿瘤依次为平滑肌肉瘤(3例,7%)和侵袭性血管黏液瘤(2例,5%).结论 非上皮来源的外阴肿瘤少见,组织来源多为间叶组织,大部分临床表现缺乏特异性,术后组织病理学诊断是确诊的关键.良性肿瘤治疗上多采取局部病灶切除术,而恶性肿瘤,一般需行扩大切除术或外阴广泛性切除术.     

全子宫切除术手术途径和适应证10 155例分析

目的 探讨全子宫切除术的手术途径和适应证及其变化.方法 调用北京协和医院1996-2006年全子宫切除术患者病案首页资料,根据手术方式分为开腹子宫切除术、阴式子宫切除术和腹腔镜子宫切除术3组.对各组手术适应证及其变化进行回顾性分析.结果 开腹子宫切除术占70.9%,腹腔镜子宫切除术占20.6%,阴式子宫切除术占8.5%.腹腔镜子宫切除所占比例从1996年2.4%上升到2006年的25.4%.全子宫切除术的常见手术适应证为子宫肌瘤(53.3%～56.2%)、子宫内膜异位症(含子宫腺肌病)(17.5%～19.1%)、良性卵巢肿瘤(7.8%～9.2%)以及生殖道脱垂(7.6%～7.7%).相比1996-2001年,2002-2006年因宫颈病变和子宫内膜病变行全子宫切除术的比例增加,通过腹腔镜途径处理者增多.结论 采用腹腔镜子宫切除术逐渐增加,手术适应证与开腹子宫切除术趋于一致.宫颈病变和子宫内膜病变在子宫切除术的适应证中所占比例有增加趋势,而且通过腹腔镜途径处理者增多.     

自制甲-丁溶液治疗痤疮疗效观察

目的探讨自制甲—丁溶液治疗痤疮的疗效。方法治疗组用0.5%甲硝唑注射液100ml加丁胺卡那注射液0.4g配成甲—丁溶液后湿敷于患处,每周1次;对照组外用2%氯霉素酒精酊,1天1次;连用4周,对治疗效果对比分析。结果治疗组175例患者中,痊愈45例,占25.7%,总有效率为98.28%,对照组痊愈率和总有效率分别为13.2%和72.5%,两组相比,P值均小于0.05,均有显著性差异。结论我们自配的甲—丁溶液和传统的2%氯霉素酒精酊相比,治疗痤疮具有疗效好、操作简单、副作用少等优点,临床应用价值较大。     

Clinical Observation on Physiological and Psychological Effects of Eight-Section Brocade on Type 2 Diabetic Patients

Objective:To observe the physiological and psychological changing of type 2 diabetic patients after practicing Eight-Section Brocade,to evaluate the clinical curative effect,and to provide a safe and effective self-regulating method for type 2 diabetic Patients.Methods:This study is a random controlled trial,the 54 type 2 diabetic patients were randomly assigned into the intervention and the control group.The intervention group was given a 2-month period of Eight-Section Brocade practice,then a comparison between groups was made.The intervention group continued to do Eight-Section Brocade practice for 2 months,so it was 4 months' intervention all together for this group.and then a comparison within the intervention group was made.Results:There was significant difierence 4 months later on HbAlc in the intervention group (P<0.05).There was significant difference between the intervention and control groups on obsessive-compulsive,depression,anxiety and hostility scores after 2 months' practice(P<0.05).There was significant difference between 2 and 4 months' practice on hostilities scores within the intervention group P<0.05).Conclusions:As an important part of the traditional Chinese medicine,Eight-section Brocade has physiological and psychological effects on type 2 Diabetic Patients.