补肾中药靶向经穴给药对骨质疏松患者的归经调节

目的:通过临床实验观察补肾方药靶向经穴位给药治疗骨质疏松症的疗效,分析靶向给药与药物归经的相关性。方法:①观察对象:选择2004-08/2006-12河北医科大学骨质疏松专科门诊和石家庄市桥东区医院门诊骨质疏松患者180例(患者知情同意,并经单位伦理委员会批准)。②实验分组:采用随机数字表法将180例患者分为6组:补肾方药口服组,外贴肾经组,外贴膀胱经组,依普拉封组,骨疏康组,非经非穴位组,每组30例,平均年龄(60.5±6.0)岁,平均病程(6.32±2.03)年。6组一般资料差异无显著性(P>0.05),具有可比性。补肾方药由地黄、淫羊藿、山药、丹参、骨碎补、独活等药物组成,每5丸含原药材3g;抗骨松贴剂:由地黄、淫羊藿、山药、丹参、骨碎补、独活等药物组成);依普拉封为正大青春宝药业有限公司产品;骨疏康颗粒由熟地黄、淫羊藿、黄芪、丹参、骨碎补、木耳、黄瓜子组成。③实验干预:补肾方药口服组:口服补肾方药10丸/次,3次/d,连续服用6个月。外贴肾经穴位组:选择足少阴肾经原穴太溪和络穴大钟;外贴膀胱经穴位组:选择足太阳膀胱经背部肾俞穴和络穴飞扬;外贴非经非穴位组:选择大腿外侧和后背部较广阔没有经络循行的区域;外贴组每个穴位贴2g生药量,每2天1次,左右交替进行。依普拉封组:口服依普拉封200mg/次,3次/d。骨疏康组:口服骨疏康颗粒10g/次,2次/d,各组均以6个月为1疗程,用药期间不进行任何其他中西医抗骨质疏松治疗。④实验评估:比较6组的骨痛症状与骨密度、血清Ca、P、碱性磷酸酶、尿羟脯氨酸,甲状旁腺素、降钙素、雌二醇、睾酮等指标的变化情况。进行综合疗效评价,评估标准分为显效、有效、无效。结果:180例患者全部进入结果分析。①补肾方药口服组、外贴肾经组、外贴膀胱经组、依普拉封组、骨疏康组治疗后,升高骨密度、雌二醇、睾酮、降钙素;降低甲状旁腺素;总有效率分别为90.0%,83.33%,83.33%,83.33%,83.33%。②非经非穴位组治疗后,骨密度、雌二醇、睾酮、降钙素、甲状旁腺素与治疗前比较差异无显著性(P>0.05);总有效率为46.67%。结论:靶向经穴给药可明显提高补肾方药的归经调节作用,至少在骨和性腺两个靶点起作用。     

血管内皮生长因子与基质金属蛋白酶2在血管瘤不同生长过程中的表达特征

目的:观察血管内皮生长因子与基质金属蛋白酶2在血管瘤不同分期中的表达。方法:取自承德医学院附属医院1998-01/2005-12期间血管瘤手术切除的标本共60例及正常带血管皮肤手术切除标本10例,患者家属知情同意。①实验分组:根据Mulliken标准进行病理诊断并分类,所有标本共分4组。增生组22例;退化组20例;退化完成组18例。另取10例正常带血管皮肤组织作为对照组。②采用免疫组织化学S-P法对各组标本的血管内皮生长因子、基质金属蛋白酶2进行染色。③实验评估:以正常血管上皮细胞或肿瘤细胞胞浆出现棕黄色颗粒为阳性,检测各组血管内皮生长因子与基质金属蛋白酶2的表达。结果:①随着血管瘤病理时期的变化,血管内皮生长因子与基质金属蛋白酶2出现明显不同的表达。②增生组血管内皮生长因子与基质金属蛋白酶2的阳性表达率明显高于其他各组,且随着血管瘤的退化,两者的阳性表达率逐渐下降,至退化完成期时与对照组几乎无差别。③血管内皮生长因子与基质金属蛋白酶2的表达呈正相关。结论:血管内皮生长因子与基质金属蛋白酶2在血管瘤的不同分期中起重要作用,其表达水平与血管瘤的病理分期有密切关系。     

Tight junction proteins contribute to barrier properties in human pleura

The permeability of pleural mesothelium helps to control the volume and composition of the liquid lubricating pleural surfaces. Information on pleural barrier function in health and disease, however, is scarce. Tissue specimens of human pleura were mounted in Ussing chambers for measurement of transmesothelial resistance. Expression of tight junction (TJ) proteins was studied by Western blots and immune fluorescence confocal microscopy. Both visceral and parietal pleura showed barrier properties represented by transmesothelial resistance. Occludin, claudin-1, -3, -5, and -7, were detected in visceral pleura. In parietal pleura, the same TJ proteins were detected, except claudin-7. In tissues from patients with pleural inflammation these tightening claudins were decreased and in visceral pleura claudin-2, a paracellular channel former, became apparent. We report that barrier function in human pleura coincides with expression of claudins known to be key determinants of epithelial barrier properties. In inflamed tissue, claudin expression indicates a reduced barrier function.