电针对局灶性脑缺血大鼠缺血灶周围区星形胶质细胞的影响

BACKGROUND： Astrocytes react sensitively to cerebral ischemia, causing reactive proliferation and activation, which may contribute to their effect in protecting or injuring neuronal regeneration. Whether acupuncture, as a treatment for cerebral ischemia, regulates the activated state of astrocytes has become a focus of recent investigations. OBJECTIVE： To observe the effects of electroacupuncture （EA） on ultrastructure changes and reactive proliferation of astrocytes in the marginal zone of focal cerebral ischemia in rats. DESIGN, TIME AND SETTING： Randomized, controlled animal study. This study was performed at the Experimental Animal Center of Guangzhou University of Traditional Chinese Medicine between December 2007 and July 2008. MATERIALS： A total of 90 male Wistar rats were randomly divided into sham operated, model and EA groups. Each group was subdivided into 1 hour, 1, 3, 7, and 21 days post-cerebral ischemia groups, with six animals for each time point. Rabbit anti-rat glial fibrillary acidic protein （GFAP） and goat anti-rabbit IgG/tetramethylrhodamine isothiocyanate were provided by Beijing Biosynthesis Biotechnology. The G-6805 electric acupuncture apparatus was provided by Shanghai Huayi. METHODS： Heat-coagulation-induced occlusion of the middle cerebral artery was performed to establish a model of focal cerebral ischemia, in the model and EA groups. Middle cerebral arteries were exposed without occlusion in sham operated group. EA was applied immediately after surgery in the EA group, 4/20 Hz, 2.0-3.0 V, 1-3 mA, to Baihui（GV 20） and Dazhui（GV 14）, for 30 minutes. The treatment was performed once a day. The sham operated and model groups did not receive acupuncture. MAIN OUTCOME MEASURES： In the marginal zone of focal cerebral ischemia in rats at different time points after intervention, the ultrastructure changes of astrocytes were observed by using transmission electronic microscopy. GFAP expression in astrocytes was also measured by laser confocal scanning microscopy. RESULTS： Cell swelling and rapid proliferation of astrocytes were observed following cerebral ischemia. In comparison to the model group, the degree of swelling of astrocytes was significantly decreased in the EA group. Compared with the sham operated group at hour 1 post-surgery, there was no significant difference in the expression of average fluorescence intensity of GFAP between the EA and model groups （P 〉 0.05）, while the expression of GFAP in both the EA and model groups increased significantly at days 1, 3, 7 and 21 post-surgery （P 〈 0.01）. The expression of GFAP in EA group was also significantly lower than in the model group （P 〈 0.01, P 〈 0.05）. CONCLUSION： Ultrastructural changes and reactive proliferation of astrocytes appear in the marginal zone of focal cerebral ischemia in rats. EA can relieve the degree of swelling of astrocytes and inhibit GFAP overexpression by activated astrocytes. These effects may be related to its ability to regulate the activated state of astrocytes.     

通冠胶囊对冠心病介入术后患者心功能及血清SDF-1的影响

目的：观察通冠胶囊对冠心病介入术（PCI）后患者的疗效及作用机制。方法：将60例冠心病行PcI的患者随机分为2组各30例,术前和术后30天分别进行心功能检测及患者血清基质细胞衍生因子-1（SDF-1）的检测,观察其变化。结果：2组术后1月LvEF均有明显改善（P〈0．01）,而治疗组LvEF的改善程度优于对照组（P〈0．05）。2组术后1月室壁运动积分均较术前有显著改变（P〈0．01）;同时发现治疗组室壁运动积分较对照组有显著降低（P〈0．01）。术后1月,治疗组NYHA分级与术前比较,差异有非常显著性意义（P〈0.01）,NYHAⅡ～Ⅳ级的人数由术前的19例减少为6例,对照组与术前比较,差异有显著性意义（P〈0．05）,NYHAⅡ～Ⅳ级的人数由术前的21例减少为15例;术后2组心功能分级比较,治疗组心功能不全的人数低于对照组,差异有显著性意义（P〈0．05）。2组患者术后1月SDF-1表达水平明显低于术前（P〈0．01,P〈0．05）。而治疗组sDF一1的表达显著高于于对照组（P〈0．05）。结论：通冠胶囊可以明显改善PCI术后患者的LvEF、室壁运动积分及心功能,可以上调冠心病患者的sDF-1表达。     

老年病中医四诊教学方法初探

老年病房是医院集中收治老年患者的专业科室，老年患者具有高龄、病情复杂、病程长等特点，对其的临床诊治工作除了应用现代医学手段，中医治疗也是非常重要的一方面。如何在老年病房进行中医临床教学，提高中医院校学生对老年病的中医辨证论治能力是值得探索和思考的问题之一。     

中医药干预血管内皮生长因子的研究进展

动脉粥样硬化和再狭窄的发病机制是血管内皮损伤,而在内皮的结构和功能损伤的修复过程中,血管内皮生成因子作用非常重要,本文从5个方面综述目前中医药干预血管内皮生长因子的研究进展及存在的问题和不足。     

归脾汤对老年慢性心力衰竭心脾两虚型患者心功能和肠道菌群的影响

目的：探讨归脾汤对老年慢性心力衰竭心脾两虚型患者心功能和肠道菌群的影响。方法：将60例老年慢性心力衰竭心脾两虚型患者随机分为治疗组和对照组,每组30例。对照组予常规抗心衰治疗,治疗组在对照组治疗的基础上加用归脾汤治疗,两组疗程均为4周。比较两组患者治疗前后N末端B型利钠肽前体（NT-proBNP）水平、左心室射血分数（LVEF）变化情况,并采用Illumina测序平台对各组粪便微生物进行16S rRNA高通量测序,分析两组肠道微生物群落的差异性。结果：治疗后,两组LVEF较治疗前升高,且治疗组高于对照组（P<0.05）;两组NT-proBNP水平较治疗前降低,且治疗组低于对照组（P<0.05）。测序结果显示,治疗后治疗组Chao1指数、ACE指数与对照组比较均显著升高（P<0.01或P<0.05）,Simpson指数均显著下降（P<0.01）;两组β-多样性分析无显著性差异（P>0.05）;治疗组治疗后考拉杆菌属、经黏液真杆菌属、颤螺菌属、梭状芽孢杆菌属、霍尔德曼氏菌属、弯曲杆菌属水平与治疗前比较相对丰度相似性存在差异（P<0.05）,其中拟杆...     

中医天人相应的养生观及针灸治疗观浅析

纵观古今,健康长寿一直是世人所追求、所向往的最朴实、最美好的人生目标,人们固然不能摆脱生、长、壮、老、已的事物发展规律,但要追求享尽天年,度百岁乃去则未尝不可.有关养生的方法、原则、意义,在<素问>的"上古天真论"、"四气调神论"、"生气通天论"篇中有着较集中的论述,在这些精辟的论述中,贯穿了<周易>、道家、儒家的思想.此就中医天人相应的养生观及针灸治疗观浅析如次.     

中西药联用治疗慢性心力衰竭20例临床研究

目的:观察参附注射液对慢性充血性心力衰竭的临床疗效及其对慢性心衰患者血清T3、T4、TSH水平的影响.方法:40例慢性充血性心力衰竭患者随机分为2组,每组20例.对照组在西医基础治疗上加用多巴酚丁胺针剂,治疗组在西医基础治疗上加用参附注射液,治疗14d,监测治疗前后2组患者中医症候积分、心功能分级及T3、T4、TSH的含量.结果:2组治疗后T3指标均明显高于治疗前,且治疗组改善程度明显优于对照组.结论:参附注射液可以纠正患者异常的甲状腺激素水平.甲状腺激素水平的变化对CHF患者的心功能损害程度、治疗和预后判断可能有一定意义.     

中医专业学位研究生临床技能培训四段式教学法探索

中医专业学位研究生的培养重在临床诊疗技能,如何提高研究生的临床诊疗技能,增强他们的临床实践能力和处理问题的能力,更好地适应临床医疗工作的需要,适应社会的需要,这是关系到专业学位研究生培养质量的一个首要问题。     

通冠胶囊对颈动脉球囊损伤后大鼠血清基质细胞衍生因子-1和血管内皮生长因子表达的影响

[目的] 观察通冠胶囊对颈动脉球囊损伤模型大鼠基质细胞衍生因子-1(SDF-1)和血管内皮生长因子(VEGF)表达的影响.[方法] 复制大鼠左颈总动脉球囊损伤模型,将54只造模成功的SD大鼠随机分为通冠胶囊组(剂量为600 mg·kg-1·d-1)、模型组和辛伐他汀组(剂量为2 mg·kg-1·d-1);于术后第4、8、12周处死动物,采用苏木素-伊红(HE)染色及弹力纤维染色法观察血管壁增生情况,采用计算机图像分析内、中膜面积比值(Ai/Am)观察通冠胶囊对新生内膜形成的影响,采用酶联免疫吸附法检测SDF-1、VEGF水平. [结果] 通冠胶囊组、辛伐他汀组与模型组比较,VEGF、SDF-1水平在颈动脉球囊损伤后不同时段大鼠的血清中表达显著增高(均P<0.01),8周时通冠胶囊组SDF-1表达较辛伐他汀组显著升高(P<0.05),12周通冠胶囊组VEGF表达与辛伐他汀组比较,差异有显著性意义(P<0.05).球囊损伤后4周内膜增生明显,8周形成的增生内膜有少量减少,12周时形成的新生内膜减少明显.通冠胶囊可使损伤后4、8、12周形成的新生内膜较模型组显著减少,Ai/Am较模型组显著降低(均P<0.01).[结论] 通冠胶囊可以促进大鼠颈总动脉球囊损伤后血清中SDF-1及VEGF的表达,并减少新生内膜的形成.     

1784例高血压病中医证型及证候要素的临床调查研究

目的:研究高血压病的中医证候要素分布情况。方法:采用横断面调查方法,对1 784高血压病住院患者应用临床调查表采集中医病名、证候类型及其证候要素等相关信息,并应用频数法进行分析。结果:中医与高血压病相关的病名有眩晕、胸痹、心悸、头痛等6种,以眩晕居多(82.40%);中医证候类型有7种,以风阳上扰证(31.61%)、痰湿壅盛证(26.51%)和肝肾阴虚证(15.86%)居多;证候要素有10种,以内风(47.48%)与阴虚(42.71%)居多,其次为阳亢、内湿、痰浊、气虚、内火、血虚、血瘀、阳虚等。结论:高血压病中医病名以眩晕为主,证候类型以风阳上扰证、痰湿壅盛证及肝肾阴虚证常见,证候要素以内风、阴虚、阳亢为主。