麝香保心丸辅助常规西药治疗急性心肌梗死气滞血瘀证临床研究

目的:观察麝香保心丸辅助常规西药治疗急性心肌梗死(AMI)气滞血瘀证的临床疗效。方法:选取AMI患者95例,按随机数字表法分为麝香保心丸组50例与常规组45例。常规组给予常规西药治疗,麝香保心丸组在常规组治疗方案的基础上加用麝香保心丸治疗。治疗8周后,比较2组临床疗效、症状改善情况,并检测心功能[左心室射血分数(LVEF)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)]、血管内皮功能[一氧化氮(NO)、内皮素(ET)]。结果:临床总有效率麝香保心丸组96.00%,高于常规组75.56%,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分较治疗前下降(P<0.05),且麝香保心丸组低于常规组(P<0.05)。治疗后,2组LVEF水平较治疗前上升,LVESV、LVEDV水平较治疗前下降(P<0.05),麝香保心丸组LVEF水平高于常规组,LVESV、LVEDV水平低于常规组(P<0.05)。治疗后,2组血清NO水平较治疗前上升,血清ET水平较治疗前下降(P<0.05),麝香保心丸组血清NO水平高于常规组,血清ET水平低于常规组(P<0.05)。结论:麝香保心丸辅助常规西药治疗AMI气滞血瘀证疗效确切,可有效帮助患者减轻临床症状,使其心功能、血管内皮功能明显改善。     

地稔的止血活性初探

目的研究地稔的止血作用,寻找其止血有效部位。方法选取健康小鼠,应用剪尾法、玻片法和毛细管法研究地稔水提液、50%乙醇提液和95%乙醇提液的止血凝血时间。然后对止血效果最好的提取液依次用氯仿、乙酸乙酯和正丁醇萃取,对所得萃取部位进行止血实验,找到地稔的止血有效部位。结果 3种提取液中以50%乙醇提液止血效果最佳:剪尾法止血时间为3±1.49min;玻片法凝血时间为1.4±0.45min;毛细管法凝血时间为1.8±0.48min。50%乙醇提液依次萃取的各部位中,正丁醇部位止血效果最佳:剪尾法止血时间为2.35±1.16min;玻片法凝血时间为1.4±0.56min;毛细管法凝血时间为1.4±0.57min。结论选取的3种提取溶剂以50%乙醇为最佳,地稔的止血有效部位为正丁醇部位。     

当归不同有效部位对高原低氧模型小鼠免疫功能的影响

目的探讨当归不同有效部位对高原低氧模型小鼠免疫功能的干预作用。方法将SPF级小鼠采用随机数字表法分为对照组、模型组、红景天组及当归有效部位B、X、C组。灌胃给药,每日1次,连续21 d。除对照组外,第8日起各组小鼠每日灌胃30 min后于低氧舱中模拟高海拔环境进行低氧暴露。第22日出舱称重后眼球采血处死小鼠,制备脾淋巴细胞悬液。MTT法检测各组小鼠脾淋巴细胞增殖能力、转化能力及NK细胞杀伤活力。ELISA检测各组小鼠血清白细胞介素(IL)-2含量。结果与对照组比较,模型组小鼠在处死前体质量明显下降,脾淋巴细胞增殖能力、转化能力、刺激指数及NK细胞杀伤活性均明显下降,血清IL-2含量明显降低(P0.05,P0.01);与模型组比较,各给药组小鼠脾淋巴细胞增殖能力、转化能力及NK细胞杀伤活性均明显升高(P0.05,P0.01),当归有效部位X组刺激指数明显升高,当归有效部位X、C组血清IL-2含量均明显升高(P0.05,P0.01)。结论当归不同有效部位对低氧暴露下的小鼠免疫功能具有一定的增强作用。     

Attenuation of diabetic nephropathy by Chaihuang-Yishen granule through anti-inflammatory mechanism in streptozotocin-induced rat model of diabetics

Ethnopharmacological relevance

Traditional Chinese medical herbs have been used in China for a long time to treat different diseases. Based on traditional Chinese medicine (TCM) principle, Chaihuang-Yishen granule (CHYS) was developed and has been employed clinically to treat chronic kidney disease including diabetic nephropathy (DN). The present study was designed to investigate its mechanism of action in treatment of DN.

Materials and methods

Diabetic rats were established by having a right uninephrectomy plus a single intraperitoneal injection of STZ. Rats were divided into four groups of sham, diabetes, diabetes with CHYS and diabetes with fosinopril. CHYS and fosinopril were given to rats by gavage for 20 weeks. Samples from blood, urine and kidney were collected for biochemical, histological, immunohistochemical and molecular analyses.

Results

Rats treated with CHYS showed reduced 24 h urinary protein excretion, decreased serum TC and TG levels, but CHYS treatment did not affect blood glucose level. Glomerular mesangial expansion and tubulointerstitial fibrosis in diabetic rats were significantly alleviated by CHYS treatment. Moreover, CHYS administration markedly reduced mRNA levels of NF-κB p65 and TGF-β1, as well as decreased protein levels of NF-κB p65, MCP-1, TNF-α and TGF-β1 in the kidney of diabetic rats.

Conclusions

CHYS ameliorates renal injury in diabetic rats through reduction of inflammatory cytokines and their intracellular signaling.     

怡心饮对糖尿病心脏病大鼠心肌CTGF-mRNA和MCP-lmRNA表达的影响

目的观察怡心饮对糖尿病心脏病大鼠心脏单核趋化因子1（MCP-1）和结缔组织生长因子（CTGT）mRNA表达的影响。方法运用高糖高脂饲料加链脲佐茵素腹腔注射建立大鼠2型糖尿病心肌病模型,分为怡心饮高剂量组、怡心饮低剂量组、生脉饮对照组、正常组、模型组。灌胃治疗8周后,观察糖尿病心肌病大鼠的心脏单核趋化因子1和结缔组织生长因子mRNA的表达,以及血清结缔组织生长因子的变化,分析其减轻大鼠心肌病变的机制。结果怡心饮能明显降低大鼠心肌单核趋化因子1和结缔组织生长因子ITIRNA表达,降低大鼠血清结缔组织生长因子含量。结论怡心饮对糖尿病大鼠心肌病变有一定的改善作用,其作用机制可能与降低单核趋化因子1和结缔组织生长因子mRNA的表达有关。     

慢性心力衰竭患者血清CA125水平与心功能的关系

目的探讨慢性心力衰竭（CHF）患者血清肿瘤相关抗原125（CA125）水平与心功能的关系。方法测定150例CHF患者血清CAl25,CAl53,CAl99,CEA,AFP及N末端脑钠肽前体（NT—proBNP）水平,通过心脏超声心动图测定左室射血分数（LVEF）。所有病例按照NYHA心功能分级标准分为心功能I～Ⅱ级组、Ⅲ级组、Ⅳ级组,根据有无合并胸腔积液、心包积液或外周水肿分为积液水肿组和非积液水肿组,根据有无合并房颤分为合并房颤组及未合并房颤组。另随机抽取心功能正常的50例健康体检者作为对照组。结果CHF患者血清CAl25水平高于对照组,Ⅳ级组血清CAl25水平明显高于Ⅲ级组,而Ⅳ级组明显高于I～Ⅱ级组。血清CAl99、CEA、AFP、CAl53水平在CHF组与对照组之间无显著性差异。CHF患者治疗前CAl25水平明显高于治疗后水平。CHF合并胸腔积液、心包积液或外周水肿患者血清CAl25水平明显高于无这些体征的患者。CHF合并房颤患者与未合并房颤患者的CAl25水平比较无显著性差异。CHF患者血清CAl25水平与NT—proBNP水平呈正相关,与LVEF呈负相关,与导致CHF的原发病种类不相关。结论血清CAl25水平随心功能恶化而升高,随心功能改善而减低,可用来评价心力衰竭严重程度、治疗疗效及短期预后。血清CAl25水平与胸腔积液、心包积液、外周水肿、NT—proBNP、LVEF有关,与房颤及导致心力衰竭的原发病种类无关。     

缓释辅料对三七总皂苷缓释片中人参皂苷Rg1,Rb1释药特性的影响

目的 :探讨缓释辅料对三七总皂苷缓释片中人参皂苷Rg₁,Rb₁释药特性的影响。方法 :通过考察由HPMC和EC 2种缓释辅料 ,不同黏度规格的EC ,以及EC的不同用量制成的缓释骨架片 ,测定人参皂苷Rg₁,Rb₁在这些缓释片中的释放度。结果 :缓释辅料的种类 ,规格及用量均影响人参皂苷Rg₁,Rb₁的释药特性 ,在各缓释片中人参皂苷Rg₁,Rb₁间的释药行为也存在差异。结论 :中药有效部位缓释制剂研究中应当重视有效成分间释药特性的异同。     

胆红素对新生儿脐血单核细胞髓样分化蛋白-2、肿瘤坏死因子受体相关因子6mRNA表达的影响

目的观察脐血单核细胞(CBMC)经不同水平胆红素孵育后髓样分化蛋白2(MD-2)、TNF受体相关因子6(TRAF6)mRNA表达的变化。方法采集10例健康足月新生儿的脐血,经纤维蛋白结合法分离得CBMC,将其加入含不同水平胆红素(0μmol.L-1、17.1μmol.L-1、42.8μmol.L-1、102.6μmol.L-1、153.9μmol.L-1、220.6μmol.L-1和307.8μmol.L-1)的牛血清清蛋白溶液中孵育1 h,再加入脂多糖(LPS)刺激30 min。收集CBMC,采用反转录-PCR方法测定其MD-2、TRAF6 mRNA的表达水平。结果 1.LPS单独作用对CMBC MD-2 mRNA和TRAF6 mRNA表达水平无明显影响,低水平胆红素(17.1μmol.L-1、42.8μmol.L-1)单独作用对CBMC MD-2 mRNA和TRAF6 mRNA表达水平无明显影响。2.先经不同水平胆红素孵育,再接受LPS刺激,胆红素有抑制细胞MD-2 mRNA表达的趋势,随着胆红素水平的升高,抑制趋势越明显;先经不同水平胆红素孵育,再接受LPS刺激,低水平胆红素促进细胞TRAF6 mRNA的表达,当胆红素≥102.6μmol.L-1时,抑制TRAF6 mRNA表达,胆红素水平越高,抑制作用越明显。在相同胆红素水平作用下,随着MD-2 mRNA表达水平的降低,TRAF6 mRNA表达水平随之降低。结论低水平胆红素对CBMC MD-2 mRNA的表达无明显影响,对TRAF6 mRNA的表达有促进作用。高水平胆红素对二者的表达均有抑制作用,随着胆红素水平升高,抑制作用越来越明显。高胆红素血症患儿免疫功能低下可能与高浓度胆红素对免疫细胞的抑制作用有关。     

“Heart failure in COVID-19 patients: Critical care experience”: A letter to the editor

Coronavirus disease 2019 (COVID-19) is associated with poor cardiovascular outcomes in patients with heart failure (HF) of all categories of ejection fraction (EF), but mainly in patients with HF with reduced EF. Moreover, cardiac transplant patients exhibit worse cardiovascular prognosis, high mortality, and more admissions to the intensive care unit. In general, COVID-19 seems to de-teriorate the clinical status of HF and favors the development of acute respiratory distress syndrome and multiorgan failure, especially in the presence of cardiovascular comorbidities such as diabetes mellitus, kidney dysfunction, and older age. COVID-19 may induce new-onset HF with complex mechanisms that involve myocardial injury. Indeed, myocardial injury comprises a large category of detrimental effects for the myocardium, such as myocardial infarction type 1 or type 2, Takotsubo cardiomyopathy, microvascular dysfunction and myocarditis, which are not easily distinguished by HF. The pathophysiologic mechanisms mainly involve direct myocardial damage by severe acute respiratory syndrome coronavirus 2, cytokine storm, hypercoagulation, inflammation, and endothelial dysfunction. The proper management of patients with COVID-19 involves careful patient evaluation and ongoing monitoring for complications such as HF.