滋肾方和调心方对阿尔茨海默病模型大鼠疗效比较

目的:探讨调心方和滋肾方对阿尔茨海默病(Alzheimer's disease,AD)模型大鼠治疗机制及疗效比较。方法:持续注射D-半乳糖法致亚急性衰老大鼠模型,再用鹅膏蕈氨酸(ibotenic acid,IA)化学损毁大鼠双侧Meynert基底核。造模后,大鼠分为AD模型组、调心方组、滋肾方组、脑复康组。给药治疗前后以"Y"型电迷宫进行学习记忆观察,用分光光度法测定大鼠海马组织胆碱酯酶(cholinesterase,CHE)的活性,并与对照组比较。结果:调心方组大鼠学习能力提高(P<0.05),滋肾方组大鼠学习和记忆能力均提高(P<0.05或P<0.01),调心方组和滋肾方组大鼠海马组织中CHE活性较AD模型组均提高(P<0.01)。结论:调心方和滋肾方均可以提高AD模型大鼠学习记忆能力,其作用机制可能与大鼠海马组织中CHE活性改变有关。     

The Impact of Acute Kidney Injury With Temporary Dialysis on the Risk of Fracture

Acute kidney injury (AKI) has a negative impact on long‐term renal function and prognosis. However, the association between acute renal dysfunction and long‐term effects on bone disorders has not yet been characterized. Using a population‐based cohort study, we aimed to evaluate associations between AKI and long‐term effects on bone fractures. We identified relevant data of all hospitalized patients aged >18 years with histories of dialysis‐requiring AKI, with subsequent recovery and discharge, from the claim records of the Taiwan National Health Insurance database between 2000 and 2008. We determined long‐term de novo bone fracture and all‐cause mortality after patients' index‐hospitalization discharge using propensity score–adjusted Cox proportional hazard model. Varying‐time models were used to adjust for long‐term effects of end‐stage renal disease (ESRD) on main outcomes. Among 448 AKI patients who had dialysis and survived 90 days after index‐hospitalization discharge without reentering dialysis, 273 were male (60.9%) with a mean age of 61.4 ± 16.6 years. Controls included 1792 hospitalized patients without AKI, dialysis, or bone fracture history. In the AKI recovery group, bone fracture incidence was 320 per 10,000 person‐years and hazard ratio (HR) of long‐term bone fracture was 1.25 (p = 0.049) compared with the control group, independent of subsequent ESRD status (HR = 1.55; p = 0.01). Both AKI recovery status (HR = 2.31; p < 0.001) and time varying factor of bone fracture (HR = 1.43; p < 0.001) were independent predictors of mortality compared with controls. In conclusion, AKI requiring temporary dialysis independently increases long‐term risk of bone fracture, regardless of subsequent progression to ESRD. Long‐term bone fractures may negatively impact patient mortality. © 2014 American Society for Bone and Mineral Research.     

The antioxidant tempol ameliorates arterial medial calcification in uremic rats: important role of oxidative stress in the pathogenesis of vascular calcification in chronic kidney disease

Vascular calcification is closely related to cardiovascular morbidity and mortality. Accumulating data indicate that oxidative stress is associated with dysfunction of various organs, including cardiovascular diseases in chronic kidney disease (CKD). However, it remains undetermined if oxidative stress induced by uremia promotes arterial medial calcification. The present study investigated the role of oxidative stress in the pathogenesis of arterial medial calcification in uremic rats. Rats with uremia induced by adenine-rich diet progressively developed arterial medial calcification, which was accompanied by time-dependent increases in both aortic and systemic oxidative stress. Immunohistochemical and biochemical analyses showed that the arterial medial calcification progressed in a time-dependent manner that is parallel to the osteogenic transdifferentiation of vascular smooth muscle cells. Accumulation of oxidative stress was also identified in the calcified regions. Time-course studies indicated that both oxidative stress and hyperphosphatemia correlated with arterial medial calcification. Tempol, an antioxidant, ameliorated osteogenic transdifferentiation of vascular smooth muscle cells and arterial medial calcification in uremic rats, together with reduction in aortic and systemic oxidative stress levels, without affecting serum biochemical parameters. Our data suggest that oxidative stress induced by uremia can play a role in the pathogenesis of vascular calcification in CKD, and that antioxidants such as tempol are potentially useful in preventing the progression of vascular calcification in CKD.     

祛风凉血补肾法治疗难治性特发性血小板减少性紫癜的临床观察

[目的]观察祛风凉血补肾法对难治性特发性血小板减少性紫癜(ITP)患者的治疗效果.[方法]对15例难治性ITP患者,予以祛风凉血补肾法治疗,经治疗3个疗程(共18周)后统计临床疗效,并观察治疗前后血小板数量和巨核细胞成熟情况的变化.[结果](1)15例患者中,临床治愈8例,显效4例,有效2例,无效1例,总有效率为93.3%.(2)治疗后患者的血小板明显上升(与治疗前比较,P＜0.01);骨髓中幼巨细胞、颗粒巨细胞明显减少,产板巨细胞明显增多(与治疗前比较,P＜0.05).[结论]以祛风凉血补肾法治疗难治性ITP,疗效满意,值得进一步推广应用.     

补肾健脾利湿中药在体外受精—胚胎移植周期中防治卵巢过度刺激综合征的临床研究

【目的】研究补肾健脾利湿中药在体外受精—胚胎移植(IVF-ET)周期中防治卵巢过度刺激综合征(OHSS)的效果。【方法】筛查IVF-ET超促排卵周期OHSS高危因素患者68例,随机分为中药组(37例)和对照组(31例),2组应用相同的超促排卵方案,中药组加用补肾健脾利湿中药。比较2组的临床各项指标及OHSS的发生情况。【结果】2组患者的年龄、体质量指数(BMI)、促性腺激素(Gn)用量、Gn天数、获卵数、应用人绒毛膜促性腺激素日(HCG日)雌二醇(E2)水平及临床妊娠率等比较差异均无统计学意义(P>0.05)。胚胎移植日中药组OHSS发生率(21.6%)显著低于对照组(87.1%),差异有统计学意义(P<0.05);中药组新鲜周期胚胎移植率(94.6%)显著高于对照组(45.2%),差异有统计学意义(P<0.05)。2组共19例患者为了预防中、重度OHSS的发生进行了全部胚胎冻存。【结论】对于IVF-ET周期OHSS高危患者加用补肾健脾利湿中药,能显著降低OHSS发生率和OHSS严重程度,增加OHSS高危患者新鲜周期胚胎移植率。