平阳霉素对呼吸道黏膜的影响及其预防探讨

目的　观察平阳霉素对健康Wistar大鼠鼻和气管黏膜组织形态、超微结构的影响并探讨维生素E(VitE)、复方丹参注射液对它的干预作用。方法　健康Wistar大鼠 3 0只采用随机数字表法分为 4组 ,甲组 :对照组 (腹腔注射 0 9%氯化钠溶液 ) ;乙组 :平阳霉素腹腔注射组 ,每次 1 0mg/kg体重每周 2次 ,共 4周 ;丙组 :平阳霉素腹腔注射 +VitE灌胃组 ;丁组 :平阳霉素腹腔注射 +复方丹参注射液腹腔注射组。于 1、2、4、6周取鼻和气管黏膜行光镜和电镜观察。结果　乙组在第 1周见细胞水肿、变性 ,表现为内质网扩张 ,线粒体肿胀 ,嵴排列紊乱 ,线粒体空泡化 ,部分细胞线粒体减少 ,核周间隙轻度扩大 ,染色质轻度边集等。第 2周见上皮细胞坏死、脱落 ,细胞膜破裂 ,线粒体、内质网等细胞器外溢。第 4周细胞受损伤程度更加重 ,停药 2周后仍呈较重损伤。丙、丁 2组均可见细胞受损伤程度明显减轻 ,且出现时间推迟 ,停用平阳霉素并续用VitE、复方丹参注射液 2周可见细胞无明显改变 ,与甲组相似。结论　平阳霉素可损伤健康Wistar大鼠鼻和气管黏膜 ,并随剂量增加而损伤程度加重 ;VitE、复方丹参注射液均可减轻平阳霉素对Wistar大鼠鼻和气管黏膜的损害 ,对平阳霉素的呼吸道黏膜损伤具有保护作用     

急慢性高黏滞血症模型动物血管内皮细胞分泌功能的变化及复方丹参滴丸干预作用研究

[目的]观察复方丹参滴丸对高黏滞血症血管内皮分泌功能的影响，探索其作用机制。[方法]复合因素(高分子右旋糖酐、肾上腺素、牛血清白蛋白)、长时间(112d)造成高黏滞血症慢性模型；1次性静脉注射高分子右旋糖酐，皮下注射肾上腺素造成急性高黏滞血症模型，分别用复方丹参滴丸进行治疗，观察血管内皮细胞分泌功能的变化及复方丹参滴丸的干预效果。[结果]1)慢性高黏滞血症模型血浆血栓素B2（TXB2)和内皮素(ET)浓度非常显著升高，而6-酮-前列腺素F1A(6-酮)浓度非常显著降低；2)急性高黏滞血症模型血管内皮分泌功能无显著变化；3)长期使用复方丹参滴丸能调整、改善血管内皮分泌功能的异常状态；4)复方丹参滴丸改善血管内皮分泌功能的即时效应不显著。[结论]长期应用复方丹参滴丸能调整、改善血管内皮分泌功能，血管内皮细胞可能是复方丹参滴丸的作用靶点之一，但本药改善血管内皮分泌功能的即时效应不显著。     

Response of Human Insulinoma Cells to Extracellular Calcium Is Different from Normal B Cells

The preoperative determination of thelocalization of a small insulinoma is sometimesdifficult using routine imaging techniques. We have usedthe selective arterial calcium injection (SACI) test todetermine the location of the tumor preoperatively. Thepathophysiologic basis of the SACI test is based on theresponsiveness of insulinomas to calcium injected intothe feeding artery. In this study, we demonstrated the in vitro response of the insulinoma cellsto the extracellular calcium challenge by usingprimary-cultured insulinoma cells. Human insulinomacells were obtained from three patients. MIN6 cells(normal pancreatic B cells) were used as a control;their insulin response to various stimuli resembles thatof normal B cells. The insulin secretory dynamics inresponse to extracellular calcium were observed using a perfusion system. Second, the change ofthe concentration of cytosolic free calcium([Ca²⁺]_i) was monitored byfluorometry using fura-2/AM. When the concentration ofextracellular calcium ([Ca²⁺]_o) was changed from 2.54 mM to 10 mM, insulinsecretion from the insulinoma cells was markedlyincreased within 6 min (10- to 18-fold at maximum), andrapidly returned to the basal level; at the same time, [Ca²⁺]_i was immediatelyelevated and reached a peak within 1 min. In contrast,in the MIN6 cells, the insulin secretion and [Ca2+]iwere not significantly changed when[Ca²⁺]_o was switched to 10 mM. The results of these in vitro experiments agreedwith the clinical results of the SACI test. The positiveresponse of the insulinoma to the SACI test is probablydue to the different response of insulinoma cells to the extracellular calcium challengecompared with normal B cells. The role of[Ca²⁺]_i may be important in themechanism underlying the SACI test.     

Submucosal injection of poly(lactic-co-glycolic acid) microspheres in rabbit bladder as a potential treatment for urinary incontinence and vesicoureteral reflux: preliminary results

Endoscopic injection of bulking agents has been gaining attention as a therapy for urinary incontinence and vesicoureteral reflux because this therapy is simpler, less operation time-consuming and less painful than traditional surgical operations. The ideal bulking agent for the injection therapies must be easily injectable, biocompatible, volume-stable, non-antigenic and non-migratory. We evaluated poly(lactic-co-glycolic acid) (PLGA) microspheres as an injectable bulking agent for urologic injection therapies. To determine whether PLGA microspheres meet the requirements of an ideal bulking agent, PLGA microspheres were injected into the submucosal sites of a rabbit bladder wall. The microspheres were easily injectable. Two and five weeks post-implantation, histological examinations indicated that host cells from the surrounding bladder tissues migrated to the space between the injected microspheres and formed new hybrid tissue structures. Lymphocyte migration was noted around the implanted microspheres, but the inflammatory reaction diminished at 5 weeks. The hybrid tissue volume did not significantly decrease over time. There was no evidence of microsphere migration to the distant organs. Although long-term studies are needed to evaluate the therapeutic potential of this method, these preliminary results suggest the possibility of PLGA microspheres as a potentially useful injection material for urinary injection therapies.     

静脉滴注丹参注射液致过敏反应1例

病例介绍患者,男性,58岁。因反复腰痛30年、加重2月,伴双足麻木1月,于2005年9月16日来我院门诊,经检查和Ⅹ线确诊后,以“腰椎间盘突出症、腰椎骨质增生、高血压Ⅱ期”收住入院。入院后测T36.5℃,P90次/min,R20次/min,BP165/110mmHg,医嘱给予静脉滴注能量合剂和灯盏花素,无异常反应,4天后停用;第6天给予丹参注射液250ml静脉滴注,40滴/min,5min后患者感觉双脚心瘙痒,继之四肢及背部极度瘙痒,无法忍受,并出现少量皮疹,立即停药,给予肌肉注射非那根25mg,静脉推注地塞米松5mg,5min后症状减轻,10min后症状消失,以后改用5%GS250ml 血塞通400mg…     

清开灵注射液治疗原发性肝癌介入后综合征

[目的]观察清开灵注射液治疗原发性肝癌行经肝动脉化疗栓塞（TACE）介入后综合征的疗效。[方法]将46例行经肝动脉灌注化疗栓塞的原发性肝癌患者,随机分库药组和对照组。于ATXE治疗后当天,中药组予清开灵注射液40mL静脉滴注,1次/d。连续7d;对照组予抗生素静脉滴注。[结果]中药组在减轻发热、腹痛、恶心呕吐、便秘等副作用的程度以及在缩短TACE后毒副反应持续时间方面,均优于对照组,中药组在TACE后有显著的护肝降酶作用,能提高原发性肝癌患者对TACE所致肝功损害的耐受性。[结论]清开灵注射液对原发性肝癌行TACE治疗后的栓塞综合征有较好的疗效。     

活血化瘀中药对原发性青光眼患者视力的影响

【目的】探讨活血化瘀中药对原发性青光眼患者视力的影响。【方法】回顾性总结原发性青光眼 32例6 0眼治疗前后的视力变化。根据用药方法不同分为常规治疗组 (33眼 )和活血化瘀组 (2 7眼 ) ,常规治疗组按病情常规给予降眼压药物及手术治疗。活血化瘀组在常规治疗的基础上加用活血化瘀药物。【结果】常规治疗组治疗后 8眼 (2 4 .2 4 % )视力提高 ,活血化瘀组治疗后 16眼 (5 9.2 6 % )视力提高 ,两组疗效差异有显著性 (P<0 .0 5 )。活血化瘀组中采用复方丹参注射液者 15眼 ,治疗后 8眼 (5 3.33% )视力提高 ,采用脉络宁注射液者 8眼 ,治疗后 6眼 (75 % )视力提高 ,差异无显著性 (P>0 .0 5 )。【结论】在常规治疗的基础上 ,加用活血化瘀中药治疗有助于提高原发性青光眼患者的视力。     

Trigger Point Dry Needling

Abstract

Trigger point dry needling is a treatment technique used by physical therapists around the world. In the United States, trigger point dry needling has been approved as within the scope of physical therapy practice in a growing number of states. There are several dry needling techniques, based on different models, including the radiculopathy model and the trigger point model, which are discussed here in detail. Special attention is paid to the clinical evidence for trigger point dry needling and the underlying mechanisms. Comparisons with injection therapy and acupuncture are reviewed. Trigger point dry needling is a relatively new technique used in combination with other physical therapy interventions.     

丹参及丹参注射液指纹图谱的HPLC-MS研究

目的 采用HPLC－UV－MS法对丹参药材、丹参注射液中间体及丹参注射液进行指纹图谱的研究。方法 采用Alltima C18分析柱，甲醇－水－冰醋酸梯度洗脱系统，流速：1mL/min，检测波长：281nm，MS册时记录总离子流（TIC）色谱图。结果 得到分离度较好的丹参药材、中间体及注射液的HPLC－UV及HPLC－MS指纹图谱。结论为丹参药材、中间体及注射液的质量控制提供全面、可靠的依据。     

Use of FDP and F1P Aldolase to Detect Tumorous and Nontumorous Tissue Damage by Ethanol Injection of Hepatocellular Carcinoma

Changes in serum levels of tumor-specificfructose 1,6-diphosphate (FDP) aldolase andnontumor-specific fructose 1-phosphate (F1P) aldolaseactivities were analyzed in patients with hepatocellularcarcinoma (HCC) to detect the damage of tumorous andnontumorous hepatic cells after percutaneous ethanolinjection (PEI). Initial PEI was performed in 20patients containing 22 HCC nodules with a diameter of4 cm. Changes in serum hepatic enzyme activities weremeasured before and after repeated PEI. FDP and F1Paldolase levels were measured by substrate-specificenzymatic methods. Pre- and posttreatment-fetoprotein (AFP) levels were determined byradioimmunoassay. The consequent changes in the totalnontumorous liver volumes after PEI were also analyzedby follow-up CT scans. Serum levels of FDP aldolasereleased by ethanol injection were progressivelyincreased (P < 0.0001) until the third PEI andthereafter decreased. In contrast, serum levels of F1Paldolase were continuously elevated even after the third PEI (P < 0.0001). Serum levels oftransaminases were also elevated after repeated PEI (P< 0.0001). The FDP/F1P aldolase ratio decreasedsignificantly with increased volume (>20 ml) ofinjected ethanol (P = 0.01) caused by nontumorous liverdamage. The elevation of FDP aldolase was markedlyassociated with a decrease in serum levels of AFP (P< 0.001), indicating adequate tumor necrosis. The progression of the total nontumor liver atrophydepended on the volume of injected ethanol andcorrelated significantly with F1P aldolase levels afterPEI (P < 0.01) but not with FDP aldolase. These results demonstrated that caution is needed toavoid nontumorous liver damage caused by the largevolume of ethanol injection in treating HCC. Measurementof FDP and F1P aldolase activities in serum after PEI is clinically useful to detect the degreeof tumorous and nontumorous tissue damage byethanol.