再生障碍性贫血小鼠T-bet表达及骨髓巨噬细胞对其表达的影响

目的 探讨再生障碍性贫血(简称再障)小鼠外周血单个核细胞Th1细胞转录因子T-bet的表达及骨髓巨噬细胞对正常小鼠外周血单个核细胞T-bet的影响. 方法 ①免疫介导(γ射线照射和淋巴细胞输入)的方法 建立再障小鼠模型.②RT-PCR方法 检测再障小鼠外周血单个核细胞上T-bet mRNA的表达.③正常小鼠外周血单个核细胞分别经再障小鼠骨髓基质细胞培养上清和小鼠骨髓型正常巨噬细胞株Ana-1培养上清刺激后,用RT-PCR方法 检测T-bet mRNA的表达. 结果 ①再障小鼠外周血单个核细胞T-bet mRNA的表达(1.49±0.18)较正常对照组(1.03±0.06)增高(P<0.05);②正常小鼠外周血单个核细胞分别经再障小鼠骨髓基质细胞培养上清和Ana-1细胞株培养上清刺激后,T-bet mRNA的表达分别为1.29±0.03和1.54±0.03,均较正常对照组(1.03±0.06)增高(均P<0.05). 结论 结果 提示巨噬细胞可能通过增加T-bet的表达参与再生障碍性贫血的免疫发病机制.     

重组人骨形成蛋白成熟肽4对急性放射损伤小鼠造血系统的修复作用

目的探讨重组人骨形成蛋白成熟肽-4(rhBMP-4m)对~(60)Coγ射线照射引起的小鼠造血系统损伤的修复作用。方法 90只BALB/c小鼠随机分为正常对照组、模型组和rhBMP-4m治疗组,每组30只。模型组和rhBMP-4m治疗组小鼠接受~(60)Coγ射线照射,照射剂量7 Gy,全身照射200 s;正常对照组小鼠不接受照射。模型组小鼠每日腹腔注射生理盐水1.0 mL,rhBMP-4m治疗组小鼠每日腹腔注射rhBMP-4m 0.5 mg,连续治疗6 d。分别于照射后第1、3、5、7、9天检测小鼠外周血白细胞数、骨髓单个核细胞数、骨髓单个核细胞中CD34~+细胞比例;照射后第9天进行脾结节计数,并计算脾脏质量与体质量的比值(脾体比)。结果照射后第1天3组小鼠外周血白细胞计数比较差异均无统计学意义(P>0.05);照射后第3、5、7、9天模型组小鼠外周血白细胞计数低于正常对照组(P<0.01);照射后第3、5天rhBMP-4m治疗组小鼠外周血白细胞计数与模型组比较差异无统计学意义(P>0.05),照射后第7、9天rhBMP-4m治疗组小鼠外周血白细胞计数高于模型组(P<0.05)。模型组小鼠照射后各时间点骨髓单个核细胞计数均低于正常对照组(P<0.01)。照射后第1、3天rhBMP-4m治疗组小鼠骨髓单个核细胞计数与模型组比较差异无统计学意义(P>0.05),照射后第5、7、9天rhBMP-4m治疗组小鼠骨髓单个核细胞计数高于模型组(P<0.05)。模型组小鼠照射后各时间点的单个核细胞中CD34~+细胞百分率均低于正常对照组(P<0.01)。rhBMP-4m治疗组小鼠照射后第1、3天单个核细胞中CD34~+细胞百分率与模型组比较差异均无统计学意义(P>0.05),照射后第5、7、9天rhBMP-4m治疗组小鼠单个核细胞中CD34~+细胞的百分率高于模型组(P<0.05)。照射后第9天,模型组小鼠脾结节计数高于正常对照组,脾体比低于正常对照组(P<0.05);rhBMP-4m治疗组小鼠脾结节计数和脾体比高于模型组(P<0.01)。结论辐射可引起小鼠骨髓造血系统损伤,rhBMP-4m能够促进骨髓造血系统的重建。     

鹿龙再生汤对再障小鼠外周血单个核细胞及脾teff细胞T-bet和GATA-3基因表达的影响

目的 探讨鹿龙再生汤对再生障碍性贫血(简称再障)模型小鼠外周血单个核细胞以及脾CD4+CD25-细胞(teff细胞)中T-bet、GATA-3基因表达的影响.方法 通过IFN-γ腹腔注射加白消安灌胃的方法建造40只再障小鼠模型,分别予同体积的生理盐水、一般浓度、5倍浓度和10倍浓度的鹿龙再生汤进行灌胃治疗,分别归为再障组、再障小剂量组、再障中剂量组和再障大剂量组(n=10);另取40只正常小鼠按上述方法进行分组处理,分别归为正常组、正常小剂量组、正常中剂量组和正常大剂量组(n=10).通过骨髓活检病理学检查观察用药后各组小鼠的骨髓造血变化,免疫磁珠分选各组小鼠脾teff细胞,利用RT-PCR技术检测各组小鼠外周血单个核细胞以及脾teff细胞T-bet、GATA-3基因mRNA的表达情况.结果 (1)与再障组相比,再障中剂量组和再障大剂量组小鼠的骨髓造血有所恢复,尤其是再障大剂量组.(2)再障大剂量组小鼠的外周血单个核细胞以及脾teff细胞T-bet基因mRNA的表达、T-bet/GATA-3的比值较再障组均明显下降(P＜0.05),而GATA-3基因mRNA的表达明显上调(P＜0.05).结论 大剂量鹿龙再生汤可改善再障小鼠骨髓造血功能,可能是通过调节再障小鼠外周血单个核细胞及脾teff细胞的T-bet、GATA-3基因的表达来实现.     

升白胶囊对环磷酰胺所致小鼠白细胞减少症影响的研究

目的研究升白胶囊对环磷酰胺所致小鼠白细胞减少症的影响以及升高白细胞的作用机制。方法将60只小鼠随机分为正常对照组,模型对照组,贞芪扶正胶囊组及升白胶囊大、小剂量组,每组12只,各组分别灌胃给予蒸馏水及相应药物混悬液,灌胃第8 d,除正常对照组外,其余4组小鼠通过腹腔注射环磷酰胺制备白细胞减少症模型,观测升白胶囊对小鼠外周血象、骨髓有核细胞数和骨髓DNA含量的影响。结果与正常对照组比较,模型对照组白细胞(WBC)数、骨髓有核细胞(BMNC)数及骨髓DNA含量显著降低(P0.01);与模型对照组比较,贞芪扶正胶囊组与升白胶囊大、小剂量组WBC数、BMNC数及骨髓DNA含量显著升高(P0.01或P0.05)。结论升白胶囊对环磷酰胺所致小鼠白细胞减少有显著的升高作用,其机制与促进骨髓造血功能有关。     

再生障碍性贫血发病机制的初步研究

目的:探讨再生障碍性贫血(再障)的发病机制.方法:采用甲基纤维素半固体培养法及胶原半固体培养法对56例再障患者的骨髓CFU-GM、CFU-E、BFU-E及CFU-MK、BFU-MK进行培养;采用APAAP法及双抗体夹心酶联免疫吸附法(ELISA)对再障患者外周血T细胞亚群、血清sIL-2R进行检测.结果:再障患者CFU-GM、CFU-E、BFU-E及CFU-MK、BFU-MK集落数均明显低于对照组(P＜0.01),且严重型再障CFU-GM、CFU-E、BFU-E及CFU-MK、BFU-MK集落数减少程度较慢性再障更明显;再障患者CD3亚群细胞无变化,CD4亚群细胞减低,CD8亚群细胞增高,CD4/CD8降低,重型再障患者血清sIL-2R中水平明显高于对照组(均P＜0.01). 结论:骨髓造血祖细胞数量减少是再障发病的重要因素,其减少程度与再障的病情有关;细胞免疫功能异常及造血负调控因子可能在再障发病中起一定的作用.     

血小板因子4对环磷酰胺损伤小鼠骨髓细胞增殖能力的影响

目的 探讨血小板因子4(PF4)对环磷酰胺(CTX)诱导的化学损伤小鼠骨髓细胞增殖能力的影响. 方法 36只小鼠随机分为PF4组、CTX组和对照组.小鼠腹腔注射CTX 200 mg/kg制备化学药物损伤小鼠模型.在注射CTX前26 h和20 h,PF4组和CTX组各注射PF4(40μg/kg)和等体积的PBS缓冲液,对照组只注射等体积的PBS缓冲液.通过体外双层琼脂培养法测定PF4对CTX损伤小鼠骨髓细胞粒一巨噬细胞集落(CFU-GM)形成的影响,流式细胞仪测定细胞周期的变化.结果 注射CTX后第5天CTX组骨髓细胞数(BMK)较对照组显著减少(P<0.01);第8天PF4组BMK较CTX组显著增多(P<0.01).注射CTX后第5天CTX组骨髓CFU-GM数量较对照组和PF4组显著减少(P<0.01);第8天PF4组与CTX组的骨髓CFU-GM数量均有不同程度的上升,但两组间差异仍有统计学意义(P<0.05).注射CTX后第5天PF4组骨髓有核细胞GO/G1期细胞百分率比CTX组显著提高,且细胞坏死、凋亡率显著下降(P<0.01),而与对照组相比差异无统计学意义(P>0.05).第8天各组间G0/G1期细胞百分率、细胞坏死/凋亡率差异均无统计学意义(P>0.05). 结论 PF4使处于G0/G1期的骨髓细胞数增多,降低了其坏死和凋亡率,增加骨髓细胞CFU-GM集落形成率.     

血必净注射液对2Gy照射小鼠造血系统的保护作用

目的:探讨血必净注射液对辐射诱导小鼠造血系统损伤的影响。方法:将ICR小鼠分为对照组、照射组、血必净组。对照组接受假照射,对其余两组进行2Gy全身照射。血必净组小鼠0.4ml/kg腹腔注射,照射前3d开始给药,持续给药8d。血必净末次给药24h后处死小鼠,取外周血和单侧股骨细胞进行计数,取胸腺和脾脏计算脏器指数,检测骨髓细胞CFU-GM。结果:与对照组比较,照射组小鼠外周血白细胞和骨髓有核细胞计数、胸腺和脾脏指数、CFU-GM均明显下降(P<0.05),而血必净组小鼠除胸腺指数外也均显著下降(P<0.05)。与照射组相比,血必净组小鼠外周血白细胞、胸腺指数及CFU-GM有显著提高(P<0.05)。结论:血必净注射液对辐射引起的造血系统损伤有一定的保护作用。     

当归多糖对辐射损伤小鼠造血系统保护作用的研究

目的研究当归多糖(APS)对电离辐射引起小鼠骨髓损伤的影响,旨在阐明APS对辐射性造血损伤的保护作用。方法采用直线加速器一次性4.0Gy剂量全身均匀照射C57BL/6小鼠,建立小鼠放射损伤动物模型。取外周血并进行常规检测,提取骨髓单个核细胞(BMNC)并计数;骨髓切片染色观察骨髓造血细胞数量改变;流式细胞术检测细胞周期,细胞凋亡率;免疫细胞化学法检测p53的表达。结果与对照组相比,生理盐水(NS)组外周血白细胞(WBC)、红细胞(RBC)、血小板(PLT)及BMNC计数均明显减少,骨髓腔内造血组织显著减少,BMNC G0/G1期比例、凋亡率、p53表达均升高;2mg/kg APS组和8mg/kg APS组均能提高外周血WBC、RBC、PLT及BMNC计数,增加骨髓腔内造血细胞数量,降低G0/G1期细胞比例以及细胞凋亡率。结论 APS可以促进骨髓造血系统恢复,对辐射损伤具有良好的保护作用。     

升白胶囊对辐射所致小鼠白细胞减少症影响的研究

目的探讨升白胶囊对辐射所致小鼠外周血白细胞减少症的影响以及升高白细胞的作用机制。方法将60只小鼠随机分为5组,正常对照组、模型对照组、贞芪扶正胶囊组、升白胶囊大剂量组、升白胶囊小剂量组,每组12只。经低能X射线照射制备小鼠白细胞减少症模型,造模成功后各组分别给予相应药物灌胃。造模后第8d、第14d取血及股骨进行检测。观测小鼠外周血象、骨髓有核细胞数(BMNC)和骨髓DNA的含量。结果与正常对照组比较,模型对照组白细胞(WBC)数、BMNC数及骨髓DNA含量显著降低(P﹤0.01);与模型对照组比较,贞芪扶正胶囊组与升白胶囊大剂量组第8d、第14dWBC数及升白胶囊小剂量组第14dWBC数显著升高(P﹤0.01);与模型对照组比较,贞芪扶正胶囊组、升白胶囊大剂量组BMNC数及骨髓DNA含量显著升高(P﹤0.01或P﹤0.05),升白胶囊小剂量组骨髓DNA含量显著升高(P﹤0.05)。结论升白胶囊对低能X射线照射所致小鼠白细胞减少有显著升高作用,其机制与促进骨髓造血功能有关。     

补肾解毒活血法对环磷酰胺所致小鼠骨髓抑制的预防作用研究

目的研究补肾解毒活血法对环磷酰胺所致骨髓抑制的预防作用及机制。方法昆明小鼠60只,随机分成空白组、模型组和中药预防组,中药预防组连续灌胃给药10 d,空白组和模型组给予等体积的生理盐水。造模后,各组随机抽取10只,于造模前1 d及造模后第1、3、5、7、10天检测外周血象,其余10只小鼠在造模后第1天检测骨髓有核细胞计数、骨髓细胞凋亡情况、造血生长因子及培养造血祖细胞集落。结果造模后外周血WBC、PLT,骨髓有核细胞计数,粒—巨噬系集落形成单位（colony forming unit-granulocyte macrophage,CFU-GM）,造血祖细胞集落形成单位及造血生长因子中药预防组均显著高于模型组（P〈0.01或P〈0.05）。中药预防组总凋亡率远低于模型组（P〈0.01）。结论补肾解毒活血法可以减轻环磷酰胺对小鼠的骨髓抑制毒副作用,明显促进骨髓抑制小鼠WBC、PLT、CFU-GM及骨髓有核细胞的增加,抑制环磷酰胺所致的细胞凋亡。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.