苍术提取物对实验性脾虚证大鼠胃肠动力及免疫功能的影响

目的:探讨苍术提取物对实验性脾虚证大鼠胃肠动力及免疫功能的影响,阐明苍术提取物调节胃肠动力及免疫功能的作用机制。方法:60只雄性SD大鼠随机分为正常组,模型组,低、中、高剂量苍术提取物组和多潘立酮组,每组10只。除正常组外,其余各组大鼠喂饲小承气汤煎剂加饥饱失常建立大鼠脾虚证模型,造模结束后,苍术提取物低、中、高剂量组大鼠分别灌胃0.5、1.0和2.0 g·mL^-1苍术提取物煎剂,多潘立酮组大鼠灌胃多潘立酮混悬溶液,正常组和模型组大鼠则灌胃生理盐水。采用炭末灌胃法检测大鼠胃内残留率和小肠推进比;采用肠道灌流法检测大鼠肠道灌流液中IgA水平;腹主动脉采血法检测大鼠血清中IgG和血浆中胃动素(MTL)、P物质(SP)、生长抑素(SS)水平;免疫组织化学法检测大鼠十二指肠、空肠和回肠组织中Toll样受体4(TLR4)的表达水平。结果:与模型组比较,低、中、高剂量苍术提取物组和多潘立酮组大鼠肠道灌流液中IgA和血清中IgG水平升高,胃内残留率降低、小肠推进比升高,而大鼠血浆中MTL、SP和SS水平升高(P<0.05,P<0.01);与低剂量苍术提取物组比较,中和高剂量苍术提取物组大鼠肠道灌注液中IgA和血清中IgG水平升高,胃内残留率降低,小肠推进比升高,大鼠血浆中MTL、SP和SS水平升高,十二指肠、空肠和回肠组织中TLR4表达水平升高 (P<0.05或P<0.01)。结论:苍术提取物可改善实验性脾虚大鼠胃肠动力及免疫功能,对因脾虚而导致的胃肠功能紊乱及全身和局部免疫功能的低下状态均有较好的调节和治疗作用。     

开胃进食汤超微颗粒对胃肠平滑肌细胞MLCK表达的影响

目的 研究开胃进食汤超微配方颗粒对脾虚大鼠胃肠平滑肌细胞肌球蛋白轻链激酶(MLCK)表达的影响,探求其对大鼠胃肠动力调节作用的机制.方法 采用利血平脾虚模型,将大鼠随机分为正常组、模型组、开胃进食汤超微配方颗粒(超微)组、传统汤剂(煎剂)组和健胃消食片对照(健胃)组,用免疫组化半定量分析MLCK的表达情况,同时观察药物对其影响.结果 模型组大鼠胃窦平滑肌内MLCK表达明显减少,空肠平滑肌内明显增强,与正常组比较差异具有统计学意义(P＜0.05);健胃组、煎剂组和超微组胃窦平滑肌内MLCK表达较模型组增强,差异具有统计学意义(P＜0.05),煎剂组和超微组空肠平滑肌内MLCK表达低于模型组,差异具有统计学意义(P＜0.05).结论 开胃进食汤超微配方颗粒能促进胃窦平滑肌收缩和空肠平滑肌舒张,可能与其提高胃窦平滑肌组织和降低空肠平滑肌组织内MLCK水平表达有关.     

薏苡仁水煎液对脾虚证大鼠胃肠动力及激素水平的影响

目的:观察和探讨薏苡仁水煎液对脾虚证大鼠胃肠动力的调节及胃肠激素水平作用。方法:将雄性SD大鼠随机分为正常组、模型组、多潘立酮组和薏苡仁水煎液高、低剂量组。除正常组外,其余各组复制脾虚证动物模型,造模时间为15 d。建模成功后,正常组给予生理盐水1. 5 m L·100 g-1·d~(-1)灌胃、多潘立酮组给予5 mg·kg~(-1)·d~(-1)灌胃、薏苡仁水煎液高、低剂量组分别给予20 g·kg~(-1)·d~(-1)、10 g·kg~(-1)·d~(-1)灌胃。给药期间观察大鼠状况、体征,末次给药后所有大鼠均用炭末灌胃法测定胃内残留率和小肠推进率,腹主动脉取血后用放免法测定血浆胃动素(motilin,MTL)、P物质(Serum P,SP)、生长抑素(somatostatin,SS)、胃泌素(Gastric gastrin,GAS)、胆囊收缩素(cholecystokinin,CCK)和胰多肽(panoreatio polypeptide,PP)的含量。结果:与模型组比较,多潘立酮组和薏苡仁水煎液高、低剂量组的胃内残留率明显下降、小肠推进率明显升高,而大鼠血浆MTL、SP、SS含量不同程度升高,差异有统计学意义(P 0. 05)。结论:薏苡仁水煎液可能通过升高血清SP、MTL、GAS、CCK、SS水平,降低血清PP含量进而调节胃肠道运动,表明其对因脾虚导致的胃肠道功能紊乱有较好的调节和治疗作用。     

四君子汤对脾虚大鼠胃肠平滑肌细胞肌球蛋白轻链激酶含量的影响

【目的】观察四君子汤颗粒剂对脾虚大鼠胃肠平滑肌细胞肌球蛋白轻链激酶(MLCK)含量的影响,探求其对大鼠胃肠动力调节的机制。【方法】采用饥饱失常+劳倦+破气耗气方法复制脾虚大鼠模型,将60只SD大鼠随机分为正常组、模型组、四君子汤组(剂量为6.3 g/kg)、莫沙必利组(剂量为1.35 mg/kg),采用酶联免疫吸附(ELISA)法测定胃肠平滑肌细胞MLCK含量。【结果】模型组大鼠胃窦及空肠平滑肌细胞MLCK含量显著减少,与正常组比较差异有统计学意义(P0.05);治疗后,中药组胃窦和空肠平滑肌细胞MLCK含量显著上升,与模型组比较,差异均有统计学意义(P0.05)。【结论】四君子汤能促进大鼠胃窦及空肠平滑肌收缩,可能与其提高胃窦及空肠平滑肌细胞MLCK含量有关。     

调中汤对脾虚肝旺型功能性消化不良幼鼠胃动素、干细胞因子的影响

目的 通过观察调中汤对脾虚肝旺型功能性消化不良幼鼠胃窦胃动素(MTL)、血清干细胞因子(SCF)的影响,探讨调中汤对脾虚肝旺型功能性消化不良的具体作用机制。 方法 选取清洁级SD幼鼠36只,日龄21～28 d,体重50～70 g,随机分为6组,每组6只:空白对照组、模型组、调中汤高剂量组、调中汤中剂量组、调中汤低剂量组、多潘立酮组(西药组)。幼鼠在购入后适应环境喂养1周,正常喂养,第2周开始,除对照组每日常规饲养不予造模外,其余组采用不规则喂养、饮用4℃冰水及夹尾刺激法造模。造模成功后,从造模后第7天开始用药,持续给药14 d。各组幼鼠在末次给药前12 h禁食(自由饮水),腹腔静脉取血,分离血清,采用ELASE法用酶标分析仪检测SCF;取胃窦的胃壁全层一块,用免疫组化法测定MTL。 结果 调中汤高、中剂量组均能提高幼鼠血清SCF含量,与模型组比较差异有统计学意义(P＜0.01),调中汤高剂量组可以增加幼鼠胃窦MTL含量,与模型组比较差异有统计学意义(P＜0.01),中剂量组与模型组比较差异有统计学意义(P＜0.05)。 结论 成功建立脾虚肝旺型功能性消化不良幼鼠模型,并观察到调中汤能明显提高脾虚肝旺型功能性消化不良幼鼠血清SCF及胃窦MTL水平,说明上调MTL、SCF表达是调中汤治疗脾虚肝旺型FD的作用机制之一。      

茯苓甘草汤对功能性消化不良大鼠血清中胃动素、胃泌素及5-羟色胺的影响

目的:探讨茯苓甘草汤治疗功能性消化不良的大鼠的效果及对血清中胃肠激素的影响。方法:将72只大鼠随机分为正常组、模型组、茯苓甘草汤高剂量组、茯苓甘草汤中剂量组、茯苓甘草汤低剂量组、多潘立酮组。采用低温盐酸灌胃法造模,取材后比较各组大鼠血清中胃动素(MTL)、胃泌素(Gas)及5-羟色胺(5-HT)的含量变化情况。结果:模型组FD大鼠与正常组大鼠比较,血清中MTL、GAS和5-HT的含量均降低,均有统计学意义(P0.05)。茯苓甘草汤高剂量组、茯苓甘草汤中剂量组、茯苓甘草汤低剂量组以及多潘立酮组与模型组比较,FD大鼠血清中MTL、GAS及5-HT的含量均升高,均有统计学意义(P0.05)。茯苓甘草汤高、中、低剂量组及多潘立酮组间在提高血清中MTL的含量比较,差异无显著性意义。对于提高血清中GAS、5-HT的含量,茯苓甘草汤低剂量组与其余给药组相比疗效更显著,差异有统计学意义。结论:茯苓甘草汤高、中、低剂量各组能够提高FD大鼠血清中MTL、GAS及5-HT的含量,能够缓解FD大鼠的症状,这可能是治疗FD的作用机制之一。     

疏肝健脾活血方对肝郁脾虚证FD大鼠血浆NT、CRH、SS的影响

目的:研究疏肝健脾活血方对肝郁脾虚证功能性消化不良(functional dyspepsia,FD)大鼠血浆神经降压素(neurotensin,NT)、促肾上腺皮质激素释放激素(corticotropin releasinghormone,CRH)、生长抑素(Somatostatin,SS)的影响,探讨其作用机制。方法:70只SPF级雌性SD大鼠按体质量随机抽取10只作为正常组,其余60只采用"慢性束缚+过度疲劳+饮食失节"复合因素法造模21 d,造模成功后,按体质量随机分为模型组、疏肝健脾活血方高剂量组、中剂量组、低剂量组、柴芍六君子汤组、多潘立酮组。分组后,正常组和模型组大鼠灌胃给予相应体积纯净水,其他大鼠灌胃给予相应药物干预14 d。实验结束后,ELISA法检测血浆NT、CRH、SS含量。结果:与正常组比较,模型组大鼠血浆NT含量显著下降(P0.05);血浆CRH含量明显增加(P0.05);SS含量显著下降(P0.01)。给药干预后,与模型组比较,多潘立酮组、柴芍六君子组、疏肝健脾活血方高剂量组、疏肝健脾活血方低剂量组大鼠血浆NT含量显著增加(P0.05),中剂量组大鼠血浆NT含量有增加的趋势,但差异无统计学意义(P0.05);多潘立酮组、疏肝健脾活血方高剂量组、疏肝健脾活血方中剂量组、疏肝健脾活血方低剂量组大鼠血浆CRH含量显著下降(P0.05);多潘立酮组、柴芍六君子组、疏肝健脾活血方各剂量组大鼠血浆SS含量显著增加(P0.05或P0.01)。结论:疏肝健脾活血方能够调节肝郁脾虚型FD大鼠血浆NT、SS、CRH表达,这可能是其作用机制之一。     

健脾化湿颗粒对IBS模型大鼠血浆胃动素的影响

目的:观察健脾化湿颗粒对脾虚型肠易激综合征(Irritable Bowel Syndrome,IBS)模型大鼠血浆胃动素(MTL)水平的影响.方法:采用束缚应激刺激2周加灌服番泻叶煎剂的方法建立脾虚型IBS大鼠模型;采用放射免疫法检测血浆MTL水平.结果:健脾化湿颗粒中、高剂量可明显降低IBS模型大鼠血浆MTL水平(P＜0.05),且作用优于健脾化湿颗粒低剂量和得舒特(P＜0.05).结论:健脾化湿颗粒中、高剂量可显著降低IBS大鼠血浆MTL水平,改善大鼠的腹泻症状.     

大承气汤对里实热证大鼠胃肠激素GAS、MTL、VIP、NT的影响

目的 探讨大承气汤对里实热证大鼠血和不同胃肠组织中胃肠激素水平的影响.方法 Wistar大鼠随机分为正常对照组、里实热证模型组、大承气汤小剂量、大剂量干预组4组.自身粪便法建立里实热证大鼠模型,干预组分别灌胃给予4.59、9.18 g/kg的大承气汤,模型组和正常对照组则给予等量的生理盐水.放射免疫法检测各组大鼠血和胃窦、十二指肠、空肠、结肠中胃泌素(GAS)、胃动素(MTL)、血管活性肠肽(VIP)、神经降压素(NT)水平的变化.结果 模型组大鼠血中GAS、MTL和十二指肠GAS,空肠NT含量较正常组明显增加,而血浆VIP、NT和胃窦、结肠NT则显著减少(P＜0.05,P＜0.01).大承气汤各组血浆VIP、NT和十二指肠GAS、NT,以及大剂量组空肠、结肠GAS和小剂量组空肠NT水平,较模型组亦显著升高(P ＜0.05,P＜0.01),而大承气汤各组血清GAS,小剂量组血浆、胃窦、结肠中MTL及胃窦NT,大剂量组胃窦、结肠VIP水平则明显降低(P＜0.05,P＜0.01).结论 大承气汤具有调控胃肠激素的作用,改善里实热证大鼠胃肠道分泌紊乱的机制可能与提高胃肠道GAS,降低MTL、VIP及双向调节NT分泌水平密切相关.     

莪术对功能性消化不良大鼠胃窦组织中神经递质含量的影响

目的观察不同剂量莪术对功能性消化不良（FD）大鼠胃窦组织乙酰胆碱酯酶（AchE）、一氧化氮（NO）、血管活性肠肽（VIP）含量的影响。方法50只大鼠随机分为正常对照组、模型对照组、25%莪术组、50%莪术组、0.1%多潘立酮组，每组各10只。刺激大鼠建立FD动物模型，之后采用不同浓度莪术和多潘立酮进行灌胃给药，14d后比较各组大鼠胃窦组织中AchE、NO、VIP水平。结果模型对照组大鼠胃窦组织中NO和VIP水平较正常对照组升高（均P＜0.01）,而AchE减低（P＜0.01）；25%莪术组、50%莪术组大鼠胃窦组织的AchE水平均升高，而VIP和NO水平均降低（均P＜0.01）。结论莪术可升高FD大鼠胃窦AchE水平，降低VIP和NO水平，可能对FD有改善作用。     

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.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.