替米沙坦对糖尿病心肌病大鼠心脏保护作用

目的:探讨替米沙坦对糖尿病心肌病(DCM)大鼠心脏的保护作用。方法:30只健康雄性Wistar大鼠,随机分成空白组(n=10)和糖尿病组(n=20),糖尿病组用链脲佐菌素(STZ)腹腔注射建模,成功后随机分成对照组(n=10)及治疗组(n=10)。治疗组用替米沙坦(20mg/kg)每天灌胃治疗一次,空白组和对照组给予相同体积的生理盐水灌胃,给药16周后彩色多普勒检测心功能,光镜下观察心肌病理改变,电镜下观察心肌超微结构,原位缺口末端标记法(TUNEL法)检测心肌细胞凋亡,免疫组化法检测心肌组织转化生长因子β1(TGF-β1)的表达。结果:糖尿病对照组心功能明显下降,心肌出现明显病理学改变,凋亡细胞增多(P<0.05),TGF-β1的表达增加(P<0.05);而替米沙坦治疗组,心功能无明显改变,心肌病理改变较对照组明显减轻,凋亡细胞减少(P<0.05),TGF-β1的表达减少(P<0.05)。结论:替米沙坦对糖尿病心肌病大鼠心肌有保护作用,改善心功能。     

卡托普利对糖尿病大鼠心肌细胞凋亡及相关蛋白表达的影响

目的:探讨血管紧张素转换酶抑制剂(ACEI)卡托普利对糖尿病(DM)大鼠心肌细胞凋亡及凋亡相关蛋白Bcl-2、Bax、Caspase-3表达的影响。方法:成年雄性SD大鼠30只,随机分为正常对照组(NC组)、DM组、卡托普利治疗组(Cap组),每组10只。应用链脲佐菌素(STZ)诱导构建DM大鼠模型,Cap组每日灌胃给予卡托普利50 mg/kg,其余两组给予等容积的0.9%氯化钠溶液。用药12周后,原位缺口末端标记法(TUNEL法)检测计算心肌细胞凋亡指数(AI),Western blot法检测心肌Bcl-2、Bax、Caspase-3蛋白的表达,透射电镜观察心肌超微结构变化。给药期间动态观察测定大鼠行为、体质量及血糖水平的改变。结果:与NC组相比,DM组大鼠心肌细胞AI明显升高,Bcl-2蛋白表达减少,Bax、Caspase-3蛋白表达增加;电镜示心肌细胞超微结构呈明显损伤性变化。与DM组相比,Cap组心肌细胞AI明显降低,Bcl-2蛋白表达增加,Bax、Caspase-3蛋白表达减少;超微结构损伤不同程度减轻。结论:卡托普利可能通过上调Bcl-2表达,下调Bax表达,减少Caspase-3依赖性的心肌细胞凋亡,从而起到保护DM大鼠心肌细胞的作用。     

灯盏花素对糖尿病大鼠心肌转化生长因子-β1和Smad7表达的影响

目的 探讨灯盏花素对糖尿病大鼠心肌转化生长因子-β1(TGF-β1)和Smad7表达的影响.方法 健康SD大鼠30只,随机选取20只造模成功后分为糖尿病组(DM组)和灯盏花素治疗组(Bre组)各10只,余10只作为正常对照组(NC组).Bre组给予灯盏花素注射液20 mg/(kg*d)腹腔内注射,DM组和NC组等量生理盐水腹腔内注射,12周后,尾静脉测血糖,测定大鼠心功能,计算心指数,光镜观察心肌结构病理改变,电镜观察心肌超微结构改变,免疫组化法检测大鼠心肌TGF-β1、Smad7蛋白表达水平.结果 Bre组与DM组间血糖值差异无统计学意义(P>0.05);灯盏花素能显著降低糖尿病大鼠的心指数,明显升高左心室内压最大上升和下降速率,显著减轻心肌病理改变,减少心肌TGF-β1和增加Smad7的表达(P<0.05,P<0.01).结论 灯盏花素可减轻糖尿病大鼠心肌的病理改变,保护糖尿病大鼠心脏功能,其机制可能是通过改善心肌中TGF-β1、Smad7的表达,从而抑制糖尿病大鼠心肌的纤维化来发挥对糖尿病大鼠心脏的保护作用.     

灯盏花素对糖尿病大鼠心肌TGF-β1和Smad7表达的影响

目的 探讨灯盏花素对糖尿病大鼠心肌TGF-β1和Smad7表达的影响。方法 健康SD大鼠30只,随机选取20只造模成功后分为糖尿病组(DM组)和灯盏花素治疗组(Bre组）各10只,余10只作为正常对照组(NC组)。Bre组给予灯盏花素注射液20mg·kg-1·d-1腹腔内注射,DM组和NC组等量生理盐水腹腔内注射,12w后,尾静脉测血糖;测定大鼠心功能;计算心指数;光镜观察心肌结构病理改变;电镜观察心肌超微结构改变;免疫组化法检测大鼠心肌TGF-β1、Smad7蛋白表达水平。结果 Bre组与DM组间血糖值无明显差异（P>0.05）;灯盏花素能显著降低糖尿病大鼠的心指数,明显升高左室内压上升、下降最大速率,显著减轻心肌病理改变,减少心肌TGF-β1和增加Smad7的表达（P<0.05或P<0.01）。结论 灯盏花素可减轻糖尿病大鼠心肌的病理改变,保护糖尿病大鼠心脏功能,其机制可能是通过改善心肌中TGF-β1、 Smad7的表达,从而抑制糖尿病大鼠心肌的纤维化来发挥对糖尿病大鼠心脏的保护作用。     

Bcl-2和Bnip-3在糖尿病性心肌病大鼠心肌细胞中的表达

目的探讨细胞凋亡因子Bcl-2、Bnip-3在实验性糖尿病性心肌病大鼠心肌细胞中的表达情况。方法选取8周龄Sprague-Dawley大鼠30只,随机分为对照组和模型组。对照组大鼠腹腔注射枸橼酸缓冲液,模型组大鼠一次性腹腔注射链脲佐菌素溶液建立糖尿病模型,继续饲养12周,自然形成糖尿病性心肌病模型;然后处死2组大鼠,取血测定血糖、血脂,取心脏称质量计算心脏质量指数,切取心肌组织电镜观察心肌超微结构变化,并测定乳酸脱氢酶(LDH)和肌酸激酶(CK)水平,免疫组织化学法测定心肌细胞Bcl-2、Bnip-3的表达。结果模型组大鼠血糖、三酰甘油、胆固醇、高密度脂蛋白、低密度脂蛋白、心肌酶及心肌形态学改变均符合糖尿病性心肌病表现。模型组大鼠心肌细胞中Bcl-2的表达明显低于对照组(P<0.01),Bnip-3的表达明显高于对照组(P<0.01)。结论细胞凋亡因子Bcl-2和Bnip-3可能参与了糖尿病性心肌病的心肌细胞凋亡过程。     

EPO通过抑制心肌细胞凋亡保护糖尿病心肌病大鼠的心功能

目的探讨促红细胞生成素(erythropoietin,EPO)对糖尿病心肌病(diabetes cardiomyopathy,DCM)大鼠心脏的保护作用及机制。方法将25只SD大鼠随机分为3组:对照组(n=5)、DCM组(n=10)、DCM+EPO组(n=10),DCM组及DCM+EPO组应用链脲佐菌素60 mg/kg一次性腹腔注射构建DCM大鼠模型,饲养4周后,DCM+EPO组另外给予rhEPO 2 000 U/kg腹腔注射。行心脏超声心动图检测心功能,心肌HE染色、电镜检查,TUNEL染色测定细胞凋亡,Western Blot检测Caspase-3的表达,RT-PCR检测Bcl-2及Bax的mRNA的相对表达量。结果与对照组比较,DCM组和DCM+EPO组心功能降低(P<0.01),rh EPO能改善DCM+EPO组的心功能(P<0.01)。与对照组比较,DCM组及DCM+EPO组心肌细胞凋亡指数明显增加(P<0.001),rh EPO能改善DCM+EPO组的心肌细胞凋亡(P<0.001)。DCM组大鼠心肌的Caspase-3的蛋白表达量较正常组增加(P&l... 更多     

替米沙坦对糖尿病模型鼠心肌微血管新生的促进作用

目的探讨替米沙坦对糖尿病大鼠心肌微血管新生的促进作用。方法将雄性SD大鼠40只随机分为正常组(C组)、糖尿病模型组(D组)、替米沙坦干预组(T组)。给药12周末结束实验。用Western blot法分别检测心肌中肝细胞生长因子(HGF)表达,电镜下观察心肌微血管改变。结果D、T组心肌中HGF水平高于C组,T组高于D组。电镜下T组心肌细胞表面积和心脏血管细胞基底膜厚度小于D组。结论替米沙坦能够改善糖尿病心肌微血管病变,可能与增加糖尿病大鼠心肌HGF表达有关。     

槲皮素对糖尿病大鼠心肌非酶糖基化及细胞凋亡的影响

目的 观察槲皮素(quercertin,Que)对糖尿病大鼠心肌非酶糖基化及细胞凋亡、凋亡相关基因Caspase-3表达的影响,探讨槲皮素对糖尿病心肌的保护作用及机制.方法 16只健康雄性SD大鼠腹腔注射链脲佐菌素诱发糖尿病模型,随机分为糖尿病组(DM)和槲皮素治疗组(Que).同时设立正常对照组(NC)8只.治疗组灌胃给予槲皮素100 mg/kg,每天1次,共8周.分别测定各组大鼠血糖、血清果糖胺(FMN)、心肌AGEs 含量;TUNEL法检测心肌细胞凋亡,免疫组织化学法检测心肌Caspase-3蛋白表达.结果 与正常对照组相比,糖尿病大鼠血糖、血清果糖胺(FMN)及心肌AGEs含量均明显升高(P＜0.01);Caspase-3蛋白表达显著增强(P＜0.01),心肌细胞凋亡数明显增多(P＜0.01);与糖尿病组相比,槲皮素治疗组大鼠血糖、血清果糖胺(FMN)含量无明显改变(P＞>0.05),心肌AGEs含量明显降低(P＜0.01);Caspase-3蛋白表达减弱(P＜0.01),心肌凋亡细胞数减少(P＜0.05).结论 槲皮素可通过抑制糖尿病大鼠心肌组织非酶糖化,下调Caspase-3表达,减少心肌细胞凋亡,发挥心肌保护作用.     

培哚普利对糖尿病大鼠心肌病变及TGF-β_1表达的影响

目的 研究培哚普利(Perindopril)对糖尿病(Diabetes mellitus,DM)大鼠心肌病变及转化生长因子β_1(TGF-β_1)表达的影响.方法 36只雄性SD大鼠随机分为正常对照组(NC,n=12)和糖尿病组(DC,n=24),4周后再分为糖尿病对照组(DC,n=12)和培哚普利治疗组[DP,n=12,2 mg/(kg·d)].治疗12周后,检测血糖、Ang Ⅱ浓度;电镜观察心肌超微结构改变;RT-PCR检测TGF-β_1 mRNA水平.结果 DC组的血糖、血浆和心肌Ang Ⅱ、心肌TGF-β_1 mRNA、左室重量指数(LVMI)均明显高于NC组,而DP组则均低于DC组,差异有显著性(P<0.01);DM大鼠出现了心肌肥厚和超微结构改变,其病变程度与心肌Ang Ⅱ水平呈一致性,而DP组心肌病变明显减轻.结论 培哚普利可能通过降低Ang Ⅱ水平,下调心肌TGF-β_1表达而逆转糖尿病大鼠的心肌肥厚和超微结构改变,对糖尿病大鼠心肌病变有治疗作用.     

基于TGF-β1/Smad3信号通路观察促血小板生成素对阿霉素致心力衰竭大鼠心肌细胞凋亡的影响

目的探讨促血小板生成素(TPO)对阿霉素致心力衰竭(CHF)大鼠抗心肌细胞凋亡的作用以及其对TGF-β1/Smad3信号的调控机制。方法将大鼠随机分为对照组、模型组、治疗组、抑制剂组;模型组、治疗组、抑制剂组采用腹腔注射阿霉素构建心衰模型,治疗组每日腹腔注射5μg/kg TPO;抑制剂组每日腹腔注射1. 2 mg/kg SB431542、TUNEL染色、免疫荧光、Western blot检测大鼠心肌细胞的凋亡、Caspase-3、TGF-β1及p-Smad3的表达水平。结果与对照组相比,模型组心肌细胞凋亡率、TGF-β1、p-Smad3、Caspase-3的表达明显升高,与模型组相比,治疗组、抑制剂组心肌细胞凋亡率、TGF-β1、p-Smad3、Caspase-3的表达明显降低,差异均具有统计学意义(P0. 05)。结论 TPO能够降低由阿霉素导致CHF大鼠的心肌细胞凋亡率,其机制可能与抑制TGF-β1/Smad3信号有关。     

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…     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.