火针放血配合中药治疗急性痛风关节炎67例

目的:观察火针放血配合中药复方制剂酸脂清胶囊治疗原发性急性痛风性关节炎的临床疗效。方法:将67例原发性急性痛风性关节炎患者给予火针放血(主穴为行间、太冲、内庭、陷谷等)治疗同时口服中药酸脂清胶囊。结果:总有效率为95.5%。提示:火针放血法配合中药治疗急性痛风性关节炎,既可以"急则治标",迅速消除关节局部症状,又可以治本以降低血尿酸值,显示出祖国医学在该病治疗中的独特优势。

刺络放血加针刺治疗周围性面瘫42例

目的:观察刺络放血配合常规针刺治疗周围性面瘫的临床疗效。方法:42例周围性面瘫患者,急性期(1～7d)选翳风穴刺络放血每日1次,恢复期(8～21d)抬眉动作差的选阳白穴及周围刺络放血,闭眼差的选上、下眼睑刺络放血,口角歪斜的选患侧口角周围刺络放血,面颊活动差或感觉异常的选下关穴或牵正穴及周围刺络放血。后遗症期(22d～3个月)选取刺络放血部位大致同恢复期。结果:总有效率97.62%。结论:刺络放血疗法配合针刺治疗周围性面瘫临床疗效显著。

针刺结合大椎放血治疗椎动脉型颈椎病120例

目的:观察针刺结合大椎放血治疗椎动脉型颈椎病的临床疗效。方法 :对照组60例予以颈夹脊、风池、天柱、百会、四神聪针刺治疗,治疗组60例在此基础上采用针刺大椎放血治疗。结果:治疗组总有效率88.3%,对照组总有效率为76.7%,治疗组疗效优于对照组,差异有统计学意义(P<0.05)。结论 :采用针刺结合大椎放血治疗椎动脉型颈椎病,疗效较为满意。

刺络放血法治疗儿童过敏性紫癜疗效观察

目的:观察刺络放血法治疗儿童过敏性紫癜的临床疗效。方法:选取本院过敏性紫癜患儿40例,随机分为两组,两组均常规给予静点葡萄糖酸钙及抗组胺药治疗,治疗组给予刺络放血治疗。观察患儿的临床症状。结果:治疗组在临床症状好转,出院时间方面优于对照组,有统计学意义。结论:刺络放血法治疗儿童过敏性紫癜疗效好。

耳穴为主治疗青春期痛经疗效观察

目的:观察耳穴为主治疗原发性痛经的疗效。方法:采用耳穴(神门、子宫、内分泌、皮质下、交感、肾、肝)一次性针刺络放血治疗本病68例,并设对照组观察疗效。结果:治疗组总有效率91.7%,对照组总有效率77.8%。2组疗效比较,差异有显著性意义(P<0.05);且治疗组远期疗效优于对照组。结论:本方法对本病有补血通络,调经止痛的功效。

Effect of Intravascular Irradiation on Intimal Smooth Muscle Cells Proliferation and Apoptosis in Balloon Injuried Arteries

Objective: To investigate the effect of intravascular in radiation on thearterial wall smooth muscle cells (SMCs) proliferation and apoptosis after iliac artery bollominjury in figs. Methods: Twenty-seven miniature figs were divided into three groups. All pigsunderwent iliac artery balloon over-stretch. An^(192) Ir source through afterloader was positionedat the injuried segments to give 10 Gy in 9 pigs and 20 Gy in the other 9 pigs, and the rest 9 pigswere, used as control group. The pigs were killed on the 3rd, 10th and 28th days respectively forobservation. The injured segments were processed to examine SMCs proliferation by proliferation cellnuclear antigen (PCNA) and apopto-sis by terminal deoxynucleotidyl transferase-mediated dUTPnick-end labeling (TUNEL). Results: PC-NA index analysis has some that SMCs proliferation inneointima was significantly inhibited in irradiation group on the 10th and 28th days. The value forintimal SMCs apoptosis in control vs 10 Gy and 20 Gy irradiation groups were: (1. 185+-0. 49)% vs(2. 27+-0. 49)%(P>0. 05) and (1. 85+-0. 49)% vs (2. 53+-0. 45)%(P<0. 05), at the 10th day; (1.61+-0. 35)% vs (3. 11+-0. 51)%(P<0. 05), and (1.61+-0. 35)% vs (7. 05+-1. 82)% (P<0. 05), on the28th day. In irradiated arteries, the maximal incidence of intimal SMCs apoptosis was (7. 05+--1.82)% in 20 Gy group vs (3. 11+-0. 51)% in 10 Gy group (P<0. 05), on the 28th day. In the same doseirradiation group, the incidence of intimal SMCs apoptosis was higher on the 28th day than that onthe 10th day. Conclusion: Intra-arterial gamma irradiation can inhibit intimal SMCs proliferationand stimulate SMCs apoptosis in balloon-in jured arteries. These may be contributive to preventionof restenosis of arteries after balloon injury.

Pharmaceutical Characteristics of Daunorubicin Stealth Liposomes

This report studied on pharmaceutical characteristics of the stealth liposome containing dau-norubicin (DNR). The shape, size, entrapment efficiency and stability of the daunorubicin stealth liposomes (DNRSL) were examined. Visible spectrophotometry and the HPLC method were established for determination of the DNR in the DNRSL. The release of DNR from DNRSL in HBS (pH 7.5) and rat serum at 37 oC were examined. The results showed that the DNRSL had high entrapment efficiency (>85%), small size and slow release.

Effect of L158,809 and Cilazapril on the Expression of TGF-β_1 and Secretion of Extracellular Matrix Proteins in Cultured Human Mesangial Cells

Objective: To explore the effect of L158, 809 (angiatensin Ⅱ receptorMockers, ARBs) and Cilazapril (Angiotensin converting enzyme inhibitor, ACEI) on the expression oftransforming growth factor-β_1 (TGF-β_1) and secretion of fibronectin, laminin and type Ⅳcollagen from the cultured human mesangial cells . Methods: Human mesangial cells were cultured indifferent glucose (5.6 mmol/L and 30 mmol/L) and agents (1, 10, 100 and 500 μmol/L) concentrations. The proliferation of mesangial cells were detected at 24, 48 and 72 h . Then the mesangial cellsare divided into four groups, low glucose (5.6 mmol/L) control group, high glucose (30 mmol/L)control group , L158, 809 (10 μmol/L) group and cilazapril (10 μmol/L) group. Forty- eight hourslater, the expression of TGF-β_1 were detected by RT-PCR. Concentrations of TGF-β_1 ,fibronection, laminin and type Ⅳ collagen in the su-pematants of the, mesangial cells weredetermined by EUSA and radioimmunoassay methods. Results: Compared with low glucose control group,the mesangial cells under high glucose medium show excessive proliferation and more TGF-β_1,fibronectin, laminin and type Ⅳ collagen in the supernatant. The expression of TGF-β_1 mRNA wasalso significantly increased under high glucose. The levels of TGF-β_1 and ECM (extracellularmatrix) proteins in the L158, 809 group and cilazapril group are obviously lower than that of thehigh glucose control group. The expression of TGF-β_1 mRNA was markedly decreased in the L158, 809group and cilazapril group compared with that of high glucose control group . Conclusion: Highglucose stimulated the cultured human mesangial cells to excessively proliferate, express TGF-β_1and secrete ECM proteins, and the high glucose-indeced changes were suppressed by either L158, 809and cilazapril.

遗传性球形红细胞增多症患者红细胞内快泳血红蛋白缺失

目的:利用我室创建的血红蛋白释放试验,研究遗传性球形红细胞增多症患者红细胞释放血红蛋白情况。方法:采用一系列血红蛋白释放试验:单向释放电泳、双向释放电泳、全血多组分电泳和等低渗全程释放电泳(室温、37℃),比较研究患者与正常人红细胞的差异。结果:患者红细胞经单向电泳释放出的血红蛋白快泳部分缺失或明显减少。双向电泳结果,患者红细胞除快泳血红蛋白减少或缺失外,还可见红细胞及全血Hb A2沿对角线分布,而且全血出现高铁血红素白蛋白。全血多组分实验中可见,患者红细胞及全血均无再释放。等低渗全程电泳显示,患者红细胞及全血的再释放都明显减弱或消失。结论:从电泳释放角度证明患者的红细胞明显异常,发现患者红细胞内快泳血红蛋白明显减少或缺失。

Changes of serum p53 antibodies and clinical signifi cance of radiotherapy for esophageal squamous cell carcinoma

AIM： To explore the relationship between serum p53 antibodies （p53-Abs） and clinicopathological characteristics and therapeutic effect in patients with esophageal carcinoma （EC）, and to investigate sequential changing regularity of serum pS3-Abs after radiotherapy. METHODS： The serum pS3-Ab levels were detected in 46 EC patients and 30 healthy adults by enzyme linked immunosorbent assay （ELISA）. The blood samples were collected on the day before radiotherapy and on the administration of an irradiation dose of 20 Gy/10 f/12 d, 40 Gy/20 f/24 d and 60 Gy/30 f/36 d after radiotherapy. RESULTS： The level and positive rate of serum pS3-Abs in EC patients were significantly higher than those in normal individuals （P 〈 0.05）. Serum anti-p53 antibodies were positive in 18 of 46 EC patients （39.1%）. The positive rate of pS3-Abs in EC was related to histological grade, disease stage and lymph node metastasis （P 〈 0.05）, but it was not significantly related to sex, age and to the size and site of tumor. The level and positive rate of p53-Abs had significant differences between before radiotherapy and after administration of an irradiation dose of 40 Gy/20 f/24 d and 60 Gy/30 f/36 d （P 〈 0.05 orP 〈 0.01）. The positive rate of p53-Abs in EC patients with effect was significantly lower than that in those without effect after radiotherapy （P 〈 0.0001）.CONCLUSION： Detection of serum p53-Abs is helpful to the diagnosis of esophageal carcinoma. Monitoring for sequential change of serum p53-Abs before and after radiotherapy in patients with esophageal carcinoma is also useful to evaluate the response to the treatment and prognosis of the patients.

Anemia and long-term outcome in adjuvant and neoadjuvant radiochemotherapy of stage Ⅱ and Ⅲ rectal adenocarcinoma:The Freiburg experience(1989-2002)

AIM： To evaluate the long-term outcome of standard 5-FU based adjuvant or neoadjuvant radiochemotherapy and to identify the predictive factors, especially anemia before and after radiotherapy as well as hemoglobin increase or decrease during radiotherapy. METHODS： Two hundred and eighty-six patients with Union International Contre Cancer （UICC） stage Ⅱ and Ⅲ rectal adenocarcinomas, who underwent resection by conventional surgical techniques （low anterior or abdominoperineal resection）, received either postoperative （n = 233） or preoperative （n = 53） radiochemotherapy from January 1989 until July 2002. Overall survival （OAS）, cancer-specific survival （CSS）, disease-free survival （DFS）, local-relapse-free （LRS） and distant-relapse-free survival （DRS） were evaluated using Kaplan-Meier, Log-rank test and Cox＇s proportional hazards as statistical methods. Multivariate analysis was used to identify prognostic factors. Median follow-up time was 8 years. RESULTS： Anemia before radiochemotherapy was an independent prognostic factor for improved DFS （risk ratio 0.76, P= 0.04） as well as stage, grading, R status （free radial margins）, type of surgery, carcinoembryonic antigen （CEA） levels, and gender. The univariate analysis revealed that anemia was associated with impaired LRS（better local control） but with improved DFS. In contrast, hemoglobin decrease during radiotherapy was an independent risk factor for DFS （risk ratio 1.97, P= 0.04）. During radiotherapy, only 30.8% of R0-resected patients suffered from hemoglobin decrease compared to 55.6% if R1/2 resection was performed （P= 0.04）. The 5-year OAS, CSS, DFS, LRS and DRS were 47.0%, 60.0%, 41.4%, 67.2%, and 84.3%, respectively. Significant differences between preoperative and postoperative radiochemotherapy were not found. CONCLUSION ： Anemia before radiochemotherapy and hemoglobin decrease during radiotherapy have no predictive value for the outcome of rectal cancer. Stage, grading, R status （free radial margins）, type of surgery, CEA levels, and gender have predictive value for the outcome of rectal cancer.

Treatment of Hordeolum by Bloodletting at Ear Apex

Hordeolum, the acute pyogenic infection of staphylococci in the palpebral glands, is one of the most commonly seen disorders of the external eye diseases. According to the location of the lesion, it can be divided into internal and external hordeolum. The early symptoms are redness, swelling, and pain in the eyelid. In severe cases, the condition can be accompanied with ipsilateral headache and swelling of the pre-auricular lymph node. Since TCM bloodletting has remarkable effect for treating hordeolum at the early stage, we would like to recommend this simple, easy and effective treatment to doctors who are interested in physiocracy.

Clinical Application of Blood-letting Therapy

Blood-letting therapy is extensively used in acupuncture clinic. In recent years, the author has applied blood-letting therapy to treat various kinds of diseases, with satisfactory therapeutic results reported in the following.

CLINICAL OBSERVATION ABOUT THE EFFECT OF BLOOD-LETTING OF JING-POINTS ON CEREBRAL BLOOD FLOW IN STROKE PATIENTS AT THE EARLY STAGE AND EXPERIMENTAL STUDY ON ITS MECHANISMS IN THE RABBIT

In this paper, the authors sum their research results about the effect of blood-letting of Jing (Well)-point on cerebral blood flow both in stroke patients and in experimental cerebral ischemia, cerebral hematoma and hypertension rabbits. In 30 cases of stroke (cerebral hemorrhage and cerebral infarction) patients, blood flow state of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and the posterior cerebral artery (PCA), and the blood flow velocity of the bilateral vertebral artery (VA) and the basil artery (BA) are determined before and after pricking blood of the Twelve Jing-points. In experimental cerebral ischemia (by occlusion of the common carotid artery) rabbits, cerebral hematoma model rabbits and intravenous injection of noradrenaline induced hypertension rabbits, rheoencephalogram (REC) is detected before and after blood letting of the twelve "Jing"-points. In these 30 stroke patients, ultrasound Doppler examination’s results show that in 22 cases (73.33%) whose blood flow velocity decreases, after blood-letting of the 12 Jing-points, it increases significantly (P<0.01); in the rest 8 cases ( 26.67%) whose blood flow velocity speeds up, after treatment, it decreases evidently (P<0.01), showing a good dual-directional regulative effect of blood-letting therapy. In experimental cerebral ischemia rabbits, cerebral hematoma rabbits and hypertension rabbits whose REG lowers in the amplitude apparently (P<0.01), after blood letting stimulation of the 12 Jing-points, it increases at different degrees. Three patterns of stimulation as blood letting stimulation, pain stimulation and Jing-point stimulation, also the 3 factors of blood-letting therapy, may contribute to their effect on improvement of the cerebral blood flow. Somatic afferent nerve, sympathetic nerve of the vascular wall, central cholinergic nerve (M receptors) and adrenergic nerve (α receptors) participate in the effect of blood letting on cerebral blood flow.

Percutaneous transarterial embolization of extrahepatic arteroportal fistula

Arteroportal fistula is a rare cause of prehepatic portal hypertension. A 44-year-old male with hepatitis virus C infection was admitted for acute variceal bleeding. Endoscopy showed the presence of large esophageal varices. The ultrasound revealed a mass near the head of pancreas, which was characterized at the color- Doppler by a turbulent flow, and arterialization of portal vein flow. CT scan of abdomen showed a large aneurysm of the gastroduodenal artery communicating into the superior mesenteric vein. The sinusoidal portal pressure measured as hepatic vein pressure gradient was normal, confirming the pre-hepatic origin of portal hypertension. The diagnosis of extrahepatic portal hypertension secondary to arteroportal fistula was established, and the percutaneous embolization was performed. Three months later, the endoscopy showed absence of esophageal varices and ascites. At the moment, the patient is in good clinical condition, without signs of portal hypertension.

Liver iron transport

The liver plays a central role in iron metabolism. It is the major storage site for iron and also expresses a complex range of molecules which are involved in iron transport and regulation of iron homeostasis. An increasing number of genes associated with hepatic iron transport or regulation have been identified. These include transferrin receptors （TFRI and 2）, a ferrireductase （STEAP3）, the transporters divalent metal transporter-1 （DMT1） and ferroportin （FPN） as well as the haemochromatosis protein, HFE and haemojuvelin （HJV）, which are signalling molecules. Many of these genes also participate in iron regulatory pathways which focus on the hepatic peptide hepcidin. However, we are still only beginning to understand the complex interactions between liver iron transport and iron homeostasis. This review outlines our current knowledge of molecules of iron metabolism and their roles in iron transport and regulation of iron homeostasis.

Prognostic utility of NT-proBNP greater than 70,000 pg/mL in patients with end stage renal disease

Natriuretic peptides are synthesized in ventricular myocytes and released into the circulation in response to increased myocardial wall stress, Causes of myocardial wall stress include pulmonary hypertension, ventricular dilatation, as well as heart failure with reduced or preserved left ventricular function.

Acupuncture and Blood-letting for 30 Cases of Rheumatic Gonitis

We have treated 30 cases of rheumatic gonitis by using acupuncture and the pricking method, with satisfactory therapeutic results reported as follows.

Effect of hepatic iron concentration reduction on hepatic fibrosis and damage in rats with cholestatic liver disease

AIM： TO assess the effect of iron reduction after phlebotomy in rats with ＂normal＂ hepatic iron concentration （HIC） on the progression of hepatic fibrosis, as a result of bile duct ligation （BDL）. METHODS： Rats underwent phlebotomy before or after sham operation or BDL. Animals undergone only BDL or sham operation served as controls. Two weeks after surgery, indices of hepatic damage and fibrosis were evaluated. RESULTS： Phlebotomy lowered HIC. Phlebotomy after BDL was associated with body weight increase, lower hepatic weight, less portal hypertension, less periportal necrosis, less portal inflammation, lower hepatic activity index score and higher albumin levels. On the other hand, phlebotomy before BDL was associated with body weight decrease and hepatic activity index score increase. Phlebotomy after sham operation was not associated with any hepatic or systemic adverse effects. CONCLUSION： Reduction of HIC after induction of liver damage may have beneficial effects in BDL rats. However, iron deficiency could induce impairment of liver function and may make the liver more susceptible to insults like BDL.

^(99)Tc^m direct labeling of angiostatin

Objective: To explore the method of 99 Tc m direct labeling of angiostatin (AS) and investigate the stability and bioactivity of the 99 Tc m labeled AS in vitro . Methods: AS was extracted, validated, and then labeled with 99 Tc m after having been reduced by 2 ME or SnCl 2. The best labeling condition was screened by cross design. The labeling efficiency was measured by TLC and column chromatography. The stability of 99 Tc m AS was observed and compared when BSA, saline and different molar ratios of Cys∶AS were separately added. The bioactivity of 99 Tc m AS was observed in human umbilical vein endothelial cell (CEV304). Results: The labeling efficiency can reach (97±1 5)% for the 2 ME reducing approach. Its best experimental condition was as follows: AS 100 μg,PB(0 5 mol/L, pH 7 3)1 ml, 2 ME 100 μg, MDP (dissolved in 1 ml saline) 10 μl, and 99 Tc mO 4 - 185 MBq. The labeling efficiency using SnCl 2 reducing method can reach (90±3 0)%. The best experimental procedure was as follows: AS 100 μg,boric acid buffer(0 1 mol/L, pH 9 0)1 ml, 2%SnCl 2 (dissolved in 1 mol/L hydrochloric acid) 20 μl, was added into MDP, which was diluted with 1 ml deoxygenized water, and then 20 μl, 99 Tc mO 4 - 185 MBq was added. The product of 99 Tc m labeled AS was stable in vitro and had the same bioactivity as AS. Conclusion: 99 Tc m direct labeling of AS is simple and efficient. And the bioactivity of 99 Tc m AS has no significant change compared with AS.