A comparison of the effect of alendronate and You-Gui-Wan on osteoporosis in female rats with kidney-yang deficiency

Background:In traditional Chinese medicine,You-Gui-Wan(YGW)is typically used to treat osteoporosis associated with kidney-yang deficiency.However,there have been few mechanistic studies on the effectiveness of kidney-yang deficiency-type osteoporosis with YGW.To further clarify the role of YGW in the effect of osteoporosis with kidney-yang deficiency,the study analyzed the therapeutic advantages of YGW by comparing the therapeutic effects of YGW and alendronate(ALN)on osteoporosis with kidney-yang deficiency.Methods:SPF female SD rats were randomly divided into control,osteoporosis,osteoporosis with kidney-yang deficiency,osteoporosis with kidney-yang deficiency+YGW and osteoporosis with kidney-yang deficiency+ALN groups.Except for the control group,osteoporosis was induced by the removal of bilateral ovaries.After 12 weeks,rats with osteoporosis in the kidney-yang deficiency group had kidney-yang deficiency syndrome triggered by hydrocortisone for 14 days.Rats were treated with YGW or ALN for 12 weeks.The weights of rats were recorded.Hematoxylin-eosin staining staining was used to observe pathological changes in bone trabeculae,liver,spleen,and kidneys of rats.Depletion of the growth plate cartilage of rats in different groups was observed by safranine-O staining.The expression of osteoclast key indices(ACP)and osteoblast key indices(ALP)in the bone tissue of rats in the different groups was observed by immunohistochemical staining.The expression of bone resorption-related indicators(TRAP and NXT-1),bone formation-related indicators(BALP,BGP,and P1NP),and major indicators of kidney-yang deficiency(ACTH,T3,T4,cAMP,and cGMP)were observed using an ELISA detection kit.The expression levels of the main indices of liver function(ALT and AST)were detected in different groups.Results:The differences between the osteoporosis with kidney-yang deficiency group and osteoporosis group were that the weight of rats and the expression of ACTH,T3,T4,and cAMP decreased significantly,and the expression of cGMP increased in the osteoporosis with kidney-yang deficiency group.Moreover,both YGW and ALN effectively improved the symptoms of osteoporosis,including the injury of bone trabeculae and growth plates,as well as the expression of bone metabolism-related indicators.However,unlike ALN,YGW simultaneously ameliorated the expression of key indicators of kidney-yang deficiency and prevented weight loss in rats.In addition,YGW caused no obvious damage to the liver,spleen,or kidney,whereas ALN led to liver cirrhosis.Conclusion:The results reveal that YGW plays a crucial part in osteoporosis with kidney-yang deficiency,increases bone mineral density,and improves bone metabolism indicators,and is safe and efficient for the efficacy of osteoporosis with kidney-yang deficiency.YGW might have a better therapeutic effect on osteoporosis in patients with kidney-yang deficiency.Therefore,alendronate should be used cautiously in patients with osteoporosis and poor liver function.

Observation of tongue picture and tongue and nailbed microcirculation before and after blood dialysis in 125 uremic patients with deficiency of kidney-yang

using a WZD—1 microcirculation microscope,we observed the tongue tipand nail-bed microcirculation of uremic patients with deficiency of kidney-yangbefore and after blood dialysis.The results showed that the pathological basis ofuremia with deficiency of kidney-yang may be microcirculation disturbance,in-crease of metabolites and water retention.The effusion from capillary loops intongue tip may be one of the pathogenetic factors of a swollen and jaggedtongue.The flow rate of blood in capillary loops in the nail-bed was apparentlyabnormal and markedly improved after blood dialysis.The weighted integral ofnail-bed microcirculation decreased from moderately abnormal (4.99±1.52) toapproximately normal (1.98±0.97) (P【0.01).Microcirculation seems to be a sensi-tive criterion for reflecting the pathologic changes of uremia with deficiency ofkidney-yang.

Efficacy of suspended moxibustion stimulating Shenshu(BL23)and Guanyuan(CV4)on the amygdala-HPA axis in rats with kidney-Yang deficiency symptom pattern induced by hydrocortisone

OBJECTIVE:To investigated the effects of suspended moxibustion stimulating Shenshu(BL23)and Guanyuan(CV4)acupoints on the amygdala and HPA axis in our rat model and elucidated the possible molecular mechanisms of moxibustion on kidney-Yang deficiency symptom pattern(KYDS).METHODS:Sixty male Sprague Dawley rats were randomly divided into a control group(n=12)and an experimental group(n=48).Rats in the experimental group were given intramuscular injections of hydrocortisone to establish a KYDS model.The 48 rats successfully modeled were then randomly divided into a model group(model,n=12),a carbenoxolone intraperitoneal injection group(CBX,n=12),a moxibustion group(moxi,n=12),and a moxi+CBX group(n=12).In the moxi,the Shenshu(BL23)and Guanyuan(CV 4)acupoints were treated with moxibustion for 14 d.After treatment,measures were taken of serum levels of corticosterone(CORT),adrenocorticotropic hormone(ACTH),and corticotropinreleasing hormone(CRH).The expression of mineralocorticoid receptors(MRs),glucocorticoid receptors(GRs),11beta-hydroxysteroid dehydrogenase type 1(11β-HSD1),CRH,and ACTH in the rats’amygdala,hypothalamus,or pituitary(as appropriate)was detected.Data were analyzed using one-way analysis of variance.RESULTS:Compared with those of the control group,the serum levels of CRH,ACTH,and CORT;the mRNA and protein expressions of MR,GR,and 11β-HSD1 in the amygdala;the mRNA and protein expressions of 11β-HSD1 in the hypothalamus;the CRH mRNA expression in the amygdala and hypothalamus;and the ACTH mRNA expression in the pituitary of the rats in the model group were all significantly decreased(P<0.05 or 0.01).After treatment with moxibustion,all the aforementioned observation indices except for 11β-HSD1 m RNA expression were ameliorated compared with those in the model group(P<0.05 or 0.01).CONCLUSIONS:Suspended moxibustion can effectively improve the serum levels of ACTH,CRH,and CORT and can up-regulate the mRNA and protein expressions of MR,GR,11β-HSD1,CRH,and ACTH in the amygdala and hypothalamus of KYDS rats.This may be one of the molecular mechanisms with which moxibustion alleviates KYDS.

中西医结合治疗脾肾阳虚型持续性不卧床腹膜透析30例临床观察

目的:观察和分析中西医结合治疗脾肾阳虚型持续性不卧床腹膜透析(CAPD)的临床疗效。方法:将CAPD脾肾阳虚型患者64例,随机分为观察组和对照组各32例,对照组予以规律腹膜透析和常规西医基础治疗;观察组在对照组基础上加用中药汤剂真武汤加减配合艾灸治疗。2个月后观察患者的血肌酐(SCr)、尿素氮(BUN)、24 h尿蛋白定量(24 hUP)、残余肾功能(RRF)、血清白蛋白(ALB),前白蛋白(PA)、血红蛋白(HGB)的变化情况。结果:对比治疗前后,两组治疗后患者SCr、BUN、24 hUP显著降低(P<0.05),RRF降低减缓(P<0.05),ALB、PA、HGB明显升高(P<0.05),且观察组上述观察指标改善更为显著(P<0.05)。观察组中医证候疗效评价总有效率(80.0%)明显高于对照组(46.7%)(P<0.05)。结论:CAPD脾肾阳虚型患者使用汤药真武汤加减联合艾灸治疗,能改善患者营养状况和临床症状,保护残余肾功能,提高生活质量。

神曲1号、2号对脾虚小白鼠肠道菌群调整及肠保护作用的研究

目的 研究神曲 1号、2号对脾虚小白鼠肠道菌群的调整及肠保护作用。方法 (1)昆明小白鼠 ,分成 5组 ,A组 (正常对照组 ) ,B组 (脾虚自然恢复组 ) ,C组 (神曲治疗组 ) ,D组 (神曲 1号治疗组 ) ,E组 (神曲 2号治疗组 )。 (2 )用神曲中筛选出的酵母菌、几种中药和其他配料制成液体神曲 1号、2号 ,用于实验。 (3)检测结肠内容物和粪便标本的肠杆菌、肠球菌、双歧杆菌、类杆菌和乳酸杆菌数量。 (4 )结肠组织光镜和电镜观察与一般状态观察。结果 脾虚小白鼠给予神曲、神曲 1号、2号治疗后 ,肠杆菌、肠球菌、双歧杆菌、类杆菌和乳酸杆菌数量逐渐恢复正常 ,肠壁肌层厚度增加 ,杯状细胞数量增多 ,肠黏膜微绒毛排列紊乱、线粒体肿胀显著改善 ,明显好于脾虚自然恢复组。D组、E组一般状态改善优于A、B和C组。结论 神曲 1号、2号对脾虚小白鼠具有调整肠道菌群及促进损伤肠组织恢复的作用 。

米诺环素对大鼠原代神经元和海马脑片缺氧缺糖及NMDA损伤的保护作用

目的 :建立神经元和海马脑片缺氧缺糖 ( OGD)及 N-甲基 - D-门冬氨酸 ( NMDA)损伤模型 ,观察抗炎药米诺环素的神经元保护作用及其特点。方法 :体外培养大鼠脑皮层神经元 ,以 OGD和 NMDA( 5 0μmol/L)处理 ,观察损伤前后神经元形态变化 ,并以 MTT检测神经元活性 ;以透光法检测 OGD和 NMDA处理引起的大鼠海马脑片透光度 ( L T)改变 ;在上述模型中同时观察米诺环素及 NMDA受体拮抗剂 MK- 80 1的作用。结果 :在 OGD过程中米诺环素 1、10μmol/L能浓度依赖地提高神经元的活性 ,改善神经元形态改变 ;米诺环素 10、10 0μmol/L对NMDA损伤有保护作用 ;MK- 80 11μmol/L对两种损伤模型均有保护作用。米诺环素 1或 10μmol/L对 OGD和NMDA引起的海马脑片 LT增加无明显影响 ;MK- 80 11μmol/L则能显著抑制 LT增加。结论 :米诺环素对神经元OGD损伤具有保护作用 ,可能是通过对 NMDA受体介导的兴奋性毒性的间接抑制 ;但对海马脑片 OGD和

新疆防治碘缺乏病难点地区的重点人群健康教育知识水平调查

目的了解新疆碘缺乏病(IDD)难点地区重点人群的IDD健康教育核心信息知识水平,为提高碘盐食用率,开展针对性强的健康教育活动提供依据。方法在开展项目的地区,以县(市)为单位,按“一乡两村”的抽样方法随机抽取3～5年级学生各10名,和健康教育授课教师以及3～5年级任课教师共10名进行问卷调查。在每所被调查学校附近的村中,随机调查10户家庭主妇(18～60岁),填写答卷并对家中食盐进行半定量检测。结果小学生的碘盐鉴别活动的平均碘盐覆盖率为71.9%,较项目实施前提高16.9个百分点。在学生核心信息调查中,知道缺碘是主要危害的占81.2%,知道碘盐是预防缺碘最好方法的占81.8%,向父母讲过IDD知识的占71.0%;在家庭主妇调查问卷中,知道缺碘对智力和生长发育有危害的占66.0%;在碘盐是预防缺碘最好方法的问卷中,总体正确率为73.7%;在孩子向其讲过IDD知识或带回宣传单的答卷中,总体正确率仅有49.2%;在教师调查问卷中,了解缺碘对智力和生长发育有危害、碘盐是预防缺碘最好方法以及向学生和亲友讲过IDD知识的3个核心信息的回答正确率分别为99.8%、99.8%和97.1%。结论学生及家庭主妇对缺碘造成的危害以及主要预防措施的知晓率还有待提高,教师-学生-家庭主妇的传播链有待建立和完善。

绝经后骨质疏松患者的缺钙和补钙的作用

２４例绝经后骨质疏松症患者分两组进行了钙平衡试验，年龄５６．３１±２．９９和５８．６６±４．２６，绝经年限１２．５±７．１１和１０．７７±４．５６，该组妇女平均食物钙摄入４２２．６ｍｇ／日，未补钙者平均负钙平衡１２．８８ｍｇ／日，补钙５００ｍｇ／日者平均正钙平衡３１８．２２ｍｇ／日，摄入钙的利用率占３３％，经２年单纯补钙，ＱＣＴ腰椎骨密度增高１３％，低钙摄入的妇女单纯补钙有一定预防骨质疏松的作用。

仁术健胃颗粒对慢性萎缩性胃炎脾气虚证大鼠血清MTL、SS和GAS水平的实验研究

目的:通过观察仁术健胃颗粒对慢性萎缩性胃炎(CAG)脾气虚证大鼠胃泌素(GAS)、生长抑素(SS)和胃动素(MTL)的影响,探讨仁术健胃颗粒预防和治疗慢性萎缩性胃炎脾气虚证的机制。方法:采用N-甲基-N-硝基-N-亚硝基胍(MNNG)和40%乙醇灌胃建立大鼠慢性萎缩性胃炎(CAG)模型,同时以破气苦降,饥饱失常和疲劳训练进一步建立CAG脾气虚证大鼠模型。将CAG脾气虚证大鼠随机分为模型组、胃复春组和仁术健胃颗粒3个剂量组。给予相应的药物连续治疗5周,正常组给予等量NS。实验末检测各组大鼠血清中GAS、SS和MTL水平。结果:CAG脾气虚证模型组大鼠GAS和SS水平与正常组比较明显降低;MTL水平显著升高(P<0.05、P<0.01)。经仁术健胃颗粒治疗后,6g/kg和12g/kg剂量组可显著降低MTL水平;升高GAS和SS水平。结论:仁术健胃颗粒治疗CAG脾气虚证与调节GAS、MTL、SS等胃肠激素水平,改善胃黏膜的炎症反应,促进局部胃黏膜的修复和腺体的再生有关。这可能是其治疗萎缩性胃炎的重要机制之一。

培土生金法对脾虚哮喘模型大鼠NF-κB表达的影响

目的观察培土生金法对脾虚哮喘模型大鼠TNF-α/NF-κB信号通路变化的影响,探讨培土生金法干预哮喘气道炎症和黏液高分泌的信号转导机制。方法健康雄性Wistar大鼠50只,随机分成5组:对照组、脾虚哮喘组、哮喘组、脾虚哮喘治疗组和哮喘治疗组,每组10只。采用ELISA试剂盒法测定血清和BALF中TNF-α的含量,采用免疫组化测定大鼠肺组织NF-κBp65的表达和入核率。结果脾虚哮喘组和哮喘组血清和BALF中TNF-α含量及大鼠支气管上皮细胞中NF-κBp65阳性表达均显著升高,和对照组比较差异显著(P<0.01);但是脾虚哮喘组和哮喘组比较,血清和BALF中TNF-α含量无显著性差异。与哮喘组比较,脾虚哮喘组大鼠支气管上皮细胞中NF-κBp65入核率显著增加(P<0.01)。和脾虚哮喘组比较,脾虚哮喘治疗组血清和BALF中TNF-α含量及肺组织NF-κBp65入核率显著降低(P<0.01);和哮喘组比较,哮喘治疗组血清和BALF中TNF-α含量及肺组织NF-κBp65入核率显著降低(P<0.01)。结论培土生金法能够降低脾虚哮喘和哮喘大鼠血清和BALF中TNF-α的含量和肺组织NF-κBp65入核率。

口服磷酸果糖钠盐（FDP）药效作用的研究

口服磷酸果糖钠盐，具有抗疲劳、抗缺氧抗酒精中毒等作用。在上述急性动物药效学试验中，ＦＤＰ比口服西洋参皂甙、人参皂甙、绞股蓝皂甙效果更加显著。

太子健冲剂对气虚小鼠T细胞亚群的影响

目的:探讨太子健冲剂对气虚小鼠T细胞亚群的影响。方法:将小鼠随机分为6组,正常对照组常规饲养,其余5组单笼分别控制饲料量[125g/(kg·d)]饲养,并分别灌服生理盐水、左旋咪唑、玉屏风口服液和太子健冲剂高、低剂量,连续7d。结果:与正常组小鼠相比,气虚组小鼠免疫器官指数、T细胞亚群的TH/TS比值均明显降低;太子健冲剂能增加气虚小鼠脾指数,明显提高TH/TS比值。结论:太子健冲剂具有调节机体免疫功能。

颈髓损伤与低钠血症

颈髓损伤后出现低钠血症的并发症尚未引起广泛重视，此文观察了３９例颈椎外伤住院病例，认为低钠血症与颈髓损伤及其程度明显相关，与感染、发热相关（Ｐ＜０．０５），且认为颈髓损伤后低钠血症是由交感抑制、血浆醛固酮水平不足导致。

承德市1999～2004年生态足迹与土地生态承载力分析

根据生态足迹原理和方法，用1999～2004年承德市统计数据计算出7年来承德市生态足迹和生态承载力。结果表明1999～2004年承德市人均生态足迹呈上升趋势。1999～2004年承德市人均生态足迹大于土地生态承载力为生态赤字，必须改变消费和生产方式，树立科学发展观，走集约、节约、高效型的循环经济发展模式。从横向比较看，承德市6年平均人均生态足迹仅为全球1993年平均水平的43．69％，是北京、天津、河北1990～2003年平均水平的48．17％、50．98％、50．98％，是全国1999年水平的91．98％，说明承德市的经济发展水平略低于全国平均发展水平，在京津冀地区属于相对发展滞后区。

补脾益气方药对脾虚哮喘大鼠肺组织IκB/NF-κB信号途径的影响

目的探讨脾虚型哮喘大鼠气道炎症,血液和支气管肺泡灌洗液(BALF)中嗜酸性粒细胞百分比,肺组织核因子-κB抑制蛋白α(IκBα)表达和核因子-κB(NF-κB)活性的变化及补脾益气方药对其的影响。方法将30只雄性Wistar大鼠随机分为3组:正常对照组(A组)、脾虚型哮喘组(B组)、补脾益气方药组(C组),采用HE染色检测肺组织病理变化,采用免疫组织化学方法检测肺组织IκBα表达水平和NF-κB p65的活性变化。结果B组与A组比较,肺组织IκBα表达显著降低,而NF-κB p65的活性显著增高(P<0.01);C组与B组比较,肺组织IκBα表达显著增高,而NF-κB p65的活性显著降低(P<0.01)。结论补脾益气方药能有效增加脾虚型哮喘大鼠肺组织IκBα的表达,抑制其肺组织NF-κBp65的活性,减轻哮喘时的气道炎症变化,从而对脾虚型哮喘起到治疗作用。

生长激素缺乏儿童的酸碱平衡研究

目的 :探讨生长激素缺乏 (GHD)和特发性矮身材 (ISS)儿童血浆实际碳酸氢盐浓度 (AB)差异 ,以及碳酸氢盐标准差评分 (SDS)在 GHD诊断中的价值。方法 :对 4 7例矮小症儿童作血气分析及电解质测定及 GH激发试验 ,根据 GH激发试验的峰值分为 GHD和 ISS两组 ,比较两组血浆 AB、碳酸氢盐 SDS、阴离子间隙 (AG)的差异。结果 :GHD儿童血浆 AB、碳酸氢盐 SDS分别为 (2 2 .6 0± 1.2 9) mmol/L、- 0 .2 7± 0 .98,明显低于 ISS组 [(2 3.80±0 .95 ) mmol/L、0 .6 4± 0 .73],P<0 .0 1;而 AG GHD组为 (11.73± 4 .5 2 ) mmol/L高于 ISS组 [(7.87± 1.70 ) mmol/L],P<0 .0 1。在碳酸氢盐 SDS≤ 1s的矮小儿童中 ,72 % (31/4 3)患儿为 GHD。结论 :GHD儿童血浆 AB、碳酸氢盐SDS明显低于 ISS儿童 ,血浆碳酸氢盐 SDS≤ 1s者应高度怀疑 GHD。

针药结合对中老年男性部分雄激素缺乏综合征患者生殖内分泌的影响

目的:观察针药结合对中老年男性部分雄激素缺乏综合征(PADAM)患者生殖内分泌的影响。方法:将60例患者随机分为3组,观察组(针药结合组)、对照1组(单纯针刺组)、对照2组(口服补肾胶囊组),每组各20例。采用放射免疫法分别测定各组患者治疗前后血清睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)的血清浓度水平。结果:治疗后3组患者血清T含量较前有显著性提高(其中观察组提高较为显著,P<0·01);治疗后观察组和对照1组患者血清中LH含量较前有显著性下降(P<0·05),对照2组下降不明显(P>0.05);治疗后观察组患者FSH值较前显著性提高(P<0·05),而对照1组和对照2组无显著性提高(P>0.05);治疗后观察组、对照1组及对照2组患者的症状体征均有显著改善,PADAM评分指数均有所下降,其中以观察组改善最为显著(P<0·01),对照1组、对照2组均为P<0·05。结论:针药结合治疗PADAM具有较好的疗效,能调节下丘脑-垂体-睾丸轴激素的分泌,提高血中的睾酮浓度,改善PADAM患者临床体能、血管舒缩症状、精神心理、性功能减退等临床症状,提高生活质量。

中风病急性期中医证候多元分析

收集了２２１例中风病急性期病人，进行了中风病急性期中医证候指标内部可靠性分析、主成分分析与聚类分析，从不同角度探讨和揭示中风急性期的证候特点及其与相关症状、舌象、脉象的关系。从聚类分析结果并结合临床实际，提出本组病例症状、舌象和脉象等指标可归属于火证、痰瘀证、气虚证、阴虚阳亢证四类证候，上述研究结果有助于完善中风急性期证候诊断规范。

缺锌的实验室诊断及浙江省某海岛小儿锌营养状况评价

本文对浙江省某海岛281名14岁以下小儿测定了血清锌,其中276例同时测定了发锌,于采血及发样后,全部给予硫酸锌口服30天,停药后抽血复查,得14岁以下小儿血清锌的正常参考值为平均值18.0μmol/L(117.5μg/dl),95%范围10.9~29.6μmol/L(71.3~193.6μl/dl),低限11μmol/L(71μg/dl),发锌与血清锌无相关关系.发锌含量随年龄、性别、发色不同而异.认为发锌并非诊断缺锌的可靠指标,而血清锌含量不受年龄、性别和发色的影响,反映人体锌营养状况较有价值.以所测血清锌的正常值低限标准来衡量补锌前281名小儿的锌营养状况,发现缺锌患病率为10.3%,以1~7岁小儿患病率最高,1岁以内者次之,故海岛缺锌防治重点应放在7岁以下小儿.

赔偿性颅脑外伤患者伪装智力低下的评估

Malingering and exaggeration of intellectu al impairments are common in personal injury cases involved in litigation.T he patients usually present clinically with a history of traumatic head injury,and even with objective evidences for organic brain damage,which render it difficult to discern the possibility of malingering.In our country,there has been a lack of effective and objective strategies for the evaluation of feigned intellectual deficits.The authou reviewed the relevant literaures published in r ecent years,with particular emphasis on neuropsychological approach to assessmen t of malingering.New directions for local research in this important area were s uggested.