参附养心汤对老年阳虚水泛型慢性心力衰竭患者心功能及血清IL-6、TNF-α、hs-CRP水平的影响

目的 观察参附养心汤治疗老年阳虚水泛型慢性心力衰竭的临床效果。方法 将老年阳虚水泛型慢性心力衰竭患者92例随机分为观察组和对照组,每组46例。对照组采用西医常规治疗,观察组在对照组治疗方法基础上给予参附养心汤治疗。治疗4周后,对两组患者临床疗效、脑钠肽（BNP）、6 min步行距离、心功能指标[左心室舒张末期容积（LVEDV）、收缩末期容积（LVESV）、左心室射血分数（LVEF）]及细胞炎性因子[白细胞介素-6（IL-6）、肿瘤坏死因子（TNF-α）、超敏C-反应蛋白（hs-CRP）]进行比较。结果 治疗4周后,观察组总有效率为89.1%,显著高于对照组71.7%,差异具有统计学意义（P<0.05）;观察组的BNP水平显著低于对照组,而6 min步行距离显著高于对照组,差异具有统计学意义（P<0.05）;观察组的LVEDV、LVESV均显著低于对照组,而LVEF高于对照组,差异具有统计学意义（P<0.05）;观察组的血清hs-CRP、IL-6及TNF-α水平均显著低于对照组,差异具有统计学意义（P<0.05）。结论 参附养心汤能显著改善老年阳虚水泛型慢性心力衰竭患者的心功能指标,降低BNP水平,减轻炎症反应,提高运动耐量,疗效显著。     

不同剂量大黄附子细辛汤对慢性肾功能衰竭脾肾阳虚证患者肾功能、CRP、IL-6及TNF-a的影响

目的 探讨不同剂量大黄附子细辛汤对慢性肾衰竭脾肾阳虚证患者炎症因子及临床疗效的观察。方法 120例确诊的慢性肾功能衰竭脾肾阳虚证患者随机分为治疗组和对照组各60例,两组在常规治疗基础之上,对照组给予小剂量大黄附子细辛汤,治疗组给予大剂量大黄附子细辛汤,观察两组患者治疗前后尿素氮（BUN）、血肌酐（Scr）、血清胱抑素C（CysC）、C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-a （TNF-a）水平、药物不良反应及临床疗效。结果 两组患者血清BUN、Scr、CysC、IL-6、TNF-a较治疗前均明显降低,治疗组下降幅度更为显著（P<0.05）,治疗组治疗后中医证候积分及综合疗效均优于对照组（P<0.05）,治疗后2组安全性比较无显著差异（P>0.05）。结论 大剂量大黄附子细辛汤对慢性肾功能衰竭脾肾阳虚证患者中有助于改善肾功能,降低炎症因子水平,可能与降低血清炎性因子IL-6、TNF-a值,发挥抗炎及促进肾代谢作用有关。     

邵先舫教授治疗急性痛风性关节炎经验

急性痛风性关节炎是临床常见病、多发病,其发病率呈逐年上升趋势。邵先舫教授认为该病主要病因病机为饮食不节、居处湿热,加之素体脾虚等,造成体内湿热蕴积,化生浊毒而诱发。临床治疗上应辨证施治,常以清热利湿解毒为主,疗效明显。     

甘胆口服液对BRD犊牛血清急性期蛋白和氧化应激指标的影响

【目的】探讨甘胆口服液按推荐剂量用药对牛呼吸道疾病（bovine respiratory disease,BRD）的治疗效果及对血清急性期蛋白（acute phase protein,APP）浓度和氧化应激指标的影响,为其在牛临床上的推广应用提供依据。【方法】选择40头自然发病的BRD犊牛,随机分成2组,分别为受试药物组（甘胆口服液0.2 mL/kg）、对照药物组（麻杏石甘散0.75 g/kg）,并增加健康犊牛12头作为空白对照组,按推荐剂量1次/d,连用7 d,分别于试验第0,3,5,7天记录犊牛的一般临床症状,并依据BRD评分表进行打分;在试验第0,7天随机抽取各试验组犊牛12头颈静脉采血,测定血清APP（结合珠蛋白（HP）、淀粉样蛋白A（SAA）、C-反应蛋白（CRP））浓度和氧化应激指标（丙二醛（MDA）、还原型谷胱甘肽（GSH）、过氧化氢酶（CAT）、超氧化物歧化酶（SOD）、总抗氧化能力（T-AOC））水平。【结果】药物组试验犊牛第0天证候积分均≥5分,符合试验要求。用药第3,5,7天临床症状积分均不同程度降低（P<0.05）。在第5天时积分均<5分,第7天积分减少到最小值。麻杏石甘散组犊牛在第3天时的BRD治愈率高于甘胆口服液组（P>0.05）,但随着治疗时间的延长,甘胆口服液治愈率与麻杏石甘散相近,用药5 d后,两药物组治愈率均达到60%以上。BRD组犊牛第0天血清HP、SAA、MDA水平显著高于健康对照组（P<0.05）,GSH、T-AOC水平及SOD、CAT活性均不同程度低于健康对照组,但差异不显著（P>0.05）。经过药物治疗后,BRD组犊牛第7天血清HP、SAA、MDA水平显著下降,GSH水平和SOD活性显著上升（P<0.05）。【结论】甘胆口服液能明显改善BRD犊牛临床症状,有效缓解患BRD犊牛氧化应激状态,降低血清急性期蛋白水平。联合应用急性期蛋白和氧化应激指标可以对BRD犊牛进行早期诊断及疗效监测。     

结石通片对小鼠的急性毒性试验及其对乙二酰胺致大鼠肾结石的作用研究

[目的]研究结石通片对小鼠的急性毒性作用,对健康大鼠的利尿作用,以及对乙二酰胺致大鼠肾结石的调节作用.[方法]取ICR小鼠40只,雌、雄各半,随机分为对照组与给药组,每组20只,观察结石通片给药前后小鼠的体重变化和死亡情况;另取SD大鼠36只,雌、雄各半,分为对照组、低剂量组(给予5％结石通片溶液)和高剂量组(给予10...     

碰撞变量对汽车碰撞严重程度的影响规律研究

为了深入研究汽车碰撞严重程度与碰撞变量的关系，在进行了基本物理量对汽车碰撞剧烈程度影响分析的基础上，选择碰撞车辆作用质量、碰撞车总车速和碰撞车总动量为碰撞变量，应用数学方法，研究了它们对汽车碰撞严重程度的影响规律，可为汽车碰撞事故的分析提供可借鉴的经验．     

Correlation of cardiac enlargement as assessed by vertebral heart size and echocardiographic and electrocardiographic findings in dogs with evolving cardiomegaly due to rapid ventricular pacing

Vertebral heart size (VHS) has been proposed as a method for quantifying cardiomegaly in dogs. This study was designed to determine how well echocardiographic and electrocardiographic findings correlated with VHS. Dogs were rapid-paced into varying degrees of cardiomegaly and were monitored by thoracic radiography, echocardiography, and electrocardiography during development of cardiomegaly. Echocardiographic and electrocardiographic parameters were compared with VHS. VHS increased with increased duration or rate of pacing or both, and left atrium-to-aorta ratio, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, P wave duration, and QRS duration correlated significantly with VHS. VHS (a score obtained from routine thoracic radiographs) seems to correlate well with both echocardiographic and electrocardiographic parameters. When 9 veterinarians, experienced in interpretation of cardiac silhouettes on radiographs, measured VHS from 1 normal dog and 1 dog with severe cardiomegaly, coefficients of variation (ratio of standard deviation to the mean) for their measurements were 2.7% and 2.8%, respectively. Thus, VHS could be established with great uniformity by experienced interpreters.     

Clinical assessment of left ventricular relaxation

Ventricular relaxation is altered in a number of cardiac disorders affecting domestic animals. Clinical determination of the ventricular relaxation rate can provide useful information regarding disease severity and response to therapy. We believe that the current gold standard for assessing left ventricular relaxation requires measurement of ventricular luminal pressure at end-expiration using a high-fidelity catheter. Ventricular pressure should be digitized at ≥200 Hz for the period of pressure fall between the minimum rate of change of ventricular pressure and 10 mm Hg above left ventricular end-diastolic pressure of the preceding beat. The rate of relaxation then should be determined from the digitized data by Marquardt nonlinear least squares parameter estimation using an exponential decay model with nonzero asymptote. The major disadvantage in using an invasive method for evaluating left ventricular relaxation is that it requires general anesthesia in animals that frequently are categorized as high-risk anesthetic patients. Noninvasive estimates of ventricular relaxation using echocardiographic parameters such as isovolumic relaxation time, peak early filling rate, and time from end-systole to peak filling rate provide a crude and nonspecific assessment of ventricular relaxation that can be obtained from conscious animals. Determinations of these echocardiographic indices are of limited usefulness in assessing changes in ventricular relaxation associated with disease progression or therapeutic intervention, unless concurrent estimates of left atrial pressure, mitral valve characteristics, and left ventricular compliance are available.     

Atrioventricular valvular insufficiency and congestive heart failure in a carpet python

Right atrioventricular valve insufficiency and bilateral congestive heart failure were identified in a carpet python (Morelia spilota variegata) with the aid of colour Doppler echocardiography, electrocardiography and radiography. The snake failed to respond to diuretic therapy and was euthanased. Based on this case, it appears that bilateral congestive failure is feasible in univentricular animals with lesions restricted to one side of the heart. Loop diuretic therapy may be inappropriate in non-crocodilian reptiles because reptiles lack a loop of Henle.     

Evaluation of cystatin C as an endogenous marker of glomerular filtration rate in dogs

Cystatin C is a cysteine protease inhibitor produced by all nucleated cells. It is freely filtered by the glomerulus and is unaffected by nonrenal factors such as inflammation and gender. Because of greater sensitivity and specificity, cystatin C has been proposed to replace creatinine as a marker of glomerular filtration rate (GFR) in humans. The aims of this study were to validate an automated assay in canine plasma and to evaluate the usefulness of cystatin C as a marker of GFR in dogs. Western blotting was used to demonstrate cross-reactivity of an anti-human cystatin C antibody. An immunoturbidimetric assay was used to detect cystatin C in 25 clinically healthy dogs and 25 dogs with renal failure. Mean cystatin C concentration in the healthy dogs and the dogs with renal failure was 1.08 +/- 0.16 mg/L and 4.37 +/- 1.79 mg/L respectively. Intra- and interassay variability was <5%. The assay was linear (r = .974) between 0.14 and 7.53 mg/L. Both cystatin C and creatinine concentrations were measured in banked, frozen serum from 20 remnant kidney model dogs and 10 volume-depleted dogs for which GFR measurements by exogenous creatinine clearance had been determined previously. In the remnant kidney model, cystatin C was better correlated with GFR than creatinine (r = .79 versus .54) but was less well correlated with GFR in volume-depleted dogs (r = .54 versus .95). GFR measurements were repeated in the remnant kidney model dogs 60 days after initial GFR measurements. At this time, cystatin C and creatinine concentrations correlated equally well with GFR (r = .891 versus .894, respectively). Cystatin C concentration is a reasonable alternative to creatinine for screening dogs with decreased GFR due to chronic renal failure.