目的 探讨补骨脂的反成配伍对大鼠肝脏的减毒作用及作用机制.方法 80只SD大鼠采用随机数字表法分为空白组、模型组、补骨脂组、补骨脂+制何首乌1:1组、补骨脂+制何首乌1:2组、补骨脂+制何首乌2:1组、补骨脂+熟地黄1:1组、补骨脂+五味子1:1组,每组10只大鼠.除空白组外,其他组皮下注射氢化可的松(25 mg/kg)制备肾阳虚大鼠模型,每日1次,连续注射14 d.大鼠建立肾阳虚模型后,给予相应药物干预,各组给药剂量均为12.6 g/kg,连续灌胃4周.HE染色观察大鼠肝脏组织病理变化.酶联免疫吸附测定检测大鼠血清中谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、直接胆红素(DBIL)和总胆红素(TBIL)水平,以及肝组织中超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)表达水平.实时荧光PCR检测核因子E2相关因子2(Nrf2)、Kelch样环氧氯丙烷相关蛋白1(Keap1)、血红素加氧酶-1(HO-1)、醌氧化还原酶1(NQO1)mRNA的表达.蛋白质印迹法检测AMP活化蛋白激酶(AMPK)/糖原合成酶激酶-3β(GSK-3β)/Nrf2信号通路中磷酸化AMP K(p-AMP K)、磷酸化GSK-3β(p-GSK-3β)、Nrf2、HO-1的蛋白表达.结果 与补骨脂组比较,补骨脂与补阴药制何首乌、熟地黄及五味子配伍后大鼠肝小叶结构改善,炎性浸润细胞减少.与补骨脂组比较,补骨脂+制何首乌1:2组、补骨脂+熟地黄1:1组、补骨脂+五味子1:1组大鼠血清中AST、ALT、ALP、DBIL、TBIL水平均降低(P<0.01);补骨脂+制何首乌1:2组大鼠肝组织SOD、GSH-Px、MDA的表达改善(P<0.01);补骨脂+制何首乌1:2组Nrf2、HO-1、NQO1 mRNA水平上调(P<0.01),Keap1 mRNA水平下调(P<0.01);补骨脂+制何首乌1:2组、补骨脂+制何首乌2:1组、补骨脂+熟地黄1:1组、补骨脂+五味子1:1组p-AMPK、p-GSK-3β、Nrf2、HO-1蛋白表达均升高(P<0.05,P<0.01).结论 补骨脂配伍补阴药制何首乌、熟地黄及五味子可改善补骨脂所致的肝损伤,其作用机制可能是通过激活AMP K/GSK-3β/Nrf2信号通路,抑制氧化应激状态来发挥对肝脏的保护作用,补骨脂与何首乌配伍比例1:2减毒效果最佳.

Objective It is to observe the effect of Bushen Tiaojing Cream Formula on the levels of sex hormones, growth differentiation factor-9 (GDF-9) and bone morphogenetic protein-15 (BMP-15) in patients with premature ovarian failure of kidney deficiency type. Methods 110 patients with premature ovarian failure of kidney deficiency type were ran-domly divided into 2 groups. 55 patients in the control group were treated with hormone replacement therapy. 55 patients in the observation group were treated with Bushen Tiaojing Cream Formula on the basis of treatment in the control group. The changes of main syndromes, integral scores, Kupperman scores, levels of serum estradiol ( E2 ) , follicle maturation hor-mone ( FSH) , luteinizing hormone ( LH) , GDF-9 and BMP-15 before and after treatment in the 2 groups were observed. The short-term efficacy was evaluated and the reoccurrence rate within 6 moths of follow-up was calculated. Results The scores of major syndromes, Kupperman scores, serum levels of FSH and LH in the two groups after treatment were signifi-cantly lower, and the levels of E2 , GDF-9 and BMP-15 were significantly higher than those before treatment in both groups (P<0. 05), and the improvements of the above indexes after treatment in the group were significantly better than that in the control group (P<0. 05);the total treatment efficiency in the observation group was significantly higher and the follow-up recurrence rate was significantly lower than that in the control group (P<0. 05). Conclusion Bushen Tiaojing cream formula can effectively reduce the symptoms and signs, improve the status of reproductive axis, up-regulate the levels of GDF-9 and BMP-15, and help to reduce the risk of long-term recurrence in the treatment of premature ovarian failure of kidney deficiency type.

目的 探讨缩宫素与卡前列甲酯栓对剖宫产术后产妇出血量及首次排气排尿时间的影响.方法 研究对象选取陕西中医药大学第二附属医院2015年5月至2017年5月收治行剖宫产产妇共100例,采用随机数字表法分为对照组(50例)和观察组(50例),分别于术后给予缩宫素和卡前列甲酯栓治疗;比较两组产妇术后出血量,首次排气时间,首次排尿时间及不良反应发生率.结果 观察组术后2 h和4 h出血量分别为(196.46±25.32)mL和(231.01±35.12)mL,对照组分别为(241.38±37.04)mL和(295.83±48.47)mL,观察者均少于对照组(t=7.079、7.657,P<0.001);观察组术后首次排气时间(24.95±3.60)h显著短于对照组(31.70±4.33)h(t=8.476,P<0.001);观察组术后<1 h、1～2 h、2～4 h、>4 h的排尿人数分别为3例、20例、24例和3例,对照组分别为7例、33例、10例和0例,秩和检验结果显示观察组整体短于对照组(Z=3.525,P<0.001).观察组和对照组不良反应发生率分别为6.00％和4.00％,差异无统计学意义(χ2=0.444,P=0.505).结论 相较于缩宫素,卡前列甲酯栓用于剖宫产术后产妇可有效降低术后出血量,加快胃肠功能恢复进程,实现早期排尿,且未加重药物不良反应.

Objective To investigate curative effect and influence on life quality of Oxaliplatin by intravenous injection and intraperitoneal perfusion in assisted treatment of elderly patients with recurrent ovarian carcinoma. Methods A total of 100 elderly patients with recurrent ovarian carcinoma admitted during March 2012 and March 2014 were di-vided into control group (n = 50) and observation group (n = 50) according to different treatment methods. On the basis of Docetaxel treatment, control group was added with Oxaliplatin by intravenous injection, while observation group was added with Oxaliplatin by intraperitoneal perfusion. Objective remission rate (ORR), disease control rate (DCR), sur-vival rates of follow-up for 1, 2 and 3 years, Karnofsky score (KPS) before and after treatment and incidence rate of toxic and side effects were compared in two groups. Results In observation group, ORR and DCR values were significantly higher (P < 0. 05); survival rates of follow-up for 1, 2 and 3 years were significantly higher than those in control group (P < 0. 05). KPS score after treatment in observation group was significantly than those in control group and before treat-ment in observation group (P < 0. 05). Incidence rates of bone marrow suppression and liver function damage in observa-tion group were significant lower than those in control group (P < 0. 05). Conclusion Oxaliplatin by intraperitoneal perfusion in assisted treatment of elderly patients with recurrent ovarian carcinoma may efficiently control disease progres-sion, improve long-term survival and quality of daily life and help prevent incidence of toxic and side effects, and there-fore its value is superior to that by Oxaliplatin intravenous injection.

Objective:To study the influence of Huoxue Tongluo Huatan Decoction on blood rheology,plasma bilirubin and oxidized low density lipoprotein level in rats with acute cerebral infarction.Methods:60 healthy SD rats were randomly divided into the control group,the model group and the experimental group,20 rats in each group.A rat model of acute cerebral infarction was made by the method of self-embolism.The control group and the model group were treated with normal saline by lavage,and the experimental group was treated with Huoxue Tongluo Huatan Decoction by lavage.On the fifth day and l0th day,brain pathology of rats in each group was observed;blood rheology indexes (plasma viscosity,whole high viscosity,erythrocyte aggregation index) were compared,as well as plasma bilirubin and oxidized low density lipoprotein level.Results:Compared with the control group,the neurons in the brain tissue of the model group were swollen,the necrosis of the cells and vessels in the infarction,the structure was fuzzy,and the stroma showed edema.Compared with the model group,a few nerve cells died in the experimental group,and the porosity and swelling of the experimental group were obviously reduced,and the edema of the brain tissue was alleviated.On fifth days and tenth days,plasma viscosity,whole high viscosity and whole low viscosity in the model group were significantly higher than those of the control group,while plasma viscosity,whole high viscosity,erythrocyte aggregation index of the experimental group was lower than those of the model group.The differences were statistically significant(P＜ 0.05).The plasma bilirubin in the model group was lower than that in the control group,while the experimental group was significantly higher than the model group;the difference was statistically significant(P＜ 0.05).The level of oxidized low-density lipoprotein in the model group was significantly higher than that in the control group,but the level of oxidized low density lipoprotein in the experimental group was lower than that in the model group;the difference was statisticany significant (P＜ 0.05).Conclusion:Huoxue Tongluo Huatan Decoction can improve the injury of brain tissuc in rats with acute cerebral infarction,reduce hemorheology and oxidized low-density lipoprotein,and increase plasma bilirubin.