水浴降温与室温降温对热打击大鼠肺组织损伤及预后影响比较

目的：研究冰水浴、常温水浴、室温降温对热打击(heat stress,HS)大鼠死亡构成比、肺组织病理及相关细胞因子水平的影响。方法115只雄性SD大鼠随机分为肺损伤观察组(n=70)和死亡率分析组(n=45)。肺损伤观察组随机分为空白对照(normothermic contral,NC)组(n=10)和热打击(room temperature,RT)组(n=60),NC组始终置于室温环境,HS组大鼠麻醉后置于高温高湿模拟环境,核心体温达42℃后,随机分为室温降温组(n=20),常温水浴降温(temperate-water immersion, TWI)组(n=20),冰水浴降温(ice water immersion,IWI)组(n=20),分别给予相应降温方法降温。同时,将3组大鼠分别随机分为热打击后15 min处死组(n=10)和3 h处死组(n=10)。各组大鼠在相应时间点处死,HE染色观察肺组织病理改变, Elisa检测肺组织匀浆相关细胞因子水平。死亡率分析组随机分为HS + RT组、HS + TWI组、HS + IWI组,统计热打击后3 h死亡构成比。结果与HS + RT组相比,HS + TWI组和HS + IWI组大鼠死亡构成比显著降低(χ2=10.601,P=0.001)。HS + IWI 3 h组肺组织出现间质水肿、出血,肺泡萎缩塌陷、腔内出血,促炎因子TNF-α水平高于NC组(P＜0.05)及对应TWI组、RT组(P＜0.05)。结论 TWI、IWI较RT显著改善热打击大鼠预后,但IWI诱发更为严重的肺组织损伤,提示目前的水浴温度、水浴时长等可能不是最优的。     

转化生长因子β1刺激系膜细胞的Smad2表达及对结缔组织生长因子产生的影响

目的研究在转化生长因子β1(transforming growth factor-β1,TGF-β1)刺激下系膜细胞表达Smad2及对结缔组织生长因子(connective tissue growth factor,CTGF)产生的影响.方法培养第4代大鼠肾系膜细胞分为4组对照组、1ng/ml TGF-β1刺激组、5ng/ml TGF-β1刺激组、Staurosporine抑制组.在15min、30min、1 h、2 h时用RT-PCR测Smad2 mRNA的表达,用免疫组化测Smad2蛋白的表达;同样在24h时用RT-PCR测CTGF mRNA的表达,用免疫组化测CTGF蛋白的表达.结果体外培养的大鼠肾系膜细胞,在TGF-β1刺激下,Smad2 CTGFmRNA和蛋白的表达明显增加(P＜0.05),应用丝、苏氨酸激酶抑制剂Staurosporine抑制Smad2磷酸化,可以明显减少TGF-β1刺激下系膜细胞表达CTGF(P＜0.05).结论在系膜细胞,TGF-β1主要依赖Smad信号通路调节CTGF的表达.     

Rho激酶和转化生长因子β通路在醛固酮/盐诱导的单肾切除SD大鼠肾脏损伤中的作用

目的观察Rho激酶和转化生长因子β(transforming growth factor-β,TGF-β)通路是否参与醛固酮/氯化钠诱导的单肾切除SD大鼠肾脏损伤的发病及可能的机制。方法健康雄性5周龄SD大鼠在实验初始行右肾切除,手术后2周给予1%氯化钠饮水。随机将大鼠分3组:对照组(2%酒精皮下泵入,n=9);醛固酮组(2%酒精+醛固酮0.75μg/H皮下泵入,n=9);醛固酮+fasudil组[2%酒精+醛固酮0.75μg/H皮下泵入+fasudil 10mg/(kg·day)皮下注射,n=8]。共治疗5周。观察收缩压、尿蛋白、肾功能、肾组织学改变,并用western blot法和real-time PCR法观察肾皮质磷酸化MYPT1(代表Rho激酶活性)和Smad2/3蛋白表达和TGF-β1、结缔组织生长因子(connective tissue growth factor,CTGF) mRNA表达。结果醛固酮/盐长期灌注引起渐进性高血压同时伴有以大量蛋白尿,肌酐清除率下降,严重的肾小球增生和硬化、间质纤维化为特征的肾脏损伤,同时伴有肾皮质磷酸化MYPT1和Smad2/3表达增加,TGF-β1、CTGF ...     

TGF-β1/Smad通路在养肺保元汤治疗慢性阻塞性肺病合并肺间质纤维化中的作用

目的 研究养肺保元汤治疗慢性阻塞性肺病(COPD)合并肺间质纤维化(PIF)中转化生长因子-β1(TGF-β1)/Smad通路的作用机制.方法 15只SD大鼠随机分为正常组(n=3)、模型组(n=4)、DcR3抗体组(n=4)和养肺保元汤组(n=4).除正常组外,其他12只大鼠在烟熏箱内每天被动吸烟1 h,持续42 d...     

毒胡萝卜素对小鼠肺成纤维细胞内钙离子水平及caspase-3蛋白表达的影响

目的 探讨钙泵抑制剂毒胡萝卜素(thapsigargin,TG)对体外小鼠肺成纤维细胞内钙离子（Ca2+）水平及凋亡相关蛋白含半胱氨酸的天冬氨酸蛋白水解酶-3（caspase-3）表达的影响。方法 小鼠肺成纤维细胞(L929)分为3组:空白对照组(不做处理)、转化生长因子β₁（TGF-β₁）组、TG组,后两组均用5 ng/mL TGF-β₁诱导24 h,TG组在诱导后再用4 μmol/L TG作用24 h。细胞处理48 h后,分别收集各组细胞,采用透射电子显微镜观察细胞超微结构变化,激光共聚焦显微镜观察各组细胞内Ca2+水平,免疫细胞化学方法检测caspase-3蛋白表达。结果 透射电子显微镜示,空白对照组细胞凋亡较少,TGF-β₁组无明显凋亡细胞,TG组有大量成纤维细胞凋亡。TGF-β₁组Ca2+水平和caspase-3蛋白水平均低于空白对照组（P<0.05）,TG组细胞内Ca2+水平和caspase-3蛋白水平均较TGF-β₁组、空白对照组升高（P<0.05）。结论 TG可使小鼠肺成纤维细胞细胞内钙稳态失衡,增加caspase-3蛋白表达,促进细胞凋亡。     

人参皂甙Rbl对阿霉素心力衰竭大鼠致心脏纤维化因子表达的影响

目的:探讨人参皂甙Rbl(Ginsenosides-Rbl,Gs-Rb1)是否通过心脏抑制心脏纤维化相关蛋白和mRNA介导其改善慢性心力衰竭(chronic heart failure,CHF)大鼠的心肌重构效应?方法:在构建阿霉素CHF大鼠模型成功后,将其随机分为Gs-Rb1组(n = 17)给予Gs-Rb1 70 mg/(kg·d)和CHF组(n = 15),另外选取同龄健康大鼠作为对照组(n = 10)?第4周心脏超声评估全心质量指数(HW/BW)和左室质量指数(LW/BW),应用Western blot和RT-PCR方法检测转化生长因子-β1 (transforming growth factor β1,TGF-β1)?结缔组织生长因子(connective tissue growth factor,CTGF)?内皮素-1(endothelin 1,ET-1)等蛋白和mRNA的表达?结果:与对照组相比,Gs-Rb1组全心质量指数(HW/BW,P = 0.005)及左室质量指数(LW/BW,P = 0.000)均显著改善;与CHF组相比,Gs-Rb1组TGF-β1?CTGF和ET-1蛋白的表达均显著下降(P均< 0.05),但均显著高于对照组(P均 < 0.05);Gs-Rb1组TGF-β1?CTGF和ET-1等mRNA的表达均显著低于CHF组(P均 < 0.05),但均显著高于对照组(P均 < 0.05)?结论:在Gs-Rbl改善CHF大鼠心肌重构效应中,Gs-Rbl可通过下调TGF-β1?CTGF?ET-1等蛋白和mRNA等介导其保护作用?     

雾化吸入布地奈德对肺纤维化大鼠的干预效果

目的 研究雾化吸入布地奈德对博莱霉素致大鼠肺纤维化模型的干预作用.方法 45只SD雌性大鼠随机分成3组(每组15只):模型组、对照组和布地奈德吸入组.各组大鼠分别于干预后第7、14、28天用随机数字表法处死5只,HE和Masson染色判断肺组织肺泡炎及肺纤维化程度,酶联免疫吸附法(ELISA)测定血清和肺泡灌洗液(broncho-alveolar lavage fluid,BALF)中转化生长因子(transforming growth factor-β,TGF-β)和结缔组织生长因子(connective tissue growth factor,CTGF)的含量.结果 ①HE和Masson染色结果证实成功复制经典肺纤维化模型,肺纤维化主要发生在肺组织局部,同时伴有不同程度全身反应.②布地奈德吸入组和模型组大鼠肺泡炎和肺纤维化程度较对照组严重(P＜0.05),且布地奈德吸入组大鼠肺泡炎和肺纤维化程度较模型组有明显改善(P＜0.05).③ELISA法显示各组大鼠血清和BALF中TGF-β和CTGF表达水平不同,BALF中TGF-β和CTGF表达水平较血清水平高.④与对照组比较,模型组和布地奈德吸入组大鼠血清和BALF中TGF-β和CTGF明显增加(P＜0.05),布地奈德吸入组中TGF-β和CTGF水平较模型组明显降低(P＜0.05).结论 雾化吸入布地奈德能减轻博莱霉素诱导的大鼠肺纤维化,可能与肺泡灌洗液和血清中TGF-β和CTGF表达有关.     

丹参对糖尿病大鼠肾脏的保护作用及其机制研究

目的:探讨丹参对糖尿病大鼠肾脏的保护作用及其机制.方法:采用单侧肾切除、腹腔注射链脲佐菌素诱导糖尿病肾病大鼠模型,予以丹参药物干预.观察大鼠肾脏形态学及肾功能的变化.采用荧光实时定量逆转录-聚合酶链反应法检测转化生长因子β1(transforming growth factor-beta1, TGF-β1)、结缔组织生长因子(connective tissue growth factor, CTGF)、纤溶酶原激活物抑制物1(plasminogen activator inhibitor-1,PAI-1)等细胞因子在糖尿病大鼠肾皮质中的表达水平.结果:与正常对照组比较,用药第8周末糖尿病肾病模型组大鼠的肾脏肥大指数、平均肾小球体积、尿白蛋白排泄率、肌酐清除率均有明显升高(P＜0.05),肾皮质TGF-β1、CTGF、PAI-1和纤维连接蛋白的表达水平也有显著增高(P＜0.05).丹参治疗组大鼠的上述指标与糖尿病肾病模型组比较,则有明显的降低(P＜0.05).结论:丹参可通过抑制TGF-β1、CTGF、PAI-1等细胞因子的表达,从而对糖尿病大鼠肾脏起保护作用.     

转化生长因子β1对人胚肺成纤维细胞结缔组织生长因子及低密度脂蛋白受体相关蛋白表达的影响

目的:探讨体外培养人胚肺成纤维细胞(human pulmonary fibroblasts-1,HPF-1)在外源性转化生长因子β1(transforming growth factor beta, TGF-β1)作用下结缔组织生长因子(connective tissue growth factor, CTGF)与低密度脂蛋白受体相关蛋白(low density lipoprotein receptor related proteins, LRP) 的表达变化及意义.方法:将HPF-1用5 μg/L的TGF-β1分别作用0, 3, 6, 12和 24 h.用RT-PCR方法检测CTGF及LRP mRNA的表达;用蛋白免疫印迹检测LRP蛋白表达变化;用免疫沉淀方法检测TGF-β1作用不同时间,与LRP结合的CTGF的数量变化;用细胞免疫荧光检测细胞中LRP表达情况.结果:相关分析显示,以3 h为关键点,CTGF mRNA(131.53±2.86)与LRP mRNA(224.87±7.00)表达变化具有正相关性(r=0.840 2,P＜0.05);LRP蛋白随TGF-β1作用时间不同,表达水平先升高,于3 h达高峰,而后逐渐下降,用免疫印迹法分析,相对于0 h组(190.85±2.86),3 h组(222.45±3.66)表达具有统计学意义(F=18.06,P＜0.05);用免疫荧光标记细胞LRP也得到类似的结果,比较0 h组(27.56±6.72)和3 h组(88.66±15.72)LRP蛋白表达(F=244.36,P＜0.01)差异具有统计学意义.结论:LRP作为CTGF的受体蛋白,在TGF-β1作用不同时间的情况下,表达量发生变化,并与CTGF的表达成正相关,提示其在肺间质纤维发生中发挥作用.     

血管紧张素-(1-7)对糖尿病大鼠心脏PDGF、TGF-β1以及Ⅳ型胶原的影响

目的 通过观察血管紧张素-(1-7) [angiotensin-(1-7),Ang-(1-7)]作用后糖尿病大鼠心脏血小板源性生长因子(platelet derived growth factor,PDGF)、转化生长因子β1(transforming growth factor -β1,TGF-β1)、Ⅳ型胶原的变化,及其对糖尿病大鼠心脏的作用.方法 将SD大鼠分为正常对照组(C组)、糖尿病模型Ang-(1-7)干预组(T组)及糖尿病模型组(D组).分别检测血糖等生化指标,并检测心脏组织PDGF、TGF-β1、Ⅳ型胶原的基因表达水平.结果 与T组相比,D组大鼠心脏/体质量比(heart weight/body weight,HW/BW)明显增加, PDGF、TGF-β1 、Ⅳ型胶原的mRNA表达明显上调(P<0.01).结论 Ang-(1-7) 具有抑制糖尿病大鼠心脏组织PDGF、TGF-β1、Ⅳ型胶原mRNA表达的作用,抑制心脏组织增生.     

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.     

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…     

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.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.