肾素血管紧张素醛固酮系统拮抗剂对自发性高血压大鼠心肌缝隙连接蛋白Cx43表达的影响

目的 探讨心肌缝隙连接蛋白Cx43在自发性高血压大鼠心肌中的表达以及肾素血管紧张素醛固酮系统(RASS)拮抗剂对其的干预机制。 方法 取8周雄性、体质量约200 g的自发性高血压大鼠(SHR)70只,随机分为高血压组、雷米普利组、替米沙坦组、依普利酮组、雷米普利+替米沙坦组、雷米普利+依普利酮组以及替米沙坦+依普利酮组,每组10只,再取同周龄、同体质量Wistar大鼠10只作为对照组。适应性喂养1周后,每天早8点给予灌胃给药,分别于0、4周及8周测量大鼠的尾动脉压,8周后处死动物,取出心脏,测量左心室质量及左心室质量/体质量,石蜡切片观察心肌纤维化程度,RT-PCR和Western blot观察Cx43的表达。 结果 喂养结束时,SHR组血压高于Wistar组(P<0.01),给予RAAS拮抗剂干预后,血压下降(P均<0.05),替米沙坦+依普利酮组血压下降最明显(P<0.01);替米沙坦+依普利酮组大鼠的左心室质量、左心室质量/体质量、心肌纤维化程度及血管紧张素Ⅱ(AngⅡ)下降也最明显(P<0.01);SHR组Cx43表达低于Wistar组(P<0.01),给予RAAS拮抗剂干预后,Cx43表达升高(均P<0.05),升高幅度仍以替米沙坦+依普利酮组最为明显(P<0.01)。 结论 高血压大鼠心肌缝隙连接蛋白Cx43表达降低,RAAS拮抗剂可以升高Cx43的表达,其中以替米沙坦与依普利酮联合效果最明显。     

硫化氢对自发性高血压大鼠心肌重构的作用及机制研究

目的 探讨硫化氢H2S对自发性高血压大鼠（SHR）间隙连接蛋白40（Cx40）、43（Cx43）表达的调控作用,以及与心肌重构的关系。方法 取8周龄雄性SHR 16只,随机分为SHR对照组（n?=8）、SHR+ 硫氢化钠NaHS组（n?=8）;取同周龄的正常Wistar京都（WKY）雄性大鼠8只,设为WKY组。SHR+ NaHS组腹腔注射NaHS 56?μmol/（kg·d）,SHR对照组和WKY组每日腹腔注射等量生理盐水,持续8周。用分光光度计检测各组大鼠外周血和心肌组织中H2S含量;通过HE染色及Masson三色染色观察H2S对心肌的病理学改变;通过免疫组织化学检测3组大鼠心脏组织中Cx40、Cx43表达位置的变化;运用Western blotting检测3组大鼠心脏组织中Cx40、Cx43及α-平滑肌肌动蛋白（α-SMA）、骨桥蛋白（OPN）表达量的变化。结果 与WKY组大鼠比较,SHR组大鼠外周血及心肌组织中H2S含量减少（P?<0.05）,NaHS干预后SHR外周血及心肌组织中H2S含量增加（P?<0.05）;与WKY组大鼠比较,SHR组大鼠心肌纤维结构排列较为紊乱,NaHS干预后SHR心肌纤维排列较为整齐;SHR组大鼠心肌中的Cx40、Cx43表达增加且分布紊乱,SHR+NaHS组大鼠心肌中的Cx40、Cx43分布较规整;且SHR组大鼠心肌中Cx40、Cx43、α-SMA、OPN表达升高（P?<0.05）,SHR+NaHS组大鼠心肌中Cx40、Cx43、α-SMA、OPN表达降低（P?< 0.05）。结论 H2S可能通过调控Cx40、Cx43的表达来改善SHR心肌重构。     

苯那普利单用及与伊贝沙坦合用对SHR心肌、肾皮质TGFβ3 mRNA表达的影响

目的探讨血管紧张素转换酶抑制剂(ACEI)苯那普利单用及与血管紧张素II-1型受体拮抗剂(ARB)伊贝沙坦合用,对自发性高血压大鼠(SHR)血压及心肌、肾皮质转化生长因子β 3(TGFβ 3)mRNA表达的影响.方法选用12周龄SHR 24只,随机分苯那普利组、苯那普利与伊贝沙坦联合干预组、SHR组,每组8只.采用灌胃法分别给苯那普利组大鼠灌入苯那普利(8mg·kg·d-1),联合干预组大鼠灌入苯那普利(8mg·kg-1·d-1)与伊贝沙坦(40mg·kg-1·d-1)混合液;SHR和WKY对照组灌入自来水,共8周.观察药物对心率、血压及处死后左心室心肌和肾皮质TGF β 3 mRNA表达水平的影响.结果与SHR对照组比较,苯那普利组、苯那普利与伊贝沙坦联合干预组大鼠,其心肌和肾皮质TGFβ 3 mRNA表达和血压水平较SHR组大鼠显著降低(P＜0.01);而与苯那普利组大鼠比较,联合干预组大鼠心肌、肾皮质TGFβ 3 mRNA表达没有显著降低(P＞0.05).结论 ACEI苯那普利单用和ARB与ACEI合用均能显著降低SHR的血压及抑制心肌、肾皮质TGFβ 3的mRNA表达,这可能是防治高血压心、肾靶器官损害的机制之一.     

替米沙坦对自发性高血压大鼠糖代谢及血清脂联素的影响

目的】 探讨血管紧张素II 1型受体拮抗剂替米沙坦对自发性高血压大鼠(SHR)糖代谢及血清脂联素的影响。 【方法】 实验分为4组: 对照组(WKY,n = 10);高血压组(SHR,n = 10);替米沙坦组(替米沙坦,50 mg·kg-1·d-1,n = 10),氨氯地平组(氨氯地平 10 mg·kg-1·d-1,n = 10),另外两组给予安慰剂,均为灌胃法给药,12周后处死大鼠,用生化方法测定糖代谢指标,ELISA方法测定血清脂联素含量。【结果】 四组大鼠空腹血糖之间没有明显差异(P > 0.05),高血压组大鼠空腹胰岛素水平高于对照组,替米沙坦和氨氯地平不能降低SHR空腹胰岛素水平(P > 0.05)。 OGTT结果显示,30 min和120 min后高血压组大鼠血糖水平高于对照组,替米沙坦可以明显降低SHR血糖水平(P < 0.05),而氨氯地平不能降低SHR血糖水平(P > 0.05)。高血压组大鼠血清脂联素的水平要低于对照组,替米沙坦可以明显升高SHR血清脂联素的水平 (P < 0.05),而氨氯地平没有作用(P > 0.05)。【结论】 血管紧张素Ⅱ 1型受体拮抗剂替米沙坦可以升高SHR血清脂联素水平,降低30 min,120 min餐后血糖水平。     

阻断RAAS不同部位对自发性高血压大鼠的心肌胶原酶mRNA表达的影响

目的　观察阻断肾素 -血管紧张素 -醛固酮系统 (RAAS)不同部位对自发性高血压大鼠 (SHR)心肌中胶原酶表达的影响。方法　对 15只 2 6周龄SHR分别采用苯那普利、Losartan和安体舒通治疗 12周 ,用点杂交方法检测治疗前后大鼠心肌胶原酶mRNA的变化。另取 2 6周龄的SHR(SHR 2 6)和未预任何治疗的 3 8周龄SHR(SHR 3 8)各 5只作为对照。结果　SHR 2 6和SHR 3 8组胶原酶mRNA量与SHR 2 6组大鼠比较差别无统计学意义 (P >0 .0 5 )。 3个治疗组中 ,苯那普利SHR组的胶原酶mRNA较未治疗组明显增加 (P <0 .0 5 ) ,其余两治疗组则无明显变化 (P >0 .0 5 )。结论　在阻断RAAS的 3种药物中 ,仅苯那普利增加胶原酶mRNA的表达。     

卡托普利对自发性高血压大鼠胸主动脉缝隙连接蛋白43表达的影响

目的:通过比较Cx43在正常大鼠和自发性高血压大鼠胸主动脉表达的差异,以及经卡托普利干预后的变化,来阐明卡托普利抗高血压血管重构的分子机制。方法:12周龄自发性高血压大鼠(SHRs)16只随机分为对照组和卡托普利干预组,以年龄和体重匹配的Wistar-Kyoto大鼠(WKYs)为正常空白对照组。干预组,灌胃法给予卡托普利[12.5mg·d)],8周后,采用无创血压测定仪测量3组大鼠尾动脉收缩压;用酶联免疫吸附法测量血浆和胸主动脉组织血管紧张素Ⅱ(AngII)浓度。采用实时定量RT-PCR和Western blot分析,检测3组大鼠胸主动脉组织内Cx43的mRNA及蛋白表达。结果:SHR组的血浆、动脉组织AngII浓度较WKY大鼠组明显升高,而卡托普利干预组的血浆、组织AngII浓度则较SHR组明显降低。SHR组胸主动脉的Cx43的mRNA表达高于WKY组(P<0.01),卡托普利降低Cx43mRNA的表达(P<0.01)。蛋白印迹法显示,SHR组大鼠胸主动脉中,Cx43蛋白表达高于WKY大鼠组(P<0.01)。卡托普利降低组织主动脉内Cx43的蛋白表达(P<0.01)。结论:自发性高血压大鼠主动脉Cx43表达增强,卡托普利能够降低胸主动脉Cx43的表达。     

福辛普利对自发性高血压大鼠终末器官损伤的影响

目的:研究福辛普利对自发性高血压大鼠(SHR)终末器官的保护作用.方法:自发性高血压大鼠饲料中给予福辛普利[15 mg/(kg·d)]16周,在清醒状态下记录24 h血压波动性,应用光镜和计算机图像分析技术观察心脏和肾脏的组织病理学改变.结果:与SHR相比,福辛普利治疗组大鼠的血压波动性(收缩压、舒张压)明显降低(10.7±1.8vs16.3±2.1;9.0±1.6 vs 11.9±1.6),左心室/体质量比、心肌胶原容积分数、肾小球硬化积分与血压波动性呈正相关(0.712,0.686;0.745,0.682;0.651,0.533,P＜0.05或P＜0.01).结论:福辛普利长期应用可有效减轻SHR的终末器官损伤.     

血管紧张素Ⅱ对大鼠心房Cx40重构的影响及贝那普利的干预作用

目的 采用大鼠肾上腹主动脉部分结扎的模型,观察血管紧张素Ⅱ(AngⅡ)对心房缝隙连接蛋白(connexin,Cx)40重构的影响及贝那普利的干预效果.方法 将30只雄性Wistar大鼠随机数字表法分为对照组(C组)、腹主动脉结扎组(A组)、结扎 贝那普利组(B组).喂养8周后处死,用放射免疫法测血浆及心肌组织AngⅡ含量,用免疫组化方法检测大鼠心房Cx40的分布特征,半定量分析Cx40的含量.结果 与C组相比,A组血浆、心肌AngⅡ含量均明显升高(P《0.01),而B组则无明显变化(P》0.05).A组大鼠心房Cx40含量减少(P《0.01),并向侧边分布增加;而B组Cx40含量较A组增加(P《0.01),且分布不均一程度减轻.结论 AngⅡ升高可导致心房Cx40重新分布和表达减少;贝那普利通过降低AngⅡ水平,可有效减轻心房Cx40的重构.     

缝隙连接在自发性高血压大鼠肾叶间动脉收缩增强中的作用

目的 探讨肾叶间动脉(RIA)的缝隙连接(GJ)在自发性高血压病中的变化.方法 应用压力肌动图技术观察自发性高血压大鼠(SHR)及Wistar大鼠RIA对内皮非依赖血管收缩剂氯化钾(KCl)和苯肾上腺素(PE)的收缩反应的差异,以及应用GJ阻断剂后血管收缩反应的变化.应用Western blot技术比较SHR及Wistar大鼠RIA连接蛋白45(Cx45)的表达差异.结果 ①KCl和PE诱导SHR RIA的收缩反应要强于Wistar大鼠,应用GJ阻断剂18β-甘草次酸(18β-GA)(100 μmol/L)干预后,KCl和PE引起的RIA血管的收缩明显降低,SHR较Wistar大鼠收缩降低幅度更为显著.②SHR大鼠RIA Cx45蛋白表达升高(P＜0.05).结论 SHR RIA收缩作用的增强可能是通过上调Cx45增强平滑肌细胞间GJ通讯引起的.     

异氟烷对心肌动作电位及缝隙连接蛋白Cx43的作用

目的:观察异氟烷对心肌动作电位及缝隙连接蛋白Cx43表达的影响.方法:健康家兔40只,采用Langendorff离体心脏平衡灌注15min后,随机分为5组:I0.65组,用0.65MAC异氟烷的K-H液灌注;I0,65H用0.65MAC异氟烷加0.5mmol/L庚醇的K-H液灌注;I1.3组,用1.3MAC异氟烷的K-H液灌注;H0.5组,用庚醇0.5mmol/L的K-H液灌注;S组,用K-H液灌注.观察记录灌流15min时(基础值)和给药15min时的心率(HR)及心内膜心肌(Endo)、中层心肌(M)、心外膜心肌(Epi)的动作电位时程(APD)和振幅(APA),灌注完毕取左心室心肌组织,用免疫组织化学检测心肌Cx43蛋白表达.结果:I0.65组心肌动作电位无明显影响,I1.3组APD显著延长(P＜0.05),H0.5组HR显著减慢(P＜0.05),APD显著延长(P＜0.05),k0.65H组给药后有发生心律失常甚至心电活动停止现象;Cx43蛋白表达I0.65H组较H0.5组表达少(P＜0.05),H0.5组较I0.65、I1.3组表达少(P＜0.05),I1.3组较I0.65组、S组表达少(P＜0.05).结论:异氟烷与庚醇对心脏动作电位和缝隙连接蛋白Cx43可能有着相似的作用,延长动作单位时程,减少Cx43蛋白表达,改变Cx43蛋白分布;异氟烷可能通过阻滞缝隙连接,对心脏动作电位产生作用.     

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…     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.