重型脑损伤后AQP4表达与脑水肿的关系

目的观察重型脑损伤后水通道蛋白-4（AQP4）表达变化，及其与脑损伤后脑水肿之间的关系。方法健康成年Wistar大鼠，随机分成创伤性脑损伤（TBI）组和各假手术（SO）组。自由落体硬膜外撞击方法致重度脑创伤模型。于伤后4h、8h、12h、1d、3d、5d、7d取出大鼠脑组织，免疫组化（IHC）和原位杂交（ISH）检测AQP4的表达变化，干湿重法计算脑组织含水量。结果IHC和ISH显示，脑损伤后AQP4在脑组织中的表达上调，1d达高峰，持续至3d后下降，7d接近SO组水平。与SO组相比，除7d亚组外，TBI其余各亚组中AQP4表达水平均明显增高（P〈0、05）。脑损伤后4h脑组织含水量即比SO组增加（P〈0、05），随时间延长，脑组织含水量亦逐渐增加，伤后1-3d达高峰。AQP4表达和脑组织含水量呈正相关，r=0．978，P〈0，01。结论脑损伤后，随着脑水肿加重，AQP4表达上调。提示脑损伤后AQP4的表达变化与脑水肿的形成密切相关，AQP4在损伤后脑水肿的形成中发挥着重要作用。     

AQP4在幼年大鼠感染性脑水肿中的作用机制

目的观察内毒素致幼年大鼠感染性脑水肿后水通道蛋白4（AQP4）的表达变化。方法将50只幼鼠随机分为内毒素组（40只）和对照组（10只）。建立内毒素致大鼠感染性脑水肿模型,于术后6h、12h、24h和48h处死动物,分别行脑组织含水量、血脑屏障通透率的测定,以伊文思兰含量判定血脑屏障通透率,并应用免疫组织化和RT--PCR,技术检测脑组织内AQP4蛋白和mRNA的表达水平。结果内毒素组脑组织含水量和伊文思兰含量明显高于对照组。在内毒素注射后6h时,脑组织中AQP4的表达明显增加,12h时达高峰,各时间点与对照组比较均有显著性差异（P〈0．01）。结论感染性脑水肿后脑组织中AQP4的表达增加,且与脑组织含水量和BBB的破坏呈正相关。     

瑞芬太尼对家兔缺血脑组织水通道蛋白-4表达的影响

目的观察瑞芬太尼对家兔缺血再灌注损伤脑组织水通道蛋白-4（AQP-4）表达的影响。方法健康家兔25只,随机分为假手术组、缺血模型组、瑞芬太尼组。以双侧颈总动脉阻断＋控制性低血压法建立家兔全脑缺血损伤模型,再灌注1h,6h,24h末,测定脑组织含水量,观察AQP4的表达,再灌注24h末,观察脑组织超微结构变化。结果与假手术组比较,模型组家兔脑组织含水量及脑组织内AQP4表达在1h,6h和24h逐渐升高（P〈0．05）;与模型组比较,瑞芬太尼组脑组织含水量与AQP-4表达明显降低（P〈0．05）。结论瑞芬太尼可能通过降低脑组织内AQP-4表达,减轻脑水肿,保护脑缺血损伤。     

AQP4和VEGF在大鼠视网膜缺血／再灌注损伤中表达的规律及相关性分析

目的研究水通道蛋白-4（AQP4）和血管内皮生长因子（VEGF）在视网膜缺血／再灌注（RIR）损伤机制中的表达规律,探讨二者在RIR损伤机制中有无相关性。方法运用提高眼内压的方法建立大鼠RIR模型,将56只Wistar大鼠随机分为术后6、12、24、48、72h,7d组和正常对照组,用免疫组化法、平均光密度分析和Pearson法观察二者的表达水平及相关性。结果AQP4在RIR损伤6h后出现表达上调,24h后达高峰,除7d组外,其余实验组AQP4的表达与正常对照组相比均有显著性差异fP〈0．01）。VEGF表达在RIR损伤后12h开始增加,48h达高峰,具有显著性差异（P〈0．01）。AQP4和VEGF在12-72h呈正相关,且24、48h的相关性更佳。结论AQP4和VEGF在RIR损伤中可能通过协同作用影响视网膜的水代谢。     

大鼠创伤性脑水肿早期水通道蛋白 AQP-4的表达及意义

目的探讨水通道蛋白4（AQP-4）在大鼠创伤性脑水肿早期的表达及意义。方法按Feeney自由落体撞击法建立大鼠创伤性脑损伤（TBI）模型，用干／湿法测定大鼠TBI后不同时相脑组织含水量，并采用免疫组织化学方法检测脑组织AQP-4蛋白的表达．采用Western Blot方法对AQP-4蛋白进行半定量分析。结果TBI后48小时伤侧脑水肿达高峰，同时水通道蛋白AQP-4在大脑半球表达降低（P〈0．05），损伤侧大脑半球伤后48小时降低最为明显（P〈0．01）。AQP-4的表达与脑组织水含量呈负相关。结论脑损伤后，AQP-4表达降低与脑水肿的形成密切相关。     

依达拉奉对大鼠脑出血后水通道蛋白4及血脑屏障的影响

目的研究大鼠脑出血后血脑屏障（BBB）通透性与水通道蛋白4（AQP4）的关系及自由基清除剂依达扭奉的干预作用。方法采用自体动脉血注入尾状核法制成大鼠脑出血模型，Westernblot法观察AQP4的表达，伊文思兰法测量BBB通透性，干湿重法计算脑含水量表示脑水肿。结果与对照组相比，脑出血组及依达拉奉组BBB通透性均在出血后6h开始升高，l-3d最高，依达拉奉组低于脑出血组（P〈0．05）；两组AQP4表达也于6h即开始升高，3d时达到高峰，依达拉奉组低于脑出血组（P〈0．05）；BBB通透性与AQP4表达呈正相关（r=0．585，P〈0．05），与脑水肿变化趋势一致。结论脑出血后可能通过上调APQ4表达，增加BBB通透性，参与脑水肿形成，依达拉奉可抑制此过程。     

七氟醚与大鼠缺血性脑水肿脑组织内水通道蛋白4表达的影响

目的探讨七氟醚对大鼠缺血性脑水肿脑组织中水通道蛋白4（AQP4）表达的影响。方法选择健康SD大鼠90只,随机分为三组：假手术组、大脑中动脉栓塞（MACO）组、七氟醚预处理组,每组各30只;各组分别按术后6、24、48 h 3个时间点分为3个亚组,每个亚组各10只。分别在术后6、24、48 h检测脑组织含水量,采用RT-PCR检测脑组织中AQP4 mRNA基因表达。结果①MACO组及七氟醚预处理组术后6、24、48 h的AQP4mRNA光密度积分均高于假手术组,差异有统计学意义（P〈0.05）;七氟醚预处理组术后6、24、48 h的AQP4mRNA光密度积分[（1.2743±0.0460）、（1.3454±0.0450）、（1.4443±0.0740）分]均高于MACO组[（1.4385±0.0540）、（1.5370±0.0580）、（1.6489±0.0940）分],差异有统计学意义（P〈0.05）。②MACO组及七氟醚预处理组术后6、24、48 h的脑组织含水量均高于假手术组,差异有统计学意义（P〈0.05）;七氟醚预处理组术后6、24、48 h的脑组织含水量[（75.8±6.8）%、（77.6±8.9）%、（76.3±6.4）%]均低于MACO组[（78.4±6.5）%、（80.1±7.6）%、（83.4±7.2）%],差异均有统计学意义（P〈0.05）。结论脑水肿形成与AQP4的表达有密切关系,七氟醚对脑组织内AQP4的基因表达有抑制作用,进而抑制脑水肿的发展。     

大鼠去骨瓣减压术后水孔蛋白-4表达变化的实验研究

目的：研究去骨瓣减压术对大鼠创伤性脑损伤后脑水肿、水孔蛋白-4（AQP-4）表达的影响。方法：应用改良Feeney’s自由落体脑损伤打击装置制成大鼠创伤性脑损伤模型,分为假手术组（SO组）、对照组（C组）及去骨瓣减压组（DC组）,各组在损伤后再分为6、12、24、72、120 h及168 h等6个时间点断头取脑损伤区组织。分别利用干湿重量法测量脑组织含水量和Western-Blot检测AQP-4蛋白的表达。结果：大鼠去骨瓣减压组脑组织含水量及AQP-4蛋白表达呈现先升高后降低的趋势,于伤后24 h达高峰后逐渐下降。与C组相比,上述指标含量均有所下降：脑组织含水量在24、120、168 h差异有统计学意义（P〈0.05）,72 h差异有高度统计学意义（P〈0.01）;AQP-4蛋白表达在12、120 h时间点有统计学意义（P〈0.05）,24、168 h时有高度统计学意义（P〈0.01）。结论：创伤后大鼠脑组织脑水肿与AQP-4表达上调密切相关;去骨瓣减压术可减轻脑水肿,减缓AQP-4表达。该手术对创伤性脑损伤的保护机制可能与减缓AQP-4蛋白表达,从而减轻脑水肿和继发性脑损伤,保护脑组织有关。     

水通道蛋白4在高原脑水肿大鼠脑组织中的表达变化及意义

[目的]探讨水通道蛋白4(aquaporin4,AQP4)与高原脑水肿之间的关系.[方法]制作大鼠高原缺氧损伤模型,测脑组织含水量,采用RT-PCR、免疫组织化学、Western blotting技术测定脑组织缺氧损伤24 h后AQP4 mRNA和蛋白表达变化.[结果]缺氧损伤后,脑组织含水量增加,水肿明显;HE染色显示部分神经元肿胀或浓缩;缺氧24 h后,AQP4 mRNA和蛋白表达量均明显增加(P＜0.05).[结论]AQP4在高原缺氧脑水肿的形成过程中可能发挥了重要作用.     

水通道蛋白4 RNA干扰对爆炸伤后脑水肿的影响

目的 研究水通道蛋白4 RNA干扰(aquaporin4 RNA interference,AQP4 RNAi)对爆炸伤后脑水肿的影响.方法 Wistar成年大鼠150只.按随机数字表法分为爆炸伤组、爆炸伤前RNAi组、爆炸伤后RNAi组、单纯RNAi组、假手术组(n=30).构建特异性抑制AQP4表达的短发夹环质粒载体AQP4 RNAi pGenSil-2,分别在伤前7 d和伤后1 h采用右侧脑室给药的方法 抑制AQP4的表达,右侧颞顶部开直径为1 cm的骨窗后用80 mg TNT当量电雷管在5 cm垂直距离爆炸,分别于伤后4、12 h,1、2、5、7 d对损伤区脑组织光、电镜病理形态、AQP4 mRNA和蛋白表达水平以及脑含水量进行比较.结果 爆炸伤前RNAi组、爆炸伤后RNAi组大鼠星形胶质细胞和神经元水肿的范围和程度均低于爆炸伤组;在爆炸伤后4 h,爆炸伤组、伤前RNAi组和伤后RNAi组相比,损伤区脑含水量差异不显著(P＞0.05);12 h至7 d,同一时间点爆炸伤前、后进行AQP4 RNAi组大鼠脑含水量均明显低于只行爆炸致伤而未进行AQP4 RNAi组大鼠(P＜0.01).伤前RNAi组损伤区脑含水量在伤后12 h达高峰,伤后RNAi组损伤区脑含水量伤后1 d达高峰,爆炸伤组脑含水量于伤后2 d达高峰.伤前和伤后RNAi组最高脑含水量明显低于爆炸伤组最高脑含水量(P＜0.01).伤前RNAi组最高脑含水量低于伤后RNAi组最高脑含水量(P＜0.01).结论 采用AQP4 RNAi的方法可明显减轻爆炸伤后脑水肿.AQP4可能对爆炸伤早期(4 h内)脑水肿的形成过程影响较小,而后期的脑水肿加重过程可能和AQP4表达增高有关.     

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     

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.     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.