活性氧对缺氧大鼠肺动脉平滑肌细胞凋亡的影响及其机制

目的 研究和探讨缺氧状态下大鼠肺动脉平滑肌细胞(pulmonary arterial smooth muscle cells,PASMCs)内活性氧(reactive oxygen species,ROs)对细胞凋亡的影响及其调控机制.方法 原代培养正常大鼠PASMCs,选用第2～4代用于实验.分别在常氧及低氧条件下使用ROS清除剂Tiron进行分组干预.通过四唑硝基蓝(NBT)还原法、2,7-二氢二氯荧光黄双乙酸钠(DCFH-DA)荧光探针检测细胞内ROS水平,原位细胞凋亡检测法(TUNEL)检测细胞凋亡,免疫细胞化学法检测Bcl-2和Bax蛋白表达.结果 ①缺氧组细胞ROS水平[NBT:(0.214±0.024),DCFH-DA:(39.33±3.27)]明显高于对照组[NBT:(0.114±0.017),DCFH-DA:(15.84±2.86)](均P<0.01);②缺氧组细胞凋亡指数(2.42±0.74)显著低于对照组(4.50±0.45)(P<0.01),Tiron+缺氧组细胞的凋亡指数(5.75±0.94)与缺氧组比较则明显升高(P<0.01);③与对照组[Bcl-2:(0.098±0.017),Bax:(0.210±0.031),Bcl-2/Bax:(0.465±0.021)]相比较,缺氧组Bcl-2蛋白表达(0.141±0.024)增强(P<0.05),Bax蛋白表达(0.074±0.020)减弱(P<0.05),Bcl-2/Bax比值(1.973±0.283)升高(P<0.01);④和缺氧组比较,缺氧+Tiron组Bcl-2蛋白表达(0.124±0.018)降低(P<0.05),同时Bax蛋白表达(0.182±0.019)增强(P<0.05),Bcl-2/Bax比值降低(0.678±0.071)(P<0.01).结论 缺氧状态时大鼠PAsMCs内ROS生成增多,ROS可通过促进Bcl-2/Bax蛋白表达比值升高来抑制PASMCs凋亡,从而在缺氧性肺动脉重建的发病机制中发挥重要作用.     

有氧运动对衰老大鼠骨骼肌细胞凋亡及Bcl-2和Bax表达的影响

目的: 研究有氧运动对衰老模型大鼠骨骼肌细胞凋亡及Bcl-2和Bax蛋白表达的影响。方法： 建立衰老大鼠模型,随机分为对照组和2组运动组,运动组分别给予6次/周和3次(隔日)/周的游泳训练,每次运动持续90 min,共训练12周,于末次训练48 h后处死动物。TUNEL法检测骨骼肌细胞凋亡,免疫印迹法检测骨骼肌细胞内Bcl-2、Bax的表达,并计算Bcl-2/Bax的比值。结果： 与对照组相比,2组运动组骨骼肌细胞凋亡指数和Bax蛋白表达均显著降低(P均<0.01),而Bcl-2蛋白表达和Bcl-2/Bax明显升高(P均<0.01);与6次/周运动组比较,3次/周运动组骨骼肌凋亡指数和Bax表达明显降低(P均<0.05),而Bcl-2表达和Bcl-2/Bax明显升高(P均<0.05)。结论： 有氧运动能优化Bcl-2/Bax的比值,降低骨骼肌细胞凋亡指数,有效减少衰老导致的骨骼肌过度凋亡;且隔日有氧运动效果更佳。     

科索亚对心力衰竭大鼠骨骼肌细胞凋亡及Bcl-2和Bax蛋白表达的影响

目的:探讨科索亚对心力衰竭大鼠骨骼肌细胞的凋亡及Bcl-2和Bax蛋白表达的影响.方法:将38只SD大鼠随机分为4组:正常对照组(A组,n=8),心力衰竭组(B组,n=10),心力衰竭科索亚治疗1组(C组,n=10),心力衰竭科索亚治疗2组(D组,n=10).B、C、D组分别腹腔一次性注射野百合碱30 mg/k.2周后,C组和D组分别用科索亚10 mg·k-1·d-1和30 mg·k-1·d-1灌胃2周,A组和B组则以生理盐水灌胃2周.2周后处死动物,以腓肠肌质量和体质量比作为骨骼肌萎缩的指标.TUNEL法检测腓肠肌细胞凋亡.免疫组织化学和免疫印迹法检测腓肠肌Bcl-2、Bax的表达,并计算Bax/Bcl-2的比值.结果:与A组相比,B组腓肠肌凋亡指数升高(P＜0.01),Bcl-2表达减少(P＜0.01),Bax表达升高(P＜0.05),Bax/Bcl-2比值＞1.与B组相比,C组和D组腓肠肌细胞凋亡指数降低(P＜0.01);且C组和D组Bcl-2表达升高(P＜0.01),Bax表达减少(P＜0.05),Bax/Bcl-2比值均＜1.结论:细胞凋亡可能是心力衰竭时骨骼肌萎缩的原因之一;科索亚可能通过改变Bax/Bcl-2比值减轻心力衰竭时骨骼肌的凋亡和萎缩.     

缬沙坦后处理对离体大鼠心肌缺血再灌注细胞凋亡及Bcl-2、Bax表达的影响

目的观察缬纱坦后处理对离体大鼠心肌缺血再灌注(ischemia-reperfusion, I/R)细胞凋亡及凋亡相关蛋白Bcl-2、Bax表达的影响.方法利用Langendorff 离体心脏灌流装置,采用完全复灌/停灌的方法制备I/R模型.24只SD大鼠随机等分为:①对照(sham)组:K-H液持续灌流110min;②I/R组:停灌30 min,复灌60 min;③缬纱坦后处理(Po vst)组:I/R+缬沙坦1μmol/L(再灌注头15min给药).Hoechst 荧光染色观察凋亡情况,计算凋亡指数(AI);Western blot 检测Bcl-2、Bax的表达.结果 sham组凋亡细胞零星分布(AI=3.48±0.38),另两组均有大量凋亡细胞存在,且Povst组AI(25.87±1.04)明显低于I/R组(36.99±2.26)(P<0.05);Bcl-2、Bax的表达在I/R、Povst组均明显高于sham组(P<0.01),Povst组Bcl-2的表达明显高于I/R组(P<0.01),而Bax的表达与I/R组无显著差异(P>0.05).结论缬纱坦后处理抑制离体大鼠心肌再灌注细胞的凋亡,与上调Bcl-2表达、增加Bcl-2/Bax 比值有关.     

碱性成纤维细胞生长因子对急性心肌梗死时心肌细内Bcl-2、Bax表达的影响

目的 bFGF对大鼠急性心肌梗死(AMI)时心肌细胞内Bcl-2、Bax表达的影响,并探讨其发生机制.方法 实验动物随机分为假手术组,缺血 生理盐水组,缺血 bFGF组,结扎大鼠左冠状动脉复制AMI模型.术前分别注入生理盐水及bFGF,于结扎后2、4和8h处死动物,采用免疫组织化学方法 检测大鼠缺血区心肌细胞内Bcl-2、Bax蛋白的表达水平.结果 在急性心肌梗死后第2、4 h时,缺血 bFGF组心肌细胞Bcl-2蛋白的表达(141.75±26.91)‰,(125.63±24.09)‰明显高于缺血 生理盐水组(15.63±5.05)‰,(42.12±14.08)‰,P＜0.01,Bax蛋白表达(11.25±3.80)‰,(30.87±8.05)‰明显低于缺血 生理盐水组(32.62±6.61)‰,(83.638±9.84)‰,P＜0.05.结论 bFGF可促进AMI时心肌细胞内Bcl-2的表达、抑制Bax的表达,对心肌细胞具有保护作用.     

心肌肥大大鼠心肌细胞凋亡与Bcl-2、Bax蛋白表达的变化

目的:探讨心肌肥大大鼠心肌细胞凋亡及Bcl-2和Bax蛋白表达的变化。方法:腹腔注射异丙肾上腺素,建立大鼠心肌肥大模型。采用原位末端缺口标记(TUNEL)法观察心肌细胞凋亡;应用Westernblotting和免疫组化方法检测Bcl-2和Bax的蛋白表达,并使用HPIAS10009图像分析仪进行定量分析。结果:与对照组比较,心肌肥大组心肌细胞凋亡显著增加(P<0.01),Bax表达增加(P<0.01),而Bcl-2表达减少(P<0.01),Bcl-2/Bax比值下降(P<0.01)。结论:Bcl-2和Bax基因参与了心肌肥大心肌细胞凋亡的调控。     

氯沙坦对心力衰竭大鼠心肌细胞Bax、Bcl-2蛋白表达的影响

目的:探讨氯沙坦对心力衰竭大鼠心肌细胞促凋亡蛋白Bax和抗凋亡蛋白Bcl-2的影响。方法:选24只雄性8周龄SD大鼠,分为对照组、心衰组和氯沙坦干预组各8只。采用阿霉素腹腔注射造模,氯沙坦干预组同时灌胃给氯沙坦连续给药6周。用原位脱氧核糖核酸酶未端标记法(TUNEL法)检测大鼠心肌细胞凋亡,用免疫组化法检测大鼠心肌Bax、Bcl-2蛋白的表达。结果:与对照组比较,心衰组心肌细胞凋亡指数升高,提示心衰组存在明显心肌细胞膜损伤。与心衰组比较,氯沙坦干预组心肌细胞凋亡指数降低。心衰组和氯沙坦干预组心肌细胞Bax和Bc1-2基因蛋白表达显著高于对照组,与心衰组相比,氯沙坦干预组明显下调Bax基因表达,上调Bc1-2基因表达。结论:氯沙坦可明显提高抗凋亡蛋白Bcl-2蛋白表达,降低促凋亡蛋白Bax蛋白表达,提示氯沙坦具有有效抑制心肌细胞凋亡,改善心衰作用。     

新辅助动脉化疗对宫颈癌细胞凋亡及Bcl-2、Bax的影响

目的 检测宫颈癌行新辅助动脉化疗后细胞凋亡及Bcl-2、Bax的变化,探讨其意义.方法 选取宫颈癌Ⅰb2~Ⅱb期患者46例,动脉化疗前后宫颈活检,采用DNA片段末端标记法检测凋亡细胞,免疫组化法检测Bcl-2及Bax蛋白.结果 动脉化疗后,细胞凋亡指数(%)由0.67±0.21升高至3.57±1.29,P<0.05;Bcl-2表达阳性率(%)化疗前为19.23±4.17,化疗后为8.15±5.03,化疗后较化疗前降低,P<0.05;Bax表达阳性率(%)化疗前7.46±5.43,化疗后22.34±6.58,化疗后较化疗前明显升高,P<0.05.结论 宫颈癌行新辅助动脉化疗后细胞凋亡增加,Bcl-2表达降低,Bax表达升高,Bcl-2/Bax比值降低,提示动脉化疗可通过提高Bax的表达,降低Bcl-2/Bax的比值,从而诱导肿瘤细胞凋亡.     

五甲基槲皮素对Ang Ⅱ致心肌肥厚和细胞凋亡的作用

目的 研究五甲基槲皮素(PMQ)对血管紧张素Ⅱ(AngⅡ)致大鼠心肌肥厚和细胞凋亡的作用及机制.方法 30只SD大鼠随机分为5组.试验持续21 d.①空白组:每晨生理盐水灌胃;②PMQ组:每晨PMQ 50 mg/kg灌胃;③AngⅡ组:于第15天开始皮下注射AngⅡ 288μg/(kg·d);④PMQ+Ang Ⅱ组:PMQ和AngⅡ处理同前;⑤溶剂+AngⅡ组:每晨溶剂灌胃,AngⅡ处理同前.于第22天处死大鼠.测量心脏指数、左心指数,心肌超氧化物歧化物(SOD)活力和丙二醛(MDA)含量,实时荧光定量(real time)PCR检测脑钠素(BNP)mRNA的表达,TUNEL法测心肌凋亡,免疫组化测Bax、Bcl-2蛋白的表达.结果 PMQ能明显抑制Ang Ⅱ所致的心肌肥厚[左心指数,(2.02±0.16)vs(2.34±0.10)mg/g]及BNP mRNA表达上调;抑制心肌细胞凋亡[凋亡指数,(0.72±0.18)vs(1.28±0.27)%]及凋亡相关蛋白Bax表达[平均吸光度(0.037 3±0.007 3)vs(0.054 0±0.006 8)]和Bax/Bcl-2的提高[(0.17±0.03)vs(0.25±0.04)].并降低SOD活力、增加MDA含量.结论 PMQ能对抗AngⅡ引起的心肌肥厚及细胞凋亡.此效应可能与其抗氧化作用有关.     

心肌肥大和心力衰竭大鼠心肌细胞凋亡及Bax和Bcl-2的表达

目的:探讨心肌肥大和心力衰竭(心衰)大鼠心肌细胞凋亡及Bax和Bcl-2蛋白表达的变化。方法:24只健康雄性SD大鼠随机分为假手术组(对照组)、心肌肥大组、心衰组,每组8只。心肌肥大组和心衰组均采用缩窄腹主动脉构建模型。假手术组和心肌肥大组大鼠于第4周处死,心衰组大鼠于第12周处死。分别检测各组血流动力学和左室肥大指标,TUNEL法检测心肌细胞凋亡,免疫组织化学法检测心肌Bcl2和Bax的表达。结果:心力衰竭组与心肌肥大组比较,左室收缩末压、左室舒张末压、心室内压变化最大速率差异均有统计学意义(P<0.01或0.05)。心衰组较心肌肥大组心肌细胞凋亡增加,Bax表达增加,Bcl-2表达减少(P<0.01)。结论:心肌细胞凋亡在心脏由心肌肥大向衰竭的转变过程中起着重要的作用,并与凋亡蛋白Bax和Bcl-2表达改变有关。     

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.     

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.