糖尿病大鼠模型建立及其脂肪组织PPARγ和GLUT-4表达的改变

目的:探讨糖尿病大鼠模型建立方法及过氧化物酶体增殖物激活受体γ(PPARγ)及葡萄糖转运蛋白4(GLUT-4)在高脂饮食联合小剂量链脲佐菌素(STZ)腹腔注射诱导的糖尿病形成中的作用。方法:35只雄性Wistar大鼠随机分为正常对照组(NC,n=15)和糖尿病造模组(DM,n=20),NC组饲以基础饲料,DM组饲以高脂饲料。5周后给予DM组单次腹腔注射STZ(30 mg/kg),以1周后空腹血糖>11.1 mmol/L为成模标准(n=15)。17周末测定血生化指标并计算胰岛素敏感指数(ISI),采用免疫组化法及Western-blot法分别检测脂肪组织中PPARγ及GLUT-4蛋白表达水平。结果:实验结束时DM组FBG、糖化血红蛋白(HbA1c)、糖化血清蛋白(GSP)较NC组均显著升高(P<0.01),肿瘤坏死因子α(TNF-α)较NC组明显升高(P<0.05),而ISI较NC组明显下降(P<0.05);脂肪PPARγ及GLUT-4蛋白表达与正常组相比明显下降(P<0.01)。结论:脂肪组织PPARγ及GLUT-4表达减弱在胰岛素抵抗、糖脂类代谢紊乱及糖尿病发病机制中可能起关键作用。     

肥胖Wistar大鼠骨骼肌细胞GLUT-4转位变化的研究

目的:探讨肥胖大鼠骨骼肌细胞的葡萄糖转运因子4(GLUT-4)转位变化.方法:10周龄雄性Wistar大鼠46只,随机平均分成对照组和肥胖组.6周肥胖模型建立后,用超速蔗糖梯度离心方法分离骨骼肌细胞内膜和外膜的匀浆,用Westem blot方法检测两组大鼠骨骼肌细胞内、外膜GLUT-4的蛋白水平.同时分别检测其空腹血糖、空腹胰岛素和血脂浓度.结果:肥胖组大鼠的胰岛素敏感指数明显下降(P＜0.01),肥胖组的内、外膜GLUT-4蛋白含量均较对照组下降,而且外膜GLUT-4下降比内膜更明显(分别为57.0%、12.2%,P＜0.01).结论:肥胖下调骨骼肌细胞GLUT-4总量,抑制细胞内膜GLUT-4向细胞外膜的转位,提示肥胖大鼠的骨骼肌存在由于GLUT-4下降调节所致的胰岛素抵抗.     

六味地黄丸对糖尿病大鼠骨骼肌GLUT-4基因表达的影响

目的:研究六味地黄丸对糖尿病大鼠血糖、胰岛素、葡萄糖转运蛋白-4(glucosu tramporter-4,GLUT-4)基因表达的影响.方法:20只雄性Wistar大鼠尾静脉注射四氧嘧啶复制糖尿病动物模型.将成模的糖尿病大鼠按血糖和体重随机分为糖尿病组、六味地黄丸组,同时设立正常对照组,并分别给予蒸馏水和六味地黄丸灌胃6周,6周后测定空腹血糖,血清胰岛素水平,RT-PCR.半定量测定骨骼肌GLUT-4mR3qA表达.结果:糖尿病组大鼠血糖显著升高,GLUT-4mRNA含量显著降低;补充六味地黄丸后血糖显著下降,GLUT-4mRNA含量显著增加.结论:六味地黄丸能改善糖尿病大鼠糖代谢,降糖机制可能与增加骨骼肌GLUT-4mRNA的表达有关.     

有氧运动与六味地黄丸对实验性糖尿病大鼠骨骼肌GLUT-4基因表达的影响*

[目的]研究有氧运动与六味地黄丸对糖尿病大鼠血糖、胰岛素、葡萄糖转运蛋白-4(GLUT-4)基因表达的影响.[方法]40只雄性Wistar大鼠尾静脉注射四氧嘧啶复制糖尿病动物模型.将成模的糖尿病大鼠按血糖和体质量随机分为糖尿病组、运动组、六味地黄丸组、运动+六味地黄丸组,同时设立正常对照组,6周后测定空腹血糖、血清胰岛素水平,逆转录-聚合酶链反应(RT-PCR)半定量测定骨骼肌GLUT-4 mRNA表达.[结果]糖尿病组大鼠血糖显著升高,GLUT-4mRNA含量显著降低;补充六味地黄丸和有氧运动干预后血糖显著下降,GLuT-4 mRNA含量显著增加.[结论]有氧运动和六味地黄丸能改善糖尿病大鼠糖代谢,降糖机制可能与增加骨骼肌GLUT-4 mRNA的表达有关.     

槟榔碱上调高果糖诱导胰岛素抵抗大鼠骨骼肌GLUT-4和p-PI3K的表达

目的 探索槟榔碱对高果糖诱导Wistar大鼠胰岛素抵抗的改善作用. 方法 采用高糖喂养Wistar大鼠建立胰岛素抵抗大鼠模型.实验大鼠随机分成4组:普通饲料对照组(Control)、高果糖模型组(HF)、普通饲料对照+5 mg/kg槟榔碱组(Con+Are)、高果糖+5 mg/kg槟榔碱组(HF+Are).Western blot检测GLUT-4和p-PI3K的表达.结果 与对照组相比高果糖模型组大鼠骨骼肌葡萄糖转运载体4(GLUT4)和磷酸化磷脂酰肌醇3-激酶(p-PI3K)的表达是明显降低的,而5 mg/kg槟榔碱能明显上调高果糖模型组GLUT-4和p-PI3K的表达,但对对照组无显著影响. 结论 5 mg/kg槟榔碱能上调高果糖诱导胰岛素抵抗大鼠骨骼肌细胞GLUT-4和p-PI3K的表达.     

黄精对2型糖尿病胰岛素抵抗大鼠葡萄糖转运蛋白-4基因表达的影响

目的观察黄精水提液对2型糖尿病(T2DM)胰岛素抵抗大鼠肌肉组织葡萄糖转运蛋白-4(GLUT-4)基因表达的影响。方法采用小剂量链脲佐菌素加高脂高热量饲料喂养方法建立2型糖尿病胰岛素抵抗模型,将造模大鼠随机分为模型对照组和黄精高、中、低剂量治疗组(分别灌胃10.0、5.0、2.5 g·kg-1·d-1),另选10只为正常对照组。灌胃8周后,空腹取材,反转录-聚合酶链反应法检测肌肉组织GLUT-4基因mRNA水平。结果与正常对照组相比,模型对照组及黄精高、中、低剂量治疗组大鼠GLUT-4基因mRNA表达减少,空腹血糖(FPG)显著升高,差异均有统计学意义(P<0.01)。与模型对照组比较,黄精高、中、低剂量治疗组FPG均降低,其中以中、高剂量治疗组降低显著,差异有统计学意义(P<0.01);黄精高、中、低剂量治疗组GLUT-4基因mRNA表达均增高,其中以中、高剂量治疗组增高显著,差异有统计学意义(P<0.01)。结论黄精水提液具有增强T2DM胰岛素抵抗大鼠GLUT-4基因表达,从而降低血糖的作用。     

运动对2型糖尿病大鼠骨骼肌胰岛素信号通路PI3K/PKB磷酸化与表达的影响

目的 探讨运动对2型糖尿病大鼠骨骼肌磷脂酰肌醇3激酶(PI3K)与蛋白激酶B(PKB)磷酸化和蛋白表达及葡萄糖转运蛋白4(GLUT4)和mRNA表达的影响.方法 30只SD雄性大鼠随机分为对照组、糖尿病组与糖尿病运动组.糖尿病组与糖尿病运动组大鼠经高脂饲料喂养8周后,一次性腹腔注射链脲佐菌素(STZ,30mg/kg),注射后3周确认2型糖尿病建模成功,糖尿病运动组大鼠进行4周游泳训练.糖尿病组与糖尿病运动组大鼠建模过程始终喂养高脂饲料;对照组大鼠喂养普通饲料.糖尿病运动组大鼠4周游泳训练结束,于最后一次运动后恢复48 h,取材各组大鼠腓肠肌.采用Western blot法分析PI3K与PKB的磷酸化水平和蛋白表达,检测GLUT4蛋白表达:RT-PCR检测GLUT4 mRNA表达.结果 与糖尿病组比较,运动改善2型糖尿病大鼠腓肠肌PKB磷酸化水平与蛋白表达(P<0.05);增加了糖尿病大鼠腓肠肌GLUT4蛋白与mRNA表达(P<0.01,P<0.05).结论 运动可能通过改善2型糖尿病大鼠骨骼肌胰岛素信号通路蛋白激酶磷酸化和蛋白表达,增加对葡萄糖的吸收与利用.     

胰岛素抵抗大鼠肌肉中IRS-1、P70S6K的表达

目的 应用不同饮食喂养大鼠,测定大鼠产生胰岛素抵抗(IR)的情况,观察大鼠骨骼肌IPS-1、P70S6K的表达及大鼠血清中游离脂肪酸(FFA)和超敏C反应蛋白(hsCRP)的变化.方法 4周龄Wistar雄性大鼠40只,随机分为4组,分别以普通饲料、高糖饲料、高脂饲料、高糖高脂饲料喂养大鼠8周后,行高胰岛素-正葡萄糖钳夹实验,对大鼠胰岛素抵抗程度进行评估,应用酶联免疫吸附方法 检测大鼠血清中游离脂肪酸及超敏C反应蛋白,分别用Western-Blot、Rt-PCR检测大鼠骨骼肌中的IRS-1、P70S6K.结果 高脂饲料、高糖高脂饲料组大鼠产生胰岛素抵抗,普通饲料、高糖饲料组未出现胰岛素抵抗,胰岛素抵抗组大鼠游离脂肪酸及超敏C反应蛋白明显高于非胰岛素抵抗大鼠(P<0.01),IRS-1在胰岛素抵抗组大鼠明显低于非胰岛素抵抗组大鼠、P70S6K在胰岛素抵抗组大鼠明显高于非胰岛素抵抗组大鼠体重.结论 高脂饲料、高糖高脂饲料喂养大鼠8周可成功的诱导大鼠产生胰岛素抵抗,胰岛素抵抗的产生可能与肥胖、高游离脂肪酸及炎症反应有关.IRS-1在胰岛素抵抗大鼠中的表达降低,P70S6K升高.     

祛胰抵方对2型糖尿病大鼠肝脏IRS-2蛋白表达的影响

目的 :观察2型糖尿病大鼠血糖、血清胰岛素浓度和胰岛素受体底物-2(insulin receptor substrate 2,IRS-2)的蛋白表达变化及祛胰抵方对其变化的影响。方法 :以小剂量链脲佐菌素(30 mg/kg)腹腔注射合并高脂饮食诱导2型糖尿病大鼠模型,给予不同剂量祛胰抵方治疗12周。分别测定其血糖、血清胰岛素浓度、肝脏组织的IRS-2蛋白表达。结果 :造模后2型糖尿病大鼠的血糖、血清胰岛素升高,肝脏组织的IRS-2蛋白表达下降;祛胰抵方能降低模型大鼠的血糖和血清胰岛素,并能显著升高肝脏组织IRS-2的蛋白表达。结论 :祛胰抵方治疗2型糖尿病可能与其提高肝脏组织IRS-2的蛋白表达从而改善胰岛素信号传导有关。     

十二指肠空肠旁路术与十二指肠空肠吻合术对2型糖尿病大鼠视黄醇结合蛋白4的作用及意义

目的：探讨十二指肠空肠旁路术（duodenal-jejunal bypass,DJB）与十二指肠空肠吻合术（duodenal-jejunal anastomosi,DJA）对2型糖尿病治疗效果的异同及视黄醇结合蛋白4(retinol binding protein-4,RBP-4)和葡萄糖转运蛋白4（glucose transporter-4,GLUT-4）在其中的作用。方法：糖尿病大鼠随机分为DJA组、DJB组和假手术组,测定其手术前后体重、摄食量、空腹血糖、空腹胰岛素、RBP-4水平,评估手术前后糖代谢情况及胰岛素抵抗情况,术后第8周测定GLUT-4水平。结果：与假手术组相比,DJA组和DJB组术后空腹血糖降低,OGTT葡萄糖曲线下面积减少,胰岛素抵抗有所改善,RBP-4水平下降,骨骼肌GLUT-4水平升高。结论：DJB和DJA手术能不依赖摄食量、体重及胰岛素分泌的增加而改善糖尿病大鼠糖代谢,缓解其胰岛素抵抗状态,两者对空腹血糖的改善作用相似,但DJA手术对餐后血糖调节作用较差,可能与术后RBP-4降低、GLUT-4升高幅度不同有关。     

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.