成年大鼠心肌细胞的分离和培养技术

目的建立稳定的成年大鼠心肌细胞分离和培养方法,以便进行成年大鼠心肌细胞收缩功能的研究。方法将成年大鼠心脏挂于Langendorff装置上灌流,胶原酶消化分离成年大鼠心肌,无血清悬浮培养心肌细胞。光镜观察,结合形态学和收缩功能评价心肌细胞。结果新分离的心肌细胞的收获量为(4~6)×106个,杆状和圆形,其中长杆状细胞大于75%,横纹清晰,收缩幅度(12.00±2.68)%。无血清培养24 h后,细胞保持完整的形态结构,长杆状心肌细胞占总数的70%以上,收缩幅度(11.78±1.59)%,与刚培养时的细胞相比,无显著差别(P>0.05)。结论通过本方法可以对成年大鼠心肌细胞进行良好的分离培养。     

吡那地尔后处理对成年大鼠缺氧/复氧心肌细胞超微结构的影响

目的 建立成年大鼠心肌细胞缺氧/复氧损伤模型,观察吡那地尔（Pinacidil,P）后处理对心肌细胞超微结构的影响.方法 体外培养成年大鼠心肌细胞,建立心肌细胞缺氧/复氧损伤模型,将细胞随机分为6组,正常组（N）、缺氧/复氧组（H/R）、缺氧后处理组（HPO）和吡那地尔不同浓度组（25 μmol/L、50 μmol/L、100 μmol/L,P25、P50、P100组）,采用透射显微镜观察各组心肌细胞缺氧/复氧损伤后心肌细胞超微结构的变化.结果 透射显微镜显示N组超微结构正常,H/R组超微结构损伤严重,HPO、P25、P50、P100组损伤较轻,P50组较P25、P100组损伤更轻.结论 缺氧/复氧能使成年大鼠心肌细胞造成损伤,吡那地尔后处理对此损伤具有一定保护作用.     

5种静脉麻醉药对成年大鼠心肌细胞的影响

目的 比较静脉麻醉药对单个心肌细胞功能的影响.方法 选取氯胺酮、依托咪酯、羟丁酸钠、硫喷妥钠、异丙酚5种麻醉药对成年大鼠进行麻醉,分离大鼠心肌细胞观察心肌细胞存活率和单个心肌细胞的收缩功能.结果 硫喷妥钠、异丙酚麻醉对成年大鼠心肌细胞的存活率及收缩功能均有抑制作用,而异丙酚较明显.结论 静脉麻醉药异丙酚对成年大鼠心肌细胞抑制作用显著.     

同种大鼠心肌细胞移植研究

目的　评价大鼠胎鼠和新生鼠心肌细胞同种移植后的收缩能力及它们在纤维组织中的生存能力 ,为临床心肌细胞移植提供相关依据。方法与结果　将筛选的胎鼠和新生鼠的心肌细胞进行培养 ,将两种心肌细胞悬浮液注射到成年同种同品系大鼠后肢的皮下纤维组织中 ,用环孢素A(5mg/kg)进行免疫抑制。 3个月后处死大鼠 ,移植的心肌细胞在体内形成心肌组织样结构 ,且仅在移植的前 2周其体积不断增大。源于胎鼠的心肌移植组织的自发收缩能力为 (73± 12 )次 /min ,而源于新生鼠心肌移植组织的自发收缩能力为 (4 3± 2 1)次 /min ,心电图显示其收缩节律与心脏室性收缩节律相似。从组织发育程度上来看 ,移植组织呈现出有心肌样肌小节结构 ,并有血管生成。结论　将悬浮培养的大鼠胎鼠和新生鼠心肌细胞注射到同种同品系的成年大鼠后肢皮下纤维组织中 ,形成了具有自发收缩节律的心肌样组织     

不同剂量钴对大鼠心肌细胞培养液中心肌酶活性的影响

目的：在体外培养大鼠心肌细胞培养液中加入不同剂量钴,观察其中心肌酶活性的改变,确定钴引起心肌细胞损害的阈浓度。方法：取新生1～3dWistar大鼠心室肌组织,按常规法进行细胞培养,待细胞达到亚融合状态时,向细胞培养液中加入不同剂量钴,观察心肌细胞培养液中心肌酶活性的改变。结果：钴浓度在10～20mg／L时,对天冬氨酸转氨酶(AST)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、羟丁酸脱氢酶(HBDH)活性影响不大;当钴浓度增加到40mg／L时,AST、CK、LDH和HBDH活性有了明显升高。结论：钴浓度越高,心肌酶活性改变越大,从中选出了能引起心肌细胞损害的阈浓度。     

不同剂量钴对大鼠心肌细胞培养液中心肌酶活性的影响

目的 :在体外培养大鼠心肌细胞培养液中加入不同剂量钴 ,观察其中心肌酶活性的改变 ,确定钴引起心肌细胞损害的阈浓度。方法 :取新生 1～ 3d Wistar大鼠心室肌组织 ,按常规法进行细胞培养 ,待细胞达到亚融合状态时 ,向细胞培养液中加入不同剂量钴 ,观察心肌细胞培养液中心肌酶活性的改变。结果 :钴浓度在 10～ 2 0 mg/ L时 ,对天冬氨酸转氨酶 (AST)、肌酸激酶 (CK)、乳酸脱氢酶 (L DH)、羟丁酸脱氢酶 (HBDH)活性影响不大 ;当钴浓度增加到 4 0 mg/ L时 ,AST、CK、L DH和 HBDH活性有了明显升高。结论 :钴浓度越高 ,心肌酶活性改变越大 ,从中选出了能引起心肌细胞损害的阈浓度。     

成年大鼠心肌细胞分离培养及兴奋-收缩耦联表征

目的比较两种细胞分离液分离成年大鼠心肌细胞,进一步表征成年大鼠心室肌细胞兴奋-收缩耦联。方法 Langendorff装置进行主动脉逆流灌流,分别用两种细胞分离液分离成年大鼠心肌细胞,无血清培养并进行腺病毒感染。显微镜下观察单个心肌细胞的形态学特点,荧光显微镜下检测病毒感染。采用IonOptix仪器检测心肌细胞肌节收缩-舒张指标以及心肌细胞钙离子摄入-排出指标。结果两种分离液均可获得70%横纹清晰的长杆状心肌细胞,培养可存活7 d以上。腺病毒感染48 h,绿色荧光蛋白持续表达7 d以上。分离液一获得的心肌细胞不能很好地随电场刺激产生收缩,分离液二获得的细胞可用于检测兴奋-收缩耦联特性,心肌细胞肌节缩短分数为11.61%±2.15%,舒张时间为(0.177±0.031)s,钙瞬变幅度为30.79%±9.74%,钙瞬变衰减时间为(0.300±0.074)s。结论两种分离液均可用于分离和培养成年大鼠心肌细胞,并用于腺病毒转染等长时程研究。分离液二更适用于检测成年大鼠心肌细胞的兴奋-收缩耦联特性。     

丙泊酚对新生和成年大鼠心肌细胞钙离子移动的影响

目的　观察不同浓度丙泊酚对氯化钾和咖啡因诱发的新生和成年大鼠心肌细胞钙离子移动的影响 ,探讨其心肌抑制作用的可能机制。方法　用Fluo 3AM钙荧光指示剂染色培养的新生大鼠或急性分离的成年大鼠心肌细胞 ,在激光共聚焦显微镜下动态观察使用丙泊酚前及丙泊酚 (5 0 ,2 5 0 μmol/L)预处理后 ,氯化钾和咖啡因诱发的细胞内钙离子浓度的变化。结果　丙泊酚 5 0 μmol/L使氯化钾诱发的新生或成年大鼠心肌细胞内钙荧光强度的峰值下降 ,较对照组有明显差异 (P <0 .0 1 ) ,对新生大鼠心肌细胞的抑制作用较成年大鼠明显。丙泊酚 2 5 0 μmol/L使细胞内钙荧光强度峰值进一步降低。但两种浓度的丙泊酚对咖啡因诱发的两种心肌细胞钙荧光强度的升高均无明显影响 (P >0 .0 5 )。结论　丙泊酚浓度依赖地降低心肌细胞内钙离子浓度 ,与其抑制细胞外钙内流有关 ,它对新生大鼠心肌细胞的抑制作用更强。提示临床上使用丙泊酚作为麻醉剂 ,尤其对小儿麻醉时应有足够重视。     

增加β1-肾上腺素受体表达对心力衰竭大鼠心肌细胞收缩功能的影响

目的:观察在心力衰竭细胞上增加β1肾上腺素受体(β1-AR)表达对收缩功能的影响.方法:首先用异丙肾上腺素制作大鼠心力衰竭模型,然后分离、培养心肌细胞,转入含入β1-AR基因的腺病毒,24 h后Westernblot检测细胞中β1-AR的含量,并进行单个心肌细胞收缩功能的分析.结果:心衰细胞上β1-AR含量为正常对照组的(0.56±0.19)倍(P＜0.01),心力衰竭 转基因组β1-AR的含量为正常对照组的(5.68±0.36)倍(P＜0.01);心力衰竭组心肌细胞对异丙肾上腺素刺激引起的收缩幅度较正常对照组明显降低(P＜0.01),转入β1-AR基因后,可明显改善心力衰竭大鼠心肌细胞的收缩功能,选择性β1-AR拮抗剂CGP20712A可以完全阻断转入β1-AR后的效应,选择性β2-AR拮抗剂ICI118,551可以部分降低心力衰竭大鼠和β1-AR表达增加的心衰大鼠心肌细胞的收缩幅度.结论:在心力衰竭后的大鼠心肌细胞上增加β1-AR的表达,可改善细胞的收缩功能,这种作用可能是直接通过β1-AR实现的.β2-AR也参与了心力衰竭大鼠和β1-AR表达增加的心力衰竭大鼠心肌细胞的收缩功能.     

二氮嗪预处理对培养成年大鼠心肌细胞模拟缺血/再灌注损伤的保护作用及其与剂量的关系

目的探讨二氮嗪预处理对培养大鼠心肌细胞模拟缺血/再灌注损伤的保护作用及其与剂量的关系.方法采用培养成年大鼠心肌细胞模拟缺血/再灌注损伤模型,观察不同浓度的二氮嗪预处理对心肌细胞缺血再灌注损伤后的细胞成活率和肌酸激酶(CK)释放的影响.结果二氮嗪预处理培养大鼠心肌细胞后,对模拟缺血/再灌注损伤要保护作用,能减少心肌细胞的损伤和死亡.在10～200mmol/L的浓度范围内,随着二氮嗪剂量的增加,其预处理心肌细胞的保护效应也相应增加.结论在50～200 mmol/L的浓度范围内,二氮嗪能剂量依赖地产生预处理心肌保护效应.     

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.