5羟色胺4受体激动剂对糖尿病小鼠结肠黏膜巨噬细胞极化的影响

目的研究5-羟色胺4受体（5-hydroxytryptamine 4 receptor, 5-HT4R）激动剂对糖尿病结肠黏膜巨噬细胞极化的影响。方法使用链脲佐菌素（streptozotocin, STZ）建立小鼠1型糖尿病模型,使用5-HT4R激动剂RS67333进行治疗干预,实验动物随机分为3组,即非糖尿病组、糖尿病对照组和糖尿病给药组。通过免疫荧光方法验证巨噬细胞标记物F4/80和iba1在CX3CR1-GFP+细胞中的表达;通过激光共聚焦显微镜观察CX3CR1-GFP+细胞形态和数目分析结肠黏膜巨噬细胞的活化数量;通过RNAscope技术检测精氨酸酶1（arginase 1, Arg1）和一氧化氮合酶（inducible nitric oxide synthase, iNOS）的表达和分布变化。结果免疫荧光结果显示F4/80和iba1免疫阳性的细胞与CX3CR1-GFP+的细胞基本共定位。与非糖尿病小鼠相比,STZ诱导的1型糖尿病模型小鼠结肠黏膜层活化的巨噬细胞数目增多（P<0.001）,且M1型巨噬细胞产物iNOS在黏膜层腔侧表达增加（P<0.001）,而M2型巨噬细胞产物Arg1在黏膜固有层表达下降（P<0.001）;与糖尿病对照组相比,给予5-HT4R激动剂可以抑制活化的巨噬细胞数目（P<0.001）,结肠黏膜iNOS的表达上调（P<0.01）和Arg1的表达下调（P<0.05）。 结论5-HT4R激动剂可以抑制糖尿病小鼠结肠黏膜巨噬细胞向M1型极化。     

山楂水提物对肠易激综合征大鼠结肠黏膜5-HT和5-HT3R表达的影响

目的：探讨山楂水提物对肠易激综合征（IBS）大鼠结肠黏膜5-HT和5-HT3R的影响,探讨其改善消化功能的作用机制。方法：采用乳鼠结肠PTCA球囊刺激法复制IBS大鼠模型。随机分为模型组、空白组、西沙必利组、山楂水提物高、中、低剂量组,给药2周后,应用免疫组化法检测大鼠结肠黏膜5-HT和5-HT3R表达变化。结果：与空白组比较,模型组大鼠结肠黏膜5-HT和5-HT3R水平显著升高,差异有统计学意义（P〈0．01）;给药组大鼠5-HT和5-HT3R的表达明显降低（P〈0．01;P〈0．05）。结论：山楂水提物可抑制IBS模型大鼠结肠黏膜5-HT和5-HT3R的过分表达,从而改变肠道敏感度,达到改善肠道消化功能作用。     

肠道硫化氢合成酶CSE与糖尿病大鼠结肠动力的相关研究

目的：探讨肠道硫化氢（H2 S）合成酶胱硫醚‐γ‐裂解酶（CSE）与糖尿病（DM ）大鼠近端结肠动力的关系。方法一次性腹腔注射1％链脲佐菌素（STZ）65 mg／kg ,建立1型糖尿病模型,观察大鼠的一般情况;注药第10天制作结肠平滑肌纵行肌条,使用生物机能实验系统记录每组纵行肌肌条自发性收缩活性;分别采用免疫组化及双重免疫荧光的方法观察结肠全层标本及肌间神经丛（M P）中CSE分布;采用Western blot方法观察肠道组织（去黏膜及黏膜下层）CSE的表达。结果 DM组近端结肠肌条收缩活性均低于对照组（P＜0．05）;CSE在黏膜下层、黏膜下神经丛、MP、纵行肌和环形肌都有分布;CSE在大鼠肌间神经元细胞核中分布,但CSE阳性神经元所占MP比例差异无统计学意义（P＞0．05）;DM组大鼠结肠（去除黏膜及黏膜下层后）CSE的表达上调（P＜0．05）。结论 CSE表达上调可能是DM大鼠近端结肠运动减退的原因之一。     

温中健脾方对腹泻型肠易激综合征大鼠下丘脑及结肠黏膜5-HT表达的影响

目的：观察温中健脾方对腹泻型肠易激综合征（D-IBS）大鼠下丘脑和结肠黏膜5-羟色胺（5-HT）表达的影响。方法：48只雄性Wistar大鼠依体重匹配分为正常组、模型组、中药组（温中健脾方组）和西药组（得舒特组）,每组12只。用番泻叶联合束缚应激刺激复制D-IBS模型。造模2周后给予药物干预,共14d。治疗结束后处死动物,取下丘脑及结肠黏膜进行免疫组化染色,应用医学图像定量分析系统进行免疫组化图像分析。结果：模型组、中药组及西药组下丘脑和结肠黏膜内5-HT的PA值、OD值及IHC-I较正常组明显升高（P〈0．05,P〈0．01）;经药物干预后,中药组和西药组上述各指标均较模型组明显降低（P〈0．05,P〈0．01）;中药组与西药组比较,除下丘脑5-HT的PA值未见明显差异外,其余指标西药组下降尤为显著（P〈0．05,P〈0．01）。结论：温中健脾方能降低D-IBS模型大鼠下丘脑及结肠黏膜5-HT的表达,调控脑-肠轴以治疗D-IBS。     

肠易激综合征患者肠黏膜5-羟色胺的表达及意义

目的检测肠易激综合征（IBS）患者肠黏膜5-羟色胺（5-HT）表达的差异,探讨外周5-HT在IBS发病中的作用。方法选择IBS腹泻型（D—IBS）21例、便秘型（C—IBS）22例患者及正常对照组19例,利用免疫组化方法检测各组回肠、近端结肠、远端结肠黏膜5-HT阳性细胞,计数阳性细胞数量并进行分析。结果D—IBS组回肠、近端结肠、远端结肠5-HT阳性细胞数显著多于对照组（P〈0．05）,并且回肠黏膜阳性细胞数也多于C—IBS组（P〈0．05）,C—IBS组回肠、近端结肠、远端结肠阳性细胞显著多于对照组（P〈0．05）。结论肠道5-HT的增加与IBS发病相关,IBS不同亚型发病机制可能与5-HT不同受体在中枢神经系统和消化道表达分布有一定关系。     

防风提取物通过5-羟色胺信号轴对腹泻型肠易激综合征大鼠结肠黏膜肥大细胞的影响

[目的]探讨防风提取物通过5-羟色胺(5-hydroxytryptamine,5-HT)信号轴对腹泻型肠易激综合征大鼠结肠黏膜肥大细胞的作用。[方法]60只清洁级健康SD大鼠中随机选择10只作为A组,剩余50只建立腹泻型肠易激综合征模型,建模成功46只,随机分为B组(11只)、C组(11只)、D组(12只)、E组(12只)。A组、B组灌胃5 mL蒸馏水;C组灌胃5-HT信号抑制剂昂丹司琼2.6mg/(kg·d)(溶于5 mL蒸馏水);D组灌胃防风提取物6.3mg/(kg·d)(溶于2.5 mL蒸馏水)+昂丹司琼2.6mg/(kg·d)(溶于2.5 mL蒸馏水);E组灌胃防风提取物6.3mg/(kg·d)(溶于5 mL蒸馏水)。观察各组大鼠精神心理行为变化,检测排便粪点数、直肠内玻璃小球排出时间;以苏木精-伊红(hematoxylin-eosin,HE)染色法观察结肠黏膜组织病理学改变;甲苯胺蓝染色法检测结肠黏膜肥大细胞数、阳性面积;实时荧光定量聚合酶链式反应(Real-time fluorescent quantitative polymerase chain reaction,Real-time q PCR)检测结肠组织5-HT3受体(5-HT3 receptor,5-HT3R)、5-HT4受体(5-HT4 receptor,5-HT4R)、色氨酸羟化酶1(tryptophan hydroxylase 1,TPH1)mRNA相对表达量;Western blot检测结肠组织5-HT3R、5-HT4R、TPH1蛋白相对表达量。[结果]与A组比较,B组、C组、D组、E组水平运动次数、垂直运动次数减少,而且C组B组D组E组(P0.05)。与A组比较,B、C、D、E组粪点数增多,直肠内玻璃小球排出时间减少,且粪点数,E组D组B组C组,直肠内玻璃小球排出时间,C组B组D组E组(P0.05)。HE染色显示,与B、C组比较,D、E组结肠黏膜上皮较完整,腺体排列较整齐,间质未见炎性细胞、红细胞,其中E组改善更显著。与A组比较,B、C、D、E组肥大细胞数、阳性面积增高,E组D组B组C组(P0.05)。与A组比较,B、C、D、E组5-HT3R、TPH1 mRNA及蛋白相对表达量升高,5-HT4R m RNA及蛋白相对表达量降低,且5-HT3R、TPH1 m RNA及蛋白相对表达量,E组D组B组C组,5-HT4R mRNA及蛋白相对表达量,C组B组D组E组(P0.05)。[结论]防风提取物可减少腹泻型肠易激综合征大鼠结肠黏膜肥大细胞数,改善肥大细胞功能及大鼠行为,作用机制可能与调节5-HT信号轴有关。     

济川煎对老年慢传输型便秘大鼠TPH1、5-HT表达的影响

目的:探索济川煎对老年慢传输型便秘(STC)大鼠结肠色氨酸羟化酶1(TPH1)、五羟色胺(5-HT)表达的影响,阐述济川煎的通便机制.方法:30只老年SD大鼠,随机分为空白对照组、老年STC模型组、济川煎组,每组10只.复方苯乙哌啶饲养大鼠建立老年STC大鼠模型.济川煎组用济川煎汤剂灌胃,空白对照组和老年STC组经灌胃给予等量的生理盐水.10 d后记录各组大鼠一般情况,活性炭灌胃法检测肠道推进率,荧光免疫组织化学法检测结肠TPH1、5-HT表达.结果:与空白组比较,老年STC大鼠肠道推进率下降(48.86±5.98)％(P<0.05),济川煎实验组与模型组比较,肠道推进率上升(62.78±7.26)％(P<0.05).模型组大鼠结肠TPH1阳性细胞数(9.97±2.94)个,低于空白对照组(28.54±8.94)个,模型组5-HT阳性细胞数(5.6±1.37)个低于空白组(10.72±2.43)个;与模型组比较,济川煎组大鼠结肠TPH1阳性细胞数增多(22.48±7.82)个,5-HT阳性细胞数增多(8.91±2.75)个(P<0.05).结论:济川煎方可显著改善老年慢传输型便秘模型大鼠便秘症状,可能是通过升高TPH1,提高5-HT表达水平,从而调节肠道功能,发挥治疗慢传输型便秘的作用.     

Bax、Bcl-2在糖尿病大鼠结肠动力障碍中的作用机制

目的：研究凋亡相关基因Bax和Bcl-2在糖尿病大鼠结肠平滑肌细胞中的表达,探讨其在糖尿病结肠动力障碍平滑肌细胞凋亡中的作用。方法：雄性SD大鼠随机分为糖尿病组和正常对照组。于成模10周后处死两组大鼠,以HE染色法观察结肠组织平滑肌的变化,采用实时荧光定量PCR法对糖尿病组和对照组大鼠结肠平滑肌细胞中Bax和Bcl-2基因的转录水平进行检测。结果：HE染色显示,糖尿病组大鼠结肠平滑肌比对照组肌层变薄,肌细胞数目减少,肌细胞体积变小;荧光实时定量PCR分析表明,Bax在糖尿病组的表达显著高于正常对照组（P〈0.05）,Bcl-2在糖尿病组的表达显著低于正常对照组（P〈0.05）。结论：糖尿病大鼠结肠平滑肌中Bcl-2表达减少和Bax表达增加,可能是结肠动力障碍发病机制之一。     

术芍易激胶囊对腹泻型肠易激综合征模型大鼠结肠黏膜5-HT和5-HT_3R表达的影响

目的 观察术芍易激胶囊对腹泻型肠易激综合征(D-IBS)模型大鼠结肠黏膜5-羟色胺(5-HT)和5-羟色胺3受体(5-HT3R)的表达的影响.方法 将48只SD雌性大鼠随机分为正常组、模型组、得舒特组和术芍易激胶囊高、中、低剂量组,分别予生理盐水、得舒特、术芍易激胶囊灌胃2周.取大鼠结肠黏膜一块,以免疫组化方法检测5-HT和5-HT3R的表达.结果 与模型组比较,术芍易激胶囊各剂量组容量阈值增加(P＜0.01),5-HT和5-HT3R的表达明显降低(P<0.01),尤以术芍易激胶囊高剂量组为优.结论 术芍易激胶囊能抑制D-IBS模型大鼠结肠黏膜5-HT和5-HT3R的表达,可能通过进一步影响肠道动力学和肠道敏感性来实现其治疗作用.     

痛泻要方干预大鼠肠易激综合征肝郁脾虚证的作用及机制

目的探讨痛泻要方对肝郁脾虚型肠易激综合征大鼠内脏敏感性的干预作用。方法采用番泻叶加束缚应激刺激制备肝郁脾虚型肠易激综合征动物模型。予痛泻要方灌胃治疗（西药匹维溴铵对照）。观察大鼠结肠黏膜肥大细胞数目及脱颗粒情况;检测血标本中5-羟色胺（5-HT）、P物质（SP）、降钙素基因相关肽（CGRP）的含量。结果模型对照组大鼠结肠黏膜肥大细胞数目及脱颗粒显著增加;西药组和中药组大鼠5-HT、SP含量显著下降,CGRP含量显著增加,差异均有高度统计学意义（均P〈0.01）,且有一定的量效关系。结论痛泻要方可能通过减少肥大细胞脱颗粒,降低模型大鼠血清5-HT、血浆SP含量,增加血浆CGRP含量,从而改善胃肠动力并降低内脏敏感性,发挥治疗肠易激综合征的效应。     

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.