Egb761对大鼠局灶脑缺血/再灌注诱导JNK1/2活化的影响

目的观察大鼠局灶性脑缺血/再灌注后丝裂原活化蛋白激酶家族中JNK1/2（c-Jun氨基末端激酶1/2）的活化情况以及银杏叶提取物Egb761对其影响。方法雄性成年SD大鼠随机分成3组（n=5）：假手术组、生理盐水对照组和Egb761组。分别于缺血前6天每天用生理盐水4 ml和Egb761 150mg/kg（Egb761用4 ml生理盐水溶解）灌胃。采用线栓法致大脑中动脉栓塞（MCAO）模型,在脑缺血再灌注后处死大鼠,对缺血侧海马进行免疫印迹法检测JNK1/2磷酸化水平。结果局灶脑缺血/再灌注可以诱导JNK1/2激活,30 min达第1个高峰,3天达第2个高峰;Egb761可显著抑制脑缺血再灌注后JNK1/2的激活（P〈0.05）,JNK1/2的蛋白表达量在以上不同处理条件下没有明显变化。结论局灶性脑缺血再灌注可诱导缺血侧海马JNK1/2活化,Egb761干预可使缺血侧海马JNK1/2活化受到抑制,减轻缺血侧海马的损伤。     

全脑缺血复灌不同时间对大鼠海马神经元损伤及JNK通路的影响

目的探讨大鼠全脑缺血和复灌不同时间对海马神经元损伤、C-Jun氨基末端激酶（JNK）表达以及JNK激活的影响。方法采用四血管法（4-vessel-occlusion,4-vo）法制作大鼠全脑缺血模型,随机将51只SD大鼠分成假手术组、缺血组和缺血再灌注组,用Western blot检测海马组织JNK的表达和P-JNK的含量。另取9只大鼠缺血10min或缺血20min后复灌7d,甲醛灌注固定后取海马组织用于组织学评价。结果JNK在全脑缺血10min表达明显增加,缺血20min时达到峰值;全脑缺血20min复灌阶段JNK在复灌6h表达明显增加并达到-高峰,复灌12h到达最高峰;P-JNK含量在全脑缺血20min后复灌1h达到高峰,复灌12h再次出现高峰。结论20min全脑缺血后JNK高表达持续时间延长,JNK激活时间更早,更为显著,表明长时间缺血时JNK通路介导的损害作用更大。     

c-Jun氨基末端激酶在高血糖加重脑缺血性损伤中的作用

目的探讨c-Jun氨基末端激酶（JNK）在高血糖加重大鼠脑缺血再灌注损伤中的作用。方法建立大鼠全脑缺血模型,通过免疫组织化学、Western blot,研究正常血糖和高血糖大鼠脑缺血时JNK的表达。结果正常血糖缺血组和高血糖缺血组大脑皮质和海马CA1区随着缺血再灌注时间的延长,JNK表达明显升高,与对照组比较有统计学意义（P〈0.01）,但两组在缺血再灌注相同时间点比较JNK表达均无统计学意义（P〉0.05）。Western blot分析可见,正常血糖组再灌注后1h,JNK达到高峰;高血糖组再灌注后3h,JNK达到高峰,与对照组比较有统计学意义（P〈0.05）,高血糖组与正常血糖组在各缺血再灌注时间点比较无统计学意义（P〉0.05）。结论高血糖可加重脑缺血再灌注损伤;JNK参与了脑缺血性损伤的发生,但高血糖并不能明显增加脑缺血性损伤时JNK的表达,故在高血糖加重脑缺血性损伤中JNK可能不发挥主要作用。     

大鼠脑缺血再灌注损伤后神经细胞NF-κB和IL-6的表达

目的 探讨局灶脑缺血再灌注损伤后神经细胞核因子-κB（NF-κB）和白细胞介素-6（IL-6）表达的变化。方法 成年健康雄性Wistar大鼠32只，随机分为假手术组（n=4）和缺血再灌注组（n=28），应用线栓法制备大鼠脑缺血再灌注模型，免疫组织化学方法检测缺血再灌注6h、12h、1d、2d、3d、7d、14d神经细胞NF-κB和IL-6的表达，并进行图像分析。结果 假手术组大鼠脑组织神经细胞有微弱的NF-κ表达，阳性细胞为淡棕色。脑缺血再灌注6h开始，皮质区和纹状体区神经细胞NF-κB表达逐渐增强，于再灌注1d达高峰，之后逐渐下降。IL-6表达部位和变化规律与NF-κB相似，但其表达高峰在再灌注2d。NF-κB和IL-6的表达水平在缺血再灌注损伤后的变化规律具有显著相关性（r=0．9196，P〈0．01）。结论 NF-κB和IL-6表达在脑缺血再灌注损伤的病理过程中起重要作用。     

IL-6对脑缺血后大鼠海马及纹状体神经细胞Fos表达的影响

使用免疫组织化学方法 ,观察了大鼠大脑中动脉区缺血再灌注动物模型中海马 Fos的表达及 IL- 6对其表达的影响。结果发现 :经侧脑室注射 IL- 6后大鼠海马及纹状体神经细胞 Fos的表达明显低于单纯缺血再灌注动物组。表明 IL- 6对脑缺血再灌注后大鼠海马及纹状体神经细胞 Fos表达的增加有明显的抑制作用。提示 IL- 6可能参与缺血性脑损伤的调控过程。     

马尾松松针提取物调节JNK3/caspase-3信号转导减轻大鼠脑缺血再灌注后氧化应激损伤

目的：探讨马尾松松针提取物（PNE）对大鼠脑缺血再灌注后氧化应激损伤的保护作用。方法：将SD雄性大鼠随机分为手术对照组、模型对照组、依达拉奉组、PNE小剂量组（200?mg/kg）、PNE中剂量组（400?mg/kg）、PNE大剂量组（800?mg/kg）, 于造模前连续7?d及造模后6?h分别灌胃给药。其中,手术对照组和模型对照组灌胃给予等渗氯化钠溶液,依达拉奉组灌胃给予等渗氯化钠溶液的同时腹腔注射依达拉奉3?mg/kg,PNE各组灌胃给予各剂量PNE。通过大脑中动脉阻塞法建立脑缺血再灌注损伤大鼠模型,于再灌注24?h后测定各组大鼠神经功能缺损评分、脑组织含水量、脑梗死体积。采用苏木素-伊红染色观察大脑皮层及海马组织结构病理变化并统计正常神经细胞数;TUNEL法检测大脑皮层神经细胞凋亡率;试剂盒检测缺血侧脑组织一氧化氮、丙二醛含量与超氧化物歧化酶（SOD）活性;蛋白质印迹法检测大脑皮层c-Jun氨基末端激酶（JNK）3、磷酸化JNK3、B淋巴细胞瘤蛋白（Bcl）-2、Bcl-2相关X蛋白（Bax）、细胞色素C、胱天蛋白酶（caspase）-3的蛋白表达水平。结果：与模型对照组比较,PNE各剂量组行为学评分、脑组织含水量及脑梗死体积均显著降低（均P<0.05）,大脑皮层及海马CA1区组织病理性损伤显著减轻,缺血侧皮层及海马CA1区中正常神经细胞数增加（均P<0.05）,以PNE中剂量组效果最好。与模型对照组比较,PNE中剂量组皮层神经细胞凋亡率显著减小,大脑皮层组织中一氧化氮、丙二醛含量显著减少,SOD活性显著升高,磷酸化JNK3/JNK3比值、细胞色素C、caspase-3蛋白表达水平均显著降低,Bcl-2/Bax比值显著升高（均P<0.05）。结论：PNE对脑缺血再灌注损伤具有保护作用,这种保护作用可能与清除一氧化氮和丙二醛,抑制氧化应激介导的JNK3/caspase-3信号转导来抑制神经细胞凋亡有关。     

对大鼠脑缺血再灌注后tTG表达的影响

目的   研究胱氨酸（Cystamine）对全脑缺血再灌注损伤后大鼠海马组织型转谷氨酰胺酶（tTG）表达的影响。方法    用四血管阻断法制作大鼠全脑缺血再灌注模型。将SD大鼠随机分为假手术组（n=8）,全脑缺血组（n=48）及全脑缺血治疗组（n=48）,全脑缺血组和全脑缺血治疗组按照缺血再灌注时间点的不同再将大鼠随机分为6h、12h、1d、3d、5d、7d六个亚组,每个亚组8只。全脑缺血治疗组大鼠给予Cystamine腹腔注射（0.15mg/g）,全脑缺血组和假手术组大鼠给予生理盐水腹腔注射。TUNEL染色法观察细胞凋亡水平的变化,免疫组织化学方法分析再灌注后不同时间点海马CA1区tTG表达水平的变化。另取52只大鼠随机分为假手术组（n=4）、全脑缺血组（n=24）及全脑缺血治疗组（n=24）,全脑缺血组和全脑缺血治疗组按照不同时间点每个亚组4只,免疫印迹方法测定tTG的表达。结果   缺血组再灌注24h后TUNEL阳性细胞明显增加,1、3、5、7d亚组与假手术组差异有统计学意义（P<0.05）;治疗组与缺血组相比,在1、3、5、7d相应时间点亚组TUNEL阳性细胞数减少（P<0.05）。治疗组海马CA1区tTG平均阳性细胞数于全脑缺血后12h开始下降,3、5、7d亚组均明显低于缺血组（P<0.05）。治疗组海马tTG蛋白水平于缺血再灌注后1d开始降低,3、5和7d亚组显著低于缺血组（P<0.05）。结论   Cystamine可以降低大鼠全脑缺血再灌注后海马CA1区tTG的表达,从而对神经元细胞起到一定的保护作用。     

胡黄连对大鼠缺血脑组织神经营养因子的影响

目的观察大鼠脑缺血再灌注损伤后脑组织神经生长因子（NGF）的变化,探讨胡黄连抗脑缺血再灌注损伤的机制。方法参照线栓法制作脑缺血再灌注模型,免疫组织化学方法观察胡黄连对脑皮质、纹状体NGF表达的影响。结果手术组缺血侧皮质区和纹状体区于缺血再灌注1 d时NGF表达至高峰,3 d后逐渐下降,14 d降至基础水平;胡黄连治疗组大鼠脑皮质与纹状体的NGF阳性细胞显著增加,与假手术组及模型组相比差异有显著性（F=4.8、9.1,q=13.6-17.2;t=12.6-18.4,P〈0.05）。结论胡黄连可使脑缺血再灌注损伤后脑组织内NGF表达增加。     

紫杉醇通过MLK_3/JNK_3信号通路对海马神经元损伤的保护作用

目的研究紫杉醇对脑缺血/再灌注后海马神经元损伤的保护作用的分子机制。方法采用SD大鼠四动脉结扎脑缺血模型（4-VO）,在缺血前30 min脑室注射紫杉醇（4、8、12、20μg/kg）,应用免疫沉淀及免疫印迹方法分析JNK3/MLK3/Fas-L的蛋白表达量和激活情况;焦油紫染色,观察紫杉醇对大鼠海马神经元的作用。结果紫杉醇显著抑制了脑缺血/再灌注后JNK3/MLK3/Fas-L的激活;焦油紫染色观察,紫杉醇对大鼠海马神经元的凋亡有明显的抑制作用。结论紫杉醇对脑缺血/再灌注诱导的海马神经元的损伤具有保护作用,这种保护作用和JNK3介导的信号通路密切相关,为临床治疗脑中风提供理论依据。     

外源性NO供体对脑缺血/再灌注神经元的保护作用

目的观察外源性一氧化氮（NO）供体硝普钠（SNP）和亚硝基谷胱甘肽（GSNO）对脑缺血/再灌注过程中c-jun N末端激酶3（JNK3）磷酸化的影响,及其对再灌注海马CA1区锥体神经元的作用。方法采用四动脉结扎法建立大鼠全脑缺血模型。SNP（5 mg/kg）溶于生理盐水,间隔1.5 h分别腹腔注射3次,第1次注射时间在全脑缺血前30 min。GSNO（100μg/kg）溶于生理盐水,缺血前20 min于侧脑室注射给药。大鼠随机分为假手术组、缺血/再灌注组、缺血/再灌注溶剂对照组、缺血/再灌注给予SNP组和缺血/再灌注给予GSNO组,缺血15 min后分别灌注1天或5天。利用免疫印迹、免疫沉淀和焦油紫染色法检测相关蛋白的表达、磷酸化水平及神经元细胞的存活。结果给予SNP组和GSNO组与生理盐水对照组相比,能够显著抑制脑缺血/再灌注过程中JNK3的磷酸化,并且能显著提高再灌注过程中海马CA1区锥体神经元的存活。结论外源性NO供体能够抑制脑缺血/再灌注过程中JNK3的磷酸化,进一步对海马CA1区锥体神经元发挥了保护作用。本研究为外源性NO对脑卒中的有效治疗提供了参考价值。     

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.