豚鼠耳蜗微血管内皮细胞的体外通透性

目的　研究豚鼠耳蜗微血管内皮细胞的体外通透性特征。方法　 (1)用小池技术建立起内皮细胞通透性的体外模型 ;(2 )研究该体外模型耳蜗微血管内皮细胞的跨细胞电阻及对12 5I 牛血清白蛋白的通透曲线 ,并与脑及肺的内皮细胞通透性进行对照。结果　 (1) 3种内皮细胞的体外模型中加入12 5I 牛血清白蛋白后 ,贝克 时间变化图均呈抛物线型上升曲线 ,其通透性从小到大依次为脑、耳蜗、肺内皮细胞 ,各组间相差显著 (P <0 .0 1) ;(2 )耳蜗、脑及肺 3种内皮细胞在培养增殖过程中其跨细胞电阻呈动态增加过程 ,以 5× 10 4/cm2 的细胞密度接种时 ,7d左右电阻均到达峰值 ,其跨细胞电阻峰值大小分别为脑 (2 4 4 .7± 4 6 .9Ω/cm2 ) >耳蜗 (118.9± 18.5Ω/cm2 ) >肺 (4 6 .6± 5 .9Ω/cm2 ) ,且各组间相差显著 (P <0 .0 1)。结论　该模型下耳蜗微血管内皮细胞的通透性与其活体时的通透性特征基本一致。     

豚鼠血迷路屏障通透性的体外模型

目的 研究豚鼠血迷路屏障通透性体外模型的建立方法及其通透性特征。方法 （1）用组织块贴壁培养法分离培养豚鼠耳蜗微血管内皮细胞，免疫组化法进行鉴定；（2）用小池技术建立起内皮细胞通透性的体外模型，并研究该模型中耳蜗、脑及肺3种内皮细胞对^125I-牛血清白蛋白的通透性；（3）研究豚鼠血迷路屏障对^125I-牛血清白蛋白的通透性。（3）研究豚鼠血迷路屏障对^125I-牛血清白蛋白的通透性。结果 （1）培养细胞致密融合对具有内皮细胞培养时典型的“铺路石样”外观，经免疫组化检测其内皮细胞标志性抗原Ⅷ因子，95％以上的培养细胞的胞质中呈棕黄色阳性反应；（2）耳蜗、脑及肺3种内皮细胞的体外模型中加入^125I-牛血清白蛋白后，贝克－时间变化图均呈抛物线型上升曲线，90min内几乎呈直线；（3）豚鼠血迷路屏障对^125I－牛血清白蛋白的通透性曲线与体外模型相似。结论 血迷路屏障的体外模型能大体反映在体时的通透性特征。     

豚鼠内耳微血管内皮细胞的跨细胞电阻

目的　研究豚鼠内耳微血管内皮细胞跨细胞电阻的动态变化及峰值大小。方法　①胶原酶消化法分离培养豚鼠内耳及脑微血管内皮细胞 ,免疫组化法进行鉴定 ;②建立起内皮细胞通透性的体外模型 ,研究该模型下内耳内皮细胞的跨细胞电阻 ,并与脑及肺内皮细胞进行比较。结果　①培养细胞致密融合时具有内皮细胞培养时典型的“铺路石样”外观 ,与肺内皮细胞株的形态一致 ,经免疫组化检测其内皮细胞标志性抗原Ⅷ因子 ,95 %以上的培养细胞的胞浆中呈棕黄色阳性反应 ;②三种内皮细胞在培养增殖过程中其跨细胞电阻值呈动态变化过程 ,以 5× 10 4 cm2 的细胞密度接种时 ,7d左右电阻到达峰值 ,内耳、脑及肺三种内皮细胞的跨细胞电阻峰值大小分别为 (118 9± 18 5 )Ω cm2 ,(2 44 7± 46 9)Ω cm2 ,(4 6 6± 5 9)Ω cm( n =6) ,三者相差非常显著 (P <0 0 0 1)。结论　内耳微血管内皮细胞跨细胞电阻峰值小于脑内皮而大于肺内皮细胞 ,证明了三者通透性的差别。     

TNF-α对体外培养豚鼠耳蜗血管纹微血管内皮细胞通透性的影响

目的 研究TNF-α对体外培养豚鼠耳蜗血管纹微血管内皮细胞通透性的影响.方法 体外分离培养豚鼠耳蜗血管纹微血管内皮细胞并建立耳蜗血管纹微血管内皮细胞通透性体外模型,实验分TNF-α组和对照组.依据作用时间和浓度不同,检测其对伊文思蓝的通透率变化.结果 TNF-α能显著增加耳蜗血管纹微血管内皮细胞的通透性,使伊文思蓝的通透率显著升高(P＜0.01),且随TNF-α浓度升高和作用时间的延长而升高.结论 TNF-α可以显著的增加耳蜗血管纹微血管内皮细胞的通透性.     

不同剪切力对豚鼠微血管内皮细胞形态学的影响

目的 观察不同剪切力对体外培养的豚鼠耳蜗、脑微血管内皮细胞的影响.方法 用自制的流体力学装置在不同时相点、以不同剪切力对豚鼠脑、耳蜗微血管内皮细胞进行力学作用,获得形态学图像并进行形状参数Pyx的测定分析.结果 通过胶原酶消化法可获得单层培养的豚鼠耳蜗、脑微血管内皮细胞.对于耳蜗微血管内皮细胞,剪切力为0.883 dyn/cm2时作用24 h未发生细胞形态改变;当剪切力增加到1.184 dyn/cm2时,作用8 h后细胞形态即开始出现顺流体方向的顺应性变化,随时间延长,变化趋势更明显.而脑微血管内皮细胞在剪切力0.267 dyn/cm2时作用24 h未发生细胞形态改变;当剪切力增加到1.069 dyn/cm2时,作用4 h后细胞形态即开始出现顺流体方向的顺应性变化.结论 耳蜗、脑微血管内皮细胞在受到剪切力作用后其形态学不同于静态培养的内皮细胞.     

豚鼠微血管通透性变化在内耳缺血性损伤中的作用

目的　研究豚鼠耳蜗微循环障碍动物模型的耳蜗微血管通透性变化特点 ,了解耳蜗微血管通透性变化在内耳缺血性损伤中的可能作用。方法　①光化学法建立豚鼠耳蜗微循障碍动物模型 ;②改良伊文思蓝荧光法定量研究其耳蜗微血管通透性变化特点 ;③记录CAPN1阈值研究其听力损伤。结果　豚鼠耳蜗发生微循环障碍后 2h和 4h ,伊文思蓝通过耳蜗微血管的渗出量分别为 ( 1 .70 9± 0 .76 9) μg/只和 ( 2 .849± 0 .6 5 3) μg/只 (P <0 .0 1 ) ;CAPN1阈值分别增加 ( 2 4.44± 7.2 7)dBpeSPL和 ( 38.33± 7.91 )dBpe SPL(P <0 .0 1 )。结论　豚鼠耳蜗发生微循环障碍后其耳蜗微血管通透性明显增高并随时间的延长而加重 ,可能是微循环障碍致内耳听力损伤的重要机制之一     

大鼠脑微血管内皮细胞的原代培养

目的 建立稳定的大鼠脑微血管内皮细胞(brain microvascular endothelial cells, BMECs)体外培养模型,并对其生物学特性进行初步研究.方法 取Sprague-Dawley大鼠脑组织,通过匀浆、酶消化和梯度离心获得纯化的脑微血管段后,接种于涂布明胶的培养瓶进行原代培养;培养的细胞采用相差显微镜形态学观察、Ⅷ因子相关抗原免疫细胞化学鉴定;采用跨内皮电阻(transendothelial electrical resistance, TEER)检测单层细胞通透性;Cell Counting Kit-8(CCK-8)方法测定细胞生长曲线.结果 细胞从贴壁的脑微血管段周围长出,呈短梭形和多角形,区域性单层生长,5～7 d细胞融合,经Ⅷ因子相关抗原免疫细胞化学检测证实培养的细胞是血管内皮细胞,原代培养的脑微血管内皮细胞表现出很强的屏障特性,随着传代次数的增加脑微血管内皮细胞的跨内皮阻抗减弱.结论 提示该方法能成功进行纯度较高的大鼠脑微血管内皮细胞原代培养,原代培养的脑微血管内皮细胞是研究脑部微血管和血脑屏障的可靠技术手段.     

体外血脑屏障模型的建立与鉴定

目的应用原代分离培养BALB／c小鼠脑微血管内皮细胞（brain microvascular endothelial cells，BMVEC）建立体外血脑屏障模型，探讨跨血脑屏障（blood brain barrier，BBB）电阻与屏障渗透功能的动态关系以及最佳构建条件。方法用酶消化、机械分离结合密度离心的方法得到原代BALB／c小鼠脑血管内皮细胞，通过培养在具有特殊质材和孔径的Transwell小室上建立BBB体外实验模型，采用倒置显微镜、电镜观察细胞形态结构和生长规律，紧密连接ZO-1蛋白免疫组化检测，比较血脑屏障形成前后膜两侧电阻动态变化与1H葡萄糖通透性的关系等方法，探讨血脑屏障模型的建立及生长特性。结果BMVEC培养至汇合后具有典型的“铺路石”样外观；扫描电镜显示细胞形成致密单层，透射电镜、ZO-1蛋白免疫组化证实细胞问形成光滑、连续、高密度的紧密连接；1H葡萄糖的通透量与实时电阻呈负相关，内皮细胞电阻随着通透性的增加而降低，通透率最低时跨细胞电阻为（346&#177;10）Ω／cm2。结论建立的BBB体外模型在形态学、电阻和通透性方面具备了BBB的基本特性。     

肿瘤坏死因子对豚鼠耳蜗血管纹微血管内皮细胞纤维肌动蛋白的影响

目的 观察肿瘤坏死因子(TNF-α)对豚鼠耳蜗血管纹微血管内皮细胞纤维肌动蛋白(F-actin)的影响,为研究豚鼠耳蜗血管纹微血管内皮细胞通透性改变的机制提供依据.方法 体外分离培养豚鼠耳蜗血管纹微血管内皮细胞,用0.05、0.1、0.2 ng/ml浓度的TNF-α作用90 min后,用免疫荧光激光共聚焦扫描显微镜法测定其中各组的F-actin含量变化,对照组为空白对照.结果 TNF-α能使耳蜗血管纹微血管内皮细胞的F-actin含量明显减少(P<0.01),且TNF-α的浓度越高F-actin的含量降低越明显.结论 通过TNF-α的作用能够改变豚鼠耳蜗微血管内皮细胞内F-aetin密度及含量.     

内毒素对鼠肺／肠微血管及体外培养内皮细胞通透性的影响及凋亡在其中的作用

目的观察内毒素（LPS）对鼠肺和肠微血管及体外培养内皮细胞通透性的影响及凋亡在其中的可能作用。方法（1）观察内毒素血症时大鼠肺、肠组织微血管通透性的改变。（2）观察LPS对体外培养人脐静脉内皮细胞（HUVECs）通透性的影响。（3）观察LPS对体外培养HUVEC凋亡的影响，从而探讨凋亡在内皮细胞通透性改变中的作用。结果（1）在大鼠内毒素血症模型中，5ms／ks和10mg／kg LPS均可造成肺、回肠组织伊文氏兰含量增加（P〈0．01或0．05）。（2）100μg／ml LPS可显著增加体外单层HUVEC对牛血清白蛋白的通透性（P〈0．05或0．01）。（3）LPS可引起的体外培养内皮细胞的凋亡。结论（1）LPS能迅速提高体内肺微血管内皮细胞通透性，而LPS作用后6h肠微血管通透性开始增加。（2）LPS可剂量依赖性的引起体外培养脐静脉内皮细胞通透性升高。（3）细胞凋亡可能是引起内毒索血症时内皮细胞通透性的原因之一。     

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.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.