缺血后处理对肾缺血再灌注损伤大鼠肾组织细胞凋亡及bcl-2和bax基因表达的影响

目的:观察缺血后处理(IPo)对大鼠肾缺血再灌注(I/R)损伤后肾组织细胞凋亡及bcl-2和bax基因表达的影响,并探讨其肾保护的机制.方法:18只雄性SD大鼠随机分为3组:假手术组(S组),缺血再灌注组(I/R组),缺血后处理组(IPo组),每组6只.采用夹闭双侧肾蒂45 min,再灌注6 h制备肾脏缺血再灌注模型.IPo组在夹闭双侧肾蒂45 min后,再灌注10 s,缺血10 s,反复3次,再全面恢复血液灌注.再灌注6 h时处死大鼠,酶法测定血清肌酐(Cr)含量;苦味酸不除蛋白法测定尿素氮(BUN)含量;采用逆转录-多聚酶链反应(RT-PCR)检测肾组织bcl-2 mRNA和bax mRNA表达,表达水平以与其相应的内参β-actin的光密度比表示;原位末端脱氧核苷酸转移酶标记(TUNEL)法检测肾组织中凋亡细胞,计算细胞凋亡指数(AI);苏木素-伊红(HE) 染色,在光镜下观察肾组织病理学变化.结果:与S组比较,I/R组肾组织Cr 和BUN浓度升高(P＜0.05),bcl-2 mRNA表达量降低(P＜0.05),bax mRNA表达量升高(P＜0.05),bcl-2 mRNA/bax mRNA的比值降低(P＜0.05),AI增加(P＜0.05),组织形态学观察可见肾小管上皮细胞水肿,变性坏死,肾小管扩张,间质淤血、水肿、大量中性粒细胞浸润.与I/R组相比,IPo组肾组织Cr和BUN浓度降低(P＜0.05),bcl-2 mRNA表达量升高(P＜0.05),bax mRNA表达量降低(P＜0.05),bcl-2 mRNA/bax mRNA的比值升高(P＜0.05),AI减少(P＜0.05),肾组织形态学损伤减轻.结论:缺血后处理可减轻肾脏I/R损伤,其肾保护作用可能与其上调bcl-2基因和下调bax基因表达,使bcl-2 mRNA/bax mRNA比值升高,从而抑制缺血再灌注损伤后的肾组织细胞凋亡有关.     

H2S对肾缺血再灌注损伤大鼠肾组织氧化损伤的保护作用探讨

目的 观察不同剂量硫化氢(H2S)对肾缺血再灌注(I/R)大鼠肾组织氧化损伤的保护作用.方法 夹闭双侧肾动、静脉建立I/R损伤模型,24 h后处死大鼠,光镜下观察肾组织形态学变化,并测定血浆肌酐(SCr)和血浆尿素氮(BUN)及肾组织超氧化物歧化酶(SOD)、丙二醛(MDA)含量和血红素氧合酶诱导型HO-1表达水平.结果 H2S可降低大鼠血浆SCr、BUN水平,使肾组织MDA含量和SOD活力升高(P＜0.01),且可明显减轻肾组织病理损害程度.免疫组化结果显示,H2S可致I/R组大鼠肾小管上皮细胞HO-1表达水平明显升高.结论 H2S通过降低氧自由基和上调HO-1表达对I/R损伤发挥保护作用,并且随着H2S剂量的增加,这种保护作用也在增强.     

升降散对脓毒症大鼠肾组织Toll样受体4表达的影响

目的:观察升降散对脓毒症大鼠肾组织Toll样受体4(TLR4)表达的影响。方法:采用盲肠结扎穿孔术(CLP)制备脓毒症大鼠模型。30只SD大鼠分为对照组、模型组、治疗组,每组各10只。对照组和模型组在造模前72 h开始灌胃0.9%Na Cl溶液,治疗组灌胃升降散浓缩液;造模后24 h采集动脉血检测肌酐(SCr)水平及肾组织检测TLR4 mRNA表达的水平。结果:与对照组比较,模型组和治疗组SCr水平均明显升高(P0.01),但治疗组SCr水平明显低于模型组(P0.01);模型组和治疗组TLR4 mRNA表达水平显著升高(P0.05,P0.01),但治疗组TLR4 mRNA表达水平明显低于模型组(P0.01)。结论:升降散可以通过减少肾脏TRL4 mRNA表达,以减轻脓毒症大鼠肾损伤。     

脓毒症大鼠肾脏结构和功能的改变及核因子-κB的表达

目的:探讨脓毒症并发急性肾损伤时大鼠肾脏结构和功能的变化,以及核因子-κB(NF-κB)在肾脏组织中的表达。方法:雄性SD大鼠36只,随机分为假手术组(Sham组)和盲肠结扎穿孔组(CLP组),各18只。CLP组大鼠采用盲肠结扎穿孔法建立脓毒症动物模型,Sham组除不结扎穿孔盲肠外,其余处理同脓毒症组。分别于造模后6、12和24 h观察各组心率(HR)、平均动脉压(MAP)、血清肌酐(Cr)、尿素氮(BUN)的变化及肾脏组织的改变;免疫组织化学法检测肾脏组织中NF-κB的表达情况。结果:与相同时间点Sham组比较,CLP组6～12 h HR、MAP明显升高(P0.01和P0.05),24 h MAP降低(P0.01)。与相同时间点Sham组比较,CLP组6～24 h BUN均升高(P0.05～P0.01),24 h Cr明显升高(P0.01)。CLP各组大鼠肾小体中血管球淤血、皱缩,肾小囊腔扩大,且随病程延长,淤血、皱缩的血管球增多,且伴有肾小管上皮细胞肿胀和坏死。Sham组NF-κB位于细胞质中,着色浅;CLP组NF-κB移位进入细胞核,着色加深。结论:随脓毒症病程的延长,大鼠肾脏结构和功能损伤加重。NF-κB在细胞核内的高表达提示NF-κB的活化可能是促进肾脏结构和功能损伤的重要因素。     

氯胺酮对脓毒症大鼠肾脏保护作用的研究

目的探讨氯胺酮对脓毒症大鼠肾脏的保护作用及其机制。方法选健康雄性Wistar大鼠54只,随机分为三组：假手术组（SHAM）组、盲肠结扎加穿孔组（CLP）组及氯胺酮组（KT）组。SHAM组开腹后不做任何处理,其余各组行盲肠结扎穿孔术（CLP）。KT组于CLP前20min腹腔给药40mg/kg。各组在3h、6h和12h分别经心脏采血,检测尿素氮和肌酐的含量,并取肾脏行HE染色观察其病理组织学变化,用免疫组化方法检测热休克蛋白70（HSP70）的表达。结果与SHAM组比较,CLP组大鼠血清BUN含量在术后6h和12h显著升高（P〈0.01）,血清Cr在术后12h显著升高（P〈0.01）;与CLP组比较,KT组大鼠血清BUN较CLP组含量在6、12h时相点明显降低（P〈0.05）。血清Cr在12h明显降低（P〈0.05）。三组肾组织中HSP70均有表达,CLP组及KT组均明显高于SHAM组（P〈0.01）,而KT组明显高于CLP组（P〈0.05）。结论氯胺酮能抑制脓毒症大鼠血清BUN和Cr的增高,减轻肾组织损害,对脓毒症大鼠肾脏具有一定的保护,此作用可能与诱导HSP70表达增强有关。     

核因子-KB在脓毒症大鼠肾细胞凋亡中的作用

目的 研究脓毒症时核因子-kB（NF-kB）在肾细胞凋亡信号转导中的作用，探讨脓毒症时肾功能降低的机制。方法 将30只大鼠随机分为5组，其中6只作为对照组，另外24只采用盲肠结扎穿孔术（CLP）复制脓毒症模型，以术后2h、3h,4h,5h时限分为4组作为实验组。各组均测定肾脏组织NF-kB蛋白及肾细胞凋亡的情况，同时测定肾功能的变化。结果 CLP术后肾组织NF-kB蛋白表达升高，与对照组相比差异有统计学意义（P〈0．01）；4h组NF-kB的含量达高峰，3h组相对较弱。CLP术后肾细胞凋亡数目与肾组织NF-kB蛋白表达相反。CLP术后血清尿素氮及肌酐增加，与对照组相比差异有统计学意义（P〈0．01）。结论 CLP所致的脓毒症过程中，NF-kB蛋白表达升高，其活性增强可抑制肾细胞凋亡。     

核因子-κB在脓毒症大鼠肾细胞凋亡中的作用

目的研究脓毒症时核因子-κB(NF-κB)在肾细胞凋亡信号转导中的作用,探讨脓毒症时肾功能降低的机制。方法将30只大鼠随机分为5组,其中6只作为对照组,另外24只采用盲肠结扎穿孔术(CLP)复制脓毒症模型,以术后2 h、3 h、4 h、5 h时限分为4组作为实验组。各组均测定肾脏组织NF-κB蛋白及肾细胞凋亡的情况,同时测定肾功能的变化。结果CLP术后肾组织NF-κB蛋白表达升高,与对照组相比差异有统计学意义(P<0.01);4 h组NF-κB的含量达高峰,3 h组相对较弱。CLP术后肾细胞凋亡数目与肾组织NF-κB蛋白表达相反。CLP术后血清尿素氮及肌酐增加,与对照组相比差异有统计学意义(P<0.01)。结论CLP所致的脓毒症过程中,NF-κB蛋白表达升高,其活性增强可抑制肾细胞凋亡。     

天然虾青素对脓毒症大鼠急性肾损伤的作用

目的探讨天然虾青素对盲肠结扎穿孔（caecal ligation and puncture,CLP）所致大鼠脓毒症诱导的急性肾损伤（acute kidney injury,AKI）的保护作用。方法将72只成年雄性Sprague-Dawley（SD）大鼠随机分成空白组、假手术（Sham）组、CLP模型组和天然虾青素高、中、低剂量组。采用CLP法建立大鼠脓毒症AKI模型,造模后天然虾青素高、中、低剂量组即刻分别静脉推注虾青素100、50、25 mg/kg,注药后24 h按随机原则处死大鼠。检测血肌酐（serum creatinine,SCr）、血尿素氮（blood urea nitrogen,BUN）、血尿酸（blood uric acid,BUA）、胱抑素C（cystatln C,Cys C）、肿瘤坏死因子α（tumor necrosis factor alpha,TNF-α）和白细胞介素6（interleukin 6,IL-6）、肾组织核因子κB（nuclear factorκappa B,NF-κB）的水平,并观察肾组织形态学。结果与CPL模型组相比,天然虾青素降低了血清SCr、BUN、BUA、Cys C、TNF-α、IL-6的含量及肾组织中NF-κB蛋白表达水平,差异有统计学意义（P〈0.05或0.01）。结论天然虾青素对CPL所致的AKI具有一定的保护作用,该作用可能与其降低脓毒症大鼠血清TNF-α、IL-6、NF-κB的水平有关。     

异氟烷后处理减轻大鼠盲肠结扎穿孔所致急性肺损伤

目的 研究异氟烷后处理对大鼠盲肠结扎穿孔(CLP)所致急性肺损伤(ALI)的保护作用.方法 将48只Sprague-Dawley雄性大鼠随机分为4组,每组12只:正常对照组,不做任何处理;假手术组,单纯行开腹关腹术;CLP组,行CLP建立大鼠ALI模型;异氟烷组,CLP模型建立后4h,使大鼠吸入体积分数为0.014的异氟烷2h.分别在实验后6和24 h,每组各处死6只大鼠作为6h亚组和24 h亚组.取腹主动脉血行动脉血气分析,取左肺测定肺组织湿/干重比(W/D),取心脏血测定血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6浓度,取右肺行苏木精-伊红(H-E)染色观察肺组织病理学变化、免疫组织化学染色观察核转录因子(NF)-κB的表达.结果 假手术组大鼠的动脉血氧分压(paO2)、肺组织W/D及血清TNF-α和IL-6水平与正常对照组的差异均无统计学意义(P值均＞0.05).CLP组和异氟烷组的paO2均较正常对照组显著降低(P值均＜0.05),肺组织W/D均较正常对照组显著增大(P值均＜0.05),血清TNF-α和IL-6水平均较正常对照组显著升高(P值均＜0.05);但异氟烷组上述指标的变化均较CLP组小,与CLP组比较的差异均有统计学意义(P值均＜0.05).正常对照组和假手术组大鼠的肺组织无明显损伤;CLP组大鼠的肺组织损伤严重,24 h亚组的损伤更为明显;异氟烷组大鼠的肺组织损伤较CLP组轻.正常对照组和假手术组偶见NF-κB表达阳性细胞,CLP组见大量NF-κB表达阳性细胞,异氟烷组的NF-κB阳性细胞数目较CLP组减少.结论 异氟烷后处理对脓毒症ALI具有保护作用,这种保护作用可能部分是通过抑制炎性因子和NF-κB的表达实现的.     

缺血后处理对大鼠肾脏缺血再灌注损伤的影响

目的 探讨缺血后处理对大鼠肾缺血再灌注(I/R)损伤的影响及其机制.方法 采用摘除右肾夹闭左侧肾蒂45 min再灌注6 h制备肾脏缺血再灌注损伤模型.2 w前已行右肾切除术的30只雄性SD大鼠随机分为3组(n=10):假手术组(S组)、缺血再灌注组(I/R组)和缺血后处理组(IPO组).IPO组在夹闭左侧肾蒂45 min后,再灌注10 s,缺血10 s,重复6次后,完全恢复肾血流.再灌注6 h处死大鼠抽取颈动脉血和切取左肾.测定血清肌酐(Cr)、尿素氮(BUN)浓度,肾组织中丙二醛(MDA)含量和超氧化物歧化酶(SOD)活性;光镜下观察肾组织病理学改变 ,采用流式细胞仪检测细胞凋亡率.结果 与S组比较,I/R组和IPO组Cr和BUN浓度升高,肾组织SOD活性降低,MDA含量升高,肾细胞凋亡率升高,病理损伤明显.与I/R组比较,IPO组Cr和BUN浓度降低,肾组织SOD活性升高,MDA含量降低,肾细胞凋亡率降低,病理损伤减轻.结论 缺血后处理能减轻大鼠肾缺血再灌注损伤,其机制与增强肾脏抗氧化能力和制肾组织细胞凋亡有关.     

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.     

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…     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.