电针预处理对脑缺血再灌注大鼠皮质神经元TRPC6表达的影响

目的观察电针预处理对脑缺血再灌注大鼠皮质神经元TRPC6表达的影响,探讨其对神经元可能的保护机制。方法将SD大鼠随机分为假手术组、模型组和电针预处理组,每组8只。采用大脑中动脉栓塞法制备脑缺血再灌注模型。电针预处理组在造模前取"百会"和"大椎"穴给予电针刺激。造模后24h进行神经功能评分并急性分离大鼠皮质神经元,通过蛋白免疫印迹(western blot)检测神经元TRPC6和Caspase-3蛋白表达,钙影像检测细胞内相对钙离子浓度。结果与假手术组比较,模型组大鼠的神经功能评分明显增高(P0.05),大脑皮质神经细胞TRPC6和Caspase-3蛋白表达明显增高(P0.05),神经元内钙离子浓度升高(P0.01);与模型组比较,电针预处理组能明显改善脑缺血再灌注后大鼠的神经功能症状(P0.05),抑制大脑皮质神经细胞TRPC6和Caspase-3蛋白表达(P0.05),并降低细胞内钙离子浓度(P0.01)。结论电针预处理对脑缺血再灌注大鼠脑损伤有保护作用,其机制可能与TRPC6下调,减少细胞钙离子内流从而抑制神经凋亡。     

红景天苷对大鼠心肌缺血预处理后血管内皮生长因子表达的影响

目的观察红景天苷对大鼠心肌缺血/再灌注预处理后血管内皮生长因子表达的影响。方法选取16只健康大鼠,随机分为缺血/再灌注组、红景天苷预处理组,其中缺血/再灌注组、红景天苷预处理组经尾静脉注射垂体后叶素制作大鼠急性心肌缺血模型,另设8只为空白对照组。红景天苷预处理组经尾静脉注射1%红景天苷2 m L/(kg·d),每天1次,连续7 d,空白对照组和缺血/再灌注组给予等体积生理盐水预处理。于缺血预处理前及缺血预处理7 d后经眶静脉取血,采用双抗体夹心酶联免疫吸附测定(ELISA)法测定大鼠血清受体胎肝激酶1(FLK-1)及FLK-1 m RNA,缺氧诱导因子-1α(HIF-1α)及HIF-1αm RNA,心肌血管内皮生长因子(VEGF)及m RNA表达;采用测试药盒测定心肌组织中丙二醛(MDA)含量、血清超氧化物歧化酶(SOD)及过氧化氢酶(CAT)活性等指标。结果红景天苷预处理组在缺血预处理7 d后FLK-1及FLK-1 m RNA、HIF-1α及HIF-1αm RNA、VEGF蛋白质及VEGF m RNA的表达均明显增强,与空白对照组、缺血/再灌注组、预处理前比较,差异均有统计学意义(P<0.05)。同时,红景天苷预处理组CAT、SOD活性明显升高,MDA含量明显降低,与缺血/再灌注组及缺血预处理前比较,差异均有统计学意义(P<0.05)。结论红景天苷预处理急性心肌缺血大鼠,可减轻其血管内皮炎症反应及损伤程度,促使大鼠缺血心肌血管内皮新生,增强组织对自由基清除酶活性,抑制脂质过氧化反应,对急性心肌缺血再灌注损伤模型大鼠有保护作用。     

缺血预处理对糖尿病大鼠心肌缺血再灌注损伤的影响

目的 探讨缺血预处理对糖尿病大鼠心肌缺血再灌注损伤的影响. 方法 建立糖尿病大鼠模型,将18只糖尿病大鼠随机分为3组,即心肌缺血再灌注组、心肌缺血预处理组及假手术组,每组6只.硝酸还原酶法测定各组大鼠的血清和心肌组织中一氧化氮(NO)水平,免疫组织化学法测定大鼠的心肌基质金属蛋白酶-2(MMP-2)的表达. 结果 假手术组大鼠血清NO水平为(46±11)μmol/L,心肌缺血再灌注组为(66±18)μmol/L,心肌缺血预处理组为(45±11)μmol/L,心肌缺血再灌注组的血清NO水平与假手术组间差异有统计学意义(P<0.05),与心肌缺血预处理组间差异亦有统计学意义(P<0.05).假手术组大鼠心肌组织NO水平为(21.4±5.3)μmol/mgprot,心肌缺血再灌注组为(30.2±3.3)μmol/mgprot,心肌缺血预处理组为(25.6±2.9)μmol/mgprot,心肌缺血再灌注组的心肌组织NO水平与假手术组间差异有统计学意义(P<0.01),与心肌缺血预处理组间差异亦有统计学意义(P<0.05).假手术组大鼠心肌组织中MMP-2阳性细胞百分比为(30.4±2.2)%,心肌缺血再灌注组为(44.2±6.3)%,心肌缺血预处理组为(25.2±4.5)%,心肌缺血再灌注组与假手术组间差异有统计学意义(P<0.05),与心肌缺血预处理组间差异亦有统计学意义(P<0.05). 结论 缺血预处理可通过减少NO生成和MMP-2表达,降低糖尿病大鼠的心肌缺血再灌注损伤.     

舒芬太尼对大鼠心肌缺血再灌注心肌组织超氧化物歧化酶活性及丙二醛水平的影响

目的探讨舒芬太尼对大鼠心肌缺血再灌注损伤的保护作用。方法 Wistar雄性大鼠56只随机分为对照组(n=8)、缺血再灌注组(n=24)和舒芬太尼预处理组(n=24),其中缺血再灌注组和舒芬太尼预处理组分别于再灌注30 min、1、2 h处死大鼠(每组每次处死大鼠8只),取心脏分离心肌,测定并比较各组心肌组织超氧化物歧化酶(SOD)活性及丙二醛(MDA)水平。结果再灌注30 min、1、2 h时,缺血再灌注组和舒芬太尼预处理组心肌组织SOD活性显著低于对照组(P<0.05),MDA含量显著高于对照组(P<0.05);而舒芬太尼预处理组心肌组织SOD活性显著高于缺血再灌注组(P<0.05),MDA含量显著低于缺血再灌注组(P<0.05)。结论舒芬太尼预处理对大鼠心肌缺血再灌注损伤具有一定的保护作用。     

芦丁对大鼠缺血再灌注心肌组织iNOS和eNOSmRNA表达的影响

目的：研究芦丁对大鼠心肌缺血再灌注损伤的保护作用及其机制。方法通过左冠状动脉结扎建立SD大鼠心肌缺血再灌注模型,将大鼠随机分为对照组、模型组、芦丁组、L-NAME（eNOS 抑制剂）组,ELISA 法检测血清一氧化氮（NO）水平,免疫抑制法检测血清肌酸激酶同工酶（CK-MB）浓度,实时荧光定量 PCR分析各组心肌组织iNOS 和eNOS mRNA 表达的变化。结果与模型组比较,芦丁组血清 NO 水平增高（P＜0.01）,CK-MB 浓度下降（P＜0.01）,eNOS mRNA 表达升高（P＜0.01）,iNOS mRNA 表达下降（P＜0.01）。结论芦丁缺血预处理对心肌起到了保护作用,其机制可能与上调心肌组织eNOS mRNA 、下调iNOS mRNA 表达有关。     

三七丹参片预处理对心肌缺血再灌注大鼠SOD及MDA的影响

目的:观察三七丹参片预处理对大鼠心肌缺血再灌注损伤(IR)模型超氧化物歧化酶(SOD)、丙二醛(MDA)含量的影响,研究三七丹参片对心肌缺血再灌注损伤大鼠的保护作用。方法:采用冠状动脉结扎法建立心肌缺血再灌注损伤大鼠模型,检测大鼠血清中SOD活性与MDA含量。结果:三七丹参组、心肌缺血预适应组MDA含量低于再灌注损伤组,SOD活性则高于再灌注损伤组,差异有统计学意义(P<0.05)。结论:三七丹参片预处理后,明显减轻大鼠急性心肌缺血所致心肌损伤。     

尾加压素Ⅱ对针刺预处理I/R损伤大鼠心肌细胞血管VEGF的影响

目的：研究尾加压素Ⅱ（UⅡ）在针刺抗心肌缺血再灌注损伤中的作用。方法：选择健康SD大鼠120只,随机分为6组,正常对照组（A）、模型组（B）、针刺预处理组（C）、针刺＋尾加压素低浓度组（20pmol/kg）（D）、针刺＋尾加压素高浓度组（60pmol/kg）（E）和血管紧张素Ⅱ特异性受体拮抗剂（Losartan,氯沙坦）（F）,每组20只。针刺预处理组连续3d电针预处理,第3天复制心肌缺血再灌注模型。D组、E组造模前尾静脉给药,给药后即刻造模。F组于造模前进行灌胃给药,给药后即刻造模。造模成功后常规饲养24h,处死取材,用ELISA法测定心肌组织中的VEGF。结果：心肌缺血再灌注损伤时模型大鼠心肌组织中的VEGF含量显著升高,针刺预处理、针刺结合不同剂量UⅡ以及使用UⅡ拮抗剂均可使缺血区心肌组织中的VEGF含量降低（P〈0.05）,以针刺预处理结合低剂量UⅡ效果最优（P〈0.01）。结论：UⅡ可能是抗急性心肌缺血再灌注损伤的重要作用途径之一。     

姜黄素对急性心肌缺血再灌注损伤大鼠内皮素-1水平的影响

目的探讨姜黄素对大鼠心肌缺血再灌注损伤的保护作用。方法将60只成年健康Wistar大鼠采用随机数字表法分成6组,即假手术组、缺血30 min组、再灌注1、2 h组、姜黄素+再灌注1、2 h组,每组10只。应用放射免疫方法检测血清内皮素-1(ET-1)水平;反转录-聚合酶链反应及蛋白免疫印迹法检测大鼠心肌组织ET-1 mRNA及蛋白表达水平。结果与假手术组比较,缺血30 min组、再灌注1、2 h组、姜黄素+再灌注1、2 h组大鼠血清ET-1和心肌组织ET-1 mRNA及蛋白表达水平均显著升高(P<0.05);与缺血30 min组比较,再灌注1、2 h组、姜黄素+再灌注1、2 h组大鼠血清ET-1和心肌组织ET-1 mRNA及蛋白表达水平显著升高,且再灌注2 h组显著高于再灌注1 h组(P<0.05);姜黄素+再灌注1、2 h组较再灌注2 h组大鼠血清ET-1和心肌组织ET-1 mRNA及蛋白表达水平显著下调(P<0.05)。结论 ET-1在急性心肌缺血再灌注损伤缺血和再灌注阶段表达上调,姜黄素预处理可下调其表达。     

电针“内关”、“心俞”对急性心肌缺血再灌注损伤大鼠血清白介素-1β、白介素-10含量及心肌组织NF-κB p65蛋白表达的影响

目的：探讨针刺“内关”、“心俞”穴对心肌缺血再灌注损伤大鼠心肌组织NF-κB p65蛋白表达及相关炎症因子的影响。方法按照随机数字表将60只Wistar大鼠随机分为假手术组、模型对照组、针刺“内关”＋“心俞”组（针刺观察组）、针刺“太渊”＋“肺俞”组（针刺对照组）,每组15只,针刺观察组选取“内关”和“心俞”穴进行电针刺激,刺激电流1mA,频率为2 Hz,每次刺激20min,1次/d,共3d。针刺对照组选取“太渊”、“肺俞”,电针方法同针刺观察组。假手术组、模型对照组不电针。分别检测各组大鼠心肌缺血面积、梗死面积,ELISA法检测血清白介素-1β（interleukin-1β,IL-1β）、白介素-10（interleukin-10,IL-10）含量,免疫组织化学法检测心肌组织NF-κB p65蛋白表达情况。结果模型对照组大鼠的心肌缺血面积和梗死面积、NF-κB p65阳性细胞数和平均光密度、血清IL-1β含量明显升高,IL-10含量显著降低,与假手术组比较差异有统计学意义（P＆lt;0.05）,针刺观察组大鼠的心肌缺血面积、梗死面积和NF-κB p65表达较模型对照组和针刺对照组比较均显著减少（P＆lt;0.05）,血清IL-1β含量较模型对照组和针刺对照组显著降低,IL-10明显升高（P＆lt;0.05）。结论电针“内关”、“心俞”穴可显著降低急性心肌缺血再灌注损伤大鼠血清IL-1β含量及心肌组织NF-κB p65蛋白表达水平,升高IL-10含量,可能是其针刺抗急性心肌缺血再灌注损伤效应的作用机制之一。     

RhoA-MMP-2信号通路在缺血预处理保护糖尿病大鼠心肌缺血再灌注中的作用

目的 探讨糖尿病心肌缺血再灌注损伤的发生机理,观察RhoA-MMP-2信号转导通路在缺血预处理保护糖尿病大鼠心肌缺血再灌注中的作用.方法 SD大鼠40只,分为非糖尿病心肌缺血再灌注(CIR)组、非糖尿病心肌缺血预处理(CIP)组、糖尿病心肌缺血再灌注(DIR)组和糖尿病心肌缺血预处理(DIP)组.免疫组织化学法检测心肌MMP-2蛋白的表达,Western blot法测定心肌RhoA和ROCK蛋白的表达,检测血清和心肌组织中NO、NOS、SOD和MDA的水平,进行心肌梗死范围的测定.结果 与DIR组相比,DIP组血清和心肌中的MDA含量明显降低,血清和心肌中的SOD活性明显升高.与DIR组相比,DIP组血清和心肌中的NO含量明显降低,血清和心肌中的NOS活性明显降低.与DIR组相比,DIP组心肌中的MMP-2蛋白表达明显降低.CIP组的心肌梗死面积较CIR组降低;DIP组的心肌梗死面积较DIR组降低;与CIP组比较,DIP组的心肌梗死面积显著增加.DIP组中RhoA蛋白的表达明显低于DIR组.DIP组中ROCK蛋白的表达明显低于DIR组.结论 缺血预处理可减轻糖尿病大鼠的心肌缺血再灌注损伤,可能与减轻脂质过氧化和自由基损伤、下调MMP-2、RhoA和ROCK蛋白的表达以及降低心肌梗死的范围等有关.     

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.     

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.