水飞蓟素对急性肺损伤小鼠肺组织IL－1β、IL－6、趋化因子fractalkine表达的影响

目的:探讨水飞蓟素(silymarin,SIL)对急性肺损伤小鼠肺组织中白细胞介素(interleukin,IL)-1β?IL-6?趋化因子fractalkine表达的影响与意义?方法:利用内毒素(lipopolysaccharide,LPS)气管内滴入制备小鼠急性肺损伤的模型;设立SIL治疗组(S组)?LPS组(L组)?生理盐水对照组(N组),S组在气管内滴入LPS前6?4?2 h以200 mg/kg水飞蓟素灌胃,分别在LPS处理后6?12?24 h取肺组织匀浆,用ELISA法分别测定各组IL-1β?IL-6?fractalkine蛋白水平?结果:在各时间点,S组肺组织中IL-1β?IL-6?fractalkine蛋白表达水平均显著低于L组?结论:SIL能有效抑制小鼠急性肺损伤时肺组织中IL-1β?IL-6?趋化因子fractalkine的表达?     

米屈肼预给药对小鼠急性肺损伤的保护作用

目的： 研究米屈肼对脂多糖所致小鼠急性肺损伤的保护作用。 方法： 雄性ICR小鼠72只,随机分为正常对照组、急性肺损伤模型组、米屈肼预处理组。米屈肼组连续6天经腹腔注射米屈肼（100 mg/kg）,正常对照组和模型组均以等量生理盐水代替米屈肼。模型组和米屈肼组以脂多糖（4 mg/kg）经气管内滴入,正常对照组经气管内滴入等量生理盐水,6、12、24 h后处死小鼠,收集小鼠肺组织,测定各组肺湿重/干重比值、肺组织匀浆丙二醛（malondialdehyde, MDA）含量、总超氧化物歧化酶（total superoxide dismutase,T-SOD）活力及中性粒细胞髓过氧化物酶（myeloperoxidase,MPO）含量。 结果： 米屈肼组炎症浸润和出血渗出均较模型组减轻,肺湿重/干重比值（W/D）及肺组织中丙二醛、MPO含量均较模型组明显降低（P<0.05）,肺组织总SOD活力则明显升高（P<0.05）。 结论： 米屈肼预处理对脂多糖所致急性肺损伤具有保护作用。     

乌司他丁对脂多糖诱导的大鼠急性肺损伤NF-κ Bp65及MMP-2表达的影响

目的 探讨乌司他丁对脂多糖(LPS)诱导的失鼠急性肺损伤中肺组织NF-κ Bp65及MMP-2表达的影响.方法 将45只SD大鼠随机分为3组,每组15只.正常对照组尾静脉注射生理盐水2mL/kg;急性肺损伤组尾静脉注射脂多糖5 mg/kg;乌司他丁干预组大鼠腹腔注射乌司他丁100 ku/kg,30 min后尾静脉注射脂多糖5 mg/kg.给药后4h处死大鼠,测动脉血氧分压、肺湿干重比、行肺组织HE染色.采用免疫组化法测定肺组织NF-κ Bp65及MMP-2的表达,并进行统计学分析.结果 与正常对照组相比较,急性肺损伤组和乌司他丁干预组肺组织NF-κ Bp65及MMP-2的表达均增多,差异有显著性(P＜0.05),乌司他丁干预组较急性肺损伤组NF-κBp65及MMP-2的表达低,差异有显著性(P＜0.05).结论 NF-κ Bp65及MMP-2在急性肺损伤中起着一定的作用,乌司他丁可抑制NF-κ Bp65及MMP-2表达.     

法舒地尔对脂多糖诱导的小鼠急性肺损伤的保护作用

目的:探讨Rho激酶抑制剂法舒地尔(fasudil)对脂多糖(lipopolysaccharide,LPS)所致小鼠败血症继发急性肺损伤(acute lung injury,ALI)的保护作用及机制?方法:C57BL/6小鼠随机分为对照(Control)组?LPS模型组?LPS+fasudil(10 mg/kg)组?LPS + 地塞米松(dexamethasone,Dex,5 mg/kg)组?造模后观察不同时间点各组生存率,6 h处死小鼠收集血清?支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)?肺组织,ELISA测定血清中肿瘤坏死因子α(TNF-α)?白细胞介素(IL)-1β?IL-10水平,检测BALF中细胞计数和蛋白浓度,HE染色观察各组肺组织病理改变,湿干重比评估肺含水量,ELISA测定肺组织中性粒细胞髓过氧化物酶(myeloperoxidase,MPO)含量?结果:fasudil可显著改善动物生存率?延长生存时间;缓解肺组织炎性损伤及肺水肿程度,降低MPO含量,下调血清中促炎细胞因子IL-1β?TNF-α水平,上调抗炎细胞因子IL-10表达?结论:fasudil可有效缓解LPS所致的小鼠ALI,其作用可能与减轻受累肺组织炎症反应相关?     

ADH-503保护脂多糖引起的急性肺损伤

目的：研究ADH-503能否减轻脂多糖(LPS)诱导的小鼠急性肺损伤,为临床治疗急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)提供新的思路。方法：选取C57BL/6雄性野生型小鼠40只,随机分为对照组（control组）、模型组（LPS组)、ADH-503低/高剂量治疗组（LPS+ADH-503组）,对照组腹腔注射生理盐水;模型组腹腔注射LPS(10 mg/kg)诱导ALI模型;ADH-503低/高用量治疗组分别腹腔注射ADH-503 30 mg/kg或60 mg/kg预处理2 h后,腹腔注射LPS(10 mg/kg)。LPS灌注12 h后处死小鼠,收集小鼠肺组织,检测肺湿/干重比(W/D)值;用HE染色法观察肺组织病理损伤;ELISA检测肺组织中TNF-α、IL-1β和IL-6的含量,Western Blot检测肺组织中p-STAT3,p-NF-κB p65蛋白表达水平。结果：与对照组相比,模型组小鼠肺组织产生病理性变化,W/D比值、炎性细胞因子含量明显升高(P<0.05),急性肺损伤模型建立成功。与模型组比较,ADH-503治疗组的病理损伤评分、炎性因子水平显著降低(P&...     

硫辛酸对急性肺损伤大鼠IL-10的影响

目的探讨硫辛酸(LA)对内毒素(脂多糖,LPS)诱导的急性肺损伤(ALI)大鼠白细胞介素(IL)-10含量的影响。方法72只大鼠随机分为4组,对照组、LPS组LPS+LA30mg干预组。LPS+LA100mg干预组。各实验组舌下静脉注射LPS诱导大鼠ALI模型,30min后2个干预组分别给予LA30mg/kg和100mg/kg舌下静脉注射,对照组给予等体积生理盐水。LPS注射1、3、6h后测定血清及肺组织中IL-10浓度。结果各实验组血清及肺组织中IL-10分别在不同时间点显著高于对照组(P<0.01)。2个干预组血清及肺组织中IL-10水平在3h、6h明显升高,均显著高于LPS组(P<0.01),且LPS+LA100mg组显著高于LPS+LA30mg组(P<0.05)。结论LPS可导致ALI的发生,LA可提高IL-10水平,改善肺损伤。     

还原型谷胱甘肽对内毒素性休克小鼠肺损伤的保护作用

目的 探讨还原型谷胱甘肽对内毒素诱导小鼠的急性肺损伤保护作用的可能机制.方法 于小鼠腹腔注射LPS(10 mg/kg)复制ALI动物模型.将小鼠随机分为对照组(n=10)、LPS组(n=10)、还原型谷胱甘肽(GSH)+LPS组(n=10).观察各组肺组织病理学改变,测量肺干/湿(D/W)重比,用免疫组织化学技术检测肺组织NF-κB的表达,ELISA法检测肺匀浆中TNF-α和IL-6.结果 病理学改变B组与A,C组比较的肺组织有更多白细胞浸润和肺泡壁结构的破坏.B组肺组织中TNF-αd和IL-6含量与A和C比较明显增加,B组肺组织NF-κB的表达组与A和C组比较明显增加.结论 GSH通过抑制NF-κB、TNF-α和IL-6的表达减轻LPS所致急性肺组织损伤.     

内毒素复合油酸二次打击致大鼠急性肺损伤模型的建立

目的研究腹腔注射内毒素（LPS）和（或）静脉注射油酸（OA）的方法致大鼠急性肺损伤（ALI）模型的不同特点及其可能机制。方法将24只雄性Wistar大鼠随机分为4组,每组6只。对照组（C组）：腹腔注射生理盐水10ml/kg;内毒素组（LPS组）：腹腔注射1%LPS10mg/kg;油酸组（OA组）：静脉注射OA0.15ml/kg;内毒素＋油酸组（LPS＋OA组）：腹腔注射1%LPS10mg/kg,30min后静脉注射OA0.15ml/kg。观察120min内各组大鼠平均动脉压和心率变化率的改变。120min后处死动物采集标本。分别检测肺组织核转录因子κB（NF-κB）P65、血清IL-6、肺组织髓过氧化物酶（MPO）含量、动脉血气指标和肺组织湿-干重比（W/D）,HE染色观察肺组织病理学改变。结果与C组比较,LPS组肺组织NF-κBp65水平、MPO含量及血清IL-6含量显著增加,肺组织W/D比值及血气分析结果无显著性差异,病理组织学改变轻微;OA组肺组织NF-κBp65水平和MPO含量及血清IL-6含量无显著改变,肺组织W/D比值升高,pH值和PaO2降低,PaCO2升高,肺脏出现严重的肺泡上皮细胞损伤和肺泡结构破坏。LPS＋OA组肺组织NF-κBp65水平、MPO含量和W/D比值及血清IL-6含量显著增加,pH值和PaO2降低,PaCO2升高,肺泡破坏严重,大量组织液渗出。结论内毒素复合油酸可以产生协同作用,产生大量致炎细胞因子,并造成大鼠严重的肺脏病理生理改变,临床ALI/ARDS发病过程更为接近,是一种研究ALI发病机制及早期干预的较理想的动物模型。     

羟基红花黄色素A抑制脂多糖诱导的急性肺损伤小鼠炎症因子表达的研究

目的探讨羟基红花黄色素A(HSYA)是否可抑制肺部炎症信号转导通路的相关环节。方法以脂多糖(LPS)腹腔注射法建立急性肺损伤模型。将84只雄性昆明鼠随机分为7组,每组12只,包括空白组、LPS组、地塞米松(DXM)组(LPS+DXM)、HSYA低剂量组(LPS+HSYA6 mg/kg)、HSYA中剂量组(LPS+HSYA 15 mg/kg)、HSYA高剂量组(LPS+HSYA 37.5 mg/kg),以及HSYA对照组(生理盐水+HSYA 37.5 mg/kg)。采用ELISA法测小鼠血清中肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)及IL-6水平;RT-q PCR法检测肺组织Toll样受体4(TLR4)mRNA的表达,Western blot法检测肺组织TLR4蛋白的表达。结果 HSYA在浓度分别为6、15、37.5 mg/kg时均可抑制脂多糖诱导的急性肺损伤小鼠肺组织中TLR4 mRNA和蛋白的表达,以及外周血中TNF-α、IL-1β及IL-6蛋白的表达,且抑制效应随着HSYA剂量升高而增强。DXM抑制效应强于HSYA。结论HSYA对LPS诱导的小鼠急性肺损伤中TLR4、TNF-α、IL-1β及IL-6表达升高有抑制作用,且呈现一定的量效趋势,但其抑制效应弱于DXM。     

N-乙酰半胱氨酸对感染性休克小鼠肺损伤保护作用的研究

目的探讨N-乙酰半胱氨酸（NAC）能否通过抗氧化应激、抗炎作用,起到减轻感染性休克小鼠肺损伤的作用。方法采用随机数字表法将30只小鼠分为对照组、模型组和NAC干预组3组,每组10只。模型组和NAC干预组腹腔注射脂多糖（LPS）（25mg/kg,溶于0.2ml0.9%氯化钠注射液）制备内毒素诱发感染性休克模型,对照组则腹腔内注射等量0.9%氯化钠注射液。NAC干预组注射LPS后即刻腹腔注射NAC（300mg/kg,溶于0.2ml0.9%氯化钠注射液）,而对照组和模型组腹腔注射等量0.9%氯化钠注射液。6h后处死小鼠,光镜下观察肺组织形态学变化,并进行肺组织病理损伤评分。采用ELISA法测定肺组织中炎症介质IL-6、TNF-α水平,采用比色法测定肺组织中氧化应激产物丙二醛（MDA）含量和抗氧化酶超氧化物歧化酶（SOD）活性。结果与对照组比较,模型组和NAC干预组小鼠肺组织病理损伤评分、IL-6、TNF-α水平、MDA含量均升高,SOD活性降低（均P＜0.05）;与模型组比较,NAC干预组小鼠肺组织病理损伤评分、IL-6、TNF-α水平、MDA含量均降低,SOD活性升高（均P＜0.05）。结论NAC可减轻LPS诱导的感染性休克小鼠肺损伤的严重程度,使肺组织中抗氧化酶水平升高,而氧化应激产物和炎症介质水平降低。     

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.