基于microRNA-92a-3p靶向SIRT1调控氧糖剥夺再灌注诱导脑微血管内皮细胞炎症反应的作用机制研究

目的 探讨基于microRNA-92a-3p（miR-92a-3p）靶向调控SIRT1氧糖剥夺再灌注（OGD/R）诱导小鼠脑微血管内皮细胞（bEnd.3）炎症反应的作用机制。方法 实时荧光定量聚合酶链反应（qRT-PCR）测定miR-92a-3p、SIRT1、肿瘤坏死因子α（TNF-α）、白细胞介素1β（IL-1β）mRNA的表达；Western blotting明确SIRT1、核转录因子-κB（NF-κB）p65、磷酸化NF-κB（p-NF-κB）p65、TNF-α和IL-1β蛋白的表达；双荧光素酶报告基因验证miR-92a-3p与SIRT1靶向关系；划痕实验检测bEnd.3细胞的迁移能力。结果 OGD/R组miR-92a-3p相对表达量较对照组升高（P <0.05）。M_SIRT1 WT+mimics+TK组荧光素酶活性较M_SIRT1 WT+mimics NC+TK组低（P <0.05）。OGD/R组SIRT1蛋白和mRNA相对表达量较对照组降低（P <0.05），OGD+92a抑制剂组较OGD+92a抑制剂内参组升高（P <0.05）。miR-92a-3p模拟物组NF-κBp65/p-NF-κBp65蛋白较模拟物内参组高，SIRT1蛋白和mRNA表达较模拟物内参组低（P <0.05）。miR-92a-3p模拟物组IL-1β、TNF-α蛋白和mRNA相对表达量较模拟物内参组高（P <0.05）。miR-92a-3p模拟物组伤口愈合率较模拟物内参组低（P <0.05）。结论 miR-92a-3p通过靶向抑制SIRT1表达，促进OGD/R诱导的脑微血管内皮细胞炎症反应。     

妊娠糖尿病患者血清microRNA-21调节Bcl-2/Caspase-9对滋养层细胞生物学行为的影响

目的 探讨妊娠糖尿病（GDM）患者血清microRNA-21（miR-21）表达变化及其对滋养层细胞生物学行为的作用机制。方法 选取2019年1月—2020年10月三亚市妇幼保健院收治的66例GDM孕妇及同期体检且孕周相近的38例健康孕妇作为研究对象。采用实时荧光定量聚合酶链反应（qRT-PCR）检测血清miR-21 mRNA表达水平,microRNA转染JAR细胞系构建Control、miR-21 NC、miR-21、miR-21 inhibitor NC和miR-21 inhibitor组细胞。采用CCK-8法检测细胞活力,Brdu检测细胞增殖,Matrigel侵袭实验检测细胞侵袭,TUNEL法检测细胞凋亡;采用Western blotting检测Bcl-2、Bax、Cleaved-Caspase 9、E-cadherin及Vimentin蛋白表达。结果 研究组患者miR-21 mRNA相对表达量及FPG、HbA1c水平较对照组高（P <0.05）。miR-21组细胞miR-21 mRNA相对表达量高于Control组（P <0.05）,miR-21 inhibitor组细胞 mRNA相对表达量低于Control组（P <0.05）。CCK-8法检测结果显示,miR-21组细胞活力较Control组下调（P <0.05）,miR-21 inhibitor组细胞活力较Control组上升（P <0.05）。miR-21组细胞增殖能力较Control组减弱（P <0.05）,miR-21 inhibitor组细胞增殖能力较Control组增强（P <0.05）。miR-21组细胞凋亡率较Control组升高（P <0.05）,miR-21 inhibitor组细胞凋亡率较Control组降低（P <0.05）。miR-21组的穿膜细胞数低于Control组（P <0.05）,miR-21 inhibitor组的穿膜细胞数高于Control组（P <0.05）。相较于Control组,miR-21组E-cadherin表达上调,Vimentin表达下调（P <0.05）,miR-21 inhibitor组E-cadherin表达下调,Vimentin表达上调（P <0.05）。相较于Control组,miR-21组Cleaved Caspased-9、Bax蛋白相对表达量上升,Bcl-2蛋白相对表达量下降（P <0.05）;miR-21 inhibitor组Caspased-9、Bax蛋白相对表达量下降,Bcl-2蛋白相对表达量上升（P <0.05）。结论 GDM孕妇存在miR-21高表达,miR-21可通过调节Bcl-2/Caspase-9介导对滋养层细胞增殖、侵袭的抑制作用,继而促进细胞凋亡。     

血清剥夺抑制心肌细胞增殖、促进凋亡及对P53和Wnt/β-catenin信号通路的影响

目的 研究血清剥夺对心肌细胞增殖和凋亡的影响及其机制。方法 将人心肌细胞AC16分为血清剥夺组（细胞在无胎牛血清的DMEM培养液中培养48 h）、对照组（细胞在含10%胎牛血清的DMEM培养液中培养48 h）。采用CCK-8法检测心肌细胞活力,EdU实验法检测细胞DNA合成水平,流式细胞术检测细胞凋亡水平及线粒体膜电位变化,蛋白质印迹分析检测心肌细胞中caspase-9、Bcl-2、P53、增殖细胞核抗原（PCNA）、cyclin D1、β-连环蛋白（β-catenin）、Wnt5a、Axis抑制蛋白1（Axin1）、蓬乱蛋白2（Dvl2）、蓬乱蛋白3（Dvl3）、低密度脂蛋白受体相关蛋白6（LRP6）的表达水平。结果 CCK-8实验结果显示对照组的光密度值为1.93±0.01,血清剥夺组的光密度值为1.08±0.08,后者为前者的55.8%,两组比较差异有统计学意义（P<0.01）;细胞DNA合成受到抑制,血清剥夺组细胞DNA合成水平下降为对照组的65.6%,两组比较差异有统计学意义（P<0.05）。血清剥夺诱导了心肌细胞的凋亡,对照组凋亡率为（6.34±0.47）%,血清剥夺组凋亡率为（56.83±1.90）%,后者为前者的8.9倍,两组比较差异有统计学意义（P<0.01）;血清剥夺组心肌细胞线粒体膜电位下降,但与对照组比较差异无统计学意义（P>0.05）。蛋白质印迹分析结果显示,血清剥夺促进了心肌细胞中caspase-9蛋白的表达,同时抑制了心肌细胞中Bcl-2、P53、PCNA、cyclin D1蛋白的表达;血清剥夺抑制了心肌细胞中β-catenin、Wnt5a、Axin1、Dvl2、Dvl3、LRP6蛋白的表达。结论 血清剥夺可抑制心肌细胞增殖并促进细胞凋亡,其机制可能与抑制Wnt/β-catenin信号通路有关。     

MicroRNA-126对类风湿性关节炎滑膜成纤维细胞增殖、侵袭、凋亡的作用及其机制研究

目的 探究microRNA-126（miR-126）通过靶向Dickkopf-1（DKK1）参与类风湿性关节炎滑膜成纤维细胞（RASFs）增殖、侵袭、凋亡的机制研究。方法 选取2018年6月—2019年9月在武汉市第一医院就诊的25例类风湿性关节炎（RA）患者的滑膜组织（RA组）,同时收集在该院同期接受膝关节十字韧带断裂重建手术的21例非类风湿关节炎患者的滑膜组织作为健康组,检测其miR-126和DKK1蛋白。利用RA组织构建原代RASFs,通过双萤光素酶报告验证miR-126与DKK1的靶向关系。将RASFs分为对照组、miR-126组、DKK1组、miR-126+DKK1组。采用CCK-8、Transwell及流式细胞术检测过表达miR-126和/或DKK1对RASFs增殖、侵袭和凋亡的影响。结果 RA组滑膜组织miR-126相对表达量低于健康组（P <0.05）,而DKK1蛋白相对表达量高于健康组（P <0.05）。miR-126 mimic与DKK1 Wt共转染后的相对萤光素酶活性低于miR-126 NC质粒与DKK1 Wt共转染（P <0.05）,证明miR-126与DKK1靶向结合。miR-126组RASFs增殖力和侵袭细胞数低于对照组（P <0.05）,而凋亡率高于对照组（P <0.05）。DKK1组RASFs增殖力和侵袭细胞数高于对照组（P <0.05）,而凋亡率低于对照组（P <0.05）。miR-126+DKK1组增殖力和侵袭细胞数高于miR-126组（P <0.05）,而低于DKK1组（P <0.05）;miR-126+DKK1组凋亡率低于miR-126组（P <0.05）,而高于DKK1组（P <0.05）。结论 miR-126在RA滑膜组织中低表达,miR-126可通过靶向DKK1抑制RASFs增殖、侵袭及凋亡。     

MicroRNA-27b在高血压脑出血大鼠脑组织中的表达及对星形胶质细胞生物学功能的影响

目的 探讨microRNA-27b（miR-27b）在高血压脑出血（HICH）大鼠脑组织中的表达及对星形胶质细胞生物学功能的影响。方法 选取15只健康WKY大鼠作为对照组,15只自发性高血压大鼠作为HICH组。HICH组通过自体血脑内注射法复制HICH大鼠模型,对照组进行假手术但不注射自体血。HE染色和TUNEL染色检测大鼠脑组织损伤和凋亡情况,实时荧光定量聚合酶链反应（qRT-PCR）检测miR-27b mRNA相对表达量。将星形胶质细胞分为NC组、miR-27b mimic组及miR-27b inhibitor组,分别转染miR-27b mimic和miR-27b inhibitor质粒,过表达和抑制miR-27b水平。qRT-PCR检测各组细胞miR-27b mRNA相对表达量,CCK-8法检测各组细胞增殖及凋亡情况。结果 HICH组大鼠出血脑组织出现显著损伤,凋亡指数（35.91±3.24）高于对照组（2.75±0.36）（P <0.05）;HICH组miR-27b mRNA相对表达量（3.45±0.48）高于对照组（1.00±0.12）（P <0.05）;miR-27b mimic组的miR-27b mRNA相对表达量高于NC组,增殖活力低于NC组,凋亡率高于NC组（P <0.05）。miR-27b inhibitor组的miR-27b mRNA相对表达量低于NC组,增殖活力高于NC组,凋亡率低于NC组（P <0.05）。结论 miR-27b mRNA相对表达量在HICH大鼠脑组织中显著升高,并抑制星形胶质细胞的增殖,促进星形胶质细胞凋亡。     

黄酒多酚诱导沉默调节蛋白3表达减轻阿霉素心肌损伤研究

背景 阿霉素（DOX）是一种常见的强效蒽环类抗肿瘤药物,被广泛应用于各类肿瘤尤其是实体性肿瘤的治疗中。然而,DOX有较强的心脏毒性,临床表现为不可逆性心肌病和充血性心力衰竭。黄酒多酚（YWPC）是从绍兴黄酒中提取的多酚类物质,具有抗炎、抗氧化等生理活性,对DOX所致心肌损伤有一定缓解作用,但其作用机制还不明晰。 目的 通过体内外实验探讨YWPC减轻DOX心肌损伤的作用机制。 方法 动物实验：使用SD大鼠建立DOX心肌损伤模型,分为对照组、YWPC组、DOX组与DOX+YWPC组;取心脏组织进行MASSON染色、原位末端标记（TUNEL）染色及免疫组织化学染色,取血清测定乳酸脱氢酶（LDH）水平,并用动物组织蛋白、Western Blot法检测凋亡水平〔B淋巴细胞瘤-2蛋白（Bcl-2）、Bcl-2相关X蛋白（Bax）〕及沉默调节蛋白3（SIRT3）表达水平变化。体外实验：通过1 μmol/L DOX干预H9C2细胞24 h建立DOX诱导H9C2细胞损伤模型,先将一批H9C2细胞分为对照组、DOX组、DOX+YWPC（1 mg/L）组、DOX+YWPC（10 mg/L）与DOX+YWPC（100 mg/L）5组,采用CCK-8法检测H9C2细胞活力,通过Western Blot法检测凋亡水平及SIRT3表达水平变化;之后将另一批H9C2细胞分为对照组、DOX组、DOX+YWPC组、DOX+SIRT3抑制剂（3-TYP）组及DOX+YWPC+3-TYP组,通过3-TYP抑制SIRT3蛋白活性,通过Western Blot法检测凋亡水平及SIRT3表达水平变化,进一步明确SIRT3在YWPC减轻DOX心肌损伤中的作用。 结果 动物实验中,大鼠心肌切片通过MASSON染色后可见：DOX组大鼠心肌纤维排列紊乱,大量蓝色胶原纤维贯穿心肌纤维;DOX+YWPC组大鼠心肌切片纹理部分恢复,蓝色胶原纤维减少。DOX组胶原纤维占比、血清LDH水平高于对照组、DOX+YWPC组（P<0.05）。DOX组Bcl-2/Bax比值、SIRT3表达水平低于对照组、DOX+YWPC组（P<0.05）;DOX组大鼠心肌切片中代表凋亡的绿色亮点明显增多,呈片状分布,而经YWPC治疗后凋亡亮点减少。体外实验中,DOX组吸光度值、Bcl-2/Bax比值、SIRT3表达水平低于对照组、DOX+YWPC（1 mg/L）组、DOX+YWPC（10 mg/L）组、DOX+YWPC（100 mg/L）组（P<0.05）,DOX组、DOX+3-TYP组Bcl-2/Bax比值、SIRT3表达水平低于对照组（P<0.05）;DOX+YWPC+3-TYP组Bcl-2/Bax比值低于DOX+YWPC组（P<0.05）,DOX+YWPC组与DOX+YWPC+3-TYP组SIRT3表达水平比较,差异无统计学意义（P>0.05）。 结论 YWPC可以通过调节SIRT3表达水平减轻DOX心肌损伤,抑制SIRT3会降低YWPC的作用。     

MicroRNA-137通过Wnt信号通路对宫颈癌细胞增殖、凋亡及裸鼠移植瘤的作用研究

目的 探究microRNA-137（miR-137）通过Wnt信号通路对人宫颈癌细胞HeLa的增殖与凋亡,以及对裸鼠移植瘤的作用。方法 将人宫颈癌细胞HeLa分别转染miR-137-mimic质粒（miR-137组）和空载质粒（NC组）,另设空白组只加入等量转染试剂不做其他处理。待细胞稳定转染后,采用CCK-8法检测细胞活性。采用流式细胞仪检测细胞凋亡。采用实时荧光定量聚合酶链反应（qRT-PCR）检测Wnt、基质金属蛋白酶-7（MMP-7）、分泌型蛋白Dickkopf-1（DKK1）、miR-137 mRNA相对表达量;采用Western blotting检测Wnt、MMP-7、DKK1蛋白的相对表达量。将稳定转染的细胞接种于裸鼠背部,观察裸鼠移植瘤的生长情况,绘制生长曲线并计算抑瘤率。结果 空白组、NC组、miR-137组12 h、24 h、48 h的OD值比较,采用重复测量设计的方差分析,结果 ①不同时间点的OD值有差异（P <0.05）;②3组的OD值有差异（P <0.05）,miR-137组OD值较空白组和NC组低,相对细胞活性较低;③3组OD值的变化趋势有差异（P <0.05）。miR-137组细胞凋亡率高于空白组和NC组（P <0.05）。miR-137组细胞Wnt和MMP-7 mRNA相对表达量较空白组和NC组降低（P <0.05）;miR-137组细胞DKK1和miR-137 mRNA相对表达量较空白组和NC组升高（P <0.05）。miR-137组细胞Wnt、MMP-7蛋白相对表达量较空白组和NC组降低（P <0.05）;miR-137组细胞DKK1蛋白相对表达量较空白组和NC组升高（P <0.05）。NC组裸鼠移植瘤的抑瘤率与miR-137组比较,差异有统计学意义（P <0.05）,miR-137组裸鼠移植瘤的抑瘤率增加。空白组、NC组、miR-137组裸鼠不同时间点的肿瘤体积比较,采用重复测量设计的方差分析,结果 ①不同时间点的肿瘤体积有差异（P <0.05）;②3组的肿瘤体积有差异（P <0.05）,miR-137组与空白组和NC组相比,肿瘤生长缓慢,相对抑瘤效果较好;③3组肿瘤体积的变化趋势有差异（P <0.05）。结论 在人宫颈癌细胞中过表达miR-137可以促进癌细胞凋亡,抑制癌细胞增殖,该作用可能与Wnt及其上下游MMP-7/DKK1信号通路有关。     

miR-138在肾脏缺血再灌注损伤中的作用及其机制

目的 观察miR-138在肾脏缺血再灌注损伤中的作用及其机制。方法 60只成年SD大鼠,随机分为假手术组（Sham组）、RIRI组、RIRI+空载体（vector）组、RIRI+miR-138（miR-138）组、RIRI+miR-138 shRNA（sh miR-138）组,每组15只,通过夹闭双侧肾蒂建立肾脏缺血再灌注组损伤模型。采用检测血清中肌酐、尿素氮比较各组肾功能差异、Tunel染色检测细胞凋亡、荧光定量PCR检测p53及下游基因变化等方法研究miR-138对肾脏缺血再灌注损伤的作用及其机制。结果 与假手术组比较,缺血再灌注组的肾脏功能BUN、Cr水平,凋亡水平均显著升高,差异有统计学意义（P<0.05）。上调miR-138后,以上指标均显著升高,且差异有统计学意义（P<0.05）,下调miR-138则保护肾脏缺血再灌注损伤;进一步研究发现miR-138可能通过抑制p53信号通路发挥作用。结论 miR-138对大鼠肾脏缺血再灌注损伤具有明显的加重作用,其机制可能与p53信号通路密切相关。     

神经肽Y/Y1受体激活β⁃catenin信号通路介导心肌细胞损伤

目的：研究神经肽Y（neuropeptide Y,NPY）/Y1受体信号转导在心肌细胞损伤中的作用及机制。方法：C57BL/6J小鼠皮下注射异丙肾上腺素（isoprenaline,ISO）构建心肌损伤模型,腹腔注射Y1受体特异性拮抗剂BIBO3304干预。小鼠随机分为对照组（生理盐水）、ISO组［20 mg/（kg·d）ISO］、BIBO3304+ISO组［0.1 mg/（kg·d）BIBO3304+20 mg/（kg·d）ISO］、BIBO3304组 ［0.1 mg/（kg·d）BIBO3304］,每组10只,连续给药14 d。实时定量PCR和Western blot检测小鼠心肌组织中NPY表达。HE染色和Masson染色观察各组小鼠心肌纤维结构变化和纤维化程度;定量PCR检测小鼠心肌肥大基因心房钠尿肽（atrial natriuretic peptide,ANP）、β-肌球蛋白重链（β-myosin heavy chain,β-MHC）mRNA表达。采用Y1受体特异性激活剂［Leu31,Pro34］-NPY刺激 H9C2 细胞,检测 ANP、β-MHC mRNA 表达;CCK-8 检测心肌细胞活力。Western blot 检测各组小鼠心肌组织和 H9C2 细胞中 active β-catenin、磷酸化糖原合成酶激酶-3β（phospho-glycogen synthesis kinase 3β,p-GSK3β）、总糖原合成酶激酶-3β（total glyco- gen synthesis kinase 3β,t-GSK3β）蛋白表达。免疫荧光染色检测心肌细胞β-catenin 入核情况。利用β-catenin 特异性抑制剂 ICG001处理细胞,检测［Leu31,Pro34］-NPY诱导的心肌细胞肥大和细胞活力变化。结果：与对照组比较,ISO组小鼠心肌组织 NPY mRNA 和蛋白表达均显著增加（P < 0.05）,心肌纤维排列紊乱,心肌纤维化程度高,心肌肥大基因表达增加。与 ISO 组比较,BIBO3304+ISO组小鼠心肌损伤和纤维化得到有效缓解,心肌肥大基因表达下降（P < 0.01）。与对照组比较,［Leu31, Pro34］-NPY 增加 H9C2 细胞 ANP、β-MHC mRNA 表达,降低心肌细胞活力（P < 0.01）。与对照组比较,ISO 组小鼠心肌组织 active β-catenin、p-GSK3β表达明显上调,p-GSK3β/t-GSK3β增加;与 ISO 组比较,BIBO3304+ISO 组心肌组织 active β-catenin、 p-GSK3β表达降低（P < 0.05）。与对照组比较,［Leu31,Pro34］-NPY 显著增加心肌细胞 active β-catenin、p-GSK3β表达（P < 0.05）,促进细胞核β-catenin 积累。与［Leu31,Pro34］-NPY 组比较,BIBO3304 抑制细胞核β-catenin 表达,ICG001 显著缓解 ［Leu31,Pro34］-NPY诱导的心肌细胞肥大和细胞活力下降（P < 0.01）。结论：NPY通过Y1受体转导激活β-catenin信号通路介导心肌细胞损伤和心肌纤维化。     

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.     

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.     

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.