急性甲醇中毒大鼠模型及其眼部改变的研究

 【目的】探讨急性甲醇中毒大鼠模型的制作方法及其眼部改变，为研究中毒后视功能损害及救治方法建立基础。【方法】SD大鼠32只，随机分为A（低剂量甲醇组）、B（高剂量甲醇组）、C（生理盐水对照组）、D（空气对照组）4组，每组8只。A、B组吸入N2O／O2混合气及不同剂量甲醇灌胃，C组吸入N2O／O2混合气及生理盐水灌胃，D组置于正常空气中并按B组剂量给予甲醇灌胃，观察各组大鼠一般情况、体质量及眼部改变、静脉血甲醇浓度、视网膜电图和视网膜组织学改变。【结果】染毒大鼠反应迟钝、运动失调，视盘充血水肿、视网膜点状出血，A组大鼠体质量为（187±12）g，B组为（176±131g，较C、D对照组显著减轻（P〈0．05）；A组视网膜电图a、b波振幅分别为（87±13）μV、（187±38）μV，B组a、b波振幅分别为（53±19）μV、（132±39）μV，与对照组相比明显下降（P〈0．05）；视网膜在光镜下表现为各层细胞水肿、排列紊乱及空泡化；电镜下细胞凋亡，线粒体肿胀、嵴断裂；B组动物上述改变尤其明显。【结论】吸入N2O/O2混合气及甲醇灌胃可建立急性甲醇中毒的大鼠模型，出现典型的视网膜结构和功能改变。     

银杏内酯B对谷氨酸诱导视网膜神经细胞凋亡的影响

【目的】探讨银杏内酯B拮抗谷氨酸诱导的体外培养新生大鼠视网膜神经细胞凋亡作用及其可能的机制。【方法】MTT法检测不同浓度谷氨酸对原代培养sD大鼠视网膜神经细胞的兴奋性毒性作用。细胞分为正常组、谷氨酸组和不同浓度（10、50、100μmol／L）银杏内酯B治疗组（n=6）。MTT法检测不同浓度的银杏内酯B对谷氨酸诱导凋亡的视网膜神经细胞存活率的影响。流式细胞仪结合AnnexinV／PI检测细胞凋亡率，JC-1染色检测线粒体膜电位。【结果】100μmol／L谷氨酸作用下，视网膜神经细胞的吸光度值降低至0．50±0．07，凋亡率为52．4％，JC-1的红／绿比值为1．77。10～100μmol／L银杏内酯B作用下神经细胞的吸光度值分别为0．52±0．09、0．64±0．15和0．74±0．11，细胞的凋亡率分别下降至36．7％，12．4％和2．1％，JC-1的红／绿比值则分别上升为1．898、2．089、2．276（P〈0．05）。【结论】银杏内酯B可以拮抗谷氨酸诱导的视网膜神经细胞凋亡。其作用机制可能与提高线粒体膜机能有关。     

左旋精氨酸恢复肺动脉高压一氧化氮和氧自由基的平衡

【目的】探讨左旋精氨酸（l-Arg）对大鼠中期肺动脉高压（PH）的防治作用及机理。【方法】将18只雄性SD大鼠随机分为3组,对照组（C组,n=6）、PH组（M组,n=6）、l-Arg＋PH组（L组,n=6）。于M组和L组用野百合碱（MCT）一次腹膜腔注射诱导PH模型,L组每天进行腹膜腔注射l-Arg。21d后用右心导管法测定右心室收缩压（RVSP）;用化学比色法检测血浆中一氧化氮（NO）水平;用Hydroethidine进行肺灌注测量肺组织氧自由基（O2^.-）的产量。【结果】M组RVSP（31±5）mmHg明显高于C组（12±5）mmHg,而L组（23±5）mmHg比M组有所下降。血浆NO水平M组（11±7）μmol/L比C组（24±6）μmol/L低,而L组（22±12）μmol/L恢复到近C组水平。肺组织O2^.-含量M组（41±5）U明显高于C组（18.1±1.0）U,L组（27±3）U介于C组与M组之间。【结论】在PH中NO与O2^.-的平衡被打破,l-Arg可恢复PH中NO与O2^.-的平衡,这可能是L-Arg降低肺动脉压力的原因。     

慢速冷冻和玻璃化冷冻对人类卵巢组织中卵泡形态的影响

【目的】比较慢速冷冻、麦管玻璃化冷冻和尼龙网玻璃化冷冻对人类卵巢组织中卵泡形态的影响。【方法】16例人卵巢组织切成薄片随机分配到新鲜卵巢组（A组1、麦管玻璃化冷冻组（B组）、尼龙网玻璃化冷冻组（C组）和慢速冷冻组（D组）后行组织学和电镜检查。【结果】A、B、C、D组中形态正常的原始卵泡比例分别为72．5％±8．4％、65．6％±12．8％、66．1％±11．1％、48．4％±13．3％；形态正常的初级卵泡比例分别为62．0％±13．9％、58．1％±7．9％、59．0％±16．2％、37．0％±14．0％。D组中形态正常的原始卵泡比例和初级卵泡比例均明显低于A、B、C组。B、C组形态正常的原始卵泡比例和初级卵泡比例。与A组相比无统计学差异。B、C组中形态正常的原始卵泡超微结构无明显改变，D组中形态正常的原始卵泡超微结构存在一定程度的改变。【结论】玻璃化冷冻是人类卵巢组织较适宜的冷冻保存方法。     

改变组织醛固酮及其受体表达对SHR大鼠肾脏纤维化的影响

【目的】观察改变肾组织醛固酮及其受体水平对自发性高血压大鼠肾脏纤维化的影响。【方法】8周龄的雄性自发性高血压大鼠（SHR）24只及同源正常京都大鼠（WKY）8只，SHR分为贝那普利干预组[30ing／（kg·d）]、大剂量安体舒通干预组[100mg／（kg·d）]和高血压模型对照组，同时设同源的正常对照组，干预时间为8周，检测收缩压、尿蛋白、血白蛋白、尿素氮、肌酐、肾组织醛固酮受体、TGF-β1的mRNA和蛋白表达。【结果】贝那普利能下调组织醛固酮【（15．8±2．6）vs（22．2±0．6）pg／mg]及其受体水平【（15±4）vs（13±5）PU]并减轻肾脏纤维化[（17．0±1．8）vs（20．0±2．3）PU]，均为P〈0．05；大剂量安体舒通能上调组织醛固酮[（24．3±4．6）vs（22．2±0．6）pg／mg]及其受体水平[（16±6）vs（13±5）PU]并加重肾脏纤维化[（22．6±3．0）vs（20．0±2．3）PU]，均为P〈0．05。【结论】肾组织醛固酮及其受体水平的改变可能影响高血压肾脏纤维化的过程。     

联合免疫治疗对重症肌无力术后危象发生的影响

【目的】观察术后预防性应用甲基强的松龙，环磷酰胺（CTX）NN~球蛋白联合免疫治疗对重症肌无力患者行胸腺切除术后危象发生的影响。【方法】选择具有高危因素的60例重症肌无力患者并随机分成A（联合免疫治疗）和B（对照）两组，观察两组术后危象的发生情况。【结果】两组的临床基础资料无显著差异（P〉0.05）。A组术后危象发生率（6．7％）明显少于B组的危象发生率（26．7％）（P〈0．05）。发生危象的患者中A组呼吸机使用时间平均为（6．25±6．28）d，B组平均为（24．20±26．38）d．A组患者使用呼吸机时间明显短于B组（P〈0.05）。A组患者平均ICU住院时间为（3．25±2．35）d，B组患者平均ICU住院时间为（9．87±6．56）d，A组患者的ICU住院时间明显短于B组患者（P〈0.05）。【结论】术后预防性的联合免疫疫治疗有助于减少术后危象的发生率和缩短危象的持续时间。     

不停跳心内直视手术对心肌细胞凋亡的影响

【目的】评价不停跳体外循环心内直视手术对心肌细胞凋亡的影响和探讨其临床意义。【方法】停跳心内直视手术患者25例（A组）,不停跳心内直视手术患者20例（B组）,取心肌组织作TUNEL细胞凋亡检测,比较分析术前和术后心肌细胞凋亡率并参照围手术期肌钙蛋白T（cTnT）检测。【结果】两组患者均无低心输出量综合征的发生。心肌细胞凋亡指数A组（0.003±0.002）和B组（0.004±0.003）术前无明显差别（P〉0.05）;术后心肌细胞凋亡指数A组（0.012±0.008,P〈0.001）和B组（0.006±0.004,P〈0.001）均高于术前;A、B两组术后心肌细胞凋亡指数差别有明显差别（P〈0.05）。围手术期cTnT水平A组在CPB末和术后2 h明显高于B组（P〈0.05）。【结论】本实验提示不停跳体外循环心内直视手术引起心肌细胞凋亡和心肌损害小于停跳手术。     

骨形态发生蛋白-4对人始基卵泡的作用

【目的】观察骨形态发生蛋白-4（BMP-4）对人卵巢组织体外培养中始基卵泡存活和生长发育的影响。【方法】34例卵巢组织切成2mm×2mm×1mm皮质片，每例标本的皮质片均随机分成3组：研究组（BMP-4组）、对照组和非培养组，培养15d后行组织学检查、雌孕激素测定和凋亡分析。【结果】培养结束后对照组和研究组始基卵泡比例分别为58％±35％和48％±40％，低于非培养组（91％±9％），P〈0．05；窦前卵泡比例分别为52％±40％和42％±35％，高于非培养组（9％±9％），P〈0．05。研究组间质细胞凋亡指数和培养液孕激素浓度分别为（0．16±0．08）μg／L和（3．6±2．0）μg／L，低于对照组，对照组分别为（0．41±0．16）μg／L和（6±4）μg／L（P〈0．05）。【结论】BMP-4可以促进始基卵泡向窦前卵泡转化，降低细胞凋亡率，抑制孕激素分泌，是卵泡生长发育过程中的促进因子。     

各期慢性阻塞性肺疾病患者诱导痰细胞成分与肺功能的关系

【目的】比较不同时期慢性阻塞性肺病（COPD）患者诱导痰中细胞组成的变化，及其诱导痰中细胞成分尤其中性粒细胞百分比与气流受限的关系。【方法】对110例COPD患者[急性加重期COPD（AECOPD）患者（A1组）62例、稳定期COPD患者（B组）48例]及30例健康对照者（C组）进行肺功能测定及痰诱导，痰液处理后沉渣作细胞学分析。其中AECOPD组在治疗1周后（A2组）再次进行上述指标的测定。【结果】140例受试者中有21例因不能耐受痰诱导过程或痰标本不合格而退出研究，最终有119例受试者完成本研究（A。2组48例，B组43例，C组28例）。A，组、A2组、B组、C组诱导痰中细胞总数（106／mL）分别为（8．8±3．7）、（6．5±2．6）、（5．0±2．8）、（2．8±1．3），细胞分类中A。组、A2组、B组以中性粒细胞为主，分别为66％’15％、60％±10％、55％±11％，而在C组中则以巨噬细胞、中性粒细胞为主。分别为37％±10％、32％±8％；AECOPD患者（A1组、A2组）诱导痰中性粒细胞百分比与肺功能指标（FEV1、FEV1％pre、FVC、FEV1/FVC）呈负相关（r分别为-0．860、-0．682、-0．662、-0．300，P〈0．001）；稳定期组（B组）中性粒细胞与FEV1、FEV1％pre负相关（r分别为-0．346、-0．421，P〈0．05），对照组中性粒细胞与肺功能无相关性（P〉0．05）。【结论】AECOPD、缓解期、稳定期患者诱导痰细胞以中性粒细胞为主，健康者诱导痰细胞以巨噬细胞为主；气道局部中性粒细胞增多与各期COPD患者气流受限存在密切的关系。     

核因子-κB对TNF-α诱导的脂肪细胞葡萄糖转运蛋白4表达的影响

【目的】观察TNF-α对3T3-L1脂肪细胞葡萄糖转运蛋白4（GLUT4）mRNA与蛋白表达的作用,并探讨核因子-κB（NF-κB）对上述作用的影响。【方法】成熟的3T3-L1脂肪细胞分成3组：A组正常对照组,B组肿瘤坏死因子α（TNF-α）组,C组吡咯烷二硫基甲酸酯（NF-κB活性抑制剂）＋TNF-α组。各组干预48h后检测phospho-NF-κBp65（Ser536）的蛋白水平、GLUT4mRNA及蛋白水平。蛋白检测采用Western法,mRNA检测采用RT-PCR法。【结果】B组phospho-NF-κBp65蛋白水平（71.1±5.9）高于A组（41.3±1.7,P〈0.001）和C组（25.4±4.7,P〈0.001）。B组GLUT4的mRNA水平（0.86±0.14,P〈0.001）与蛋白水平（31.6±7.2,P〈0.001）低于A组（2.01±0.65;60.7±8.4）,C组mRNA水平（0.46±0.12）与B组比较有下降趋势但无统计学意义（P=0.100）,C组蛋白水平（9.5±3.0）低于B组（P=0.001）。【结论】TNF-α下调3T3-L1脂肪细胞的GLUT4表达,抑制NF-κB活性后GLUT4表达进一步下调。这提示了TNF-α可能不是通过激活NF-κB而使GLUT4的表达下调。     

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.     

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.     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.