缺血预处理对兔缺血再灌注心肌bcl-2,bax,p53基因表达的影响

目的 :探讨缺血预处理对兔在体心脏局部缺血再灌注过程中心肌细胞bcl 2 ,bax ,p5 3基因表达的影响。方法 :2 4只新西兰白兔随机分成 3组 (n =8) :假手术对照组 (P组 )、缺血再灌注对照组 (IR组 )、缺血预处理组(IP组 )。除P组外 ,其余两组均接受左冠脉前降支 3h阻断和 3h再灌注。IP组在 3h缺血前接受连续 3次每次缺血 5min ,再灌注 5min的预处理。取心肌缺血区边缘组织用流式细胞仪测凋亡指数 (AI)和bcl 2 ,bax ,p5 3基因的蛋白表达量。结果 :凋亡指数 ,IP组 ( 5 .85± 1.5 9) %较IR组 ( 13.83± 3.98) %显著减少 (P <0 .0 1)。bcl 2基因的蛋白表达量IP组高于IR组 ;bax ,p5 3基因的蛋白表达量IP组低于IR组。结论 :缺血预处理抑制缺血再灌注所致心肌细胞凋亡与上调bcl 2基因的蛋白表达 ,下调p5 3和bax基因的蛋白表达有关。     

丹参对大鼠急性心肌缺血再灌注时心肌细胞凋亡及凋亡相关基因表达的影响

目的　探讨丹参对大鼠急性心肌缺血再灌注时心肌细胞凋亡及凋亡相关基因表达的影响。方法　采用结扎大鼠左冠状动脉法制备心肌缺血 +再灌注模型 ,2 4只大鼠随机均分为 :①缺血再灌注 (IR)组 :缺血45min ,再灌注 1h ,滴注生理盐水 ;②丹参治疗 (DS)组 :缺血 45min ,再灌注 1h ,滴注丹参注射液 (5mg/kg ,制药厂生产 ) ;③假手术 (Sham)组 :行假手术 ,滴注生理盐水 ,分别采用地高辛随机引物法及免疫组织化学法检测心肌凋亡细胞、心肌细胞bax和bcl 2基因的蛋白表达情况。结果　缺血再灌注心肌细胞凋亡数量显著高于Sham组 (P <0 .0 1) ,DS组心肌细胞凋亡明显受到抑制 (P <0 .0 5 )。IR组和DS组bax、bcl 2基因蛋白表达均明显增加(P值均 <0 .0 1) ;丹参明显抑制bax基因表达 (P <0 .0 5 ) ,但对bcl 2基因表达无明显影响。结论　急性心肌缺血再灌注时心肌细胞调亡加剧 ,bax和bcl 2参与调控缺血再灌注时心肌细胞调亡 ,丹参可抑制调亡加速基因bax的表达 ,因而在缺血再灌注损伤心肌细胞凋亡的保护方面有一定价值。     

黄芪对缺血再灌注心肌细胞凋亡的影响

目的：探索黄芪对大鼠急性心肌炔血再灌注时心肌细胞凋亡及凋亡相关基因表达的影响。方法：采用结扎大鼠左冠状动脉法制备心肌缺血再灌注(IR)模型，分别以地高辛随机引物法及免疫组化法检测心肌凋亡细胞、心肌细胞bax、bcl—2基因的蛋白表达情况。结果：缺血再灌注心肌细胞凋亡数量显著高于假手术组(P＜0．01)，黄芪治疗组心肌细胞凋亡(P＜0．05)明显受到抑制。IR组和黄芪组bax和bcl--2基因蛋白表达均明显增加(P均＜0．01)，黄芪明显抑制bax基因表达(P＜0．05)，但对bcl—2基因表达无明显影响。结论：急性心肌缺血再灌注时心肌细胞凋亡加剧，bax、bcl—2参与了缺血再灌注时心肌细胞凋亡凋控，黄芪可抑制凋亡加速基因bax的表达，因而在缺血再灌注损伤心肌细胞凋亡的保护方面有一定价值。     

脑钠肽对缺血再灌注心肌细胞凋亡的影响

目的:探索脑钠肽(BNP)对大鼠急性心肌缺血再灌注时心肌细胞凋亡及凋亡相关基因表达的影响.方法:采用结扎大鼠左冠状动脉法制备心肌缺血再灌注(IR)模型.将大鼠随机分为三组,(1)假手术组(Sham组)行假手术,滴注生理盐水,观察时间同实验组;(2)缺血再灌注组(IR组):缺血45分钟,再灌注1小时,滴注生理盐水;(3)脑钠肽治疗组(BNP组):缺血45分钟,再灌注1小时,滴注BNP注射液.分别以地高辛随机引物法及免疫组化法检测心肌凋亡细胞、心肌细胞bax、bcl-2基因的蛋白表达情况.结果:缺血再灌注心肌细胞凋亡数量显著高于假手术组(P<0.01),脑钠肽治疗组心肌细胞凋亡(P<0.05)明显受到抑制.IR组和BNP组bax和bcl-2基因蛋白表达均明显增加(P均<0.01),BNP明显抑制bax基因表达(P<0.05),但对bcl-2基因表达无明显影响.结论:急性心肌缺血再灌注时心肌细胞调亡加剧,bax、bcl-2参与了缺血再灌注时心肌细胞调亡调控, BNP可抑制调亡加速基因bax的表达,因而在缺血再灌注损伤心肌细胞凋亡的保护方面有一定价值.     

牛磺酸对大鼠心肌缺血再灌注损伤心肌细胞凋亡的影响

目的　探讨牛磺酸对缺血再灌注损伤时心肌细胞凋亡的保护及初步机制。方法　采用在体结扎大鼠冠状动脉左前降支建立心肌缺血再灌注模型。以TUNEL法检测心肌凋亡细胞 ,免疫组化法分析心肌细胞Fas/FasL、Caspase 8及Caspase 3蛋白表达变化。荧光分析法测定Caspase 3活性。结果　凋亡组 (心肌缺血 1h ,再灌注 2 4h)心肌细胞凋亡指数为 (16 .3± 4 .5 2 ) ,较对照组 (0 .4 3± 0 .0 4 )有显著性升高 ,Fas/FasL及Caspase 3蛋白水平也均显著高于正常对照组 (P <0 .0 5 )。牛磺酸保护组的心肌细胞凋亡指数、Fas/FasL、Caspase 3蛋白水平及Caspase 3活性均显著性低于凋亡组。结论　牛磺酸对缺血再灌注损伤心肌细胞凋亡有较好的拮抗作用 ,其机制可能与降低Fas死亡受体通路中相关蛋白酶水平及其活性有关。     

灯盏花素对大鼠缺血-再灌注心肌细胞凋亡和bcl-2表达的影响

目的 :探讨灯盏花素 (breviscapine,BRE)对大鼠缺血 -再灌注 (ischemia/reperfusion ,I/R)心肌细胞凋亡和凋亡抑制基因bcl 2表达的影响。方法 :采用TUNEL法、免疫组化和原位杂交方法 ,观察I/R心肌细胞死亡和凋亡抑制基因的bcl 2表达。结果 :(1)灯盏花素组凋亡心肌细胞核数量及阳性心肌细胞核占总心肌细胞核数的百分比均明显少于I/R组 (P <0 0 5 ) ;(2 )灯盏花素组bcl 2蛋白 (mRNA)表达阳性的心肌细胞数及阳性心肌细胞占心肌细胞总数的百分比均明显高于I/R组 (P <0 0 1)。结论 :(1)灯盏花素能够显著减少大鼠I/R心肌细胞凋亡 ;(2 )灯盏花素通过上调凋亡抑制基因bcl 2的表达可能是其减少大鼠I/R心肌细胞凋亡的机制之一。     

P53、PCNA、bcl—2和bax与乳腺癌关系的实验研究

目的　研究P5 3蛋白 ,增殖细胞抗原 (PCNA) ,bcl 2 ,bax基因蛋白在乳腺浸润性导管癌中表达的相关性及预后的关系。方法　应用免疫组织化学ABC法检测乳腺浸润性导管癌组织P5 3蛋白和PCNA ,bcl 2 ,bax基因蛋白的表达。结果　死亡组P5 3蛋白阳性表达率 (32 / 35 )和PCNA指数 (PI) (5 6 .5± 2 6 .5 4) % ,明显高于存活组的P5 3蛋白阳性率 (31/ 6 5 )和PI(31.5± 2 6 .5 8) %。且两者表达与淋巴结转移和临床分期有显著关系。存活组bcl 2基因蛋白阳性表达率 (46 / 6 5 )明显高于死亡组bcl 2阳性表达率 (12 / 35 ) ,且bcl 2基因蛋白表达与淋巴结转移和临床分期呈负相关关系 ,而bax在死亡组的阳性率 (31/ 35 )显著高于存活组 (2 6 / 6 5 ) ,与淋巴结转移和临床分期呈正相关。结论　P5 3蛋白 ,PCNA ,bcl 2 ,bax表达对于估测患者预后有重要意义     

G-CSF后处理对大鼠缺血再灌注心肌细胞凋亡的影响

目的探讨粒细胞集落刺激因子(G-CSF)后处理对大鼠急性心肌缺血再灌注损伤(MIRI)细胞凋亡的影响及其可能机制。方法 SD大鼠48只随机分为假手术组(Sham组)、缺血再灌注组(I/R组)和G-CSF后处理组(G-CSF组),每组16只。在体缺血30min再灌注180min后,检测血清肌酸激酶(CK)、乳酸脱氢酶(LDH)的活性,采用三苯基氯化四氮唑(TTC)染色法测定各组心肌梗死面积,TUNEL法检测心肌细胞的凋亡情况并计算凋亡指数(Apoptosis Index,AI),免疫组化法检测Bcl-2、Bax蛋白的表达。结果 G-CSF组心肌梗死面积[(28.01±1.43)%]较I/R组[(41.82±1.22)%]显著缩小(P<0.01),CK、LDH的活性及心肌细胞的AI和Bax的表达明显降低(P<0.01),而Bcl-2的表达则明显上调(P<0.01)。结论在再灌注前应用G-CSF进行药物后处理明显减轻心肌缺血再灌注损伤,其机制可能与其调控Bcl-2/Bax的表达抑制心肌细胞凋亡有关。     

瑞舒伐他汀对心肌缺血再灌注损伤大鼠 心肌凋亡及相关基因表达的影响

目的 探讨瑞舒伐他汀对心肌缺血再灌注损伤（MIRI）大鼠心肌细胞凋亡及相关基因表达的影响。 方法 雄性Wistar 大鼠随机分为假手术组（Sham 组）、心肌缺血再灌注组（MIRI 组）、心肌缺血再灌注+ 瑞 舒伐他汀组（MIRI+R 组）,每组10 只。复制大鼠MIRI 模型,观察各组大鼠左心室舒张末压（LVEDP）,左 心室内压最大上升和下降速率（±dp/dtmax）;脱氧核糖核苷酸末端转移酶介导的缺口末端标记法检测大鼠 左心室心肌细胞的凋亡指数;免疫组织化学染色检测左心室心肌组织凋亡相关基因（Bcl-2、Bax）蛋白表达, RT-PCR 法检测Bcl-2、Bax mRNA 表达。结果 MIRI 组与Sham 组比较,大鼠LVEDP、心肌细胞凋亡指 数（AI）、Bax 蛋白及mRNA 的表达升高（P <0.05）,±dp/dtmax、Bcl-2 蛋白及mRNA 的表达、Bcl-2/Bax 比值下降（P <0.05）;与MIRI 组比较,MIRI+R 组大鼠LVEDP、AI、Bax 蛋白及mRNA 的表达降低（P <0.05）, ±dp/dtmax、Bcl-2 蛋白及mRNA 的表达、Bcl-2/Bax 比值升高（P <0.05）。结论 瑞舒伐他汀可降低心肌缺 血再灌注损伤引起的心肌细胞凋亡,具有良好的心肌保护作用。     

家兔心肌缺血再灌注后肺中bcl-2、bax表达的改变

目的　研究家兔心肌缺血再灌注后肺中bcl 2、bax的表达 ,探讨心肌缺血再灌注后对肺组织的损伤。方法　建立心肌缺血再灌注模型 (缺血 30min ,再灌注 6 0min) ,于再灌注结束后检测血清中SOD、MDA含量 ,用免疫组织化学SABC法观察肺中bcl 2和bax的表达情况。结果　家兔心肌缺血再灌注后血清中SOD浓度减少 ,MDA浓度升高。bcl 2、bax免疫阳性细胞主要位于肺组织中血管内皮细胞和肺泡上皮细胞 ,正常时两者微量表达。再灌注 6 0min后两者光密度值均明显上升 ,但两组bcl 2光密度值没有统计学差别 ,而bax光密度值差别显著 (P <0 .0 5 )。结论　家兔心肌缺血再灌注后引起bcl 2、bax阳性细胞在肺组织中的表达变化并可能引起肺组织细胞凋亡和损伤。     

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.     

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.     

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.     

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.