参松养心胶囊对心室肌细胞钾通道的影响

目的观察参松养心胶囊干粉提取溶液对大鼠单个心室肌细胞内向整流钾电流(IK1)、瞬时外向钾电流(Ito)以及豚鼠心肌细胞延迟整流钾电流(Ik)的影响。方法用酶解法分离单个心室肌细胞,并用全细胞膜片钳记录技术。结果当药物浓度0.5%时,可以使大鼠心肌细胞IK1内向成分降低,使-100mV时IK1电流密度从(-10.8±1.8)pA/pF降至(-7.2±2.1)pA/pF,平均抑制率为(33.1±16.9)%(n=11,P<0.05),但不改变电流的翻转电位及整流特性。药物同时对Ito电流的瞬时成分有抑制作用,60mV时Ito电流密度从(-19.8±7.1)pA/pF降至(-10.0±3.9)pA/pF,平均抑制率为(50.6±10.8)%(n=6,P<0.05),稳态失活曲线左移,失活后恢复时间常数增大。药物浓度0.5%时,对Ik有电压依赖性抑制作用,50mV时对尾电流峰值的抑制率为(30.8±1.1)%(n=5,P<0.05)。结论参松养心胶囊干粉提取溶液对IK1,Ito和Ik均具有不同程度的阻滞作用。这种多离子通道阻滞作用不仅使参松养心胶囊具有广谱的抗心律失常疗效,减少致心律失常的副作用,对Ito的阻滞效应还将显示其独特的抑制2相折返的作用,值得对其作更深入和广泛的研究。     

卡维地洛对大鼠心室肌细胞Ito电流影响的实验研究

目的探讨卡维地洛对大鼠心室肌细胞瞬时外向钾电流(Ito)的作用.方法采用胶原酶酶解法分离得到大鼠单心室肌细胞;采用膜片钳全细胞技术记录灌流卡维地洛前后Ito电流的变化.结果灌流0.1 mM及1.0 mM卡维地洛后,Ito电流密度分别为(pA/pF)(5.06±1.98),(3.91±0.66),P＜0.05;不同去极化电压水平Ito电流值也有明显减小,Ⅰ-Ⅴ曲线向下方移位.结论卡维地洛对大鼠心室肌细胞Ito电流具有抑制作用,此抑制作用呈浓度依赖趋势.     

哇巴因诱发大鼠心律失常作用靶点的研究

目的　观察哇巴因对大鼠心室肌细胞动作电位时程、钾通道的作用 ,探讨哇巴因诱发心律失常的作用机制 ,为寻找新的抗心律失常药物提供依据。方法　应用全细胞膜片钳技术记录哇巴因对大鼠心肌细胞动作电位时程 (APD)、内向整流钾电流 (Ik1 )、瞬时外向钾电流 (Ito)的作用。结果　①哇巴因 5μmol/L使大鼠心室肌细胞动作电位时程从给药前的 86 .3ms± 2 5 .2ms(APD90 ) ,缩短至 58.9ms± 2 0 .8ms(n =5 ,P <0 .0 1 ,给药 1 0min) ;②哇巴因 5μmol/L可增加大鼠心室肌细胞内向整流钾电流 ,使Ik1 从 - 1 868pA± 1 88pA增加到 - 2 393pA± 367pA(刺激电压 - 1 2 0mV ,n=1 0 ,P <0 .0 1 ) ;③哇巴因 5μmol/L可增加大鼠心室肌细胞瞬时外向钾电流 ,使Ito从 1 2 73pA± 31 8pA增加到 1 70 7pA± 486pA(刺激电压 +60mV ,n =5 ,P <0 .0 1 )。结论　哇巴因诱发室性心律失常可能与它缩短心室肌细胞动作电位时程有关 ,而Ito的增加使二期平台期缩短 ,Ik1 的增加使三期复极加快 ,均参与了动作电位时程缩短的过程。同时增加Ik1 将影响静息膜电位 ,可能使膜反应性增强     

藻酸双酯钠对豚鼠心室肌细胞离子电流的作用

目的:观察藻酸双酯钠(Polysaccharide sulfate,PSS)对豚鼠单个心室肌细胞离子流的影响。方法:采用Ⅰ型胶原酶分离单个豚鼠心室肌细胞的方法,利用全细胞膜片箝记录技术,在不同箝制条件下,记录并分析了PSS对L-型Ca2+电流(ICa,L)、内向整流K+电流(IK1)的影响。结果:①PSS使ICa,L的激活时间常数变大,电流幅度减小,Ⅰ-Ⅴ曲线上移。在箝制电位为+10 mV时,PSS在6-9 min内使ICa,L的激活时间常数从(0.92±0.10)ms增加到了(1.15±0.11)ms(n=5,P<0.052);ICa,L的电流幅度从(16.80±1.71)pA/pF下降至(13.86±1.67)pA/pF(n=5,P<0.01)。②PSS可使IK1的内向成分和外向成分均增加。当箝制电位在-170 mV时,PSS能使IK1内向电流幅度从(224±16.17)pA／pF增加至(257±17.36)pA／pF(n=7,P<0.01);箝制电位在-50 mV时,PSS使IK1的外向电流幅度从(8.89±0.86)pA／pF增加至(10.38±1.18)pA／pF(n=7,P<0.05)。在反转电位附近时(-70--120 mV),PSS的作用不明显。PSS能使IK1的激活时间常数减小,当箝制电位在-160 mV时,激活时间常数从加药前的(1.05±0.11)ms减小到了加药后的(0.78±0.90)ms(n=7,P<0.01);同时,IK1的电导值变大,从(2.53±0.17)nS／pF增加到了(2.82 ±0.20)nS／pF(n=7,P<0.05)。结论:PSS对L-型Ca2+电流有抑制作用,对内向整?     

AngⅡ对人心房肌细胞膜钾通道电流的影响及替米沙坦的拮抗作用

目的: 观察AngⅡ对人心房肌细胞膜钾电流的作用,揭示其参与房性心律失常的电生理机制,为应用AngⅡ受体拮抗剂治疗房性心律失常提供实验基础.方法: 急性分离单个人心房肌细胞,采用全细胞膜片钳方法记录内向整流钾电流(Ik1)、短暂外向钾电流(Ito).实验分4组:对照组,AngⅡ(0.1 μmol/L)组,替米沙坦(0.01 μmol/L)组,AngⅡ 替米沙坦组.结果: 与对照组相比,0.1 μmol/L AngⅡ使人心房肌细胞膜Ito峰值电流密度明显下降(pA/pF, 6.55±0.52 vs 12.65±1.06,P＜0.01), 在-100mV电压下使IK1 峰值电流密度显著升高 (pA/pF, -9.31±1.02 vs -5.23±0.98, P<0.01).0.01 μmol/L替米沙坦对人心房肌细胞膜Ito IK1无明显影响,但可拮抗AngII的作用;AngⅡ 替米沙坦组的Ito峰值电流密度 (pA/pF,11.74±1.28 )和IK1 峰值电流密度(pA/pF, -6.13±1.15) 与AngⅡ组相比有显著差别(P＜0.01).结论: AngⅡ对人心房肌细胞具有明显的电生理学作用,0.1 μmol/L AngⅡ可促进人心房肌细胞膜IK1并抑制Ito,替米沙坦可拮抗AngⅡ对人心房肌细胞膜钾电流的作用.     

血管紧张素Ⅱ及替米沙坦对大鼠心房肌细胞钾和钙电流的影响

目的研究血管紧张素Ⅱ(AngⅡ)和替米沙坦对SD大鼠心房肌细胞瞬时外向钾电流(Ito)和L型钙电流(ICa-L)的作用。方法急性酶解法分离SD大鼠心房肌细胞,采用全细胞膜片钳技术,观察AngⅡ、替米沙坦以及AngⅡ联合替米沙坦对大鼠心房肌细胞Ito和ICa-L的影响。结果 AngⅡ(0.1μmol/L)和替米沙坦(0.01μmol/L)以及两药联合均能抑制大鼠心房肌细胞Ito,AngⅡ组、替米沙坦组、联合组干预前后Ito的电流密度值比较差异有统计学意义[(22.48±2.75)vs(15.71±2.06)pA/pF,(24.16±2.36)vs(16.15±1.82)pA/pF,(24.41±2.27)vs(21.35±1.46)pA/pF,P<0.05]。AngⅡ(0.1μmol/L)能显著增强大鼠心房肌细胞ICa-L的峰值电流密度[(-4.51±0.38)vs(-5.16±0.29)pA/pF,P<0.01];替米沙坦(0.01μmol/L)对心房肌细胞ICa-L无明显作用[(-4.35±0.27)vs(-4.29±0.34)pA/pF,P>0.05],但联合组中替米沙坦可拮抗AngⅡ对ICa-L的增强效...     

银杏叶提取物对家兔心室肌细胞瞬时外向钾电流和动作电位的影响

目的:探讨银杏叶提取物(Egb761)对家兔心室肌细胞瞬时外向钾电流(Ito)和动作电位的作用,揭示其抗心肌缺血及缺血引起的心律失常的离子机制。方法:酶解法分离家兔的心室肌细胞。全细胞膜片钳技术记录心肌细胞的Ito和动作电位及其被Egb761作用后的变化。结果:①在电压钳制方式下,60μg/L Egb761作用心室肌细胞5 min后,各个钳制电位下的Ito均明显增大,在钳制电位为+50 mV时,Egb761使Ito的电流密度由对照组的(7.59±0.19)pA/pF增加到(11.18±0.89)pA/pF(P<0.01,n=8),Egb761还使Ito的I-V曲线比对照组Ito的I-V明显抬高,但I-V曲线方向没有发生改变,表明Egb761引起了心肌细胞Ito的明显外流。②在电流钳制下,对照组心室肌细胞动作电位都具有从0期到4期的动作电位形态,60μg/L Egb761使心肌细胞动作电位形态呈三角形尖锥锋形,动作电位时程(APD)明显缩短,其复极化50%时程(APD50)和复极化90%时程(APD90)分别由(83.6±4.3)ms缩短为(51.3±3.2)ms和由(168.7±4.1)ms缩短为(93.8±4.4)ms(分别与对照组相比,P<0.01,n=8),尽管Egb761使动作电位幅度(APA)和静息电位(RP)降低,但与对照组相比,没有显著性差异(P>0.05)。结论:Egb761可使心室肌细胞Ito显著增加和APD明显缩短,从而减轻心肌缺血时细胞内阳离子超载对心肌造成的损伤和心肌缺血引起的心律失常的发生,以及增加心脏泵血功能。     

高浓度姜黄素对大鼠心室肌细胞瞬时外向钾电流和内向整流钾电流的影响

目的研究高浓度姜黄素对大鼠心室肌细胞瞬时外向钾电流(Ito)和内向整流钾电流(Ik1)的影响。方法采用急性酶解分离法获得大鼠心室肌细胞,以全细胞膜片钳技术记录Ito和Ik1,观察50μmol/L姜黄素对Ito和Ik1的影响。结果 50μm/L姜黄素对Ito和Ik1通道电流的抑制率分别是(84±11)%(P<0.05)和(59±8)%(P<0.01)。它使Ito和Ik1通道电流密度-电压曲线电流幅度减小,但不改变其整流特性。结论 50μmol/L姜黄素能明显抑制大鼠心室肌细胞Ito和Ik1电流,提示其可能存在心脏毒性作用。     

胡椒碱对H2O2所致兔心房肌细胞瞬时外向钾电流异常的保护作用

目的研究胡椒碱对H2O2引起的兔单个心房肌细胞瞬时外向钾电流(Ito)异常的保护作用。方法采用全细胞膜片钳技术分析50μmol/L的H2O2对兔单个心房肌细胞Ito的影响,并研究预先应用7μmol/L的胡椒碱对其的保护作用。结果 7μmol/L胡椒碱对正常兔心房肌细胞Ito及其通道动力学无显著影响。在50μmol/L H2O2作用下,兔心房肌细胞Ito峰值由(39.3±5.4)pA/pF降低至(32.8±2.0)pA/pF(P<0.05),电流-电压曲线下移,通道稳态激活曲线右移,通道稳态失活曲线及恢复时间不变,关闭态失活加速。预先给予7μmol/L胡椒碱,明显减轻H2O2对Ito的抑制作用(P<0.01),并可减轻H2O2对瞬时外向钾通道动力学的异常影响。结论胡椒碱可减轻氧化应激对心房肌细胞Ito的影响。     

一种筛选抗心律失常药物新模型的建立

目的　建立一种细胞水平的心律失常模型 ,以用于抗心律失常药物的筛选和评价。方法　酶解法分离单个大鼠心室肌细胞 ,在细胞水平给予传统诱发心律失常药物乌头碱 ,应用膜片钳技术观察记录应用乌头碱后心肌动作电位时程 (APD)、钠电流(INa)、L 型钙电流 (ICa L)、内向整流钾电流 (IK1 )及瞬时外向钾电流 (Ito)的变化。结果　应用乌头碱 1μmol·L- 1 使大鼠单个心室肌细胞 90 %复极化动作电位时程 (APD90 )从给药前的 (15 0 .2 3± 7.0 2 )ms延长至 (2 36 .0 3± 2 3.2 2 )ms(n =8,P <0 .0 1)。应用奎尼丁 10 μmol·L- 1 后动作电位…     

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.     

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.