内毒素致兔急性肺损伤及磷脂酶A2致伤机制的研究

目的研究大肠杆菌内毒素致兔急性肺损伤(ALI)发病机制及磷脂酶A2(PLA2)激活在此病理生理过程中的致伤机制.方法大耳白兔随机分为对照组、内毒素致伤组、内毒素致伤+氯喹干预组.静脉注射内毒素(500μg/kg)引起兔ALI,测定血清及肺组织中PLA2活性、动脉血气分析及肺组织病理改变.观察PLA2抑制剂氯喹对ALI病理生理过程的影响.结果静注内毒素后兔出现氧分压下降 (P<0.05)、肺水肿、肺内炎细胞浸润、透明膜形成、上皮细胞及内皮细胞受损等早期ALI病理生理改变.损伤组兔血清及肺组织中PLA2活力高于静注内毒素前及正常对照组(P<0.01).氯喹干预组氧分压未见下降,血清及肺组织中PLA2活力较对照组增高(P<0.01)但低于内毒素组(P<0.05).结论静脉注射内毒素可诱导兔早期ALI,PLA2激活在此病理生理过程中起了重要作用.应用PLA2抑制剂氯喹可抑制内毒素致伤后PLA2激活,从而缓解内毒素引起的低氧血症,减轻早期肺损伤.     

内毒素致兔急性肺损伤及1,6-二磷酸果糖保护性作用的研究

目的：研究1，6-二磷酸果糖(FDP)对大肠杆菌内毒素(ET)致大耳白兔急性肺损伤(Au)的保护性作用及其对磷脂酶A2(PLA2)活性的影响。方法：大耳白兔随机分为对照组、ET致伤组、ET致伤 FDP干预组。经静脉一次性注射ET复制兔ALI模型。各组分别于0h、0．5h、2h、4和6h等不同时点测定呼吸频率、心率、血压、血气分析及血清中PLA2活性；于6h点处死动物，测定肺组织PLA2活性，并行肺组织病理学观察。结果：静注ET后，致伤组动物与对照组相比较，出现呼吸频率加快、血压下降、心率加快、血氧分压降低和PLA2活性增高，肺组织出现明显的病理损害。干预组动物肺损伤轻于致伤组。结论：FDP对PLA2激活起抑制作用，可改善其病理生理过程；对ET所致的兔早期ALI有一定的保护作用。     

内毒素致家兔急性肺损伤及萘普生保护性作用的研究

目的:探讨大肠杆菌内毒素(ET)致兔急性肺损伤(ALI)的发病机制及萘普生的干预作用。方法:24只大耳白兔随机均分为对照组(A组)、ET致伤组(B组)、ET致伤 萘普生处理组(C组)。颈静脉注射ET(600μg/kg)致兔ALI,监测动物动脉血气、血清和肺组织中TXB2和6-keto-PGF1α含量的变化。于4h处死动物,取肺组织观察病理变化及用免疫组化方法检查过氧化物酶增殖子活化受体γ(PPARγ)的表达情况。结果:与对照组相比,损伤组动物动脉血氧分压(PaO2)下降、血清及肺组织中TXB2和6-keto-PGF1α含量增加(P<0.01);肺组织出现明显的病理损害。萘普生处理组PaO2未见明显下降,血清及肺组织中TXB2和6-keto-PG1α值低于ET组;病理检查见轻度肺水肿,炎细胞浸润较ET组少。免疫组化见损伤组肺组织PPARγ表达明显下降,萘普生组好于损伤组。结论:静脉注射ET可复制兔ALI动物模型;环氧合酶(COX)在ALI时激活,PPARγ表达减少。萘普生可能通过抑制COX的活性和激活PPARγ对ALI有一定的干预作用。     

急性肺损伤兔ACE、ET-1变化及美洛昔康的拮抗作用

目的:观察内毒素致兔急性肺损伤(ALI)时血清血管紧张素转换酶(ACE)活性和肺组织内皮素-1(ET-1)含量变化及美洛昔康对急性肺损伤干预作用的机制。方法:将24只日本大耳白兔随机分为对照组、致伤组、美洛昔康干预组。用内毒素(700μg/kg)一次性静脉注射方法复制兔ALI模型,应用美洛昔康(2.5 mg/kg)进行干预。分别检测血清ACE活性和肺组织ET-1含量。结果:致伤后0.5 h,血清ACE活性明显升高,1 h时血清ACE活性达到峰值。美洛昔康组血清ACE活性也出现升高,但明显低于致伤组。致伤组肺组织ET-1高于对照组(P<0.01),美洛昔康干预组肺组织ET-1明显低于致伤组(P<0.01)。结论:美洛昔康可以抑制血清ACE活性和降低肺组织中ET-1的含量,对内毒素所致ALI具有一定的拮抗作用。     

参附对急性肺损伤大鼠热休克蛋白70表达的影响

目的观察参附对急性肺损伤(ALI)大鼠热休克蛋白70(HSP70)表达的影响,初步探讨参附对内毒素致急性肺损伤的保护作用机制。方法采用尾静脉注射内毒素建立急性肺损伤模型,将SD大鼠按随机数字表法分为生理盐水对照组(NS组)、内毒素注射组(ET组)、参附治疗组(SF组),每组10只。参附采用腹腔注射给药,分别于尾静脉注射内毒素或生理盐水后2h处死实验动物。观察肺组织病理学检查及评分、肺系数和动脉血氧分压(PaO2),并应用免疫组织化学和蛋白印迹方法检测肺组织中HSP70的表达。结果 ET组较NS组肺组织病理学检查评分、肺系数和HSP70表达显著升高(P<0.05),而PaO2显著下降(P<0.05);SF组和ET组相比,其肺组织病理学检查评分和肺系数显著降低(P<0.05),PaO2和肺组织HSP70表达显著升高(P<0.05)。结论参附可显著减轻内毒素所致急性肺损伤,同时显著增加肺组织HSP70的表达。     

兔急性肺损伤肺组织中PPAR-γ蛋白表达及美洛昔康的影响

目的:观察内毒素(ET)致兔急性肺损伤(ALI)时肺组织中过氧化物酶体增殖物激活受体γ(PPAR-γ)蛋白表达及美洛昔康的影响,探讨美洛昔康对兔急性肺损伤干预的机制。方法:将24只日本大耳白兔随机分为对照组、致伤组、美洛昔康干预组。用ET(700μg/kg)一次性静脉注射方法复制兔ALI模型,应用美洛昔康(2.5mg/kg)进行干预。采用免疫组织化学技术和Westernblot方法检测肺组织中PPAR-γ蛋白的表达。结果:PPAR-γ蛋白表达在致伤组显著低于对照组(P<0.01),美洛昔康干预组显著高于致伤组(P<0.01)。结论:PPAR-γ蛋白表达在ALI时下调。美洛昔康可促进PPAR-γ蛋白的表达,在一定程度上对兔内毒素性ALI产生保护作用。     

促凝血活性在急性肺损伤中的变化及1,6-二磷酸果糖的作用

目的:观察内毒素(ET)致大耳白兔急性肺损伤(ALI)过程中肺组织的促凝血活性变化及1,6-二磷酸果糖(FDP)的影响,研究FDP对ALI的可能拮抗作用。方法:大耳白兔随机分为对照组、ET致伤组、ET致伤 FDP干预组。经静脉一次注射ET复制兔ALI模型。各组分别于0 h、0.5 h、2 h、4 h及6 h等不同时点测定呼吸频率、心率、血压、血气分析和血常规;于6 h点处死动物,测定肺组织中血栓烷B2(TXB2)、6-酮-前列腺素F1α(6-keto-PGF1α)的含量,并行肺组织病理学观察。结果:致伤组静注ET后与对照组相比较,出现呼吸频率增加、心率加快、血压下降、血氧分压降低、外周血白细胞计数下降和肺组织TXB2/6-keto-PGF1α比值升高,肺组织出现明显的病理损害。干预组动物的相应指标好于致伤组。结论:肺组织促凝血活性升高在ALI发病过程中起了重要作用;FDP可抑制肺组织促凝血活性的升高,对ET诱导的ALI有一定的拮抗性作用。     

内毒素致兔急性肺损伤及血必净保护作用

目的：观察内毒素（ET）致兔急性肺损伤（Au）时肺组织中丙二醛（MDA）含量及超氧化物岐化酶（SOD）活性的的变化,探讨血必净对急性肺损伤保护作用的机制。方法：将24只日本大耳白兔随机分为对照组（A组）,内毒素致伤组（B组）,内毒素致伤及血必净干预组（C组）。用内毒素（750μg／kg）一次性静脉注射方法复制兔ALI模型,应用血必净按1．8mL／kg静脉注射进行干预,分别检测肺组织中的MDA含量及SOD活性。结果：A组氧合指数保持稳定,B组在致伤后0．5h动物氧合指数显著下降,之后略有回升但仍低于基础水平,C组下将趋势低于B组。B组动物肺组织中MDA含量明显高于A组（P〈0．01）与C组（P〈0．05）,A组、C组间无差别。B组肺组织SOD活性明显低于A组（P〈0．01）与C组（P〈0．05）,A组、C组间无差别。肺组织病理学发现A组肺组织正常,B组出现渗出,淤血,炎细胞浸润等,C组病理损伤轻于B组。结论：血必净可以降低肺组织中MDA的含量和提高SOD的活性,该药对内毒素所致兔ALI有一定的保护作用。     

急性肺损伤大鼠肺组织内皮素含量的变化及腺苷和黄芪对它的影响

目的：探讨油酸型急性肺损伤（ALI）大鼠内皮素（ET）含量的变化和腺苷、黄芪的保护作用及其机制。方法：观察腺苷、黄芪对ALI大鼠肺组织匀浆ET、支气管肺泡灌洗液（BALF）白蛋白、血清SOD含量及肺湿重、湿/干比、动脉血氧分压（PaO2)变化的影响,并进行组织病理学检查。结果：油酸型ALI大鼠注入腺苷或黄芪能显著降低肺湿重、湿/干比、肺组织匀浆ET和BALF白蛋白含量,提高PaO2和血清SOD水平。结论：腺苷、黄芪能降低油酸型肺损伤的肺水肿和白蛋白渗出,改善缺氧,增强抗氧化,减轻肺损伤程度。     

内毒素致家兔急性肺损伤vWF变化及氯喹的干预作用

目的:用内毒素(ET)静注复制家兔急性肺损伤(ALI)模型,测定模型不同时间点微血管内皮细胞释放血管性假血友病因子(vWF)的变化,并用氯喹干预,以揭示微血管内皮细胞在ALI中的受损机制,并寻找有效的干预药物。方法:设A组(对照组)、B组(损伤组)和C组(损伤 干预组),A组静注生理盐水对照,B组按600μg/kg剂量静脉注射ET,复制家兔ALI模型,C组同等剂量静注ET后,按5 mg/kg剂量静注氯喹,分别测量用药前和用药后0.5 h、1 h、2 h、4 h动脉血的氧分压、血清中丙二醛(MDA)、超氧化物歧化酶(SOD)及血浆中vWF含量,比较三组之间的差别。结果:B组vWF活性和MDA含量明显高于A组,而SOD降低;C组也有类似变化,但变化幅度较B组小,三组之间比较相差显著。结论:血浆中vWF活性增高,是ALI的重要标志;应用氯喹后血浆中vWF活性明显降低,证实其对肺微血管内皮细胞具有一定的保护作用。     

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.