福辛普利对心肌缺血再灌注损伤心肌细胞的作用和对Bcl-2、Bax表达的影响

目的探讨福辛普利对大鼠心肌缺血再灌注模型心肌细胞凋亡及相关调控基因Bcl-2、Bax表达的影响及相关机制。方法24只动物随机分成假手术组（n=8），缺血再灌注损伤组（n=8）和福辛普利预处理组（n=8），再灌注24h后处死动物。用透射电镜观察大鼠心肌超微结构的变化，TUNEL法检测心肌细胞凋亡，RT-PCR检测Bcl-2及Bax基因表达。结果电镜结果显示福辛普利的应用促使缺血再灌注大鼠心肌组织肌原纤维排列趋于恢复正常、线粒体肿大好转、细胞核和核仁显示良好，无细胞核变形，无胞核空洞样变及核固缩等现象。TUNEL显示福辛普利组细胞凋亡明显减少。缺血再灌注损伤24h后心肌组织Bcl-2基因表达较假手术组显著降低，而Bax基因表达则显著增高，福辛普利则可以逆转这种趋势。结论应用福辛普利能抑制心肌缺血再灌注损伤导致的心肌细胞凋亡，发挥心肌保护作用，从而缓解缺血再灌注损伤的发生发展。     

瓜蒌薤白半夏汤对大鼠缺血再灌注心肌细胞凋亡及Bcl-2、Bax蛋白表达影响

目的 研究瓜萎薤白半夏汤对缺血再灌注损伤大鼠心肌细胞凋亡及Bcl-2、Bax蛋白表达影响.方法 通过结扎大鼠冠状动脉左前降支造成心肌缺血再灌注损伤模型,各组动物至实验时限心肌缺血30min、再灌注90min后,取出心脏.采用TUNEL检测心肌细胞凋亡,免疫组化方法检测心肌Bcl-2、Bax蛋白表达.结果 与假手术组对照,模型组细胞凋亡率及Bax表达水平均明显升高、Bcl-2表达水平降低,组间比较差异有统计学意义(P＜0.01);瓜萎薤白半夏能有效降低Bax表达、升高Bcl-2表达水平,抑制细胞凋亡的发生,与模型组比较,差异有统计学意义(P＜0.01).结论 瓜萎薤白半夏汤可能通过上调Bcl-2、下调Bax蛋白表达而有效抑制心肌缺血再灌注损伤大鼠心肌细胞凋亡的发生.     

参附注射液对大鼠缺血再灌注心肌Bcl-2、Bax与c-fos基因蛋白表达的影响

目的 观察大鼠急性缺血再灌注损伤与凋亡相关基因Bcl-2、c-fos和Bax蛋白表达的关系及参附注射液(SF)的影响.方法 采用整体缺血再灌注(ischemia-reperfusion,IR)模型,35只大鼠分为假手术组(C组)、生理盐水30 min对照组(IR 30)、生理盐水120 min对照组(IR 120)、SF 30 min组(SF 30)和SF 120 min组(SF 120),心肌缺血40 min再灌注30 min或120 min后,用免疫组化法检测Bcl-2、Bax和c-fos在心肌中的表达量.结果 与C组比较,IR组心肌Bcl-2、Bax和c-fos蛋白表达显著升高(P＜0.01),Bcl-2/Bax比值显著下降(P＜0.01);与IR组比较,SF组Bcl-2蛋白表达显著升高(P＜0.01),Bax和c-fos蛋白表达显著降低(P＜0.01),Bcl-2/Bax比值显著升高(P＜0.01).结论 SF对IR心肌保护效应可能与其促进Bcl-2蛋白高表达、抑制Bax与c-fos蛋白表达、增加Bcl-2/Bax比值,从而抑制心肌细胞凋亡有关.     

苯那普利对大鼠缺血再灌注的影响

目的 观察苯那普利对大鼠心肌缺血再灌注损伤的保护作用,并初步探讨其可能的作用机制.方法 32 只SD大鼠随机分为3 组:假手术组、缺血再灌注组、苯那普利预处理组.大鼠在体结扎冠状动脉前降支30 min后,松开结扎线再灌注120 min制备心肌缺血再灌注损伤模型,测定血清肌酸激酶(CK)的含量,TTC染色后计算心肌梗死范围(MIS),TUNEL法检测心肌细胞凋亡并用免疫组化方法测定抑凋亡基因(Bcl-2)和促凋亡基因(Bax)的表达.结果 缺血再灌注损伤组较假手术组的CK明显增高,其凋亡指数增多,Bcl-2的蛋白表达减少而Bax的蛋白表达增加.苯那普利预处理组的CK较缺血再灌注组明显降低,其凋亡指数减少,Bcl-2蛋白表达增加而Bax的蛋白表达降低;心肌梗死面积明显减小.结论 苯那普利预处理通过抑制心肌细胞的凋亡而对缺血再灌注的心肌起保护作用.     

黄芩茎叶总黄酮预处理对大鼠心肌缺血再灌注损伤的保护作用

目的 探讨黄芩茎叶总黄酮(Scutellaria baiculensis stem-leaf total flavonoid,SSTF)对大鼠心肌缺血再灌注损伤的保护作用.方法 40只SD大鼠随机分为假手术组、缺血再灌注组和SSTF预处理组.SSTF组大鼠于术前1周分别灌胃不同剂量的SSTF[(17.5、35、70mg/(kg·d)],另两组给等量生理盐水.采用结扎大鼠左冠状动脉前降支方法制备心肌缺血再灌注模型.缺血30min、再灌注2h后,观察大鼠心电图的变化;并用免疫组织化学法检测心肌组织中Bax和Bcl-2蛋白表达情况.结果 SSTF抑制了缺血再灌注损伤大鼠心电图T波升高,降低了心律失常发生率.缺血再灌注组Bcl-2蛋白表达阳性细胞率明显比假手术组低(P＜0.05),Bax蛋白表达阳性细胞率明显较假手术组高,而SSTF预处理组Bcl-2蛋白表达阳性细胞率明显高于缺血再灌注组(P＜0.05), Bax蛋白表达阳性细胞率明显较缺血再灌注组为低(P＜0.05).结论 SSTF预处理对缺血再灌注的心肌细胞具有保护作用,其机制可能与上调Bcl-2和下调Bax蛋白表达进而抑制心肌细胞凋亡有关.     

苯那普利对大鼠缺血再灌注的影响

目的观察苯那普利对大鼠心肌缺血再灌注损伤的保护作用,并初步探讨其可能的作用机制。方法32只SD大鼠随机分为3组：假手术组、缺血再灌注组、苯那普利预处理组。大鼠在体结扎冠状动脉前降支30 min后,松开结扎线再灌注120 min制备心肌缺血再灌注损伤模型,测定血清肌酸激酶（CK）的含量,TTC染色后计算心肌梗死范围（MIS）,TUNEL法检测心肌细胞凋亡并用免疫组化方法测定抑凋亡基因（Bcl-2）和促凋亡基因（Bax）的表达。结果缺血再灌注损伤组较假手术组的CK明显增高,其凋亡指数增多,Bcl-2的蛋白表达减少而Bax的蛋白表达增加。苯那普利预处理组的CK较缺血再灌注组明显降低,其凋亡指数减少,Bcl-2蛋白表达增加而Bax的蛋白表达降低;心肌梗死面积明显减小。结论苯那普利预处理通过抑制心肌细胞的凋亡而对缺血再灌注的心肌起保护作用。     

黄芩茎叶总黄酮预处理对大鼠缺血再灌注心肌细胞凋亡的影响

目的:探讨黄芩茎叶总黄酮预处理对大鼠缺血再灌注心肌细胞凋亡的影响。方法:40只SD大鼠随机分为假手术组,缺血再灌注组,SSTF预处理组(SSTF组)。SSTF组于术前1周灌服不同剂量SSTF(17.5、35、70mg/kg.d)。采用结扎大鼠左冠状动脉前降支方法制备心肌缺血再灌注模型。缺血30min,再灌注2h,用HE染色在光学显微镜下观察凋亡心肌组织的病理改变;并用免疫组织化学法检测心肌组织中Bax和Bcl-2蛋白表达情况。结果:缺血再灌注组Bcl-2蛋白表达明显比假手术组低(P<0.05),而SSTF预处理组Bcl-2蛋白表达明显比缺血再灌注组高(P<0.05),缺血再灌注组Bax蛋白表达较假手术组高,而SSTF预处理组Bax蛋白表达明显较缺血再灌注组低(P<0.05);缺血再灌注组大鼠心肌细胞结构出现明显的病理改变。结论:SSTF对结扎大鼠左冠状动脉前降支引起的心肌缺血再灌注损伤有保护作用,它可能通过上调Bcl-2蛋白表达和下调Bax蛋白表达进而抑制心肌细胞凋亡。     

缺血后处理对缺血再灌注心肌细胞凋亡及Bcl-2和Bax蛋白表达的影响

目的:研究缺血后处理对缺血再灌注心肌细胞凋亡及Bcl-2和Bax蛋白表达的影响.方法:24只大耳白兔随机分成4组:假手术组(S)、缺血再灌注组(IR)、缺血预适应组(IP)和缺血后处理组(IPO).S组(6只):开胸只穿线不结扎血管,麻醉维持120 min;IR组(6只):结扎30 min,再灌注120 min;IP组(6只):结扎5 min,再灌注5 min,反复3次诱导缺血预适应,之后再按IR组操作;IPO组(6只):结扎30 min后, 再灌注10 s、缺血10 s, 反复6次,再灌注120 min.应用TUNEL法观察各组心肌细胞凋亡,应用免疫组化SP法观察Bcl-2和Bax蛋白的表达.结果:与IR组相比,IP组和IPO组心肌梗死范围减小,心肌细胞的凋亡指数降低(P＜0.05),Bcl-2/Bax比例升高(P＜0.05),而IP组和IPO组间差异无统计学意义(P＞0.05).结论:缺血后处理可以减轻再灌注心肌细胞的凋亡,这一过程可能是通过升高Bcl-2/Bax比值来实现的.     

缬沙坦后处理对心肌缺血再灌注损伤的保护作用

目的 了解血管紧张素Ⅱ受体拮抗剂缬沙坦后处理对缺血再灌注心肌细胞凋亡的影响及其机制.方法 将24只新西兰大白兔随机分为3组,每组8只.对照组结扎左冠状动脉前降支1 h,再灌注6 h;后处理组结扎左冠状动脉前降支1 h,于再灌注前15 min耳缘静脉注射缬沙坦(30 mg/kg),再灌注6 h;药物干预组结扎左冠状动脉前降支1 h,于再灌注前15 min耳缘静脉注射缬沙坦(30 mg/kg),再灌注前5 min给予蛋白激酶C抑制剂GF109203X (0.05 mg/kg)耳缘静脉注射持续5 min,最后心肌再灌注6 h.处死家兔,取缺血坏死区心肌常规制作石蜡切片,光镜下观察缺血坏死区心肌组织结构的变化,采用Tunel法检测心肌细胞凋亡程度,用免疫组化法检测心肌细胞中Bax和Bcl-2蛋白的表达.结果 与对照组和药物干预组比较,后处理组心肌组织结构变化轻微,细胞凋亡指数明显降低(F=4.58,q=3.321、4.001,P<0.01),Bcl-2表达明显增多(F=7.23,q=4.730、4.580,P<0.01),Bax表达明显减少(F=8.35,q=4.684、5.275,P<0.01).而药物干预组与对照组比较各检测指标差异无显著性(P>0.05).结论 缬沙坦后处理可减少急性缺血再灌注后心肌细胞凋亡,并影响Bcl-2、Bax蛋白的表达,从而对缺血心肌产生保护作用,其保护机制可能与激活蛋白激酶C有关.     

丙酮酸乙酯对大鼠心肌缺血再灌注细胞凋亡及Bcl-2、Bax蛋白表达的影响

目的研究丙酮酸乙酯（EP）对缺血／再灌注（I／R）心肌细胞凋亡及Bcl-2、Bax蛋白表达的影响，探讨其抑制缺血／再灌注心肌细胞凋亡的可能机制。方法应用Langendorff主动脉逆行灌流的体外大鼠缺血／再灌注心脏模型，24只雄性大鼠随机分为3组（每组各8只）：对照组，K—H液持续灌流120min；缺血／再灌注组，平衡灌流30min，全心停灌30min，再灌60min；EP组，实验程序与缺血／再灌注组相同，平衡15min后和再灌注期间灌流使用含2mmol／LEP的K—H液。检测心肌丙二醛（MDA）含量，分别以缺口末端标记法（TUNEL法）及免疫组化法检测心肌细胞凋亡指数（AI）及Bcl-2、Bax蛋白表达的变化。结果缺血／再灌注组MDA含量，AI和Bcl-2、Bax蛋白表达水平均明显高于对照组（均P〈0．05）；与缺血／再灌注组比较，EP组MDA含量，AI与Bax蛋白表达水平均下降，而Bcl-2蛋白表达水平显著增高（均P〈0．05）。结论EP可抑制缺血／再灌注后心肌细胞凋亡，此作用可能与其减轻氧化应激、上调Bcl-2和下调Bax蛋白表达水平有关。     

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.