蛋白激酶C在肺缺血预处理保护中的作用

目的:建立大鼠肺缺血/再灌注(I/R)损伤模型,探讨蛋白激酶C(PKC)在肺缺血预处理(IPC)保护中的作用。方法:建立在体单侧肺原位I/R模型。50只SD大鼠随机均分为假手术(S)组、I/R组、IPC组、多黏菌素B(PMB)组和缺血预处理加多粘菌素B(IPC+PMB)组5组。实验结束时测定各组肺组织SOD活力、MDA含量、肺湿干重比和肺泡损伤数比值,观察肺超微结构变化。结果:(1)与S组相比,I/R组SOD活力下降,MDA含量升高,肺湿干重比升高,肺泡损伤数比值升高(均P<0.01);与I/R组比较,IPC组SOD活力升高,MDA含量降低,肺湿干重比降低,肺泡损伤数比值降低(均P<0.01);与I/R组比较,PMB组和IPC+PMB组各项指标差异无统计学意义(均P>0.05)。(2)肺组织病理学改变:I/R组、PMB组和IPC+PMB组肺组织损伤明显,IPC组肺组织损伤较I/R组明显减轻,S组肺组织结构基本正常。结论:IPC对肺I/R损伤有明显的保护作用,而且这一作用可被PKC抑制剂PMB抑制。     

虎杖甙在兔肺缺血再灌注损伤中的保护作用

目的:探讨虎杖甙(polydatin,PD)对兔肺缺血再灌注损伤的保护作用.方法:采用在体兔单肺原位缺血再灌注损伤模型.30只日本大耳兔,随机均分为三组:假手术组(S组),缺血再灌注组(I/R组)和缺血再灌注 PD组(PD组).实验末测血清SOD活力和MDA含量,肺湿干重比和肺泡损伤数比值,观察肺超微结构变化.结果:①I/R组与S组相比,SOD活力下降,MDA含量、湿干重比及肺泡损伤数比值增加(P均＜0.01).PD组与I/R组相比,S0D活力增加,MDA含量降低,湿干重比及肺泡损伤数比值下降(P均＜0.01).②电镜显示I/R组有明显的肺超微结构损伤,而PD组损伤不明显.结论:PD对肺缺血再灌注损伤有明显的保护作用.     

缺血预处理对兔肺缺血再灌注损伤的保护作用

目的:探讨缺血预处理 (IP)对兔肺缺血 /再灌注 (I/ R)损伤的保护作用。 方法 :将 30只新西兰白兔随机分为对照组 (C组 )、缺血 /再灌注组 (I/ R组 )和缺血预处理组 (IP组 ) ,每组 10只。对比观察各组同侧肺静脉血氧分压 (Pa O2 )、肺湿 /干重比、血清及肺组织超氧化物歧化酶 (SOD)活性、丙二醛 (MDA)、髓过氧化物酶 (MPO)含量和肺组织形态学变化。结果:再灌注后 I/ R组 Pa O2 呈进行性下降 ,尤以再灌注 30 min内明显 ;IP组 Pa O2 、SOD活性和 MPO含量均优于 I/ R组 (P <0 .0 5 ) ,肺湿 /干重比和 MDA含量均低于 I/ R组 (P <0 .0 1) 。结论 :肺的缺血预处理可通过减轻肺毛细血管的通透性 ,提高机体抗氧化自由基的能力 ,减轻 I/ R损伤 ,起到保护肺脏的作用。     

川芎嗪对幼兔肺缺血再灌注损伤的保护作用

目的:探讨川芎嗪(LZ)对幼兔肺缺血再灌注损伤中肺的保护作用。方法:将36只实验用幼兔随机分成缺血再灌注组(I/R)、假手术组(S)和川芎嗪组(LZ60mg/kg),每组12只。建立在体幼兔肺缺血再灌注模型,并检测肺组织中超氧化物歧化酶(SOD),丙二醛(MDA)及髓过氧化物酶(MPO)的水平。测定肺泡灌洗液(BALF)中性粒细胞(PMN)计数、计算肺湿干重比(W/D)和光镜下观察肺组织病理改变。结果:I/R组与S组相比,SOD活性下降,W/D、MDA含量及MPO活性均显著增加,肺组织病理损伤明显。LZ组与I/R组相比,W/D、SOD活性增加,MDA含量、MPO活性降低及再灌注肺BALF中性粒细胞计数LZ组低于I/R组(P<0.05),肺组织病理损伤明显减轻。结论:川芎嗪能明显减轻幼兔肺缺血再灌注损伤,其作用机制可能与抑制中性粒细胞在肺内积聚、减轻氧自由基造成的肺损伤有关。     

缺血预处理与氧化苦参碱对肺缺血再灌注损伤保护的实验研究

目的 探讨缺血预处理(ischemic preconditioning,IPC)与氧化苦参碱(oxymatrine,OMT)对肺缺血再灌注损伤(lung ischemia reperfusion injury,LIRI)的保护作用及机制.方法 24只大白兔随机分为假手术组(sham组,n=6);缺血再灌注损伤组(ischemic reperfusion,I/R,n=6); IPC组(n=6);IPC+OMT组(n=6).测定各组开胸后0 min,缺血后40 min,再灌注后80 min、120 min、160 min各时点肺组织中超氧化物歧化酶(SOD)、丙二醛(MDA)、湿干重比(W/D)、凋亡指数(apoptosis index,AI)、热休克蛋白90α(heat shock protein 90α, Hsp90α)表达及160 min时肺病理改变.结果 各组开胸后0 min 、缺血后40 min时 SOD、MDA值差异无统计学意义(P>0.05),I/R 80 min后,I/R组W/D、AI值高于IPC、IPC+OMT组(P<0.05,P<0.01),SOD、Hsp90α表达低于IPC、IPC+OMT组(P<0.05,P<0.01).IPC+OMT组与IPC 组比较,MDA、W/D、AI低于IPC组(P<0.05);SOD、Hsp90α表达持续上调(P<0.05).IPC组和IPC+OMT组肺病理改变较I/R组明显减轻.结论 IPC与OMT诱导肺组织SOD和Hsp90α的高表达,减少MDA的生成,抗氧化损伤,抑制细胞凋亡,对减轻LIRI有协同作用.     

参麦注射液对兔肺缺血再灌注损伤时脂质过氧化的影响

目的 探讨兔肺缺血/再灌注损伤时脂质过氧化的变化和参麦注射液的影响,为临床防治提供理论依据.方法 实验兔70只,随机分为3组:假手术组(C组,n =10)、缺血/再灌注组(I/R1、3、5h组,n=10)和参麦注射液干预组(SM1、3、5h组,n=10).采用在体兔单侧肺原位缺血/再灌注损伤模型,参麦注射液干预组于缺血前20min经耳缘静脉注射参麦注射液15ml/kg,其余处理同缺血/再灌注组.分别于上述时间点抽取动脉血,检测血清超氧化物歧化酶(SOD)活性及丙二醛(MDA)浓度;提取肺组织,检测肺湿干重比(W/D)以及肺泡损伤数定量评价指标(IQA).结果 与C组比较,I/R3h组和I/R5h组SOD活性下降(P＜0.01),MDA浓度、W/D及IQA均升高(P＜0.01);与I/R组比较,SM组在相应时间点的SOD活性升高(P＜0.01),MDA浓度、W/D和IQA均下降(P＜0.01).结论 参麦注射液可通过抑制氧自由基的生成,减轻脂质过氧化对肺缺血/再灌注损伤的肺组织发挥积极的保护作用.     

热休克蛋白27参与兔肺缺血预处理保护

目的：探讨热休克蛋白27（HSP27）在肺缺血预处理保护中所起的作用及意义。方法：采用在体兔单肺原位缺血再灌注模型,30只日本大耳兔随机均分为三组：假手术（S）组、缺血/再灌注（I/R）组及缺血预处理（PC）组,实验检测肺组织湿干重比和肺泡损伤数比值,电镜评定肺组织超微结构损伤,免疫组化检测肺组织热休克蛋白27的定位及表达。结果：①I/R组肺组织湿干重比（W/D）及肺泡损伤数比值（IAR）明显于S组（均P〈0.01）;PC组W/D及IAR均显著低于I/R组（P〈0.05或P〈0.01）。②免疫组化显示PC组肺小动脉内膜及外膜层、肺小静脉壁全层、远端呼吸性细支气管及少许肺泡上皮HSP27有强表达;肺小静脉HSP27含量（平均吸光度值LD）高于I/R组和S组（均P〈0.01）。③I/R组肺组织超微结构的损伤明显,而PC组损伤明显减轻。结论：肺缺血预处理能减轻肺缺血再灌注损伤,HSP27表达增加并参与肺缺血预处理保护。     

左旋精氨酸对兔肺缺血再灌注损伤的保护作用

目的 :观察左旋精氨酸对在体兔肺缺血再灌注损伤的影响。方法 :复制在体兔肺缺血再灌注损伤模型。 30只日本雄性大耳兔 ,随机分为三组 :假手术组 ,缺血再灌注组 (IR组 )和左旋精氨酸 +缺血再灌注组(Larg组 )。对比观察各组血浆SOD活力 ,NO、MDA含量 ,肺组织湿干重比 (W /D) ,肺损伤组织学定量评价指标 (IQA)及光镜和电镜下的组织形态学改变。结果 :缺血再灌注后Larg组血浆NO含量和SOD活力较S组、IR组明显升高 (P <0 .0 1) ,MDA、W/D、IQA较IR组明显降低 (P <0 .0 5 ,P <0 .0 5 ,P <0 .0 1) ;IR组镜下见有肺组织水肿 ,肺泡损伤严重 ,内皮细胞线粒体水肿或空泡化 ,毛细血管内炎性细胞浸润 ;而Larg组肺组织上述改变明显减轻。结论 :在体兔肺缺血前预先用L Arg处理 ,可减轻随后的缺血再灌注损伤 ;其机制之一可能与L Arg抗氧自由基作用有关     

葛根素对兔肺缺血再灌注损伤中细胞凋亡的影响

目的:观察葛根素对兔肺缺血再灌注损伤中细胞凋亡的影响.方法:复制兔单侧肺缺血再灌注损伤模型,随机分为三组,每组10只:对照组(C组)、缺血再灌注组(IR组)和葛根素组(Pur组).对比观察各组血浆超氧化物歧化酶(SOD)活力、一氧化氮(NO)及丙二醛(MDA)含量、肺湿干重比(W/D)、肺泡损伤数定量评价指标(IQA)及肺组织细胞凋亡指数(AI).结果:再灌注后各时间点IR组与C组比较发现,SOD活力、NO含量明显降低(P＜ 0.01),MDA、W/D、IQA、AI明显升高(P＜ 0.01),Pur组与IR组相比较发现,SOD活力、NO含量均明显升高(P＜ 0.01),MDA、W/D、IQA、AI不同程度地有所降低(P＜ 0.05).结论:葛根素通过抗氧化与提高NO含量,可抑制再灌注后肺组织细胞凋亡,从而减轻肺损伤.     

大鼠整体低氧预处理减轻肺缺血再灌注损伤

目的:探讨低氧预处理(HPC)对肺缺血再灌注(I/R)损伤的保护作用.方法:重复性低氧5次建立大鼠HPC模型,双活结套扎左侧肺门45 min后再灌注120min复制肺I/R损伤模型;设立对照组、I/R组和HPC+I/R组,每组10只大鼠,检测各组肺组织湿重与干重比,肺组织丙二醛(MDA)含量、超氧化物歧化酶(SOD)及髓过氧化物酶(MPO)活性.结果:I/R组大鼠肺组织湿重与干重比较对照组明显增加(P<0.05),肺组织SOD活性显著降低(P<0.01),MDA含量和MPO活性明显增高(P<0.05);HPC+I/R组大鼠上述指标较I/R组均明显改善,差异有显著性.结论:大鼠整体HPC可能通过减轻氧化应激反应,保护肺的缺血再灌注损伤.     

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.