高压氧对缺氧缺血性脑损伤新生大鼠的远期影响

【目的】探讨早期和延迟高压氧(HBO)治疗对缺氧缺血性脑损伤(HIBD)新生大鼠的远期影响。【方法】7日龄大鼠37只随机分为对照组(n=10,假手术处理)、HIBD组(n=9)、EHBO组(n=9,HIBD模型后0.5～1h开始2个绝对大气压HBO治疗,稳压30min／次,间隔24h,连续2次)和LHBO组(n=9,HIBD模型后48～72h开始2个绝对大气压HBO治疗,稳压30min／次,间隔24h,连续5次),以大鼠远期的学习记忆功能(Morris水迷宫实验)和海马形态组织学(海马锥体细胞层结构和CA1区存活神经元数)来判断干预效果。【结果】HIBD组大鼠的学习记忆功能严重不良伴海马结构严重受损,与对照组相比,水迷宫实验中平均逃逸潜伏期延长(56.35s与23.07s,P＜0.05)、搜索时间和搜索路程缩短(分别为29.29s与51.21s,548cm与989cm,均P＜0.05)、海马存活神经元减少(100个／mm与183个／mm,P＜0.05);早期HBO治疗明显减轻HIBD大鼠的学习记忆功能障碍(潜伏期：39.17s与56.35s;搜索时间：36.84s与29.29s;搜索路程：686cm与548cm,P＜0.05),并使海马存活神经元增多(131个／mm与100个／mm,P＜0.05),延迟HBO治疗不能减轻HIBD大鼠的学习记忆功能障碍(潜伏期：56.25s与56.35s;搜索时间：30.11s与29.29s;搜索路程：572cm与548cm,P＞0.05),海马存活神经元无增多(95个／mm与100个／mm,P＞0.05);大鼠在水迷宫实验中的逃逸潜伏期与海马锥体细胞层存活神经元数呈直线负相关(r=-0.819,P＜0.01)。【结论】早期HBO治疗可减轻HIBD程度,并可改善HIBD所引起的远期学习记忆功能缺陷,延迟HBO治疗对HIBD无效。     

高压氧对HIBD新生大鼠学习记忆功能及海马CA1区神经元的远期影响

目的 探讨高压氧(hyperbaric oxygen,HBO)对缺氧缺血性脑损伤(hypoxia-ischemia brain damage,HIBD)新生大鼠远期的学习记忆功能和海马CA1区神经元的保护作用.方法 18只7日龄SD大鼠随机分为3组(n=6),分别是:假手术组、HIBD组、HBO干预组(HBO HIBD).基于Rice法制作HIBD模型,HIBD HBO组大鼠在HIBD后1 h应用2.5 ATA(1 ATA=100 kPa)的高压氧进行一次性治疗,治疗时间为1.5 h.在大鼠6周龄时,应用抑制性回避实验评价其短时程记忆功能,用Morris水迷宫实验评价大鼠8周龄时的空间学习和记忆功能.9周龄时灌注取脑,观察大鼠海马CA1区的神经元死亡和丢失情况.结论 在抑制性回避实验中,各组大鼠在学习期跳台潜伏期差异没有统计学意义,在测试期,HIBD HBO组大鼠的跳台潜伏期长于HIBD组(P＜0.05);在Morris水迷宫实验中,HIBD HBO组大鼠无论在定位航行实验中还是在空间探索实验中均比HIBD组表现良好,在定位航行实验中,各组大鼠的寻台潜伏期随着实验次数的增多而逐渐缩短,而HIBD HBO组的平均寻台潜伏期比HIBD组短(P＜0.05);在空间探索实验中,无论是站台区探索时间还是穿越站台区的次数,HIBD HBO组均优于HIBD组(P＜0.05).HIBD HBO组大鼠的脑组织病理变化比HIBD组轻,且损伤侧的海马CA1区的神经元没有明显的死亡和丢失.结论 新生大鼠HIBD后1 h给予单次高压氧(2.5 ATA,1.5 h)治疗,可以有效地改善大鼠远期的学习记忆功能,同时也可以减轻大鼠海马CA1区的神经元的坏死与丢失.     

高压氧对缺氧缺血性脑损伤新生大鼠caspase-3及caspase-9表达的影响

目的：通过检测caspase-3,caspase-9的表达情况,探讨高压氧（HBO）对缺氧缺血新生大鼠脑细胞凋亡的影响及分子机制．方法：建立缺氧缺血性脑损伤（HIBD）大鼠模型,将其分为HIBD组（24只）及HBO干预组（24只）,同时设立假手术（Sham）组（24只）．分别于造模后18,24,48和96h4个时间点断头取脑观察其病理改变（海马及皮层区）,并用免疫组化的方法检测caspase-3及caspase-9的蛋白表达．结果：HIBD组18,24,48和96h时间点海马及皮层区caspase-3,caspase-9蛋白的表达均明显高于Sham组（P〈0．05）,HBO干预组则显著缓解,caspase-3,caspase-9表达的升高程度均低于HIBD组（P〈0．05）．结论：HBO能减轻新生大鼠HIBD模型海马及皮层区脑细胞的凋亡,其作用可能是通过下调caspase-9进而影响caspase-3的活性表达来完成的．     

早期干预对脑损伤大鼠神经可塑性相关蛋白的影响

目的 研究早期干预对缺氧缺血性脑损伤（HIBD）大鼠学习记忆能力及脑细胞中神经生长相关蛋白-43（GAP-43）表达的影响。方法 选用SD大鼠建立宫内HIBD动物模型，随机分为HIBD干预组、HIBD非干预组和对照组，每组12只。HIBD干预组采取早期触摸和丰富环境刺激，HIBD非干预组与对照组常规饲养。干预28d后，通过三等臂Y型迷宫试验检测大鼠学习记忆功能，而后取大鼠额皮质和海马组织，用免疫组织化学染色法检测GAP-43表达情况。结果 HIBD非干预组学习与记忆能力明显低于对照组（P〈0．01），HIBD干预组Y迷宫测试成绩则优于HIBD非干预组（P〈0．01）。同时，HIBD非干预组额皮质和海马神经元GAP-43阳性系数高于对照组（P〈0．01），而HIBD干预组GAP-43的表达又明显高于HIBD非干预组（P〈0．01）。结论 早期干预具有改善HIBD大鼠认知能力的效果，其促进HIBD脑功能修复的作用与增加脑组织GAP-43的表达有关。     

帕罗西汀对应激抑郁模型大鼠海马锥体神经元的保护作用

目的：探讨帕罗西汀对应激抑郁模型大鼠海马锥体神经元的保护作用。方法：强迫大鼠游泳4周建立抑郁模型。用Nid染色观察海马CA1和CA3区锥体神经元的形态。结果：用药4周（Ⅵ）组的大鼠海马CA1区锥体神经元的计数显著高于其他各组（P〈0．05或P〈0．01）。在CA3区，模型组、用药1次组和用药1周组海马锥体神经元计数均显著少于对照（Ⅰ）组（P〈O．05），用药2周组与Ⅰ组比无统计学意义（P〉0．05），Ⅵ组CA3区神经元计数显著高于Ⅰ组（P〈0．05）。结论：帕罗西汀长期用药对慢性应激抑郁模型大鼠的海马锥体神经元的存活具有保护作用。     

愈痫灵颗粒对戊四氮致痫大鼠海马CA3区超微结构及认知功能障碍的影响

目的探讨愈痫灵颗粒（YXL）对痫性大鼠海马CA3区超微结构及认知功能障碍的影响。方法采用腹腔注射戊四氮点燃癫痫大鼠模型,随机分为癫痫模型组、愈痫灵颗粒干预组、丙戊酸钠干预组、拉莫三嗪干预组、正常对照组共5组：跳台实验测试大鼠的学习记忆能力,透射电镜观察海马CA3区超微结构。结果造模后反应期和学习成绩比较。正常组与其它各组差异有统计学意义（P〈0．01）,潜伏期和记忆成绩比较,正常组与其它各组差异无统计学意义（P〉0．05）;抗痫药物干预后各组反应期和潜伏期及学习、记忆成绩比较差异有显著统计学意义（P〈0．001）,愈痫灵组与正常组比较差异无统计学意义（P〉0．05）,愈痫灵组、拉莫三嗪组优于丙戊酸钠组与模型组,差异有统计学意义（P〈0．05）;抗痫药物干预前后反应期、潜伏期、学习、记忆成绩比较,愈痫灵组、拉莫三嗪组差异有统计学意义（P〈0．01）,丙戊酸钠组、模型组差异无统计学意义（P〉0.05）,正常组反应期、潜伏期、记忆成绩差异无统计学意义（P〉0．05）,学习成绩差异有统计学意义（P〈0．01）。电镜观察模型组大鼠海马CA3区神经元可见明显损伤。愈痈灵组多数神经元结构正常。少数粗面内质网有轻度脱颗粒。结论愈痫灵颗粒减少戊四氮致痫大鼠海马组织神经元坏死可能是其改善癜痫大鼠认知功能障碍的作用机制之一。     

发育期大鼠反复痫性发作后远期学习记忆障碍及海马神经元可塑性的研究

目的探讨发育期大鼠反复痫性发作对大鼠成年后学习记忆及海马神经元可塑性的影响。方法生后10dsD大鼠32只,随机分为实验组16只和对照组16只。实验组用戊四氮（PTZ）反复腹腔注射5d,制成反复痫性发作模型,对照组腹腔注射等量生理盐水。在生后第60天用Morris水迷宫评价大鼠的学习记忆功能,用RT—PCR方法检测大鼠海马神经元可塑性标志物神经生长相关蛋白-43（GAP一43）mRNA的表达变化。结果与对照组比较,实验组在Morris水迷宫测试中平均逃避潜伏期明显延长（P〈0．05）,原平台所在象限的游泳时问明显缩短（P〈0．05）;海马组织GAP一43mRNA的表达显著增多（P〈0．05）。结论发育期大鼠反复痫性发作可引起远期学习记忆损害及海马神经元激活和突触重建等神经元可塑性改变,而GAP一43表达增多可能是学习记忆功能和可塑性变化的分子机制。     

韩氏针刺改善海洛因依赖大鼠学习记忆障碍和海马NOS、AchE的关系

目的初步探讨韩氏针刺对海洛因依赖大鼠学习记忆的影响及其作用机制。方法按逐日递增的原则皮下注射海洛因建立成瘾模型,利用Morris水迷宫测定大鼠成瘾后及针刺治疗后学习记忆的变化,用蛋白定量考马斯亮兰法测定海马组织中一氧化氮合酶（NOS）和乙酰胆碱酯酶（AchE）活性。结果①Morris水迷宫定位航行实验中,成瘾组逃避潜伏期较对照组明显延长（P〈0．05）,而针刺组较成瘾组明显缩短（P〈0．05）;空间探索实验中,成瘾组在第4象限搜索时间及120s内跨越安全岛的次数较对照组明显下降（P〈0．05）,而针刺组较成瘾组明显增加（P〈0．05）。②成瘾组海马组织中NOS和AchE活性高于对照组（P〈0．05）,针刺组明显低于成瘾组（P〈0．05）,而对照组和针刺组相比无明显差异。结论韩氏针刺可以改善海洛因依赖大鼠学习记忆障碍,降低海洛因依赖引起的海马内NOS和AchE活性的增高。     

糖尿病脑病海马神经元凋亡的实验研究

目的 检测糖尿病大鼠学习与记忆成绩及海马神经元凋亡情况，探讨糖尿病对学习与记忆影响的机制。方法 Wistar大鼠共24只，随机分成2组，对照组12只，糖尿病组12只，糖尿病组用链脲服佐菌素（STZ）制模，满12周后，用Y-迷宫检测大鼠学习与记忆成绩，处死动物取脑，应用TUNEL法、HE染色及图像分析技术对大鼠海马进行观察。结果 糖尿病组大鼠学习成绩降低（P〈0．05），海马神经元数目较正常组减少（P〈0．05），并出现TUNEL法阳性细胞。结论 海马神经元凋亡可能是糖尿病大鼠学习与记忆障碍的机制之一．     

电针治疗血管性痴呆对海马CAl区Noxa、Caspase-3表达的影响

为探讨电针对血管性痴呆（Vascular dementia．VD）大鼠的学习记忆能力的影响及其作用的分子机制。采用双侧颈总动脉永久性结扎法制作VD大鼠模型，Morro水迷宫检测大鼠平均逃避潜伏期和搜索策略，HE染色观察海马的病理变化，免疫荧光染色观测海马神经元细胞Noxa、Caspase-3的表达。结果：电针治疗改善VD大鼠的学习记忆能力．减轻VD大鼠海马病理损害，减少VD大鼠的海马CAl区Noxa、Caspase-3表达阳性细胞数（P〈0．01）。说明电针治疗改善海马神经元的凋亡状况．从而促进智能恢复．     

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.