福辛普利及氯沙坦对单侧输尿管梗阻大鼠肾脏TGF—β1表达的影响

目的观察福辛普利及氯沙坦对单侧输尿管梗阻(UUO)大鼠肾脏转化生长因子β1(TGF-β1)表达的影响,及其对肾间质纤维化的作用。方法UUO大鼠分别于术前1d及术后给予福辛普利(fosinopril,10mg.kg-1.d-1)、氯沙坦(losartan,50mg.kg-1.d-1)、福辛普利联合氯沙坦混悬液灌胃,用逆转录-聚合酶链反应(RT-PCR)的方法检测术后第7、14天TGF-β1表达量的改变。结果与假手术组相比,UUO组及药物治疗组TGF-β1表达均增高,但UUO组显著高于各治疗组(P<0.05),且联合治疗组更低于单用药组。结论福辛普利及氯沙坦可通过下调TGF-β1表达,从而减轻UUO术后肾组织间质纤维化,且联合用药作用更优于单用药。     

黄芩苷对UUO大鼠肾间质纤维化的影响及可能机制

目的 探讨黄芩苷对单侧输尿管梗阻(UUO)模型肾间质纤维化(RIF)的影响及可能机制.方法 40只雄性SD大鼠分为假手术组、模型组、黄芩苷组、贝那普利组及黄芩苷+贝那普利组,每组各8只.黄芩苷组给予黄芩苷溶液灌胃40 mg·kg-1·d-1,贝那普利组给予贝那普利混悬液灌胃10 mg·kg-1·d-1,黄芩苷+贝那普利组给予黄芩苷溶液40 mg·kg-1·d-1和贝那普利混悬液10 mg·kg-1·d-1灌胃,假手术组与模型组大鼠给予等量生理盐水灌胃.在造模第14、21和28天处死动物,取肾脏标本,免疫组化法检测肾组织转化生长因子-β1 (TGF-β1)和α-平滑肌肌动蛋白(α-SMA)的表达.结果 与假手术组相比,模型组大鼠在造模第14、21和28天,肾组织内TGF-β1、α-SMA的表达均明显升高(P＜0.05).与模型组相比,黄芩苷组、贝那普利组及黄芩苷+贝那普利组大鼠在造模第14、21和28天,肾组织内TGF-β1、α-SMA的表达均不同程度降低(P＜0.05).而黄芩苷组、贝那普利组和黄芩苷+贝那普利组3组之间各时间点肾组织内TGF-β1、α-SMA的表达两两比较差异均无统计学意义(P＞0.05).结论 黄芩苷可能通过下调TGF-β1、减少α-SMA表达,从而延缓UUO大鼠RIF的进展.     

双重阻断肾素血管紧张素系统对糖尿病肾病大鼠肾小管间质纤维化的影响

目的观察双重阻断肾素血管紧张素系统（RAS）对糖尿病肾病大鼠肾小管间质TGF-β1、CTGF、FN表达的影响。方法将STZ诱导的糖尿病肾病大鼠模型随机分为对照组（A组）、贝那普利组（B组）、贝那普利联合氯沙坦组（C组）。B组给予贝那普利10mg／kg灌胃,C组给予贝那普利5mg／ks、氯沙坦10mg／kg灌胃,8周后免疫组化观察各组肾小管间质TGF-β1、CTGF、FN表达,RT-PCR测定TGF-β1、CTGF、FN的mRNA表达。结果B组、C组大鼠小管间质TGF—β1、CTGF、FN表达、mRNA表达较A组均明显下调（P〈0．01）,同时C组TGF-β1、CTGF、FN表达较B组也显著下调（P〈0．05）。结论贝那普利与氯沙坦联合阻断RAS,比单用贝那普利能更有效下调糖尿病大鼠肾小管间质TGF-β1、CTGF、FN的表达。     

肾疏宁对HBV诱导人肾小管上皮细胞转分化的影响

目的探讨肾疏宁干预乙型肝炎病毒(HBV)诱导人肾小管上皮细胞(HK-2)转分化,延缓肾间质纤维化作用的可能机制。方法通过75只C57BL/6小鼠的中药肾疏宁灌胃,制备含药血清;使用Lipofectamine转染HBV至HK-2的方法造模;将细胞分为:空白血清对照组、空质粒组、HBV组、贝那普利组、肾疏宁低浓度组、肾疏宁中浓度组、肾疏宁高浓度组。运用酶联免疫吸附实验(ELISA)、实时荧光定量PCR法、蛋白质印迹(Western blot)法检测HK-2细胞中HBsAg、HBeAg、TGF-β1、p-Smad2、p-Smad3、Smad7、Col-Ⅲ、ColⅣ、FN的表达。结果 ELISA检测结果:HBV组与空质粒组比较,HBsAg、HBeAg、TGF-β1表达上调(P0.01);与HBV组比较,贝那普利组、肾疏宁低浓度组、肾疏宁中浓度组、肾疏宁高浓度组TGF-β1蛋白表达下降(P0.001);与贝那普利组比较,肾疏宁低浓度组TGF-β1的表达相对较高(P0.05)。实时荧光定量PCR检测结果:与HBV组比较,贝那普利组、肾疏宁各干预组ColⅢ、Col-Ⅳ、FN mRNA表达明显下降(P0.001)。Western blot检测结果:与HBV组比较,贝那普利组、肾疏宁各干预组p-Smad2、p-Smad3蛋白表达明显下降(P0.001)。结论肾疏宁可通过干预TGF-β1/Smad信号通路减轻HBV诱导的人肾小管上皮细胞转分化,并减轻细胞外基质的沉积,从而延缓纤维化的进程。     

氯沙坦及霉酚酸酯对单侧输尿管梗阻大鼠肾脏的保护作用

目的:观察氯沙坦及霉酚酸酯对单侧输尿管梗阻(UUO)大鼠肾脏转化生长因子(TGF)β1、Ⅲ型胶原、α平滑肌肌动蛋白(α-SMA)表达介导的肾间质纤维化的作用. 方法:雌性SD大鼠30只,随机分为假手术组(Sham、UUO组、氯沙坦组(LSRT、霉酚酸酯组(MMF和联合用药组(L M).制备UUO大鼠模型后,LSRT组给予氯沙坦(50 mg·kg-1·d-1)灌胃、MMF组给予霉酚酸酯(25 mg·kg-1·d-1灌胃、L M组给予氯沙坦霉和霉酚酸酯(剂量同前)灌胃,用免疫组织化学方法检测术后14 d肾组织α-SMA、TGF-β1、Ⅲ型胶原表达量,并进行Masson染色评分.同时测定收缩压、尿蛋白及肌酐清除率. 结果:各组大鼠收缩压、尿蛋白及肌酐清除率均无差异(P＞0.05).与Sham组比较,UUO组及治疗组α-SMA 、TGF-β1、Ⅲ型胶原表达及Masson染色评分均增高,且UUO组高于各治疗组(P＜0.05),而联合治疗组低于单用药组(P＜0.05).结论:氯沙坦及霉酚酸酯可通过下调α-SMA、TGF-β1、Ⅲ型胶原表达减轻UUO术后肾组织间质纤维化,联合用药作用优于单独用药.     

联合用药延缓阿霉素肾病大鼠肾间质纤维化的研究

目的：探讨贝那普利和蝙蝠蛾拟青酶Cs-4联合应用对阿霉素肾病模型大鼠肾纤维化的保护作用及调节机制。方法：将60只SD大鼠随机分为模型组（M组）、贝那普利组（B组）、联合治疗组（U组）3组，每组20只。8周后观察各组大鼠24h尿蛋白定量、血脂、血浆总蛋白（TP）、血浆白蛋白(ALB)、尿素氮(BUN)、肌酐(Scr)的水平及肾脏病理改变，免疫组化检测肾层粘连蛋白（LN）、肾组织中纤连蛋白(FN)、胶原蛋白Ⅳ(Col Ⅳ)、转化生长因子β1(TGF-β1)的表达，RT PCR方法测定肾皮质转化生长因子β1（TGF-β1）和纤溶酶原激活物抑制物（PAI-1）、组织性金属蛋白酶抑制物1(TIMP 1)mRNA的表达。结果：U组、B组分别和M组相比，24h尿蛋白定量、BUN、Scr、甘油三脂(TG)、总胆固醇(Cho)明显降低（P＜0.01），TP和ALB明显升高（P＜0.01）,U组和B组相比，BUN、Scr、TG、Cho亦明显降低（P＜0.05）；M组肾脏病理肾间质纤维化较重，而B组较轻，U组最轻；免疫组化可见B组和U组中LN、FN、Col Ⅳ、TGF-β1的表达明显低于M组（P＜0.01），并且U组和B组相比，Col Ⅳ、TGF-β1的表达明显降低（P＜0.05）；RT PCR显示B组、U组TGF-1mRNA、PAI-1mRNA、TIMP-1mRNA的表达，均较M组降低（P＜0.01），U组较B组亦明显降低（P＜0.05）。结论：蝙蝠蛾拟青酶Cs-4和贝那普利联合应用有相加作用，能有效的延缓肾间质纤维化。     

清肾颗粒对单侧输尿管梗阻致肾间质纤维化大鼠肾组织Wnt/β- catenin信号通路的干预作用

目的 基于Wnt/β- 连环蛋白（β- catenin）信号转导通路探讨清肾颗粒抗肾间质纤维化的作用机制。方法 将38只SD大鼠随机分为清肾颗粒组、贝那普利组、模型组和假手术组。采用单侧输尿管梗阻法复制肾间质纤维化模型。模型复制成功后,清肾颗粒组和贝那普利组大鼠分别给予清肾颗粒、贝那普利灌胃,假手术组和模型组给予等容积温水灌胃,疗程均为4周。检测24 h尿蛋白定量、血清肌酐、尿素氮水平以及肾脏组织中Wnt1、β- catenin和E- 钙黏蛋白（E- cadherin）含量。结果 模型组大鼠24 h尿蛋白定量、血尿素氮、血清肌酐、Wnt1、β- catenin水平均高于假手术组（P＜0.05）,E- cadherin水平低于假手术组（P＜0.05）;与模型组比较,清肾颗粒组和贝那普利组24 h尿蛋白定量、血尿素氮、血清肌酐、Wnt1、β- catenin水平明显降低（P＜0.05）,E- cadherin水平明显升高（P＜0.05）,清肾颗粒组上述指标的改善显著优于贝那普利组（P＜0.05）。结论 清肾颗粒改善肾间质纤维化的机制与抑制Wnt/β- catenin信号通路有关。     

肾病Ⅰ号方对肾间质纤维化大鼠TGF-β1和CTGF表达的影响

[目的]探讨肾病Ⅰ号方对肾间质纤维化大鼠肾组织转化生长因子-β_1(transforming growth factor-β_1,TGF-β_1)和结缔组织生长因子(connective tissue growth factor,CTGF)表达的影响,以及抗肾间质纤维化的可能机制。[方法]选取SPF级健康成年雄性SD大鼠72只,随机分为假手术组、模型组、贝那普利组和肾病Ⅰ号方组,每组18只。除假手术组外,其余大鼠建立单侧输尿管梗阻(unilateral ureteral obstruction,UUO)模型,术后第2天开始给予对应药物灌胃,贝那普利组给予贝那普利0.8mg/(kg·d)灌胃,肾病Ⅰ号方组则予肾病Ⅰ号方30g/(kg·d)灌胃,均为2次/d,共3周。检测术后第7、14、21天各组大鼠肾功能及肾组织病理学改变,应用免疫组化检测TGF-β_1和CTGF在肾组织的表达情况。[结果]与假手术组比较,模型组和两个药物处理组第7、14、21天血肌酐、尿素氮水平均明显升高(P0.05);与模型组比较,两个药物处理组血肌酐、尿素氮水平明显降低(P0.05)。Masson染色提示,与假手术组比较,模型组第7、14、21天肾间质纤维化指数均明显升高,两组之间差异均有统计学意义(P0.05),而贝那普利组和肾病Ⅰ号方组各时间点的肾间质纤维化指数均明显低于模型组(P0.05),两个药物处理组之间差异无统计学意义(P0.05)。与假手术组比较,第7、14、21天模型组和两个药物处理组TGF-β_1、CTGF表达水平均明显升高(P0.05);与模型组比较,贝那普利组或肾病Ⅰ号方组的表达水平均明显降低(P0.05);两个药物处理组之间差异则无统计学意义(P0.05)。[结论]肾病Ⅰ号方通过抑制肾小管上皮细胞TGF-β_1、CTGF的表达,减少细胞外基质的沉积,从而起到保护肾小管、抗肾间质纤维化的作用。     

贝那普利在大鼠酒精性肾损伤中作用的探讨

目的 探讨血管紧张素转换酶抑制剂贝那普利在酒精引起的大鼠肾损伤过程中对肾组织的保护作用.方法 以酒精灌胃法制备大鼠酒精性肝肾损伤模型,同时给予贝那普利[4mg/(kg·d)]灌胃,在4、8、12周收集尿液,放免法检测尿中β2-微量球蛋白(β2-MG)含量;利用光镜和透射电镜观察其肾组织病理改变;免疫组化法检测肾组织中转化生长因子-β1(TGF-β1)的表达. 结果与对照组相比较模型组尿β2-MG值明显增高(P<0.01),贝那普利组尿β2-MG值明显低于模型组(P<0.01);电镜下模型组肾组织在相应阶段出现间质内的纤维成分增多,而贝那普利组间质结构无明显改变;在免疫组化染色中模型组肾小管上皮细胞内TGF-β1呈阳性表达,随时间的增加阳性表达增加(P<0.01);贝那普利组阳性表达与模型组相比较明显减少(P<0.01).结论 大鼠酒精性肾损伤以肾小管-间质的炎性改变及形成肾间质纤维化为主要特征;肾组织中TGF-B1的阳性表达明显增加;贝那普利在酒精引起的肾损伤的过程中对肾脏具有保护作用,其机制可能与通过阻断肾素-血管紧张素系统(RAS),下调TGF-β1的表达,抑制细胞外基质(ECM)积聚等有关.     

川芎嗪联合贝那普利对GK大鼠肾间质MCP-1和TGF-β1表达干预的实验研究

目的：观察川芎嗪联合贝那普利对GK大鼠肾间质TGF—β1、MCP-1等表达的干预作用。方法：将GK大鼠随机分为模型组、川芎嗪组、贝那普利组、川芎嗪＋贝那普利组,每组10只;另设10只鼠龄、体重相匹配的Wistar大鼠作为正常对照组,分别予以相应处理,实验第8周、第12周和第16周,收集24h尿液,测定24h尿蛋白定量;治疗16周后处死动物,摘取肾脏,免疫组化法检测肾组织TGF—β1和MCP-1的表达。结果：与模型组相比,各治疗组24h尿蛋白、TGF-β1、MCP-1等指标改善（P〈0．05,或P〈0．01）;在下调TGF—β1、MCP-1方面,川芎嗪联合贝那普利组与川芎嗪组、贝那普利组相比有降低趋势（P〈0．05）。结论：川芎嗪联合贝那普利能改善GK大鼠肾脏的功能,其机制可能与降低GK大鼠血糖水平,下调肾组织TGF—β1、MCP-1表达有关。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.