抗呆1号对脑缺血再灌注小鼠海马星形胶质细胞GFAP表达的影响

应用免疫组织化学方法探讨抗呆Ⅰ号对小鼠前脑缺血再灌注损伤后海马星形胶质细胞表达GFAP动态变化的影响,其与缺血性神经元的联系.结果显示:前脑缺血再灌注1 d只有少数星形胶质细胞表达GFAP,再灌注3 d表达GFAP的阳性细胞数增加,再灌注7～10 d表达GFAP的阳性细胞数达到高峰,同时,可见细胞反应性胶质化特征,前脑缺血再灌注15 d GFAP阳性反应细胞数仍维持在较高水平.用药组GFAP的表达细胞数较模型组明显减少.而正常对照组和假手术组只有少数星形胶质细胞表达GFAP.且星形胶质细胞表达GFAP的强弱与神经细胞的存亡有关.说明前脑缺血再灌注后海马反应性星形胶质细胞表达GFAP呈动态变化,抗呆Ⅰ号对缺血再灌注损伤星形胶质细胞和神经细胞有良好的保护作用.     

环磷酰胺对脑缺血再灌注海马GFAP表达的影响

目的观察环磷酰胺对脑缺血再灌注后大鼠大脑海马区胶原纤维酸性蛋白（GFAP）表达的影响。方法设正常组、假手术组、缺血再灌注组（I／R）和环磷酰胺处理组（T）,以改良Longa线栓法建立sD大鼠局灶性脑缺血模型。处理组缺血后1h给予环磷酰胺腹腔注射,处理组和I／R组均于缺血后2h形成再灌注,每组均分为三个时间段（24h、72h和5d）分别观察。应用免疫组织化学技术检测各组脑组织不同时段以及正常脑组织中海马GFAP的表达情况。结果脑缺血再灌注5d内,随着缺血时间的延长,GFAP在海马区星形胶质细胞中的阳性表达逐渐增多,缺血24h后即有表达,缺血再灌注72h后增多,5d后表达最高;经过环磷酰胺处理后,海马区GFAP表达减少（P〈0．05）。正常组及假手术组未见GFAP表达。结论大鼠脑缺血再灌注后5d内GFAP在海马中的表达与缺血时间呈明显的相关性,随着缺血时间延长而增加。用环磷酰胺处理后GFAP表达明显减少,提示环磷酰胺对缺血诱导的星形胶质细胞活化具有抑制作用,可能对脑缺血再灌注损伤的恢复起重要作用。     

补阳还五汤和黄芪对脑缺血再灌注后星形胶质细胞的影响

[目的]为了探讨补阳还五汤和黄芪对脑缺血再灌注后星形胶质细胞（AS）的影响。[方法]采用沙土鼠双侧颈动脉夹闭脑缺血模型。于脑缺血15min再灌注24h和48h后运用免疫组织化学技术观察星型胶质纤维酸性蛋白（GFAP）的动态表达。[结果]缺血15min再灌注24h后，GFAP免疫阳性反应达高峰，补阳还五汤和黄芪可使GFAP免疫反应减轻；缺血15min再灌注48h后GFAP表达减弱，补阳还五汤和黄芪可使其增强。[结论]补阳还五汤和黄芪对脑缺血再灌注后星形胶质细胞的调节作用可能与脑缺血损伤后神经功能的恢复有关。     

银杏内酯B对局灶性脑缺血时星形胶质细胞GFAP表达的影响

目的 观察血小板活化因子(PAF)受体拮抗剂银杏内酯B(GB)对局灶性脑缺血时星形胶质细胞胶质纤维酸性蛋白(GFAP)表达的影响,并探讨其作用机制.方法 建立光化学诱导树局灶性脑缺血模型,用HE染色和电镜技术观察缺血后不同时间脑组织星形胶质细胞的形态学改变;用免疫组织化学法观察脑缺血后4 h、24 h、72 h及给予GB后24 h半暗区及对侧皮层星形胶质细胞GFAP的表达,并测定其平均灰度值.结果 光镜下可见,HE染色显示树局灶性脑缺血后,随缺血时间延长,星形胶质细胞形态有不同程度改变;电镜观察显示缺血24 h时星形胶质细胞明显肿胀.免疫组织化学染色可见,半暗区星形胶质细胞GFAP表达在4 h时没有明显改变, 24 h时增加 (P＜0.01),72 h时仍维持在较高水平(P＜0.01);对侧皮层星形胶质细胞GFAP表达于72 h时开始增加(P＜0.05).缺血后6 h舌下静脉注射GB至缺血24 h时,星形胶质细胞GFAP表达少于缺血组(P＜0.05),但仍较假手术组高.结论 脑缺血后星形胶质细胞GFAP表达增强,GB可通过减少星形胶质细胞GFAP的表达而起脑保护作用.     

补阳还五汤及其有效部位组方对沙土鼠脑缺血后反应性星形胶质细胞活化的影响

目的：比较研究补阳还五汤及其有效部位组方对脑缺血后反应性星形胶质细胞活化的影响。方法：采用沙土鼠双侧颈总动脉夹闭脑缺血模型,分别腹腔注射补阳还五汤及其有效部位组方,于不同时间取脑组织,以 免疫组化方法测定胶质纤维酸性蛋白（GFAP）的表达。结果：缺血15min后各组脑组织无GFAP表达。缺血15min再灌注24h后,脑组织GFAP表达达高峰,主要在海马区表达,补阳还五汤及其有效部位组方可使GFAP表达减弱,两者作用相近。缺血15min再灌注48h后,GFAP表达有所减弱,而补阳还五汤及其有效部位方组GFAP表达则较模型组有所增强,两者作用相近。结论：星形胶质细胞活化主要在脑缺血后再灌注期,在再灌注早期,补阳还五汤及其有效部位组方通过对抗缺血性脑损伤而改善星形胶质细胞功能的紊乱;在再灌注后期,则通过促进星形细胞的活化,利于损伤的修复。     

病变侧亚低温对局灶脑缺血再灌注后胶质纤维酸性蛋白表达的影响

目的 观察病变侧亚低温(32—33℃)对局灶脑缺血再灌注后星形胶质细胞活性和组织病理变化的影响。方法 采用改良线栓法建立大鼠大脑中动脉缺血再灌注模型，将雄性Wisutr大鼠随机分为缺血常温组、亚低温组和假手术组。根据缺血时间不同，每组又分为缺血3h和12h。缺血30min后应用反馈控温半导体制冷块对大鼠病变侧给予亚低温治疗，并持续至再灌期。采用免疫组织化学方法检测胶质纤维酸性蛋白(GFAP)表达及HE染色观察组织病理变化。结果 缺血常温组GFAP阳性细胞数量增多，突体粗大，胞体肿胀；亚低温组GFAP表达数量明显减少。结论 病变侧亚低温能明显抑制脑缺血后星形胶质细胞反应性增生和肥大，并能减轻组织损伤程度。     

补阳还五汤对脑缺血再灌注后星形胶质细胞connexin43影响

目的:探讨补阳还五汤对大鼠脑缺血再灌注后海马CA1区缝隙连接小体connexin43(Cx43)的影响。方法:采用颈内动脉线栓法建立大脑中动脉栓塞模型,脑缺血2 h再灌注1、3和7 d后,免疫组织荧光染色观察海马CA1区Cx43的表达情况,并通过星形胶质细胞标记物胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)的免疫染色比较星形胶质细胞的激活程度。结果:补阳还五汤组脑缺血再灌注1 d后海马CA1区Cx43的表达较模型组显著降低(P<0.05),而第3天和第7天海马CA1区Cx43的表达较模型组高(P<0.05)。同时,补阳还五汤组缺血再灌注1 d后星形胶质细胞的激活较模型组受到抑制;第3天和第7天星形胶质细胞激活均较第1天明显减弱,而且第7天时两组无明显差异。结论:补阳还五汤可能通过调控星形胶质细胞Cx43表达对脑缺血再灌注后不同时间点的损伤和修复进行调控。     

缺血预处理对局灶性缺血大鼠脑梗死区周围TLR4及GFAP表达的影响

目的观察局灶性脑缺血预处理(CIP)对Toll样受体4(TLR4)及胶质原纤维酸性蛋白(GFAP)表达的影响,探讨TLR4介导的炎性信号通路及星形胶质细胞活化在诱导脑缺血耐受(BIT)发生中的作用。方法第1次脑缺血20min作为预处理,72h后行持续2h的第2次局灶性脑缺血。45只SD雄性大鼠随机分为脑缺血预处理(CIP)组、大脑中动脉阻塞(MCAO)组、假手术(sham)组。MCAO组第1次脑缺血以假手术代替,假手术组两次均为假手术。第2次脑缺血后每组又分再灌注6、24、72h等3个时间段。光学显微镜下观察脑组织病理改变,免疫组织化学染色和图像分析评价各组TLR4及GFAP的表达。结果 CIP组TLR4阳性细胞数明显低于同时间段的MCAO组,而GFAP阳性细胞数则均高于同时间段的MCAO组(P<0.05)。TLR4、GFAP在CIP组及MCAO组的表达高峰均分别出现于再灌注后6、72h。结论短暂的CIP可能通过抑制TLR4炎症信号通路,明显激活反应性星形胶质细胞,从而诱导脑缺血耐受的发生。     

红景天胶囊对脑缺血再灌注大鼠脑组织胶质纤维酸性蛋白表达的影响

目的观察红景天胶囊对大鼠局灶性脑缺血再灌注梗死区胶质纤维酸性蛋白（GFAP）表达的影响。方法将96只健康Wistar大鼠随机分为红景天治疗组、缺血再灌注组、假手术组和正常对照组。正常对照组未进行特殊处理,其他3组采用改良线栓法制成大脑中动脉缺血再灌注模型。观察各组神经功能缺损评分,2,3,5-三苯基氯化四唑染色测量各组脑梗死体积,采用免疫组织化学方法测定GFAP表达,用末端标记法测定神经细胞凋亡。结果红景天治疗组神经功能缺损评分低于缺血再灌注组（P〈0．05）,脑梗死体积小于缺血再灌注组（P〈0．01）。GFAP阳性细胞于脑缺血2h后即已．出现,各组之间GFAP阳性表达比较差异无统计学意义。随缺血再灌注时间推移,缺血6—72h时红景天治疗组较缺血再灌注组GFAP表达减低（P〈O．05）。红景天治疗组神经细胞凋亡较缺血再灌注组减少（P〈0．05）。结论红景天胶囊能够减轻脑缺血再灌注损伤及提高神经功能评分,可能与减少星形胶质细胞GFAP的表达有关。     

转小鼠TNFα基因大鼠脑缺血时TNFα表达对小胶质细胞激活的影响

目的：观察转小鼠TNFα基因大鼠脑缺血再灌流不同时间TNFα表达的动态变化及其对小胶质细胞激活的影响。方法：采用线栓法制作大鼠大脑中动脉闭塞模型,用TNFα、整合素QM(OX42)免疫组化染色观察转小鼠TNFα基因大鼠未缺血脑组织及缺血1h再灌注3h、12h、24h、72h、7d时的TNFα表达及小胶质细胞激活状态。结果：转小鼠TNFα基因大鼠缺血1h再灌注3hTNFα表达较未缺血脑组织明显增加,并达峰值,缺血1h再灌注12～72h,TNFα表达仍较显著,但随时间的延长逐渐减少,再灌注7d时,TNFα表达接近缺血前水平。转小鼠TNFα基因大鼠脑组织小胶质细胞缺血1h再灌注3h小胶质细胞极显著地被激活,并达峰值;缺血1h再灌注12h、24h、72h、7d时脑组织小胶质细胞与未缺血脑组织比较显著被激活,但随时间的延长,小胶质细胞激活状态逐渐接近缺血前的水平。结论：脑缺血再灌注后TNFα表达的动态变化与小胶质细胞激活的动态变化完全一致,提示脑缺血再灌注后小胶质细胞的激活主要与TNFα的过度表达有关。     

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.     

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.