山茶花提取物对脑缺血再灌注小鼠学习记忆损伤的改善作用

目的 探讨山茶花提取物对脑缺血再灌注诱导小鼠学习记忆损伤的保护机制.方法 双侧颈总动脉结扎法建立重复前脑缺血再灌注模型.小鼠随机分为假手术组、模型组、银杏叶提取物对照组(EGB,35 mg·kg-1,ip)和山茶花提取物治疗组(ECJ,50,15,5 mg·kg-1,ip).用水迷宫检测小鼠学习记忆能力;用紫外分光光度计检测脑组织SOD活性和MDA含量;用RT-PCR技术检测凋亡蛋白抑制剂XIAPmRNA在小鼠CA1区的表达.结果 前脑重复缺血再灌注使小鼠的学习记忆能力显著下降(P＜0.01),同时伴随脑内SOD活性降低和MDA含量升高以及XIAPmRNA表达显著下调 (P＜0.01).5 mg·kg-1,15 mg·kg-1和50 mg·kg-1山茶花提取物及银杏提取物能显著提高缺血小鼠学习记忆能力(P＜0.05或P＜0.01),并提高脑组织SOD活性,并抑制XIAPmRNA表达的下调(模型组XIAPmRNA表达下调63.2%,P＜0.01;低、中、高剂量的山茶花提取物和银杏叶提取物分别使XIAPmRNA表达上调55.7%、58.9%、61.2%和57.4% ,P＜0.05或P＜0.01).结论 山茶花提取物能减轻缺血再灌注引起的脑损伤,改善小鼠学习记忆能力,该作用可能与其提高脑组织抗氧化和抗细胞凋亡能力有关.     

山茶花提取物对脑缺血再灌注小鼠学习记忆损伤的改善作用

目的探讨山茶花提取物对脑缺血再灌注诱导小鼠学习记忆损伤的保护机制。方法双侧颈总动脉结扎法建立重复前脑缺血再灌注模型。小鼠随机分为假手术组、模型组、银杏叶提取物对照组(EGB,35mg·kg-1,ip)和山茶花提取物治疗组(ECJ,50,15,5mg·kg-1,ip)。用水迷宫检测小鼠学习记忆能力;用紫外分光光度计检测脑组织SOD活性和MDA含量;用RT-PCR技术检测凋亡蛋白抑制剂XIAP mRNA在小鼠CA1区的表达。结果前脑重复缺血再灌注使小鼠的学习记忆能力显著下降(P<0.01),同时伴随脑内SOD活性降低和MDA含量升高以及XIAP mRNA表达显著下调(P<0.01)。5mg·kg-1,15mg·kg-1和50mg·kg-1山茶花提取物及银杏提取物能显著提高缺血小鼠学习记忆能力(P<0.05或P<0.01),并提高脑组织SOD活性,并抑制XIAP mRNA表达的下调(模型组XIAP mRNA表达下调63.2%,P<0.01;低、中、高剂量的山茶花提取物和银杏叶提取物分别使XIAP mRNA表达上调55.7%、58.9%、61.2%和57.4%,P<0.05或P<0.01)。结论山茶花提取物能减轻缺血再灌注引起的脑损伤,改善小鼠学习记忆能力,该作用可能与其提高脑组织抗氧化和抗细胞凋亡能力有关。     

表没食子儿茶素没食子酸酯对大鼠脑缺血再灌注损伤的保护作用

目的 观察表没食子儿茶素没食子酸酯(EGCG)对大鼠脑缺血再灌注损伤的作用.方法 采用线栓法栓塞大鼠大脑中动脉建立急性局灶性脑缺血再灌注损伤模型,检测缺血2 h再灌注24 h后脑梗死体积、脑组织含水量、神经细胞凋亡及相关基因Bcl-2与Bax的表达,脑组织SOD、MDA和GSH-Px水平,以及对缺血再灌注后神经功能进行评分等评价EGCG的作用.实验分假手术组、脑缺血/再灌注组、EGCG(高、低剂量)治疗组、尼莫地平对照组.结果 模型组大鼠的神经功能缺陷症状、脑梗塞体积和脑组织水肿表现明显;脑组织SOD、GSH-px活性显著降低,MDA含量显著增高;神经细胞凋亡、Bcl-2与Bax表达明显增加,但Bcl-2/Bax显著降低(与假手术组比较,P<0.01).而上述这些指标在EGCG和尼莫地平组均得到明显改善(与模型组比较,P<0.05或P<0.01).结论 EGCG通过提高清除自由基能力以及上调Bcl-2表达和下调Bax的表达抑制神经细胞凋亡,对大鼠脑缺血再灌注损伤发挥保护作用.     

夏天无总碱抗实验性脑缺血的作用

目的:观察夏天无总碱(Corydalis ambailis migo total alkaloids,COAMTA)对脑缺血/再灌注损伤的保护作用并对其机制作初步探讨.方法:采用小鼠断头张口喘气模型、大鼠大脑中动脉缺血2 h/再灌注22 h模型,以神经病学评分、脑梗死范围及脑组织水含量变化,观察COAMTA抗脑缺血/再灌注损伤的效应;通过测定大鼠脑组织中一氧化氮合酶(nitric oxide synthase,NOS)、超氧化物歧化酶(superoxide dismutase,SOD)活性及丙二醛(malondialdehyde,MDA)含量的变化,并采用原位末端标记法观察对神经细胞凋亡的影响以探讨药物作用的机制.结果:COAMTA可延长小鼠张口喘气时间,降低大鼠脑缺血/再灌注后神经病学评分及梗死范围,降低脑组织MDA含量和NOS活性及升高SOD活性,COAMTA还可抑制神经细胞凋亡.结论:COAMTA对脑缺血/再灌注损伤有保护作用,其作用机制与抑制NOS活性、提高SOD活性、减少神经细胞脂质过氧化损伤和抑制神经细胞凋亡有关.     

雌激素对去卵巢沙土鼠脑缺血再灌注脑组织SOD和MDA的影响

目的观察雌激素对沙土鼠脑缺血再灌注自由基损伤的影响。方法雌性沙鼠40只，随机分为假手术组、缺血再灌注组、去卵巢组、补充雌激素组。采用夹闭双侧颈总动脉法复制沙鼠脑缺血再灌注模型，缺血7min再灌注12h，取脑组织测定脑组织中SOD活力、MDA含量的变化，并观察海马CA1区神经细胞的病理改变。结果缺血再灌注组、去卵巢对照组脑组织中SOD活力明显降低，MDA含量明显增高，与假手术组比较有显著性差异（P〈0．01）；补充雌激素组脑组织中SOD活力明显增高，MDA含量明显减少，与缺血再灌注组、去卵巢对照组比较有显著性差异（P〈0．01）；缺血再灌注组脑组织海马CA1区神经细胞损伤明显，脑组织水肿明显；补充雌激素组神经细胞损伤明显减轻。结论预防性应用雌激素能明显减轻缺血再灌注所造成的神经细胞损伤，对脑缺血再灌注自由基损伤有保护作用。     

银杏叶提取物联合依达拉奉对气虚血瘀型脑缺血再灌注大鼠细胞凋亡及bcl-2/bax表达的影响

目的:观察银杏叶提取物(EGb)与依达拉奉(ED)联合应用对气虚血瘀型脑缺血再灌注大鼠脑组织细胞凋亡率及bcl-2/bax表达的影响。方法:采用饥饿、疲劳、高脂饮食等复制大鼠气虚血瘀模型,再用线栓法阻断大脑中动脉2 h,再灌注治疗72 h后,观察EGb、ED及EGb+ED组对气虚血瘀型脑缺血再灌注损伤大鼠脑组织细胞凋亡率及bcl-2/bax表达的影响。结果:与模型组比较,EGb、ED及EGb+ED组均能降低气虚血瘀型脑缺血再灌注损伤大鼠脑组织凋亡细胞数(P<0.01),下调bax基因表达,上调bcl-2基因表达,减轻神经细胞损伤(P<0.01),两药联用变化趋势更明显。结论:银杏叶提取物和依达拉奉能降低气虚血瘀型脑缺血再灌注损伤模型鼠脑组织细胞凋亡基因bax的表达,增加具有神经元保护作用的bcl-2基因表达,从而抑制神经细胞凋亡,加速神经功能的恢复,共同发挥脑保护作用。     

灯盏花素对缺血再灌注诱导小鼠学习记忆损伤的保护作用

目的 探讨灯盏花素对脑缺血再灌注诱导小鼠学习记忆损伤的保护机制.方法 双侧颈总动脉结扎法建立重复前脑缺血再灌注模型.小鼠随机分为假手术组、模型组、阳性药物对照组(银杏叶提取物,35 mg&#183;kg-1,ip)和灯盏花素治疗组(80,20,5 mg&#183;kg-1,ip).小鼠适应3 d后,灯盏花素治疗组和阳性药物对照组分别腹腔注射灯盏花素和银杏叶提取物,连续给药7 d.模型组和对照组在相同时间点注射等量生理盐水.第7天给药30 min后,用1.275 g&#183;kg-1乌拉坦腹腔注射麻醉小鼠,重复缺血再灌注手术.术后第2天用开场行为模型检测小鼠在新异环境中的自发行为;第3天用水迷宫检测小鼠学习记忆能力;用紫外分光光度计检测脑组织超氧化物歧化酶(SOD)活性和丙二醛(MDA)含量;同时检测灯盏花素对H2O2引红细胞溶血的影响.结果 前脑重复缺血再灌注并没有明显影响小鼠在新异环境中的自发活动和探究行为,但使小鼠的学习记忆能力显著下降,同时伴随脑内SOD活性降低和MDA含量升高.5,20和80 mg&#183;kg-1灯盏花素及银杏提取物能显著提高缺血小鼠学习记忆能力(P＜0.05,P＜0.01),并提高脑组织SOD活性(P＜0.01),使MDA含量明显下降(P＜0.05,P＜0.01);体外实验表明,0.015 g&#183;L-1以上剂量的灯盏花素能明显降低H2O2引起的红细胞溶血率(P＜0.05,P＜0.01),且呈剂量依赖关系.结论 灯盏花素能减轻缺血再灌注引起的脑损伤,改善小鼠学习记忆能力,该作用可能与其提高脑组织抗氧化能力有关.     

大脑中动脉缺血再灌注大鼠脑组织PAR-1表达与炎症反应的关系

目的:研究脑缺血再灌注(CIR)后脑组织中蛋白酶激活受体-1(PAR-1)的表达及其与炎症反应的关系。方法:40只雄性SD大鼠线栓法建立大脑中动脉栓塞(MCAO)模型,再灌注后于3、6、12h及1、2、3、7d取脑,免疫组化法和脑组织匀浆法检测PAR-1、超氧化物歧化酶(SOD)和丙二醛(MDA)的含量。结果:缺血再灌注后脑组织PAR-1表达增加(P<0.01),MDA含量增多(P<0.01),SOD活性降低(P<0.01);PAR-1表达与MDA含量正相关(r1=0.844,P<0.05),与SOD含量负相关(r2=-0.901,P<0.01)。结论:CIR后PAR-1表达增多可加重脑组织炎性反应。     

心脑舒通胶囊对大鼠脑缺血再灌注后氧化损伤与细胞凋亡的影响

目的研究心脑舒通胶囊对局灶性脑缺血再灌注大鼠神经细胞的保护作用,并探讨其抗氧化作用。方法采用线栓法阻塞大脑中动脉致大鼠局灶性脑缺血再灌注模型(MCAO),24h后断头取脑,HE染色,光镜下观察大鼠大脑皮层区细胞损伤程度,TUNEL法检测皮层区神经细胞凋亡程度,分光光度计检测患侧脑组织中丙二醛(MDA)、超氧化物歧化酶(SOD)、乳酸(LD)、乳酸脱氢酶(LDH)的含量。结果缺血再灌注模型组大鼠均出现明显的神经功能缺损症状,有明显缺血性形态学改变如细胞水肿等;皮层区凋亡细胞数增多,缺血侧脑组织的MDA增多、SOD活性降低,与假手术组比较均有显著性差异(P＜0.01)。心脑舒通胶囊能明显改善MCAO大鼠神经症状体征,减轻皮层区神经细胞水肿,降低细胞凋亡;并可显著提高SOD活性,降低MDA、LD、LDH的含量,与模型组比较有统计学意义(P＜0.05～0.01)。结论心脑舒通胶囊有减轻缺血再灌注脑组织损伤程度、降低神经细胞凋亡的作用,其机制可能是通过调整氧化应激、提高自由基酶性清除能力,从而减轻脑损伤。     

富氢液对大鼠全脑缺血再灌注损伤的影响

目的脑组织缺血缺氧后,过量自由基产生,破坏组织细胞,形成再灌注损伤。最近,学者研究报道氢气溶解在液体中可选择性中和培养细胞中的羟自由基和亚硝酸阴离子。文中观察腹腔注射富氢液对大鼠暂时性全脑缺血再灌注损伤的影响。方法雄性SD大鼠90只,建立四血管阻塞全脑缺血(15 min)再灌注损伤模型,分为3组:假手术组(n=30),模型组(再灌注同时腹腔注射等渗盐水5ml/kg,n=30)和治疗组(再灌注同时腹腔注射0.6mmol/L富氢液5ml/kg,n=30),检测各组再灌注24 h海马丙二醛(malondialdehyde,MDA)浓度、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)浓度、核因子-κB(nu-clear factor-kappaB,NF-κB)免疫组化阳性细胞数和活化caspase-3的表达水平以及再灌注72 h海马CA1区HE染色未损伤锥体细胞数。结果与模型组相比,治疗组海马MDA浓度、TNF-α浓度和NF-κB阳性细胞数活均显著下降(P<0.01);活化caspase-3蛋白表达显著降低(P<0.05);海马CA1区锥体细胞数显著增多(P<0.01)。结论腹腔注射富氢液能够有效减轻全脑缺血(15 min)后再灌注时大鼠脑的氧化应激和炎症反应,进而缓减再灌注损伤。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.