缺血再灌注损伤的肾小管细胞ATP酶和自由基代谢的变化

目的：探讨肾缺血再灌注损伤时，小管上皮细胞ATP酶活性与自由基代谢的变化。方法：利用离体培养小管细胞的缺血再灌注模型，观察ATP酶与超氧化物歧化酶(superoxide dismutase，SOD)、脂质过氧化产物丙二醛(malondialdehyde，MDA)的变化。结果：缺血再灌注损伤导致肾小管细胞ATPase、SOD活性明显降低，而MDA含量明显增高，中药参麦注射液(ShenMai injeclion，SMI)能明显提高ATPase、SOD活性，同时脂质过氧化MDA含量明显降低。结论：实验结果提示在缺血再灌注中，氧自由基损伤了细胞的ATP酶和脂质成分，SMI对缺血再灌注损伤的肾小管上皮细胞有一定的保护作用。     

参麦注射液对兔肢体缺血再灌注致远隔器官脂质过氧化损伤的保护作用

目的 :通过动物实验观察家兔肢体缺血再灌注所致心、肝、肺、肾的脂质过氧化损伤及参麦注射液的保护作用。方法 :将 2 5只家兔随机分为假手术组 ( Sham)、缺血再灌注组 ( IR)和缺血再灌注 +参麦注射液组 ( IR+ SMI)。各组均经缺血 4h后再灌注 4h取材 ,分别测定血浆及各种组织中丙二醛 ( MDA)含量和超氧化物歧化酶 ( SOD)活性。结果 :缺血再灌注后血浆及各组织中 MDA含量较假手术组显著升高 ,SOD活性显著降低 ( P<0 .0 5 ) ,而参麦注射液治疗组血浆及组织中 MDA含量较缺血再灌注组显著降低 ,SOD活性显著升高( P<0 .0 5 )。结论 :肢体缺血再灌注可引起远隔器官的脂质过氧化损伤 ,参麦注射液对肢体缺血再灌注 ( L IR)引起的远隔器官脂质过氧化具有保护作用。     

参麦对氧化损伤的肾小管细胞的代谢影响

目的探讨参麦注射液(SMI)对H2O2导致的肾小管细胞氧化性损伤的有氧代谢的影响。方法建立H2O2致鼠肾小管细胞损伤模型,用组织化学方法显示培养小管细胞琥珀酸脱氢酶(SDH)和乳酸脱氢酶(LDH)。结果参麦注射液和泛醌都具有减轻氧化性损伤肾小管细胞SDH及LDH活性丧失的作用,与模型组比较有显著性差异(P<0.01),且参麦注射液对未损伤的小管细胞有明显的保护作用(P<0.01)。结论参麦注射液对H2O2所致的小管细胞氧化性损伤具有明显的保护作用,能保护有氧代谢关键酶的活性,能提高其有氧代谢功能。     

参麦注射液对肢体缺血-再灌注后肾脏脂质过氧化损伤的保护作用

①目的　探讨参麦注射液(SMI)对实验性家兔肢体缺血-再灌注所致肾的脂质过氧化损伤保护作用。②方法　将24只 家兔随机分为假手术组(Sham)、缺血再灌注组(I/R)和缺血再灌注+参麦注射液组(I/R+SMI)。各组均经缺血4小时后再灌注4小 时取材,分别测定血浆、肾组织及出肾血、入肾血中丙二醛(MDA)含量、超氧化物歧化酶(SOD)活性,同时测定血清肌酐(Cr)含量。③ 结果　肢体缺血-再灌注后血浆及肾组织中MDA含量较假手术组显著升高,SOD含量显著降低(P<0.05),而参麦注射液治疗组血 浆及组织中MDA含量较缺血再灌注组显著降低,SOD活性显著升高(P<0.05);I/R组出肾血中MDA含量明显高于入肾血(P< 0.05),SOD活性明显低于入肾血(P<0.01);而Sham组和I/R+SMI组出、入肾血中MDA含量和SOD活性无显著差异;I/R组血清Cr较 Sham组明显升高,而I/R+SMI组与I/R组相比血清Cr明显降低,但仍高于Sham组。④结论　肢体缺血-再灌注可引起肾脏的脂质 过氧化损伤,参麦注射液对肢体缺血-再灌注引起的肾脏脂质过氧化具有保护作用。     

参麦对大鼠肾小管细胞氧化性损伤的影响

目的 :探讨参麦注射液 (SMI)对H2 O2 所致小管细胞氧化性损伤的影响。方法 :通过H2 O2 致鼠肾小管细胞损伤模型建立 ,用组织化学方法显示培养小管细胞琥珀酸脱氢酶 (SDH)和乳酸脱氢酶 (LDH)。结果 :参麦注射液和辅酶Q1 0 能减轻氧化性损伤肾小管细胞SDH及LDH活性丧失的作用 ,与模型组比有显著差异 (P <0 .0 1 ) ,且对未损伤小管细胞具有明显的保护作用 (P <0 .0 1 )。结论 :SMI对H2 O2 所致的小管细胞氧化性损伤具有明显的修护作用 ,其效应略优于辅酶Q1 0 ,SMI能提高受损小管细胞有氧代谢的功能     

肾缺血再灌流性兔血清致人肾小管细胞损伤的作用及机制研究

目的：研究肾缺血再灌流性兔血清致培养肾小管细胞损伤的作用及机制。方法：健康家兔16只,随机分为对照和缺血再灌流（IR）组,IR组作双肾动脉夹闭1小时再灌注2小时;对照组不夹闭肾动脉,其余处理同IR组。测定对照组血清（SC）和IR组血清（SIR）中的MDA、SOD和NO含量。肾细胞培养实验分对照组（DMEMJ＋小牛血清）;SC组（DMEM＋对照兔血清）;SIR组（DMEM＋IR肾损伤性兔血清）。培养96小时,测定其增值状况和细胞存活率;细胞或培养液中MDA、SOD、NO、LDH、Na^＋－K^ －ATP酶和Ca^2 －ATP酶。结果：①急性肾缺血1小时再灌流2小时后SIR与SC比较,MDA含量增加,SOD活力降低（P＜0．05）。②SIR组MDA、NO含量、LDH活力比对照组、SC组高（P＜0．05）,对照组与SC组间差异无显著性;肾小管细胞中的SOD活力,对照组最高,SC组次之,SIR组最低,组间差异都具有显著性（P＜0．05）;Na^ -K^ -ATP 酶和Ca^2 -ATP酶的活力在SIR组均较对照组、SC组低,差异有显著性（P＜0．05）,对照组与SC组间差异无显著性。结论：IR性肾损伤兔血清具有抑制培养人肾小管细胞增殖的作用,其机制可能同氧自由基的致伤作用有关。     

益母草对大鼠心肌缺血再灌注损伤影响及机制的实验研究

目的：探讨益母草注射液对心肌缺血再灌注损伤的保护作用及机制。方法：60只SD大鼠被随机分为3组：假手术组、缺血再灌注损伤（IR）组、益母草注射液治疗（LJI）组。建立大鼠心肌缺血再灌注损伤模型，检测血清SOD、MDA、LDH和CK水平，观察心律失常及心肌损伤的形态学改变。结果：与IR组比较，LJI组SOD活力显著升高（P〈0．01），MDA、LDH和CK含量显著降低（P〈0.01），心律失常发生率（P〈0.01）及形态学改变（P〈0．05）均显著减轻。结论：益母草注射液对缺血再灌注损伤的心肌有保护作用，对缺血再灌注诱发的心律失常亦有治疗作用。其机制可能与增加SOD活性、增强心肌抗氧化能力、稳定生物膜有关。     

银杏叶提取物对大鼠急性肾缺血损伤的实验研究

目的　观察银杏叶提取物对大鼠急性肾脏缺血再灌注损伤的保护作用及其机理。方法　SD大鼠随机分为假手术对照组、单纯缺血再灌注组、缺血再灌注 +银杏叶提取物处理组。测定肾组织丙二醛 (MDA)、超氧化物歧化酶(SOD)、Na+ K+ ATP酶、Ca2 + ATP酶变化并观察肾脏病理学改变。结果　与假手术对照组相比 ,单纯缺血再灌注组肾小管上皮细胞呈明显的缺血性改变 ,MDA含量增加 (P <0 0 1) ,SOD、Na+ K+ ATP酶、Ca2 + ATP酶活性降低 (P <0 0 1) ;缺血再灌注 +银杏叶提取物处理组与单纯缺血再灌注组相比 ,MDA含量明显降低 (P <0 0 5 ) ,SOD活性显著升高 (P <0 0 1) ,Na+ K+ ATP酶、Ca2 + ATP酶活性增高 (P <0 0 1、P <0 0 5 ) ,肾小管上皮细胞缺血性改变减轻。结论　银杏叶提取物通过抗氧化 ,对急性肾缺血再灌注损伤有保护作用     

普伐他汀配伍参麦注射液干预兔心肌缺血再灌注损伤的实验研究

目的研究普伐他汀配伍参麦注射液对家兔心肌缺血再灌注损伤的保护作用。方法32只日本大耳白兔随机分为假手术组(Sham组)、心肌缺血再灌注未干预组(IR组)、普伐他汀组(P组)、普伐他汀配伍参麦注射液干预组(P S组),建立心肌缺血再灌注的模型。实验中持续监测ECGⅡ导联的变化,实验结束后处死动物,用Evans B lue染色法测量心肌梗死面积,取左心室缺血心肌制成组织匀浆,用试剂盒分别检测一氧化氮合酶(NOS)活性,超氧化物歧化酶(SOD)及丙二醛(MDA)的含量。结果IR组、R组和P S组均造成明显的心电图动态改变。与IR组比较,P S组心肌梗死面积、MDA含量均显著减小(P<0.01)。P S组分别与IR组和P组比较,SOD活性增加,MDA含量下降。P组及P S组总一氧化氮合酶(tNOS)活性均显著高于IR组(P<0.05),IR组诱导型一氧化氮合酶(iNOS)活性与tNOS活性比值显著大于Sham组、P组和P S组(P<0.05)。结论普伐他汀配伍参麦注射液对心肌缺血再灌注损伤有良好的保护作用,联合用药优于单一用药。     

吡格列酮经Ras依赖性途径保护缺血再灌注心肌细胞的实验研究

目的观察吡格列酮对缺血再灌注损伤心肌细胞的保护作用,并探讨其与Ras信号转导通路的关系。方法体外培养乳鼠心肌细胞,分正常对照组（Co组）、缺血再灌注组（I/R组）、吡格列酮预处理组（Pi组）、Ras抑制剂Manumycin组（Ma组）。采用MTT分析法测定各组心肌细胞活性;测定各组MDA、SOD、LDH、ATP含量。比较组间差异。结果与Co组比较,I/R组心肌细胞活性、SOD、ATP含量降低,MDA、LDH含量增加,差异有统计学意义（P〈0.01）;与I/R组比较,Pi组心肌细胞活性、SOD、ATP含量增加,MDA、LDH含量降低,差异有统计学意义（P〈0.01）;与Pi组比较,Ma组心肌细胞活性、SOD、ATP含量降低,MDA、LDH含量增加,差异有统计学意义（P〈0.01）。结论吡格列酮预处理可减轻缺血再灌注心肌细胞损伤,保护机制与Ras信号转导通路有关。     

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.     

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.