缺血预处理对大鼠心肌离子泵,离子及氧自由基的影响

目的：探讨心肌缺血预处理（Ｉｓｃｈｅｍｉｃ ｐｒｅｃｏｎｄｉｔｉｏｎｉｎｇ，ＩＰＣ）的心肌保护作用机制。方法：通过大鼠在低心肌缺血预处理模型，观察预处理（ＰＣ）对缺血再灌注心肌钠泵（Ｎａ＾２＋Ｋ＾＋－ＡＴＰ酶）、钙泵（Ｃａ＾２＋－ＡＴＰ酶）活性、Ｎａ＾＋、Ｃａ＾２＋浓度及超氧化物歧化酶（ＳＯＤ）、丙二醛（ＭＤＡ）的影响。结果：与单纯缺血再灌注组相比，ＰＣ组缺血再灌注心肌缺泵、钙泵的活性降低幅度小（     

药物预处理对离体大鼠缺血再灌注损伤心肌的保护作用

为观察药物预处理对缺血再灌注所致心肌损伤是否有保护作用，离体大鼠心脏在３０ｍｉｎ全心缺血和３０ｍｉｎ再灌注前有和０＾－７Ｍ／Ｌ去甲肾上腺素和１ｍｇ／Ｌ苯肾上腺素灌注５ｍｉｎ，随后用正常Ｋ－Ｈ液冲洗１０ｍｉｎ，结果发现，去甲肾腺素和苯肾上腺素预处理可以１）显著降低再灌注性心律失常发生率；２）增加再灌注期间的心率和冠脉回流量；３）减少心肌细胞内ＣＫ和ＬＤＨ的漏出以及抑制心肌ＭＤＡ含量的升高。结果表明，     

局限缺血－再灌注心肌细胞内钙超负荷发生机制的探讨

本文通过犬急性心肌缺血－再灌注模型探讨缺血－再灌注心肌Ｃａ２＋超负荷的发生机制。当心肌持续缺血１５０ｍｉｎ，心肌细胞内Ｃａ２＋、Ｎａ＋增加、Ｋ＋降低；心肌细胞膜Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ、Ｃａ２＋－ＡＴＰａｓｅ活性降低，心肌组织丙二醛（ＭＤＡ）含量增加．而心肌缺血９０ｍｉｎ后，再灌注６０ｍｉｎ，与之比较细胞内Ｃａ２＋明显增加，伴Ｎａ＋升高、Ｋ＋降低，心肌细胞膜Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ、Ｃａ２＋－ＡＴＰａｓｅ活性降低，ＭＤＡ含量增加，说明缺血－再灌注过程中Ｎａ＋升高、Ｎａ＋－Ｃａ２＋交换增加，Ｃａ２＋－ＡＴＰａｓｅ活性降低是细胞内Ｃａ２＋超负荷发生的重要原因。     

心肌缺血再灌注Na^＋—K^＋ATPase活性变化及鹿茸精的保护作用

目的：研究心肌缺血再灌注损伤Ｎａ＾＋－Ｋ＾＋ＡＴＰａｓｅ活性变化，探讨鹿茸精对心肌缺血再灌注损伤的保护作用及其机理。方法：采用大鼠离体心脏灌注模型，应用电镜酶细胞化学技术观察Ｎａ＾＋－Ｋ＾＋ＡＴＰａｓｅ定位，分布及活性变化。结果：正常心肌Ｎａ＾＋－Ｋ＾＋ＡＴＰａｓｅ主要位于肌膜上，缺血３０ｍｉｎ，酶活性显著减弱，再灌注３０ｍｉｎ及６０ｍｉｎ酶活性进一步减弱或缺失，而应用鹿茸精此酶活性减弱不明显。结     

辅酶Q10与供心缺血再灌注损伤

目的：探讨Ｃｏ－Ｑ１０与供心血缺血再灌注损伤的关系，评价Ｃｏ－Ｑ１０对供心缺血再灌注损伤的保护作用。方法：选用１６只新西兰大白兔随机分为对照组和实验组。常规取心后用ＵＷ液冷保存６小时；然后在Ｌａｎｇｅｎｄｏｒｆｆ模型上，对照组用ＫＨＢ液灌注，实验组用ＫＨＢ＋Ｃｏ－Ｑ１０液灌注３０分钟。分别测定灌注前、后的心肌丙二醛（ＭＤＡ）含量和超氧化物歧化酶（ＳＯＤ）活性。结果：实验组ＭＤＡ含量明显低于对照组（     

API0134对缺血——再灌注心肌氧自由基和钙超负荷的作用

在犬生心肌缺血－－再灌注模型上，结扎冠状动脉左前降支（ＬＡＤ）９０ｍｉｎ后，行再灌注１２０ｍｉｎ，发现缺血区心肌组织超氧化物歧化酶（ＳＯＤ）、谷胱甘肽过氧化物酶（ＧＳＨ－Ｐｘ）活性降低，丙二醛ＭＤＡ含量增加；Ｎａ、Ｃａ＾２＋含量明显增加，Ｋ含量及Ｋ／Ｎａ幽会显著降低。再灌注前４５ｍｉｎ静脉给予ＡＰＩ０１３４，则见相应在的缺血区ＳＯＤ、ＧＳＨ－Ｐｘ活怀，Ｋ含量及Ｋ／Ｎａ比值高于对照，而ＭＤＡ和Ｎａ、     

局限缺血—再灌注心肌细胞内钙超负荷发生机制的探讨

本文通过犬急性心肌缺血－再灌注模型探讨缺血－再灌注心肌Ｃａ＾２＋超负荷的发生机制。当心肌持续缺血１５０ｍｉｎ，心肌细胞内Ｃａ＾２＋、Ｎａ＾２＋增加、Ｋ＾＋降低；心肌细胞膜Ｎａ＾＋－Ｋ＾＋－ＡＴＰａｓｅ、Ｃａ＾２＋－ＡＴＰａｓｅ活性降低，心肌组织丙二醛含量增加。     

GIK对大鼠离体心脏能量代谢的影响

目的：探讨葡萄糖－胰岛素－氯化钾（ＧＩＫ）对离体作功心脏能量代谢的影响，方法：通过离体作功心脏模型，测定对照组，缺血再灌注组与ＧＩＫ防护组心肌三磷酸腺苷（ＡＴＰ），二磷酸腺苷（ＡＤＰ）与总腺嘌呤核苷酸（ＴＡＮ），能量负荷（ＥＣ），心肌膜Ｎａ＾＋－Ｋ＾＋－ＡＴＰａｓｅ活性，线粒体钙含量，结果：缺血再灌注可明显降低ＡＴＰ，ＡＴＰ／ＡＤＰ，ＴＡＮ，ＥＣ及Ｎａ＾＋－Ｋ＾＋－ＡＴＰａｓｅ活性，增加心肌线粒体     

再灌注前后稀释血液对兔缺血再灌注心肌SOD和丙二醛的影响

观察应用右旋糖酐４０分别于再灌注前后稀释血液对兔缺血再灌注心肌ＳＯＤ活性和丙二醛（ＭＤＡ）含量的影响。心肌缺血４５ｍｉｎ，再灌注１８０ｍｉｎ，复制急性心肌缺血再灌注模型。３０只兔随机分为３组，每组１０只。其中Ⅰ组（对照组）、Ⅱ组于再灌注后２０ｍｉｎ稀释血液；Ⅲ组于再灌注前２０ｍｉｎ稀释血液。结果：与Ⅰ组相比，Ⅱ组ＳＯＤ活性无明显变化，ＭＤＡ含量明显降低（Ｐ＜００５）；而Ⅲ组ＳＯＤ活性明显升高及ＭＤＡ含量显著降低（Ｐ＜００５）。提示：再灌注前后稀释血液对缺血再灌注心肌均有保护作用；而且再灌注前稀释血液的效果明显优于再灌注后稀释。     

肢体缺血再灌注时红细胞内MDA,血浆中TXB2和6—Keto—PGF1α？…

将２１例择期下肢手术病人随机分为非缺血对照组，缺血再灌注组，以观察肢体缺血再灌注时红细胞内丙二醛（ＭＤＡ），血浆中血栓素Ｂ２（ＴＸＢ２）和６－酮－前列腺素Ｆ１α（６－Ｋｅｔｏ－ＰＧＦ１α）含量的变化，结果发现，肢体缺血再灌注１０ｍｉｎ后，红细胞内ＭＤＡ显著升高，血浆中ＴＸＢ２及ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α的比值无明显变化，再灌注２０ｍｉｎ后，红细胞内ＭＤＡ，血浆中ＴＸＢ２以及ＴＸＢ２／６－Ｋ     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.