HO-1对抗汞引起的肾细胞凋亡

目的探讨血红素氧合酶-1(HO-1)对汞引起肾细胞凋亡的影响及其可能的机制。方法64只雄性Wistar大鼠随机分为对照组、单纯染汞组、HO-1诱导组和HO-1抑制组,每组16只。先分别腹腔注射生理盐水、空白液、血晶素、锌原卟啉Ⅸ(ZnPPⅨ)预处理,8 h后处死各组内半数鼠取肾查HO-1表达水平,余鼠除对照组注射生理盐水外,其余3组均腹腔注射HgCl2(2 mg.kg-1),24 h后检测血肌酐(Cr)、尿素氮(BUN)及肾内总抗氧化能力(TAOC)、丙二醛(MDA)、Bcl-2蛋白表达水平与细胞凋亡指数(AI)。结果与对照组比较,单纯染汞组TAOC降低而MDA、Cr、BUN、Bcl-2表达水平和AI均明显增加(P<0.01),HO-1抑制组除Bcl-2表达受抑外,其余指标的变化与单纯染汞组相似,但更为显著。HO-1诱导组与单纯染汞组及HO-1抑制组比较,TAOC及Bcl-2表达均显著升高,而MDA、Cr、BUN及AI则明显降低(均P<0.01)。结论HO-1通过抗氧化、上调Bcl-2蛋白表达水平而对抗汞引起的肾细胞凋亡作用。     

银杏叶提取物抗心肌缺血再灌注损伤作用的研究

目的探讨银杏叶提取物(EGb761)对减轻心肌缺血再灌注(IR)损伤的作用。方法54只兔随机分入单纯IR组(n=18)、EGb761组(n=18)、EGb761 锌原卟啉Ⅸ(ZnPPⅨ)组(n=18),各组兔分别先给予生理盐水5 m l、EGb761(10 mg.kg-1)、EGb761(10 mg.kg-1) ZnPPⅨ(7.5 mg.kg-1)腹腔内注射。24 h后,每组任选6只处死,检测IR前心肌细胞内血红素氧合酶-1(HO-1)的表达与活性;余兔行心肌缺血40 m in再灌注4 h,检测IR后心肌总抗氧化能力(T-AOC)、丙二醛(MDA)含量、中性粒细胞浸润、心肌梗死范围和心肌细胞凋亡指数(AI)。结果与单纯IR组比较,EGb761组心肌细胞HO-1表达及活性显著升高,T-AOC升高,而MDA含量、中性粒细胞浸润及心肌梗死范围和AI均明显降低(P<0.01);EGb761 ZnPPⅨ组HO-1表达增加但活性反而降低(P<0.01),T-AOC降低(P<0.05),但MDA含量及中性粒细胞浸润明显增加(P<0.01),心肌梗死范围及AI则与单纯IR组无显著差异。EGb761 ZnPPⅨ组与EGb761组比较,心肌细胞HO-1表达与活性及T-AOC明显降低,MDA含量、中性粒细胞浸润及心肌梗死范围和AI则显著升高(P<0.01)。结论EGb761可通过诱导HO-1表达,发挥抗氧化与抗炎作用,有效抑制心肌IR损伤。     

银杏叶提取物抗大鼠肾缺血/再灌注损伤的实验研究

目的:探讨银杏叶提取物(EGb)能否诱大鼠肾脏表达HO-1并减轻其缺血/再灌注损伤。方法:采用切除右肾,夹闭左肾动脉50min/再灌注24h的动物模型。32只雄性Wistar大鼠随机均分为4组:假手术组、缺血再灌注(I/R)组、EGb组(术前24h腹腔注射EGb20mg/kg)、EGb ZnPPⅨ组(EGb20mg/kg ZnPPⅨ45μmol/kg),检测肾组织中HO-1蛋白表达及HO-1活力、丙二醛(MDA)含量、总抗氧化能力(TAOC)和血清肌酐(Cr)、尿素氮(BUN)含量及肾组织形态学改变。结果:①EGb明显诱导肾内HO-1表达并使其活力增加(P<0.01);②同假手术组比较,I/R组Cr、BUN、MDA升高(P<0.05),TAOC降低(P<0.05),肾组织损伤严重,I/R前用EGb诱导HO-1表达可逆转上述病理改变(P<0.05),用HO的抑制剂ZnPPⅨ可部分抑制EGb的保护作用。结论:EGb通过诱导肾内HO-1表达,可明显改善大鼠的I/R性肾损伤,其作用机制可能同HO-1增强肾组织抗氧化能力有关。     

姜黄素抗心肌缺血再灌注损伤作用及其机制研究

目的探讨姜黄素抗心肌缺血再灌注(IR)损伤的效果及其可能的作用机制。方法选用日本大耳白兔随机分为4组:单纯IR组、姜黄素组、姜黄素预处理组、血红素氧合酶-1(HO-1)抑制组。分别给予单纯IR、同时用姜黄素 IR、提前8h用姜黄素 IR、提前8h用姜黄素 ZnPPⅨ然后行IR等处理。IR采用的是结扎冠状动脉左前降支40min、松开6h的方法进行。检测IR前心肌HO-1蛋白表达与活性以及IR后心肌中性粒细胞浸润、超氧化物歧化酶(SOD)活性、谷胱甘肽(GSH)及丙二醛(MDA)含量、心肌梗死范围及心肌细胞凋亡指数(AI)。结果与单纯IR组比较,与IR同时应用的姜黄素仅显示较弱的抗氧化作用,轻度缩小心肌梗死范围(P<0.05),对AI无影响。姜黄素预处理可明显上调HO-1蛋白表达与活性,并显著抑制IR后心肌中性粒细胞浸润及脂质过氧化反应,明显降低心肌梗死范围及AI(P<0.01)。这一保护作用可被HO-1抑制剂ZnPPⅨ消除。结论姜黄素可通过抗氧化作用防止心肌IR损伤,其保护作用主要是通过上调HO-1蛋白表达与活性实现的。     

大鼠血红素加氧酶-1表达对呼吸机相关性肺损伤时SOD、MDA的影响

目的以大鼠呼吸机相关性肺损伤（VILI）为模型,用血晶素（hemin）诱导大鼠血红素加氧酶-1（HO-1）表达,观察VILI时超氧化物歧化酶（SOD）和丙二醛（MDA）活性变化及HO-1对SOD和MDA的影响,探讨在VILI过程中的抗氧化应激保护作用及其机制。方法32只雄性SD大鼠随机分成4组（每组n=8）：对照组只做气管切开术,保留自主呼吸;模型组气管切开后行机械通气4 h;诱导剂组于模型制备前24 h腹腔注射血晶素40μmol/kg;抑制剂组于模型制备前24 h腹腔注射锌原卟啉（ZnPP）10μmol/kg。机械通气4 h后处死大鼠,收集肺组织和支气管肺泡灌洗液（BALF）标本,测定BALF中总蛋白含量,肺组织湿/干重比值（W/D）,肺组织LDH、SOD活性和MDA含量,检测肺组织HO-1蛋白表达,光镜下行肺组织病理学观察。结果与对照组相比,模型组大鼠肺组织病理损伤严重,肺W/D、BALF中总蛋白、LDH活性均明显增加,VILI模型复制成功。与模型组比较,诱导剂组肺组织HO-1表达增加,肺组织病理损伤明显减轻,SOD活性明显增加而MDA含量明显下降,用ZnPP抑制HO-1表达,此种保护作用消失。结论血晶素诱导大鼠HO-1表达可以增加SOD活性,降低MDA含量,减轻肺的氧化应激损伤,降低VILI的程度。     

HO-1抗大鼠肾缺血/再灌注损伤的实验研究

目的探讨诱导血红素氧合酶-1(HO-1)表达能否减轻随后的肾缺血/再灌注损伤(IRI)及其可能的机制。方法采用切除右肾,夹闭左肾动脉50min/再灌注24h的动物模型,30只雄性Wistar大鼠随机均分为3组:假手术组,缺血/再灌注(I/R)组,血晶素处理组(皮下注射血晶素30mg/(kg·d),连续2d),检测肾组织中HO-1蛋白表达及HO-1活力、丙二醛(MDA)含量、总抗氧化能力(TAOC)和血清肌酐(Cr)、尿素氮(BUN)含量及组织形态学改变。结果血晶素明显诱导了肾内HO-1表达并使其活力增加,与I/R组比较,P<0.01;与假手术组比较,I/R组Cr,BUN,MDA升高(P<0.05),TAOC降低(P<0.05),组织学损伤严重。在I/R前血晶素诱导HO-1表达可逆转上述病理改变(P<0.05)。结论肾内HO-1的诱导表达可明显改善大鼠随后的I/R性肾损伤,作用机制与其增强机体抗氧化能力有关。     

银杏叶提取物抗氯化汞急性肾损伤的实验研究

目的探讨银杏叶提取物(EGb)能否诱导大鼠肾脏表达HO-1,减轻氯化汞所致的急性肾损伤.方法56只雄性Wistar大鼠随机分为Ⅰ组(腹腔注射EGb 20 mg/kg,24 h后再注射HgCl21 mg/kg)、Ⅱ组(腹腔注射EGb 20 mg/kg ZnPPⅨ45μlmol/kg,24 h后再注射HgCl2 1 mg/kg)、Ⅲ组(同时腹腔注射等量生理盐水 HgCl21 mg/kg)、Ⅳ组(同时腹腔注射等量生理盐水 等量蒸馏水).检测肾组织中HO-1蛋白表达及HO-1活力、丙二醛(MDA)含量、总抗氧化能力(TAOC)和血清肌酐(Cr)、尿素氮(BUN)含量并观察组织形态学改变.结果EGb明显诱导了肾内HO-1表达并增加其活力;与Ⅳ组比较,Ⅱ、Ⅲ组Cr、BUN、MDA升高,TAOC降低,组织学损伤严重(均P＜0.05);与Ⅲ组比较,Ⅰ组染汞损伤前用EGb诱导HO-1表达,可逆转上述病理改变,而Ⅱ组用HO-1的抑制剂ZnPPⅨ后,则不能完全逆转上述病理改变.结论EGb能显著诱导肾内HO-1的表达并减轻HgCl2所致的急性肾损伤,其作用机制与HO-1增强肾组织抗氧化能力有关.     

血红素氧合酶-1高表达抗兔心肌缺血再灌注损伤研究

目的探讨血红素氧合酶-1（HO-1）高表达抗兔心肌IR损伤的效果及其作用机制。方法32只兔随机均分为单纯IR组与HO-1诱导组，分别预先给予生理盐水5mL及血晶素25mg／kg腹腔内注入。24h后，开胸结扎冠脉左前降支缺血40min，松开再灌注4h，测定心肌中HO-1表达及活性、中性粒细胞浸润、丙二醛（MDA）含量、心肌梗死范围及心肌细胞凋亡指数。结果与单纯IR组比较，HO-1预诱导组心肌中HO-1表达及活性均明显升高（P〈0．01），中性粒细胞浸润及MDA含量明显降低（P〈0．01），心肌梗死范围及心肌细胞凋亡指数均显著减少（P〈0．01）。结论HO-1可通过抗炎、抗氧化等作用减轻急性心肌IR损伤。     

HO-1在缺血后处理抗肺缺血再灌注损伤中的作用及其对STAT-3表达的影响

目的 研究血红素加氧酶-1（hemeoxygenase-1,HO-1）在缺血后处理（ischemic postconditioning,IPO）抗肺缺血再灌注损伤中的作用机制及其对STAT-3蛋白表达的影响。方法 40只SD雄性大鼠（250-280 g）随机分为假手术组（S）、缺血再灌注组（IR）、缺血后处理组（IPO）及缺血后处理 HO-1抑制剂组（IPO ZnPP）。称重法计算缺血肺组织干/湿比（W/D）,试剂盒检测缺血肺组织MDA水平及MPO与HO-1活性,Western Blot检测HO-1,p-STAT-3蛋白表达水平。结果 与S组比较,IR组大鼠W/D、MDA、MPO、HO-1活性及蛋白表达水平均显著增加,而p-STAT-3蛋白表达水平显著降低,IPO可以逆转上述变化,而HO-1特异性抑制剂可以取消IPO对上述指标的影响。结论 IPO可以通 过促进HO-1活性及蛋白表达的增加从而激活STAT-3信号通路而发挥抗肺缺血再灌注损伤作用。     

HO-1在EPO保护小鼠肾缺血再灌注损伤中的作用

目的:探讨血红素氧化酶-1(Heme oxygenase-1,HO-1)对促红细胞生成素(Erythropoietin,EPO)减轻小鼠肾缺血再灌注损伤的保护机制中的作用.方法:建立小鼠肾缺血再灌注损伤模型,80只雄性小鼠分为锌原卟啉(ZnPP)组、EPO治疗组、缺血组及对照组4组,检测血丙二醛(MDA)、肌酐(Cr)、尿素氮(BUN)和肾组织匀浆超氧化物歧化酶(Superoxide dismutase,SOD)、白介素-6(IL-6)水平以及HO-1的变化.结果:EPO组的HO-1酶活性明显升高、HO-1蛋白表达增加,同时血浆MDA、Cr、BUN水平较缺血组显著下降(P<0.05),肾组织匀浆SOD显著升高、IL-6显著降低(P<0.05);ZnPP组的肾保护作用较EPO组显著降低.结论:EPO对肾缺血再灌注损伤的保护作用可能与HO-1活性增强有关.     

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.