没食子酸丙酯对大鼠缺血再灌注心肌线粒体损伤的保护

目的观察没食子酸丙酯对大鼠缺血再灌注心肌线粒体损伤的保护。方法结扎大鼠冠状动30min再灌注20min,测定心肌线粒体中琥珀酸脱氢酶(SDH)、细胞色素氧化酶(CCO)、Ca2+·Mg2+-ATP酶、Ca2+-ATP酶、超氧化物歧化酶(SOD)、谷光甘肽过氧化物酶(GSH-PX)活性及细胞色素、磷脂和丙二醛含量。结果没食子酸丙酯(20和40mg/kg,结扎冠状动脉前60minip)能显著减轻缺血再灌注所致琥珀酸脱氢酶(SDH)、细胞色素氧化酶(CCO)、Ca2+·Mg2+-ATP酶、Ca2+-ATP酶、超氧化物歧化酶(SOD)、谷光甘肽过氧化物酶活性的抑制(P<0.05),及细胞色素aa3、细胞色素C和膜磷脂含量的减少,并能抑制丙二醛含量的升高。结论没食子酸丙酯对缺血再灌注时心肌线粒体功能具有保护作用,其机制可能是通过提高对氧自由基的清除功能和抑制脂质过氧化。     

再灌注损伤心肌线粒体呼吸酶系的变化及川芎嗪的影响

目的：观察大鼠缺血再灌注损伤心肌线粒体中琥珀酸脱氢酶（SDH）和细胞色素氧化酶（CCO）活化变化及川芎嗪对其的影响。方法：结扎冠状动脉30min后再灌注20min复制再灌注损伤模型。分析心肌线粒体中SDH，CCO，SOD和GSH．PX活力，MDA及细胞色素含量。结果：再灌注损佃组心肌SDH和CCO活力均显著低于对照组，而川芎嗪保护组的CCO和SDH活力均显著高于再灌注损伤组（P＜0．01），与对照组比无明显差异。与再灌注损伤组比较，川芎嗪保护组的MDA含量明显降低，SOD及GSP．PX活力有明显升高。结论：川芎嗪对再灌注损伤心肌线粒体SDH和CCO活力下降有拮抗作用，其机理可能与清除自由基和抑制脂质过氧化作用有关。     

EGB对缺血心肌线粒体膜脂质过氧化与ATP酶活性的影响

目的　探讨银杏叶提取物 (EGB)对缺血心肌的细胞保护机制。方法　用垂体后叶素 (2 0U/kg,腹腔内注射 )复制小鼠急性心肌缺血模型 ,观察不同剂量 (10 0mg/kg ,2 0 0mg/kg)EGB对心肌缺血 6 0min线粒体获得率 ,膜磷脂含量 ,Ca2 + ATP酶 ,Mg2 + ATP酶活性 ,MDA及胞浆SOD活性变化的影响。结果　预先给予EGB可有效抑制缺血所致线粒体膜磷脂含量减少 ,MDA水平增高 ,提高线粒体Ca2 + ATP酶及胞浆SOD酶活性 ,其部分作用表现为剂量依赖性。结论　EGB对缺血心肌的保护作用可能与其增加胞液SOD活性 ,防止线粒体膜脂质过氧化 ,维持线粒体膜Ca2 + ATP酶活性 ,改善缺血心肌细胞Ca2 + 转运有关。     

缺血预处理对高血脂大鼠心肌线粒体酶及氧自由基的影响

目的观察缺血预处理对高血脂大鼠心肌线粒体ATP酶及氧自由基的影响。　方法建立高血脂大鼠离体心肌缺血预处理模型 ,观察预处理对缺血再灌注心肌Na+ -K+ -ATP酶、Ca2 + -ATP酶、Ca2 + -Mg2 + -ATP酶、胱甘肽过氧化物酶 (GSH -Px)、超氧化物歧化酶 (SOD)及丙二酰二醛 (MDA)的影响。　结果与单纯缺血再灌注组相比 ,预处理组心肌线粒体Na+ -K+ -ATP酶、Ca2 + -ATP酶、Ca2 + -Mg2 + -ATP酶及GSH -Px降低幅度减小 (P <0 .0 5 ) ,SOD活性上升 ,MDA含量下降。　结论高血脂大鼠经心肌缺血预处理后 ,可减少再次长时间缺血后复灌对心肌的损伤 ,具心肌保护作用     

缺血预处理对高血脂大鼠心肌线粒体酶及氧自由基的影响

目的观察缺血预处理对高血脂大鼠心肌线粒体ATP酶及氧自由基的影响. 方法建立高血脂大鼠离体心肌缺血预处理模型,观察预处理对缺血再灌注心肌Na+-K+-ATP酶、Ca2+-ATP酶、Ca2+-Mg2+-ATP酶、胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)及丙二酰二醛(MDA)的影响. 结果与单纯缺血再灌注组相比,预处理组心肌线粒体Na+-K+-ATP酶、Ca2+-ATP酶、Ca2+-Mg2+-ATP酶及GSH-Px降低幅度减小(P＜0.05),SOD活性上升,MDA含量下降. 结论高血脂大鼠经心肌缺血预处理后,可减少再次长时间缺血后复灌对心肌的损伤,具心肌保护作用.     

参附注射液对病毒性心肌炎小鼠心肌能量代谢的保护作用

目的 探讨参附注射液对病毒性心肌炎(VMC)小鼠心肌能量代谢的保护作用.方法 将雄性Balb/c小鼠随机分为柯萨奇B3病毒(CVB3)感染组、CVB3感染加参附注射液治疗组和对照组.分别采用电镜和形态计量学方法观察心肌线粒体形态、数量和膜磷脂定位;酶细胞化学法分析线粒体细胞色素C氧化酶(CCO)和琥珀酸脱氢酶(SDH)活性.结果 感染组小鼠心肌线粒体大量破坏,膜磷脂严重缺失、定位改变;CCO和SDH活性降低.各时间点治疗组上述各项指标均较感染组显著改善.结论 VMC心肌线粒体结构严重破坏、功能明显下降,参附注射液能有效保护VMC心肌线粒体结构和功能,改善心肌能量代谢.     

参附注射液对腹腔感染脓毒症小鼠心肌能量代谢的保护作用研究

目的:观察腹腔感染脓毒症小鼠心肌能最代谢情况,用参附注射液进行干预治疗,探讨参附注射液对其能量代谢的保护作用.方法:采用肓肠结扎穿孔法(Cecal ligation and puncture,CLP)复制腹腔感染脓毒症动物模型.83只小鼠随机分为CLP组(感染组)、CLP加参附注射液治疗组(治疗组)和假CLP组(对照组).于造模后6h、12 h及24h分别采用电镜和形态计量学方法观察心肌线粒体形态、数量和膜磷脂定位;酶细胞化学法分析线粒体细胞色素氧化酶(Cytochrome oxidase,CCO)和琥珀酸脱氢酶(Succinate dehydrogenase,SDH)活性,反相高效液相色谱法测定心肌组织ATP、ADP和AMP含量.结果:感染组小鼠心肌线粒体大最破坏,膜磷脂严重缺失、定位改变;CCO和SDH活性降低,ATP、ADP和AMP含量下降.各时间点治疗组上述各项指标均较感染组显著改善.结论:脓毒症小鼠心肌线粒体结构严重破坏、功能明显下降,参附注射液能有效保护脓毒症小鼠心肌线粒体结构和功能,改善心肌能量代谢.     

丹参多酚酸对大鼠缺血心肌线粒体酶的影响

目的:探讨丹参多酚酸对大鼠心肌缺血再灌注过程中线粒体Na+,K+-ATP酶和Ca2+-ATP酶的影响。方法:采用健康Wistar大鼠(n=40)建立Langendorff离体心脏灌注模型,并分为4组。对照组用Krebs液持续灌注120 min;缺血再灌注组平衡30 min后全心缺血30 min,再灌注60 min;丹参多酚酸预处理组平衡5 min后加入丹参多酚酸使其在灌流液中终浓度为14μmol/L,持续灌注25 min后全心缺血30 min,再灌注60 min;丹参多酚酸后处理组平衡30 min后全心缺血30 min,加入丹参多酚酸使其在灌流液中终浓度为14μmol/L,再灌注60 min。TTC染色观察心肌梗死面积,并用心肌梗死面积、乳酸脱氢酶(LDH)活性和心脏血流动力学(包括心率、主动脉流量、冠状动脉流量和心输出量)的变化评估大鼠心肌的损伤程度。利用差速离心法提取线粒体,并通过紫外分光光度法测定心肌线粒体Na+,K+-ATP酶和Ca2+-ATP酶的活性。结果:丹参多酚酸预处理组的心肌梗死面积和LDH活性均显著低于缺血再灌注组([24.47±2.14)%比(34.30±2.31)%、(81.46±13.39)U/g比(142.6±6.46)U/g,均P<0.05],缺血再灌注组与后处理组无明显差异。丹参多酚酸对缺血再灌注心肌的血液动力学没有明显作用,只是冠脉流量有较小幅度的增加。丹参多酚酸预处理组线粒体Na+,K+-ATP酶和Ca2+-ATP酶活性显著高于缺血再灌注组([6.12±0.42)U/mg比(4.29±0.28)U/mg、(3.42±0.16)U/mg比(2.62±0.96)U/mg,均P<0.05],而与对照组无明显差异。丹参多酚酸后处理组线粒体Na+,K+-ATP酶和Ca2+-ATP酶活性与缺血再灌注组无统计学差异。结论:丹参多酚酸可以维持心肌线粒体Na+,K+-ATP酶和Ca2+-ATP酶的活性,通过降低缺血再灌注对心肌线粒体的损伤保护心肌。     

小鼠脑缺血再灌后海马组织SDH、CCO活力的动态变化

目的:观察高脂血症小鼠脑缺血再灌注后海马组织琥珀酸脱氢酶(Succinodenhydrogenase, SDH)、细胞色素氧化酶(Cytochrome C oxidase, CCO)活力的动态变化.方法:在造成小鼠高脂血症基础上, 制备脑缺血再灌注模型.采用差速离心法提取脑海马组织线粒体,用生化法测定SDH、CCO活力.结果:模型组小鼠海马组织SDH活力在术后第1、7、15、30天均显著低于正常对照组(P＜0.01),且随着时间的延长,酶活力一直处于低水平.CCO活力与SDH活力的变化趋势相同.结论:SDH、CCO活力降低导致的能量代谢障碍是脑缺血再灌注引起神经元损伤的机制之一.     

四氢生物蝶呤对未成熟心肌保护作用及线粒体ATP酶活性的影响

目的:观察四氢生物蝾呤(BH4)对未成熟缺血再灌注心肌的保护作用及心肌线粒体ATP酶活性的影响.方法:建立幼鼠离体全心缺血再灌注模型,80只幼鼠随机分为实验组(BH4停搏液)和对照组(St.ThomasⅡ液),每组40只.测定缺血前、缺血再灌注30,60和120min时的冠状动脉流出量.分别测定两组之间不同时间点的心肌丙二醛(MDA)含量、心肌一氧化氮(NO)浓度以及心肌细胞线粒体Na ,K -ATP酶和Ca2 -ATP酶的活性.结果:BH4能显著提高冠脉流出量的恢复率,增加NO的产量,降低脂质过氧化物的产生并抑制心肌缺血再灌注后Na ,K -ATP酶和Ca2 -ATP酶活性的下降(P＜0.05).结论:BH4心脏停搏液通过增加NO的产量,保护心肌细胞线粒体ATP酶的功能,对未成熟心肌具有更好的保护效果.     

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.