脂多糖对肺泡Ⅱ型上皮细胞的损伤作用

目的: 研究急性肺损伤时脂多糖(LPS)对肺泡Ⅱ型上皮细胞(AT-Ⅱ)的损伤作用. 方法: 将16只SD大鼠随机等分为生理盐水对照组、LPS模型组. 通过颈外静脉给药4 h后处死动物,收集肺泡灌洗液(BALF),测定BALF表面张力、总磷脂含量(TPL)、乳酸脱氢酶(LDH)、碱性磷酸酶(AKP)、丙二醛(MDA)及总蛋白(TP)含量;取右肺下叶,行HE染色光镜观察. 结果: 与对照组相比,LPS可提高BALF中LDH活性[(8.4±1.9) vs (4.8±1.9) μkat /L, P＜0.05] 和增加TP含量[(100±32)vs (28±17) g/L, P＜0.05],使BALF中MDA含量升高;光镜下可见,LPS组呈典型间质性肺水肿表现;LPS可降低BALF中TPL含量[(342±59) vs (432±45) μg/kg, P＜0.05]、增加表面张力[(23.3±2.9) vs (19.8±2.6) mN/m, P＜0.05],LPS组AKP活性较对照组显著升高[(360±100) vs (100±80) nkat/L, P＜0.05]. 结论: LPS可以引起AT-Ⅱ的损伤,并抑制其合成、分泌肺表面活性物质.     

肢体负压治疗对改善犬缺血肢体自由基损伤的影响

目的: 观察肢体负压治疗(limb negative pressure,LNP)对实验性缺血组织自由基损伤的保护作用.方法: 采用切断犬股动脉分支,动脉腔内置入螺旋状金属丝的方法,在2 wk内复制出肢体动脉闭塞性病变的动物模型,对动物模型进行8～10 d的负压治疗后,采集模型建成及治疗前后的静脉血样,分别测定血中脂质过氧化物(lipid peroxides, LPO)含量及超氧化物歧化酶(superoxide dismutase,SOD)活性并进行分析比较.结果: 治疗组犬后肢缺血模型建成后,患肢静脉血中LPO 含量显著升高而SOD活性显著下降,二者与建模前正常时相比具有显著差异[(35.6±10.8) μmol/L vs (24.8±9.0) μmol/L, P<0.05;(6.23±2.75) μkat/L vs (9.44±1.05) μkat/L,P<0.01];经8～10 d的负压治疗后,LPO 含量明显下降而SOD活性显著升高,可恢复到模型建成前水平.与治疗组相比较,对照组未经负压治疗,患肢静脉血中测得的LPO 含量持续升高,SOD活性持续下降.两组在负压治疗开始前未见明显差异[(40.0±12.5) μmol/L vs (35.6±10.8) μmol/L;(6.87±1.72) μkat/L vs (6.23±2.75) μkat/L,P﹥0.05];在负压治疗完成后,两组同期再次检测,LPO 含量和SOD活性均存在显著性差异[(45.5±10.2) μmol/L vs (24.7±4.4) μmol/L;(6.61±1.85) μkat/L vs (9.96±2.08) μkat/L,P<0.05].结论: 肢体缺血后,局部组织的脂质过氧化反应增强,自由基清除能力下降,引起或加重组织损伤;肢体负压治疗可明显减轻脂质过氧化反应,增强自由基的清除能力,改善局部代谢状态,减轻缺血损伤,对缺血肢体具有明显的保护作用.     

血清降钙素原和C反应蛋白检测在脓毒症早期诊断中的意义

目的 探讨降钙素原(PCT)、C反应蛋白(CRP)在脓毒症早期诊断及判断病情严重程度中的意义.方法 以收治的48例脓毒症和32例非感染性全身炎症反应综合征(SIRS)患者为研究对象.采用免疫比浊测量法检测血清中CRP含量,采用双抗夹心免疫荧光发光法定量分析血清中PCT 含量.结果 一般脓毒症患者与非感染性SIRS患者相比,血清PCT [(3.02±2.58)μg/L vs (0.85±0.63) μg/L,P<0.01]和CRP [(45.23±15.12)mg/L vs (32.25±9.32) mg/L,P<0.05]水平升高.严重脓毒症患者与一般脓毒症患者相比,血清PCT [(7.12±2.34) μg/L vs (3.02±2.58)μg/L,P<0.01]和CRP [(78.16±14.02) mg/L vs (45.23±15.12)mg/L,P<0.01]水平显著升高.诊断脓毒症的ROC曲线下面积,PCT为0.802±0.054,CRP为0.726±0.043,两者比较差异有统计学意义(P<0.05).结论 在鉴别脓毒症和非感染性SIRS方面PCT优于CRP,在评估脓毒症病情严重程度方面,两者均有一定价值.     

牛磺酸对大鼠肢体缺血再灌注后肝脏损伤的保护效应

目的: 观察大鼠肢体缺血再灌注后肝脏的损伤性变化,以及牛磺酸对肝脏损伤性变化的保护效应,探讨牛磺酸对大鼠肢体缺血再灌注后肝脏功能保护作用的可能机制. 方法: 实验用Wistar大鼠30只,随机分为对照(control, C)组,缺血再灌注(ischemia reperfusion, IR)组和牛磺酸 缺血再灌注(taurine ischemia reperfusion, TR)组,每组10只. 观察缺血4 h再灌注4 h各组大鼠血浆中XOD, LDH, MDA, AST, ALT和SOD的变化;观察肝组织XOD, MDA, ROS, MPO和Ca2 的变化;观察肝线粒体GSH-PX和Ca2 的变化. 结果: 单纯肢体缺血再灌注组大鼠血浆中LDH [(190.16±13.36) μkat/L], XOD [(758.82±151.53) nkat/L], MDA [(5.19±0.67) nmol/L], ALT [(78.40±6.45) nkat/L], AST [(47.70±4.47) nkat/L] 等较正常对照组血浆中LDH[(122.39±14.87) μkat/L], XOD[(543.61±43.51) μkat/kg], MDA[(1.27±0.21) nmol/L], ALT[(20.50±3.70) nkat/L], AST[(25.25±2.98) nkat/L]明显增加,而SOD[(1.30±0.15) μkat/L]较对照组 (1.80±0.16) μkat/L明显降低;单纯肢体缺血再灌注组大鼠肝组织XOD [(104.69±12.34) μkat/Kg], MDA [(2.66±0.08) nmol/L], ROS[ (771.65±100.69) μkat/ L], MPO (0.47±0.04), [Ca2 ] [(0.248±0.050) mmol/L]较正常对照组肝组织XOD[(59.01±10.50) μkat/kg], MDA [(1.29±0.14) nmol/L], ROS [(606.45±52.01) μkat/L], MPO[(0.28±0.06)], [Ca2 ] [(0.123±0.014) mmol/L] 均明显增加;缺血再灌注组大鼠肝线粒体GSH-Px活性[(20.34±4.67) nkat/L]与正常对照组[(31.17±11.50) nkat/L]比较明显降低,而[Ca2 ]浓度[(0.38±0.06) mmol/L]则高于正常对照组[(0.14±0.03) mmol/L]. 牛磺酸 缺血再灌注组大鼠血浆中LDH[(158.29±4.87) μkat/L], XOD [(758.82±151.53) nkat/L], MDA [(2.81±0.19) nmol/L], ALT [(64.40±9.05) nkat/L], AST [(38.70±8.10) nkat/L]较单纯缺血再灌注组明显降低,而SOD [(1.50±0.17) μkat/L]则增加;肝组织XOD[(94.19±13.50) μkat/L], MDA [(1.67±0.12) nmol/L], ROS [(710.81±55.34) μkat/L], MPO (0.36±0.04), [Ca2 ] [(0.192±0.426) mmol/L]等指标也较单纯缺血再灌注组明显降低,此外牛磺酸 缺血再灌注组大鼠肝线粒体GSH-Px活性[(22.50±3.17) nkat/L]与单纯肢体缺血再灌注组相比明显增加,而Ca2 浓度[(0.31±0.06) mmol/L]则降低,损伤减轻. 结论: 牛磺酸可以减轻大鼠肢体缺血4 h再灌注4 h后所致的肝损伤.     

严重创伤患者早期肠黏膜屏障功能检测的临床意义

目的:探讨严重创伤患者早期肠黏膜屏障功能损伤情况及对预后的影响。方法:采用肠道屏障功能生化指标分析系统检测72例严重创伤患者创伤后24 h内的血清二胺氧化酶(DAO)、D-乳酸和内毒素水平,分别按创伤严重程度、是否发生胃肠道功能障碍、是否休克、缺氧、后期合并感染、是否生存分组,并比较不同分组下的血清二胺氧化酶、D-乳酸和内毒素水平的变化。结果:严重创伤组对比创伤较轻组血清早期DAO水平[(7.01±3.07)vs(5.14±1.88)U/L]、D-乳酸水平[(22.23±4.40)vs(14.67±4.58)mg/L]显著升高,差异有统计学意义(P<0.05),血清DAO、D-乳酸水平与APACHEⅡ评分呈正相关关系(DAO/APACHEⅡ评分:r=0.395,P=0.001,D-乳酸/APACHEⅡ评分:r=0.736,P=0.000);胃肠道功能障碍组对比非胃肠道功能障碍组,血清早期DAO水平[(6.42±2.75)vs(5.19±2.19)U/L]、D-乳酸水平[(19.93±5.27)vs(14.79±5.26)mg/L]显著升高,差异有统计学意义(P<0.05);合并休克及ARDS组对比无休克无ARDS组血清D-乳酸[(22.92±3.70)vs(15.578±5.61)mg/L]显著升高,差异有统计学意义(P<0.05);与无明显感染者相比,后期合并感染者早期血清中D-乳酸水平[(20.08±6.02)vs(16.46±5.37)mg/L]、内毒素水平[(9.57±3.62)vs(8.16±1.61)U/L]显著性升高,差异有统计学意义(P<0.05),死亡组对比存活组早期血清中DAO水平[(7.28±3.47)vs(5.39±1.99)U/L]、D-乳酸水平[(22.96±2.55)vs(15.83±5.51)mg/L]均有显著升高,差异有统计学意义(P<0.05)。结论:严重创伤早期即可出现肠黏膜屏障的损伤,以D-乳酸增高较为常见;血清D-乳酸、DAO水平与胃肠功能损害有关;缺氧合并低血压可对肠黏膜屏障功能造成损害;早期肠黏膜屏障受损后期更易出现感染;肠黏膜屏障能一定程度上反应患者预后。     

维生素E对小鼠日本血吸虫病肝纤维化的治疗作用及其机制

目的: 探讨维生素E (Vit E)抗小鼠日本血吸虫病肝纤维化作用及其机制. 方法: 用日本血吸虫尾蚴皮肤敷贴法感染小鼠,构建日本血吸虫病肝纤维化模型,以肝纤维化达Ⅱ级或Ⅱ级以上作为开始Vit E治疗标志. 实验分5组: 正常对照组、模型组及Vit E高、中、低剂量组(每日150, 50, 5 mg/kg), 8 wk末处死动物,HE和VG染色对肝组织进行病理学检查,分光光度法检测肝组织丙二醛(MDA)含量和超氧化物歧化酶(SOD)活性,免疫组化SP法检测肝星状细胞(HSC)标记物α-平滑肌动蛋白(α-SMA)表达,RT-PCR方法检测肝脏α1(I)型前胶原mRNA表达. 结果: Vit E降低模型组肝脏MDA含量[(5.00±0.31) μmol/g vs (11.66±1.84) μmol/g, P＜0.05],提高SOD活性[(249.84±26.22) μkat/g vs (120.11±42.61) μkat/g, P＜0.05];减少α-SMA阳性表达 [(0.41±0.02) vs (0.68±0.02), P＜0.05];降低肝脏胶原含量[(0.23±0.01) vs (0.60±0.11), P＜0.05]和α1(I)型前胶原基因表达[(0.28±0.01) vs (0.85±0.15), P＜0.05]. 结论: Vit E具有抗小鼠日本血吸虫病肝纤维化作用,其机制与抗脂质过氧化作用、抑制HSC活化和增殖、降低α1(I)型前胶原基因表达和胶原合成有关.     

依达拉奉对急性肺损伤的治疗作用及其机制探讨

目的探讨自由基清除剂依达拉奉对急性肺损伤大鼠模型的保护作用。方法将32只SD大鼠随机分为C组(生理盐水+生理盐水,n=8)、E组(生理盐水+依达拉奉,n=8)、LPS组(脂多糖+生理盐水,n=8)和LPS+E组(脂多糖+依达拉奉,n=8),各组经尾静脉注入LPS和依达拉奉或等体积生理盐水。6 h后麻醉大鼠并行动脉血气分析及肺病理学检查,检测血浆中肿瘤坏死因子α(TNF-α)和白介素6(IL-6)及肺组织中丙二醛(MDA)和NO水平。结果与C组相比,LPS组出现明显的肺损伤改变、动脉血氧分压显著下降[(99.37±4.35)mmHg vs(60.11±8.41)mmHg,P<0.01]、血浆中TNF-α[(3.89±0.53)pg/mL vs(11.95±1.97)pg/mL,P<0.01]和IL-6[(4.73±0.91)pg/mL vs(41.25±7.11)pg/mL,P<0.01]显著升高,肺组织中MDA[(2.06±0.42)nmol/mg vs(8.91±2.03)nmol/mg,P<0.01]和NO[(3.97±0.87)nmol/mg vs(8.74±2.01)nmol/mg,P<0.01]也显著升高;与LPS组相比,自由基清除剂依达拉奉使肺组织中MDA[(8.91±2.03)nmol/mg vs(3.76±0.68)nmol/mg,P<0.01]和NO[(8.74±2.01)nmol/mg vs(3.53±0.71)nmol/mg,P<0.01]显著降低,显著减轻急性肺损伤(ALI)大鼠的肺损伤程度,提高动脉血氧分压[(60.11±8.41)mmHg vs(85.69±6.41)mmHg,P<0.01],并使血浆中的TNF-α[(11.95±1.97)pg/mL vs(5.65±1.09)pg/mL,P<0.01]和IL-6[(41.25±7.11)pg/mL vs(11.06±1.27)pg/mL,P<0.01]显著降低。结论自由基清除剂依达拉奉能减轻急性肺损伤的病理生理变化,其机制在于依达拉奉能有效清除自由基并减少致炎因子的释放。     

染料木素和17β-雌二醇对卵巢切除大鼠学习与记忆的影响

目的: 探讨染料木素(genistein, GST)和17β-雌二醇(17-βestradiol, E2)对卵巢切除大鼠认知功能的影响及可能的机制. 方法: 选用成年雌性SD大鼠40只,随机分为假去势组(Sham)、去势组(卵巢切除术,ovariectomy, OVX)、雌二醇组(OVX E2)、GST高剂量组(GST-h)及GST低剂量组(GST-L),每组8只. 采用Morris水迷宫方法观察去卵巢大鼠学习记忆的改变及GST和E2对其改善作用,用比色法测定了大鼠前脑皮层和海马中乙酰胆碱脂酶(acetylcholinesterase, Ache)的活性,观察了药物对此酶活性的影响. 结果: OVX后7 wk大鼠出现学习记忆障碍,表现为OVX组逃避潜伏期较Sham组明显延长(88.9±35.1) s vs (51.7±36.9) s, P<0.05,记忆频度下降(18.7±2.7) vs (24.9±4.5), P<0.05;前脑皮层、海马的Ache活性升高(286.7±27.8) μkat/L vs (245.6±36.1) μkat/L, (363.9±46.1) μkat/L vs (275.8±52.8) μkat/L, P<0.05, P<0.01. 用药后,E2组逃避潜伏期及记忆频度较OVX组有明显改变(57.3±21.7) s vs (88.9±35.1) s, (25.5±5.4) vs (18.7±2.7), P<0.05, P<0.01; GST-L组记忆频度也较OVX组增加(22.7±2.0) vs (18.7±2.7), P<0.05;GST及E2能降低因OVX造成的大鼠前脑皮层和海马中Ache的活性的升高(P<0.01). 结论: GST和E2有改善因OVX造成的大鼠学习记忆减退作用,其可能的机制是抑制了脑内Ache的活性,使乙酰胆碱的降解减少.     

硫化氢在内毒素休克大鼠急性肺损伤中的作用及其与一氧化氮、一氧化碳的关系

目的 探讨硫化氢(H2S)在内毒素休克(ES)大鼠急性肺损伤(ALI)中的作用及一氧化氮(NO)、一氧化碳(CO)与其作用机制的关系.方法 将64只雄性SD大鼠随机分为对照组(经尾静脉注射生理盐水0.5 ml/kg)、脂多糖组(经尾静脉注射脂多糖复制ES模型)、脂多糖+硫氢化钠[NaHS(外源性H2S供体)]组、脂多糖+炔丙基甘氨酸(PPG)组,每组16只.给药后连续监测平均动脉压(MAP)的变化,6 h后处死,测定肺系数;光镜观察肺组织形态学改变并观测肺损伤的定量评价指标(IQA);化学法检测血浆H2S含量、肺组织丙二醛、NO和CO含量、髓过氧化物酶(MPO)、胱硫醚-γ-裂解酶(CSE)、一氧化氮合酶(NOS)和血红素氧合酶(HO)活性;用免疫组织化学法和Western印迹检测肺组织诱生型NOS(iNOS)和HO-1蛋白表达.结果 脂多糖组大鼠MAP明显低于对照组,肺组织出现明显的结构损伤,脂多糖组大鼠IQA、肺系数、肺组织丙二醛含量、MPO活性、血浆H2S含量和肺组织CSE活性均明显高于对照组(P<0.05或P<0.01);脂多糖+NaHS组大鼠血浆H2S含量和肺组织CSE活性均高于脂多糖组,而血压低于脂多糖组,且大鼠肺损伤加重;脂多糖+PPG组大鼠血压高于脂多糖组,且大鼠肺损伤减轻(均P<0.05);脂多糖组肺组织中eNOS活性明显低于对照组[(5.26±0.25)U·mg-1·prot-1vs(6.45±0.42)U·mg-1·prot-1],而iNOS活性和NO含量均高于对照组[(12.6±0.6)U·mg-1·prot-1vs(10.5±0.7)U·mg-1·prot-1、(144±25)μmol/L vs(68±5)μmol/L,P<0.05或P<0.01];脂多糖+PPG组肺组织中eNOS活性明显高于脂多糖组,iNOS活性[(10.2±0.4)U·mg-1·prot-1]、蛋白表达和NO含量[(74±5)μmol/L]均明显低于脂多糖组(P<0.05或P<0.01),而脂多糖+NaHS组肺组织中eNOS活性[(4.81±0.23)U·mg-1·prot-1]明显低于脂多糖组,iNOS活性[(14.6±0.4)U·mg-1·prot-1]、蛋白表达和NO含量[(217±18)μmol/L]均明显高于脂多糖组(P<0.05或P<0.01);脂多糖组肺组织中HO活性[(173±31)pkat/g]、蛋白表达和CO含量[(3.63±0.24)%]均明显高于对照组[(125±22)pkat/g、(2.48±0.33)%,均P<0.05]和脂多糖+PPG组[(88±17)pkat/g、(2.98±0.23)%,均P<0.05],而脂多糖+NaHS组肺组织中HO活性[(263±37)pkat/g]、蛋白表达和CO含量[(4.35±0.32)%]均明显高于脂多糖组(均P<0.05).结论 H2S生成增多参与了ES大鼠肺组织炎症损伤的发生,此作用与其引起的eNOS活性下降,iNOS活性升高及随后产生的大量NO有关;H2S可上调ES大鼠肺组织HO-1/CO体系,这可能是机体针对损伤产生的内源性的代偿性保护反应.     

比索洛尔联合胰岛素增敏剂治疗对PCOS患者内分泌功能的影响

目的：探讨比索洛尔联合胰岛素增敏剂治疗对多囊卵巢综合征(PCOS)患者内分泌功能的影响。方法选择2011年8月至2014年8月我院内分泌科收治的60例PCOS患者,根据随机数表法将60例患者分为观察组(n=30)和对照组(n=30),对照组接受胰岛素增敏剂吡格列酮治疗,观察组患者接受比索洛尔联合吡格列酮治疗,比较两组患者治疗前后的空腹胰岛素(FIN)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、雌二醇(E2)、睾酮(T)、孕酮(PRGE)、垂体泌乳素(PRL)、性激素结合蛋白(SHBG)、皮质酮(Cor)、促肾上腺皮质激素(ACTH)、肾上腺皮质激素释放激素(CRH)、促性腺激素释放激素(CnRH)、环磷酸腺苷和环磷酸鸟苷的变化,并对疗效进行评价。结果治疗后,观察组患者的FIN [(18.5±3.9) mIU/L vs (26.3±4.7) mIU/L]、FPG [(7.13±1.4) mmol/L vs (4.72±1.7) mmol/L]、HOMA-IR [(0.65±0.13) vs (0.42±0.19)]、HOMA-β[(2.45±0.47) vs (1.69±0.14)]、E2[(56.9±8.7) pg/mL vs (46.9±10.5) pg/mL]、T [(58.5±4.2) ng/dL vs (39.6±6.7) ng/dL]、PRGE [(0.69±0.21) pg/mL vs (0.52±0.17) pg/mL]、PRL [(17.5±5.3) pg/mL vs (13.2±4.7) pg/mL]和环磷酸腺苷水平[(26.9±3.5) pmol/L vs (21.2±2.4) pmol/L]较治疗前均明显降低(P<0.05),SHBG [(18.5±3.9) nmol/L vs (26.3±4.7) nmol/L]、Cor [(18.5±3.9) ng/mL vs (26.3±4.7) ng/mL]、ACTH [(18.5±3.9) ng/mL vs (26.3±4.7) ng/mL]、CRH [(53.7±6.4) pg/mL vs (61.3±7.2) pg/mL]和环磷酸鸟苷的水平[(25.6±4.9) pmol/L vs (27.1±1.8) pmol/L]较治疗前均明显升高,差异均有统计学意义(P<0.05);治疗后,对照组患者的FIN [(25.9±3.7) mIU/L vs (18.5±3.9) mIU/L]、FPG [(7.09±0.93) mmol/L vs (5.52±1.86) mmol/L]、HOMA-IR [(0.67±0.14) vs (0.45±0.11)]、HOMA-β[(2.39±0.96) vs (2.08±0.33)]、E2[(57.8±6.4) pg/mL vs (46.9±10.5) pg/mL]、T [(59.6±5.5) ng/dL vs (45.8±9.1) ng/dL]、PRGE [(0.67±0.19) pg/mL vs (0.53±0.15) pg/mL]和PRL [(17.4±3.3) pg/mL vs (14.2±5.6) pg/mL]较治疗前均明显降低,SHBG [(84.3±15.8) nmol/L vs (131.9±30.1) nmol/L]水平较治疗前明显升高,差异均有统计学意义(P<0.05),而Cor、ACTH、CRH、环磷酸腺苷水平和环磷酸鸟苷水平较治疗前均无明显变化(P>0.05);观察组患者的治疗总有效率为93.33%,明显高于对照组的66.67%,差异有统计学意义(P<0.05)。结论比索洛尔联合胰岛素增敏剂吡格列酮治疗PCOS可明显改善患者机体的内分泌环境,提高患者的治疗效果。     

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.     

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.     

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.