大鼠小肠缺血再灌注后血中NO,SOD浓度及肺中Bax,Bcl-2表达的改变

目的：研究大鼠小肠缺血再灌注后后血中一氧化氮（NO），超氧化物歧化酶（SOD）的浓度变化以及肺组织中Bax,Bcl-2的表达，探讨小肠缺血再灌注后对肺组织的损伤，方法：建立小肠缺血再灌注模型，分对照 ，再灌注后0，30min，1，2h,1,3,7d共8组，于各时点检测血中Bax,Bcl-2的表达情况。结果：大鼠小肠缺血再灌注后NO浓度0min明显升高，2h时降低，随后升高，7d时达高峰，SOD浓度0min明显下降，2h 时升高，随后下降，7d时达最低，Bax,Bcl-2免疫阳性细胞主要位于肺组织中血管内皮细胞和肺泡上皮细胞，再灌注0min,Bax,Bcl-2阳性细胞率增多，30min时Bax,Bcl-2阳性细胞率均升高分别为17．1％和78．1％，Bcl-2表达高于Bax，两者差别显著（P＜0．01），2h时降低，其后升高，7d时阳性细胞率达高峰分别为94．1％和83．4％，Bax表达明显高于Bcl-2，两者差异显著（P＜0．01）。结论：大鼠小肠缺血再灌注后可引起血中NO，SOD的浓度变化和Bax及Bcl-2阳性细胞在肺组织中的表达改变并可能引起肺组织细胞凋亡和损伤。     

抗呆1号对脑缺血再灌注小鼠海马星形胶质细胞GFAP表达的影响

应用免疫组织化学方法探讨抗呆Ⅰ号对小鼠前脑缺血再灌注损伤后海马星形胶质细胞表达GFAP动态变化的影响,其与缺血性神经元的联系.结果显示:前脑缺血再灌注1 d只有少数星形胶质细胞表达GFAP,再灌注3 d表达GFAP的阳性细胞数增加,再灌注7～10 d表达GFAP的阳性细胞数达到高峰,同时,可见细胞反应性胶质化特征,前脑缺血再灌注15 d GFAP阳性反应细胞数仍维持在较高水平.用药组GFAP的表达细胞数较模型组明显减少.而正常对照组和假手术组只有少数星形胶质细胞表达GFAP.且星形胶质细胞表达GFAP的强弱与神经细胞的存亡有关.说明前脑缺血再灌注后海马反应性星形胶质细胞表达GFAP呈动态变化,抗呆Ⅰ号对缺血再灌注损伤星形胶质细胞和神经细胞有良好的保护作用.     

局灶性脑缺血及再灌注大鼠大脑皮质IL—1RI蛋白和mRNA的表达

①目的 探讨脑缺血白细胞介绍-1I型受体（IL-1RI）蛋白和mRNA表达及其在缺血性脑损伤中的作用。②方法 应用免疫组化和原位杂交方法,检测栓线法阻塞大脑中动脉制备的局灶性脑缺血及再灌注模型大鼠脑内IL-1RI蛋白和mRNA的表达。③结果 正常及假手术大鼠IL-1RI蛋白免疫阳性细胞主要在皮质表达;缺血后IL-1RI蛋白免疫阳性细胞在缺血侧皮质、海马及纹状体表达明显增加,在皮质再灌注后12h达高峰,随后逐渐降低。原位杂交结果显示,正常及假手术大鼠IL-1RI mRNA阳性细胞主要在皮质表达,海马区偶见阳性细胞;脑缺血大鼠IL-1RI mRNA阳性细胞在缺血再灌注后2h表达增加,再灌注后6h达高峰,随后逐渐降至正常水平。④ 结论 脑缺血后IL-1RI上调竞争结合IL-1β,通过受体后信号转导加重缺血后脑损伤。     

脑缺血再灌注大鼠脑内Mrp1的表达变化

目的观察脑缺血再灌注后多药耐药蛋白（Mrp1）在脑内的表达变化,探讨其与缺血再灌注的关系.方法 24只大鼠随机分为假手术组（n=6）和缺血再灌注后1、3、7d组（n=6）.应用颈内动脉线栓法建立大鼠大脑中动脉缺血再灌注模型,以抗Mrp1抗体进行免疫组化染色,检测缺血再灌注后脑组织中Mrp1的表达变化.结果 Mrp1在正常脑内的神经元及胶质细胞中均有表达.缺血再灌注后1d、3 d、7d组中,缺血再灌注区的皮质、海马及纹状体内可见Mrp1表达升高,阳性细胞数量增多,在3d组达高峰（P〈0.05）.结论大鼠脑缺血再灌注后细胞中Mrp1的表达增高,可能是细胞受损时的自我保护反应,但同时也可能与临床耐药性的发生有关.     

脑缺血再灌注后神经细胞bcl-2和p53 mRNA的表达

①目的　探讨大鼠局灶性脑缺血再灌注后神经细胞bcl 2和p5 3mRNA表达的变化规律。②方法采用原位杂交技术分别观察缺血 1.5h再灌注后 2h ,6h ,12h ,1d ,2d ,3d ,7d和 14d神经细胞bcl 2 ,p5 3mRNA的表达。③结果　脑缺血再灌注 2h在缺血周围区bcl 2mRNA开始表达 ,1d达高峰 ,之后逐渐减弱 ,14d达接近假手术组水平 ;p5 3mRNA于再灌注 6h出现 ,1～ 2d达高峰 ,7d达假手术组水平。④结论　大鼠局灶性脑缺血再灌注后bcl 2和p5 3mRNA的表达与缺血性损伤有一定关系 ,bcl 2和p5 3mRNA参与了神经细胞凋亡的调节。     

脑缺血后细胞凋亡与PARP的关系

目的 观察多聚ADP—核糖聚合酶(PARP)在脑缺血再灌流损伤中的表达，探讨PARP在细胞凋亡中的作用。方法 应用线栓法建立大鼠大脑中动脉闭塞再灌流模型(MCAO)。用原位TUNEL和原位杂交技术探求脑缺血后PARP与细胞凋亡的变化关系。结果 缺血再灌流组凋亡细胞主要位于皮质和纹状体的缺血周围区，至24h达高峰。PARP的表达在皮质于脑缺血再灌流6h达高峰，在纹状体于再灌流后2h已达高峰。结论 PARP的mRNA表达发生在细胞凋亡之前，表明PARP促进缺血性脑损伤后神经细胞凋亡。     

人参皂甙Rb1对大鼠局灶性脑缺血脑组织GDNF表达的影响

目的从蛋白水平探讨大鼠局灶性脑缺血再灌注后的胶质细胞源性神经营养因子（GDNF）的表达规律性及人参皂甙Rb1对其的影响。方法阻塞大鼠大脑中动脉（middle cerebral artery，MCA）2小时再灌注3小时至5天制备脑缺血模型，通过免疫组织化学（immunohistochemistry，IHC）染色观察GDNF表达的改变与分布的特点及人参皂甙Rb1对其的影响。结果脑缺血再灌注损伤后GDNF表达在3小时与2天分别有两个高峰。给予人参皂甙Rb1后，GDNFmRNA与蛋白表达在2天达高峰。单纯脑缺血再灌注组和人参皂甙Rb1给药组，GDNF阳性细胞数主要分布于额顶皮质缺血周边区，其次为纹状体缺血周边区，下丘脑缺血周边区GDNF阳性细胞数最少。根据两组间GDNF免疫组织化学（IHC）染色的强弱比较，给予人参皂甙Rb1后，在同一时间点，同一缺血周边区GDNF阳性细胞数染色增强。对GDNF阳性细胞数统计分析显示，人参皂甙Rb1给药组各时间点GDNF阳性细胞数远远高于与单纯脑缺血再灌注组同时间点的GDNF阳性细胞数（P〈0．01），提示人参皂甙Rb1诱导GDNF表达。结论脑缺血再灌注后GDNF的表达与缺血性损伤有一定的联系，人参皂甙Rb1对中枢神经系统有保护作用。     

全脑缺血再灌注后海马神经元凋亡及组织NO含量动态变化的研究

目的:观察全脑缺血15 m in后再灌注不同时间点海马神经元凋亡及海马组织NO含量的动态变化。方法:采用4血管闭塞法制备大鼠全脑缺血再灌注模型,采用DNA琼脂糖凝胶电泳和流式细胞仪检测缺血15 m in后再灌注1 d、2 d、3 d、5 d、7 d时海马神经元凋亡情况;硝酸还原酶法检测各时间点海马组织中NO含量。结果:DNA琼脂糖凝胶电泳显示:在再灌注1 d时呈大致正常条带,2 d、3 d呈“梯状条带,”5和7 d出现了代表部分神经元坏死的涂抹状条带;流式细胞仪检测结果显示:在脑缺血再灌注1 d时,海马神经元凋亡率即明显增加,再灌注3 d时凋亡率达高峰,随后凋亡率逐渐下降,7 d时大致达正常水平;海马组织中NO含量于再灌注后2 d明显升高,3 d达峰值,以后逐渐下降,7 d降至接近对照组水平。结论:全脑缺血再灌注后海马神经元凋亡和NO含量均于再灌注3 d时达高峰,7 d大致恢复至正常水平,提示NO增多可能是诱导海马神经元凋亡的机制之一。     

脑缺血再灌注后神经细胞bcl—2和p53mRNA的表达

目的：探讨大鼠局灶性脑缺血再灌注后神经细胞bcl-2和p53mRNA表达的变化规律。方法：采用原位杂交技术分别观察血1.5h再灌注后2h,6h,12h,1d,2d,3d,7d和14d神经细胞bcl-2,p53mRNA的表达。结果：脑缺血再灌注2h在缺血周围区bcl-2mRNA开始表达，1d达高峰，之后逐渐减弱，14d达接近假手术组水平;p53mRNA于再灌注6h出现，1-2d达高峰，7d达假手术组水平。结论:大鼠局灶性脑缺血再灌注后bcl-2和p53mRNA的表达与缺血性损伤有一定关系，bcl-2和p53mRNA参与了神经细胞凋亡的调节。     

兔脑缺血再灌注后细胞凋亡与TIMP-1表达的特点

目的 探讨兔脑缺血再灌注后细胞凋亡和基质金属蛋白酶抑制因子-1(TIMP-1)表达的特点.方法 成年健康新西兰兔103只,应用线栓法建立大脑中动脉闭塞(MCAO)动物模型,将成功的60只兔MCAO模型随机分为永久性缺血组和缺血再灌注组,各30只.原位末端标记法检测两组脑组织细胞凋亡的情况,免疫组织化学方法检测脑组织TIMP-1表达的情况.结果 脑缺血后脑组织细胞凋亡数逐渐增多,缺血12 h达高峰,以后逐渐减少(F=14.48,q=4.79～9.39,P<0.01).缺血1 h时脑组织TIMP-1阳性细胞数逐渐增多,48 h达高峰(F=52.05,q=4.98～19.43,P<0.01).动物缺血1 h再灌注后,各时间点凋亡细胞数和TIMP-1表达都低于永久性缺血组,再灌注23 h阳性细胞数最多,再灌注47 h下降(F=8.34、53.34,q=3.10～18.70,P<0.01).结论 急性脑缺血再灌注后,细胞凋亡与TIMP-1表达一致.     

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.