乌司他丁对失血性休克大鼠肺细胞间粘附分子-1的影响及其肺保护作用

目的 探讨乌司他丁(UTI)对失血性休克大鼠肺组织细胞间粘附分子－1（ICAM-1）的影响及其肺保护作用。方法 24只成年雄性SD大鼠随机分为3组(n=8)：对照组（C组）、失血性休克组（H组）、乌司他丁组（U组）。经股动脉放血使平均动脉压（MAP）维持在（5.3±0.7)kPa建立失血性休克模型,H组60 min后开始复苏并回输全部血液和等量的乳酸林格液。U组复苏开始前注入UTI 50 000 U/kg,C组只做股动﹑静脉穿刺不放血。复苏后4h处死动物取肺组织,测定其ICAM-1表达、 髓过氧化物酶（MPO）活性、肺湿干重比(W/D)并观察肺组织病理学变化。结果 H组和U组ICAM-1表达、MPO活性以及W/D比与C组相比均明显升高（P<0.05）;U组上述指标较H组明显降低（P<0.05）。光镜下见U组肺泡结构的破坏和炎症细胞聚集程度明显轻于H组。结论 在失血性休克状态下,UTI可减少大鼠肺组织ICAM-1的表达,抑制MPO活性,降低肺含水量,减轻肺组织病理学改变,从而减轻失血性休克大鼠肺组织损伤。     

乌司他丁对失血性休克大鼠肺细胞间黏附分子-1的影响及其肺保护作用

目的探讨乌司他丁（UTI）对失血性休克大鼠肺组织细胞间黏附分子-1（ICAM-1）的影响及其肺保护作用。方法24只成年雄性SD大鼠随机分为3组（n=8）：对照组（C组）、失血性休克组（H组）、乌司他丁组（U组）。经股动脉放血使平均动脉压（MAP）维持在（5．3&#177;0．7）kPa建立失血性休克模型,H组60min后开始复苏并回输全部血液和等量的乳酸林格液。U组复苏开始前注入UTI50000U／kg,C组只作股动、静脉穿刺不放血。复苏后4h处死动物取肺组织,测定其ICAM—1表达、髓过氧化物酶（MPO）活性、肺湿干重比（W／D）并观察肺组织病理学变化。结果H组和U组ICAM-1表达、MPO活性以及W／D比与C组相比均明显升高（P〈0．05）;U组上述指标较H组明显降低（P〈0．05）。光镜下见U组肺泡结构的破坏和炎症细胞聚集程度明显轻于H组。结论在失血性休克状态下,UTI可减少大鼠肺组织ICAM-1的表达,抑制MPO活性,降低肺含水量,减轻肺组织病理学改变,从而减轻失血性休克大鼠肺组织损伤。     

利多卡因对失血性休克兔肺损伤的保护作用

目的 探讨利多卡因对失血性休克兔肺损伤的保护作用.方法 18只兔随机分为3组,每组6只:利多卡因组(L组)、失血性休克组(H组)和对照组(C组).L组于放血前静脉注射2.5 mg/kg利多卡因,此后每隔1 h静脉注射1 mg/kg利多卡因维持;L组与H组建立失血性休克模型后,分别于放血前(T0)、休克2 h(T1)、复苏2 h(T2)各从股静脉取血测定血浆丙二醛(MDA)、超氧化物歧化酶(SOD);C组在上述对应时间点测定血浆MDA和SOD.3组动物复苏2 h后处死,取左上肺测肺组织的湿/于重比值(W/D).结果 H组与L组在T1、T2时点,与T0时点及C组相比,MDA含量均显著升高(P＜0.05),L组MDA低于H组(P＜0.05);SOD含量则显著下降(P＜0.05),L组SOD高于H组(P＜0.05);L组肺组织W/D比值低于H组而高于C组(P＜0.05).结论 早期静脉注射利多卡因可抑制MDA产生,增加SOD含量,降低肺含水量,从而减轻失血性休克兔肺组织的损伤.     

乌司他丁预先给药对大鼠呼吸机相关肺损伤的影响

目的 研究乌司他丁预先给药对大鼠呼吸机相关肺损伤(VILI)的影响及机制.方法 30只雄性SD大鼠随机分为3组:对照组(C组)、大潮气量组(H组)和乌司他丁组(U组),每组10只.H组和U组接受机械通气,参数设置均为:潮气量40 mL/kg,呼吸频率40次/min,呼气末正压(PEEP)为零,吸入氧浓度为21%.机械通气4 h 后放血处死大鼠,取肺组织测定肺湿/干重比(W/D);收集支气管肺泡灌洗液(BALF)并测定其中的蛋白含量、白细胞计数以及血清和BALF中肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、IL-8、IL-10及超氧化物歧化酶(SOD)和丙二醛(MDA)的水平.结果 与C组相比,H组大鼠W/D、BALF中白细胞计数、总蛋白含量以及血清和BALF中TNF-α、IL-6、IL-8、MDA水平均显著增高,但 IL-10和SOD水平则显著降低;与H组相比,U组大鼠W/D、BALF中白细胞计数、总蛋白含量以及血清和BALF中TNF-α、IL-6、IL-8、MDA水平均显著降低,但 IL-10和SOD水平则显著升高.结论 乌司他丁预先给药能减轻大鼠VILI,其机制可能与抑制肺内炎性细胞因子的释放和氧自由基的生成有关.     

乌司他丁对失血性休克大鼠血流动力学及多器官保护的研究

[目的]观察乌司他丁对失血性休克大鼠血流动力学及多器官的保护作用.[方法]参考Chaudry方法制作大鼠失血性休克模型,休克60 min后用回输血液和生理盐水进行复苏,其中一部分则加用乌司他丁治疗.监测正常、休克、复苏后1 h、3 h、6 h、12 h不同时相血压和心率的变化;光镜观察心、肺、肝、肾、肠组织超微结构的改变;电镜观察回肠组织超微结构的改变.[结果]与休克时对比,用生理盐水或乌司他丁复苏后,大鼠的收缩压、舒张压、平均压、心率均可得到明显的改善(P＜0.01);乌司他丁疗效评价的两因素方差分析,乌司他丁和复苏时间均可影响疗效(P＜0.01),但乌司他丁的P值比时间的P值小,对疗效的影响更大;心、肺、肝、肾、肠组织的损伤明显减轻.[结论]乌司他丁能够改善失血性休克大鼠的血流动力学、对多个器官具有保护作用,能够有效的辅助治疗失血性休克.     

乌司他丁复合氧氟沙星对大鼠肠黏膜超氧化物歧化酶和丙二醛的影响

目的 通过检测肠黏膜超氧化物歧化酶(SOD)和丙二醛(MDA)的变化,评价乌司他丁对脓毒症大鼠肠黏膜的保护作用和安全性.方法 SD大鼠80只,采用经典盲肠打孔法制成脓毒症模型,随机均分为四组:空白对照组(C组)、氧氟沙星组(O组)、乌司他丁组(U组)和氧氟沙星加乌司他丁组(O+U组),每组再分为24 h 和48 h 两组.O组给予氧氟沙星8mg/kg,U组给予乌司他丁150 000 U,O+U组则同时给予氧氟沙星8 mg/kg 和乌司他丁150 000 U,2次/d,连续2 d,C组给予生理盐水4 ml/kg 作为对照.在治疗后24 h 和48 h 取大鼠肠组织观察肠黏膜的改变和MDA、SOD的变化.结果 三组经过治疗的大鼠肠黏膜改变不如C组明显,MDA、SOD等指标均较对照组明显改善,治疗组中 MDA明显降低, SOD明显升高, O组、U组与C组比较差异有统计学意义(P<0.05),O+U组与C组比较差异有显著统计学意义(P<0.01),O+U组与O组、U组比较差异有统计学意义(P<0.05).结论 乌司他丁复合氧氟沙星能显著降低SOD消耗,增加SOD活性,减少MDA的产生,保护肠黏膜的屏障功能.     

乌司他丁对急性肺损伤大鼠肺组织HO-1表达的影响

目的 乌司他丁对内毒素诱导大鼠急性肺损伤(acute lung jury,ALI)时血红素氧合酶(hemeoxygenase,HO)-1表达,从而为探讨乌司他丁在ALI中的应用提供理论依据.方法 将48只健康雄性SD大鼠随机分为阴性对照组、ALI模型组、乌司他丁干预组和乌司他丁+氯血红素(Hm)组,每组各12只.模型组用5mg/kg LPS诱发ALI模型,乌司他丁组按50000u/kg体重给予乌司他丁静脉注射.各组给药后2h、6h、12h观察丙二醛(MDA)的含量以及HO-1的活性;RT-PCR和Western blot检测HO-1 mRNA和蛋白的表达情况.结果 用LPS成功复制出ALI模型,同时,肺组织中MDA含量、HO-1蛋白活性、HO-1 mRNA以及蛋白水平均高于阴性对照组(P均<0.05);乌司他丁+LPS组、乌司他丁+LPS+Hm组肺MDA含量低于LPS模型组,但HO-1活性、mRNA和蛋白水平高于相应LPS组(P均<0.05).结论 乌司他丁对ALI的保护作用可能是通过增强HO-1活性、上调mRNA和蛋白表达水平而实现的.     

限制性液体复苏对孕兔肺缺血再灌注损伤的保护作用

目的 应用孕兔非控制性失血性休克模型研究不同液体复苏方案对孕兔失血性休克时肺脏超氧化物歧化酶(SOD)、丙二醛(MDA)、髓过氧化物酶(MPO)水平的影响,探讨不同液体复苏方法对孕兔肺缺血再灌注损伤的保护作用.方法 30只孕中晚期新西兰大白兔被随机分为5组,建立重度控制性失血性休克模型,假休克组(SS组),休克未处理组(SH组),传统复苏组(NS组)、限制性复苏组(NH组)及高渗高胶限制性复苏组(HHH组)分别于休克30min后接受不同的液体复苏方案.各组均于休克后90 min接受手术止血和输血输液治疗.于实验结束后处死动物取肺脏检测SOD、MDA和MPO水平.结果 失血性休克时缺血再灌注损伤导致肺组织SOD活性降低及MDA、MPO水平增高,其中MDA、MPO水平HHH组、NH组显著低于NS组(P<0.05),HHH组显著低于NH组(P<0.05);SOD活性呈与MDA相反的变化趋势.结论 限制性输液复苏较传统快速输液复苏缓解了组织缺血再灌注后肺损伤,羟乙基淀粉高渗盐可显著抑制肺组织再灌注损伤.     

高渗氯化钠羟乙基淀粉40注射液对失血性休克大鼠肠缺血-再灌注损伤中氧自由基的影响

目的:观察高渗氯化钠羟乙基淀粉40注射液(HSH)对失血性休克/内毒素二次打击大鼠复苏时是否能降低氧自由基的产生.方法:SD大鼠54只,采用失血性休克/内毒素二次打击模型.动物随机分为对照组(C组)、乳酸林格氏液复苏组(RL组)、高渗氯化钠羟乙基淀粉40注射液(HSH组).检测肠组织超氧化物歧化酶(SOD)、丙二醛(MDA)含量;肠标本进行病理学检查.结果:休克复苏后1h,RL组与HSH组肠组织MDA含量均明显升高,SOD活力明显下降;复苏后2h,HSH组肠组织MDA含量开始下降,SOD活力升高,而RL组变化不明显;至复苏后4h,两组比较MDA和SOD相差显著(P＜0.05);病理学检查,HSH组肠组织较RL组损伤轻.结论:HSH可以降低机体氧自由基的产生,减轻肠组织缺血再灌注损伤.     

乌司他丁对呼吸机相关性肺损伤大鼠肺组织影响的研究

目的 探讨乌司他丁(Uti)对机械通气大鼠肺组织的影响.方法 40只健康SD大鼠随机分为5组,每组8只:自主呼吸组(C)、大潮气量通气组(M)以及通气前应用乌司他丁1万u/kg组(U1)、5万u/kg组(US)和10万u/kg组(U10).除C组外均给予容量控制性通气4h(参数设置:VT=30mL/kg;RR=40次/min;I/E=1:3;FiO2=21%).通气中监测动脉血气.实验结束收集支气管肺泡灌洗液(BALF)和肺组织标本,分别测定肺湿/干重比(W/D),BALF中总蛋白含量、白细胞总数和分类;并对肺组织行病理学观察.结果 ①M组大鼠通气中PaO2逐渐下降,4h后较基础值差异有显著性(P<0.05).同C组相比,肺W/D比值和BALF中白细胞总数和蛋白含量明显升高.②通气前预先应用Uti各组PaO2降低明显减缓.同M组比较,肺W/D比值和BALF中白细胞计数和蛋白含量明显减少,其中U1组的变化不明显,而U5和U10组与M组比较差异有显著性(P<0.05).结论 Uti可以通过抑制肺组织中性粒细胞的募集和活化,减少肺血管内蛋白渗出,保护机械通气大鼠肺组织,且保护作用似呈剂量依赖性.     

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.