氯膦酸二钠脂质体对重症急性胰腺炎大鼠脑损伤的保护作用

目的: 探讨氯膦酸二钠脂质体对重症急性胰腺炎（severe acute pancreatitis, SAP）大鼠脑损伤的保护作用。方法: 利用薄膜法制备氯膦酸二钠脂质体。将48只健康雄性SD大鼠随机分为3组：假手术组、空白脂质体组（LB组）和氯膦酸二钠脂质体组（LC组）。LB组和LC组采用胰腺被膜下均匀注射5%牛磺胆酸钠（2 mL/kg）制备SAP模型,假手术组仅模拟注射操作。LB组在建模后立即于大鼠尾静脉内注射空白脂质体（4 mL/kg）,LC组注射氯膦酸二钠脂质体（4 mL/kg）。制模后2 h、6 h取肠系膜上静脉血液,检测各组大鼠血清中淀粉酶、IL-6、肿瘤坏死因子-α（TNF-α）的含量;观察各组胰腺组织的病理学变化及胰腺病理学评分;检测脑组织的含水量、伊文氏蓝浓度和脑脊液中髓鞘碱性蛋白（myelin basic protein, MBP）含量。结果： LB组较假手术组2 h、6 h血清淀粉酶、IL-6、TNF-α含量及胰腺病理学评分均显著增高（P<0.01）,LC组较LB组2 h、6 h血清淀粉酶、IL-6、TNF-α含量及胰腺病理学评分均显著降低（P<0.01）; LB组较假手术组2 h、6 h脑组织的含水量、伊文氏蓝浓度及脑脊液MBP含量均显著增高（P<0.01）,LC组较LB组2 h、6 h脑组织的含水量、伊文氏蓝浓度及脑脊液MBP含量均显著降低（P<0.01）。结论： 氯膦酸二钠脂质体可选择性清除单核巨噬细胞,对SAP大鼠脑组织损伤有保护作用。     

早期肝素治疗对重症急性胰腺炎大鼠胰腺组织微血栓形成的影响

目的 观察和评价早期肝素治疗对重症急性胰腺炎(SAP)大鼠胰腺组织微血栓形成的影响和疗效.方法 SD大鼠随机分为SAP组、肝素组和假手术组.12 h检测血清淀粉酶、血浆D-二聚体(D-dimer)、肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6);采集胰腺行普通病理检查并计数微血栓.结果 SAP诱发后12 h,SAP组大鼠的存活率显著低于肝素组和假手术组(P<0.05);胰腺组织病理学观察显示,肝素组微血栓数、病理评分显著少于SAP组(P<0.05);血清淀粉酶、D-dimer、TNF-α以及IL-6检测结果也显示肝素组较SAP组显著改善(P<0.05).结论 早期肝素治疗能减轻胰腺病理损害,减少胰腺组织微血栓数量,降低全身炎性反应,提高SAP大鼠的生存率.     

塞来昔布对大鼠重症急性胰腺炎血清TNF-α,IL-1β,IL-6及IL-8水平的影响

目的: 探讨重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠血清促炎性细胞因子TNF-α,IL-1β,IL-6和 IL-8的变化及意义,以及应用塞来昔布(celecoxib)的干预效应.方法: 胆胰管内注射5 %牛磺胆酸钠造模.将动物随机分成对照组、SAP组及塞来昔布组,各组分别于术后3,6,12和24 h 4个时间点处死大鼠,测血清淀粉酶,TNF-α,IL-1β,IL-6和IL-8水平,每次每组5只;取各组术后24 h处死大鼠的胰腺组织,行HE染色,分别观察大鼠胰腺组织病理学变化.结果: 对照组胰腺组织基本正常, SAP模型组胰腺腺泡结构严重破坏消失,塞来昔布组病理改变明显减轻;SAP组、塞来昔布组大鼠血清中TNF-α,IL-1β,IL-6和IL-8水平随病程进展而升高(P<0.01),各时相SAP组水平明显高于对照组(P<0.01),塞来昔布组水平明显低于SAP模型组(P<0.01).结论: TNF-α,IL-1β,IL-6和IL-8与SAP的进展有关,塞来昔布可以减轻SAP的炎症反应,抑制促炎性细胞因子的产生.     

三七总皂苷对重症急性胰腺炎大鼠血清中炎症因子的影响

目的：探讨三七总皂苷（PNS）对重症急性胰腺炎（SAP）大鼠血清肿瘤坏死因子（TNF）α、白细胞介素（IL）6、IL-10水平的影响,为其治疗SAP提供理论基础。方法：SD大鼠随机分为假手术组、SAP组、PNS治疗组,每组30只。各组在术后6、12、24h检测血清淀粉酶、TNF-α、IL-6和IL-10水平,观察胰腺病理改变及各组术后48h死亡率。结果：SAP组各时间点血清淀粉酶、TNF-α、IL-6和IL-10水平均显著高于假手术组（P〈0.01）;PNS治疗组各时间点血清淀粉酶、TNF-α和IL-6显著低于SAP组（P〈0.05）,而IL-10水平显著高于SAP组（P〈0.05）;PNS治疗组胰腺组织损害较SAP组减轻（P〈0.01）;假手术组和治疗组48h死亡率显著低于SAP组（P〈0.05）。结论：PNS可减少促炎细胞因子TNF-α、IL-6产生,上调抗炎细胞因子IL-10,从而达到治疗SAP的目的。     

重症急性胰腺炎时大鼠血IL-1，IL-6，IL-8，TNF—α水平及B淋巴细胞百分比的变化

目的 探讨大鼠重症急性胰腺炎(severe acute pancreatitis, SAP)时血IL-1、IL-6、IL-8、TNF-α水平及B淋巴细胞百分比的变化.方法 将雄性SD大鼠50只随机分为两组,假手术组(n=25)开腹后仅轻揉胰腺及十二指肠.SAP组(n=25)开腹后向大鼠胰管注射牛磺胆酸钠建立SAP动物模型.于实验前和实验后2、4、6、12 h 经颈静脉取血,采用双抗体夹心ELISA法测定血清中白细胞介素-1 (IL-1)、白细胞介素-6 (IL-6)、白细胞介素-8 (IL-8)、肿瘤坏死因子-α(TNF-α)水平,单克隆抗体致敏花环法测定淋巴细胞悬液中B淋巴细胞的百分比.结果 造模术后SAP组IL-1、IL-6、IL-8、TNF-α水平均升高 (P<0.01); 术后SAP组B淋巴细胞比例明显降低并随SAP时间增加而逐渐降低(P<0.01).结论 SAP时血IL-1、IL-6、IL-8、TNF-α水平明显升高,可能是加重SAP病情的损伤性因子;B淋巴细胞比例明显降低,提示SAP时大鼠体液免疫功能减退.     

参附注射液减轻重症急性胰腺炎大鼠肠屏障功能障碍及二次打击损伤

目的:探讨参附注射液(Shenfu injection,SFI)对重症急性胰腺炎(SAP)大鼠肠屏障功能障碍与二次打击的防护作用。方法:雄性Wistar大鼠54只,随机分为3组:SAP组(SAP,n=24),采用逆行十二指肠胰胆管注射5％牛黄胆酸钠溶液制备SAP大鼠模型;SAP+SFI组(n=24),建模前2 h先给予SFI 10 ml/kg 体质量腹腔注射;假手术组(SO,n=6)。建模成功后3、6、12、24 h,分别取血液和小肠、胰腺、肺脏、肝脏标本。光镜下观察小肠组织病理改变,检测各时段血浆TNF-α、IL-6和二胺氧化酶(diamine oxidase,DAO)活性,以及相应时段胰腺、肺脏、肝脏中髓过氧化物酶(MPO)含量。结果:SAP组各时间点血液TNF-α、IL-6、DAO均较SO组显著升高(P<0.01),6～24 h胰腺、肺脏、肝脏MPO较SO组显著升高(P<0.01);SAP+SFI组各时间点血液DAO、TNF-α和IL-6水平显著低于SAP组(P<0.05或P<0.01),6～24 h胰腺、肺脏、肝脏MPO显著低于SAP组(P<0.05或P<0.01);SAP+SFI组建模后24 h小肠病理组织改变较SAP组明显减轻。结论:SFI可防护SAP大鼠肠屏障功能障碍,并可减轻胰腺、肺脏、肝脏遭受二次打击的严重程度,其作用机制可能与减少中性粒细胞聚集、抑制促炎细胞因子TNF-α、IL-6相关。     

急性胰腺炎大鼠胰腺组织核因子-κB动态变化

目的: 观察急性胰腺炎大鼠胰腺组织中核因子-κB (NF-κB)的表达和血清中细胞因子的变化,探讨胰腺组织NF-κB的表达和血清细胞因子的变化关系。方法: 实验动物随机分为5组,正常对照组(Normal组)、急性水肿性胰腺炎6h组(AEP6h组)和急性坏死性胰腺炎3h组(ANP3h)、6h组(ANP6h)、12h组(ANP12h),观察各组血清淀粉酶(Amy)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的含量及胰腺组织NF-κB的表达。结果: 急性水肿性胰腺炎大鼠TNF-α、IL-6、胰腺组织NF-κB的表达均较正常组明显增高(P<0.01),急性坏死性胰腺炎TNF-α、IL-6及胰腺组织NF-κB表达较水肿性胰腺炎增高(P<0.05~P<0.01),6h达高峰,此后下降。结论: 胰腺组织NF-κB参与急性胰腺炎的发病并呈动态变化;胰腺组织NF-κB表达与TNF-α、IL-6含量呈正相关。     

肠内营养联合中药干预对兔重症急性胰腺炎炎症反应和肠黏膜屏障功能的影响

目的 探讨肠内营养联合中药干预对兔重症急性胰腺炎(SAP)炎症反应和肠黏膜屏障功能的影响. 方法 日本大耳白兔36只,随机分为3组(n=12):对照组(A组)、SAP组(B组)和SAP肠道干预组(C组),B、C两组采用胰管结扎联合胆汁注射法制成兔SAP模型,C组造模后滴注肠毒清和百普力.造模前及造模后6、12、24、72、120 h取静脉血测定并比较血清淀粉酶(AMY)、肿瘤坏死因子-α(TNF-α)和白介素-6 (IL-6)水平.动物于实验后死亡或第5 天处死动物,收集胰腺和小肠组织,观察胰腺和小肠组织病理学改变并进行病理学评分.制备小肠组织匀浆,测定并比较TNF-α、IL-6、和丙二醛(MDA)水平. 结果 除造模后120 h的IL-6水平,B、C组造模后各时点的血清AMY、TNF-α和IL-6水平均显著高于A组(P<0.05);造模12 h后的血清AMY水平、24 h后的血清TNF-α水平以及24 h和72 h的血清IL-6水平,C组均显著低于B组(P<0.05).胰腺和小肠组织病理学改变以B组最为严重,C组较B组明显减轻.C组小肠组织中TNF-α、IL-6和MDA水平较B组显著降低(P<0.05). 结论 肠内营养联合中药干预可抑制SAP炎症介质的释放,减轻肠黏膜损伤程度,从而保护肠黏膜屏障,有助于SAP的治疗及预后改善.     

乌司他丁对急性重症胰腺炎大鼠血清TNF-α及IL-1β水平的影响

目的:探讨乌司他丁对重症胰腺炎大鼠TNF-α和IL-1β水平的影响。方法:胰胆管逆行注射牛磺胆酸钠制作大鼠SAP模型,wistar大鼠60分为3组,乌司他丁治疗组,重症胰腺炎(SAP)组,对照(NC)组,每组20只。术后6h对各组大鼠行血清淀粉酶、TNF-α及IL-1β的检测,并取各组大鼠胰腺组织标本行病理学观察。结果:乌司他丁治疗组血清淀粉酶、TNF-α及IL-1β较SAP组明显降低,胰腺组织坏死程度减轻(P0.05)。结论:乌司他丁可调节细胞因子水平,改善胰腺组织微循环,减轻全身炎症反应,对SAP有治疗作用。     

陈义汉寄语

目的探讨青蒿琥酯对大鼠重型胰腺炎时胰腺细胞凋亡的保护作用。方法逆行胆管微量泵入5%牛磺酸钠制备大鼠急性重型胰腺炎模型,鼠尾静脉采血应用酶联免疫吸附(ELASE)方法检测血清淀粉酶,肿瘤坏死因子-α(TNF-α),白介素-6(IL-6)及髓过氧化物酶(MPO),丙二醛(MDA),超氧化物歧化酶(SOD)的变化情况;用Western-bolt蛋白印迹分析方法检测大鼠胰腺组织内凋亡相关因子半胱天冬酶-3(Caspase-3)和半胱天冬酶-9(caspase-9)的表达水平;对大鼠胰腺病理切片伊红(HE)染色观察大鼠胰腺组织坏死,出血,炎症,水肿等情况,并进行病理学组织学分析,原位末端标记法(TUNEL)检测大鼠胰腺细胞凋亡情况及凋亡指数,根据各组大鼠存活率绘制生存曲线并进行比较。结果大鼠血清淀粉酶在重型胰腺炎组大鼠(Severe acute pancreatitis,SAP)与假手术组比较明显增高(P<0.05),青蒿琥酯干预处理后血清淀粉酶水平较SAP组大鼠有明显下降趋势(P<0.05);对各组实验大鼠血清中炎症因子TNF-α, IL-6, MPO, MDA检测发现经青蒿琥酯干... 更多     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.