三七总皂苷对脑缺血再灌注损伤神经细胞凋亡机制的研究进展

近年来,脑血管病的发病率逐年升高,其中缺血性脑血管疾病占67%～78%.在这一疾病及其相应的治疗过程中,引起脑缺血再灌注损伤(cerebral ischemia reperfusion injury ,CIRI)是脑缺血缺氧后恢复缺血区血供的又一次损伤,也是一种迟发性神经元死亡,与细胞凋亡密切相关.细胞凋亡是在生理和病理条件下受细胞内、外因子调控的生物学过程的一种主动死亡方式[1] .     

中药单体保护脑缺血再灌注损伤的研究进展

脑缺血再灌注损伤(CIRI)是一个复杂的病理生理过程,主要涉及自由基累积、钙超载、兴奋性氨基酸毒性、一氧化氮和一氧化氮合酶、内质网应激、线粒体损伤、炎症反应、细胞凋亡、血-脑脊液屏障等一系列机制。近年来,随着CIRI研究的不断深入,中药对CIRI的保护作用研究逐渐受到广泛关注,本文就CIRI的分子机制以及中药单体干预CIRI的研究现状予以综述。     

NF—κB信号通路在脑缺血再灌注损伤中的作用及中药有效组（成）分的干预研究

脑缺血／再灌注损伤（cerebral ischemia reperfusion injury,CIRI）是一种机制复杂的级联反应性疾病,在其机制中炎症反应最为关键。核因子-κB（nuclear factor—κappa B,NF—κB）信号通路作为炎症反应的主要环节,通过调节多种细胞因子及下游基因表达启动炎症反应与细胞凋亡。目前研究显示,部分中药有效成分对CIRI具有保护作用,为明确中药有效成分在CIRI中的作用机理,就近年来NF-κB信号通路在CIRI后炎症反应及细胞凋亡方面可能相关作用作一综述。     

细胞凋亡与疾病

近年来,细胞凋亡(apoptosis)分子机理的研究已成为生物医学中一个十分新颖、受人关注的热门课题.细胞凋亡是细胞生命周期的最终生理过程,它对生物个体的发育、存活以及保持正常生理功能都有重要意义,细胞凋亡规律异常,会给人类造成许多疾病.涉及凋亡调节和执行的基因产物对于疾病诊断和介入治疗是极具潜力的研究方向,它们使许多疾病的治疗获得新的希望.本文复习文献,对细胞凋亡的概念、细胞学及生化特征、调控基因及其与疾病的关系做一概述.     

七氟醚后处理对脑缺血再灌注损伤大鼠的保护作用及对Toll样受体4/核因子-κB信号通路的影响

目的探讨七氟醚后处理对脑缺血再灌注损伤(CIRI)大鼠的保护作用及对Toll样受体4(TLR4)/核因子-κB(NF-κB)信号通路的影响。方法将60只Sprague Dawley大鼠随机分为假手术组、CIRI组和七氟醚后处理组(Se组),每组20只。CIRI组和Se组大鼠采用线栓法制备CIRI损伤模型,假手术组大鼠不给予线栓。Se组大鼠于再灌注即刻给予体积分数2. 5%七氟醚和氧气持续吸入30 min,氧流量1 L·min-1;假手术组和CIRI组大鼠持续吸入氧气30 min,氧流量1 L·min-1。再灌注24 h后采用改良神经功能缺损评分(m NSS)评估大鼠的神经功能,评估结束后取血并处死大鼠取出脑组织;检测各组大鼠脑梗死体积比、细胞凋亡指数、血清肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-10和IL-1β水平、脑组织中丙二醛(MDA)水平及超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)的活性。Western blot法检测大鼠脑组织中Caspase-3、Bax、Bcl-2、TLR4及NF-κB p65蛋白的表达水平。结果 CIRI组和Se组大鼠m NSS评分、脑梗死体积比及细胞凋亡指数高于假手术组(P <0. 05); Se组大鼠m NSS评分、脑梗死体积比、细胞凋亡指数低于CIRI组(P <0. 05)。与假手术组比较,CIRI组和Se组大鼠血清TNF-α、IL-6和IL-1β水平升高,IL-10水平降低(P <0. 05);与CIRI组比较,Se组大鼠血清TNF-α、IL-6和IL-1β水平降低,IL-10水平升高(P <0. 05)。与假手术组比较,CIRI组和Se组大鼠脑组织中MDA水平及Caspase-3、Bax、TLR4、NF-κB p65蛋白表达水平显著升高,SOD、GSH-Px活性及Bcl-2蛋白表达水平显著降低(P <0. 05);与CIRI组比较,Se组大鼠脑组织中MDA水平及Caspase-3、Bax、TLR4、NF-κB p65蛋白表达水平显著降低,SOD、GSH-Px活性及Bcl-2蛋白表达水平显著升高(P <0. 05)。结论七氟醚对CIRI大鼠脑组织具有一定的保护作用,其作用机制可能是通过抑制TLR4/NF-κB介导的炎性级联反应,减少炎性因子的释放,降低炎症和氧化应激反应,从而抑制细胞凋亡。     

脑缺血/再灌注损伤后内质网应激对神经元转归的影响

内质网本身在细胞生理及组成结构方面起至关重要的作用,当内质网出现功能障碍时,未折叠蛋白反应(UPR)试图增加未折叠蛋白的折叠能力而减轻内质网应激(ERS)的压力。当无法缓解时,细胞便通过内质网凋亡途径走向凋亡。而脑缺血/再灌注损伤(CIRI)会导致内环境紊乱,引起ERS反应,进而通过ERS途径引起神经元凋亡。现对内质网的结构、功能、ERS机制、ERS后产生的UPR机制以及凋亡机制予以阐述,并提出了对CIRI后ERS状态下神经元转归的应对措施。     

脑缺血-再灌注损伤机制及其药物治疗方法的研究进展

脑缺血-再灌注损伤(CIRI)是多种机制参与的复杂的病理生理过程,主要与自由基过度形成、兴奋性氨基酸毒性作用、细胞内钙超载、炎性反应和细胞凋亡多种机制有关,多种环节因素之间又互相作用,进一步促进CIRI后的神经功能破坏和脑梗死灶形成。本文作者从发病机制和药物治疗靶点两方面对最新研究进展予以综述。
［关键词］ ［中图分类号］     

细胞凋亡与疾病

近年来，细胞凋亡（apoptosis)分子机制的研究已成为生物医学中一个十分新的、受人关注的热门课题。细胞凋亡是细胞生命周期的最终生理过程，它对生物个体的发育、存活以及保持正常生理功能都有重要意义，细胞凋亡规律异常，会引起许多疾病。涉及凋亡调节和调控的基因产物对于疾病诊断和介入治疗是极具潜力的研究方向，它们使许多疾病的治疗获得新的希望。本文复习文献对细胞凋亡的概念、细胞学及生化特征、调控基因及其与疾病的关系做一概述。     

Caspase-8及Caspase-3与细胞凋亡

细胞凋亡与多种疾病的发生、发展密切相关。Caspasec依赖的凋亡过程中caspase-8与caspase-3着关键作用。就Caspase-872．Caspase-3在细胞凋亡过程中的作用及其研究进展做一综述。     

细胞凋亡与疾病及中医中药相关性

细胞凋亡 ( apoptosis)是 1 972年英国生物学家 Kerr等首次提出的概念。它是由基因控制的细胞自我消亡过程 ,其发生对机体维持稳态和组织器官正常生理功能具有重要意义。本文就细胞凋亡与疾病的相关性加以概述。1　细胞凋亡与疾病　　已有大量文献报道表明 ,细胞凋亡的过度或不足与许多疾病的发生、发展及与药物治疗的效果关系密切。这里简要介绍几种疾病的研究概况。1 .1　慢性白血病 ( CML )　本病的特征是成熟髓细胞及其干 /祖细胞的异常扩增 ,最终发展为白血病。白血病克隆的细胞遗传学标志为 Ph染色体 ,即 9号染色体与 2 2号染色体上…     

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.     

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.     

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.