高温高湿环境习服对大鼠肺脏细胞凋亡及能量代谢的影响

目的 观察高温高湿环境习服对大鼠肺脏细胞凋亡及能量代谢的影响.方法 20只SD大鼠按随机数字表法分为常温常湿对照组和高温高湿环境组,每组10只大鼠.采用人工气候箱模拟高温高湿环境,条件设置为温度35℃、相对湿度(relative humidity,RH) 90％ ～ 95％.高温高湿环境组大鼠每天置于箱中10 h,其余时间与常温常湿对照组饲养于清洁环境(温度22 ～ 26℃,RH 40％ ～ 60％),连续处理30 d.动物模型制作完成后,乙醚麻醉,取肺脏组织,分别行HE染色观察病理改变、TUNEL法检测细胞凋亡情况,ELISA检测肺组织细胞胞质中Bax、Bcl-2及Cyt-C的变化,荧光素酶法测定肺组织ATP含量.结果 光镜下可见高温高湿环境组大鼠肺脏毛细血管增生、扩张充血;血管及支气管周围淋巴细胞浸润,肺泡隔增宽、水肿;支气管上皮细胞和肺泡上皮细胞凋亡指数(20.79 ±7.65)显著高于对照组[(3.81±1.90),P＜0.001].肺组织细胞胞质Bax显著升高(P＜0.001),Bax/Bcl-2较对照组升高了30.18％ (P =0.021),Cyt-C升高了85.36％ (P＜0.001),ATP含量降至对照组的69.30％ (P=0.002).结论 高温高湿环境习服过程中,长期反复的高温高湿刺激可致大鼠肺脏组织细胞发生凋亡改变,同时伴有ATP合成障碍,能量代谢失衡,导致机体产生蓄积性损伤效应.     

SD大鼠极端高温高湿环境暴露的实验研究

目的 调查极端高温高湿环境暴露对SD大鼠生存、血液生化指标的影响及对主要脏器的伤害.方法 26只SD大鼠分为常温常湿组和极端高温高湿组.观察SD大鼠在极端高温高湿环境中的死亡情况并于半数致死时间点捕杀动物进行血清生化指标测定和心、肺、肾、脑、肌肉和小肠6种组织的病理检测.结果 极端高温高湿环境暴露可导致SD大鼠死亡,半数致死时间为48 h;极端高温高湿组与常温常湿组相比,SD大鼠血清肌酐(Scr)显著性升高(P<0.05),血清碱性磷酸酶(ALP)、缺血修饰性清蛋白(IM A)明显下降(P<0.05),其他生化指标无显著性改变;极端高温高湿组SD大鼠心、肺、肾、小肠组织可见炎性细胞浸润,脑和肌肉组织未见明显病理性改变.结论 极端高温高湿环境暴露对SD大鼠有明显伤害,可引起某些血液生化指标异常和心、肺、肾、小肠组织的炎性改变,甚至造成死亡.     

用诱发电位检测亚低温对高温高湿环境下特重型颅脑伤的疗效

目的通过诱发电位(EP)监测,探讨亚低温对高温高湿环境下特重型颅脑伤的疗效。方法选择受伤后在高温高湿环境下(≥32℃,RH≥80%)8h内入院的特重型颅脑伤患者(GCS≤5)60例,患者随机分为亚低温组(n=30)和常温组(n=30)。亚低温组体温降至33~35℃,于降温前、降温过程中及复温后监测正中神经短潜伏期体感诱发电位(SLSEP)和脑干听觉诱发电位(BAEP):常温组在同样的时间段监测上述指标。统计分析亚低温组与常温组诱发电位的变化情况。结果亚低温组在治疗后SLSEP的N20波同变化值为(0.87±0.52)μV,常温组为(0.61±0.49)μV,两者有显著性差异(P<0.05):BAEP的V/I波幅比值,差异显著性(P<0.05)。结论从神经电生里角度来看,亚低温对GCS为3~5分的高温高湿环境下特重型颅脑伤有较好疗效。     

高温复合脂多糖应激大鼠血清尿素和肌酐的变化特点

目的 探讨高温与脂多糖(LPS)复合应激大鼠血清尿素、肌酐含量等指标的动态变化特点.方法 雄性SPF级Wistar大鼠随机分为常温 生理盐水组(C组)、高温 生理盐水组(H组)、常温 LPS组(L组)、高温 LPS组(HL组).置动物于模拟气候舱,HL组、H组暴露环境干球温度为(35.0±0.5)℃,L组、C组Tdb为(26±0.5)℃;HL组、L组动物经尾静脉注射LPS 8 mg/kg,H组、C组动物经尾静脉注射0.9% NaCl 8 ml/kg.检测动物应激0、40、80、120 min时血清尿素、肌酐等物质含量的变化.结果 肌酐在不同温度、时间、药物水平间不存在显著性差异(P＞0.05);不同温度、时间、药物水平间动物血清尿素存在显著性差异(P＜0.01),时间与药物、温度与药物、时间与温度交互效应显著(P＜0.01).应激40 min起各组间尿素差异显著,HL组尿素显著高于其余3组(P＜0.01).尿素水平与TNF-α含量存在正相关关系(r=0.730,P=0.000).结论 高温与LPS复合应激可促发、扩大全身炎症反应综合征,造成肾损伤.     

高温复合脂多糖应激大鼠血清天门冬酸氨基转移酶的变化

目的:探讨高温与脂多糖(LPS)复合应激大鼠血清天门冬酸氨基转移酶(AST)含量的变化特点.方法:雄性SPF级Wistar大鼠64只随机均匀分为常温 生理盐水组(C组),高温 生理盐水组(H组),常温 LPS组(L组),高温 LPS组(HL组).置动物于模拟气候舱,HL和H组暴露环境干球温度(Tdb)为(35.0±0.5)℃,L和C组Tdb为(26±0.5)℃;HL和L组动物经尾静脉注射LPS 10 mg/kg,H和C组动物经尾静脉注射9 g/L NaCl 10 mL/kg.持续监测动物平均动脉压(MAP)的动态变化,检测动物应激0,40,80,120 min时血清AST等物质含量的变化.结果:AST在不同温度、时间、药物水平间存在统计学差异(P＜0.01);时间与温度、时间与药物、温度与药物交互作用有统计学意义(P＜0.05),120 min时相点HL组动物血清AST含量高于其余3组,差异有统计学意义(P＜0.01);AST水平与MAP存在负相关关系(r=-0.818,P=0.029).结论:高温与LPS复合应激可促发、扩大全身炎症反应综合征.     

湿热复合创伤应激对大鼠血浆SOD,MDA及NO的影响

目的　探讨高温高湿创伤复合应激条件下SOD ,MDA及NO的变化规律 ,为研究提高部队应对应激反应的能力提供实验依据。方法　 2 1只Wistar大鼠随机分为常温对照组、常温创伤组和湿热创伤组 ,每组 7只。常温组置于干球温度 ( 2 4± 1)℃、相对湿度 ( 5 5± 5 ) %的环境 ;常创组置于同等环境 ,99℃沸水背部浅Ⅱ度烫伤 ,烫伤面积约为体表面积的 10 % ,不给予任何处理 ;湿创组动物给予和创伤组同样的处理 ,置于干球温度 ( 37± 0 5 )℃、相对湿度 ( 6 5± 5 ) %的湿热环境中。结果　常温组、常创组、湿创组MDA ,SOD和NO组间比较差异有显著性 (P均<0 0 5 ) ;其中与常温组相比较 ,湿创组和常创组血浆MDA含量差异有显著性 (P均 <0 0 5 ) ;常温组和常创组血浆SOD含量比较差异有显著性 (P均 <0 0 5 ) ;湿创对照组与常温和常创组血浆NO含量比较差异有显著性 (P均 <0 0 1)。结论　湿热创伤复合应激对机体脂质过氧化反应和NO的影响超过创伤应激     

全身低温对吸入性损伤大鼠肺的保护作用

目的 观察全身低温对烟雾吸入性损伤大鼠的急性肺部损伤的影响.方法 将54只健康雄性SD大鼠随机分为3组,正常对照组、单纯致伤组、全身低温组,每组18只.单纯致伤组致伤后放恒温水浴箱中,维持正常体温.全身低温组致伤后作全身低温处理维持(33±0.5)℃持续1 h后升为正常体温.正常对照组不致伤.3组大鼠于伤后6 h后取腹主动脉血2 mL离心取血清,检测肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的含量.取右下肺行病理切片,左肺作肺组织湿干重比.结果 单纯致伤组和全身低温组与正常对照组相比烟雾吸入性损伤6 h后肺组织湿干重比显著升高(P＜0.05),腹主动脉血中TNF-α、IL-6的含量显著升高(P＜0.05),肺部充血水肿及炎症细胞浸润程度严重.全身低温组与单纯致伤组相比肺组织湿干重比降低(P＜0.05),腹主动脉血中TNF-α、IL-6的含量降低(P＜0.05),肺部充血水肿及炎症细胞浸润程度减轻.结论 全身低温可以减轻烟雾吸入性损伤大鼠的急性肺部炎症、减轻肺损伤.     

高温高湿环境对大鼠创伤性脑水肿的影响

目的 通过研究实验大鼠颅脑损伤后创伤区脑含水量变化情况及脑组织水通道蛋白4表达的影响,分析高温高湿环境对创伤性脑水肿的影响.方法 选择成年健康雄性SD大鼠64只,随机分为常温无创组16只(25℃、RH 50％),常温创伤组(16只),高温高湿无创伤组16只(35℃、RH 85％),高温高湿创伤组(16只).采用Feeney自由落体法建立大鼠急性颅脑损伤模型.以上四组动物分别于6h、24h时间点断头处死,对脑组织含水量、HE染色后组织学观察、AQP4蛋白和mRNA的表达检测及电镜观察.结果 与常温创伤组比较,高温高湿创伤组AQP4&mRNA的表达和脑组织含水量明显增加(P＜0.01).结论 高温高湿环境能明显加重创伤性脑水肿.     

亚低温治疗高温高湿环境下重型颅脑损伤的临床观察

目的观察亚低温治疗高温高湿环境下重型颅脑损伤的疗效,探讨亚低温治疗的平稳性和安全性。方法将200例高温高湿环境下重型颅脑损伤病人随机分为亚低温组(100例)和对照组(100例),亚低温组入院后或术后立即行亚低温治疗,酌情运用冬眠合剂、肌松剂和呼吸机,肛温控制在33℃~35℃,持续24h~5天。对照组行常规治疗。两组均观察颅内压(1CP)、生命体征、脑干听觉诱发电位(BAEP)I/V波幅比值等的变化。结果亚低温组经亚低温治疗后,ICP下降明显;23例血压下降,24例心率减慢,复温后以上指标均恢复正常;亚低温治疗后24h及复温后、双侧BAEPI/V比值与对照组同时间相比差异显著(P<0.05)。亚低温组死亡39例,死亡率39%;对照组死亡52例,死亡率52%,两组有显著性差异(P<0.05)。结论亚低温治疗高温高湿环境后重型颅脑伤能降低脑外伤后增高的ICP,从而使死亡率及致残率明显下降,亚低温治疗中合理使用辅助药物,可以保障亚低温治疗的平稳性和安全性。     

大鼠热应激对细胞免疫学的影响

目的 探讨热应激对大鼠脾脏细胞Toll样受体4(TLR4)及外周血T调节(Treg)细胞表达的影响.方法 将72只SD大鼠分为20℃常温组和37℃高温湿热组,每组分非刺激、细菌脂多糖(LPS)刺激、刀豆素-A(Con-A)刺激亚组,每个亚组设1、12、48、168 h观察点;流式细胞术测定TLR4+细胞及Treg细胞.结果 37℃高温湿热组脾脏TLR4+细胞比率在各亚组的1～168 h均低于20℃常温组(P＜0.05).37℃高温湿热组各亚组1～48 h的外周血CD4+ CD25+ Treg较20℃常温组显著下降(P＜0.05),只有LPS刺激的168 h稍有升高,37℃高温湿热组中非刺激及Con-A刺激亚组CD4+ CD25+ Foxp3+ Treg在12h时间点较20℃常温组显著升高,而在168 h时间点各亚组显著降低(P＜0.05).37℃高温湿热组中各亚组1h和168 h的外周血CD8+ CD25+ Treg较20℃常温组显著升高;而CD8+ CD25+ Foxp3+ Treg各亚组在1h和48 h较20℃常温组显著降低,在非刺激和LPS刺激亚组的12 h和168 h较20℃常温组显著升高(P＜0.05).结论 高温湿热可破坏大鼠固有免疫并改变适应性免疫的功能状态.     

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.