20（S）-人参皂苷Rg3抗异丙肾上腺素诱导心肌缺血作用

[目的]研究20（S）-人参皂苷Rg3抗心肌缺血作用及其机制.[方法]随机将50只Wistar大鼠分成5组,即空白对照组（CON）,异丙肾上腺素组（ISO）,20（S）-人参皂苷Rg3（5、10、20 mg/kg）组.各组大鼠灌胃给予相应药物,除CON外其余各组大鼠皮下注射盐酸异丙肾上腺素（20 mg/kg）制备心肌缺血模型.末次注射异丙肾上腺素2h后麻醉大鼠,取血检测血清中肌酸激酶（creatine kinase,CK-MB）和乳酸脱氢酶（lactate dehydrogenase,LDH）活力,取大鼠左心室制备匀浆后检测心肌组织超氧化物歧化酶（superoxide dismutase,SOD）活性、谷胱甘肽过氧化物酶（glutathione peroxidas,GSH-Px）活性、总抗氧化能力（total antioxygencapabilit,T-AOC）及丙二醛（malonaldehyd,MDA）含量.[结果]与CON组相比,ISO组血清CK-MB、LDH活力明显增高.与ISO组比较,20（S）-人参皂苷Rg3（5,10,20 mg/kg）可显著降低血清CK-MB、LDH活力;与CON组比较,ISO组SOD活性、GSH-Px活性及T-AOC降低,MDA含量增高;与ISO组相比,20（S）-人参皂苷Rg3（5、10、20 mg/kg）可显著提高SOD活性、GSH-Px活性及T-AOC,降低MDA含量.[结论]20（S）-人参皂苷Rg3具有抗心肌缺血作用,其作用机制与清除自由基和抗脂质过氧化有关.     

参力保对家兔心肌缺血再灌注损伤的保护作用

目的 观察参力保对家兔心肌缺血再灌注损伤的保护作用.方法 结扎兔冠状动脉左前降支(LAD)30 min,再灌注120 min后制备家兔心肌缺血再灌注模型.56只家兔,随机分为7组,生理盐水对照组:假手术组,模型组(给予溶媒8.58 mg/kg),参力保高剂量组(22.36 mg/kg,内含5.2 mg/kg人参皂苷Rg2),参力保中剂量组(11.18 mg/kg,内含2.6 mg/kg人参皂苷Rg2),参力保低剂量组(5.59 mg/kg,内含1.3 mg/kg人参皂苷Rg2),阳性对照组(给予盐酸尼卡地平注射液),测定血浆磷酸激酸同工酶(CK-MB)、乳酸脱氢酶(LDH)、天门冬氨酸转氨酶(AST)和心肌组织中超氧化物歧化酶(SOD)活性、丙二醛(MDA)及游离脂肪酸 (NFFA) 含量;高效液相法测定心肌组织去甲肾上腺素(NE)含量.结果 参力保能显著降低血浆CK-MB和LDH、AST的活性,与模型组相比有显著差异(F=13.031～32.604,P<0.05、0.01).参力保3个剂量组与模型组比较可明显降低心肌MDA含量,提高SOD活性和NE的含量(F=2.880～15.927,q=5.249～12.510,P<0.05);参力保高、中、低剂量组NFFA与模型组比较,差异有显著性(Z1=Z2=Z3=-2.329,P<0.05).结论 参力保对家兔心肌缺血再灌注损伤有保护作用,其机制与清除自由基抑制脂质过氧化反应有关.     

刺五加叶皂苷B对急性心肌梗死大鼠的保护作用

目的 研究刺五加叶皂苷B (ciwujianoside B) 对大鼠急性心肌梗死的影响及其机制。方法 通过结扎大鼠左冠状动脉前降支制备急性心肌梗死模型;观测以下指标：左室收缩压 (LVSP)、左室舒张末期压 (LVEDP)、左室压最大上升/下降速率 (±dp／dtmax)、动脉收缩压 (SBP)、动脉舒张压 (DBP)、平均主动脉压 (MAP)、心率 (HR)、心肌梗死范围 (MIS);肌酸激酶 (CK)、乳酸脱氢酶 (LDH)、天冬氨酸转氨酶 (AST) 活性;游离脂肪酸 (FFA) 及乳酸 (LA) 水平;超氧化物歧化酶 (SOD)、丙二醛 (MDA)、谷胱甘肽过氧化物酶 (GSH-Px)、肿瘤坏死因子-α(TNF-α) 及白细胞介素-6 (IL-6) 水平。结果 与模型组比较,刺五加叶皂苷B可显著升高急性心肌梗死大鼠 LVSP、±dp/dt max、HR、SBP (P＜0.05),降低 LVEDP (P＜0.05),对 DBP、MAP 的增加不显著;刺五加叶皂苷B可明显缩小 MIS,降低血清 CK、LDH、AST 活性及 MDA、FFA、LA、TNF-α、IL-6水平 (P＜0.05、0.01);提高 SOD、GSH-Px 活性 (P＜0.05)。结论 刺五加叶皂苷 B 对大鼠急性心肌梗死具有明显保护作用,可能与其增强抗氧化酶活性,减少自由基损伤,纠正 FFA 代谢紊乱及 LA 堆积,抑制炎症反应等机制有关。     

西洋参茎叶皂甙对大鼠冠脉前降支损伤心肌FFA和LDH的影响

应用大鼠冠状动脉前降支损伤心肌模型，观察西洋参茎叶皂甙（panax quinquefolium saponins,PQS)对大鼠心肌游离脂肪酸（FFA）含量和乳酸脱氢酶（LDH）活性的影响，结果提示PQS抗心肌缺血作用与其降低心肌FFA含量和提高LDH活性有密切关系。     

二氢石蒜碱对异丙肾上腺素致大鼠心肌缺血的保护作用

目的:观察二氢石蒜碱(dihydrolycorine,DL)对大鼠心肌缺血损伤的保护作用。方法:采用异丙肾上腺素(Isoproterenol,Iso)制作大鼠心肌缺血模型,检测DL对缺血损伤后大鼠血清肌酸激酶(CK)和乳酸脱氢酶(LDH)活性、心肌组织及线粒体中超氧化物歧化酶(SOD)和谷光甘肽过氧化物酶(GSH-Px)活性及MDA含量以及心肌线粒体ATP酶活性的影响。结果:试验组大鼠缺血损伤后血清肌酸激酶(CK)和乳酸脱氢酶(LDH)活性明显升高,心肌组织与线粒体中SOD与GSH-Px活性显著下降,MDA含量明显升高,心肌线粒体ATP酶活性明显降低,与对照组比较具有显著性差异(P<0.01);随药物剂量增加(10、20、40 mg/kg)其血清CK和LDH活性逐渐降低,心肌组织及线粒体中SOD与GSH-Px活性逐渐回升,MDA含量逐渐趋于正常,ATP酶活性逐渐增加,以DL 20及40 mg/kg组作用更显著(P<0.01或P<0.05)。结论:DL对Iso致大鼠心肌缺血损伤具有保护作用,其机制可能与DL减少心肌组织脂质过氧化、提高心肌细胞抗氧化损伤的能力、减轻心肌能量代谢障碍有关。     

环维黄杨星D对麻醉犬急性心肌梗死的保护作用

目的研究环维黄杨星D(CD)对犬急性心肌梗死模型的血流动力学影响和对心肌的保护作用.方法阻断犬左冠状动脉前降支(LAD)6h,记录缺血前和缺血6h内的血流动力学和生物化学指标的变化.然后通过TTC染色测定心肌梗死面积.结果心肌缺血前10min静脉灌注CD对心脏血流动力学无明显影响,但CD可明显抑制心肌梗死后左心室压力上升最大速率(LVdp/dtmax)、平均动脉压(MAP)和心肌耗氧量指数(RPP)的降低.CD明显缩小心肌梗死面积,对照组心肌梗死面积占缺血面积比(IS/ARR)为(85.4±9.2)%;CD0.15mg/kg、0.3mg/kg和0.6mg/kg组分别为(51.2±13.2)%、(46.6±14.3)%、(58.4±8.8)%,P<0.01.CD明显降低缺血后血清CK(肌酸激酶),LDH(乳酸脱氢酶),FFA(游离脂肪酸)和MDA(丙二醛)水平,并提高血清SOD(超氧化物歧化酶)活性,但CD0.15mg/kg组降低CK作用明显强于0.3mg/kg和0.6mg/kg组.结论CD静脉给药具有明显的心肌保护作用,此作用不依赖于心脏血流动力学的影响,CD小剂量的心肌缺血保护作用优于大剂量.其保护心肌缺血作用可能与抑制脂质过氧化,清除自由基有关.     

多药效学指标评价冠心平颗粒中制黄精的提取工艺

目的 用多药效学指标确定冠心平颗粒中制黄精的提取工艺.方法 采用异丙肾上腺素(ISO)致大鼠心肌缺血损伤模型,比较水提取(A)和水提醇沉取粗多糖(B)2种工艺对心肌缺血大鼠心电图、血清肌酸激酶(CK)、乳酸脱氢酶(LDH)和丙二醛(MDA)及病理组织形态学的影响.结果 2种工艺样品均有抑制心肌缺血大鼠心电图J点升高,降低CK、LDH、MDA水平的作用,与水提醇沉工艺相比,水提工艺样品能更好的降低CK、LDH、MDA水平(P<0.01),且水提醇沉工艺样品对心肌间质血管充血无明显改善作用.结论 冠心平颗粒中制黄精工艺为水提取,不宜进行醇沉处理.     

滁菊总黄酮对异丙肾上腺素致大鼠急性心肌缺血的影响

目的观察滁菊总黄酮对异丙肾上腺素(ISO)致急性心肌缺血模型大鼠的保护作用。方法将大鼠皮下注射ISO复制大急性心肌缺血模型,观察滁菊总黄酮对模型大鼠心电,血清肌酸激酶(CK)、乳酸脱氢酶(LDH)、心肌组织超氧物歧化酶(SOD)、过氧化氢酶(CAT)和丙二醛(MDA)含量的影响。结果滁菊总黄酮能够抑制急性心肌缺血模型大鼠心电图J点抬高,降低血清CK、LDH活性,升高心肌组织SOD、CAT活性,降低MDA含量。结论滁菊总黄酮对ISO致心肌缺血模型大鼠有保护作用。     

人参皂苷Rg1和白藜芦醇配伍对心肌缺血再灌注损伤保护作用

目的:观察人参皂苷Rg1和白藜芦醇配伍预处理对大鼠心肌缺血再灌注损伤的影响。方法:75只大鼠分为假手术组、缺血再灌注损伤组(模型组)、人参皂苷加白藜芦醇组(配伍组)、人参皂苷组和白藜芦醇组,每组15只,药物治疗组给予人参皂苷Rg1和白藜芦醇等预处理,制备心肌缺血再灌注损伤模型,观察大鼠血清中IL-17与CK的水平,心肌组织中Bcl-2、Bax的表达水平,ATP、NO、丙二醛(MDA)含量及超氧化物歧化酶(SOD)、诱导型一氧化氮合酶(iNOS)、内皮型一氧化氮合酶(eNOS)活性的变化。结果:与假手术组比较,模型组血清IL-17与CK的水平明显升高;心肌组织Bcl-2表达水平降低、Bax表达水平升高,ATP、NO含量降低;MDA含量升高,SOD活性降低,iNOS活性升高,eNOS活性降低。与模型组比较,人参皂苷加白藜芦醇组大鼠血清IL-17与CK的水平降低;心肌组织Bcl-2表达水平升高、Bax表达水平降低,ATP、NO含量升高;MDA含量降低,SOD活性升高,iNOS活性降低,eNOS活性升高。结论:人参皂苷Rg1与白藜芦醇配伍可能通过抑制心肌细胞凋亡,降低细胞内游离Ca2+浓度,增加自由基清除能力,减低内皮功能及炎症损伤程度等机制对缺血心肌产生一定的保护作用。     

去甲肾上腺素预处理对大鼠供心超氧化物歧化酶及丙二醛表达的影响

目的探讨去甲肾上腺素预处理对大鼠供心心肌细胞超氧化物歧化酶(SOD)及丙二醛(MDA)表达的影响。方法雄性Wistar大鼠18只随机分为对照组和实验组各9只,对照组腹腔注射生理盐水0.5 mL,24 h后取离体心脏灌注Histidine-tryptophan-ketoglutarate心脏保护液,4℃保存3 h后建立Langendorff离体心脏灌注模型,灌注Krebs-Henseleit液2 h;实验组腹腔注射重酒石酸去甲肾上腺素(溶于生理盐水)3.1μmol.kg-1(0.53 mg.kg-1),24 h后取离体心脏,处理方法同对照组。测定2组肌酸激酶(CK)、乳酸脱氢酶(LDH)漏出率以及心肌水含量(MWC)、SOD、MDA的水平。结果实验组SOD的水平较对照组明显升高(P<0.01);MWC、MDA含量、CK、LDH漏出率较对照组明显降低(P<0.01)。结论去甲肾上腺素预处理能促进SOD表达,降低MDA含量,对抗氧自由基损伤,从而发挥对离体大鼠供心心肌的保护效应。     

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.