未去肾上腺大鼠肝胞液糖皮质激素受体的测定及烫伤后的变化

在内源性激素存在的条件下,用交换法测定了大鼠肝胞液的糖皮质激素受体。交换条件为Oc4.5～5小时。在这条件下,[~3H]皮质酮—受体复合物的解离将近90％。向去肾上腺大鼠肝胞内预先加入不同量的皮质酮保温后,再测定[~3H]地塞米松特异结合,其结果表明,胞液皮质酮浓度在6nm以内时,[~3H]地塞米松特异结合容量(Ro)的测定值的减少不超过10％,表面上的解离常数(Kd)的测定值基本上不变。用这方法测定烫伤大鼠肝胞液的Ro和Kd,结果Ro减少。烫伤后1、12、24、36小时和5天的Ro分别为对照组的67.4±15.2、70.6±22.0、79.7±5.8、113.0±24.8和102.9±17.6％(均值±标准差)。烫后1小时Kd增大。对其可能的机理作了讨论。     

大鼠脾淋巴细胞糖皮质激素受体的测定

建立了测定大鼠脾淋巴细胞糖皮质激素受体(GR)的方法。实验结果表明大鼠脾淋巴细胞具有和地塞米松结合的高亲和力、低容量的特异结合部位,最大结合量为6773±585特异结合部位/细胞,平衡解离常数(Kd)为5.05±1.70 nmol/L,受体-配体复合物具有温度依赖性核转位现象。本文为进一步研究糖皮质激素作用的分子机理以及GR的病理变化和生理调节提供了简便的方法。     

儿童激素性高眼压与外周血淋巴细胞糖皮质激素受体表达相关性研究

目的 检测激素性高眼压患儿外周血淋巴细胞糖皮质激素受体（glucocorticoid receptor,GR）,GRα和 GRβ的表达,研究其与儿童激素性高眼压的相关性。 方法 收集20例激素性高眼压患儿(高眼压组),10例使用激素后眼压正常患儿（对照组）,10例健康儿童(健康组)的外周血,提取淋巴细胞RNA,采用半定量逆转录-聚合酶链反应 (RT-PCR)法检测淋巴细胞内GRα、GRβmRNA表达水平。结果 儿童外周血淋巴细胞有GRα、GRβmRNA表达, 以GRα为主。高眼压组的 GRαmRNA 半定量比值为(1.35±0.08) , 与对照组（1.25±0.04）及健康组(1.33±0.09)相比,差异无显著性意义(均 P＞0. 05)。高眼压组的GRβmRNA半定量比值为(1.24±0.04),与对照组(1.28±0.03)及健康组(1.20±0.07)相比,3组之间的表达差异无显著性意义(均 P >0. 05)。结论 未发现儿童外周血淋巴细胞糖皮质激素受体GRα和 GRβ的表达水平与激素性高眼压之间相关性。     

改变组织醛固酮及其受体表达对SHR大鼠肾脏纤维化的影响

 【目的】观察改变肾组织醛固酮及其受体水平对自发性高血压大鼠肾脏纤维化的影响。【方法】8周龄的雄性自发性高血压大鼠（SHR）24只及同源正常京都大鼠（WKY）8只，SHR分为贝那普利干预组[30ing／（kg·d）]、大剂量安体舒通干预组[100mg／（kg·d）]和高血压模型对照组，同时设同源的正常对照组，干预时间为8周，检测收缩压、尿蛋白、血白蛋白、尿素氮、肌酐、肾组织醛固酮受体、TGF-β1的mRNA和蛋白表达。【结果】贝那普利能下调组织醛固酮【（15．8±2．6）vs（22．2±0．6）pg／mg]及其受体水平【（15±4）vs（13±5）PU]并减轻肾脏纤维化[（17．0±1．8）vs（20．0±2．3）PU]，均为P〈0．05；大剂量安体舒通能上调组织醛固酮[（24．3±4．6）vs（22．2±0．6）pg／mg]及其受体水平[（16±6）vs（13±5）PU]并加重肾脏纤维化[（22．6±3．0）vs（20．0±2．3）PU]，均为P〈0．05。【结论】肾组织醛固酮及其受体水平的改变可能影响高血压肾脏纤维化的过程。     

支气管哮喘患者胰岛素与胰岛素受体的研究

目的 了解支气管哮喘（简称哮喘）患者外周血胰岛素与外周血淋巴细胞胰岛素受体的情况。方法 哮喘患者40例，其中初诊轻中度非激素治疗组（简称未治疗组）20例，轻中度慢性持续期激素治疗组20例（简称治疗组）；健康对照20例。清晨空腹采血，测定外周血白细胞总数和分类计数；测定空腹血糖、胰岛素、胰岛素受体；进行肺功能测定。结果 未治疗组和治疗组哮喘患者外周血中嗜酸粒细胞计数显著高于对照组[（4．04±2．57）％和（4．24±2．34）％比（0．90±1．38）％，P〈0．05]。未治疗组哮喘患者胰岛素、胰岛素受体水平显著高于对照组[胰岛素：（13．00±5．20）mIU／L比（10．08±3．79）mIU／L；胰岛素受体：（2．59±3．11）％比（0．99±0．62）％；P均〈0．05]。结论 哮喘患者在炎症状态下胰岛素分泌增多，胰岛素受体表达增加。     

热休克蛋白90和糖皮质激素受体比例失衡对哮喘患者T淋巴细胞凋亡的影响

目的探讨热休克蛋白90(HSP90)与糖皮质激素受体(GR)比例失调对T淋巴细胞凋亡的作用,同时观察地塞米松(Dex)对HSP90和GR mRNA表达的影响.方法选择10例哮喘患者和7例正常对照,利用格尔得霉素(GA)特异性阻断HSP90的作用, 造成功能性HSP90与 GR比例降低,用碘化丙啶(PI)染色流式细胞仪计数凋亡细胞的方法,观察用Dex和GA处理的T细胞凋亡情况;用逆转录聚合酶链反应(RT-PCR)的方法观察Dex和GA处理对哮喘T淋巴细胞HSP 90和GR mRNA 表达的影响.结果 Dex可明显诱导哮喘T淋巴细胞的凋亡(3 3 .8%±3.2% 比 23.2%±1.5%,P<0.01),GA对T淋巴细胞的凋亡无明显影响,却可阻断Dex诱导T淋巴细胞凋亡的作用(24.5%±6.0% 比 33.8%±3.2%, P<0.01);De x对正常人T淋巴细胞的凋亡有诱导作用,但其程度较弱(25.9%±3.5% 比 23.1%±1.5%, P<0.05).Dex可抑制哮喘患者T淋巴细胞HSP90和GR 的表达(分别为1.23±0.16比1.68±0.38 和 0.42±0.06比0.54±0.07, P 均<0.05),GA对 Dex的这一作用有阻断作用,但GA本身对HSP90和GR mRNA的表达无明显影响.结论 HSP90/GR 比例降低可影响Dex诱导的T细胞凋亡;Dex对哮喘患者GR和HSP90mRNA的表达有下调作用,而 Dex的这一作用可被GA所阻断.     

大鼠外周血白细胞糖皮质激素受体的测定

为了测定糖皮质激素受体的结合参数，以利于今后进步探讨ＧＲ改变在某些疾病发生中的作用及对治疗的指导意义。材料和方法以「＾３Ｈ」地塞公为配基，建立了大鼠外周血ＧＲ的放射配体结合测定方法。结果Ｓｃａｔｃｈａｒｄ作图分析「＾３Ｈ」Ｄｅｘ特异结合呈一直线，表观结合容量和平衡解离常数分别为（３３８７±３２８）位点细胞和（２。３５±１．１３）ｎｍｏｌ／Ｌ（ｘ±ｓ，ｎ＝５），「＾３Ｈ」Ｄｅｘ特异结合有明显的甾体特     

抑郁症大鼠海马CA1区及齿状回毛细血管的体视学研究

目的：研究慢性不可预见性刺激（chronically unpredicted stress,CUS）所致抑郁症模型大鼠海马CA1区和齿状回（den－tate gyrus,DG）体积及毛细血管的改变。方法：选取Sprague Dawley（SD）大鼠,经筛选后随机分为对照组10只和模型组10只。模型组采取慢性不可预见刺激建立抑郁症模型,共给予应激35 d,对照组不给予应激。利用糖水偏好实验和开场实验检测模型是否建立成功。建模成功后,分别从模型组和对照组中各随机选取5只SD大鼠,运用体视学和免疫组化染色相结合的方法对大鼠海马CA1区和DG毛细血管进行定量研究,剩余5只进行相关分子生物学研究。结果：模型组大鼠和对照组大鼠在体质量[（314.81±31.52） g,（349.18±28.23） g,t=2.569,P=0.019]、糖水偏好实验[（82.37±8.44）%,（89.33±3.97）%,t=2.359,P=0.03]、开场实验结果[（48.30±39.49）分,（87.70±38.32）分,u=-1.988,P=0.047]具有统计学差异,模型组较对照组大鼠海马总体积[（88.84±7.51） mm3,（99.89±12.55） mm3,t=2.388,P=0.028]、海马CA1区[（27.78±1.84） mm3,（32.38±3.69） mm3,t=3.522,P=0.004]和DG[（21.02±2.61） mm3,（24.20±3.33） mm3,t=2.377,P=0.029]体积明显减少,模型组较对照组大鼠海马CA1区毛细血管总长度[（8.454±1.010） m,（11.012±1.642） m,t=2.967,P=0.018]、总体积[（0.104±0.019） mm3,（0.151±0.021） mm3,t=3.720,P=0.006]、总表面积[（1.025±0.113） cm2,（1.589±0.313） cm2,t=3.794,P=0.013]、平均直径[（3.884±0.458） μm,（4.580±0.419） μm,t=2.509,P=0.036]下降以及DG毛细血管的总体积[（0.078±0.021） mm3,（0.117±0.024） mm3,t=2.716,P=0.026]、总表面积[（0.838±0.184） cm2,（1.133±0.074） cm2,t=3.32,P=0.011]、平均直径[（3.611±0.493） μm,（4.630±0.635） μm,t=2.834,P=0.022]下降,结果具有统计学意义。结论：抑郁症模型大鼠大脑海马萎缩,CA1区、DG毛细血管改变,海马结构与毛细血管的改变可能参与了抑郁症的发病机制。     

系统性红斑狼疮患者高表达的CD154促进自身抗体分泌

 目的】探讨系统性红斑狼疮（SLE）患者外周血单个核细胞（PBMC）CD154表达水平、及CD40/CD154对SLE患者分泌自身抗体的影响和地塞米松（Dex）对此的作用。【方法】选择SLE活动期患者（10例）和正常对照者（11例）,分离PBMC,检测其CD154的表达水平;培养PBMC,应用CD40 mAb和Dex进行干预,使用ELISA法检测培养液上清抗dsDNA水平。【结果】①活动期组PBMC CD154表达水平明显高于对照组6.4%±2.1%vs 1.5%±1.2%,（P〈0.05）;②活动期组培养液上清抗dsDNA抗体水平明显高于对照组[（11.8±6.8）U/mL vs（5.6±2.3）U/mL（RPMI 1640）,（11.4±7.0）U/mL vs（6.3±2.1）U/mL（IgG）,P均〈0.05];③CD40 mAb使两组培养液上清抗dsDNA抗体水平明显增高[活动期组：（18.6±7.7）U/mL vs（11.8±6.9）U/mL,对照组：（8.3±4.4）U/mL sv（5.6±2.3）U/mL,P均〈0.05]。④在活动期组,Dex明显抑制CD40 mAb引起的PBMC培养液上清抗dsDNA抗体水平的增高[（8.8±5.2）U/mL vs（18.6±7.7）U/mL,P〈0.05],使其低于非特异性处理时水平[（8.8±5.2）U/mL vs（11.8±6.8）U/mL,P〈0.05];Dex不影响对照组。【结论】活动期SLE患者PBMC表达的CD154水平升高,此能够促进抗dsDNA抗体的分泌,而Dex能够抑制其作用。     

大鼠肺泡巨噬细胞Bcl-2相关抗凋亡蛋白-1表达变化及其调节糖皮质激素受体功能的研究

目的：在模拟大鼠肺泡巨噬细胞炎症合并糖皮质激素治疗的条件下，阐明Bcl-2相关抗凋亡蛋白-1（BAG-1）的表达变化及其对糖皮质激素受体（GR）功能的调节作用。方法：Western blot检测脂多糖（LPS）和地塞米松（Dex）作用大鼠肺泡巨噬细胞BAG-1表达变化；免疫共沉淀法检测核蛋白中BAG-1与GR相互结合作用；相对荧光素酶法检测GR转录激活活性。结果：LPS和Dex作用后，细胞总蛋白中BAG-1L表达增加，BAG-1S表达无变化；核蛋白中只能检测到BAG-1L，表达量在LPS作用24h内逐渐增加；细胞核内BAG-1L与GR在LPS和Dex作用后存在着相互结合，同时GR转录激活活性逐渐降低，其变化与核蛋白中BAG-1L表达变化呈负相关。结论：LPS和Dex作用大鼠肺泡巨噬细胞BAG-1L表达增加，与GR结合后共同转核，并抑制GR活性。该机制可能是感染条件下糖皮质激素抵抗的重要因素。     

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.     

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.     

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.