PAF拮抗剂红花黄色素对急性心肌梗死大鼠心功能及心肌IL-1β mRNA表达的影响

目的:探讨血小板活化因子(Platelet activating facfor,PAF)拮抗剂红花黄色素对急性心肌梗死大鼠心功能及心肌白介素细胞-1 β(Interleukin-1 β,IL-1 β)表达的影响.方法:将54只SD大鼠随机分成假手术组、心梗组和红花黄色素治疗组,采用结扎左冠状动脉前降支方法建立急性心肌梗死动物模型,术后24 h治疗组给予腹腔内注射红花黄色素40 mg/(kg·d),心梗组和假手术组给予相同体积的生理盐水腹腔内注射.28 d后用Vivid 7型多普勒超声仪检测各组大鼠心功能,计算左室重量指数,用RT-PCR法检测IL-1 β mRNA水平表达.结果:与假手术组相比,心梗组和治疗组心功能明显降低(P＜0.05);与心梗组比较,治疗组心功能明显好转(P＜0.05).与假手术组相比,心梗组和治疗组左室重量指数、IL-1 β mRNA水平的表达明显增加(P＜0.05);和心梗组比较,治疗组左室重量指数及IL-1 β mRNA表达减少(P＜0.05).结论:PAF拮抗剂红花黄色素可通过改善急性心肌梗死大鼠心室重构,调节炎性细胞因子IL-1 β的表达,从而改善急性心肌梗死大鼠心功能.     

乌榄叶水提取物对心脏血流动力学的作用探究

目的:探讨乌榄叶水提取物对心脏血流动力学的作用。方法:采用心室内插管技术,通过Med Lab生物信号采集处理系统,股静脉给药,观察药物对正常大鼠心室峰压(LVSP)、左室内压最大上升速率(+dp/dtmax)、左室内压最大下降速率(-dp/dtmax)、心室舒张末压(LVEDP)、左室开始收缩至左室内压上升速率达峰值时间(t-dp/dtmax)、心率(HR)的影响。结果:LVSP、+dp/dtmax、-dp/dtmax、t-dp/dtmax等指标先降后升,且上升时间明显长于下降;LVEDP无显著变化;在整个过程中HR减慢,并在1min后具有统计学意义。结论:乌榄叶水提取物对心功能具有双向性,先有短暂抑制,后有持续加强,且在加强时,心率下降,有利于改善心肌血液灌注,起保护心肌的作用。     

红花黄色素缓解大鼠心肌缺血的作用

目的研究红花黄色素(SY)对异丙肾上腺素(ISO)诱发的大鼠心肌缺血的作用。方法多次ipISO造成大鼠心肌缺血模型;观察大鼠血压、Ⅱ导联心电图J点的改变和出现T波倒置的阳性率,以及光镜下心肌组织形态学的变化;荧光素酶生物发光法测定心肌组织ATP量;硫代巴比妥酸比色法测量心肌组织丙二醛(MDA)量;Falholt法测定血浆脂肪酸(FFA)量。结果SY可明显抑制ISO诱导的大鼠心肌缺血所致最大收缩压、平均收缩压、平均动脉压降低;缓解心肌缺血导致的心肌MDA、血浆FFA水平升高及心肌ATP量的降低,同时SY还可减少心肌缺血后心电图出现T波倒置的阳性率(P<0.05);但对大鼠心电图J点抬高和缺血心肌细胞组织形态学变化未见明显改善。结论SY具有缓解大鼠心肌缺血的作用。     

红花黄色素改善大鼠缺氧心肌能量代谢的研究

目的 探讨红花黄色素(SY)缓解大鼠心肌缺氧性损伤作用及其对能量代谢的影响。方法 建立大鼠离体心脏的冠状动脉灌流模型，以2，4—二硝基苯肼比色法测心室肌组织乳酸脱氢酶(LDH)漏出量，以荧光素酶法测心室肌组织ATP含量，透射电镜观察心尖部组织超微结构；制备大鼠心室肌组织线粒体混悬液，分别以比浊法与荧光偏振法观察线粒体肿胀与膜流动性的变化。结果 SY可减少大鼠低灌流离体心脏LDH漏出，缓解心室肌组织ATP含量下降及其超微结构的损伤；SY可缓解大鼠心肌线粒体混悬液中线粒体的肿胀及其膜流动性下降。结论 SY可改善大鼠心肌能量代谢，进而缓解心肌缺氧性损伤。     

前列腺素E1对异丙肾上腺素致大鼠心肌缺血的保护作用

目的:观察前列腺素E-1(PGE-1)预处理对异丙肾上腺素(ISO)诱导的大鼠急性心肌缺血性损伤的保护作用.方法:45 只Wistar大鼠随机分为3组,即正常对照组、模型损伤组、PGE-1治疗组,每组15只.正常对照组不给予任何处理;模型损伤组皮下注射ISO10 mg/kg复制大鼠急性心肌损伤模型;PGE-1治疗组预先给予尾静脉注射PGE-1,剂量为5 μg·kg-1·d-1,每天1次,连续3 d,于末次给药24 h后皮下注射10 mg/ kg ISO.24 h后记录各组血流动力学变化,测定并比较血浆内皮素(ET)水平,观察心肌组织病理形态学改变.结果:与正常对照组相比,模型损伤组大鼠左室收缩压(LVSP)与左心室收缩压最大上升速(+dp/dtmax)明显下降(P<0.05～0.01),左室舒张末压(LVEDP)升高,左心室舒张压最大下降速率 (-dp/dtmax)降低(P<0.01),血浆ET水平明显增高(P＜0.01),心肌细胞损伤严重.与模型损伤组相比,PGE-1治疗组预先静脉注射PGE-1可增强心肌收缩和舒张功能,改善大鼠心功能,抑制血浆ET水平的升高(P＜0.05),明显减轻受损心肌的变性坏死及炎性细胞浸润.结论:PGE-1可明显降低心肌缺血大鼠血浆ET水平,改善血管内皮功能,减轻心肌缺血,对ISO诱导的大鼠缺血损伤心肌具有保护作用.     

红花黄色素对阿霉素心肌损伤小鼠缝隙连接蛋白的影响

【目的】探讨红花黄色素对阿霉素心肌损伤模型中缝隙连接蛋白(Cx43)的影响。【方法】选用SPF级昆明小鼠随机分为5组,正常对照组每天腹腔注射生理盐水,其他各组均腹腔注射阿霉素(ADR)3 mg/kg,隔日1次。同时每日给药:模型组腹腔注射生理盐水,中药高、中、低剂量组腹腔注射红花黄色素(剂量分别为10、5、2.5 g·kg-1·d-1)。第15天解剖取小鼠左心室组织,观察各组心肌组织病理变化,采用免疫组织化学法检测心肌Cx43蛋白表达水平。【结果】在阿霉素心肌损伤模型组中,心肌损伤明显,心肌Cx43的表达水平显著降低,与正常对照组比较差异有统计学意义(P0.05)。中药中、高剂量组对阿霉素心肌损伤具有保护作用,均能显著增加心肌Cx43表达水平(P0.05),而中药低剂量红花黄色素抗阿霉素心肌损伤的作用不明显。【结论】红花黄色素对阿霉素心肌损伤具有一定的保护作用,其作用机制可能与上调心肌缝隙连接蛋白的表达有关。     

辛伐他汀改善急性心肌梗死后心室重塑与心功能的实验研究

目的:观察辛伐他汀对急性心肌梗死后大鼠心室重塑及心功能的影响,并探讨其可能的机制.方法:结扎大鼠冠状动脉前降支造成心肌梗死模型,给予辛伐他汀干预.8周后,测定心脏重量指数、血流动力学指标、心肌及血液中总-氧化氮合酶(NOS)、诱导型一氧化氮合酶(iNOS)活性,并与假手术组比较.结果:心肌梗死组大鼠右室重量指数(RVWI)、左室重量指数(LVWI)升高(P<0.01),外周动脉压(APS)、舒张压(APD)均降低,心率增快(P<0.01).左室收缩压(LVSP)和心室收缩期室内压上升速率( dp/dtmax),心室舒张期室内压下降速率(-dp/dtmax)下降(P<0.01),左室舒张末压(LVEDP)升高(P<0.01).血清和心肌NOS、iNOS活性下降(P<0.01).辛伐他汀干预组较心肌梗死组(M组)RVWI、LVWI下降(P<0.01),APS、APD、LVSP、 dp/dtmax、-dp/dtmax均回升(P<0.01),LVEDP回落(P＜0.01);血清和心肌NOS、iNOS活性升高.结论:辛伐他汀减轻左室重塑,改善心功能.     

辛伐他汀抑制大鼠急性心肌梗死后血管紧张素Ⅱ的生成和改善心室重塑的研究

目的在大鼠结扎前降支致心肌梗死的模型上观察辛伐他汀抑制血管紧张素Ⅱ(AngⅡ)及AngⅡ诱导的活性氧(H2O2)生成,是否有利于改善心室重塑和心功能的作用.方法结扎大鼠冠状动脉前降支造成心肌梗死模型,给予辛伐他汀干预.8周后,测定心脏重量指数、血流动力学指标、血液及心肌中AngⅡ含量,血液过氧化氢(H2O2)含量,并与假手术组比较. 结果心肌梗死组(M组)大鼠右室重量指数(RVWI)、左室重量指数 (LVWI)升高(P<0.01),外周动脉压(APS)、舒张压(APD)均降低,(P<0.01).左室收缩压(LVSP)和心室收缩期室内压上升速率( dp/dtmax),心室舒张期室内压下降速率(-dp/dtmax)下降(P<0.01),左室舒张末压( LVEDP)升高(P<0.01).心肌、血液中AngⅡ含量升高(P<0.01);H2O2含量升高 (P<0.01).辛伐他汀干预组较M组辛RVWI、 LVWI下降(P<0.01),APS、APD、LVSP、 dp/dtmax、-dp/dtma均回升(P<0.01),LVEDP回落(P<0.01);心肌、血液中AngⅡ含量下降(P<0.01),H2O2含量下降(P<0.01).结论辛伐他汀抑制急性心肌梗死后血管紧张素Ⅱ(AngⅡ)及AngⅡ诱导的H2O2生成,可能是改善心室重塑和心功能的机制之一.     

大豆异黄酮对阿霉素致心衰大鼠心功能的影响

目的:观察大豆异黄酮(soybean isoflavones,SI)对阿霉素(adriamycin,ADR)致心力衰竭大鼠心功能的影响.方法:取成年雄性SD大鼠30只,随机分为空白对照组、阿霉素组及大豆异黄酮低、中、高剂量组,每组6只.大豆异黄酮低、中、高剂量组分别予SI 30、60、120 mg·kg-1·d1灌胃,1次/d,连续6 d;其他两组灌注等量生理盐水.第7天除空白对照组外,其余4组一次性腹腔注射盐酸阿霉素10mg/kg,复制急性心衰大鼠模型,利用MedLab-U/4c生物信号采集处理系统采集心室内压并分析.电镜观察心肌细胞超微结构变化.结果:与对照组相比,阿霉素组左室收缩峰压(LVSP)、室内压最大上升速率( dp/dtmax)、室内压最大下降速率(-dp/dtmax)、心肌纤维收缩成分缩短速度的最大值(Vpm)显著降低(P ＜0.01);与阿霉组相比,高剂量大豆异黄酮组LVSP、±dp/dtmax和Vpm显著升高(P ＜0.05或P ＜0.01).电镜显示阿霉素组大鼠心肌细胞线粒体水肿、破裂、嵴消失,肌原纤维变性、溶解、大片坏死.闰盘间隙增宽,心肌间质纤维化.高剂量大豆异黄酮组,心肌肌原纤维病变明显减轻,部分排列紊乱,无坏死和溶解;部分线粒体水肿.结论:高剂量大豆异黄酮可减轻阿霉素对心肌的毒性作用,明显改善心衰大鼠心脏的收缩功能,表明该药有一定的抗心衰作用.     

锌指基因ZFP580在大鼠心肌缺血损伤中的表达

【目的】观察大鼠ZFP580基因在急性心肌缺血的不同时期的表达变化,以初步探讨锌指基因ZFP580在心肌缺血损伤中的作用。【方法】腹腔注射异丙肾上腺素（ISO）建立大鼠急性心肌缺血模型,分别于ISO注射后1h、24h取材,对照组腹腔注射等量生理盐水。观察心肌形态学改变,检测血清中乳酸脱氢酶（LDH）及肌酸激酶（CK）的含量,半定量RT—PCR及免疫组化方法分析ZFP580 mRNA及蛋白水平的表达变化。【结果】ISO处理组大鼠心肌组织广泛缺血损伤,血清LDH、CK含量明显升高（P〈0．05）,心室肌ZFP580 mRNA表达下调（P〈0．05）,免疫组化染色阳性细胞百分率明显降低,以ISO注射1h后变化更为明显。【结论】ZFP580是心肌缺血损伤的早期调控基因之一,其表达下调可能参与了心肌缺血损伤的形成。     

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.