庆大霉素对截瘫大鼠肠道细菌移位影响的实验研究

目的探讨庆大霉素灌胃和肌注两种不同给药方式对脊髓损伤并发截瘫大鼠肠道细菌移位的影响。方法建立大鼠脊髓损伤性截瘫模型,以庆大霉素灌胃治疗和肌注治疗两组大鼠为实验组,以脊髓损伤生理盐水灌胃和肌注两组大鼠为相应对照组。采集动物下腔静脉血进行内毒素定量检测和细菌培养,采集肝、脾、肠系膜淋巴结、肠内容物作细菌培养并进行菌种鉴定。取实验组和对照组各动物的肝、脾、肠系膜淋巴结、空肠、回肠进行病理切片及染色检查。结果庆大霉素灌胃组内毒素低于其他三组,血细菌培养仅生理盐水灌胃组阳性率高,脾细菌培养仅生理盐水肌注组阳性率高;肠系膜淋巴结细菌培养、庆大霉素灌胃组阳性率低,而生理盐水灌胃组阳性率高。结论本研究提示在预防及治疗脊髓损伤性截瘫后并发细菌／内毒素时应以经胃肠道途径给药为主。     

谷氨酰胺对大鼠急性坏死性胰腺炎肠道细菌移位的影响

目的 观察谷氨酰胺（ＧＬＮ）对急性坏死性胰腺炎（ＡＮＰ）大鼠肠道细菌称位的影响。方法 将实验大鼠１２０只,随机分成对照组、ＡＮＰ组及ＧＬＮ组,每组各４０只,ＡＮＰ模型采用结扎胰胆管诱发,ＧＬＮ组制作ＡＮＰ后灌入ＧＬＮ,观察３组肠粘膜组织学和ＤＮＡ含量,肠系膜淋巴结,胰腺组织细菌培养及吖啶橙标记菌实验。结果 ＡＮＰ后７２ｈ,肠粘膜出现明显损伤,ＤＮＡ含量下降,肠系膜淋巴结,胰腺组织细菌培养计数明显升     

肠内及肠外营养对梗阻性黄疸大鼠肠屏障功能的影响

目的：比较肠内营养（EN）及肠外营养(PN)对阻塞性黄疸(OJ)大鼠肠黏膜屏障功能的影响。方法：结扎胆总管建立OJ大鼠模型。60只SD大鼠随机分为A组：假手术组（SHAM）,B组：梗黄组（CBDL），C组：梗黄肠外营养组(CBDL+PN)，D组：梗黄肠内营养组(CBDL+EN)，E组：梗黄抗生素自由饮水组，每组12只，饲养1周后采腔静脉血分离血清待测内毒素；取肠系膜淋巴结、肝脾少量培养后观察记录细菌生长情况。取小肠制作切片光镜观察小肠黏膜形态学变化及绒毛高度、厚度和隐窝深浅等。结果：与A组比较，B组及D组空肠黏膜隐窝深度变浅(P<0.05),C组及E组大鼠空肠黏膜亦有不同程度变薄、萎缩、绒毛变短、隐窝变浅等；A组无肠系膜淋巴结细菌移位，B、C、D和E组肠系膜淋巴结细菌移位率高于A组（P<0.05或P<0.01）；B、C、D和E组血内毒素含量高于A组（P<0.05或P<0.01）,E组低于B、C和D组（P<0.05）。结论：①OJ时肠道屏障功能受损，发生细菌移位及内毒素血症；②肠内及标准肠外营养都不能维持OJ大鼠肠黏膜屏障及阻止肠道细菌移位，但肠内营养组好于肠外营养组；③肠道抗生素可降低内毒素血症的发生率及有利于阻止细菌移位。     

谷氨酰胺防治梗阻性黄疸肠道细菌移位

目的 观察谷氨酰胺（GLN）对梗阻性黄疸（OJ）大鼠肠道细菌移位的影响。方法 将实验大鼠90只,随机分成对照组,OJ组及GLN组,每组各30只,OJ模型采用结扎胆总管诱发,GLN组制作OJ后每天灌入GLN,动物处理8d后观察3组肠黏膜组织学和DNA含量,肠系膜淋巴结吖啶橙标记菌试验。结果 OJ后8d,肠黏膜出现明显损伤,DNA含量上降,肠系膜淋巴结吖啶橙标记菌移位率明显升高,应用GLN能明显减轻肠黏膜损伤,增加DNA含量,减少肠系膜淋巴结吖啶橙标记菌移位率。结论 GLN有利于维持OJ黏膜屏障功能,减少肠道细菌移位的发生。     

大黄等中药对梗阻性黄疸大鼠肠道细菌易位的影响

目的：探讨大黄等中药对梗阻性黄疸大鼠肠道细菌易位的影响。方法：胆总管下段结扎制成梗阻性黄疸的动物模型。60只Wister大鼠随机分为假手术组(A组，20只)、胆总管结扎组(B组，20只)、胆总管结扎加中药治疗组(C组，20只)。观察各组血浆肝功能、内毒素、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)，对末端回肠肠粘膜进行病理学检查以及对胰腺、肺、肠系膜淋巴结细菌培养。结果：术后第21天，C组和B组血浆总胆红素值、谷丙转氨酶值无差别。血浆内毒素、TNF-α、IL-6的值C组明显低于B组。肠粘膜损伤C组轻于B组。胰腺、肺、肠系膜淋巴结细菌培养阳性率C组明显低于B组。结论：中药可以保护肠粘膜屏障，减少肠道细菌内毒素的易位，降低血浆中细胞因子的水平。     

大黄四君子汤对重症胰腺炎大鼠肠黏膜屏障的保护作用

目的：研究大黄四君子汤对重症胰腺炎（SAP）大鼠肠黏膜屏障的保护作用。方法：采用胰管逆行注射牛磺胆酸钠建立大鼠SAP模型。60只大鼠随机分为空白对照组（A组）,SAP组（B组）,SAP＋肠外营养（TPN）组（C组）,SAP＋TPN＋谷氨酰胺（Gln）组（D组）,SAP＋肠内营养（EN）组（E组）,SAP＋TPN＋中药组（F组）;分别给予相应处理：肠内和肠外营养液等热卡为250kcal·kg^-1·d^-1,氮热卡比值为1：100,Gln浓度为2g／100ml,大黄四君子汤浓度为1g／ml。术后第5天处死大鼠,检测胰腺、空肠黏膜形态学变化,观察肝脾及肠系膜淋巴结细菌培养结果。结果：B、C组黏膜厚度、绒毛高度及隐窝深度较D、E、F组均明显降低（P〈0．01）;E组高于D、F组（P〈0．05）;D组与F组比较,无统计学差异（P〉0．05）。B、C组脏器细菌培养阳性率明显高于D、E、F组（P〈0．05）,以肠系膜淋巴结培养阳性率最高;检出细菌多数为革兰阴性肠道杆菌。结论：大黄四君子汤可减少SAP大鼠肠源性细菌移位,起到保护肠黏膜屏障的作用。     

谷氨酰胺防治梗阻性黄疸肠道细菌移位

目的　观察谷氨酰胺(GLN)对梗阻性黄疸(OJ)大鼠肠道细菌移位的影响。方法　将实验大鼠90只,随机分成对照组、OJ组及GLN组,每组各30只,OJ模型采用结扎胆总管诱发,GLN组制作OJ后每天灌入GLN,动物处理8 d后观察3组肠黏膜组织学和DNA含量,肠系膜淋巴结吖啶橙标记菌试验。结果　OJ后8 d,肠黏膜出现明显损伤,DNA含量下降,肠系膜淋巴结吖啶橙标记菌移位率明显升高,应用GLN能明显减轻肠黏膜损伤,增加DNA含量,减少肠系膜淋巴结吖啶橙标记菌移位率。结论　GLN有利于维持OJ黏膜屏障功能,减少肠道细菌移位的发生。     

大黄对严重烧伤大鼠肠黏膜屏障保护作用的实验研究

目的探讨大黄对严重烧伤大鼠肠黏膜屏障的保护作用。方法将36只SD大鼠随机分为对照组（n=6）、烧伤组（n=15）和大黄治疗组（n=15）。对照组不作任何处理；烧伤组和大黄治疗组均于背部造成30％TBSAⅢ度烫伤（以下称烧伤）创面，伤后立即经腹腔补充乳酸林格液（40mL／kg），大黄治疗组大鼠伤后通过灌胃给予大黄混悬液（60mg／kg）治疗。检测各组大鼠伤后72h的血浆内毒素含量，取肠系膜淋巴结（MLN）、肝、脾组织匀浆后进行细菌培养，对空肠黏膜组织进行病理形态学分析。结果血浆内毒素含量大黄治疗组〈对照组〈烧伤组；肠系膜淋巴结、肝、脾组织匀浆细菌移位量大黄治疗组〈烧伤组；空肠黏膜组织病理形态学观察发现，大黄治疗组较烧伤组绒毛上皮细胞水肿减轻，绒毛被覆上皮比较完整，绒毛顶端上皮细胞坏死、脱落减少。结论大黄能减轻严重烧伤引起的肠黏膜损伤，可减少肠源性感染的发生。     

谷氨酰胺双肽对大鼠肠切除后细菌移位的影响

为了改善传统肠外营养可能导致的肠道细菌移位，作者研究了手术应激时谷氨酰胺双肽强化的肠外营养液对肠粘膜结构和肠道细菌移位的影响。方法将３０只大鼠随机分成３组，６０％小肠切除造成手术应激模型，饲料组（ｎ＝１０）喂普通饲料；传统肠外营养组（ｎ＝１０）接受传统肠外营养液；双肽组（ｎ＝１０）接受传统肠外营养液加３％谷氨酰胺双肽，观察７天。结果３组手术前及手术后的体重均无显著性差异。双肽组血浆谷氨酰胺浓度、空肠粘膜厚度和绒毛高度均高于传统肠外营养组。饲料组细菌移位率为２０％，双肽组细菌移位率为２０％，传统肠外营养液组为７０％，双肽组与传统肠外营养液组相比差异有显著意义（ｐ＜０．０５），与饲料组相比差异无显著意义。结论显示在大鼠６０％肠切除后，含谷氨酰胺双肽的胃肠外营养液可改善其肠粘膜代偿性增生和减轻肠道细菌移位。     

雌激素对创伤失血性休克肠道细菌移位的影响

目的探讨雌激素对创伤失血性休克(Trauma/hemorrhageshock,T/HS)肠粘膜屏障损伤以及肠道细菌移位的影响。方法雌性青春期Wistar大鼠40只,随机分为卵巢切除组10只,对照组10只,雌二醇组10只,大剂量雌二醇组10只,观察T/HS60min,复苏4h后的肠粘膜损伤程度(Chiu氏评分),并取肠系膜淋巴结、肝组织及门静脉血进行细菌培养,改良鲎试剂法测定血浆内毒素含量。结果雌二醇组和大剂量雌二醇组与其他两组相比,肠粘膜Chiu氏评分显著降低,细菌培养计数及内毒素含量明显减少,P均<0.05。结论雌激素能改善创伤失血性休克大鼠的肠粘膜损伤程度,降低肠道细菌及内毒素移位的发生率。     

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.