缬沙坦对超负荷大鼠心肌细胞凋亡、ASK1的影响

目的:探讨压力超负荷模型下血管紧张素Ⅱ(AngⅡ)受体拮抗剂缬沙坦对凋亡信号调节激酶(ASK1)介导心肌肥厚信号通路的影响.方法:复制腹主动脉缩窄高血压大鼠模型,TUNEL法检测心肌细胞凋亡,免疫印迹和免疫组化法检测心肌ASK1蛋白含量并测定左室质量指数.结果:缬沙坦组左心室质量指数、心肌细胞凋亡指数、ASK1表达均显著低于高血压组(P＜0.05).结论:AngⅡ参与激活压力负荷下ASK1通路,缬沙坦能干预ASK1介导通路并抑制心肌细胞凋亡从而预防心肌肥厚.     

秋水仙碱对心肌组织中TGF-β_1的影响

目的 探讨秋水仙碱对压力负荷性大鼠心肌中转化生长因子β_1(TGF-β_1)的影响.方法 利用腹主动脉缩窄的方法 建立压力超负荷性心肌大鼠模型,放射免疫分析法测定局部心肌组织中血管紧张素Ⅱ(Ang Ⅱ)水平,RT-PCR法半定量TGF-β_1mRNA的表达变化,免疫组织化学法测定心肌TGF-β_1的表达,同时给予秋水仙碱8周,观察上述指标的变化.结果 与对照组相比,模型组AngⅡ、TGF-β_1 mRNA和TGF-β_1 表达明显增加(P<0.01),秋水仙碱能明显减少上述指标的表达.结论 秋水仙碱可以通过抑制压力负荷性心室重构大鼠RAAS和交感神经系统活性,减少神经内分泌因子AngⅡ生成,减少纤维化因子TGF-β_1的表达.     

卡托普利对大鼠肥厚心肌中血管紧张素Ⅱ与谷胱甘肽过氧化物酶的影响

采用腹主动脉缩窄法建立大鼠压力负荷性心肌肥厚模型,探讨卡托普利对大鼠肥厚心肌组织中血管紧张素Ⅱ(MAng Ⅱ)与谷胱甘肽过氧化物酶(GSH-PX)的影响.结果表明:(1)腹主动脉缩窄后4周,心脏重量、MAngⅡ水平与GSH-PX活性物显著增加,而血浆内血管紧张素Ⅱ(MAng Ⅱ)变化不明显;(2)卡托普利能够降低全心重/体重比值及MAngⅡ水平,增加GSH-PX活性.提示心脏局部肾素-血管紧张素系统(RAS)参与心肌肥厚的形成,卡托普利能够抑制MAngⅡ生成,提高心肌抗氧化能力,保护心肌细胞,减少心肌损害.     

AT2参与调控肥大心肌细胞炎症因子的合成和分泌

目的 观察血管紧张素Ⅱ二型受体(AT2)对压力超负荷性肥大心肌细胞炎症因子合成和分泌的影响.方法 采用腹主动脉缩窄法构建成年SD大鼠压力超负荷性心肌肥大模型,选用缩窄术后8周的肥大心肌细胞,经Ang Ⅱ及losartan或PDl23319处理36 h后.放免法检测培养上清液中IL-1β、TNF-α及IL-6的表达水平.结果 随着浓度增大,AngⅡ可以诱导肥大心肌细胞TNF-α和IL-1β分泌.PDl23319,而不是losartan,预处理可使TNF-α和IL-1β表达下调.实验中未能检测出培养液中IL-6含量.结论 AngⅡ诱导压力超负荷性肥大心肌细胞炎症因子TNF-a和IL-1β的合成与释放主要受AT2的调控.     

卡托普利防治心肌肥厚的实验研究

本文采用腹主动脉缩窄法建立大鼠压力超负荷性心肌肥厚模型,并用血管紧张素转换酶抑制剂卡托普利进行了防治实验。结果表明,心肌肥厚大鼠血压增高;全心重/体重比值增加。应用卡托普利治疗后,与对照组相比,其血压未见增高,心脏重量未见明显增加。提示肾素—血管紧张素系统参与心肌肥厚的形成,卡托普利能有效地防治心肌肥厚的发生。     

补肾方药对压力负荷增加大鼠肥厚心肌血管紧张素Ⅱ及其Ⅰ型受体的影响

目的　研究补肾方药对心肌局部血管紧张素Ⅱ及其Ⅰ型受体的影响。方法　采用腹主动脉狭窄术造成压力负荷增加大鼠心肌肥厚模型 ,观察补肾方药对左室重量指数 (LVWI)、放射免疫法测定血浆及局部心肌的血管紧张素Ⅱ (AngⅡ )含量、反转录PCR测定心肌血管紧张素Ⅱ -Ⅰ型受体mRNA (AT1mRNA)表达及AT1受体蛋白免疫组化的影响。结果　模型组LVWI、血浆及局部心肌的AngⅡ含量、心肌AT1mRNA表达及AT1受体蛋白与对照组间差别均有显著性意义 ;补肾方药大、小剂量组LVWI、血浆及局部心肌的AngⅡ含量、心肌AT1mRNA表达及AT1受体蛋白均与模型组间差别有显著性意义。结论　补肾方药可通过抑制心肌局部AngⅡ含量及AT1受体发挥逆转心肌肥厚的作用 ,在一定剂量范围内增加补肾方药的剂量并不能增加疗效     

细胞骨架与牵张刺激诱导心肌细胞分泌生长因子的关系

目的：探讨细胞骨架与牵张刺激诱导心肌细胞分泌生长因子中的关系。方法：在可变形膜上培养心肌细胞，采用放射免疫法测定培养上清血管紧张素Ⅱ和内皮素的含量，观察细胞骨架解聚剂对牵张刺激心肌细胞分泌生长因子的影响。结果：牵张刺激可诱导心肌细胞c—fos蛋白、β—MHCmRNA表达显著升高，同时心肌细胞分泌血管紧张素Ⅱ和内皮素明显升高。而细胞骨架解聚剂不仅可显著抑制c—fos蛋白、β—MHCmRNA表达，同时，也明显抑制牵张刺激心肌细胞分泌血管紧张素Ⅱ和内皮素。结论：细胞骨架可能是介导牵张刺激诱导心肌细胞分泌细胞生长因子的重要途径。     

TGF-β1/Smads信号通路在SIRT1抗心肌纤维化中的作用及机制研究

目的 观察沉默信息调节因子1(sirtuin 1,SIRT1)对压力超负荷致大鼠心肌纤维化及血管紧张素Ⅱ(angiotensin, AngⅡ)诱导的大鼠心脏成纤维细胞增殖的影响,并探讨其分子机制。方法 在体实验通过不完全结扎大鼠腹主动脉,使压力负荷增加诱导心肌纤维化,给予SIRT1激活剂后,左室心肌组织行Masson染色,观察心肌间质纤维化并计算胶原容积分数,免疫组化染色检测心肌组织TGF-β1/Smads蛋白表达。提取新生大鼠心脏成纤维细胞,给予AngⅡ或AngⅡ加SIRT1激活剂后,采用MTT法检测细胞增殖,qRT-PCR和Western blot法检测心肌组织及成纤维细胞Ⅰ型、Ⅲ型胶原(collagenⅠ/Ⅲ,Col1α1/3α1)、SIRT1及TGF-β1/Smads mRNA及蛋白的表达。结果 与假手术组相比,压力超负荷模型组大鼠心肌间质出现显著的纤维化,心肌胶原容积分数增加,Col1α1/3α1、TGF-β1/Smads表达明显增多,SIRT1表达减少;给予SIRT1激活剂SRT1720干预后可改善压力超负荷诱导的心肌间质纤维化,下调Col1α1/3α1、TGF-β1/Sm...     

压力超负荷大鼠心肌营养素-1表达对贝那普利干预的反应

目的 探讨心肌营养素-1(cardiotrophin-1,CT-1)在腹主动脉缩窄所致大鼠压力超负荷心肌肥大模型表达的变化及其与心肌肥大的关系,以及贝那普利(benazepril,Ben)对CT-1表达及心肌肥大的影响.方法 用腹主动脉缩窄术建立大鼠压力超负荷性心肌肥厚模型,术后随机分为左室肥厚组(n=7)和贝那普利干预组(n=7,贝那普利1 mg·kg-1·d～,灌胃3周),另设一假手术组(n=7)为对照.干预3周后测定血流动力学指标、左心室质量指数,应用放射免疫分析法测定心肌血管紧张素Ⅱ(AngⅡ)水平,逆转录聚合酶链式反应(RT-PCR)检测心肌中CT-1 mRNA表达.结果 与假手术组比较,左室肥厚组动物的血压与左心室质量指数显著升高(P＜0.05);心肌组织AngⅡ含量和CT-1 mRNA表达水平明显增加(P＜0.01).贝那普利干预可显著降低血压和左心室质量指数(P＜0.05),同时降低肥厚心肌组织AngⅡ浓度与CT-1 mRNA表达水平(P＜0.01).结论 CT-1的过度表达参与了压力超负荷性大鼠心肌肥大的发病过程;贝那普利对CT-1的表达及心肌肥大有抑制作用.     

压力超负荷左室肥厚大鼠心肌组织血管紧张素Ⅱ受体的表达

目的:本研究观察压力超负荷左室肥厚(Left ventricular hypearophy,LVH)大鼠心肌组织AT1和AT2的表达,进一步探讨血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)受体在左室肥厚中的作用及可能机制.方法:采用腹主动脉缩窄法建立LVH模型,14只Sprague-Dawley(SD)大鼠随机分为:(1)假手术组(n=7);(2)手术组(手术组n=7);用免疫组化法及RT-PCR检测血管紧张素Ⅱ受体(AT)的表达,同时检测LVH的指标:心肌纤维化、左室质量指数(LVMI)、心肌细胞横切面积(CSA)、心肌细胞凋亡指数.结果:与假手术组比较,手术组SBP、DBP、MBP、LVMI、心肌细胞CSA、心肌细胞凋亡指数(Apoptosis index,APOI)、血浆AngⅡ水平及AT1和AT2蛋白和mRNA的表达水平均显著升高.结论:左室肥厚大鼠心肌组织AT1和AT2从蛋白和mRNA表达水平均明显升高;AT1和AT2均参与左室肥厚过程,但二者可能发挥相互拮抗的作用.     

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.