BQ123对大鼠肢体缺血再灌注后骨骼肌损伤和细胞凋亡的影响

目的:观察大鼠肢体缺血再灌注（LIR）后骨骼肌损伤和细胞凋亡情况,探讨内皮素A ( ETA)受体拮抗剂BQ123对大鼠LIR损伤的保护机制。方法：24只雄性Wistar 大鼠随机分为3 组(n= 8)：对照组、缺血再灌注（IR）组和BQ123+IR组,检测各组大鼠血浆乳酸脱氢酶 (LDH)、肌酸激酶 (CK)、丙二醛(MDA)、一氧化氮 (NO)、内皮素1(ET-1) 的含量以及NO/ET-1比值;测定腓肠肌组织中MDA、髓过氧化物酶 (MPO)、NO、ET-1、NO/ET-1比值及腓肠肌DNA双链百分率;采用免疫组织化学方法检测腓肠肌组织中凋亡蛋白酶Caspase-3 的蛋白表达情况;利用原位脱氧核糖核甘酸末端转移酶介导的缺口末端标记法 (TUNEL) 检测各组腓肠肌细胞的凋亡情况。结果：与IR组比较,BQ123+IR组血浆LDH、CK、MDA明显降低（P<0.01）,血浆NO升高（P<0.01）,ET-1下降（P<0.01）,NO/ET-1比值升高（P<0.01）。与IR组比较,BQ123+IR组腓肠肌组织MDA、MPO、ET-1含量下降（P<0.01）, NO、NO/ET-1 及DNA双链百分率值升高（P<0.05或P<0.01）;腓肠肌组织Caspase-3表达水平明显减弱,凋亡指数 （AI）下降(P<0.01)。结论：ETA受体拮抗剂BQ123 可减轻大鼠LIR后骨骼肌损伤和细胞凋亡。     

雄激素致无排卵大鼠卵巢nNOS、eNOS、ET-1的表达

目的 观察雄激素致无排卵大鼠(ASR)血浆及卵巢血管舒张因子一氧化氮(NO)、一氧化氮合酶(nNOS、eNOS)、环磷酸鸟苷(cGMP)、血管收缩因子内皮素1(ET-1)、血管紧张素Ⅱ(ATⅡ)的变化,探讨卵巢血管舒-缩因子在无排卵发病机制中的作用.方法 建立雄激素致无排卵大鼠模型,分为模型组和正常组.采用放射免疫法测定模型组、正常组大鼠血浆NO、cGMP、ET-1、ATⅡ以及血清雌二醇(E2)、孕酮(P)、睾酮(T)含量;采用免疫组化法检测大鼠卵巢nNOS、eNOS、ET-1表达;采用HE染色观察大鼠卵巢组织形态学变化.结果 与正常组比较,模型组大鼠血浆NO、cGMP含量降低(P<0.01),血浆ET-1、ATⅡ含量升高(P<0.01).血清E2、T含量及E2/P显著升高(P<0.01),血清P含量无统计学差异(P>0.05);与正常组比较,模型组大鼠卵巢颗粒细胞以及髓质nNOS、eNOS表达减弱(P<0.01),ET-1表达增强(P<0.01);正常组大鼠卵巢皮质可见发育期各级卵泡及黄体;模型组大鼠卵巢皮质卵泡囊状扩张,颗粒细胞层极薄.结论 雄激素致无排卵大鼠血浆及卵巢血管舒张因子降低、收缩因子增高,可能使卵巢血液供应障碍、颗粒细胞凋亡,导致卵泡在排卵前闭锁,无排卵的发生.     

健脾化痰祛瘀方药对脾气虚证大鼠血管内皮相关指标影响

目的研究健脾化痰祛瘀方药对脾气虚证大鼠血管内皮指标的影响。方法将120只SPF级SD大鼠随机分为正常组、模型组和中药组,每组各40只,雌雄各半。运用复合因素成功塑造大鼠脾气虚证模型后进行中药干预,分别于给药后第7、14、21、28天测评各组大鼠体质量及脾气虚症状积分,并检测大鼠血清内皮素-1(ET-1)、一氧化氮(NO)及血管内皮生长因子(VEGF)的含量。结果脾气虚证大鼠血管内皮发生功能障碍,与正常组比较,模型组ET-1水平显著升高(P0.01),NO含量有降低趋势,VEGF水平明显降低(P0.05)。健脾化痰祛瘀方药可改善大鼠脾气虚症状积分,与模型组相比,中药组ET-1含量显著降低(P0.01),NO含量有升高趋势,VEGF水平升高(P0.05)。结论脾气虚时大鼠血清ET-1含量升高,VEGF含量降低,健脾化痰祛瘀方药能干预以上机制,改善大鼠脾气虚证,提高血管内皮功能。     

白藜芦醇对心肌缺血再灌注损伤的保护作用

目的:观察白藜芦醇预处理对心肌缺血/再灌注损伤的保护作用。方法:40只雄性SD大鼠随机分成4组,每组10只,即生理盐水灌胃28天进行假手术组、白藜芦醇75 mg/(kg·d)灌胃28 d进行假手术组、生理盐水灌胃28 d进行手术组、75 mg/(kg·d)白藜芦醇灌胃28 d进行手术组。生理盐水或者75 mg/(kg·d)白藜芦醇灌胃结束手术组大鼠通过结扎冠状动脉左前降肢进行心肌缺血再灌注,缺血时间为40 min,再灌注时间为150 min。假手术组大鼠只插管不结扎。再灌注结束检测血清乳酸脱氢酶(LDH)、一氧化氮(NO)含量,心肌组织超氧化物歧化酶(SOD)、丙二醛(MDA)以及凋亡相关蛋白Bcl-2/Bax的表达。结果:心肌缺血再灌注可使LDH、MDA水平升高(P﹤0.01),NO、SOD含量降低(P﹤0.01)。白藜芦醇能够降低缺血再灌注损伤中LDH以及MDA的水平(P﹤0.05),增加SOD和NO含量(P﹤0.05),并能在缺血再灌注损伤中上调Bcl-2、下调Bax表达。结论:白藜芦醇能够抑制心肌缺血再灌注损伤中的氧化应激和细胞凋亡,从而起到保护心血管的作用。     

慢性心力衰竭大鼠心肌纤维化时血浆内皮素-1的动态变化

目的：观察慢性心力衰竭(CHF)大鼠心肌纤维化时血浆内皮素-1(ET-1)的动态变化,探讨ET-1在心肌纤维化发生发展中的作用。方法：采用肾上腹主动脉缩窄法制作雄性Wistar大鼠慢性心衰模型,随机分为心衰1d组、7d组和14d组,另设立假手术组作为对照。ELISA法检测各组大鼠血浆ET-1水平。结果：心衰模型各组大鼠血浆ET-1水平均高于假手术组(P＜0.01),且随着心肌纤维化程度的加重ET-1的水平逐渐升高。结论：ET-1可能参与了大鼠压力负荷性心肌纤维化的发生发展,其水平的高低与慢性心力衰竭的严重程度密切相关。     

血管性痴呆大鼠海马神经元凋亡和蛋白表达实验研究

目的观察血管性痴呆(vascular dementia,VaD)大鼠海马CA1区神经元凋亡和bcl-2及Bax蛋白表达,探讨其在VaD发病过程中的作用。方法制备VaD大鼠模型,分别在造模后第7、14、21天用TUNEL法检测海马CA1区神经元凋亡,用免疫组织化学法检测其bcl-2及Bax蛋白表达。结果模型组大鼠海马CA1区可见大量凋亡神经元,14d时凋亡神经元达高峰,21d时仍有大量神经元凋亡。模型组bcl-2蛋白在7和21d时表达增加,14d时表达高峰,与正常组比较差异均有显著意义(P<0.01);模型组Bax蛋白表达在7d时达高峰,14d时开始下降,与正常组比较差异仍有显著性意义(P<0.01),至21d表达与正常组比较差异无显著性(P>0.05)。结论海马CA1区神经元的大量凋亡丢失,可能是脑卒中后发生VaD的病理基础;在脑卒中早期,从分子水平抑制Bax蛋白表达、促进bcl-2蛋白表达可能是阻抑神经元凋亡、避免脑卒中后VaD发病的最佳途径之一。     

骨骼肌缺血预适应对肢体缺血再灌注后心肌的远端保护作用

目的探讨发生在下肢骨骼肌的缺血预适应对肢体缺血再灌注(LIR)后心肌的作用。方法Wistar大鼠24只随机分为对照组(C)、缺血再灌注组(I/R)和缺血预适应组(IPC I/R)。测定心肌组织XO、SOD和MDA含量;检测血浆CK、CK-MB及心肌组织MPO水平;检测心肌组织Bcl-2、Bax蛋白表达情况;光镜下观察心肌组织的形态学变化。结果LIR后心肌组织SOD活性降低,MDA、XO含量增加(P<0.01或P<0.05),心肌组织MPO及血浆CK、CK-MB水平均较C组明显升高(P<0.01)。Bcl-2和Bax蛋白表达增多,但Bcl-2/Bax比值降低。镜下可见心肌细胞水肿等组织损伤的征象;在IPC I/R组,心肌组织SOD的减少和MDA、XO及MPO含量的增加受到一定程度抑制,血浆CK、CK-MB水平有所下降(P<0.01),Bcl-2表达增强而Bax表达减少,Bcl-2/Bax比值升高(P<0.01)。光镜下心肌组织的形态学表现也有所改善。结论大鼠骨骼肌缺血预适应可能通过抗氧化、抑制炎性反应和细胞凋亡等途径发挥对肢体缺血再灌注后心肌的远端保护效应。     

肾缺血大鼠心肌血管活性物质的变化

目的 研究肾缺血时心肌组织内皮素-1(ET-1)、降钙素基因相关肽(CCRP)和一氧化氮(NO)含量与心功能变化的关系.方法 将Wistar大鼠随机分为狭窄组(n=30)和假手术组(n=10),其中狭窄组在左右肾动脉之间结扎腹主动脉(狭窄程度50%).于术后16周测定大鼠血液动力学指标,分析心肌组织中ET-1、GCRP和NO含量变化以及与心功能的关系.结果 大鼠左右肾动脉之间结扎腹主动脉使狭窄组单侧肾脏萎缩、血压持续升高,左室收缩及舒张功能下降、左室重量指数增加.术后16周时,与假手术组相比,狭窄组心肌组织血管活性物质ET-1含量显著增高(P<0.01),CGRP含量显著下降(P<0.01),NO含量差异无显著性(P>0.05);心肌组织ET-1含量与左心室内压最大上升速率呈负相关(r=-0.37,P<0.05).结论 大鼠腹主动脉狭窄导致的慢性肾缺血可使心肌组织ET-1含量增高、GCRP含量下降,其中ET-1含量与大鼠左室收缩功能呈负相关.     

脑血管内皮细胞损伤对大鼠脑缺血再灌注神经元凋亡的影响

目的:探讨脑缺血再灌注脑血管内皮细胞损伤、内皮素(ET-1)、一氧化氮(NO)与神经元凋亡的关系。方法:采用4血管夹闭法制作大鼠脑缺血再灌注模型,观察缺血再灌注不同时间内皮素、一氧化氮及脑血管内皮细胞超微结构变化对神经元凋亡的影响。结果:脑缺血再灌注组缺血10m in血浆ET-1含量显著升高,再灌注24h有所下降,于72h又开始升高,血浆NO于再灌注24h有所下降,48h时间点又恢复到缺血时水平。全脑缺血10m in内皮细胞部分缺损,凋亡神经元数量较少,缺血再灌注24h内皮损伤加重,凋亡神经元数量明显增加,至48h达到高峰,再灌注72h,凋亡神经元数量明显减少。结论:脑缺血再灌注ET-1含量升高,NO水平下降,内皮损伤加重可导致神经元进一步损害。     

参芪复方对GK大鼠心肌细胞凋亡相关因子Bcl-2、Bax及NO的影响

[目的]研究参芪复方对GK大鼠心肌细胞凋亡相关因子Bcl-2、Bax及一氧化氮(NO)的影响及其可能作用机制。[方法]GK大鼠腹腔注射N-硝基-L-精氨酸甲酯(L-NAME),同时给予高脂饮食复制2型糖尿病(T2DM)心肌病变模型。选择随机血糖≥11.1mmol/L的GK大鼠随机分为4组:模型组、中药高、低剂量组、西药组,另设正常Wistar大鼠作正常对照组,共5组动物。治疗4周后,统一取心肌标本,通过免疫组化等测量方法,对照观察各组药物对GK大鼠一般状态、心肌NO、心肌Bcl-2、Bax蛋白表达的影响。[结论]GK大鼠的上述指标存在明显异常。参芪复方特别是其高剂量组能改善其一般状态、升高心肌NO(P<0.01),升高心肌细胞凋亡抑制因子Bcl-2的表达(P<0.01),降低促细胞凋亡因子Bax表达(P<0.05)和Bax/Bcl-2比值(P<0.01)。[结论]凋亡相关因子Bcl-2和Bax与NO参与糖尿病心肌损伤过程,参芪复方能升高心肌NO,降低心肌Bax表达,升高Bcl-2表达。     

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.