磷脂酶A_2抑制剂对家兔内毒素休克血中血小板活化因子活性的调节作用观察

通过家兔内毒素休克模型重点观察了磷脂酶Ａ２（ＰＬＡ２）抑制剂磷酸氯喹和地塞米松对血中ＰＬＡ２及其相关脂介质的影响。实验分成４组：（１）假手术组（ＳＯ）；（２）内毒素休克组（ＥＳ）；（３）磷酸氯喹预处理组（ＣＱ）；（４）地塞米松预处理组（ＤＸＭ）．分别于给药前、内毒素或生理盐水注射后５、３０ｍｉｎ，１、３、５、８ｈ取血测ＰＬＡ２血小板活化因子（ＰＡＦ）、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１ａ，同时连续监测平均动脉压（ＭＡＰ）、心率和呼吸，观察动物８ｈ存活率、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１ａ浓度均明显升高，ＰＬＡ２抑制剂能显著抑制ＰＬＡ２及ＰＡＦ活性，其中磷酸氯喹对ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１ａ的抑制最为显著。此外，ＰＬＡ２抑制剂可使家兔８ｈ存活率由４８％提高到７５％（ＣＱ组）和７０％（ＤＸＭ组）。提示，用ＰＬＡ２的抑制剂磷酸氯喹和地塞米松均能显著抑制内毒素休克时ＰＬＡ_２的活性及相关脂介质如ＰＡＦ、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１ａ的升高，提高动物存活率，有效地改善休克动物的预后。     

STZ－实验性糖尿病大鼠肾组织氧自由基与血浆6－酮前列腺素F_（1α）和血栓素B_2的关系

目的：研究糖尿病早期高滤过状态与前列腺素及氧自由基生成之间的关系，以探求发病机理。方法：采用低温ＥＳＲ技术动态检测大鼠肾组织的氧自由基水平，同时用ＲＩＡ试剂盒测定血浆中６－酮前列腺素Ｆ＿（１α）（６－ｋｅｔｏ＋ＰＧＦ＿（１α））和血栓素Ｂ＿２（ＴＸＢ＿２）含量。对ＳＴＺ诱导的糖尿病大鼠模型，分别在造模后１、２、３、７、１４和２８ｄ测量上述指标。同时与对照组相比较。用ＰＲＩＭＥＲ程序完成数据的ｔ－检验和相关分析。结果：证实糖尿病肾组织氧水平及血浆６－ｋｅｔｏ－ＰＧＦ＿（１α）含量均较正常对照组明显增高（ｐ＜０．０５），并且糖尿病大鼠肾组织氧自由基水平增加与６－ｋｅｔｏ－ＰＧＦ＿（１α）／ＴＸＢ＿２呈显著正相关（ｒ＝０．８７９６）。结论：糖尿病早期肾组织氧自由基水平增加可能是导致血浆中６－ｋｅｔｏ－ＰＧＦ＿（１α）增加的原因之一，并且两者在糖尿病早期肾小球血流动力学改变过程中起某种协同作用。     

活血通脉片对急性心肌缺血犬血浆ET,TXB_2及6-keto-PGF_(1a)的影响

目的：观察活血通脉片（ＨＸＴＭＴ）对实验性急性心肌缺血状态下犬血浆内皮素（ＥＴ）、血栓素（ＴＸＢ２）及６－酮－前列腺素（６－ｋｅｔｏ－ＰＧＦ１ａ）活性的影响．方法：采用结扎冠脉,造成犬急性心肌缺血、心肌梗塞动物模型,经颈外静脉插管至冠状静脉窦,测定冠脉结扎１５ｍｉｎ（药前）及药后不同实验时间点血浆ＥＴ、ＴＸＢ２、６－ｋｅｔｏ－ＰＧＦ１ａ的含量．结果：实验结果提示,与对照组比较,活血通脉片能降低血浆ＥＴ和ＴＸＢ２水平（Ｐ＜０．０５～Ｐ＜０．００１）提高６－ｋｅｔｏ－ＰＧＦ１ａ活性（Ｐ＜０．００１）,增加６－ｋｅｔｏ－ＰＧＦ１ａ／ＴＸＢ２的比值（Ｐ＜０．０１）．结论：活血通脉片对实验性急性心肌缺血犬ＥＴ、ＴＸＢ２及６－ｋｅｔｏ－ＰＧＦ１ａ有明显影响,提示该药对急性心肌缺血有保护作用．     

环孢素A肾中毒时大鼠尿中前列腺素的变化

该实验探讨了环孢素Ａ（ＣｓＡ）肾中毒与肾脏血栓素Ａ２（ＴＸＡ＿２）、前列环素（ＰＧＩ＿２）的关系。实验中将ＳＤ雄性大鼠２０只随机分为二组，Ｉ组为正常对照组；Ⅱ组为ＣｓＡ中毒组。于实验前后分别检测大鼠的肾功能、尿酶以及尿中血栓素Ｂ＿２（ＴＸＢ＿２）、６－酮－前列腺素Ｆ１ａ（６－ｋｅｔｏ－ｐＧＦ１ａ）等指标，最后进行肾脏光镜检查。结果发现，ＣｓＡ中毒组大鼠尿中的ＴＸＢ＿２显著升高，而尿中６－ｋｅｔｏ－ｐＧＦ１ａ稍低于正常对照组，ＴＸＢ＿２／６－ｋｅｔｏ－ｐＧＦ１ａ比值明显升高。实验证实，中毒剂量的ＣｓＡ引起肾脏ＴＸＡ＿２／ＰＧＩ＿２平衡常数明显升高。     

蛋白质负荷对肾血流量,肾小球滤过率及肾前列腺素的影响

测定２３例肾功能正常的原发性肾小球肾炎（ＰＧＮ）患者蛋白质负荷（ＰＬ）前后ＥＲＰＦ、Ｃｃｒ及尿ＰＧＥ２、６－ｋｅｔｏ一ＰＧＦ（１ａ）、ＴＸＢ２排泄量，并与９例健康人对照。结果显示，对照组ＰＬ后ＥＲＰＦ、Ｃｃｒ显著升高，尿ＰＧＥ２排泄增多，而ＰＧＮ组均无显著变化；ＰＧＮ组ＰＬ前后尿ＴＸＢ２及ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ（１ａ）均高于对照组。提示ＰＬ后ＧＦＲ的升高主要与肾ＰＧＥ２的合成增加有关，肾储备功能下降与ＰＬ后肾ＰＧＥ２合成无显著增加有关，一定程度上与ＴＸＡ２／ＰＧＩ２值有关。     

rhEDIL－8对大鼠失血性休克血浆6－keto－PGF_（1α）和TXB_2含量的影响

应用放射姓免疫分析技术观察ｒｈＥＤＩＬ－８对大鼠晚期失血性休克血浆６－ｋｅｔｏ－ＰＧＦ_（１α）和ＴＸＢ_２含量的影响，并与ＭＡＢＰ的变化作相关性分析。结果发现晚期失血性休克血浆６－ｋｅｔｏ－ＰＧＦ_（１α）含量明显降低（Ｐ＜０．０１），ＴＸＢ_２含量明显升高（Ｐ＜０．０１）；给予ｒｈＥＤＩＬ－８（２５０μｇ／ｋｇ）静脉注射后血浆６～ｋｅｔｏ－ＰＧＦ_（１α）含量明显升高，其血浆水平与ＭＡＢＰ呈明显的正相关性（ｒ＝０．７４６）；ｒｈＥＤＩＬ－８对血浆ＴＸＢ_２含量却无明显影响。研究结果提示：ｒｈＥＤＩＬ－８抗晚期失血性休克作用与其促进血管内皮细胞产生和释放ＰＧＩ_２有关。     

甲基黄酮醇胺抗血栓形成的机理研究

采用生物鉴定法测定甲基黄酮醇胺（ＭＦＡ）对ＰＧＩ２和ＴＸＡ２样物质生成的影响。以血小板聚集率％表示大鼠颈总动脉环ＰＧＩ２活性，ＭＦＡ（２４．８μｍｏｌ／ｋｇ，ｉｖ）组，阿斯匹林（ＡＳＡ，０．８３ｍｍｏｌ／ｋｇ，ｉｖ）组和溶媒对照组分别为０．４７±０．１９、０．１８±０．１６、０．５０±０．１３／ｍｇ，结果提示：ＭＦＡ不抑制ＴＸＡ２的生成（Ｐ＜０．０５）；ＡＳＡ明显抑制ＰＧＩ２的生成（Ｐ＜０．０１）。采用表面灌流法，ＡＡ为诱导剂，以兔主动脉条收缩强度（ｇ）表示ＴＸＡ２样物质的活性，ＭＦＡ（１０ｍｍｏｌ／Ｌ）组，咪唑（１．６７ｍｍｏｌ／Ｌ）组和溶媒对照组分别为０．３８±０．１３、０．１７±０．０９和０．６９±０．２２ｇ，结果提示ＭＦＡ和咪唑抑制ＴＸＡ２样物质的生成（Ｐ＜０．０１）。采用放射免疫法测定，ＭＦＡ６．２μｍｏｌ或１２．４μｍｏｌ／ｋｇ能明显抑制心肌梗塞家兔ＴＸＢ２的升高（Ｐ＜０．０１），而对６－ｋｅｔｏ－ＰＧＦ１α无明显影响     

维持性血液透析患者高血压与TXA_2－PGI_2严衡失调的关系

观察了２７例维持血液透析患者血浆前列腺素（ＰＧｓ）的变化，结果显示：尿毒症组血浆血栓素Ｂ２（ＴＸＢ２）、６－酮－ＰＧＦ１α（６－ｋｅｔｏ－ＰＧＦ１α）水平降低，而ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值升高。其中有高血压者６－ｋｅｔｏ－ＰＧＦ１α较无高血压者为低（Ｐ＜０．０５）。ＴＸＢ２、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比却高于无高血压者（Ｐ＜０．０１）。透析间期体重增加＞３．０ｋｇ与＜３．０ｋｇ者的血浆ＴＸＢ２、６－ｋｅｔｏ－ＰＧＦ１α水平及ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值无显著性差异。血透或血滤后ＴＸＢ２、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值降低，而６－ｋｅｔｏ－ＰＧＦ１α升高。血压与血浆ＴＸＢ２、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值呈正相关（分别ｒ＝０．６４，ｒ＝０．７２），与６－ｋｅｔｏ－ＰＧＦ１α呈负相关（ｒ＝－０．５８）。以上结果表明，维持性血液透析患者高血压与ＴＸＡ－ＰＧＩ２平衡失调有关，血透及血滤均能降低ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值，使高血压减轻。     

脑缺血再灌注损伤中内皮素、自由基PLA_2、TXA_2／PGI_2的相互作用

用四血管阻断法造成大鼠全脑缺血。脑缺血３０ｍｉｎ后再恢复双侧颈总动脉血流３０ｍｉｎ，此时大鼠体内ＰＬＡ＿２活性、ＴＸＢ＿２／６一ｋｅｔｏ一ＰＧＦ＿（１α）比值和ＥＴ、ＬＰＯ含量明显增高，大脑神经细胞和血脑屏障明显损害；预防用氯喹或ＳＯＤ治疗后，上述物质的增多受到抑制，神经细胞和血脑屏障损害也明显减轻。ＰＬＡ＿２、ＴＸＡ＿２／ＰＧＩ＿２、内皮素、自由基与脑组织损伤密切相关。脑缺血再灌注时，ＰＬＡ＿２、ＴＸＡ＿２／ＰＧＩ＿２、ＥＴ、自由基间存在相互作用，并可测定血浆中ＴＸＢ＿２、６一ｋｅｔｏ－ＰＧＦ＿（１α）、ＥＴ、ＬＰＯ浓度反映脑组织内的含量。     

银杏叶片治疗心绞痛的临床研究及对TXB＿2、6－keto－PGF＿1a的影响

银杏叶片治疗心绞痛的临床研究及对ＴＸＢ＿２、６－ｋｅｔｏ－ＰＧＦ＿１ａ的影响王智慧，孙健，王艳杰白求恩医科大学第二临床学院（１３００４１）有研究表明，内皮细胞损伤时，前列环素（ＰＧＩ２）生成减少，血栓素Ａ２（ＴＸＡ２）增加。而缩血管物质ＴＸＡ２增加与...     

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.