内毒素致兔早期急性肺损伤及氯喹的保护性作用

目的:研究内毒素(ET)致兔早期急性肺损伤(ALI)的病理生理过程,探讨氯喹对ET所致的兔早期ALI的保护性作用。方法:大耳白兔随机分为对照组、ET致伤组、ET致伤 氯喹干预组。静脉注射ET(500μg/kg)复制兔早期ALI的动物模型。测定动脉血气、血清及肺组织中磷脂酶A2(PLA2)活性、肺组织脂质过氧化物(LPO)含量和超氧化物歧化酶(SOD)的活性,并取肺组织行光镜及电镜下病理学观察。结果:与对照组相比,静注ET后,致伤组动物出现动脉血氧分压(PaO2)下降、肺内白细胞扣押、血清及肺组织中PLA2活性增高、肺组织LPO含量增高(P<0.05)和SOD活性降低(P<0.05)。组织病理学观察可见致伤组肺组织出现了典型的ALI改变。干预组PaO2未见下降,血清及肺组织PLA2活性和肺组织LPO含量低于致伤组(P<0.05),肺组织SOD活性则高于致伤组(P<0.05),组织病理学观察显示肺损伤程度较轻。结论:静脉注射ET可复制兔早期ALI的动物模型,PLA2激活及氧化损伤在ALI的病理生理过程中起重要作用;氯喹可抑制PLA2激活和氧化损伤,对ET所致的兔早期ALI具有一定的保护作用。     

内毒素致兔急性肺损伤时MDA、SOD的变化

目的:观察大肠杆菌内毒素(ET)致兔急性肺损伤时丙二醛(MDA)含量和超氧化物歧化酶(SOD)活性变化,探讨氧化应激在发病机制中的作用.方法:24只大耳白兔随机均分为对照组、ET致伤组及ET 萘普生处理组.经颈静脉注射ET(600 μg/kg)致兔急性肺损伤,监测动物呼吸、血压及心率的变化,检测动脉血气、血清中内皮素-1(ET-1)含量的变化.于240 min处死动物,取右肺膈叶组织测定MDA含量及SOD活性;取肺组织观察病理变化,测肺湿/干比.结果:与对照组相比,损伤组动物心率抑制,血压下降,呼吸频速;动脉血氧分压下降、血清ET-1含量增加;肺组织MDA含量上升及SOD活性下降;肺组织出现明显病理组织学损伤,肺湿/干比增加.萘普生处理组各项指标与对照组接近,肺组织损伤较轻.结论:家兔ET性ALI时肺组织发生了强烈的氧化性应激损伤,同时伴有机体抗氧化能力相对不足.     

促凝血活性在急性肺损伤中的变化及1,6-二磷酸果糖的作用

目的:观察内毒素(ET)致大耳白兔急性肺损伤(ALI)过程中肺组织的促凝血活性变化及1,6-二磷酸果糖(FDP)的影响,研究FDP对ALI的可能拮抗作用。方法:大耳白兔随机分为对照组、ET致伤组、ET致伤 FDP干预组。经静脉一次注射ET复制兔ALI模型。各组分别于0 h、0.5 h、2 h、4 h及6 h等不同时点测定呼吸频率、心率、血压、血气分析和血常规;于6 h点处死动物,测定肺组织中血栓烷B2(TXB2)、6-酮-前列腺素F1α(6-keto-PGF1α)的含量,并行肺组织病理学观察。结果:致伤组静注ET后与对照组相比较,出现呼吸频率增加、心率加快、血压下降、血氧分压降低、外周血白细胞计数下降和肺组织TXB2/6-keto-PGF1α比值升高,肺组织出现明显的病理损害。干预组动物的相应指标好于致伤组。结论:肺组织促凝血活性升高在ALI发病过程中起了重要作用;FDP可抑制肺组织促凝血活性的升高,对ET诱导的ALI有一定的拮抗性作用。     

ω-3鱼油脂肪乳剂对急性肺损伤兔肺组织TXB2、6-keto-PGF1α表达的影响

【目的】探讨ω-3鱼油脂肪乳剂对内毒素脂多糖（LPS）致兔急性肺损伤（ALI）急性肺损伤兔肺组织中血栓素B2（TXB2）、6酮前列腺素F1α（6-keto-PGF1α）表达的影响。【方法】清洁级新西兰兔24只,随机分为对照组（A组）、LPS致伤组（B组）、ω-3鱼油脂肪乳剂预处理＋LPS致伤组（C组）,每组8只,记录0h、0．5h、1h、2h、4h时间点氧和指数（PaO2/FiO2）的改变,4h点处死动物,取肺组织测定TXB2和6-酮-前列腺素F1α（6-keto-PGF1α）含量、观察病理变化,并做病理评分。【结果】注射LPS0．5h、1h后B、C两组0．5h、1h兔肺组织TXB2、6-keto-PGF1α均较A组明显升高（P＜0．05）,B、C两组比较有统计学意义（P＜0．05）,注射LPS2h、4h后三组比较无统计学意义（P＞0．05）;B组TXB2/6-keto-PGF1α（T/P）明显高于A、C两组（P＜0．05）,A组与C组T/P均有增高趋势（0．75VS0．73）,但两组比较无显著差异（P＞0．05）;A组、C组肺损伤病理组织评分均低于B组（P＜0．05）。【结论】ω-3鱼油脂肪乳可明显减少LPS致ALI的肺组织TXB2含量,对6-keto-PGF1α最终合成无明显抑制,从而显著下调T/P,对内毒素致兔ALI具有一定保护作用。     

急性肺损伤大鼠肺组织PPAR-γ表达的研究

目的 在脂多糖(lipopolysaccharide,LPS)复制的急性肺损伤(acute lung injury,ALI)大鼠模型中,观察PPARγ表达的改变,探讨PPAR-γ在ALI发病中的作用.方法 在LPS复制的大鼠Au模型中,观察动脉血气、肺湿/干(W/D)比值、肺组织病理,用RT-PCR法检测肺组织PPAR-γ、TNF-α mRNA表达,用ELISA法检测TNF-α蛋白变化,并用免疫组化观察肺组织PPAR-γ的改变.结果 ALI大鼠,PaO2显著降低(P<0.05),肺W/D比值显著高于对照组(P<0.05),病理显示肺组织受损;肺组织TNF-αmRNA显著升高(P<0.05),与此同时血浆TNF-α亦显著升高(P<0.05).正常大鼠肺组织可表达PPAR-γ,LPS致伤后肺组织PPAR-γ mRNA在1 h即开始下降,2 h降至谷底,并持续至实验结束.免疫组化显示致伤后1、2 h与对照组无显著差异,从4 h显著降低并持续至8 h(P<0.05).结论 正常大鼠肺组织可表达PPAR-γ,LPS可引起ALI大鼠肺组织PPA-γ的基因和蛋白水平表达下降,这可能与ALI炎症持续和损伤有关.     

兔急性肺损伤肺组织中PPAR-γ蛋白表达及美洛昔康的影响

目的:观察内毒素(ET)致兔急性肺损伤(ALI)时肺组织中过氧化物酶体增殖物激活受体γ(PPAR-γ)蛋白表达及美洛昔康的影响,探讨美洛昔康对兔急性肺损伤干预的机制。方法:将24只日本大耳白兔随机分为对照组、致伤组、美洛昔康干预组。用ET(700μg/kg)一次性静脉注射方法复制兔ALI模型,应用美洛昔康(2.5mg/kg)进行干预。采用免疫组织化学技术和Westernblot方法检测肺组织中PPAR-γ蛋白的表达。结果:PPAR-γ蛋白表达在致伤组显著低于对照组(P<0.01),美洛昔康干预组显著高于致伤组(P<0.01)。结论:PPAR-γ蛋白表达在ALI时下调。美洛昔康可促进PPAR-γ蛋白的表达,在一定程度上对兔内毒素性ALI产生保护作用。     

肺缺血再灌注损伤时TXA2/PGI2平衡的变化及红花的调控作用

目的:探讨家兔肺缺血再灌注损伤时血浆和肺组织血栓素B,(TXB,)、6-酮-前列腺素F1α(6-keto-PGF1α)含量与比值的变化以及红花对其的影响.方法:复制在体兔肺缺血再灌注损伤模型.30只日本大耳兔,随机均分为三组:假手术组(S组),缺血再灌注组(IR组)和缺血再灌注 红花注射液组(SI组).应用放免法测定血浆和肺组织TXB2、6-keto-PGF1α含量与比值的变化;观察肺超微结构变化.结果:IR组血浆和肺组织的TXB2显著高于S组(P＜0.01),6-keto-PGF1a差异均无明显.SI组与IR组相比血浆和肺组织的TXB,下降均非常明显(P＜0.01),TXB2/6-keto-PGF1α降低很显著(P＜0.01).电镜显示IR组有明显的肺超微结构损伤,而SI组损伤不明显.结论:红花能抑制血小板释放血栓素A2(TXA2),调控TXA2/PGI2的平衡,通过遏制无复流现象,对肺缺血再灌注损伤具有防治作用.     

全氟化碳雾化吸入对兔急性肺损伤肺组织结构及抗炎作用的影响

目的 观察雾化吸入全氟化碳（PFC）对急性肺损伤（ALI）兔肺组织病理学变化、气体交换及肿瘤坏死因子-α（TNF-α）mRNA表达的影响。方法 用油酸制备兔ALI模型后，随机分为常规机械通气（CMV）组和PFC组，每组8只动物。分别在ALI前，ALI后，以及治疗后1，2，3和4h共6个时相点观察动脉血气指标的变化，实验结束后取6个不同部位的肺组织做病理切片，取2个不同部位的肺组织做TNF-α mRNA原位杂交。结果 PFC组PaO2及肺静态顺应性（CLst）显著高于CMV组；PFC组病理改变轻于CMV组。原位杂交提示PFC组TNF-αmRNA原位表达低于CMV组。自身比较发现，背侧肺叶TNF-αmRNA表达重于腹侧肺叶（P〈0．05）。结论 雾化吸入PFC能明显改善实验兔ALI肺氧合能力，升高PaO2，改善CLst减少肺组织中的TNF-αmRNA表达。     

内毒素致兔急性肺损伤及1,6-二磷酸果糖保护性作用的研究

目的：研究1，6-二磷酸果糖(FDP)对大肠杆菌内毒素(ET)致大耳白兔急性肺损伤(Au)的保护性作用及其对磷脂酶A2(PLA2)活性的影响。方法：大耳白兔随机分为对照组、ET致伤组、ET致伤 FDP干预组。经静脉一次性注射ET复制兔ALI模型。各组分别于0h、0．5h、2h、4和6h等不同时点测定呼吸频率、心率、血压、血气分析及血清中PLA2活性；于6h点处死动物，测定肺组织PLA2活性，并行肺组织病理学观察。结果：静注ET后，致伤组动物与对照组相比较，出现呼吸频率加快、血压下降、心率加快、血氧分压降低和PLA2活性增高，肺组织出现明显的病理损害。干预组动物肺损伤轻于致伤组。结论：FDP对PLA2激活起抑制作用，可改善其病理生理过程；对ET所致的兔早期ALI有一定的保护作用。     

内皮素抗血清抑制动脉损伤后内膜增生的实验研究

目的通过兔颈总动脉球囊损伤模型,观察内皮素(ET)抗血清对损伤动脉内膜增生的影响,以寻找预防动脉损伤后内膜增生的新途径.方法设立假手术组、对照组、ET抗血清组.ET抗血清 组术后按0.5ml/kg/d自耳缘静脉给予ET抗血清,假手术组及对照组给同等量的正常兔血清,观察术后2周各组血浆6-keto-PGF1α、TXB2水平、血管增殖指数及血管内膜厚度和管腔狭窄度.结果1.血浆6-keto-PGF1α水平ET抗血清组显著高于对照组(P＜0.01),2.血浆TXB2水平ET抗血清组显著低于对照组(P＜0.01).3.损伤侧血管增殖指数各组均显著高于假手术组(P＜0.01),ET抗血清组显著低于对照组(P＜0.01).4.对照组损伤侧血管内膜厚度、截面积、管腔狭窄度均显著高于假手术组(P＜0.01),而ET抗血清组上述指标均低于对照组(P＜0.01).结论ET抗血清抑制动脉内膜的增生.     

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.