激活κ阿片受体改善大鼠心肌缺血导致的血流动力学变化及心律失常

目的 观察κ阿片受体激动剂(U50488H)对心肌缺血所致大鼠血流动力学及心律失常的效应.方法 实验大鼠随机分为4组,Ⅰ组:对照组(手术但未实施缺血再灌注及药物干预);Ⅱ组:缺血/再灌注(I/R)组;Ⅲ组:I/R+U50488H干预组;Ⅳ组:I/R+U50488H+κ阿片受体阻断剂(Nor-BNI)共同干预组.常规监测心电图、心率(HR)、动脉压(ABP)等血流动力学指标;记录发生室性心律失常的种类及其持续时间.结果 选择性κ阿片受体激动剂可显著降低大鼠HR和ABP;Ⅰ、Ⅱ、Ⅲ、Ⅳ组大鼠心肌缺血导致心室纤颤发生率分别为0、50%、30%、40%;Ⅲ组与Ⅱ、Ⅳ组相比,心室纤颤的发生率和Pugsley评分最低,心动过速的持续时间缩短(P<0.05).结论 U50488H通过上调心脏κ阿片受体的兴奋性产生了抗大鼠心肌缺血所致室性心律失常的作用.     

к阿片受体激动剂U50488H对大鼠心肌缺血再灌注室性心律失常的影响

目的 :研究选择性к阿片受体激动剂U5 0 4 88H对大鼠心肌缺血再灌注室性心律失常的影响 .方法 :将实验大鼠按随机原则分为 4组 ,即对照组 (Control)、缺血再灌注组 (Ⅰ /R)、U5 0 4 88H组和U5 0 4 88H +Ⅰ /R组 ,监测大鼠心率 (HR)、动脉压 (ABP)、左心室内压 (LVP)及收缩 (+dp/dtmax)和舒张功能 (-dp/dtmax)等血流动力学指标 ,并观察室性心律失常的发生情况 .结果 :①U5 0 4 88H可显著降低大鼠HR ,ABP ,LVP及±dp/dtmax;②在心肌缺血前预先给予U5 0 4 88H ,可明显降低大鼠心肌缺血再灌注室性心律失常的发生率以及室性心律失常评分 ,该作用可被选择性к阿片受体阻断剂Nor BNI阻断 .结论 :U5 0 4 88H可改变心脏节律 ,并通过激动心脏к阿片受体减少大鼠心肌缺血再灌注室性心律失常的发生 .     

阿片受体对大鼠缺血性心律失常影响实验研究

目的:大鼠心肌缺血后,U50488H激活阿片受体,观察其对心肌缺血大鼠血流动力学及心律失常的影响.方法:建立大鼠心肌缺血再灌注损伤模型,动物随机分为4组,Ⅰ组:对照组(手术但未实施缺血再灌注及药物干预);Ⅱ组:缺血/再灌注组(I/R);Ⅲ组:I/R+U50488H干预组;Ⅳ组:I/R+ U50488H+ Nor-BNI...     

U50488H对缺血-再灌注大鼠心肌的直接保护作用

目的：研究选择性κ阿片受体激动剂U50488H对缺血-再灌注大鼠心肌梗死范围和对其血浆肌酸磷酸激酶（CK）及乳酸脱氢酶（LDH）的影响。方法：将实验大鼠按随机原则分为四组，即对照组、缺血．再灌注（I／R）组、U50488H＋I／R组和Nor—BNI＋U50488H＋I／R组。观察各组大鼠心肌梗死范围，检测各组大鼠CK及LDH。结果：①U50488H可明显减少心肌缺血-再灌注引起的心肌梗死范围，但该作用可被选择性K阿片受体阻断剂NorBNI所阻断；②L／R组大鼠血浆CK和LDH含量明显高于对照组，US0488H＋I／R组较Nor-BNI＋U50488H＋I／R组明显降低。结论：U50488H可明显减少心肌缺血-再灌注大鼠心肌梗死范围，减少心肌细胞蛋白酶的漏出，对缺血-再灌注心脏具有明显的保护作用。     

к阿片受体对大鼠心肌缺血-再灌注损伤的保护作用

目的:采用选择性к阿片受体激动剂U50488H激活к阿片受体,研究大鼠发生心肌缺血-再灌注损伤时к阿片受体介导的心脏保护作用. 方法:建立心肌缺血-再灌注损伤动物模型,将实验大鼠按随机原则分组,监测大鼠心率(HR)、动脉压(ABP)、左心室内压(LVP)及收缩(+dp/dtmax)和舒张功能(-dp/dtmax)等血流动力学指标,观察к阿片受体激活后对心肌缺血-再灌注损伤大鼠心肌超微结构、心肌梗死面积、心律失常以及心肌酶谱等方面的影响. 结果: ① U50488H可显著降低大鼠HR、ABP、LVP及±dp/dtmax.②在心肌缺血前预先给予U50488H具有心脏保护作用,具体表现在可以减轻缺血-再灌注大鼠心肌超微结构的损伤、缩小心肌梗死面积、降低缺血-再灌注性心律失常的发生以及减少心肌酶的漏出. 结论:U50488H具有负性肌力作用,可通过激活心脏к阿片受体发挥心脏保护作用.上述作用可被选择性к阿片受体阻断剂Nor-BNI阻断.     

U50488H对缺血再灌注大鼠血流动力学和心肌超微结构的影响

目的 :研究选择性к阿片受体激动剂U5 0 4 88H对缺血再灌注大鼠血流动力学及心肌超微结构的影响 .方法 :实验大鼠随机分为 4组 ,即对照组 (Control) ,缺血再灌注组 (I/R) ,U5 0 4 88H组和U5 0 4 88H +I/R组 ,监测大鼠心率 (HR)、动脉压 (ABP)、左心室内压 (LVP)及收缩 (dp/dtmax)和舒张功能(-dp/dtmax)等血流动力学指标的变化 ,并观察各组大鼠的心肌超微结构 .结果 :①U5 0 4 88H可显著降低大鼠HR ,ABP ,LVP和 (±dp/dtmax) ;②缺血再灌注前预先给予U5 0 4 88H ,可明显减轻心肌缺血 /再灌注对大鼠心肌超微结构的损伤 .结论 :①U5 0 4 88H的降压作用可能与其负性肌力作用有关 ;②预先给予U5 0 4 88H具有心脏保护作用 ,可明显减轻心肌缺血 /再灌注对大鼠心肌超微结构的损伤     

κ-阿片受体激动剂U50488H对大鼠心肌缺血再灌注损伤的直接保护作用

目的：探讨选择性κ-阿片受体激动剂U50488H对大鼠心肌缺血再灌注（I/R）损伤冠状微循环和心肌超微结构的影响,明确其对I/R心肌是否具有直接保护作用.方法：将32只大鼠随机分为4组,即假手术组,I/R组,U50488H＋I/R组和Nor-BNI（特异性阿片受体阻断剂）＋U50488H＋I/R组,每组8只.实验组通过开胸结扎冠脉前降支制备大鼠I/R模型,观察各组大鼠心肌超微结构和冠状微循环的改变.结果：①U50488H＋I/R组与I/R组和Nor-BNI＋U50488H＋I/R组比较,微血管显著扩张（P〈0.05）,毛细血管腔内血细胞明显减少,心肌间质中偶见红细胞.②U50488H＋I/R组与I/R组和Nor-BNI＋U50488H＋I/R组比较,心肌超微结构损伤明显减轻.结论：U50488H可通过激活心脏κ-阿片受体,明显改善大鼠I/R心肌的微循环,减轻心肌超微结构的损伤,从而发挥对心脏的直接保护作用,该作用可被选择性的κ-阿片受体阻断剂Nor-BNI所拮抗.     

κ阿片受体对大鼠心肌缺血-再灌注损伤的保护作用

目的：采用选择性κ阿片受体激动剂U50488H激活κ阿片受体，研究大鼠发生心肌缺血-再灌注损伤时κ阿片受体介导的心脏保护作用。方法：建立心肌缺血-再灌注损伤动物模型，将实验大鼠按随机原则分组，监测大鼠心率（HR）、动脉压（ABP）、左心室内压（LVP）及收缩（＋dp／dtmax）和舒张功能（-dp／dtmax）等血流动力学指标，观察κ阿片受体激活后对心肌缺血-再灌注损伤大鼠心肌超微结构、心肌梗死面积、心律失常以及心肌酶谱等方面的影响。结果：①U50488H可显著降低大鼠HR、ABP、LVP及．4-dp／dtmax。②在心肌缺血前预先给予U50488H具有心脏保护作用，具体表现在可以减轻缺血-再灌注大鼠心肌超微结构的损伤、缩小心肌梗死面积、降低缺血-再灌注性心律失常的发生以及减少心肌酶的漏出。结论：U50488H具有负性肌力作用，可通过激活心脏κ阿片受体发挥心脏保护作用。上述作用可被选择性κ阿片受体阻断剂Nor—BNI阻断。     

U50,488H对正常及缺氧心肌细胞钾电流的作用

目的观察U50,488H(κ阿片受体选择性激动剂)对正常及缺氧心肌细胞钾电流的影响。方法采用全细胞膜片钳技术,记录了急性分离的正常及缺氧大鼠心室肌细胞的钾电流。结果U50,488H(1～500μmol/L)可以剂量依赖性地抑制正常心肌细胞的钾电流,该作用可被κ阿片受体特异性阻断剂Nor-BNI(100μmol/L)所阻断。而细胞缺氧后,钾电流虽有所下降,但与正常对照差异无显著性。U50,488H(1～500μmol/L)可以剂量依赖性地抑制低氧心肌细胞的钾电流,并且U50,488H对心肌细胞钾通道电流的抑制作用不受缺氧的影响。结论心脏阿片受体参与了对心脏钾离子通道功能的调节,这可能是阿片类物质抗心律失常的原因之一。     

κ-阿片和肾上腺素受体激动在缺血再灌注心脏中的交互作用

目的 :探讨心脏缺血及再灌注 (I- R)期间 ,阿片受体和肾上腺素受体激活在跨膜信息传递中的交互作用。方法 :采用离体心脏 L angendroff模型 ,全心停灌 2 0 min复灌 30 min造成 I- R。在心脏 I- R期间用κ-阿片肽受体激动剂 U5 0 4 88h(10 -6mol/ L)和β1肾上腺素受体激动剂 NE(10 -7mol/ L )进行干预。结果 :1NE单独作用与 I- R对照组左室收缩压 (L VSP)在心脏缺血起始 ,复灌 10、2 0及 30 min分别为 [(86 .31± 17.86 vs4 8.0 5± 15 .0 3) % ,P<0 .0 5 ]、[(136 .6 2± 16 .33vs93.33± 15 .4 5 ) % ]、[(12 7.2 3± 17.33vs73.39± 12 .92 ) % ]、[(15 3.4 8± 18.31vs6 8.11± 13.18) % ,均 P<0 .0 1];NE和 U5 0 4 88h一起灌流时及 U5 0 4 88h单独作用时不明显。 2 U5 0 4 88h与 NE同时灌流心律失常评分仅在复灌 10～ 2 0 min(0 .70± 0 .4 8)较单纯 I- R组 (1.6 4± 1.19)明显减小 (P<0 .0 5 ) ,单独 NE或 U5 0 4 88h在各时间段心律失常评分与单纯 I- R组比差别无显著性 (P>0 .0 5 )。 3在心脏缺血后再灌注 10、2 0和30 min时 ,U5 0 4 88h单独作用以及与 NE同时应用心率分别是 (185 .71± 5 5 .33)和 (197.2 2± 2 6 .97) ,(181.86±4 3.0 3)和 (195 .5 6± 5 8.6 8) ,(195 .0 0± 17.35 )和 (179.     

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.