肠易激综合征大鼠模型的复制与评价

目的 建立肠易激综合征(IBS)大鼠模型,为实验药理学提供方法.方法 采用复合因素诱导大鼠建立IBS模型,测定模型大鼠体重、摄食量、排便情况、自主运动量、胃排空率和肠推进率,分析血清5-HT、血浆SP、VIP含量以及结肠匀浆5-HT、SP、VIP含量变化,测定血液生化指标,显微观察胃窦黏膜和横结肠黏膜组织形态改变.结果 造模后各大鼠体重减轻、摄食量减少,排便量增多、出现稀便和无定形软便,自主运动量减少,胃排空率减小、肠推进率加快,血清5-HT含量升高、血浆SP和VIP含量均降低,结肠匀浆5-HT和SP、VIP含量升高(P<0.05,P<0.01),血液生化指标未见异常,胃窦黏膜和横结肠黏膜无明显形态改变;匹维溴铵15.0 mg/kg治疗30 d后,大鼠体重、摄食量增加,排便量减少、稀便减少,自主运动量接近正常,血清5-HT含量下降、血浆SP和VIP含量升高,结肠匀浆5-HT和SP、VIP含量下降.结论 复合因素随机刺激能成功复制IBS大鼠模型,其病理生理特征与临床研究结果基本吻合.     

痛泻要方干预大鼠肠易激综合征肝郁脾虚证的作用及机制

目的探讨痛泻要方对肝郁脾虚型肠易激综合征大鼠内脏敏感性的干预作用。方法采用番泻叶加束缚应激刺激制备肝郁脾虚型肠易激综合征动物模型。予痛泻要方灌胃治疗（西药匹维溴铵对照）。观察大鼠结肠黏膜肥大细胞数目及脱颗粒情况;检测血标本中5-羟色胺（5-HT）、P物质（SP）、降钙素基因相关肽（CGRP）的含量。结果模型对照组大鼠结肠黏膜肥大细胞数目及脱颗粒显著增加;西药组和中药组大鼠5-HT、SP含量显著下降,CGRP含量显著增加,差异均有高度统计学意义（均P〈0.01）,且有一定的量效关系。结论痛泻要方可能通过减少肥大细胞脱颗粒,降低模型大鼠血清5-HT、血浆SP含量,增加血浆CGRP含量,从而改善胃肠动力并降低内脏敏感性,发挥治疗肠易激综合征的效应。     

5-HT2B受体在不同亚型肠易激综合征模型大鼠发病中的作用

目的:观察5-HT2B受体在不同亚型肠易激综合征(irritable bowel syndrome,IBS)模型大鼠中表达的差异?方法:45只大鼠随机分为腹泻型IBS组(D-IBS组)?便秘型IBS组(C-IBS组)和对照组,每组15只?乙酸加束缚应激法制备D-IBS模型,冰水灌胃法制备C-IBS模型,对照组不予任何处理?从大鼠粪便湿重?含水量?结直肠扩张(CRD)刺激下腹外斜肌放电活动和结肠组织HE染色四个方面来评估造模是否成功?免疫组化法观察各组大鼠结肠组织中5-HT2B受体的分布差异;Western blot法及逆转录PCR法检测各组大鼠结肠组织中5-HT2B受体表达的不同?结果:与对照组相比,D-IBS组大鼠粪便湿重和含水量均明显增高(P < 0.05),而C-IBS组降低(P < 0.05);模型组大鼠腹外斜肌放电幅值,在压力为40?60 mmHg的CRD刺激下,均较对照组明显增加,且D-IBS组高于C-IBS组(P < 0.05);模型组结肠组织中均无炎症产生,从以上四方面可以看出造模成功?5-HT2B受体主要分布在结肠肌间神经丛?纵肌层和黏膜层?D-IBS组结肠组织中5-HT2B受体蛋白及mRNA表达量显著高于对照组(P < 0.05),而C-IBS组低于对照组(P < 0.05)?结论:5-HT2B受体可能参与了不同亚型IBS的发病?     

山楂水提物对肠易激综合征大鼠结肠黏膜5-HT和5-HT3R表达的影响

目的：探讨山楂水提物对肠易激综合征（IBS）大鼠结肠黏膜5-HT和5-HT3R的影响,探讨其改善消化功能的作用机制。方法：采用乳鼠结肠PTCA球囊刺激法复制IBS大鼠模型。随机分为模型组、空白组、西沙必利组、山楂水提物高、中、低剂量组,给药2周后,应用免疫组化法检测大鼠结肠黏膜5-HT和5-HT3R表达变化。结果：与空白组比较,模型组大鼠结肠黏膜5-HT和5-HT3R水平显著升高,差异有统计学意义（P〈0．01）;给药组大鼠5-HT和5-HT3R的表达明显降低（P〈0．01;P〈0．05）。结论：山楂水提物可抑制IBS模型大鼠结肠黏膜5-HT和5-HT3R的过分表达,从而改变肠道敏感度,达到改善肠道消化功能作用。     

逍遥散对肠易激综合征大鼠结肠5-HT 受体的干预作用

目的:研究肠易激综合征(IBS)模型大鼠结肠5-HT受体的异常变化,揭示IBS模型5-HT受体对内脏敏感性异常调节的途径及中药复方逍遥散的作用环节。方法:SD大鼠48只,随机分为正常组,模型组,逍遥散低、中、高剂量组和阳性对照组,以心理应激联合免疫诱导致敏法建立IBS模型。造模结束后各组大鼠分别灌胃给药,连续给药14天。评估球囊结直肠扩张引起腹部收缩反射(AWR)的最小容量阈值以反映模型大鼠内脏敏感性,采用酶联免疫法测定各组大鼠结肠黏膜5-HT3受体(5-HT3R)、5-HT4受体(5-HT4R)水平。结果:与正常组比较,模型组大鼠引起AWR的最小容量阈值、结肠黏膜5-HT 4受体(5-HT4R)水平降低,结肠黏膜5-HT3受体(5-HT3R)水平明显升高(P<0.05,P<0.01);逍遥散能升高IBS大鼠AWR最小容量阈值,降低结肠黏膜5-HT3R水平,升高结肠黏膜5-HT4R水平(P<0.05,P<0.01)。结论:逍遥散可能通过调节IBS模型大鼠结肠5-HT受体,减弱神经元兴奋性,从而提高内脏痛阈,消除肠道过敏。     

肠易激综合征患者肠黏膜5-羟色胺的表达及意义

目的检测肠易激综合征（IBS）患者肠黏膜5-羟色胺（5-HT）表达的差异,探讨外周5-HT在IBS发病中的作用。方法选择IBS腹泻型（D—IBS）21例、便秘型（C—IBS）22例患者及正常对照组19例,利用免疫组化方法检测各组回肠、近端结肠、远端结肠黏膜5-HT阳性细胞,计数阳性细胞数量并进行分析。结果D—IBS组回肠、近端结肠、远端结肠5-HT阳性细胞数显著多于对照组（P〈0．05）,并且回肠黏膜阳性细胞数也多于C—IBS组（P〈0．05）,C—IBS组回肠、近端结肠、远端结肠阳性细胞显著多于对照组（P〈0．05）。结论肠道5-HT的增加与IBS发病相关,IBS不同亚型发病机制可能与5-HT不同受体在中枢神经系统和消化道表达分布有一定关系。     

痛泻要方对IBS肝郁脾虚证大鼠血清、结肠5-羟色胺的影响

目的:探讨痛泻要方对肠易激综合征肝郁脾虚证大鼠血清、结肠5-羟色胺(5-HT)的调控。方法:将120只SPF级SD大鼠随机分为6组:正常组、病理组、痛泻要方低剂量组、痛泻要方中剂量组、痛泻要方高剂量组、西药(匹维溴铵)组,每组20只。除正常组外,其余各组均用"束缚应激+番泻叶灌胃法"进行造模,前肢束缚2 w,在束缚的基础上进行番泻叶灌胃1 w,1次/d。后用相应剂量的痛泻要方和匹维溴铵进行灌胃治疗7 d。造模及治疗结束后,检测各组大鼠血清及结肠5-HT的含量。结果:与正常组相比,模型组大鼠血清、结肠的5-HT含量显著升高(P0.01);与模型组相比,痛泻要方低、中、高剂量组和西药组大鼠血清、结肠的5-HT含量明显降低(P0.05或P0.01),以痛泻要方高剂量组大鼠的5-HT含量最接近正常组水平。结论:痛泻要方通过疏肝、柔肝的作用,减少大鼠血清和结肠5-HT的含量,来缓解IBS肝郁脾虚证大鼠的症状。     

痛泻要方治疗肠易激综合征肝郁脾虚证VIP作用机制探讨

目的:观察痛泻要方对肠易激综合征(IBS)肝郁脾虚证大鼠血清及结肠血管活性肠肽(VIP)水平的影响,探讨痛泻要方治疗肠易激综合征肝郁脾虚证VIP作用机制。方法:运用"束缚应激+番泻叶灌胃法"构造IBS肝郁脾虚证动物模型,运用痛泻要方和匹维溴铵进行治疗,检测各组大鼠血清及结肠VIP的含量,分析痛泻要方治疗IBS肝郁脾虚证VIP作用机制。结果:与正常组相比,病理组血清和结肠VIP含量较正常组明显升高(P0.01),与病理组相比,低、中、高剂量组及西药组血清和结肠VIP含量显著降低(P0.05,P0.01)。结论:痛泻要方治疗肠易激综合征肝郁脾虚证与降低其血清、结肠VIP的含量有关,极有可能是胃肠道动力增强之后而产生的一种负反馈机制造成的。     

痛泻要方水提物对肠易激综合征模型大鼠的治疗作用

目的:探讨痛泻要方水提物对内脏高敏感性肠易激综合征(irritable bowel syndrome,IBS)模型大鼠的治疗作用.方法:采用束缚慢性刺激法制作焦虑型内脏高敏感性IBS大鼠模型.分别给予得舒特和不同荆量痛泻要方水提物进行治疗,2周后观察各组大鼠的稀便级和小肠碳末推进率.结果:IBS大鼠的稀便级和小肠碳末推进率明显高于正常大鼠(P<0.01).药物治疗可改善IBS大鼠的稀便级和小肠碳末推进率;痛泻要方水提物中、高剂量组大鼠的稀便级和小肠碳末推进率明显低于IBS大鼠(P<0.01),且明显低于得舒特组大鼠(P<0.05).结论:痛泻要方对IBS大鼠有较好的治疗作用,且优于得舒特.     

针刺对便秘型肠易激综合征大鼠肠运动及胃肠激素含量的影响

目的 观察针刺对便秘型肠易激综合征（constipation-predominant irritable bowel syndrome,IBS-C）大鼠的小肠推进率及血清、结肠中5-羟色胺(5-hydroxytryptamine,5-HT)、血管活性肠肽（vasoactive intestinal peptide,VIP)、P物质（substunce P,SP)水平的影响,探讨针刺对IBS-C大鼠的作用机制。方法 从60只健康清洁级SD大鼠中随机选取10只作为正常对照组,其余50只大鼠采用寒冷-束缚-饥饱失常综合法进行IBS-C模型复制,进行模型评价后采用随机数字表法选取30只分为模型组、四单穴组方组、非经非穴组,每组10只。分别用活性炭粉悬浊液灌胃法观察各组大鼠小肠推进率,采用ELISA法检测血清5-HT、VIP、SP水平,采用免疫组织化学法测定结肠中5-HT、VIP、SP水平。结果 与正常对照组比较,模型组大鼠小肠推进率显著降低（P<0.05）;与模型组比较,四单穴组方组大鼠小肠推进率显著升高（P<0.05）。与正常对照组比较,模型组大鼠血清、结肠组织中5-HT、VIP水平显著升高（P<0.05）,SP水平显著降低（P<0.05）;与模型组及非经非穴组比较,四单穴组方组大鼠血清、结肠组织中5-HT、VIP水平均显著降低（P<0.05）,SP水平均显著升高（P<0.05）。结论 针刺可明显升高IBS-C大鼠小肠推进率,其作用机制可能与降低结肠、血清中5-HT、VIP水平,升高SP水平有关。     

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.