螺旋藻对阿霉素肾硬化大鼠肾脏的保护作用

目的研究螺旋藻对阿霉素肾硬化大鼠肾脏的保护作用及相关机制。方法将32只SD大鼠随机分为4组：假手术组（S组）,阿霉素肾硬化对照组（M组）,螺旋藻组（SP组）,贝那普利治疗组（B组）。8周后观察各组大鼠24 h尿蛋白定量、血尿素氮（BUN）、肌酐（Scr）及肾脏病理改变,免疫组化观察肾脏组织纤连蛋白（FN）、IV型胶原（Col IV）、转化生长因子β1（TGF-β1）的表达。RT-PCR测定肾皮质TGF-β1mRNA的表达。结果螺旋藻能减少尿蛋白、降低BUN和Scr,减轻基质增生和肾小球硬化,且能减少FN、Col IV、TGF-β1的表达。下调肾皮质TGF-β1mRNA的表达。结论螺旋藻能减轻阿霉素肾硬化大鼠肾脏损害,对肾脏有保护作用。     

血管紧张素Ⅱ受体拮抗剂对实验性肾小球硬化的作用

目的：观察血管紧张素Ⅱ受体拮抗剂氯沙坦对５／６肾切除大鼠残余肾组织肾小球硬化的影响。方法：将５／６肾切除鼠分为氯沙坦治疗组和对照组,并设假手术组为正常对照组。检测各组术后第２,４,６周的尿蛋白及第６周的血清尿素氮、肌酐、总蛋白、白蛋白,并观察第６周肾组织病理改变。结果：氯沙坦治疗组与对照组相比,尿蛋白排泄量明显减少（Ｐ〈０．０１）,血肌酐、尿素氮水平下降（Ｐ〈０．０１）,肾小球增生、硬化程度明显减     

普罗布考对肾小球硬化大鼠肾组织转化生长因子β1的影响

 目的观察普罗布考对阿霉素致肾小球硬化大鼠肾组织转化生长因子β1（TGF-β₁）的影响。方法建立单侧肾切除加重复注射阿霉素诱导的肾小球硬化大鼠模型,分为模型组和治疗组,设假手术组为对照组。检测各组大鼠第0、4、8、12 周尿蛋白排泄量,并于12 周末测定各组大鼠血清肌酐、尿素氮及血清白蛋白;行肾脏病理学检查计算肾小球硬化指数;应用免疫组化方法检测肾组织中TGF-β1的表达。结果与模型组相比,普罗布考治疗组大鼠24 h尿蛋白定量明显减少,血清肌酐、尿素氮及血清白蛋白等指标均有不同程度的改善（ P< 0.05）,肾小球硬化程度减轻（ P< 0.05）,肾小球内TGF-β1沉积明显减少（P < 0.05）。结论普罗布考对阿霉素致肾小球硬化大鼠肾脏有部分保护作用,其机制可能与抑制TGF-β₁的表达有关。     

健脾清化方对阿霉素肾病大鼠免疫炎症损伤的作用机制

目的 从细胞免疫介导的炎症损伤角度,探讨健脾清化方对阿霉素致局灶节段硬化（focal segmental glomurular sclerosis,FSGS）模型大鼠FSGS的影响。方法 左侧肾切除加尾静脉注射阿霉素致大鼠肾脏FSGS,观察健脾清化方对模型大鼠脾淋巴细胞CD4+/CD8+比值,肾小管间质纤维连接蛋白（FN）mRNA、Ⅲ型胶原（Col Ⅲ）mRNA、肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）6表达的影响。结果 健脾清化方能明显降低模型鼠脾淋巴细胞CD4+/CD8+比值,肾小管间质FN mRNA、Col Ⅲ mRNA、TNF-α、IL6水平。结论 健脾清化方对阿霉素肾病模型大鼠肾脏FSGS有一定的改善作用,该机制可能与健脾清化方抑制细胞免疫介导的炎症损伤有关。     

苯那普利对FSGS大鼠肾组织细胞外基质影响

目的探讨苯那普利对局灶节段性肾小球硬化症(FSGS)大鼠肾组织细胞外基质(ECM)的影响。方法建立单侧肾切除合并阿霉素静脉双次注射大鼠FSGS模型,经苯那普利进行灌胃治疗8周,然后采用半定量病理分析苯那普利对肾组织ECM影响,以及生化检测尿蛋白、血脂、肾功能变化。结果FSGS大鼠经苯那普利治疗后,肾组织ECM积聚减少(P<0.01),血脂、肌酐、尿素氮和尿蛋白较模型组降低(P<0.05-0.01)。结论苯那普利可以抑制肾组织ECM积聚,改善肾功能,防治肾纤维化。     

健脾清化方对肾纤维化大鼠肾功能、蛋白尿及肾组织Col-IV表达的影响

目的 探讨健脾清化方对肾切除联合阿霉素诱导局灶节段性肾小球硬化模型大鼠肾功能、蛋白尿及肾组织IV型胶原（Col-IV）表达的影响。方法 建立单侧肾切除合并阿霉素3 mg/kg尾静脉2次注射大鼠肾硬化模型,分别予以健脾清化方、健脾清化方拆方（益气健脾方及清热化湿方）、尿毒清颗粒干预8周。测定用药后各组肾功能及24 h尿蛋白定量,实时荧光定量PCR法测定肾组织Col-IV表达水平。结果 模型组与空白组及假手术组相比,血清肌酐、尿素氮、24 h尿蛋白定量及肾组织Col-IV表达水平均明显升高（P<0.01）。与模型组相比,健脾清化方组血清肌酐、尿素氮、24 h尿蛋白定量及肾组织Col-IV表达水平均明显下降（P<0.01）,清热化湿方组血清肌酐及肾组织Col-IV表达水平明显下降（P<0.01）,尿素氮降低（P<0.05）,尿毒清组尿素氮及肾组织Col-IV表达水平明显下降（P<0.01）,血清肌酐、24 h尿蛋白定量降低（P<0.05）,益气健脾方组各项指标均无明显下降（P>0.05）。结论 健脾清化方能下调肾组织IV型胶原的表达,从而抑制细胞外基质的积聚和肾小球系膜增殖,发挥抗肾纤维化和保护残存肾功能的效用。其拆方清热化湿方在改善肾功能和肾纤维化方面的疗效与健脾清化方接近,提示清热化湿类药物是健脾清化方抗肾纤维化的关键。     

肾疏宁对肾小球硬化大鼠肾小球系膜细胞表型转化的作用

目的观察中成药复方肾疏宁对肾小球硬化模型大鼠肾小球系膜细胞表型转化的作用,探讨肾疏宁防治肾小球硬化的作用机制。方法采用单侧肾切除并阿霉素尾静脉注射的方法建立大鼠肾小球硬化模型。用数字表法将SD大鼠随机分为假手术组、模型组、模型组+肾疏宁治疗组和模型组+苯那普利治疗组,共观察8周。用免疫组织化学染色法观察大鼠肾小球内α-平滑肌肌动蛋白(alpha smooth muscle actin,α-SMA)和转化生长因子-β1(transforming growth factor-β1,TGF-β1)的表达,用病理图像分析软件检测肾小球内α-SMA和TGF-β1染色阳性面积/肾小球毛细血管襻面积的改变。同时观察肾疏宁对肾小球硬化大鼠体质量、尿蛋白、血白蛋白、尿素氮、肌酐的影响。结果假手术组大鼠肾小球内未见α-SMA表达,可见TGF-β1少量表达;模型组大鼠肾小球内α-SMA和TGF-β1显著表达,与假手术组比较,差异有统计学意义(P<0.01);血白蛋白、总蛋白明显降低,与假手术组相比,差异有统计学意义(P<0.01);尿蛋白、血尿素氮、肌酐明显升高,与假手术组相比,差异有统计学意义(P<0.01)。肾疏宁治疗组和苯那普利治疗组24h尿蛋白排泄量、血尿素氮、肌酐明显降低,与模型组相比,差异有统计学意义(P<0.01)。肾小球内α-SMA阳性面积/肾小球毛细血管襻面积和TGF-β1阳性面积/肾小球毛细血管襻面积显著减少,与模型组比较差异有统计学意义(P<0.01)。相关性分析显示α-SMA和TGF-β1呈显著正相关(r=0.637,P<0.01)。结论肾疏宁可抑制肾小球系膜细胞表型转化,减少肾小球内固有细胞α-SMA和TGF-β1的表达,降低24h尿蛋白、血尿素氮和血肌酐,可能是防治肾小球硬化的部分作用机制。     

解毒通络保肾胶囊对糖尿病肾病大鼠肾组织中Col Ⅳ及FN表达的影响

目的探讨解毒通络保肾胶囊对糖尿病肾病（DN）大鼠肾组织中Ⅳ型胶原（ColⅣ）及纤维连接蛋白（FN）表达的影响。方法高脂饲料喂饲加腹腔注射链脲佐菌素复制DN大鼠模型,随机分为正常对照组、模型组、解毒通络保肾组、阳性对照组（罗格列酮联合贝那普利）。16周后采用免疫组化技术检测各组大鼠肾小球中ColⅣ及FN的表达水平,同时检测血糖、尿素氮、肌酐、尿微量白蛋白等指标的变化情况。结果模型组大鼠血糖、尿素氮、肌酐、尿微量白蛋白、ColⅣ及FN的表达明显升高（P〈0.01）,与模型组相比,解毒通络保肾组大鼠血糖、尿素氮、肌酐、尿微量白蛋白、ColⅣ及FN的表达均明显降低（P〈0.01）。结论解毒通络保肾胶囊能够减少肾组织中ColⅣ、FN含量,抑制肾小球ECM积聚,延缓DN的进展。     

Lipo-PGE1对局灶节段性肾小球硬化患者血管内皮生长因子生成影响研究

目的 :观察前列腺素E1脂微球载体制剂 (Lipo PGE1)对原发性肾病综合征局灶节段性肾小球硬化 (FS GS)患者血管内皮生长因子 (VEGF)生成的影响。方法 :39例肾活检确诊为FSGS患者随机分为治疗组 2 0例 ,未治疗组 19例 ,另选性别、年龄相匹配的健康查体者 2 0例作为对照组。治疗组用Lipo PGE110 μg ,未治疗组用ATP 2 0mg ,两组药物均溶于 10 0ml生理盐水中静脉滴注 ,1次 /d ,2周为 1疗程。 1疗程完成后采用ELISA方法测定三组血、尿VEGF水平 ,同时测定三组内生肌酐清除率和 2 4h尿蛋白定量。结果 :FSGS组血、尿VEGF及 2 4h尿蛋白定量与对照组相比明显增高 ,内生肌酐清除率较低 ;治疗组血、尿VEGF浓度显著下降 ,2 4h尿蛋白定量明显降低 ,内生肌酐清除率上升。两两比较P <0 .0 5 ,差异有统计学意义。结论 :Lipo PGE1治疗FSGS可以有效减轻蛋白尿 ,改善肾功能 ,对早期防治慢性肾衰竭有重要意义 ,VEGF的表达生成与治疗作用有一定的关系。     

血管紧张素Ⅱ受体拮抗剂对实验性肾小球硬化的作用

目的 :观察血管紧张素Ⅱ受体拮抗剂氯沙坦对 5 / 6肾切除大鼠残余肾组织肾小球硬化的影响。方法 :将5 / 6肾切除鼠分为氯沙坦治疗组和对照组 ,并设假手术组为正常对照组。检测各组术后第 2 ,4,6周的尿蛋白及第 6周的血清尿素氮、肌酐、总蛋白、白蛋白 ,并观察第 6周肾组织病理改变。结果 :氯沙坦治疗组与对照组相比 ,尿蛋白排泄量明显减少 (P <0 .0 1) ,血肌酐、尿素氮水平下降 (P <0 .0 1) ,肾小球增生、硬化程度明显减轻。结论 :氯沙坦可减轻5 / 6肾切除鼠的肾功能损害 ,延缓残余组织肾小球硬化的进展。     

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.