干扰素γ对实验性肺纤维化大鼠血清IL-4、SP-A含量的影响

目的观察干扰素γ(IFN-γ)对实验大鼠肺纤维化的治疗作用,初步探讨其抗纤维化的作用机制.方法大鼠随机分为正常对照组、模型组、IFN-γ治疗组.气管内注入博莱霉素造模后,于当天开始每日给药,分别于1、3、7、14、28d处死,取肺组织和血清,行电镜观察及HE染色,ELISA测定血清IL-4含量及Western Blotting测定表面活性蛋白A(SP-A)含量.结果 IFN-γ组与模型组比较,肺纤维化程度明显减轻,血清IL-4、SP-A含量显著减低(P<0.01).结论 IFN-γ对博莱霉素所引起的肺纤维化具有明显的治疗作用,可能通过调节失衡的Th细胞及减轻肺组织损伤发挥抗纤维化作用.     

ω-3鱼油脂肪乳对博莱霉素致肺纤维化大鼠的干预作用

目的 探讨ω-3鱼油脂肪乳对博莱霉素致肺纤维化大鼠的干预作用及其机制.方法 将清洁级雄性大鼠90只随机分成生理盐水对照组(对照组)、博莱霉素所致大鼠肺纤维化模型组(模型组)和博莱霉素所致大鼠肺纤维化+ω-3鱼油脂肪乳干预组(干预组).在第7、14、21天分别取左肺下叶供免疫组化检测转化生长因子β1(TGF-β1)、γ干扰素(IFN-γ)表达,右肺下叶供HE染色病理观察;用ELISA双抗体夹心法测定各组大鼠血清白细胞介素-4(IL-4)和IFN-γ含量.结果 (1)干预组大鼠肺泡炎、肺纤维化程度均较轻;(2)模型组大鼠在第7、14、28天的肺组织TGF-β1染色呈强阳性,IFN-γ染色较淡;而干预组TGF-β1、IFN-γ染色及定量表达则相反(P<0.01),且第7、14、28天TGF-β1定量表达逐渐减少,IFN-γ逐渐增加(P<0.05).(3)模型组大鼠第7、14、28天血清IL-4含量较高,IFN-γ含量较低;而干预组则相反(P<0.01),且第7、14、28天IL-4含量逐渐降低,IFN-γ含量逐渐升高(P<0.05).结论 ω-3鱼油脂肪乳可以下调大鼠肺组织TGF-β1 的表达,降低其血清含量和IL-4含量;上调肺组织IFN-γ的表达,增加其血清含量,从而减轻肺纤维化.     

甘草酸二铵对博莱霉素致肺纤维化大鼠的治疗作用

目的 探讨甘草酸二铵治疗博莱霉素致肺纤维化大鼠的作用及其机制.方法 将清洁级大鼠40只随机分成对照组、博莱霉素所致大鼠肺纤维化组(模型组)、甘草酸二铵组和地塞米松(DXM)组.DXM组和甘草酸二铵组滴注博莱霉素致肺纤维化动物模型第28天开始,连续14 d腹腔内分别注射DXM注射液3 mg·kg-1·d-1和甘草酸二铵150 mg·kg-1·d-1;第15天取左肺下叶用于免疫组化检测转化生长因子β1(TGF-β1)、γ干扰素(IFN-γ)表达,右肺下叶经HE染色病理观察.用ELISA双抗体夹心法测定各组大鼠血清TGF-β1、白细胞介素4(IL-4)、IFN-γ含量.结果 (1)甘草酸二铵组与DXM组大鼠肺纤维化程度均较轻微;(2)模型组大鼠肺组织TGF-β1染色呈强阳性反应,IFN-γ染色较淡,而甘草酸二铵组与DXM组TGF-β1、IFN-γ染色及定量表达则相反(P<0.01);且甘草酸二铵组与DXM组相比,TGF-β1定量表达有差异(P<0.05).(3)模型组大鼠血清TGF-β1、IL-4含量较高,IFN-γ含量较低;而甘草酸二铵组和DXM组则相反(P<0.01).结论 甘草酸二铵可以下调大鼠肺组织TGF-β1、IL-4的表达,降低其血清含量;上调肺组织IFN-γ的表达,增加其血清含量,从而减轻肺纤维化.     

干扰素-γ对大鼠肺纤维化转录因子T-bet/GATA3的影响

目的通过检测IFN-γ干预博来霉素诱导大鼠肺纤维化时各组转录因子T-bet/GATA3 mRNA表达的变化,从而探讨IFN-γ干预肺纤维化的机制。方法腹腔注射博莱霉素(BLM)诱导大鼠肺纤维化动物模型。雄性SD大鼠随机均分为对照组(C)、博来霉素致伤组(BLM1、BLM2、BLM4)及博来霉素+IFN-γ治疗组(BLM-IFN1、BLM-IFN2、BLM-IFN4)。对各组肺组织纤维化的程度行病理半定量评估,检测各组外周血单个核细胞转录因子T-bet/GATA3 mRNA的表达。结果 BLM1及BLM-IFN1组肺组织病理改变以肺泡炎为主,BLM2组兼有肺泡炎和纤维化病变,BLM4组以肺纤维化为主,BLM+INF2及BLM+INF4组中发现肺纤维化程度减轻。半定量RT-PCR法显示各博莱霉素致伤组大鼠T-bet基因的表达均低于C组而GATA3基因的表达则高于C组(P均<0.01),IFN-γ干预后,BLM+INF1、BLM+INF2及BLM+INF4 3组T-bet基因的表达增加,与同时点的博来霉素致伤组对比均有显著性差异,GATA3基因表达在2周后显著减少,甚至低于C组。结论 IFN-γ干预能减轻博来霉素所致的肺纤维化作用,其机制可能与逆转了T-bet/GATA3失衡有关。     

C型钠尿肽对博莱霉素介导的小鼠肺纤维化的保护作用

目的 观察C型钠尿肽对博莱霉素诱导的小鼠肺纤维化的抑制作用.方法 经气管注射博莱霉素制作肺纤维化小鼠模型,将实验动物分为三组,包括空白对照组、博莱霉素处理组(BLM组)和C型钠尿肽干预组(CNP组),于第1、3、7、14天进行肺泡灌洗,回收各组肺泡灌洗液并检测炎性细胞和IL-1β量;记录药物处理后小鼠死亡率;第14天处死小鼠,取肺组织制备病理切片后评价各组模型肺组织形态学变化,测定肺组织匀浆中羟脯氨酸含量.结果 BLM组的肺纤维化和炎症反应较明显,死亡率高;CNP组与BLM组相比,肺纤维化程度减轻,炎性细胞较少,组织羟脯氨酸含量减低,死亡率下降.结论 C型钠尿肽能减轻博莱霉素诱导的小鼠肺纤维化,与干预炎症因子的产生及纤维化过程有关.     

大鼠肺纤维化转录因子T—bet／GATA3的表达及其与相关细胞因子的关系

目的探讨大鼠肺纤维化时转录因子T—bet／GATA3的表达及与细胞因子IFN-γ、IL-12、IL-4的相关性。方法腹腔注射博莱霉素（BLM）制作大鼠肺纤维化动物模型。将40只雄性SD大鼠随机均分为对照组、BLM1周组（BLM1组）、BLM2周组（BLM2）及BLM4周组（BLM4组）。病理半定量评估各组大鼠肺组织纤维化的程度,并检测其外周血单个核细胞转录因子T—bet／GATA3mRNA的表达及血清细胞因子IFN—γ、IL-12、1L-4的含量。结果（1）BLM1组肺组织病理改变以肺泡炎为主,BLM2组兼有肺泡炎和纤维化病变,BLM4组以肺纤维化为主。病理半定量分析BLM1组与BLM4组差异有统计学意义（P〈0.01）,BLM2组与BLM1组及BLM4组比较亦有统计学意义（均P〈0.05）。（2）半定量RT—PCR法显示各BLM组大鼠T—bet基因的表达均低于对照组而GATA3基因的表达则高于对照组（均P〈0.01）。（3）各BLM组血清IFN—γ及IL-12含量均显著低于对照组而IL-4含量均高于对照组（均P〈0．01）。结论BLM致大鼠肺纤维化时血清IFN—γ及IL-12含量下降,IL-4含量升高,呈Th2细胞因子优势型变化。BLM致大鼠肺纤维化时转录因子T—bet表达减少,GATA3表达增加,T—bet／GATA3的改变参与了Th1/Th2的失衡,与肺纤维化的发生有关。     

罗格列酮对博莱霉素诱导大鼠肺纤维化的影响

目的 采用博莱霉素(BLM)腹腔注射诱导大鼠肺纤维化的模型,探讨过氧化物体增殖活化受体γ激动剂(PPAR-γ)--罗格列酮对肺纤维化的治疗作用.方法 经腹腔给予BLM致大鼠肺纤维化模型,将实验大鼠随机分为3组,即对照组、模型组(BLM组)、干预组(罗格列酮组).于造模完成后第21天处死大鼠,取肺组织制备病理切片,行HE,Masson染色后评价各组模型肺组织形态学变化,测定肺组织匀浆中羟脯氨酸(HYP)含量.结果 BLM组的肺组织炎症反应较明显;罗格列酮组与BLM组相比,肺组织HYP下降,肺纤维化程度减轻.结论 罗格列酮能通过活化PPAR-γ信号通路减轻大鼠肺纤维化,机制与干预炎症因子产生及纤维化过程有关.     

特发性肺纤维化小鼠肺内IL-11及其受体表达

目的：观察肺纤维化小鼠肺组织白细胞介素-11(interleukin-11,IL-11)及其受体的表达。方法：以C57BL/6 小鼠为研究对象,随机分为对照组和博莱霉素(bleomycin,BLM)组(每组6只),BLM组采用一次性气管注射BLM复制 特发性肺纤维化小鼠模型,对照组注射50 μL PBS。21 d后取小鼠肺组织。采用HE染色观察小鼠肺组织形态改变,real- time PCR法检测小鼠肺组织IL-11及其受体的基因表达,Western印迹法和免疫组织化学染色检测小鼠肺组织IL-11受体 表达,ELISA法检测小鼠血清IL-11的含量。在细胞实验中,分别采用real-time PCR和Western印迹法检测转化生长因子 β1(transforming growth factor-β1,TGF-β1)处理后小鼠成纤维细胞中IL-11受体的基因和蛋白表达。结果：HE染色结果显 示BLM注射21 d后小鼠肺组织纤维化改变明显,肺组织IL-11 mRNA表达和血清IL-11含量上调(P<0.05);肺纤维化小鼠 肺内IL-11受体的基因和蛋白表达均明显上调(P<0.05)。细胞实验结果表明TGF-β1可明显升高小鼠成纤维细胞IL-11受 体的基因和蛋白表达(P<0.05)。结论：肺纤维化小鼠肺内IL-11及其受体表达上调,可能是肺纤维化发生发展的重要机 制之一。     

血红素加氧酶-1参与博莱霉素致大鼠肺纤维化机制

目的 观察血红素加氧酶-1(HO-1)对博莱霉素(BLM)致大鼠肺纤维化模型病理生理改变的影响,探讨HO-1参与BLM致大鼠肺纤维化发病机制.方法 通过BLM复制大鼠肺纤维化模型,同时设立生理盐水(NS)组和HO-1抑制剂锌原卟啉(Znpp)组.检测支气管肺泡灌洗液(BALF)中细胞计数及中性粒细胞百分比、转化生长因子-禾β(TGF-β)和总胆红素含量;检测肺组织中还原型谷胱甘肤(GSH)和羟脯氨酸 (HYP)含量.结果 HO-1水平被抑制后,不能改善炎症细胞浸润肺组织,但可以有效抑制TGF-β、总胆红素和HYP水平,减少GSH耗竭.结论 HO-1通过其氧化损伤和促纤维化机制促进BLM致大鼠肺纤维,但不参予早期炎症反应.     

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.