重组Klotho蛋白对骨髓来源M1型巨噬细胞向M2型巨噬细胞转变的影响

目的:探究重组Klotho蛋白对小鼠骨髓来源M1型巨噬细胞向M2型巨噬细胞表型转变的影响.方法:分离并鉴定小鼠骨髓来源性巨噬细胞,用巨噬细胞集落刺激因子(M-CSF)诱导骨髓间充质干细胞(BMSC)转变为巨噬细胞M0,流式细胞术和细胞免疫荧光鉴定细胞,普通光镜观察M0细胞形态.将成熟骨髓来源巨噬细胞细胞M0分成LPS组、LPS+Klotho组和空白组.LPS组用 100ng/mL LPS处理,LPS+Klotho组给与 1 μg/mL Klotho和 100ng/mL LPS+LPS共同处理.RT-qPCR检测巨噬细胞极化相关分子:M1亚型巨噬细胞相关标志物(IL-1β、IL-6、iNOS)mRNA和M2亚型巨噬细胞相关标记物(Arg-1、IL-10)mRNA表达.Western blotting检测iNOS、Arg-1蛋白表达水平,细胞免疫荧光检测细胞肿瘤坏死因子(TNF-a)和Arg-1蛋白含量.结果:流式细胞术显示骨髓巨噬细胞纯度为98.4％,光镜和细胞免疫荧光显示骨髓巨噬细胞呈现不规则形态.与空白组相比,LPS组IL-6、iNOS、IL-1β的mRNA和iNOS、TNF-a蛋白相对表达量明显提高(P＜0.001).而与LPS组相比,LPS+Klotho组降低Ml亚型巨噬细胞标记物IL-6、iNOS、IL-1β的mRNA和iNOS、TNF-α蛋白相对表达量(P＜0.001),显著提高了M2型巨噬细胞标志物Arg-1、IL-10 mRNA和Arg-1的蛋白的表达(P＜0.001).结论:重组Klotho蛋白可促进骨髓来源性巨噬细胞由Ml表型向M2表型转变.     

橙皮苷调控Jagged1/Notch1通路对巨噬细胞极化及细支气管炎小鼠肺损伤的影响

目的 探究橙皮苷对呼吸道合胞病毒(RSV)细支气管炎模型小鼠肺损伤的影响及可能的作用机制。方法 构建RSV细支气管炎小鼠模型,采用随机数字表法将60只BALB/c小鼠分为对照组、模型组、低剂量橙皮苷组(18 mg/kg)、高剂量橙皮苷组(36 mg/kg)、高剂量橙皮苷(36 mg/kg)+Jagged1(1 mg/kg)组,每组12只,给予相应剂量的药物进行干预,对照组和模型组给予等量生理盐水。收集小鼠支气管肺泡灌洗液(BALF),并分离肺泡巨噬细胞;ELISA检测BALF中白细胞介素(IL)-4、IL-6、肿瘤坏死因子α(TNF-α)、IL-10的水平;流式细胞术检测巨噬细胞M1/M2型极化;qRT-PCR、Western blot检测肺组织诱导型一氧化氮合酶(iNOS)、精氨酸酶1(Arg-1)、Jagged1和Notch1的mRNA和蛋白表达水平。结果 与对照组相比,模型组小鼠BALF中IL-4、IL-6、TNF-α、M1型巨噬细胞比例、肺组织炎症评分和黏液分泌评分以及iNOS、Jagged1、Notch1 mRNA和蛋白表达水平均显著升高(P均<0.001),而IL-1...     

基于miR-34a/SIRT1轴探讨奥沙拉秦钠治疗溃疡性结肠炎的作用机制

目的探讨奥沙拉秦钠对溃疡性结肠炎的治疗效果及其与微小RNA-34a/沉默信息调节因子1（SIRT1）（miR-34a/SIRT1）轴在氧化应激方面的可能作用机制。方法80只雄性小鼠随机分为对照组、模型组、（奥沙拉秦钠）低、中、高剂量组、阴性转染组、miR-34a过表达组、高剂量+miR-34a过表达组（HG组）,每组各10只。观察各组小鼠生长情况并计算疾病活动指数（DAI）评分;采用HE染色检测小鼠结肠组织病理变化并计算病理HI评分;qRT-PCR法检测小鼠结肠组织中miR-34a、SIRT1mRNA表达水平;硝酸还原酶法检测各组小鼠结肠组织氧化应激水平;ELISA法检测各组小鼠血清炎性因子水平;Westernblot法检测小鼠结肠组织中SIRT1蛋白表达水平。结果与对照组相比,模型组小鼠DAI评分、HI评分、结肠组织中miR-34a表达水平、丙二醛（MDA）、髓过氧化物酶（MPO）、一氧化氮（NO）、诱导型一氧化氮合酶（iNOS）水平、血清IL-1β、IL-6、TNF-α、IL-8水平均明显升高（均P＜0.05）,结肠组织中SIRT1mRNA、蛋白表达、SOD、谷胱甘肽过氧化物酶（GSH-Px）水平均明显降低（均P＜0.05）。与模型组相比,低、中、高剂量组小鼠DAI评分、HI评分、结肠组织中miR-34a表达水平、MDA、MPO、NO、iNOS水平、血清IL-1β、IL-6、TNF-α、IL-8表达水平均明显降低,结肠组织中SIRT1mRNA、蛋白表达、SOD、GSH-Px水平均明显升高（均P＜0.05）。与高剂量组相比,低、中剂量组小鼠DAI评分、HI评分、结肠组织中miR-34a表达水平均明显升高,结肠组织中SIRT1mRNA表达水平均明显降低（均P＜0.05）,miR-34a过表达组与HG组小鼠结肠组织MDA、MPO、NO、iNOS水平、IL-1β、IL-6、TNF-α、IL-8表达水平及结肠组织miR-34a表达水平均明显升高,结肠组织SOD、GSH-Px水平及SIRT1蛋白表达水平均明显降低（均P＜0.05）。与阴性转染组相比,miR-34a过表达组小鼠结肠组织MDA、MPO、NO、iNOS水平、IL-1β、IL-6、TNF-α、IL-8表达水平及结肠组织miR-34a表达水平均明显升高,结肠组织SOD、GSH-Px水平及SIRT1蛋白表达水平均明显降低（均P＜0.05）。结论奥沙拉秦钠可下调miR-34a并上调SIRT1表达,进而有效抑制溃疡性结肠炎小鼠氧化应激反应及炎症反应实现治疗目的。     

巨噬细胞内IKKα在小鼠肾脏缺血再灌注损伤炎症反应中的作用

目的：研究巨噬细胞内IKKα在小鼠肾脏缺血再灌注损伤(ischemic reperfusion injury,IRI)炎症反应中的作用。方法：分别将20只8～10周龄健康雄性C57BL/6小鼠(WT小鼠)、20只8～10周龄健康雄性巨噬细胞内IKKα基因敲除即IKKαMKO小鼠(KO小鼠)随机分为假手术(Sham)组和肾脏缺血再灌注损伤(IRI)组,分别构建模型。苏木素-伊红(HE)染色法观察肾脏组织形态学改变及炎症细胞浸润情况,免疫组织化学法检测肾组织抑炎因子白介素-10(IL-10)、促炎因子白介素-6(IL-6)、增殖指标Ki67、巨噬细胞标记物CD68、M1型巨噬细胞标记物诱导型一氧化氮合酶(iNOS)、M2型巨噬细胞标记物精氨酸酶1(Arg-1)的表达,Western blot检测IL-10、IL-6的表达变化。结果：HE染色结果表明IRI组较Sham组肾组织结构损伤明显及炎症浸润增加。免疫组化结果表明肾脏IRI后IL-10和IL-6均呈高表达,IL-10表达随时间延长而递增,IL-6表达随时间延长而递减。与WT-RI组相比,KO-IRI组小鼠肾脏病理损伤加重(P＜0.01),IL-6、CD68、iNOS表达显著增加(P＜0.01),IL-10(P＜0.01)、Ki67(P＜0.05)表达显著降低。结论：巨噬细胞内IKKα基因敲除加重了小鼠肾脏缺血再灌注损伤的炎症反应且不利于肾脏修复,这可能与增加了肾脏早期巨噬细胞(M1型为主)浸润及促进了炎症反应有关。     

木香烃内酯对溃疡性结肠炎小鼠肠道免疫炎症的影响及其机制

目的:观察木香烃内酯对溃疡性结肠炎(UC)小鼠肠道菌群及Th1/Th2失衡的影响.方法:将50只C57BL/6小鼠随机分为空白组、模型组、柳氮磺胺吡啶(SASP)组,木香烃内酯低剂量、高剂量组,每组10只.采用DSS法建立UC模型,SASP组及木香烃内酯低、高剂量组连续灌胃相应药物7 d,观察小鼠一般状况、疾病活动度指数(DAI)和结肠长度变化;HE染色观察结肠组织形态学改变;细菌培养鉴定法比较粪便中大肠杆菌、双歧杆菌、乳酸杆菌的数量;ELISA测定血清IL-6、TNF-α、IL-10水平,RT-qPCR检测结肠组织IL-6、TNF-α、IL-10的mRNA表达;Western blotting检测结肠组织TLR-4、NF-κB p65的蛋白表达.结果:与空白组比较,模型组小鼠DAI评分显著升高,结肠长度明显缩短,结肠黏膜结构损伤严重,炎性细胞浸润明显,粪便中大肠杆菌数值明显增多,双歧杆菌及乳酸杆菌数量明显减少,IL-6、TNF-α血清和结肠组织的mRNA水平明显升高,IL-10水平和mRNA表达显著降低,结肠组织中TLR-4、NF-κBp65的蛋白表达量明显增多(均P＜0.01);与模型组相比,木香烃内酯灌胃干预显著降低了UC小鼠DAI评分,明显增长了结肠长度,结肠组织病理损伤有效改善,粪便中大肠杆菌数值减少,双歧杆菌及乳酸杆菌数量增加,降低了IL-6、TNF-α的血清水平和结肠组织mRNA表达,升高IL-10水平和mRNA表达,同时降低了结肠组织TLR-4、NF-κB p65的蛋白表达(P＜0.01或P＜0.05).结论:木香烃内酯对UC小鼠症状具有明显的改善作用,其机制可能与改善肠道菌群状态,调节Th1/Th2细胞因子平衡,抑制TLR4/NF-κB的激活相关.     

白介素35在炎性肠疾病中的抗炎作用机制

目的: 研究IL-35在炎性肠疾病中的抗炎作用及相关机制。方法: BALB/c雌性小鼠共30只,随机分为对照组、模型组（口服4%葡聚糖硫酸钠7 d）、IL-35组（口服4%葡聚糖硫酸钠7 d,第2~5天腹腔注射IL-35 2 μg/d）,每组10只。每天对小鼠进行疾病活动指数（DAI）评分;7 d后处死小鼠,留取血清和肠道组织,观察结肠大体形态;HE染色观察各组结肠组织病理形态变化;流式细胞术检测各组结肠组织中巨噬细胞极化情况;实时定量RT-PCR检测各组结肠组织中细胞因子IL-6、TNF-α、γ干扰素（IFN-γ）、IL-10和Src同源系列2结构域的肌醇5-磷酸酶1（SHIP1）的mRNA表达量;免疫组织化学法检测各组结肠组织中SHIP1的表达及分布情况;蛋白质印迹法检测各组结肠组织中SHIP1蛋白的表达。结果: 模型组在实验过程中DAI评分较对照组增加,而IL-35组自第4天起DAI评分较模型组减少（均P < 0.01）;与对照组比较,模型组结肠明显缩短（P < 0.05）,而IL-35组的结肠长度长于模型组,但差异无统计学意义（P > 0.05）;与模型组比较,IL-35组炎症细胞浸润减少、黏膜组织炎症评分和腺窝破坏组织评分较模型组减少（均P < 0.05）;IL-35组结肠组织中促炎因子IL-6、TNF-α和IFN-γ的mRNA相对表达量较模型组减少,而抑炎因子IL-10的mRNA相对表达量较模型组增加（均P < 0.05）;与对照组比较,模型组M1型巨噬细胞比例增加（P < 0.05）,而IL-35组M1型巨噬细胞的比例较模型组减少（P < 0.05）;IL-35组小鼠结肠组织中SHIP1 mRNA和蛋白相对表达量均较模型组增加（均P < 0.05）。结论: 在炎性肠疾病中,IL-35可以通过调控SHIP1表达抑制M1型巨噬细胞极化,以及调节炎症因子的表达发挥抗炎作用。     

清肠化湿方通过激活AhR/IL-22缓解小鼠溃疡性结肠炎的作用机制研究

目的  通过构建溃疡性结肠炎(Ulcerative colitis, UC)小鼠模型, 从芳香烃受体(AhR)角度, 观察清肠化湿方对白细胞介素-22(IL-22)分泌及黏蛋白-2(MUC-2)与紧密连接蛋白(Claudin4)表达的作用, 阐述其缓解小鼠UC的作用机制。 方法  用DSS构建UC小鼠模型, 每日观察小鼠体质量、粪便形状、隐血情况, 同时进行疾病活动指数(DAI)评分。给药结束后测量小鼠结肠长度,HE染色观察结肠病理情况,qPCR检测结肠组织白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、AhR的mRNA。Western blot检测结肠MUC-2、AhR、细胞色素P4501A1酶(CYP1A1)、IL-22、Claudin4表达水平。 结果  与正常组比较, 模型组小鼠DAI评分上升(P < 0.01), 结肠长度缩短(P < 0.01), 结肠黏膜病理受损情况严重; AhR的mRNA表达下降(P < 0.05), IL-1β、TNF-α、IL-6的mRNA表达上升(P < 0.05,P < 0.01);MUC-2、AhR、CYP1A1、IL-22、Claudin4蛋白表达下降(P < 0.05, P < 0.01)。与模型组比较, 美沙拉嗪组、清肠化湿方组DAI评分降低(P < 0.01), 结肠长度变长(P < 0.01), 结肠黏膜病理情况改善; IL-1β、TNF-α、IL-6的mRNA表达下降(P < 0.05,P < 0.01);MUC-2、CYP1A1、Claudin4蛋白表达升高(P < 0.01)。与模型组比较, 清肠化湿方组AhR的mRNA表达上升(P < 0.05),AhR、IL-22蛋白表达升高(P < 0.01)。与清肠化湿方组比较, 清肠化湿方+TMF组小鼠DAI评分上升(P < 0.01);结肠长度缩短(P < 0.05);结肠黏膜病理受损情况严重; IL-1β、TNF-α、IL-6的mRNA表达上升(P < 0.01);MUC-2、AhR、CYP1A1、IL-22、Claudin4蛋白表达下降(P < 0.01)。 结论  清肠化湿方能够激活AhR, 上调CYP1A1表达, 促进IL-22生成, 抑制炎症水平, 同时增加MUC-2及Claudin4的表达, 从而缓解UC。      

干扰素调节因子4基因敲除加重缺血性脑卒中小鼠脑神经功能损伤

目的：明确缺血性脑卒中(IS)后不同区域脑组织中干扰素调节因子4(IRF4)表达水平的变化趋势并探讨其在IS后神经功能损伤中的保护作用与可能机制。方法：首先通过短暂性大脑中动脉闭塞(tMCAO)构建小鼠IS模型(包括野生型和IRF4基因敲除组),随后分别利用RT-PCR与Western Blot检测核心梗死区域、缺血半暗带与对侧正常脑组织内IRF4 mRNA与蛋白表达水平。同时利用ELISA检测缺血半暗带区域促炎细胞因子IL-1β、IL-6与TNF-α的表达水平。分别利用RT-PCR与Western Blot检测M1型巨噬细胞标志物iNOS与M2型巨噬细胞标志物Arg-1的mRNA与蛋白表达水平;随后进行神经功能评分与水迷宫试验检测逃逸潜伏期(EL),利用2,3,5-氯化三苯基四氮唑(TTC)染色检测小鼠脑梗死体积,同时利用免疫荧光染色检测细胞凋亡。结果：缺血半暗带IRF4表达水平较核心梗死区域与对侧正常脑组织均明显增加。此外,缺血半暗带促炎细胞因子IL-1β、IL-6与TNF-α表达均明显增加,且与IRF4表达水平呈明显负相关;iNOS表达明显上调且Arg-1表达显著减少。而IRF4...     

α-硫辛酸对溃疡性结肠炎小鼠Th17相关炎症因子表达影响研究

目的:探讨α-硫辛酸(α-lipoic acid,ALA)对溃疡性结肠炎小鼠Th17相关炎症因子表达的影响。方法:将雄性Balb/c小鼠(22~25g)随机分为对照组(Control)、ALA对照组(ALA)、溃疡性结肠炎组(UC)、ALA治疗组(UC+ALA)四组,每组10只,观察各组小鼠疾病活动指数(DAI)评分,比较结肠质量指数及结直肠组织病理变化;酶联免疫吸附(ELISA)检测小鼠血清中IL-17、IL-21分泌情况,RT-PCR检测结肠组织TNF-α、TGF-βmRNA表达情况。结果:结肠质量指数、DAI及组织病理学评分在对照组及ALA组中无明显差异,但在UC组中显著升高,在UC+ALA组中明显降低(P<0.05);IL-17、IL-21在对照组及ALA组小鼠血清中的水平无明显差异,但在UC组中显著升高,在UC+ALA组中明显降低(P<0.05);TNF-α、TGF-βmRNA在对照组及ALA组小鼠结肠组织中的表达水平无明显差异,但在UC组中显著升高,在UC+ALA组中明显降低(P<0.05)。结论:α-硫辛酸能够降低TNBS引起的溃疡性结肠炎小鼠IL-17、IL-21、TNF-α、TGF-β等Th17相关炎症因子的表达水平,改善炎症反应及病理损伤。     

巨噬细胞表型转换对系统性硬化症胞葬功能的调控机制研究

目的 探究巨噬细胞表型转换调控胞葬功能对系统性硬化症发生发展的影响。方法 选取健康BALB/c雌性小鼠80只，随机分为空白对照组(40只)、系统性硬化症模型组(40只)。空白对照组背部注射生理盐水0.1 mL/(200 g·d)，系统性硬化症模型组背部注射博来霉素0.1 mL/(200 g·d)，取皮肤组织进行苏木素-伊红(hematoxylin and eosin，HE)染色评价病情进展，流式细胞术检测鼠心包血细胞表面B1型清道夫受体(scavenger receptor class B1，SR-B1)、A1清道夫受体(scavenger receptor class A1，SR-A1)和整合素β5(Integrin beta-5，ITGβ5)的表达水平，RT-PCR检测巨噬细胞极化因子可诱导型一氧化氮合酶(inducible nitric oxide synthase，iNOS)、精氨酸酶-1(arginase-1，Arg-1)的mRNA水平；ELISA法检测血清炎症因子白细胞介素-17(Interleukin-17，IL-17)、白细胞介素-6(Interleukin-6，IL-6)、肿瘤坏死因子α(Tumor necrosis factor alpha，TNF-α)、基质金属蛋白酶-9(Matrix metalloproteinase-9，MMP-9)、转化生长因子β1(Transforming growth factor beta-1，TGF-β1)及胞葬桥连分子生长抑制特异性蛋白6(Growth arrest-specific 6，GAS6)、乳脂球-表皮生长因子结合因子8(Milk fat globule-EGF factor 8，MFG-E8)的表达。提取原代骨髓来源巨噬细胞，采用流式细胞术检测巨噬细胞胞葬能力(phagocytosis index，PI)。结果 注药后第7、14、21、28天，与空白对照组比较，HE染色显示系统性硬化症模型组小鼠背部表皮厚度明显增加(P＜0.05)，且模型组的皮脂腺、毛囊等皮肤附属器明显减少，脂肪层被纤维组织包绕；模型组与空白组相比，皮肤组织中M1型巨噬细胞极化标志物iNOS的mRNA表达上调、M2型巨噬细胞极化标志物Arg-1的mRNA表达下调，血清IL-17、IL-6、TNF-α、MMP-9、TGF-β1等炎症因子表达水平上调(P＜0.05)，胞葬桥连分子(GAS6、MFG-E8)表达下调(P＜0.05)，清道夫受体(SR-B1、SR-A1、ITGβ5)及PI表达下调。结论 巨噬细胞向M1型表型转换与巨噬细胞胞葬功能下降呈正相关，可能共同导致了系统性硬化症的炎症反应和疾病进展。     

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.     

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.