碱性成纤维细胞生长因子对大鼠局灶性缺血再灌注损伤脑组织Caspase-3表达及细胞凋亡的影响

目的 :探讨碱性成纤维细胞生长因子 (bFGF)对大鼠脑缺血再灌注损伤后神经细胞凋亡和Caspase 3表达的影响。方法 :应用线栓法制作大鼠局灶性脑缺血再灌注模型 ,大脑中动脉阻塞 1h再灌注损伤 2 4h ,用TUNEL法和免疫组化法分别检测假手术组、缺血再灌注组和bFGF治疗组的凋亡细胞数和Caspase 3阳性细胞数。结果 :假手术组偶见凋亡细胞和Caspase 3阳性细胞 ,缺血再灌注组凋亡细胞数和Caspase 3阳性细胞数分别为 2 5 .4 6± 5 .5 7和1 8.6 0± 3.77,bFGF组凋亡细胞数和Caspase 3阳性细胞数分别为 1 6 .72± 5 .6 3和 1 0 .5 4± 2 .0 4。与缺血再灌注组比较 ,bFGF组凋亡细胞数和Caspase 3阳性细胞数显著降低 (P <0 .0 5和P <0 .0 5 )。结论 :Caspase 3表达下降可能是bFGF减少大鼠脑缺血再灌注损伤后细胞凋亡的分子机制之一     

大鼠脑缺血再灌注后血管内皮细胞Bcl—2和P53蛋白的表达

（1）目的 探讨了大鼠局灶性脑缺血再灌注损伤后血管内皮细胞Bcl-2和p53蛋白表达的变化规律。（2）方法 将40只Wistar大鼠随机分为10组,采用免疫组织化学法检测假手术组和脑缺血再灌注后2h,6h,12h,1d,2d,3d,7d,14d和21d组血管内皮细胞Bcl-2和P53蛋白的表达,（3）结果 脑缺血再灌注后2缺血周围区内皮细胞Bcl-2蛋白开始表达,12h-1d达高峰,之后逐渐下降,至14d接近假手术组水平。脑缺血再灌注后6h缺血周围区P53蛋白开始表达,1-2d达高峰,之后逐渐下降,至7d与假手术组已无显著性差异。（4）结论 Bcl-2和P53蛋白参与缺血再灌注后血管内皮细胞凋亡的调节。     

葛根素对脑缺血-再灌注损伤细胞凋亡和p53表达的影响

目的 观察葛根素对预处理后大鼠局灶性脑缺血时海马区凋亡细胞和p53蛋白表达的影响.方法 利用大脑中动脉栓线阻断法制作大鼠局灶性脑缺血2h后再灌注损伤模型.72只SD大鼠随机分为假手术组（S组）、缺血再灌注组（IR组）和葛根素组（P组）.依术后处死动物时间不同,每组分为3个亚组（n=8）.用免疫组化法检测p53蛋白和TUNEL法检测凋亡细胞的表达.结果 P组P2h组p53蛋白表达增高,P24h组显著增高,P72h组p53蛋白表达有所下降,但仍低于IR组（P＜0.01）;P组凋亡细胞数显著低于相应IR组（P＜0.01）.结论 葛根素对大鼠局灶性脑缺血再灌注损伤具有保护作用,其作用机制可能与葛根素抗细胞凋亡、下调p53蛋白有关.     

大鼠脑缺血再灌注后NGF mRNA和NGFR的表达及其意义

①目的　观察脑缺血再灌注对大鼠神经生长因子信使核糖核酸 (NGFmRNA)和神经生长因子受体(NGFR)表达的影响。②方法　线栓法制作大鼠脑缺血再灌注模型 ,采用原位杂交方法检测脑组织NGFmRNA的变化 ,免疫组织化学方法检测脑组织NGFR的变化。③结果　NGFmRNA在缺血周围区的表达 ,缺血再灌注 4h、1d、3d和 7d组较对照组明显增高 (t=9.3 2～ 13 9.5 0 ,P <0 .0 0 1) ;在缺血中心区 ,再灌注 4h组NGFmRNA表达也明显增高 (t=3 3 .0 9,P <0 .0 0 1)。NGFR在缺血周围区的表达 ,缺血再灌注 4h、1d、3d和 7d组较对照组明显增高 (t =17.2 8～ 40 .83 ,P <0 .0 0 1) ;在缺血中心区 ,再灌注 4h组较对照组明显增高 (t=13 .5 6,P <0 .0 1)。④结论　NGF与NGFR表达参与缺血再灌注后脑组织的保护作用     

促红细胞生成素对大鼠全脑缺血再灌注后海马蛋白激酶B表达的影响

目的观察促红细胞生成素(EPO)对大鼠全脑缺血再灌注后海马CA1区蛋白激酶B表达的影响,进一步探讨EPO脑保护作用的机制.方法采用改良的Pulsinelli四血管阻断方法制作大鼠全脑缺血再灌注模型.将SD大鼠随机分为4组:正常组、假手术组、缺血再灌注组和EPO治疗组.各组动物分别于缺血15min再灌注6h、24h、48h、72h、7d断头取脑.鼠脑灌注及固定后制作石蜡切片,HE染色观察海马的病理变化,用TUNEL方法检测海马CA1区神经细胞凋亡,免疫组织化学SP法观察磷酸化蛋白激酶B(p-PKB)表达.另外再取24只大鼠分为4组:正常组、假手术组、缺血再灌注组和EPO治疗组,应用Y型迷宫法对缺血再灌注7 d的大鼠进行缺血后学习和记忆功能的测定.结果 (1)TUNEL染色:假手术组48 h、72h可见个别阳性细胞.缺血再灌注组于再灌注24h可见少量阳性细胞;再灌注48h可见较多TUNEL阳性细胞,72h出现大量TUNEL阳性细胞,7d明显减少.EPO治疗组TUNEL阳性细胞在各时间点明显少于缺血再灌注组[(948.6±91.0)个vs(502.7±97.3)个,P＜0.01].(2)认知功能变化:全脑缺血再灌注后7 d大鼠学习能力降低,尝试次数明显增多(P＜0.01).EPO治疗组尝试次数减少,有显著性差异(P＜0.01).学习能力测试后24h记忆功能测定,结果发现缺血再灌注组成绩明显低下,EPO处理组可改善缺血造成的大鼠记忆功能障碍[(20.06±3.85)s vs(12.93±3.04)s,P＜0.01].(3)p-PKB免疫组化染色:缺血再灌注组于再灌注6h即出现p-PKB明显表达增高,72h达高峰,7 d明显下降.EPO治疗组于再灌注6h、48h、72h、7 d,p-PKB蛋白表达较缺血再灌注组增高[(25.42±3.86)vs(11.64±2.13),P＜0.01].(4)相关分析:TUNEL阳性细胞与p-PKB蛋白表达则呈负相关,而大鼠学习能力与海马CA1区存活神经细胞数呈正相关趋势.结论 EPO能减少大鼠脑缺血再灌注损伤后海马CA1区神经细胞的坏死和凋亡,减轻脑缺血再灌注损伤后大鼠学习、记忆功能障碍.EPO可能通过增强海马神经细胞p-PKB的表达,发挥神经细胞保护作用.     

腺苷预处理对大鼠局灶性脑缺血再灌注损伤Bcl-2蛋白表达的影响

目的观察腺苷预处理对大鼠局灶性脑缺血再灌注损伤的改善作用及其脑保护机制。方法线栓法建立大鼠局灶性脑缺血2h后再灌注损伤模型，通过HE染色在光镜下观察神经细胞损伤变化，免疫组化法检测Bcl-2蛋白的阳性表达。结果光镜下，假手术组（F组）神经细胞结构正常，腺苷预处理组（AP组）和缺血再灌注组（IR组）均有不同程度的缺血再灌注损伤，腺苷预处理组较缺血再灌注组损伤轻；假手术组Bcl-2蛋白表达极弱，缺血再灌注组和腺苷预处理组在脑缺血再灌注后2h在缺血半暗带周围出现Bcl-2蛋白弱阳性表达，6h后表达增多，24h达到高峰，72h开始减少。与假手术组相比，腺苷预处理组和缺血再灌注组Bcl-2蛋白阳性细胞数显著增多（P〈0．05）；与缺血再灌注组相比，腺苷预处理组Bcl-2蛋白阳性细胞数显著增多（P〈0．05）。结论腺苷对大鼠局灶性脑缺血再灌注损伤有保护作用，腺苷可通过上调Bcl-2蛋白的表达发挥脑保护作用。     

低氧预处理大鼠缺血再灌注脑组织缺氧诱导因子-1α的表达

目的 :探讨低氧预处理对脑缺血再灌注组织缺氧诱导因子 - 1α表达的影响。方法 :SD大鼠 80只随机分为 3组 ,即假手术组 10只 ,缺血再灌注组 35只 ,低氧预处理组 35只。低氧预处理组连续吸入V(O2 ) :V(N2 ) =8:923h作低氧预处理 ,12h后再经插线左大脑中动脉栓塞 (MCAO)作缺血再灌注模型 ,缺血再灌注组不行低氧预处理 ,在大鼠大脑中动脉缺血 3h再灌注后 2h ,6h ,12h ,2 4h ,4 8hTTC法测定脑梗死体积 ,同时采用免疫组织化学方法观察低氧预处理对缺血再灌注大鼠脑组织缺氧诱导因子 - 1α蛋白表达的影响。结果 :与缺血再灌组相比 ,低氧预处理组大鼠的脑梗死体积明显降低 ,缺氧诱导因子 - 1α蛋白的表达增加 ,差异有统计学意义 (P <0 .0 5 )。结论 :低氧预处理对脑缺血再灌注有明显的保护作用 ,缺氧诱导因子 - 1α表达增加可能是其机制之一     

脑缺血再灌注后内皮细胞凋亡与p53表达的关系

目的 探讨大鼠局灶性脑缺血再灌注损伤后血管内皮细胞凋亡及其与p53蛋白表达的关系。方法 采用原位末端标记法和免疫组化法分别观察脑缺血再灌注不同时间后血管内皮细胞凋亡和p53蛋白的表达。结果 脑缺血再灌2h在缺血周围区即有凋亡内皮细胞出现，12－24h达高峰，之后逐渐下降，至21d与假手术组已无显性差异。脑缺血再灌注6h在缺血周围区p53蛋白开始表达，24－48h达高峰，之后逐渐下降，至7d与假手术组已无显性差异。p53蛋白表达高峰时间迟于内皮细胞凋亡24h。结论 脑缺血再灌注损伤中凋亡是血管内皮细胞的死亡形式之一，p53表达蛋白参与缺血再灌注后血管内皮细胞凋亡机制的调节。     

当归对大鼠局灶性缺血脑组织细胞凋亡的作用

目的 :应用大鼠局灶性脑缺血模型观察当归对脑缺血损伤的治疗作用及其机制。方法 :TTC染色计算脑缺血梗塞灶体积。原位末端标记法观察细胞凋亡并计算凋亡率和凋亡指数。免疫组化观察凋亡相关蛋白Bcl 2及Bax蛋白表达的变化。结果 :①与单纯缺血再灌组相比 ,当归治疗组TTC染色显示当归治疗组脑缺血梗塞区体积缩小 (P <0 .0 5 ) ,凋亡率和凋亡指数较单纯缺血再灌组有明显下降 (P <0 .0 1 ) ,Bcl 2蛋白表达与单纯缺血再灌组无差异 (P >0 .0 5 ) ,而Bax蛋白表达显著减少 (P <0 .0 1 )。②缺血 2h再灌 4 8h组较缺血 2h再灌 2 4h组 ,凋亡细胞明显减少 (P <0 .0 1 )。结论 :①当归能抑制Bax蛋白的表达 ,减少脑缺血区细胞凋亡的发生 ,这是当归治疗大鼠局灶性脑缺血损伤的可能机制之一。②缺血 2h再灌 4 8h ,脑缺血神经细胞迟发性损伤已开始减轻     

缺血再灌注大鼠脑皮质Bcl-2、Bax和p53的动态表达

目的：探讨大鼠脑缺血再灌注损伤早期凋亡相关基因Bcl-2、Bax和p53 mRNA和蛋白表达的动态变化,为研究脑缺血再灌注损伤过程中的神经保护机制提供实验依据。方法：选择健康成年雄性Sprague-Dawley大鼠52只,随机分为假手术对照组（12只)和缺血再灌注2、3、6、8、12 h组(每组8只)。采用插线法制作大鼠大脑中动脉栓塞后再灌注模型;采用原位末端转移酶标记技术（TUNEL）检测脑缺血再灌注不同时间点神经细胞凋亡的变化;通过反转录聚合酶链式反应（RT-PCR）和免疫组织化学法观察凋亡相关基因Bcl-2、Bax和p53表达的动态变化。结果：TUNEL染色显示,缺血再灌注组大鼠脑缺血周围区,再灌注2 h后凋亡细胞开始出现,6~12 h明显增多。Bcl-2、Bax和p53 mRNA和蛋白的表达随着缺血再灌注时间的延长呈增高趋势,Bcl-2蛋白高表达的细胞形态相对完整,Bax和p53蛋白高表达的细胞受损严重。Bcl-2 mRNA和蛋白的表达较Bax和p53出现的早。结论：Bcl-2蛋白的表达对神经细胞具有保护作用,早期调控促进Bcl-2的表达并减少Bax和p53的表达,对降低缺血再灌注过程中神经细胞的损伤有重要作用。     

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.