低氧性肺动脉高压大鼠肺内表皮生长因子受体的表达

目的 了解低氧肺动脉高压时肺内表皮生长因子受体(EGFR)与肺血管重建的关系.方法 将20只雄性Wistar大鼠分为低氧性肺动脉高压组(低氧组)(n=10)和正常对照组(n=10),肺动脉高压组以常压低氧复制大鼠肺动脉高压模型,以微导管法测定各组大鼠肺动脉压,采用免疫组织化学和原位杂交法检测各组大鼠肺内EGFR蛋白和EGFRmRNA的表达,对肺组织切片进行图像分析.结果 低氧3周后,低氧组大鼠形成明显的肺动脉高压,管壁增厚,管腔狭窄,低氧组大鼠肺动脉压(2.86±0.39)kPa、右心室肥厚指数[RV/(LV+S)]为(43.53±3.38)％、管壁厚度占外径的百分比(WT％)为(35.24±11.2)、管壁面积占血管总面积的百分比(WA％)为(55.09±12.38),分别与正常对照组(1.35±0.28)kPa、(23.68±3.48)％、(23.63±9 74)％和(41.62±12.83)％相比明显升高(P＜0.01);肺小动脉EGFR蛋白免疫阳性染色在低氧组大鼠为(1.48±0.07),与正常对照组( 1.09±0.02)相比明显增强(P＜0.01),低氧组大鼠EGFRmRNA阳性染色为(1.43±0.05),与正常对照组(1.10±0.04)相比明显增强(P＜0.01).结论 低氧所致EGFR的合成增多在低氧性肺血管重建和肺动脉高压的发病过程中起一定的作用.     

低氧大鼠肺内血管内皮细胞生长因子表达与肺血管重建的关系

目的　了解低氧性肺动脉高压时肺内血管内皮生长因子 (VEGF)与肺血管重建的关系。方法　将 2 0只雄性 Wistar大鼠分为低氧性肺动脉高压组 (n=10 )和对照组 (n=10 )两组 ,肺动脉高压组以常压低氧建立大鼠肺动脉高压模型。以微导管法测定各组大鼠肺动脉压 ,采用免疫组织化学染色法检测模型大鼠肺内 VEGF的表达 ,对肺组织切片进行图象分析。结果　低氧 3周后 ,肺动脉高压组大鼠形成明显的肺动脉高压 ,肺小动脉壁细胞数增多 ,管壁增厚和管腔狭窄 ,管壁厚度占外径的百分比 (WT%)为 31.4%± 2 .6 %,管壁面积占血管总面积的百分比 (WA%)为 5 2 .8%± 3.4%,分别与正常对照组 16 .0 %± 1.8%和 2 8.7%± 2 .3%相比明显升高 (P<0 .0 1) ;肺小动脉内膜的 VEGF免疫阳性染色在低氧大鼠组为 2 .5 1± 0 .2 5 ,与正常对照组 1.2 7± 0 .15相比明显增强 (P<0 .0 1) ,低氧大鼠组 VEGF免疫阳性染色强度与 WT%和 WA%呈明显正相关 (r分别为 0 .792和 0 .785 ,P <0 .0 1)。结论　低氧所致 VEGF的合成增多在低氧性肺血管重建和肺动脉高压的发病过程中起一定的作用。     

Rho激酶在低氧大鼠肺小动脉表达的研究

目的探讨Rho激酶（ROCKⅠ和ROCKⅡ）在慢性低氧大鼠肺小动脉产生和表达的变化及其在低氧性肺动脉高压形成过程中的作用。方法将36只健康雄性SD大鼠随机分为正常组、低氧1d、3d、1周、2周和3周组,每组6只。低氧处理为常压间断低氧,每天8h,各低氧组分别低氧1d、3d、1周、2周和3周。采用微导管法测定大鼠平均肺动脉压（mPAP）。分离和称量大鼠右心室（RV）及左心室加室间隔（LV＋S）重量,计算出RV／（LV＋S）。应用免疫组化法测定大鼠肺组织Rho激酶蛋白的表达,原位杂交法测定Rho激酶mRNA的表达。结果大鼠mPAP、RV／（LV＋S）随低氧时间延长出现升高趋势（P〈0．05）。正常组与各低氧组的肺小动脉壁的管壁厚度占外径的百分比（WT％）和管壁面积占血管总面积的百分比（WA％）均随低氧时间的延长出现升高趋势,低氧3周组大鼠的WT％和WA％均高于正常组（P〈0．05）。ROCKⅠ、ROCKⅡ免疫组化阳性染色强度和ROCKⅠ mRNA、ROCKⅡmRNA原位杂交阳性染色强度随着低氧时间的延长均出现升高趋势,低氧3周组ROCKⅠ、ROCKⅡ免疫组化阳性染色和ROCKⅠmRNA、ROCKⅡmRNA原位杂交阳性染色均显著高于正常组（P〈0．05）。ROCKI免疫组化、ROCKⅠmRNA原位杂交、ROCKⅡ免疫组化及ROCKⅠmRNA原位杂交阳性染色强度均与mPAP、wA％和wT％呈正相关（r分别为0．404、0．267和0．263;0．500、0．263和0．260;0．490、0．295和0．286;0．579、0．251和0．254,P均〈0．05）。结论低氧可导致Rho激酶产生和表达增加。Rho激酶可能通过促进肺小动脉收缩和肺小动脉重构参与低氧性肺动脉高压的发生。     

低氧大鼠肺内酪氨酸激酶受体flk-1表达与肺血管重建

目的　评价酪氨酸激酶受体 flk- 1在低氧性肺血管重建中的变化和作用。方法　以常压间断低氧建立大鼠肺动脉高压模型 ,以微导管法测定大鼠肺动脉压 ,采用免疫组织化学染色法检测模型大鼠肺内 flk- 1的表达 ,对肺组织切片进行图象分析。结果　低氧 3周后 ,大鼠形成明显的肺动脉高压、肺小动脉壁细胞数增多 ,以及管壁增厚和管腔狭窄 ,表现为管壁厚度占外径的百分比 (WT% )和管壁面积占血管总面积的百分比 (WA% )明显升高 (P<0 .0 1) ;肺小动脉内膜的 flk- 1免疫阳性染色在低氧大鼠组明显增强 (P<0 .0 1) ,与 WT%和 WA%呈明显正相关 (r分别为 0 .714和 0 .738,P<0 .0 1)。结论　慢性低氧介导 flk- 1表达增多 ,可能在低氧性肺血管重建和肺动脉高压的发病过程中起一定的作用     

CTGF在低氧性肺血管重建中的作用

目的:通过建立低氧性肺动脉高压大鼠模型,探讨结缔组织生长因子(CTGF)在大鼠低氧性肺血管重建中的作用。方法:通过间断常压低氧法建立大鼠低氧性肺动脉高压模型,用右心导管法测定平均肺动脉压(mPAP);称重计算右心室肥厚指数[RV/(LV S)];肺组织切片经HE染色后图像分析技术定量检测大鼠肺小动脉的形态改变;免疫组织化学染色法测定肺小动脉管壁CTGF蛋白表达,并经图像分析半定量检测其表达强度。结果:3周后,低氧组大鼠的mPAP、RV/(LV S)、反映管壁增厚的管壁厚度占血管外径的百分比和管壁面积占血管总面积的百分比两指标均高于正常对照组(P<0.01)。正常对照组大鼠肺小动脉壁CTGF蛋白未表达;低氧组大鼠肺小动脉壁外膜CTGF明显表达,内膜略有表达,中膜几乎无表达。结论:常压低氧3周可成功建立肺动脉高压大鼠模型,CTGF与低氧性肺血管重建密切相关。     

瑞舒伐他汀对肺动脉高压大鼠肺动脉平滑肌细胞凋亡影响的实验研究

目的观察瑞舒伐他汀对左向右分流肺动脉高压大鼠肺血管重构、肺动脉平滑肌细胞凋亡以及bcl-2蛋白表达的影响,研究瑞舒伐他汀拮抗肺高血流性肺动脉高压的可能机制。方法 36只SD大鼠随机分为分流给药组、分流组、对照组,观察各组大鼠平均肺动脉压(mPAP)、右室肥厚指数(RVI)、肺小动脉中膜厚度百分比(WT)、肺小动脉管壁面积百分比(WA)的变化,TUNEL法检测大鼠肺动脉平滑肌细胞凋亡情况,Western Blot法检测大鼠肺组织中凋亡抑制蛋白bcl-2的表达情况。结果分流给药组较分流组大鼠mPAP、RVI、WT、WA值均有所下降,分流给药组大鼠凋亡的肺动脉平滑肌细胞明显增多,而bcl-2蛋白的表达减弱。结论瑞舒伐他汀能明显抑制肺高血流性模型大鼠肺动脉压力升高及肺血管重构,而抑制大鼠肺组织中bcl-2蛋白的表达,促进肺动脉平滑肌细胞凋亡是其可能的机制。     

尼可地尔对大鼠低氧性肺高压的影响

目的:探讨线粒体ATP敏感性钾通道开放剂(mitoKATPCO)尼可地尔(nicorandil)对大鼠低氧性肺动脉高压的影响?方法:将40只大鼠随机分成对照组(C组)?低氧组(H组)?低氧+尼可地尔组(N组)与低氧+尼可地尔+5-羟基葵酸盐组(HD组),后3组置于常压低氧仓内,每周6 d,每天8 h,持续4周后测定各组大鼠平均肺动脉压(mPAP),右心肥厚指数RV/(V+S),HE染色观察肺小动脉血管壁的病理变化并检测增殖相关抗原(PCNA)?结果:慢性缺氧可诱导大鼠mPAP及RV/(LV+S)升高,大鼠肺小血管增厚重构,PCNA表达增加,尼可地尔可显著抑制上述变化,且该效应可被线粒体KATP(mitoKATP)通道特异性阻断剂5-羟基葵酸盐阻断?结论:尼可地尔通过开放mitoKATP通道降低肺动脉压,拮抗右心肥厚,并抑制肺血管增殖重构,治疗低氧性肺高压?     

尿紧张素-Ⅱ在低氧性肺动脉高压大鼠肺内的分布变化

目的　观察低氧性肺动脉高压大鼠肺组织中尿紧张素 Ⅱ (urotensin ,U Ⅱ )的变化 ,探讨U Ⅱ在低氧性肺动脉高压发病机制中的作用。方法　将 2 0只雄性Wistar大鼠随机分为两组 ,低氧组经常压低氧处理 3周 ,建立大鼠低氧性肺动脉高压模型 ,采用免疫组化法观察低氧性肺动脉高压大鼠肺组织中U Ⅱ的变化。用图像分析技术检测大鼠肺小动脉的形态改变 ,包括肺小动脉外径、内径、管壁厚度、血管总面积及管壁面积 ,并计算MT % (管壁厚度占外径的百分比 )和MA % (管壁面积占血管总面积的百分比 ) ,并对U Ⅱ免疫组化染色切片进行灰度扫描 ,以评价阳性染色的程度。结果　低氧组大鼠肺小动脉出现管壁增厚 ,管腔狭窄 ,反映管壁增厚的两个指标MT %和MA %分别为 3 6.73± 3 .72和 63 .15±5 .3 ,与对照组的 17.44± 2 .89和 3 1.5 7± 4.9相比 ,具有显著性差异 (P =0 .0 0 0 )。U Ⅱ在低氧大鼠肺动脉壁的表达明显增强 ,且主要分布在肺动脉的内皮细胞上。经灰度扫描肺动脉壁的U Ⅱ阳性程度为 2 .81± 0 .5 4,与对照组的 1.72± 0 .3 7相比 ,具有显著性差异 (P =0 .0 0 0 ) ,且与MT %和MA %呈直线正相关关系 (MT %∶r =0 .90P =0 .0 0 3 ,MA %∶r =0 .92P =0 .0 0 2 )。结论　低氧大鼠肺内U Ⅱ明显增多 ,这与低氧性肺动脉     

阿魏酸钠对低氧性肺动脉高压大鼠肺血管平滑肌细胞Caspase-3,Bcl-2表达的影响

目的:探讨阿魏酸钠(SF)对低氧性肺动脉高压大鼠肺小动脉平滑肌细胞Caspase-3,Bcl-2表达的影响.方法:将21只Wistar大鼠随机分为对照组(n=7)、低氧组(n=7)及干预组(n=7)(胃饲SF并进行低氧处理).以常压低氧复制肺动脉高压模型,右心导管插入法检测平均肺动脉压(mPAP);分别称量大鼠右心室(RV)和左心室加室间隔(LV+S)的质量,计算出右心室肥厚指数RV/(LV+S);图像分析法测量肺小动脉管壁厚度和面积,计算出肺小动脉管壁厚度指标即管壁厚度占血管外径的百分比(WT%)和管壁面积占血管总面积的百分比(WA%);进行Caspase-3,bcl-2免疫组化染色,比较各组Caspase-3和bcl-2积分光密度值(IOD).结果:①与对照组比较,低氧组大鼠平均肺动脉压(mPAP)明显升高(P<0.05)、肺小动脉WT%,WA%以及RV/(LV+S)明显增加(P<0.05).与低氧组比较,干预组大鼠平均肺动脉压(mPAP)明显降低(P<0.05)、肺小动脉WT%,WA%以及RV/(LV+S)明显减少(P<0.05).②与对照组和低氧组分别比较,干预组Caspase-3IOD值均显著增高(...     

洛沙坦预防低氧性肺动脉高压的实验研究

目的 探讨血管紧张素Ⅱ受体拮抗剂洛沙坦对低氧性肺动脉高压的预防作用。方法 将30只Wistar大鼠分为对照组、低氧组和低＋洛沙坦组,以常压低氧建立大鼠肺动脉高压模型,采用微导管法测定平均肺动脉压,对肺组织切片进行图象分析。结果 经3周常压低氧处理后,低氧组大鼠形成了明显的肺动脉高压、肺小动脉管壁增厚和右心室肥厚;低氧＋洛沙坦处理组,其平均肺动脉压升高、肺血管壁增厚以及右心室肥厚程度均明显低于低氧组,P＜0.01。结论 血管紧张素和系统在低低氧性肺动脉高压发病过程中发挥重要的作用,洛沙坦对低氧性肺动脉高压具有明显的预防作用。     

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.     

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.