乌司他丁对急性重症胰腺炎大鼠血清TNF-α及IL-1β水平的影响

目的:探讨乌司他丁对重症胰腺炎大鼠TNF-α和IL-1β水平的影响。方法:胰胆管逆行注射牛磺胆酸钠制作大鼠SAP模型,wistar大鼠60分为3组,乌司他丁治疗组,重症胰腺炎(SAP)组,对照(NC)组,每组20只。术后6h对各组大鼠行血清淀粉酶、TNF-α及IL-1β的检测,并取各组大鼠胰腺组织标本行病理学观察。结果:乌司他丁治疗组血清淀粉酶、TNF-α及IL-1β较SAP组明显降低,胰腺组织坏死程度减轻(P0.05)。结论:乌司他丁可调节细胞因子水平,改善胰腺组织微循环,减轻全身炎症反应,对SAP有治疗作用。     

罗格列酮对急性胰腺炎大鼠肺组织HMGB1和JAK2/STAT3信号通路调控的研究

目的:探讨罗格列酮对SAP模型大鼠早期炎症介质、晚期炎症因子HMGB1和JAK2/STAT3信号通路表达的调控。方法:72只SD大鼠随机分为3组,假手术组(SO组,n=24)、胰腺炎模型组(SAP组,n=24)和罗格列酮组(ROSI组,n=24)。SAP组在麻醉后两次腹腔内注射左旋精氨酸,ROSI组在SAP建模后30min静脉注射罗格列酮针6mg/kg,SO组在麻醉后腹腔注射等体积生理盐水。3组术后6、12和24h分别采样(每个时间点n=8),测定血清TNF-α、IL-1β、IL-6等早期炎症因子含量,观察大鼠肺组织病理改变,测定肺髓过氧化物酶和肺干/湿重比,检测肺组织HMGB1、JAK2、STAT3蛋白表达情况。结果:ROSI组大鼠的血清IL-1β、IL-6、TNF-α含量较SAP组明显降低,差异有统计学意义(P<0.05);与SAP组比较,ROSI组的肺组织病理损伤减轻,肺MPO表达降低,干/湿重比下降,HMGB1、JAK2、STAT3蛋白表达明显减低,差异有统计学意义(P<0.05)。结论:罗格列酮能抑制肺组织JAK2、STAT3表达,降低早期、晚期炎症因子表达,减轻SAP导致的肺损伤。     

重症急性胰腺炎大鼠肝损伤HMGB 1/TLR4mRNA的表达

目的研究重症急性胰腺炎(SAP)大鼠肝损伤中高迁移率族蛋白B1(HMGB1)和Toll样受体(TLR)4mRNA的表达。方法采用十二指肠闭襻法制作大鼠SAP模型。50只动物分为假手术组(S组)、胰腺炎组(P组)。P组于建模后6、12、24、48 h分批剖杀,S组于术后6 h剖杀。观察血清淀粉酶、CRP、ALT和AST及肝组织IL-6和TNF-α的变化,RT-PCR方法检测各组不同时点肝组织HMGBl mRNA和TLR4 mRNA的表达。结果与S组比较,P组血清淀粉酶、CRP、ALT、AST、肝组织IL-6和TNF-α浓度升高(P<0.05)。与S组比较,P组大鼠6 h肝组织TLR4mRNA表达开始增高,术后12 h肝组织TLR4 mRNA表达迅速达到峰值(P<0.05);同时,P组HMGB1 mRNA于12 h快速上升,24～48 h时一直保持上升趋势(P<0.05);结论SAP大鼠肝组织内HMGB1和TLR4的基因表达上调;其表达增高可能在SAP肝损伤的发生、发展中起重要作用。     

参皂苷Rg3对重症急性胰腺炎大鼠血清炎症介质的影响

目的 观察人参皂苷Rg3对重症急性胰腺炎(SAP)大鼠炎症介质的影响.方法 取60只SD大鼠,随机取10只作为空白对照组,另50只腹腔注射雨蛙素联合脂多糖诱导建立重症急性胰腺炎模型后,随机分成SAP模型组、地塞米松组和高、中、低三个剂量的人参皂苷Rg3组;地塞米松组和人参皂苷Rg3组分别灌胃给予地塞米松或人参皂苷Rg3;建模24小时后处死大鼠,收集胰腺组织与血清,ELISA法检测血清IL-1β、TNF-α、IL-6的表达水平,干湿法检测胰腺水肿指数,血生化仪检测血清淀粉酶水平.结果 与空白对照组比较,SAP模型组胰腺组织水肿指数、血清淀粉酶、IL-1β、TNF-α、IL-6表达水平显著增高(P<0.05);与SAP模型组比较,地塞米松组、不同剂量人参皂苷Rg3干预组胰腺组织水肿指数、血清淀粉酶、IL-1β、TNF-α、IL-6表达水平显著降低(P<0.05).结论 人参皂苷Rg3可通过抑制炎症因子减轻SAP大鼠的炎症反应.     

重症急性胰腺炎时大鼠血IL-1，IL-6，IL-8，TNF—α水平及B淋巴细胞百分比的变化

目的 探讨大鼠重症急性胰腺炎(severe acute pancreatitis, SAP)时血IL-1、IL-6、IL-8、TNF-α水平及B淋巴细胞百分比的变化.方法 将雄性SD大鼠50只随机分为两组,假手术组(n=25)开腹后仅轻揉胰腺及十二指肠.SAP组(n=25)开腹后向大鼠胰管注射牛磺胆酸钠建立SAP动物模型.于实验前和实验后2、4、6、12 h 经颈静脉取血,采用双抗体夹心ELISA法测定血清中白细胞介素-1 (IL-1)、白细胞介素-6 (IL-6)、白细胞介素-8 (IL-8)、肿瘤坏死因子-α(TNF-α)水平,单克隆抗体致敏花环法测定淋巴细胞悬液中B淋巴细胞的百分比.结果 造模术后SAP组IL-1、IL-6、IL-8、TNF-α水平均升高 (P<0.01); 术后SAP组B淋巴细胞比例明显降低并随SAP时间增加而逐渐降低(P<0.01).结论 SAP时血IL-1、IL-6、IL-8、TNF-α水平明显升高,可能是加重SAP病情的损伤性因子;B淋巴细胞比例明显降低,提示SAP时大鼠体液免疫功能减退.     

重症急性胰腺炎中HMGB1的变化及丹参干预的实验研究

目的探讨重症急性胰腺炎(severe acute pancreatitis,SAP)时血浆高迁移率组蛋白-1(high mobilitygroup box-1,HMGB1)水平的时相变化,以及中药丹参注射液的干预作用。方法 SD大鼠120只,随机均分为对照组(C)、重症急性胰腺炎组(P)、丹参治疗组(T)。用5%牛磺胆酸钠逆行胰胆管注射制备重症急性胰腺炎(SAP)模型,用酶联免疫吸附试验(ELISA)检测各组动物不同时点的血浆HMGB1水平。结果与对照组相比,SAP组大鼠血浆HMGB1水平在建模后12 h开始有明显升高,24 h和48 h仍维持在较高水平(P0.05);丹参治疗组HMGB1水平明显低于SAP组(P0.05)。结论 HMGB1可能作为晚期炎症因子参与了SAP的全身炎症反应,丹参注射液可明显降低HMGB1指标,对SAP的病程发展具有一定的阻断作用。     

早期胆汁外引流对重症急性胰腺炎大鼠血清高迁移率族蛋白B1和血红素加氧酶1表达的影响

目的探讨胆汁外引流对重症急性胰腺炎(SAP)大鼠血清炎性因子高迁移率族蛋白B1(HMGB1)、肿瘤坏死因子α(TNF-α)和抑炎因子血红素加氧酶1(HO-1)表达的影响。方法健康SD大鼠54只,将其随机分为假手术组(SOG组)、模型未引流组(SAP组)和模型引流组(BDG组);SAP组与BDG组采用逆行十二指肠穿刺胰胆管途径注射4%牛磺胆酸钠方法构建大鼠SAP模型;SOG组只行开腹手术,并行早期胆汁外引流处理。建模成功后3组研究对象于第3、6、和12小时各处死大鼠6只,采用酶联免疫法(ELISA)检测血清细胞因子HMGB1、TNF-α和HO-1的表达。结果建模成功后第3、6和12小时SAP组TNF-α水平均显著高于SOG组(P0.05);建模成功后第3、6和12小时,SAP组与BDG组TNF-α水平比较差异均有统计学意义(P0.05);建模成功后第3、6和12小时,SAP组HMGB1水平均高于SOG组(P0.05);建模成功后第6小时,SAP组与BDG组HMGB1水平比较差异有统计学意义(P0.05);建模成功后第3、6和12小时BDG组HO-1水平均显著高于SAP组(P0.05);建模成功后第3、6和12小时,SAP组与SOG组HO-1水平比较差异均有统计学意义(P0.05)。结论早期胆汁外引流胆汁可显著抑制机体促炎细胞因子HMGB1和TNF-α的释放,提高抑炎因子HO-1的表达,从而改善SAP模型大鼠炎症状况。     

血清TNF-α、sTNF-1R及 IL-10在急性胰腺炎中的变化及意义

目的探讨肿瘤坏死因子-α(TNF-α)与抗炎细胞因子——可溶性肿瘤坏死因子受体-1(sTNF-1R)、白细胞介素-10(IL-10)在急性胰腺炎中的变化及意义。方法对26例轻症胰腺炎(MAP组)、22例重症胰腺炎(SAP组)患者分别于入院第1、4、7、14天进行血清TNF-α、sTNF-1R及IL-10的检测。同时设立30例健康体检者为对照组,并对以上数据进行统计学处理。结果两组患者血清TNF-α、sTNF-1R、IL-10水平均在第1天达到高峰,然后逐步下降。MAP组血清TNF-α水平在第7天降至对照组水平,SAP组在第14天才降至对照组水平,而SAP组血清TNF-α水平在第1、4、7天水平远高于MAP组(P<0.01)。两组sT-NF-1R水平变化趋势与TNF-α相似,但第14天SAP组sTNF-1R仍维持较高水平。第1天MAP组血清IL-10水平远高于SAP组(P<0.01)。结论 TNF-α与sTNF-1R、IL-10均参与了急性胰腺炎的炎症反应过程,可以作为临床预测胰腺炎严重程度的指标。     

瑞香素对大鼠重症急性胰腺炎促炎因子的影响及意义

目的:研究瑞香素对大鼠重症急性胰腺炎(SAP)血清中肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β)含量的影响,探讨瑞香素对大鼠SAP的保护作用。方法:用5%牛磺胆酸钠1ml/kg经胆胰管逆行注射建立SAP模型。分为四组:假手术组(SO组)、药物对照组(SO-D组)、模型组(SAP组)和干预组(SAP-D组)。造模后分别在3,6,12h处死大鼠,对胰腺组织HE染色后观察病理损伤情况,用ELISA法测定血清中TNF-α和IL-1β的水平。结果:胰腺组织病理学评分,以及血清促炎细胞因子TNF-α和IL-1β水平,SAP-D组均较SAP组明显降低(P<0.05),SO组与SO-D组之间无明显差别(P>0.05)。结论:瑞香素具有较强抗炎活性,对大鼠SAP具有明显保护作用。     

重症胰腺炎大鼠血清TNF-α浓度的变化及与肺损伤的关系

目的:测定实验性重症胰腺炎大鼠血清TNFα浓度,并探讨其与肺损伤的关系.方法:SD大鼠55只,随机分为SAP组(再分为0.5、3、6、12、24h组,各组n=8)和对照组(n=15).采用逆行胰胆管注射5%牛磺胆酸钠复制重症胰腺炎模型,取肺组织行病理观察,ELISA法测血清TNF-α浓度.结果:SAP各组血清淀粉酶水平与对照组比较,P＜0.05;血清TNF-α浓度除0.5h组外,其余各组与对照组比较,均有显著性差异(P＜0.05),至12h达高峰,随后下降.结论:血清TNF-α浓度在急性胰腺炎早期即显著升高并可能与肺损伤密切相关.     

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.