维生素A对弹性蛋白酶所致肺气肿大鼠肺组织MMP-2、MMP-9的影响

目的 观察维生素A对弹性蛋白酶所致肺气肿大鼠肺组织基质金属蛋白酶2,9(MMP-2和MMP-9)的影响,探讨维生素A防治肺气肿的可能机制.方法 Wistar大鼠24只,随机分为3组:对照组、模型组、维生素A组,每组8只.模型组,维生素A组采用弹性蛋白酶气管内滴入的方法复制肺气肿模型,正常饲养4周后,维生素A组用维生素A(10 万 u/kg·d-1)给大鼠灌胃,连续给药4周后观察各组大鼠的病理学变化,免疫组织化学染色测定MMP-2、MMP-9相对阳性面积.结果 与对照组比较,模型组平均肺泡数(MAN)减少、平均肺泡面积(MAA)、平均肺泡直径(MAD)增加(P均< 0.01),MMP-2 和MMP-9相对阳性面积增加(P均< 0.01).与模型组比较,维生素A组MAN增加(P ＜ 0.05)、MAA 和MAD均减少(P均＜ 0.01),MMP-2 和MMP-9相对阳性面积均减小(分别P ＜ 0.05、P ＜ 0.01).结论 维生素A对弹性蛋白酶所致大鼠肺气肿有一定治疗作用,作用机制可能与抑制MMP-2、MMP-9的表达而减少肺组织中弹性基质的降解有关.     

维甲酸对弹性蛋白酶诱导的大鼠肺气肿的干预作用及其与MMP-9和TIMP-1变化之间的关系

目的 观察维甲酸对弹性蛋白酶诱导的大鼠肺气肿的干预作用及其与MMP-9和TIMP-1变化之间的关系,探讨维甲酸可能的作用机制.方法 雄性Wistar大鼠21只,随机分为3组:对照组、模型组和维甲酸组,每组7只.模型组及RA组大鼠气管内滴入弹性蛋白酶复制肺气肿模型,RA组同时给予RA腹腔注射进行干预.25d后,光镜观察各组大鼠肺组织的病理改变,计算机辅助图像分析系统测量肺组织石蜡切片中平均肺泡数、平均肺泡面积、平均内衬间隔,免疫组化方法观察各组大鼠肺组织基质金属蛋白酶(MMP-9)及其组织抑制因子(TIMP-1)的蛋白表达情况.结果 模型组与对照组比较,平均内衬间隔(MLI)、平均肺泡面积(MAA)增加(P<0.01),平均肺泡数(MAN)减少(P<0.01).模型组MMP-9和TIMP-1的表达与对照组比较明显增强(P<0.01),且MMP-9/TIMP-1比值失衡;RA组与模型组比较.平均内衬间隔(MLI)、平均肺泡面积(MAA)减少(P<0.01)、平均肺泡数(MAN)增加(P<0.01).维甲酸组MMP-9和TIMP-1的表达与模型组比较明显减少(P<0.01).结论 维甲酸能够抑制弹性蛋白酶诱导的肺气肿的发生和发展,可使肺气肿时增多的MMP-9、TIMP-1下降,使其比值趋于平衡.     

AECA、VEGF在自身免疫性肺气肿大鼠中的表达及甲泼尼龙琥珀酸钠的干预效果

目的观察抗血管内皮细胞抗体(AECA)、血管内皮细胞生长因子(VEGF)在自身免疫性肺气肿大鼠中的表达及甲泼尼龙琥珀酸钠对其干预效果,为临床慢性阻塞性肺疾病(COPD)的发病机制和防治提供理论依据。方法采用随机数表法将30只SD大鼠分为对照组、模型组、干预组,每组10只。采用人脐静脉内皮细胞建立自身免疫性肺气肿大鼠模型组,在自身免疫性肺气肿大鼠腹腔内注入甲泼尼龙琥珀酸钠建立干预组,对照组仅接受完全弗式佐剂腹腔内注射。21 d后处死所有大鼠。采用酶联免疫吸附法测定3组大鼠血清、支气管肺泡灌洗液(BALF)中AECA、VEGF水平。对肺组织行苏木精-伊红(HE)染色,观察其形态学改变,计算肺平均内衬间隔(MLI)和平均肺泡数(MAN)。采用TUNEL法检测肺泡隔细胞凋亡情况,计算肺泡隔细胞凋亡指数(AI)。结果模型组MLI较对照组高,MAN较对照组低,干预组MLI较模型组低,MAN较模型组高,差异有统计学意义(均P<0.05)。模型组AI高于对照组,血清和BALF中AECA水平高于对照组,VEGF水平低于对照组,干预组AI低于模型组,血清及BALF中AECA水平低于模型组,VEGF水平高于模型组,差异有统计学意义(均P<0.05)。模型组、干预组大鼠血清和BALF中AECA水平与VEGF水平呈负相关,AECA水平与AI呈正相关,VEGF水平与AI呈负相关(均P<0.05)。结论 AECA、VEGF参与自身免疫性肺气肿大鼠肺泡隔细胞凋亡,甲强龙可能通过影响AECA、VEGF水平减少肺泡隔细胞凋亡,进而抑制肺气肿的形成。     

重组腺病毒Ad-HGF对烟熏大鼠肺气肿肺组织细胞凋亡的抑制作用

目的通过构建大鼠肺气肿模型,观察携带肝细胞生长因子基因的重组腺病毒（Ad-HGF）对肺组织细胞凋亡的抑制作用。方法40只Wistar大鼠随机分为4组：正常对照组（A组）、肺气肿组（B组）、肺气肿＋Ad～HGF组（C组）和肺气肿＋Ad—GFP组（1）组）;采用烟熏法建立大鼠肺气肿模型。造模成功后,A组正常饲养,B组给予0．5ml生理盐水灌注治疗,C组给予1×10^9 pfu Ad-HGF,D组给予1×10^9 pfuAd-GFP：干预14天后处死各组动物,取D组大鼠部分肺组织作常规冰冻切片,荧光显微镜下观察目的基因的表达;取A、B、C5-组大鼠肺组织制作病理切片,观察并计算平均肺泡面积（MAA）、平均内衬间隔（MLI）、平均肺泡数（MAN）;采用脱氧核糖核酸末端转移酶介导的dUTP缺口末端标记（TUNEL）技术对大鼠肺实质凋亡细胞的阳性细胞率（AI）进行检测。结果与A组相比,B组、C组大鼠的肺组织都存在不同程度的肺气肿病理改变;Ad—HGF治疗纽MAA和MLI均小于模型组、MAN大于模型组,差异有统计学意义（P〈O．05）;Ad—HGF治疗组肺组织细胞凋亡指数（AI）低于模型组,差异有统计学意义（P〈0．05）。结论重组腺病毒Ad—HGF对烟熏大鼠肺气肿肺组织细胞凋亡有抑制作用。     

间充质干细胞移植减轻大鼠肺气肿和肺泡壁细胞凋亡机制探讨

目的 研究骨髓间充质干细胞(mesenchymal stem cells,MSCs)移植在肺气肿大鼠肺泡壁细胞凋亡和肺气肿的发展过程中的作用.方法 36只雌性Lewis大鼠被随机分为正常对照组12只,肺气肿组12只,肺气肿+MSCs移植组12只.处理8周后处死大鼠,评估肺组织形态学;ELISA方法检测肺泡灌洗液(BALF)中血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)水平;Western blot法检测肺组织VEGF和血管内皮细胞生长因子受体-2(VEGF receptor 2,VEGFR2)蛋白表达;TUNEL法评估肺泡壁细胞凋亡指数.结果 在肺气肿组和肺气肿+MSCs移植组可以观察到大鼠肺气肿样改变.肺气肿+MSCs移植组与肺气肿组相比肺气肿样改变减轻.在这两组之间肺平均内衬间隔(MLI)、单位面积平均肺泡数(MAN)、平均肺泡面积(MAA)差异均有统计学意义(均P＜0.05).肺气肿+MSCs移植组肺泡壁细胞凋亡指数低于肺气肿组.肺气肿+MSCs移植组肺泡灌洗液中VEGF水平明显高于肺气肿组,而且肺组织中VEGF与VEGFR2水平也明显高于肺气肿组.结论 MSCs移植肺气肿大鼠,可以通过逆转VEGF和VEGFR2表达减少来减轻肺泡壁细胞凋亡和肺气肿的发生.     

培土生金法对慢性阻塞性肺疾病大鼠膈肌细胞增殖与凋亡的影响

【目的】观察培土生金法(加味陈夏六君子汤)对慢性阻塞性肺疾病(COPD)模型大鼠膈肌细胞增殖与凋亡的影响。【方法】将40只Wistar大鼠随机分为空白组、模型组、中药高剂量组(71.82 g·kg-1·d-1)、中药低剂量组(17.96 g·kg-1·d-1),采用气管内注入脂多糖(LPS)联合香烟烟熏法造模,观察各组大鼠一般情况及体质量变化;苏木素—伊红(HE)染色镜下观察大鼠膈肌病理变化,免疫组织化学法检测增殖细胞核抗原(PCNA)在膈肌中的表达,并计算增殖指数(PI)。TUNEL法检测膈肌细胞凋亡情况,并计算凋亡指数(AI)及PI/AI值。【结果】与空白组比较,模型组大鼠体质量增长缓慢(P0.01),膈肌细胞凋亡指数显著升高(P0.01),PI/AI值显著下降(P0.01);与模型组比较,中药高剂量组大鼠体质量增长迅速(P0.01),细胞凋亡指数显著降低(P0.01),PI/AI值显著升高(P0.01)。【结论】培土生金法治疗COPD的作用与其能维持细胞增殖/凋亡平衡,减少COPD大鼠膈肌细胞凋亡有关。     

气管内一次性注入胰弹性蛋白酶复制兔肺气肿模型

目的:探索一种较为简单且能有效复制中、重度兔肺气肿模型的实验方法。方法:健康雄性新西兰白兔18只,随机均分为对照组和模型组。麻醉动物后,行气管插管(盲插),然后模型组气管内滴入胰弹性蛋白酶3ml(2000U/㎏),对照组气管内滴入生理盐水3ml作为对照,测定各组肺功能,血气分析及取肺组织做光、电镜形态学观察,图文半定量分析。结果:实验第10天时,模型组有1只死亡。实验第42天,已形成明显中度全小叶型肺气肿,血气分析及肺平均内衬间隔(MIL)、平均肺泡数(MAN)与对照组比较有明显差异(P<0.05),肺功能各项指标符合中度肺气肿。结论:气管内一次性注入胰弹性蛋白酶可简便而有效地复制兔肺气肿模型。     

新辅助化疗对直肠癌细胞凋亡与增殖的影响

目的:探讨新辅助化疗(FOLFOX方案)对直肠癌细胞凋亡与增殖的影响。方法:选择进展期直肠癌患者76例,随机分为两组:常规手术组和新辅助化疗 手术组,各38例。分别应用TUNEL法和免疫组织化学染色法检测直肠癌细胞的凋亡(AI)与增殖(PI),并计算二者之间的比值(AI/PI)。结果:新辅助化疗 手术组与单纯手术组AI、PI差异具有统计学意义(P<0.01),AI/PI差异有统计学意义(P<0.01)。结论:新辅助化疗(FOLFOX方案)可明显促进直肠癌细胞凋亡并抑制其增殖。     

血管内皮生长因子干预烟熏大鼠肺气肿的实验研究

目的:探讨血管内皮生长因子(VEGF)对烟熏大鼠肺气肿病变的修复作用。方法:Wistar大鼠24只,随机分为VEGF组、对照组和健康对照组。VEGF组、对照组用烟熏气管内滴入猪胰弹性蛋白酶制作肺气肿模型,健康对照组气管内滴入生理盐水作为对照,3个月后模型成功。VEGF组大鼠气管内滴入VEGF,对照组和健康对照组滴入生理盐水,每周1次,共3次。4周后测大鼠体重,肺泡形态学变化。结果:VEGF组与对照组相比平均肺泡数明显增加(P<0.05)、平均肺泡间隔和平均肺泡面积减小(P<0.05)。结论:VEGF在一定程度上可以修复肺气肿病变。     

弹性蛋白酶诱发大鼠肺气肿模型的实验研究

目的 :观察弹性蛋白酶气管内滴入复制大鼠肺气肿模型的可靠性。方法 :Wistar大鼠 3 0只随机分为两组 ,正常对照组和模型组 ,每组各 15只。模型组采用弹性蛋白酶气管内滴的方法复制实验性肺气肿模型 ,2 5天后观察各组大鼠的体重、肺体积和病理学变化 ,免疫组化法观察增殖细胞核抗原 (PCNA)的表达情况。结果 :模型组体重和肺体积分别为 ( 3 3 6± 16) g、( 5 .1± 0 .6)cm3,与对照组 ( 3 5 2± 15 ) g、( 4.3± 0 .4)cm3比较差异有显著性 (P<0 .0 1) ;模型组的平均肺泡面积和平均内衬间隔分别为 ( 3 745± 679) μm2 和 ( 5 5 .0 3± 8.2 3 ) μm ,与正常对照组( 195 4± 3 44 ) μm2 、( 42 .0 2± 5 .98) μm比较差异有显著性 (P <0 .0 1) ;PCNA指数对照组为 ( 2 0± 4) ,模型组为 ( 5 7± 6) ,(P <0 .0 1) ,差异显著。结论 :弹性蛋白酶气管内滴入可以诱发大鼠肺气肿模型     

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.