雷米普利酸对内外源性自由基所致离体血管内皮依赖性舒张功能影响

目的:探讨雷米普利酸(Ramiprilat)对内外源性自由基所致家兔离体胸主动脉内皮依赖性舒张功能损伤的保护作用及其作用机制。方法:采用DPPH(0.25μmol/L)或通过次黄嘌呤(HX 0.06μmol/L)和黄嘌呤氧化酶(XO 2U/L)孵育家兔离体血管环10 min,诱导血管内皮依赖性舒张功能损伤。结果:DPPH和HX+XO诱导产生氧自由基超氧阴离子(O-.2),能明显抑制胸主动脉环对乙酰胆碱(Ach)诱导的血管内皮依赖性舒张反应。用雷米普利酸(5μmol/L)预孵育血管环20 min,可明显改善DPPH和HX+XO所致血管内皮依赖性舒张反应的抑制。而预先用选择性缓激肽B2受体阻断剂HOE140(10μmol/L)孵育血管10 min,可明显抑制雷米普利酸对DPPH和HX+XO所致血管内皮依赖性舒张反应的损伤保护作用。结论:雷米普利酸对DPPH和HX+XO所致血管内皮依赖性舒张反应的损伤具有保护作用,其机制至少部分是通过激活缓激肽B2受体所介导的。     

灯盏乙素对DPPH所致血管内皮依赖性舒张功能障碍的影响

目的 研究灯盏乙素对DPPH所致血管内皮依赖性舒张功能障碍的影响．方法采用家兔胸主动脉血管环DPPH氧化损伤模型评价灯盏乙素对内皮依赖性舒张反应的影响．结果灯盏乙素能显著减轻DPPH对乙酰胆碱（Ach）诱导的血管内皮依赖性舒张反应的抑制作用．结论灯盏乙素对血管内皮依赖性舒张功能具有保护作用．     

黄芪对同型半胱氨酸诱导的大鼠胸主动脉张力损伤的保护作用

目的 探讨黄芪对同型半胱氨酸诱导的大鼠胸主动脉张力损伤的保护作用及其机制。方法 采用大鼠离体胸主动脉环灌流模型。观察不同作用浓度（0．1-3．0mmol/L）同型半胱氨酸干预60min后，对主动脉环内皮依赖性舒张作用的影响，以及超氧化物歧化酶（200U／ml）和不同浓度（10-300mg／L）黄芪对同型半胱氨酸诱导的血管环张力变化的影响。结果 预孵60min后，同型半胱氨酸呈浓度依赖性抑制主动脉环内皮依赖性血管舒张作用；以超氧化物歧化酶（200U／ml）干预30min后，可以完全逆转同型半胱氨酸对血管环的抑制作用，而30-300mg/L制作用。结论 黄芪能改善同型半胱氨酸对实验大鼠胸主动脉内皮依赖性舒张功能的抑制作用。     

白桦脂酸改善氧化应激损伤大鼠血管的内皮依赖性舒张功能

目的:研究白桦脂酸(betulinic acid,BA)舒张血管效应及抗血管氧化应激损伤的血管保护作用,并探讨其内在机制.方法:取胸主动脉进行离体灌流,用累积加药法观察BA对苯肾上腺素(phenylephrine,PE)预收缩的内皮完整血管环和去内皮血管环的舒张作用,并将血管随机分为正常对照组、BA对照组、H2O2组和BA+H2O2组,并在用PE预收缩后,检测血管环对乙酰胆碱(acetylcholine,ACh)诱导的内皮依赖性舒张反应,血管环张力变化均通过PowerLab生物信号采集系统记录.结果:BA浓度依赖性(10-7 mol/L～10-4 mol/L)舒张PE(10-6 mol/L)预收缩的内皮完整胸主动脉环,pD2值为5.61±0.18,半数有效浓度(EC50)为(2.45×10-6 )mol/L;一氧化氮合酶抑制剂左旋硝基精氨酸甲酯(L-NAME,10-4 mol/L)预处理抑制了该作用,而用吲哚美辛(10-5 mol/L)预处理则无抑制作用.但对PE预收缩的去内皮血管BA无明显舒张作用.H2O2(5×10-4 mol/L)孵育15 min,能降低ACh(10-9 mol/L～10-5 mol/L)诱导的血管舒张作用;EC50的BA孵育30 min,能抑制H2O2氧化应激损伤所致的血管内皮依赖性舒张功能下降.结论:BA具有内皮依赖性舒张血管作用,BA可以减轻H2O2诱导的大鼠胸主动脉内皮依赖性舒张功能降低,这可能与其降低血管内皮氧化应激,维持血管内皮一氧化氮活性有关.     

甘草次酸对溶血性磷脂酰胆碱损伤兔胸主动脉内皮依赖性舒张功能的保护作用

目的　为观察甘草次酸对溶血性磷脂酰胆碱损伤离体兔胸主动脉血管内皮依赖性舒张功能的保护作用及机制。方法　采用离体血管环张力实验法 ,用溶血性磷脂酰胆碱 (LPC)损伤血管内皮 ,比较使用甘草次酸前后血管环对乙酰胆碱 (Ach)的舒张比值。结果　发现甘草次酸自身对血管的舒缩功能无直接的作用 ,对LPC损伤的血管环舒张功能具有保护作用 ,舒张比从 0 .4 3± 0 .15上升到 0 .60± 0 .16(P <0 .0 2 )。结论　环加氧酶抑制剂吲哚美辛、一氧化氮合成酶抑制剂Nω-硝基 -L -精氨酸及鸟苷酸环化酶抑制剂美蓝均可阻断甘草次酸的舒张保护作用 ;甘草次酸对LPC损伤血管内皮依赖性舒张功能的保护作用可能与促进内皮细胞释放或合成一氧化氮 (NO)和前列环素 (PGI2 )有关     

二甲双胍对低密度脂蛋白诱导的大鼠血管内皮功能紊乱的改善作用

目的 研究二甲双胍是否对低密度脂蛋白损伤的大鼠血管内皮功能具有保护作用并探讨其机制.方法 一次性从大鼠舌下静脉注射天然低密度脂蛋白(n-LDL)4mg/kg诱发血管内皮细胞损伤,随后测定血管舒张功能及血脂,血清一氧化氮(NO)、丙二醛(MDA)和SOD活性.结果 单次静脉注射n-LDL能降低大鼠胸主动脉乙酰胆碱诱导的内皮依赖性舒张反应,而对硝普钠诱导的非内皮依赖性舒张反应无影响;血清NO水平及SOD活性显著降低.MDA浓度明显增高而血脂水平无明显变化.二甲双胍预处理能改善n-LDL诱导的内皮舒张功能障碍,增加血清NO水平,减少MDA生成,不改变血脂含量.结论 二甲双胍对体内LDL损伤的血管内皮功能具有保护作用.其机制可能与二甲双胍保护内皮依赖性舒张因子和抗氧化作用有关.     

牛磺酸对低密度脂蛋白所致大鼠血管内皮损伤的保护作用

目的探讨牛磺酸(Tau)对低密度脂蛋白(LDL)诱导的血管内皮损伤的保护作用与内源性一氧化氮合酶抑制物的关系。方法SD大鼠在乙醚麻醉下,舌下静脉注射人血清LDL(4 mg/kg)诱发血管内皮功能损伤。检测血中非对称性二甲基精氨酸(ADMA),丙二醛(MDA)和肿瘤坏死因子-α(TNF-α)的含量,并观察离体胸主动脉环的内皮依赖性舒张反应。结果单次静注LDL(4 mg/kg)显著抑制乙酰胆碱(ACh)诱导的内皮依赖性舒张,增加血液中ADMA,MDA和TNF-α水平。两个剂量牛磺酸(60或180mg/kg)均能显著减轻LDL所致ACh诱导内皮依赖性舒张的损伤,显著抑制ADMA、MDA和TNF-α浓度升高。结论牛磺酸对LDL诱导的血管内皮细胞损伤有保护作用,其保护作用与降低ADMA浓度有关。     

脂联素改善肥胖大鼠离体主动脉内皮依赖性血管舒张功能的实验研究

目的 研究脂联素对食物诱导的肥胖大鼠内皮依赖性血管舒张功能的影响.方法 将10只SD雄性大鼠分为2组,正常对照组予普通饲料喂养;高脂饲料组予高脂饲料喂养.6周后处死动物,将3 mm长的主动脉环置于培养皿中,分别以脂联素及脂联素加内皮一氧化氮合成酶特异性抑制剂(L-NAME)孵育离体血管环,并与空白对照比较,在器官浴槽中观察离体胸主动脉环对乙酰胆碱或硝普钠的舒张反应.结果 高脂饲料喂养的大鼠内皮依赖性舒张功能明显受损,其最大舒张程度仅为对照组的29%.脂联素组内皮依赖性血管舒张功能较高脂饲料组增加102%,脂联素加L-NAME组内皮依赖性血管舒张功能接近丧失.结论 脂联素对肥胖动物受损的血管内皮细胞具有确切的直接保护作用.     

ZnPP Ⅸ对肺动脉内皮依赖性舒张反应的影响

目的: 通过观察血红素氧化酶抑制剂锌原卟啉Ⅸ(zine protoporphyrin Ⅸ,ZnPP Ⅸ)对乙酰胆碱(acetylcholine, Ach)内皮依赖性血管舒张反应的影响,探讨内源性一氧化碳(carbon monoxide, CO)对肺血管的舒张作用.方法:取Wistar大鼠肺动脉环,制备Ach浓度效应曲线,冲洗后平衡60 min,分别加入一氧化氮(nitric oxide, NO)合成酶抑制剂L-NAME 30 μmol/L或L-NAME 30 μmol /L+ZnPP Ⅸ 10 μmol/L,孵育30 min后,重复制备Ach浓度效应曲线,观察给药前后Ach浓度效应关系的变化.结果:用去氧肾上腺素收缩肺动脉后,Ach能对内皮完整的肺动脉引起浓度依赖性舒张,血管环用L-NAME孵育后,舒张反应受抑,10-5mol/L的Ach只引起(40.3±5.1)%的舒张反应,而用ZnPP Ⅸ及L-NAME共同孵育后,舒张反应进一步受抑或消失,10-5mol/L的Ach只能引起(11.1±8.4)%的舒张反应或不引起舒张反应.结论:ZnPP Ⅸ可抑制Ach的内皮依赖性舒张反应,提示内源性CO与NO共同参与了Ach的内皮依赖性血管舒张反应,CO对肺血管平滑肌有舒张作用.     

ZnPPⅪ对肺动脉内皮依赖性舒张反应的影响

目的 :通过观察血红素氧化酶抑制剂锌原卟啉Ⅸ (zineprotoporphyrinⅨ ,ZnPPⅨ )对乙酰胆碱 (acetyl choline,Ach)内皮依赖性血管舒张反应的影响 ,探讨内源性一氧化碳 (carbonmonoxide,CO)对肺血管的舒张作用。方法 :取Wistar大鼠肺动脉环 ,制备Ach浓度效应曲线 ,冲洗后平衡 6 0min ,分别加入一氧化氮 (nitricoxide,NO)合成酶抑制剂L NAME 30 μmol/L或L NAME 30 μmol /L +ZnPPⅨ 10 μmol/L ,孵育 30min后 ,重复制备Ach浓度效应曲线 ,观察给药前后Ach浓度效应关系的变化。结果 :用去氧肾上腺素收缩肺动脉后 ,Ach能对内皮完整的肺动脉引起浓度依赖性舒张 ,血管环用L NAME孵育后 ,舒张反应受抑 ,10 -5mol/L的Ach只引起 (40 .3± 5 .1) %的舒张反应 ,而用ZnPPⅨ及L NAME共同孵育后 ,舒张反应进一步受抑或消失 ,10 -5mol/L的Ach只能引起 (11.1± 8.4 ) %的舒张反应或不引起舒张反应。结论 :ZnPPⅨ可抑制Ach的内皮依赖性舒张反应 ,提示内源性CO与NO共同参与了Ach的内皮依赖性血管舒张反应 ,CO对肺血管平滑肌有舒张作用     

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.