来氟米特在大鼠异种心脏移植排斥反应中对NF-κB P65的影响

目的 复制小鼠到大鼠异种心脏移植模型,探讨来氟米特(Ieflunomide,Lef)在大鼠异种心脏移植排斥反应中对NF-κB P65的影响.方法 实验动物按随机数字表法分成4组,每组6只空白移植组、环孢素A(CsA)组、来氟米特(Lef)组、Lef CsA组.采用免疫组化法和蛋白印迹杂交法检测各组移植心肌组织中NF-κB P65的表达;凝胶电泳迁移率法检测NF-κB DNA结合活性.结果单用CsA不能延长移植心脏存活时间[(2.50±1.05)d],也不能抑制移植心肌NF-κB P65蛋白的表达(263.09±28.81,IOD)和NF-κB DNA结合活性(227.49±14.83,IOD);而单用Lef可显著延长移植心脏存活时间[(4.17±1.33)d],也能显著抑制移植心肌NF-κB P65蛋白的表达(173.48±5.85,IOD)和NF-κB DNA结合活性(109.96±12.46,IOD),与空白移植和CsA组比较,均有显著性差异(P＜0.05).Lef与CsA联合应用使移植心脏存活(6.50±2.56)d,抑制移植心肌组织中NF-κB P65蛋白的表达(67.79±3.79,IOD)和NF-κB DNA结合活性(43.61±7.42,IOD)最为显著,与其他3组比较,均有显著性差异(P＜0.05).结论 在大鼠心脏异种移植中Lef与CsA联用可通过显著抑制NF-κB P65蛋白表达和NF-κB DNA结合活性来延长移植心脏的存活时间,二者具有免疫协同作用.     

脾切除延长大鼠异种移植心脏存活时间的实验研究

目的:采用小鼠至大鼠心脏移植模型,研究脾切除联用免疫抑制剂对异种移植物存活时间的影响。方法:动物随机分为组,分别采用脾切除、来氟米特()或二者联用以观察对异种移植心脏存活时间的影响。法检测血清。7LefELISAIgG用免疫组织化学法检测。IgG结果:单行脾切除使移植心脏存活(±)天4.401.14(P,脾切除联用使移植心脏存活<0.05)CsA(±)天与组比较,4.750.95(IIP。脾切除联用显著延长移植心脏存活时间达(±)天,且显著降低受体血清>0.05)Lef8.202.17水平和移植物中沉积IgGIgG(P。加用不能显著增加脾切除联用的效果。<0.05)CsALef结论:脾切除可显著延长小鼠至大鼠移 植心脏存活时间。脾切除和具有协同免疫抑制作用,可降低移植后受体血清水平及移植物中沉积,延长异种移植物LefIgGIgG的存活时间。     

NF-κB P65在大鼠异种心脏移植后心肌中的表达及意义

目的 复制小鼠→大鼠异种心脏移植模型,探讨核转录因子κB(nuclearfactor-κB,NF-κB)P65蛋白在异种移植心肌中的表达及NF-κB的DNA结合活性.方法 动物随机数字法分成2组:A组(对照组),n=6;B组(移植组),n=6.采用免疫印迹杂交法(Western blot)检测对照组及移植组心肌组织NF-κB P65表达,凝胶电泳迁移率实验检测NF-κB DNA结合活性.结果 移植组的NF-κB P65蛋白表达和NF-κB DNA结合活性均显著高于对照组(P＜0.05).结论 NF-κB的激活可能在大鼠异种移植心脏排斥反应中起着重要作用.     

血红素加氧酶-1抗急性血管排斥反应的作用研究

目的探讨血红素加氧酶-1（HO-1）在异种心脏移植急性血管排斥反应中的作用。方法建立豚鼠到SD大鼠异位心脏移植模型,选用血红素分别诱导供体和受体,上调HO-1基因表达;眼睛毒蛇因子（CVF）、环孢素A抑制超急性排斥反应。采用免疫组织化学方法检测心脏组织中HO-1的表达;流式细胞仪检钡4受体血清异种抗体IgM的变化;免疫荧光方法观察异种抗体IgM在血管内膜的沉积情况;TUNEL方法检测心脏组织细胞凋亡情况。结果HO-1表达上调后,能明显延长移植心脏的存活时间,抑制异种抗体表达,减少心肌细胞的凋亡。结论HO-1在异种心脏移植中具有抗急性血管排斥反应的作用,对移植器官起保护作用。     

HO-1在延迟性异种心脏移植排斥反应中的表达及意义

目的:探讨血红素氧合酶-1在延迟性异种心脏移植排斥反应中的表达及意义.方法:建立NIH Wistar颈部异位心脏移植模型,分别于移植前、移植后1h、6h、12h、24h、48h和72h切取移植心脏,应用RT-PCR、Western Blot检测HO-1mRNA、HO-1蛋白表达并检测HO 1酶活性;同时比较钴原卟啉(CoPP)诱导HO-1对延迟性异种心脏移植排斥反应的影响.结果:移植心脏均有HO-1表达,HO-1mRNA(t=2.5170,P＜0.05)、HO-1蛋白表达(t=2.3702,P＜0.05)及酶活性(t=2.246,P＜0.05)移植术后24～48h表达到达高峰;CoPP诱导的HO-1明显延长了移植心脏的存活时间(t=4.74442,P＜0.001).结论:HO-1表达在延迟性异种心脏移植后24～48h到达高峰;CoPP诱导的HO-1能延长延迟性异种心脏移植的存活时间.     

苏木单体物对大鼠心脏移植后NF-κB信号传导途径的影响

目的 探讨苏木中药对移植心脏的保护作用及可能的作用机制.方法 建立大鼠腹腔同种异位心脏移植模型.实验分为3组:A组为空白对照组;B组为苏木(Caesalpinia sappan,CS)中药组;C组为环孢素(CsA)组.每组8只大鼠.术后第2天开始灌药,第7天取供心.Western blot 法检测心肌组织中NF-κB及IκBα的表达水平.结果 与移植对照组相比CsA及CS组移植物的病理损害明显减轻;NF-κB及IκBα的表达水平给药组较对照组差异显著(P<0.05),但两种药物组之间的差异不显著(P>0.05).结论 苏木中药可能通过抑制NF-κB信号传导途径的激活,减缓急性排斥反应的发生从而减轻移植物的病理损伤,发挥保护移植心脏的作用.     

前列腺素A1对供心缺血再灌注损伤心肌一氧化氮合酶的表达的影响

目的研究前列腺素A1(PGA1)对同种异位大鼠心脏移植供心一氧化氮合酶(iNOS)表达的影响。方法建立同种异位大鼠心脏移植模型,供心给予生理盐水、PGA1或脂多糖(LPS)处理,观察供心存活时间,通过酶联免疫吸附试验测定iNOS的表达,采用凝胶电泳迁移率测定NF-κB的活性。结果一次给予40 ng.kg-1PGA1组供心存活时间明显延长,心肌组织iNOS的蛋白表达明显增加,核转录因子-κB(NF-κB)的活性显著下降。结论在同种异位大鼠心脏移植中,PGA1通过抑制NF-κB的活性,上调供心缺血再灌注损伤心肌一氧化氮合酶的表达,延长供心存活时间。     

经冠状动脉转染转化生长因子-β1基因对大鼠移植心脏缺血-再灌注损伤的影响

目的:探讨经冠状动脉转染重组腺病毒介导的转化生长因子-β1(TGF-β1)基因对大鼠移植心脏缺血-再灌注损伤的影响.方法:利用Cuff技术建立颈部异位心脏移植模型.转基因组供心离体灌注含5×109 pfu/gm携带mTGF-β1基因腺病毒颗粒的4℃ Stanford大学停跳液,空白对照组灌注4 ℃ Stanford大学停跳液,空载体组灌注含5×109 pfu/gm空白载体的4℃ Stanford大学停跳液.移植术后8 h切取移植心脏,电镜下观察移植物超微结构.免疫组化染色检测移植物mTGF-β1、细胞间黏附分子-1(ICAM-1)及核因子-κB(NF-κB)的表达.结果:移植后8 h,与其他2组相比,转基因组心肌细胞肿胀减轻,炎性细胞浸润减少,心肌线粒体水肿明显减轻,无明显的肌丝断裂现象.空白对照组与空载体组无外源性mTGF-β1蛋白的表达,转基因组有mTGF-β1的表达.3组间相比,心肌组织ICAM-1与NF-κB的表达差异有统计学意义(F=23.8,P=0.008;F=36.7,P=0.007).转基因组ICAM-1与NF-κB的表达较空白对照组与空载体组降低(P＜0.01).结论:经冠状动脉灌注重组腺病毒介导的TGF-β1基因能减轻移植心脏缺血-再灌注损伤,其机制可能与下调ICAM-1及NF-κB的表达有关.     

热休克处理诱导小鼠心脏HO-1表达并延长其移植至大鼠的存活时间

目的探索热休克诱导NIH小鼠心脏表达HO-1的方法及其对延迟性异种心脏移植排斥反应的影响.方法采用取暖器加热NIH小鼠,使其温度维持在42℃20 min,分别于加热后1、6、12、24、48、72 h切取心脏,应用RT-PCR、Western blot分别检测HO-1 mRNA、HO-1蛋白以及HO-1酶活性检测.借助NIH小鼠-Wistar大鼠颈部异位心脏移植模型,对热休克处理供体并结合CoPP(cobalt protoporphyrin,CoPP)、ZnPP(zinc protoporphyrin,ZnPP)了解热休克诱导HO-1对移植心脏存活时间的影响.结果热休克预处理6 h后心脏组织HO-1 mRNA、蛋白表达及酶活性开始增多,以24～48 h为高峰,24 h组和48 h组与其余任意组比较均有显著性差异(t=3.507,P＜0.05),72 h后开始下降.热休克组心脏存活时间明显长于空白对照组(t=5.703,P＜0.01)和ZnPP 热休克组(t=4.913,P＜0.001).而热休克 CoPP组移植心脏存活时间[(6.250±1.512)d]明显长于热休克组[(4.750±1.363)d](t=2.084,P＜0.01).当热休克与ZnPP和CoPP同时使用时,移植心脏存活时间略短于热休克组,但其差异无显著性(t=0.816,P＞0.05).结论取暖器加热NIH小鼠可诱导心脏HO-1的产生,能延长NIH小鼠-Wister大鼠心脏移植存活时间,推迟DXR的发生.     

HO-1在大鼠异位心脏移植急性排斥期的表达研究

目的:观察血红素加氧酶1(HO-1)mRNA在大鼠异位心脏移植急性排斥期中的表达及意义。方法:建立大鼠腹部心脏异位移植模型,分对照组及环孢菌素(CSA)组,每组32只。分别灌胃给予生理盐水及CsA干预,每组8只用于观察移植心存活时间,术后1,3,5,7d各6只动态切取标本,常规组织切片监测排斥反应,TUNEL法检测心肌细胞凋亡,RT-PCR检测移植心肌组织HO-1 mRNA的表达。结果:CSA组移植心存活时间(15.4±5.1)d长于对照组(7.6±1.5)d,P<0.01;CSA组各采样时段的心肌凋亡指数明显低于对照组,而HO-1表达强度均强于对照组。结论:移植心脏中HO-1表达水平的高低与心脏移植免疫排斥反应的轻重存在一定的相关性,CSA干预增强HO-1表达,减轻免疫排斥反应及降低凋亡指数。提示HO-1在心脏移植术后应激及急性免疫排斥反应抑制中起着重要的作用。     

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.