银杏叶提取物的心肌延迟保护作用及其机制研究

目的观察银杏叶提取物(EGb761)对大鼠离体心脏心肌的延迟保护作用及其机制。方法离体大鼠心脏全心停灌缺血30min后再灌注30min产生缺血再灌损伤,观测心率(HR)、冠脉流量(CF)、左室内压(LVP)和左室内压变化最大速率( dp/dtmax),测定心肌组织中肌酸激酶(CK)释放量、心肌组织丙二醛(MDA)和一氧化氮(NO)的量。结果实验前24h单次ig给予EGb761(50或100mg/kg)可显著改善心肌缺血再灌注所致的心功能(LVP和 dp/dtmax)损伤,抑制心肌组织CK释放和MDA水平的增加以及NO水平的降低。预先给予NO合酶抑制剂L-NAME(5mg/kg)或心肌肌细胞膜ATP敏感钾通道(sarcKATP)阻断药HMR1883(3mg/kg),均可明显抑制EGb761对心肌缺血再灌注损伤的延迟保护作用。结论EGb761对缺血再灌注诱导大鼠心肌损伤具有延迟性保护作用,这一保护作用可能与增加NO合成和开放sarcKATP通道有关。     

腺苷A1受体激动剂预处理对心脏肿瘤坏死因子-α表达的影响

目的了解腺苷A1受体激动剂预处理能否诱发大鼠心脏延迟保护效应,并对其缺血-再灌注过程中肿瘤坏死因子-α(TNF-α)表达的影响. 方法 雄性Wistar大鼠随机分为正常对照组(Z)、缺血对照组(C)和腺苷A1受体激动剂预处理组(A).体外心脏低温缺血180 min,复灌60 min,观察左心室压力变化最大速率(±dp/dtmax)恢复率、心肌同工酶漏出量,并以免疫组化、原位杂交或逆转录-PCR技术观察TNF-α mRNA和蛋白质的表达水平. 结果 A组±dp/dtmax恢复率明显高于C组(P<0.05),心肌同工酶漏出量明显低于C组(P<0.05).A组TNF-α表达水平虽高于Z组,但明显低于C组,差异有显著性意义(P<0.01). 结论 腺苷A1受体激动剂预处理可诱导大鼠心肌延迟保护效应, 同时下调心脏TNF-α的表达.     

黄芩甙对离体豚鼠心脏缺血再灌注损伤的保护作用

目的 :观察黄芩甙对缺血再灌注离体豚鼠心脏的保护作用。方法 :豚鼠心脏按Lan gendorff灌注 10min ,夹闭 3 5min ,再灌注 3 0min ,期间实时测定血流动力学指标左室收缩压(LVSP)、左室收缩压最大变化速度 (dp/dtmax)、左室舒张末期压 (LVEDP)、左室舒张压最大下降速度 (-dp/dtmax)。实验结束后 ,测定心肌组织超氧化物歧化酶 (SOD)活力及脂质过氧化物产物丙二醛 (MDA)含量。结果 :黄芩甙 5mg·L-1、2 .5mg·L-1组均能对抗缺血再灌注对心功能造成的影响 ,增强心肌收缩性能和舒张性能 (与缺血再灌注组比较 ,P <0 .0 1) ,SOD活力高于缺血再灌注组 (P <0 .0 1) ,MDA含量低于缺血再灌注组 (P <0 .0 1)。两个剂量间有一定剂量依赖关系。结论 :黄芩甙可降低心肌脂质过氧化反应 ,对离体豚鼠心脏缺血再灌注损伤具有保护作用     

SIRT1介导VCP28抗1型糖尿病心肌缺血/再灌注损伤的研究

目的研究腺苷A1受体部分型激动剂VCP28对1型糖尿病大鼠心肌缺血/再灌注损伤的保护作用,并探讨其机制。方法建立1型糖尿病SD大鼠离体心脏缺血/再灌注模型,按照假手术组(Sham组)、单纯缺血/再灌注组(I/R组)和I/R+VCP28(腺苷A1受体部分型激动剂)组进行实验(n=8)。实验过程中持续描记采集左室压(LVP),根据压力波形分析左室发展压(LVDP)和最大收缩/舒张速率(±dp/dt_(max));TTC染色法测定心肌梗死面积;Western Blot法检测各组心肌SIRT1,Acfoxo1,Ac-p53及凋亡通路蛋白表达。结果 VCP28预处理可明显改善糖尿病大鼠离体灌流心脏缺血/再灌注后血流动力学指标,降低心肌梗死面积,抑制凋亡信号通路,显著提高SIRT1表达并下调Ac-foxo1及Ac-p53的水平(P0.01)。结论 VCP28可明显改善糖尿病大鼠离体灌注心脏缺血/再灌注后心功能指标和心肌梗死面积,对糖尿病心肌损伤有明显的保护作用;且SIRT1通路激活可能是VCP28抗糖尿病心肌缺血/再灌注损伤的重要机制。     

参麦注射液对兔离体心脏缺血-再灌注损伤的保护作用

目的探讨参麦注射液对免离体灌流心脏缺血-再灌注损伤的保护作用.方法离体兔心采用Langendorff法灌流,灌注参麦注射液10min,然后结扎冠状动脉左前降支90min,再灌注40min.记录左室内压(LVP)、左室内压最大上升速率(+dp/dtmax)、左室舒张末压(LVEDP)、心率(HR),定时收集冠脉流出液测定冠脉流量(CF)和肌酸激酶(CK)活性,再灌注结束时测定心肌梗死面积.结果缺血-再灌注可显著降低LVP、+dp/dt max,升高LVEDP,增加CK释放,心肌梗死面积为(42.9±4.8)%;预先用参麦注射液(用K-H液按体积比稀释成1320或1160)灌流心脏10min,可显著缩小心肌梗死面积,改善缺血-再灌注所致心功能损伤,减少CK释放.结论参麦注射液对兔离体灌流心脏缺血-再灌注损伤具有明显保护作用.     

大豆异黄酮对大鼠离体心肌缺血/再灌注损伤的保护作用

目的观察大豆异黄酮对离体大鼠心脏缺血-再灌注(I/R)损伤的保护效应。方法本文采用Langendorff离体心脏灌流方法,通过心脏动力学实验对大豆异黄酮抗I/R效应进行研究。结果通过离体大鼠心脏动力学实验显示,缺血前药物各组心功能参数与对照组相比较,差异没有统计学意义(P>0.05);缺血后药物各组与对照组相比较,dp/dtmax与-dp/dtmax差异有统计学意义(P<0.01);再灌注后药物各组与对照组相比较,心率有改善,低剂量组差异有统计学意义(P<0.05)。低剂量、高剂量组与对照组相比较dp/dtmax与-dp/dtmax有显著改善(P<0.01)。结论心肌缺血再灌注可抑制心脏的舒缩功能,大豆异黄酮不影响离体心脏的正常功能,但能改善缺血后再灌注引起的心律失常的离体心脏功能,可促进I/R后心功能的恢复。     

腺苷A1受体激动剂延迟预处理保存大鼠心脏的实验研究

目的 :探讨腺苷A1受体激动剂延迟预处理对大鼠心脏的保护效果。方法 :实验组 (P组 )以高选择性A1受体激动剂CCPA预处理Wistar大鼠 2 4h后处死 ,分离心脏并置于 4℃改良St.Thomas液中诱导心脏停搏 ,然后放入该液中低温保存 4h ,再灌注 1h。观察心功能恢复率、心肌ATP、Ck mb释放量。另设单纯改良St.Thomas液保存对照组 (C组 )。结果 :P组左室内压上升与下降最大速率恢复率 (±dp/dtmax,% )为 62 .83± 17.2 7,66.81± 18.99,心肌ATP含量 (10 -3 μmol/g) 3 .67± 1.42 ;而C组分别为 40 .41± 18.2 9,44 .70±2 5 .14 ,1.46± 0 .5 4。P组都明显高于C组 ,差异均有显著性 (P <0 .0 1或P <0 .0 5 )。结论 :以腺苷A1受体激动剂延迟预处理能改善离体大鼠心脏的保存效果     

腺苷A1受体激动剂延迟预处理保存大鼠心脏的实验研究

目的本研究探讨腺苷A1受体激动延迟预处理对大鼠心脏的保护效果.方法P组以高选择性A1受体激动剂CCPA预处理Wistar大鼠24h后制成离体心脏,4℃改良St.Thomas液,诱导心脏停搏,并放入该液中低温保存4h,再灌注1h.观察心功能恢复率、心肌ATP、Ck-mb释放量.另设单纯改良St.Thomas液保存对照(C).结果P组左室内压上升与下降最大变化速率恢复率(±dp/dtmax,%)为62.83±17.27,66.81±18.99,心肌ATP含量(10-3μmol/wet.g)3.67±1.42;而C组分别为40.41±18.29,44.70±25.14,1.46±0.54.P组都明显高于C组,差别均有显著性(P＜0.01或P＜0.05).结论高选腺苷A1受体激动剂延迟预处理能改善离体大鼠心脏的保存效果.     

不同配比丹酚酸A/B对大鼠离体心脏的血流动力学的影响

目的本实验探讨不同配比的丹酚酸A/B对大鼠离体心脏缺血再灌注损伤的血流动力学的影响。方法离体心脏采用Langendorff装置,预灌30 min,夹闭30 min,复灌40 min。期间实时检测血流动力学指标:左室舒张末期压(LVEDP)、左室发展压(LVDP)、左室收缩压最大变化速率(+d P/dtmax)和左室舒张压最大下降速率(-d P/dtmin)的变化。结果与模型组相比,各配比的丹酚酸A/B给药组均能降低LVEDP,并提高LVDP、+d P/dtmax、-d P/dtmax,且以1:2配比效果为最佳。结论丹酚酸A/B配伍对大鼠离体心脏有一定的保护作用。     

吸入麻醉药后处理对大鼠心肌缺血再灌注损伤影响的比较

目的 探讨七氟醚和异氟醚后处理在成年大鼠心肌缺血再灌注损伤(MIRI)中的心肌保护作用.方法 将成年雄性SD大鼠24只,采用随机数字表法分为对照组(C组)、缺血再灌注组(R组)、七氟醚后处理组(S组)和异氟醚后处理组(I组),每组6只.建立Langendorff离体心脏灌注模型.于平衡灌注末及再灌注30、90 min时记录心率(HR)、左心室舒张末压(LV-EDP)、左心室发展压(LVDP)、左心室压力上升最大速率(LV+ dp/dtmax)和左心室压力下降最大速率(LV-dp/dtmax);灌注结束后,取心尖部心肌组织1 mm3,电镜下观察线粒体结构并评分,剩余心脏组织采用2,3,5-氯化三苯基四氮唑(TTC)染色法测定心肌梗死面积(MIS).结果 与R组比较,S组和I组心肌再灌注后的心功能指标改善,MIS减小,线粒体损伤减轻(P＜0.05);与S组比较,I组心肌再灌注后的心功能变差,MIS增大,线粒体损伤程度加重(P＜0.05).结论 七氟醚和异氟醚后处理在成年大鼠MIRI中均有保护作用,但七氟醚后处理的心肌保护作用优于异氟醚后处理.     

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.