三七总皂甙对单侧输尿管梗阻后大鼠肾间质纤维化的防治作用

目的　研究三七总皂甙对单侧输尿管梗阻后大鼠肾间质纤维化过程的防治作用。方法　随机分为假手术组、手术组和三七总皂甙治疗组,建立单侧输尿管梗阻肾间质纤维化模型,分别于造模后第3、7、14、2 1d处死大鼠,留取梗阻侧肾脏制备病理切片。光镜观察肾间质病理形态学变化;免疫组织化学染色法检测增殖细胞核抗原(PCNA)和α-平滑肌肌动蛋白(α- SMA)表达。结果　手术组呈进行性肾间质纤维化,肾小管上皮细胞及间质α-SMA表达明显增加。三七总皂甙治疗组肾间质纤维化减轻,肾小管上皮细胞PCNA表达明显增加,α- SMA表达明显减少,间质PCNA、α- SMA表达明显减少(P<0 .0 5 )。结论　三七总皂甙对单侧输尿管梗阻后的肾间质纤维化有抑制作用,可阻断肾小管上皮细胞-肌纤维母细胞的转分化。     

单侧输尿管梗阻大鼠肾间质纤维化的产生机制

目的 探讨单侧输尿管梗阻后肾间质纤维化形成机制。方法 将30只大鼠采用单侧输尿管梗阻（uu0）模型，术后第3、7、14天观察双肾组织病理改变，并应用免疫组织化学方法检测肾间质中核转录因子（NF-KB），转移生长因子岛（TGF-β1），α-平滑肌肌动蛋白（α-sMA）的表达，并检测肾间质胶原蛋白的含量。结果随着梗阻时间延长，梗阻侧肾间质中NF-KB、TGF-β1、α-SMA及胶原蛋白的含量增加，对侧无明显变化，两组相比有明显差异（P〈0．05）。结论 单侧输尿管梗阻的大鼠肾间质NF-KB、TGF-β1、α-SMA的过度表达，可上调肾间质胶原蛋白的含量，是形成肾间质纤维化的主要原因之一。     

肾纤复元胶囊对单侧输尿管梗阻大鼠模型肾间质纤维化的抑制作用及机制探讨

目的观察肾纤复元胶囊对单侧输尿管梗阻（UUO）大鼠模型的治疗作用并探讨其机制。方法将48只SD大鼠随机分为假手术（SOR）组、UUO模型组、氯沙坦治疗组（LOS组）和肾纤复元胶囊治疗组（SXFYC组）。后三组采用经典的单侧输尿管梗阻术建立肾间质纤维化大鼠模型。观察术后第7、14天各组大鼠血尿生化指标变化、肾组织病理变化，检测转化生长因子β1（TGF—β1）、α-平滑肌肌动蛋白（α—SMA）、Ⅰ型胶原（ColⅠ）和纤维连接蛋白（FN）在肾组织中的表达及TGF-β1、α-SMA、ColⅠ和FN在基因水平的表达情况。结果不同组大鼠术后第7、14天24小时尿蛋白总量差异无显著性（P〉0．05），两治疗组血肌酐明显低于UUO模型组（P〈0．05），两治疗组间差异无统计学意义（P〉0．05）；光镜下肾组织病理切片显示两治疗组与同一时间点UUO模型组相比，肾间质纤维化程度显著降低（P〈0．05），两治疗组间差异无统计学意义（P〉0．05）；免疫组化和RT—PCR结果表明，两治疗组各时间点TGF—β1、α—SMA、ColⅠ和FN的表达均低于UUO模型组（P〈0．05），两治疗组间差异无统计学意义（P〉0．05）。结论肾纤复元胶囊可从一定程度上减轻UUO大鼠肾间质纤维化程度，其作用机制可能与下调TGF—β1和α—SMA表达、抑制ColⅠ和FN的合成有关。     

罗格列酮对单侧输尿管梗阻大鼠肾间质纤维化的作用

目的 探讨罗格列酮（RSG）对单侧输尿管梗阻大鼠（UUO）肾间质纤维化的作用。方法 将24只大鼠随机分为假手术组、模型组、治疗组。对治疗组、模型组行单侧输尿管结扎术建立输尿管梗阻的动物模型。术后14天处死各组大鼠，取梗阻侧肾组织做HE和Masson染色及用免疫组化方法检测结缔组织生长因子（CT-GF）和α-平滑肌肌动蛋白（d—SMA）在肾组织的表达水平。结果罗格列酮可显著下调CTGF和α—SMA的表达，改善了肾脏病理改变。结论 罗格列酮对UUO所致的肾间质纤维化的形成有抑制作用。     

黄芪当归合剂对梗阻性肾病大鼠肾间质纤维化的防治作用

目的 :研究黄芪当归合剂 (A&A)对梗阻性肾病大鼠肾小管间质纤维化的防治作用 ,探讨其抗纤维化作用的可能机制。方法 :采用单侧输尿管梗阻 (UUO)诱导肾间质纤维化的动物模型 ,以目前公认具有肾脏保护作用的血管紧张素转换酶抑制剂 (ACEI)作为阳性对照 ,将大鼠随机分为假手术组 (Sham)、模型组 (UUO)、黄芪当归合剂组 (A&A)、依那普利组 (ACEI) ,术后第 1 0天处死大鼠 ,收集血清测定肌酐、尿素氮水平 ,肾组织用Masson染色后进行图像分析评定各组肾小管间质损害程度 ,免疫组化半定量检测各组肾间质的α 平滑肌肌动蛋白 (α SMA)、转化生长因子 β1 (TGF β1 )、纤维连接蛋白 (FN)和层粘连蛋白 (LN)的表达。结果 :UUO组的肾小管间质损伤指数及α SMA、TGF β1 、FN和LN的表达明显高于Sham组 ,肾小管间质损伤指数与肾间质的α SMA、TGF β1 、FN和LN的表达均呈正相关关系。A&A组、ACEI组的肾小管间质损伤指数及α SMA、TGF β1 、FN和LN的表达均明显低于UUO组 ;两治疗组间比较 ,A&A对TGF β1 表达的抑制作用弱于依那普利的作用 ,而其余各指标差异无显著性。结论 :在单侧输尿管梗阻诱导的肾间质纤维化大鼠模型中 ,中药复方A&A的防治作用与ACEI相似 ,可能是通过减少肾间质肌成纤维细胞的数量、抑制TGF β1 表达     

地灵丹对肾间质纤维化防治作用的实验研究

目的研究中药复方地灵丹制剂对单侧输尿管梗阻模型大鼠肾间质纤维化的防治作用及其可能机制。方法将24只SD大鼠按体重随机分为假手术组、模型组、地灵丹组、依那普利组,采用单侧输尿管梗阻模型,于术后第21天分别处死各组6只。观察血肌酐、尿素氮、24小时尿蛋白定量及梗阻肾组织病理改变,应用免疫组织化学的方法对肾组织转化生长因子β1（Transforming growth factor—β1,TGF-β1）、α-平滑肌肌动蛋白（α—Smoothmuscleactin,Ot—SMA）、纤维连接蛋白（Fibmnectin,FN）、层粘连蛋白（Laminin,LN）的表达进行染色,阳性面积均采用多媒体彩色病理图像分析系统进行分析。结果地灵丹治疗组、依那普利治疗组与模型组相比,24小时尿蛋白定量、血肌酐下降,α-SMA、TGF-β1、FN、LN的表达下调,差异有显著意义（P〈0．05）,肾间质纤维化明显减轻（P〈0．005）。结论地灵丹能够减轻单侧输尿管梗阻模型大鼠的蛋白尿和肾间质纤维化。地灵丹对此实验模型的肾功能保护作用优于依那普利。     

α-平滑肌肌动蛋白在单侧输尿管梗阻大鼠肾组织中的表达

目的观察α-平滑肌肌动蛋白（α-SMA）在单侧输尿管梗阻大鼠中的表达情况,探讨其与肾间质纤维化的关系。方法采用单侧输尿管结扎术制备肾间质纤维化模型,将60只SD大鼠随机分为假手术组,模型组,每组分别于术后7、14、21d各处死10只大鼠,取梗阻侧肾组织行HE、Masson染色观察肾间质纤维化程度,行免疫组化方法检测两组大鼠不同时间段α-平滑肌肌动蛋白（α-SMA）表达水平。结果假手术组中,肾小球、肾小管和间质细胞均无α-SMA,与假手术相比,模型组手术后7d,肾间质中α-SMA阳性细胞数增多,呈进行性升高趋势,其与肾间质纤维化程度呈正相关。结论α-平滑肌肌动蛋白在肾间质纤维化的进展过程中发挥重要作用。     

银杏叶对肾间质纤维化防治作用的实验研究

目的观察银杏叶对肾间质纤维化的防治作用及其效果。方法45只雄性SD大鼠随机分为3组,假手术组、模型组和治疗组,每组15只动物。治疗组在单侧输尿管结扎(unilated ureteral obstruction,UUO)基础上给予银杏叶(300 mg/kg.d-1)灌胃治疗,1次/d;模型组在UUO基础上给予生理盐水灌胃;对照组除不结扎输尿管外,其余同模型组。分别于实验第3、7、14 d分批处死大鼠,每次处死5只。对大鼠结扎侧肾组织进行形态学和免疫组织化学观察。采用HE、Masson两种染色观察梗阻侧肾组织病理学的改变,采用免疫组织化学的方法检测肾组织中转移生长因子-β1(transforming growth factor,βTGF-β1)、核因子kappa B(nuclear factor-kappa B,NF-κB)、α-平滑肌肌动蛋白(-αsmooth muscle actin,-αSMA)的表达,采用氯胺T法测定肾组织中羟脯胺酸的含量。结果大鼠UUO术后3d,肾间质水肿,单核细胞浸润。14 d后肾小管萎缩,间质增宽,肾组织中TGF-β1、NF-κB、α-SMA的表达及肾组织中胶原蛋白含量明显增加,且随着梗阻时间延长,其阳性表达率也增加。银杏叶治疗组肾组织中TGF-β1的表达及胶原蛋白的含量较模型组明显降低,单核细胞浸润减轻,肾脏病理学明显改善。结论银杏叶能够抑制UUO大鼠肾间质炎性细胞浸润,减少肾间质胶原蛋白的含量,有防治UUO大鼠肾间质纤维化的作用。     

硒对肾间质纤维化大鼠肾组织结缔组织生长因子表达及肾小管上皮细胞表型转化的影响

目的探讨硒对肾间质纤维化大鼠肾组织结缔组织生长因子（CTGF）表达及肾小管上皮细胞表型转化的影响。方法以单侧输尿管结扎致肾间质纤维化大鼠模型。将54只SD大鼠随机分为假手术组（A组）、单侧输尿管梗阻（UUO）组（B组）、U-UO+硒组（C组）,每组18只。C组给予亚硒酸钠0.2mg/（kg·d）灌胃。A、B组给予同等剂量0.9%氯化钠溶液灌胃。术后第7、14、21天各组随机处死6只大鼠,肾组织行HE、Masson染色评定肾间质纤维化程度,免疫组织化学半定量法检测CTGF和α-平滑肌肌动蛋白（α- SMA）的表达。Western印迹法检测肾组织CTGF蛋白表达。化学比色法检测肾组织氧化指标谷胱甘肽过氧化物酶（GSH- Px）、超氧化物歧化酶（SOD）、丙二醛（MDA）的表达水平。结果术后各时点C组肾间质纤维化程度较B组明显减轻（P＜0.05）,肾组织CTGF和α- SMA的表达强度明显低于B组（P＜0.05或0.01）、GSH- Px和SOD水平明显高于B组（P＜0.05）,MDA含量明显低于B组（P＜0.05）。B组肾组织中CTGF、a- SMA表达量之间呈正相关（P＜0.05）,CTGF和a- SMA表达量与肾间质纤维化病变程度呈正相关（P＜0.05）。结论硒可以减轻UUO模型大鼠肾间质纤维化程度,其机制可能与硒的抗氧化作用、下调肾组织CTGF的表达、抑制肾小管上皮细胞－肌成纤维细胞转分化有关。     

单侧输尿管梗阻大鼠肾间质纤维化的机制

目的 :探讨单侧输尿管梗阻后肾间质纤维化的形成机制。方法 :将 2 0只大鼠采用单侧输尿管梗阻(UUO)模型 ,术后 1周、2周观察双肾组织病理改变 ,并应用免疫组织化学方法检测肾间质Ⅲ型胶原、转化生长因子β1(TGF β1)和核因子 κB(NF κB)的表达。结果 :随着梗阻时间延长 ,梗阻肾间质Ⅲ型胶原、TGF β1和NF κB的表达增加 ,对侧无明显变化 ,两组相比有显著差异 (P <0 .0 5 )。结论 :单侧输尿管梗阻肾间质TGF β1、NF κB的过度表达 ,可上调肾间质Ⅲ型胶原的表达 ,是形成间质纤维化的重要原因之一     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.