精索静脉高位结扎术对精索静脉曲张大鼠生精细胞凋亡的影响

目的:通过建立实验性精索静脉曲张大鼠动物模型,探讨精索静脉高位结扎术对同侧睾丸生精细胞凋亡机制的影响。方法:雄性大鼠60只,随机分为对照组、假手术组、EV组(模型组)、Varicocelectomy组(治疗组),每组15只。术后取左侧睾丸,采用HE染色观察睾丸组织学变化,TUNEL法检测生精细胞凋亡指数,免疫组化和RT-PCR法分别检测Bcl-2、Bax和Caspase-3的表达。结果:模型组大鼠左侧睾丸组织可见生精上皮排列紊乱,生精细胞广泛脱落,细胞凋亡指数明显高于对照组、假手术组(P<0.05),治疗后凋亡指数明显减少,与模型组比较,差异有显著性(P<0.05);治疗组中Bax、Caspase-3表达减少,Bcl-2表达增加,与模型组比较,差异有显著性(P<0.05)。结论:精索静脉高位结扎术可抑制睾丸生精细胞凋亡,且Bcl-2、Bax和Caspase-3通过线粒体信号转导通路参与并调控生精细胞凋亡过程,从而在精索静脉曲张疾病中发挥保护作用。     

L-NAME对大鼠生精细胞p53表达的影响

目的 探讨NOS抑制剂N-硝基-L-精氨酸甲酯(L-NAME)对隐睾下降固定术后生精细胞p53表达的影响.方法 将75只雄性SD大鼠建立单侧隐睾模型.术后12d将隐睾组大鼠随机分为假手术组,隐睾固定组、隐睾固定+生理盐水组、隐睾固定+L-NAME组,建立隐睾下降固定模型.术后分别于腹腔内注射生理盐水或L-NAME.术后第12d于腹腔内给药后2h大鼠尾部采血,取血清测定NO含量及NOS活性.术后第24d脱颈椎处死大鼠,TUNEI原位末端标记法检测各组右侧睾丸生精细胞凋亡;免疫组化检测p53的表达.结果 隐睾固定+L-NAME组血清中NO浓度、NOS活性以及生精细胞凋亡率及p53的表达低于隐睾固定组和隐睾固定+生理盐水组P＜0.05,差异有统计学意义假手术组最低,低于其它各组(P＜0.05),差异有统计学意义.结论 L-NAME降低隐睾下降固定后NO的产生,降低p53的表达,减少生精细胞凋亡,提示NOS抑制剂能促进隐睾下降固定术后的睾丸提高生精能力.     

L-NAME对大鼠生精细胞p53表达的影响

目的探讨NOS抑制剂N-硝基-L-精氨酸甲酯（L-NAME）对隐睾下降固定术后生精细胞p53表达的影响。方法将75只雄性SD大鼠建立单侧隐睾模型。术后12d将隐睾组大鼠随机分为假手术组,隐睾固定组、隐睾固定＋生理盐水组、隐睾固定＋L-NAME组,建立隐睾下降固定模型。术后分别于腹腔内注射生理盐水或L-NAME。术后第12d于腹腔内给药后2h大鼠尾部采血,取血清测定NO含量及NOS活性。术后第24d脱颈椎处死大鼠,TUNEL原位末端标记法检测各组右侧睾丸生精细胞凋亡;免疫组化检测p53的表达。结果隐睾固定＋L-NAME组血清中NO浓度、NOS活性以及生精细胞凋亡率及p53的表达低于隐睾固定组和隐睾固定＋生理盐水组P〈0.05,差异有统计学意义假手术组最低,低于其它各组（P〈0.05）,差异有统计学意义。结论 L-NAME降低隐睾下降固定后NO的产生,降低p53的表达,减少生精细胞凋亡,提示NOS抑制剂能促进隐睾下降固定术后的睾丸提高生精能力。     

生精冲剂对精索静脉曲张大鼠睾丸组织抗过氧化损伤的实验研究

目的　探讨生精冲剂对精索静脉曲张睾丸中超氧化物歧化酶 (SOD)、过氧化氢酶 (CAT)、血管紧张素转化酶 (ACE)活性及脂质过氧化物 (LPO)、一氧化氮 (NO)含量的影响。方法　测定治疗组大鼠睾丸中SOD、CAT、ACE活性及LPO、NO含量与模型组的差别。结果　治疗组大鼠睾丸中SOD、CAT、ACE活性高于模型组 ,LPO、NO含量低于对照组 (P <0 0 1)。结论　生精冲剂对精索静脉曲张生成的睾丸脂质过氧化损伤具有保护作用     

通精灵对实验性精索静脉曲张大鼠生精细胞凋亡的影响

目的探讨通精灵对精索静脉曲张大鼠睾丸生精功能的保护作用。方法将50只成年清洁级雄性Wistar大鼠分为假手术组(10只)、模型组(10只)、通精灵低剂量组(10只)、通精灵中剂量组(10只)和通精灵高剂量组(10只),按Sapyol法制作左精索静脉曲张大鼠模型。造模1个月后,不同浓度通精灵水煎剂灌胃,每日1次,连续60d。采用原位末端脱氧核苷酸转移酶标记法检测睾丸生精细胞凋亡,比较各组左睾丸凋亡指数(AI)。结果模型组左睾丸AI明显高于假手术组及通精灵各组(<0.01),通精灵各组左睾丸AI低于模型组(<0.05)。结论通精灵能降低实验性精索静脉曲张大鼠睾丸生精细胞凋亡,对睾丸生精功能有保护作用。     

益肾通络方对精索静脉曲张模型大鼠生精细胞凋亡、caspase-3蛋白表达的影响

目的:观察益肾通络方对精索静脉曲张模型大鼠睾丸质量、生精细胞、caspase-3蛋白表达、睾丸生精细胞凋亡指数(apoptosis index,AI)的影响。方法:取清洁级雄性SD大鼠40只随机均分为5组:假手术组、精索静脉曲张模型组、益肾通络方低剂量组、益肾通络方中剂量组、益肾通络方高剂量组。模型建立4周后,假手术组及模型组均按15 m L·(kg·d)~(-1)给予去离子水,益肾通络方低剂量组、益肾通络方中剂量组、益肾通络方高剂量组分别给予益肾通络方颗粒剂混悬液1.5g·(kg·d)~(-1)、3.0 g·(kg·d)~(-1)、6.0 g·(kg·d)~(-1),灌胃,1次·d-1,持续60 d。60 d后5组大鼠均脱臼处死并分别取双侧睾丸,电子天平称取睾丸质量,并检测caspase-3在睾丸组织中的表达,生精细胞的凋亡并计算AI。结果:(1)睾丸质量的变化:5组大鼠左右两侧睾丸质量:假手术组为[(1.88±0.19)、(1.95±0.20)g]、精索静脉曲张模型组为[(0.72±0.23)、(1.31±0.34)g]、益肾通络方低剂量组[(0.73±0.28)、(1.39±0.31)g]、益肾通络方中剂量组为[(0.78±0.25)、(1.42±0.22)g]、益肾通络方高剂量组为[(1.08±0.28)、(1.64±0.33)g],假手术组、精索静脉曲张模型组与益肾通络方高剂量组大鼠两侧睾丸质量比较,差异具有统计学意义(P0.05);益肾通络方低剂量组、益肾通络方中剂量组与精索静脉曲张模型组比较,差异无统计学意义(P0.05)。(2)益肾通络方各剂量组大鼠的生精细胞caspase-3蛋白表达低于精索静脉曲张模型组,高于假手术组;益肾通络方低剂量组大鼠生精细胞caspase-3蛋白表达高于中剂量组,益肾通络方中剂量组生精细胞caspase-3蛋白表达高于高剂量组,差异均有统计学意义(P0.05)。(3)假手术组AI评分最低,益肾通络方干预组AI评分低于精索静脉曲张模型组;益肾通络方干预组组内比较,高剂量组低于中剂量组,中剂量组低于低剂量组,差异均有统计学意义(P0.05)。结论:精索静脉曲张模型大鼠睾丸质量减轻、生精细胞caspase-3蛋白表达升高、AI增加,这可能是影响生育力的机制之一。单侧精索静脉曲张引起睾丸损害是双侧的,但右侧比左侧损害轻。益肾通络方能够降低生精细胞caspase-3蛋白表达,减少精索静脉曲张大鼠睾丸生精细胞凋亡,对睾丸生精功能具有保护作用,进而可提高睾丸的生殖能力。     

精索静脉曲张大鼠睾丸一氧化氮合酶的表达与生精功能损害关系研究

目的探索精索静脉曲张大鼠睾丸一氧化氮合酶(NOS)表达的改变及其对生精功能的影响.方法选择30例SD大鼠,20例作为实验组,建立精索静脉曲张模型;10例作为假手术对照组.3个月后,取睾丸常规切片染色,用Makler积分法分别测量实验组200个、假手术对照组100个曲细精管的生精功能,并计算平均得分;免疫组化方法测定NOS的表达强度,并比较两组之间的差异.结果实验组Makler评分显著低于假手术对照组[(8.5±0.6)分vs(16.0±1.2)分],差异有非常显著性意义(t=-6.583,P＜0.001).实验组曲细精管NOS表达强度为3.74±0.37,假手术对照组表达强度为2.10±0.12,差异有非常显著性意义(t=-6.586,P＜0.001),且其表达强度与评分值呈负相关(r-0.92,P＜0.01).结论精索静脉曲张睾丸组织中NOS表达的增加可能与生精功能损害有关,并影响精子细胞的成熟.     

精索静脉曲张对青春期大鼠睾丸生精细胞HIF-1α和VEGF表达的影响

目的:研究精索静脉曲张(VC)对大鼠睾丸生精细胞低氧诱导因子-1α(Hypoxia-inducible facmr-1α、HIF-1α)和VEGF表达的影响,探索精索静脉曲张引起不育的机理.方法:采用青春期雄性Wistar大鼠复制左侧精索静脉曲张模型,分别于术后30天、60天处死、取左侧睾丸,用免疫组化SP法检测HIF-1α和VEGF的表达.结果:HIF-1α和VEGF在VC组左侧睾丸组织中的表达均明显高于假手术组(SOG),随着精索静脉时间延长,HIF-1α、VEGF表达降低,但仍高于假手术组.结论:实验性精索静脉曲张可以改变青春期大鼠睾丸组织生精细胞HIF-1α和VEGF的表达.     

青春期精索静脉曲张模型大鼠生精细胞凋亡的研究

目的研究精索静脉曲张对青春期大鼠生精细胞凋亡的影响及生精细胞凋亡与Bcl-2/Bax表达的关系,以探讨精索静脉曲张影响睾丸生精功能的机制。方法通过部分结扎左肾静脉建立青春期大鼠左侧精索静脉曲张模型,采用原位末端脱氧核苷酸转移酶标记法检测睾丸生精细胞凋亡情况及免疫组化SABC法检测Bcl-2/Bax的表达情况。结果试验组细胞凋亡指数显著高于对照组(P<0.05),且双侧睾丸组织内均见大量生精细胞凋亡。试验组Bcl-2表达较对照组低,左侧睾丸比右侧睾丸低;而Bax表达较对照组高,左侧睾丸比右侧睾丸高。结论精索静脉曲张可明显改变青春期大鼠凋亡相关基因Bcl-2/Bax的表达,导致双侧睾丸生精细胞凋亡增加,这可能是精索静脉曲张影响睾丸生精功能的机制之一。     

精索静脉曲张对青春期大鼠生精细胞HIF-1α、Bcl-2和bax表达的影响

目的 探讨精索静脉曲张(VC)对青春期大鼠生精细胞HIF-1α,Bcl-2和bax的影响.方法 通过部分结扎左肾静脉方法制作左侧精索静脉曲张模型(EV),雄性wistar大鼠36只,随机分为6组,EV持续2周、4周、8周组和相应的接受假手术的对照组(每组6只).于造模成功后2周、4周、8周取实验组及对照组左侧睾丸,并用免疫组化方法检测睾丸组织HIF-1α、Bcl-2和bax的表达,用TUNEL法检测细胞凋亡并计算生精细胞的凋亡指数(AI).结果实验组HIF-1α,bax较对照组表达明显升高(P<0.05),而实验组Bcl-2表达较对照组明显下降(P<0.05).实验组AI较对照组明显升高(P<0.05).结论 精索静脉曲张可致大鼠睾丸组织缺氧,从而诱导睾丸组织细胞调亡增加,影响睾丸生精功能.     

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.