白喉乌头对RA大鼠B10细胞和炎症因子的影响

目的探讨白喉乌头对类风湿关节炎(RA)大鼠B10细胞和炎症因子的影响。方法将40只SPF级雌性Wistar大鼠均分为空白对照组、模型组、低剂量组、高剂量组与阳性对照组。除空白对照组外,其他组大鼠均建立类风湿关节炎模型,造模成功后,模型组生理盐水灌胃,低剂量和高剂量组每天22.5、45 mg/kg白喉乌头灌胃,阳性对照组每天1 mg/kg雷公藤灌胃,每次灌胃1 mL,每天1次,连续4周。HE染色观察各组大鼠踝关节滑膜组织病理学变化,免疫组化法检测各组滑膜组织B10细胞表面抗原CD19、CD5表达情况,ELISA法检测各组大鼠血清中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-1β、IL-10、IL-12的水平。 结果模型组关节滑膜有水肿及大量纤维组织增生;低剂量组、阳性对照组有少量纤维组织增生;高剂量组轻微水肿,无纤维组织增生。模型组CD5、CD19蛋白表达较空白对照组增高(P＜0.05),低剂量组、高剂量组和阳性对照组CD5、CD19蛋白表达较模型组降低(P＜0.05)。模型组TNF-α、IL-6、IL-12、IL-1β水平较空白对照组增加(P＜0.05),低剂量组、高剂量组、阳性对照组TNF-α、IL-6、IL-12、IL-1β水平较模型组降低(P＜0.05)。结论白喉乌头可能通过调控B10细胞减少RA滑膜组织的炎症反应。     

穴位埋线对CIA大鼠IL-1β、TGF-α及MVD表达的影响

目的通过观察穴位埋线对大鼠胶元诱导型关节炎(CIA)模型血清IL-1β、TNF-α表达及其滑膜新生血管的影响,探讨其对类风湿关节炎(RA)的作用机理。方法建立Ⅱ型胶原诱导大鼠胶原性关节炎模型,造模成功的大鼠随机分为模型组、来氟米特组、穴位埋线治疗组、来氟米特+穴位埋线治疗组。ELISA法血清中IL-1β、TNF-α表达含量变化和SP免疫组织化学染色法滑膜组织MVD计数。结果与模型组比较,各治疗组血清中IL-1β、TNF-α及滑膜组织MVD均明显下降(P0.01),且各治疗组之间比较无统计学差异(P0.05)。结论穴位埋线可能通过降低大鼠血清IL-1β、TNF-α表达而发挥抑制关节滑膜血管新生作用,这可能是姜黄素治疗类风湿关节炎的作用机制之一。     

龙须藤提取物对胶原诱导性关节炎模型大鼠的影响

目的研究龙须藤乙酸乙酯提取物对胶原诱导性关节炎模型大鼠滑膜组织中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)的影响,探讨其作用机理。方法建立胶原诱导性关节炎(CIA)大鼠模型,观察大鼠足趾肿胀度的变化,用免疫组化法检测大鼠踝关节滑膜组织中TNF-α、IL-6、IL-8的含量。结果龙须藤乙酸乙酯提取物能抑制大鼠足趾肿胀及滑膜组织中TNF-α、IL-6及IL-8的表达。结论龙须藤乙酸乙酯提取物对类风湿性关节炎有一定的治疗作用,其作用机理是降低滑膜组织中TNF-α、IL-6、IL-8的表达水平。     

苗药金乌健骨汤对胶原性关节炎模型大鼠血清IL-1、IL-1β及TNF-α的影响

目的:探讨苗药金乌健骨汤对胶原诱导性关节炎(CIA)模型大鼠血清TNF-α、IL-1、IL-1β的影响。方法:将60只Wistar大鼠随机分为6组,每组各10只,除空白对照组外,其余各组制备CIA模型。从建模第8天开始分别灌服雷公藤多苷混悬液、金乌健骨汤低、中、高剂量水煎浓缩液,空白对照组和模型对照组灌服等量生理盐水。给药第28天断头取血并处死大鼠留取关节滑膜,ELISA法检测血清TNF-α、IL-1、IL-1β表达水平,病理切片观察关节滑膜。结果:模型对照组大鼠血清IL-1、IL-1β、TNF-a表达高于空白对照组(P0.05),金乌健骨汤及雷公藤多苷对照组大鼠血清IL-1、IL-1β、TNF-a表达较模型对照组有不同程度下降(P0.01或P0.05)。结论:金乌健骨汤能下调CIA模型大鼠血清TNF-α、IL-1、IL-1β表达水平。     

穿山龙总皂苷对胶原诱导性关节炎大鼠血清及滑膜组织肿瘤坏死因子α影响的研究

目的探讨穿山龙总皂苷对Ⅱ型胶原诱导性关节炎(CIA)大鼠血清及滑膜组织肿瘤坏死因子α(TNF-α)的影响,探讨其治疗类风湿关节炎(RA)的免疫调节机制。方法选取48只清洁级Wistar大鼠,随机分成4组:正常对照组(A组)、模型组(B组)、雷公藤多苷片组(C组)和穿山龙总皂苷组(D组),每组12只。B、C、D组大鼠均建立CIA大鼠模型,待模型建立成功后,C、D组大鼠分别给予相应的药物灌胃;A、B组大鼠给予等体积0.9%氯化钠注射液灌胃;均连续给药21 d,然后处死大鼠取材。应用双抗体夹心酶联免疫吸附(ELISA)法检测4组大鼠血清TNF-α水平,同时应用逆转录联合酶链式反应(RT-PCR)方法测定4组大鼠滑膜组织TNF-αmRNA表达量。结果 B组大鼠血清TNF-α水平及滑膜组织TNF-αmRNA表达量均高于A组,差异有统计学意义(P<0.05);而C、D组大鼠血清TNF-α及滑膜组织TNF-αmRNA表达量均低于B组,差异有统计学意义(P<0.05);但C、D组大鼠上述指标比较,差异无统计学意义(P>0.05)。结论穿山龙总皂苷可能通过调节细胞因子TNF-α的水平来发挥其对RA有益的免疫调节作用。     

草乌甲素对大鼠胶原诱导性关节炎的作用

探究草乌甲素对大鼠胶原诱导性关节炎的作用。方法 20只雄性SPF级SD大鼠随机选取5只作为对照组,剩下的15只SD大鼠用来建立胶原诱导性关节炎（CIA）模型,根据关节炎评分表评估CIA模型,建模成功后再随机分成模型组、低剂量草乌甲素治疗组（50 μg/kg）、高剂量草乌甲素治疗组（100 μg/kg）,此后每组大鼠连续给药干预30 d,第31天后处死大鼠。酶联免疫吸附法（ELISA）测定大鼠TNF-α、IL-6、IL-17、MMP-3水平,逆转录聚合酶链式反应（RT-PCR）测定关节滑膜组织中MMP-3 mRNA表达水平,蛋白印迹法（Western Blot）检测关节滑膜组织中MMP-3蛋白水平,HE染色观察滑膜组织病理变化。结果 与对照组比较,模型组及草乌甲素治疗组TNF-α、IL-6、IL-17、MMP-3水平明显升高（P＜0.05）;同时,与模型组比较,草乌甲素治疗组TNF-α、IL-6、IL-17、MMP-3水平明显降低（P＜0.05）。与对照组相比,模型组MMP-3 mRNA、MMP-3蛋白表达水平明显升高;同时,与模型组比较,草乌甲素治疗组MMP-3 mRNA、MMP-3蛋白表达水平降低（P＜0.05）。组织病理结果显示草乌甲素治疗组的关节滑膜处的炎症细胞浸润及滑膜增生情况均减轻。结论 草乌甲素可以抑制炎症因子分泌和降低MMP-3的表达,对大鼠胶原诱导性关节炎具有一定的治疗作用     

胶原性关节炎大鼠滑膜病理特征及TNF-α、TGF-β表达的变化

目的观察II型胶原诱导的胶原性关节炎(CIA)大鼠模型滑膜组织病理学特征及相关细胞因子表达水平的变化。方法60只健康雄性Wistar大鼠随机分为对照组(n=10)和模型组(n=50),模型组以牛源性II型胶原皮下注射诱导建立CIA模型,造模成功后随机选取10只大鼠进行病理观察并做免疫组化指标TNF-α、TGF-β检测,并与对照组进行比较。结果与对照组比较,模型组大鼠滑膜组织大量炎性细胞浸润、增生。对照组滑膜组织中TNF-α阳性滑膜细胞数呈低表达,且染色浅,模型组呈高阳性表达,深染色,2组比较差异有统计学意义(P<0.01);对照组滑膜组织中TGF-β表达较活跃,模型组则表达少而染色浅,2组比较差异有统计学意义(P<0.05)。结论细胞因子网络失衡与CIA大鼠的发病相关。     

苗药痛风停对痛风性关节炎模型大鼠TLRs/MyD88通路及相关炎症因子的影响

目的:探讨痛风停方(TFT)对痛风性关节炎模型大鼠TLRs/MyD88通路及相关炎症因子的影响。方法:建立痛风性关节炎大鼠模型,随机分为模型对照组、空白对照组、痛风停低、中、高剂量组和秋水仙碱组,每组12只。空白对照组及模型组以等量生理盐水灌胃,其余各组予等容积相应药物灌胃,连续给药5天后收集标本,ELISA法检测外周血TNF-α、IL-1、IL-6、IL-8浓度,免疫印迹法检测大鼠关节滑膜组织TREM-1、TLR2、TLR4、MyD88蛋白表达情况,并对滑膜组织进行免疫组化检测。结果:(1)模型组大鼠血清IL-1、IL-6、IL-8、TNF-α显著升高(P0.05),与模型组比较,痛风停低、中、高剂量组及秋水仙碱组血清炎症因子均有不同程度降低(P0.05),其中痛风停高剂量组炎症因子浓度低于秋水仙碱组(P0.05)。(2)模型组大鼠关节滑膜组织中TREM-1、TLR2、TLR4、MyD88蛋白表达水平增加(P0.05),痛风停中、高剂量组及秋水仙碱组蛋白表达较模型组低(P0.05),其中痛风停高剂量组效果TLR4蛋白表达低于秋水仙碱组(P0.05)。(3)模型组滑膜组织免疫组化染色评分及阳性细胞数均显著高于空白组(P0.05),痛风停中、高剂量组及秋水仙碱组则低于模型组(P0.05),其中痛风停高剂量组在TLR4免疫组化染色评分及细胞阳性数方面较秋水仙碱组低(P0.05)。结论:苗药痛风停可以抑制痛风性关节炎大鼠关节滑膜TREM-1、TLR2、TLR4、MyD88蛋白表达,降低血清IL-1、IL-6、IL-8、TNF-α浓度,有效控制关节炎症。     

胶原性关节炎大鼠血清中TNF-α，IL-17及IL-10水平分析

[目的]检测血清TNF-α,IL-17及IL-10在Ⅱ型胶原诱导性关节炎(CIA)大鼠血清中的表达。[方法]建立CIA动物模型,用酶联免疫吸附实验(ELISA)法检测大鼠模型血清中炎性细胞因子TNF-α、IL-10及IL-17的水平,同时观察大鼠炎症指数。[结果]60只大鼠随机被分为造模组(40只)和对照组(20只),免疫4周后,造模组40只大鼠有32只发病。造模成功组大鼠血清中TNF-α、IL-17水平分别为(39.65±11.23)pg/mL和(46.1±10.9)pg/mL,明显高于造模失败组和正常对照组(P均<0.05),而IL-10水平(29.11±27.59)pg/mL明显低于造模失败组和正常对照组(P<0.05)。另外,造模组大鼠血清TNF-α和IL-17水平与CIA大鼠炎症指数呈正相关关系(r=0.573,r=0.492,P<0.05),与之相反,CIA大鼠血清IL-10水平与炎症指数呈负相关关系(r=-0.481,P<0.05)。[结论]致炎因子(TNF-α,IL-17)和抑炎因子(IL-10)表达失衡可能在CIA发病中具有重要作用。     

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.     

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.