慢性HBV感染者外周血单个核细胞凋亡相关因子的表达及其与乙肝慢性化的关系

目的 探讨外周血淋巴细胞凋亡的不同路径及其在HBV感染慢性化过程中的作用。 方法 应用实时荧光定量PCR对9例慢性HBV携带者(ASC组),48例慢性乙型肝炎患者(CHB组),24例肝硬化(LC组)患者和20例正常对照者(NC组)外周血单个核细胞(PBMC)中的凋亡相关基因(FAS、CASP8、CYCS、CASP9、CASP3)进行检测,同时应用酶联免疫吸附试验(ELISA)检测血浆中的凋亡相关基因在蛋白水平的表达。 结果 CHB组和ASC组PBMC中凋亡相关基因mRNA水平的表达较NC组和LC组明显升高(P<0.05),CHB组和ASC组间差异无统计学意义(P>0.05),LC组高于NC组(P<0.05); CHB组和ASC组血浆中凋亡相关基因蛋白水平的表达较NC组和LC组明显升高(P<0.008 3),CHB组和ASC组间差异无统计学意义(P>0.008 3),LC组表达量较NC组升高(P<0.008 3)。 结论 HBV感染可诱导外周血单个核细胞凋亡,内源性路径和外源性路径均参与其中,PBMC的凋亡在HBV感染慢性化过程中发挥了重要作用。     

星状神经节阻滞对自发性高血压大鼠心肌细胞凋亡与Bcl-2，Bax蛋白表达的影响

目的: 研究自发性高血压大鼠(SHR) 心肌细胞凋亡与Bcl-1/Bax蛋白表达的关系,探讨星状神经节阻滞对SHR心肌细胞凋亡的保护作用。方法: 将32只10周龄雄性SHR随机分为4组(n=8)：左侧星状神经节阻滞组(LS组)、右侧星状节阻滞组(RS组)、药物卡托普利组(D组)、手术对照组(C组)。用ALC-NIBP无创血压测量系统测定大鼠血压,第10周实验结束后用3%戊巴比妥钠腹腔注射(45 mg/kg)麻醉SHR,取出心脏用TUNEL法测定左室心肌细胞凋亡指数,免疫组织化学检测心肌Bcl-2和Bax表达的含量。结果: 与C组和LS组比较,RS组SHR凋亡指数明显降低(P<0.05); 心肌Bcl-2表达明显增强(P<0.05), Bax表达明显减弱(P<0.05), Bcl-2/Bax比值增高(P<0.05)。结论: Bcl-2抗凋亡及Bax促凋亡蛋白表达参与SHR心肌细胞凋亡; 右侧星状神经节阻滞能够影响凋亡相关基因蛋白的表达,降低心肌细胞凋亡指数,减轻左心室肥厚。     

血管紧张素Ⅳ型受体过表达对早期动脉粥样硬化斑块形成的影响

目的 探讨血管紧张素Ⅳ型受体(AT4R)过表达对早期动脉粥样硬化斑块形成的影响及可能机制。 方法 ApoE^-/-小鼠60只高脂饮食喂养4周后,随机分为AT4R过表达组(Ad-AT4R组)、空载体组(Ad-EGFP组)和PBS空白对照组,每组20只。分别通过尾静脉注射携带有AT4R的腺病毒、腺病毒空载体及PBS溶液。继续高脂饮食4周后处死小鼠,留取血样及血管组织。检测血糖及血脂各项指标;采用苏木精-伊红染色法及油红O染色检测主动脉根部斑块面积百分比。 结果 与空白对照组和Ad-EGFP组相比,Ad-AT4R组体质量、血糖及血脂无显著性差异(P>0.05),苏木精-伊红染色及油红O染色斑块面积百分比显著降低(P<0.05)。 结论 AT4R过表达可抑制早期动脉粥样硬化斑块的形成,且不依赖于对血糖、血脂水平的调节。因此,AT4R可能存在潜在抗动脉粥样硬化的作用。     

清毒汤对实验性重症肝损伤大鼠Bax蛋白及Bcl-2蛋白表达的影响

目的 观察清毒汤对实验性重症肝损伤大鼠Bax、Bcl-2蛋白的表达以及肝细胞凋亡的影响,探讨该方对慢性重型肝炎（chronic severe hepatitis,CSH）大鼠肝细胞凋亡作用机制。方法 建立硫代乙酰胺（thioacetamide,TAA）致实验性大鼠重症肝损伤模型,给予清毒汤干预后,用原位细胞凋亡技术法检测大鼠肝细胞凋亡指数（apoptotic index,AI）、蛋白免疫印迹法检测大鼠肝组织中Bax、Bcl-2蛋白表达的水平。结果 与正常组比较,模型组AI显著增高（P<0.05）,清毒汤各组较模型组AI明显降低,（P<0.01或P<0.05）。清毒汤对实验性肝损伤大鼠模型Bax蛋白表达具有抑制作用（P<0.01）,对Bcl-2蛋白表达具有促进作用（P<0.01）,能够提高Bcl-2/Bax的比值（P<0.01）。结论 清毒汤可以调控Bax、Bcl-2蛋白表达量、降低AI,减轻肝细胞的凋亡和坏死。     

外周血淋巴细胞/单核细胞比值与恶性胸膜间皮瘤患者预后的关系

目的 探讨外周血淋巴细胞/单核细胞比值(LMR)与恶性胸膜间皮瘤(MPM)患者预后的关系。 方法 收集85例MPM患者的临床资料和随访资料,根据外周血LMR值将患者分为高LMR组(n=27)和低LMR组(n=58),对比分析两组临床病理资料和生存时间,并采用Cox回归模型分析LMR及其他临床病理因素与患者总生存期的关系。 结果 两组性别、功能状态(PS)评分、淋巴细胞计数和单核细胞计数差异有统计学意义(P<0.05)。高LMR组中位生存时间(27个月)显著长于低LMR组(9个月)(P<0.001)。在不同组织学类型和肿瘤分期患者中,高LMR组中位生存时间均长于低LMR组(P<0.05)。多因素分析显示,LMR是影响MPM患者总生存期的独立因素(HR: 0.277; 95% CI: 0.142~0.538; P<0.001)。 结论 外周血LMR可作为反映MPM患者生存预后的生物学标志物。     

IL-25通过nuocyte细胞诱导哮喘小鼠气道重塑

目的 探索白细胞介素-25(IL-25)通过nuocyte细胞对哮喘小鼠气道重塑的作用。 方法 30只SPF级BALB/c雌性小鼠随机分为对照小鼠组、哮喘小鼠组、抗IL-25小鼠组,每组10只,鸡清卵蛋白(OVA)诱导哮喘模型。分离培养哮喘小鼠组nuocyte细胞,并分为对照细胞组、IL-25细胞组、抗IL-25细胞组。HE染色观察肺组织变化,流式细胞法计数肺泡灌洗液(BALF)中nuocyte细胞,ELISA法检测BALF及细胞上清液中IL-4、IL-13含量,免疫组化、Western blotting及RT-PCR法检测α-平滑肌肌动蛋白(α-SMA)、Ⅰ胶原蛋白(collagen-Ⅰ)在肺组织中的表达。 结果 与对照小鼠组相比,哮喘小鼠组BALF中IL-4、IL-13表达升高,nuocyte细胞增多,α-SMA和collagen-Ⅰ表达升高(P<0.05),而抗IL-25小鼠组表达无明显变化(P>0.05);与对照细胞组相比,IL-25细胞组上清液IL-4、IL-13表达增高(P<0.05),抗IL-25细胞组上清液IL-4、IL-13表达无明显变化(P>0.05)。 结论 IL-25可能通过nuocyte细胞促使TH2型细胞因子分泌,导致哮喘小鼠气道重塑。     

脂肪源性干细胞对内源性皮肤老化的治疗作用

目的 研究脂肪源性干细胞(ADSCs)对内源性皮肤老化的抗衰老作用及机制。 方法 分离培养小鼠皮肤成纤维细胞(MSFCs)及人ADSCs。将MSFCs 分为对照组、模型组、ADSCs条件培养基组。D-半乳糖(D-gal)制备MSFCs衰老模型,ADSCs条件培养基培养。镜下及流式检测ROS、β-半乳糖苷酶活性的变化,RT-PCR 检测caspase3、p53、sirt1基因的表达情况,Western blotting检测Sirt1蛋白表达。 结果 模型组较对照组ROS水平上升(P<0.001)、β-半乳糖苷酶着色增深,而ADSCs条件培养基组较模型组ROS水平降低(P<0.001)、β-半乳糖苷酶着色变浅。RT-PCR检测结果显示模型组较对照组caspase3(P<0.001)、p53(P=0.001)表达升高,sirt1表达下降(P<0.001);而ADSCs条件培养基组较模型组caspase3(P<0.001)、p53(P=0.001)表达下降,sirt1表达升高(P<0.001)。 Western blotting结果显示模型组较对照组Sirt1表达下降(P<0.001),而ADSCs条件培养基组较模型组Sirt1表达升高(P=0.006)。 结论 ADSCs可通过Sirt1通路改善D-gal引起的内源性皮肤老化。     

过表达miR-27a对急性脑梗死大鼠海马神经元损伤的影响及其机制

目的 探究过表达miR-27a对急性脑梗死大鼠海马神经元损伤的影响及可能机制。 方法 将60只SD大鼠随机分为假手术组(Sham组)、模型组(Model组)、Agomir阴性对照组(Agomir-NC组)和miR-27a agomir组(Agomir组),每组15只。采用改良Longa线栓法构建急性脑梗死大鼠模型,于造模前1天和造模成功时,分别经侧脑室注射15 mg/kg的agomir-NC或miR-27a agomir。术后72 h,采用Zea-Longa评分法对大鼠神经功能缺损进行评分;采用氯化三苯基四氮唑染色法(TTC)测量大鼠脑梗死面积;原位缺口末端标记法(TUNEL)检测大鼠海马组织细胞凋亡水平;qRT-PCR法检测各组大鼠海马组织miR-27a的表达水平;流式细胞术(FCM)检测各组大鼠海马组织中Iba-1⁺/CD68⁺小胶质细胞所占百分比;酶联免疫吸附实验(ELISA)检测各组大鼠海马组织IL-1β、IL-6、TNF-α及iNOS的表达水平;Western blotting 检测大鼠海马组织中TLR4信号通路相关蛋白TLR4、MyD88、p-NF-κB p65及NF-κB p65表达情况。 结果 与Sham组相比,Model组大鼠海马组织细胞凋亡水平及Iba-1⁺/CD68⁺小胶质细胞水平均显著增加(均P<0.001),海马组织中IL-1β、IL-6、TNF-α水平和iNOS活性及TLR4、MyD88、p-NF-κB p65蛋白表达水平均显著升高(P<0.05),海马组织中miR-27a表达水平显著降低(P<0.001)。与Model组比,Agomir组大鼠神经功能缺损评分、脑梗死面积、海马组织细胞凋亡水平及Iba-1⁺/CD68⁺小胶质细胞水平均显著降低(均P<0.001),海马组织中IL-1β、IL-6、TNF-α水平和iNOS活性及TLR4、MyD88、p-NF-κB p65蛋白表达水平均显著下降(P<0.05),海马组织miR-27a表达水平显著上升(P<0.001)。 结论 过表达miR-27a通过抑制小胶质细胞M1型极化减轻急性脑梗死大鼠海马神经元损伤,其机制可能与抑制TLR4/NF-κB信号通路活化有关。     

脐血NK细胞改善亚急性衰老大鼠肝脏损伤

目的 探讨脐血NK细胞改善亚急性衰老大鼠模型肝脏损伤的可行性及其分子机制。 方法 采用基因工程改造的K562细胞,从新鲜脐带血获得大量NK细胞。8~10周龄雄性Wistar大鼠随机分为4组:Normal组、Model组、Mod-Con组和Mod-NK组。实验完成1周后观察大鼠体质量及肝脏指数,检测血清和肝脏中超氧化物岐酶(SOD)、丙二醛(MDA)及肝脏中凋亡相关基因的表达,观察肝脏切片组织细胞形态变化。 结果 皮下注射D-半乳糖可成功构建亚急性衰老大鼠模型。输注大量高纯度的脐血NK细胞,可显著改善其肝脏损伤,促进体质量回升(P<0.01)并降低肝脏指数(P<0.05),血清及肝脏中SOD活性增强(P<0.01),MDA水平降低(P<0.01);肝脏切片示肝细胞水肿减轻,Masson染色显示肝组织纤维化减轻;促凋亡基因表达减少(P<0.01),而抗凋亡基因成纤维细胞生长因子表达上升(P<0.01)。 结论 脐血NK细胞输注可有效改善亚急性衰老大鼠的肝脏损伤。     

Th1/Th2细胞因子在眼肌型重症肌无力转基因小鼠模型中的作用机制

目的 观察重组人乙酰胆碱受体(H-AChR) γ亚单位免疫HLA-DQ8转基因小鼠眼肌型实验性自身免疫性重症肌无力(oEAMG)模型体外培养上清液中Th1/Th2细胞因子水平变化,探讨其与oEAMG免疫学发病机制的联系。方法 HLA-DQ8转基因小鼠用乳化于完全弗氏佐剂(CFA)的重组H-AChR γ亚单位,或E. Coli提取物,或纯CFA分别免疫,分别于第0天、第30天和第60天共免疫3次。第3次免疫后28 d,处死小鼠后取淋巴结和脾淋巴细胞体外培养,收集培养上清液,采用ELISA法检测白细胞介素(IL)-2、γ-干扰素(IFN-γ)、IL-6和IL-10水平。结果 H-AChR γ组小鼠淋巴结及脾淋巴细胞体外培养上清液中IL-2(F=42.835,P<0.001;F=38.030,P<0.001)和INF-γ水平(F=76.332,P<0.001;F=34.865,P<0.001)均明显高于E. coli组和CFA免疫组;IL-6(F=1.325,P=0.284;F=1.935,P=0.166)和IL-10水平(F=0.908,P=0.417;F=1.189,P=0.322)与E. coli 组和CFA组差异无统计学意义。结论 Th1细胞因子在重组H-AChR γ亚单位诱导HLA-DQ8转基因小鼠所建立oEAMG模型的发病机制中可能发挥重要作用,而Th2细胞及其细胞因子作用尚不十分明确。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.