哮喘患者诱导痰液中NO-2/NO-3水平测定的临床意义

目的研究一种无创性观察气道炎症的新指标.方法检测10名健康人、13例缓解期哮喘患者及29例发作期哮喘患者诱导痰液中NO-2/NO-3的水平,其中11例哮喘患者参加泼尼松(30 mg/d)治疗1周的前、后自身对照研究.结果哮喘发作期患者NO-2/NO-3水平为(406.34±512.18) μmol/L,显著高于正常对照者(71.80±100.98) μmol/L,两组比较有非常显著性差异(P＜0.001);哮喘发作期患者的NO-2/NO-3水平与FEV1和FEV1/FVC的下降呈正相关(r分别为0.429 8和0.430 4).应用激素后患者的症状、体征好转的同时,NO-2/NO-3的水平由(343.95±430.56) μmol/L降至(69.11±70.28) μmol/L(P＜0.001).缓解期哮喘患者的NO-2/NO-3水平与正常对照组相比,无显著性差异(P＞0.05).结论正常对照组及哮喘患者诱导痰液中能够检测到一定浓度的NO-2/NO-3;诱导痰液NO-2/NO-3水平是一项反映哮喘气道炎症程度的实用指标.     

一氧化氮-环磷酸鸟苷通路在支气管哮喘发病机制中的作用

目的:探讨一氧化氮-环磷酸鸟苷(NO-cGMP)通路在支气管哮喘发病机制中的作用.方法:给10名健康人、1 3例缓解期哮喘病人及29例发作期哮喘患者诱导痰液,检测诱导痰液中NO2-/NO3-及cGMP的水平.并对其中11例哮喘发作期患者应用强的松(30 mg/d),治疗1周的前后进行自身对照研究.结果:哮喘发作期患者NO2-/NO3-水平显著高于健康对照者[(406.34±512.18)μmol/L,(71.80±100.98)μmol/L,P＜0.01],应用激素后患者在症状、体征好转的同时,NO2-/NO3-和cGMP的水平均有明显下降,稳定期哮喘患者的NO2-/NO3-水平同正常人相比差异无显著性.结论:NO-cGMP通路可能在哮喘的发病中起重要作用,诱导痰NO2-/NO3-的测定是无创伤性检测哮喘气道炎症的一项简便易行的实用方法.     

血浆亚硝酸根及环磷酸鸟苷浓度预测早产的价值

目的　探讨血浆亚硝酸根 (NO2 - )及环磷酸鸟苷 (c GMP)浓度预测早产的价值。方法　采用示波极谱法和放射免疫法测定了 2 5 0例妊娠妇女 (2 10例正常妊娠妇女和 4 0例早产妇女 )血浆 NO2 - 和 c GMP浓度。结果　正常妊娠妇女从 2 8周至 36 + 6周 ,血浆 NO2 -和 c GMP浓度均逐渐增加。NO- 2 从 1.95 75± 0 .35 0 9增加至 2 .2 36 0±0 .3486μmol/ L ,c GMP从 31.16 2 5± 3.90 82增加至 4 2 .185 0± 11.3816μm ol/ L。血浆 NO2 - 浓度在 34～ 34+ 6 周达最高值 (2 .2 4 2 5± 0 .340 7μm ol/ L) ,血浆 c GMP浓度在 33～ 33+ 6周达最高值 (49.0 0 10± 8.6 719μm ol/ L)。早产妇女血浆 NO2 -和 c GMP浓度均低于相应孕周的正常妊娠妇女 (P<0 .0 1和 P<0 .0 5 )。结论　血浆 NO2 -和 c GMP浓度预测早产具有良好的可行性和应用前景     

拟炎症高NO大鼠原代培养肝细胞的信号转导途径研究

目的 :通过对信号分子 NO在原代培养大鼠肝细胞所经由的信号转导途径研究 ,探索炎症急性期肝细胞高 NO的生物学意义 ,及药物可能作用的新靶点。方法 :采用 NO供体硝普钠 (SNP)模拟肝脏急性炎症期高 NO环境 ,Griess法测定 NO的特异氧化终产物 NO2 - / NO3- 。测定肝细胞中 c GMP的浓度和肝细胞培养液中 GSNO的浓度 ,由此分别了解在原代培养大鼠肝细胞模型 ,NO经由 c GMP通路信号转导 ,还是经由非 c GMP通路信号转导的途径。结果 :1.5 4 3mmol/ L SNP释放 NO达峰值分别为 ,以 2 5 mmol/ L GSH为 NO释放通路 ,30 min时为 (0 .6 3± 0 .0 6 ) mmol/ L ;以 2 5 mmol/ L L - Cys为活性巯基通路 ,2 5 min时为 (0 .98± 0 .11) mmol/ L。 SNP与原代培养大鼠肝细胞共孵育过程中 ,随着孵育时间的延长及 SNP浓度的增高 ,细胞内 c GMP含量与对照组相比有显著性差异 (P<0 .0 5 ) ;培养液中 GSNO浓度也有增高。与对照组比均有显著差异 (P<0 .0 5 )。结论 :NO供体 SNP在含有巯基(GSH和 Cys)的肝细胞培养液中可持续释放 NO,通过 c GMP依赖性通路和 c GMP非依赖性通路—— GSNO通路进行信号转导 ,影响下游生物学效应靶点     

支气管哮喘急性发作期患者血清NO代谢产物的测定

为探讨一氧化氮(NO)在支气管哮喘发病中的病理生理作用及临床意义,应用比色法测定20例哮喘急性发作期患者血清NO代谢产物亚硝酸盐水平.结果,支气管哮喘急性发作期患者NO代谢产物水平明显高于缓解期及正常对照组,支气管哮喘急性发作期NO浓度6.151±0.373μmol/L,缓解期NO浓度3.198±0.680μmol/L,正常对照组NO浓度2.428±0.368μmol/L,差异有显著性(P＜0.01).表明支气管哮喘发作时NO产生过多,导致其细胞毒性反应,加重哮喘发病.     

哮喘儿童嗜酸细胞阳离子蛋白含量变化与其肺功能的关系

采用 Pharmacia Uni CAP系统检测 2 5例哮喘患儿急性发作期及 17例治疗后血及诱导痰嗜酸细胞阳离子蛋白 ( ECP)的含量 ,计数静脉血嗜酸粒细胞 ( Eos) ,测定肺通气功能 FEV1 。结果 :急性发作期哮喘血 Eos( 0 .2 75± 0 .2 63)× 10 9/L 较正常升高 ( 0 .0 68± 0 .0 2 8)× 10 9/L,P<0 .0 1;血 ECP浓度 ( 16.0 9± 13.68μg/L)高于正常对照和治疗后 ( 3.78±1.77μg/L;4.2 4± 2 .5 6μg/L) ,P<0 .0 1。发作期痰液 ECP浓度 ( 78.68± 5 3.95 μg/L)明显高于治疗后 ( 2 2 .5 4± 15 .83μg /L) ,P<0 .0 1。哮喘患儿血 Eos计数与血 ECP浓度存在显著正相关 r=0 .5 716,P<0 .0 1;与痰 ECP浓度无相关 r=0 .2 792 ,P>0 .0 5。血、痰 ECP含量与FEV1 呈显著负相关 r=-0 .430 9、-0 .40 5 0 ,P均 <0 .0 5。提示 ECP在哮喘气道炎症机理中起作用 ,是临床评价哮喘活动的指标之一     

妊高征患者血浆增加内皮细胞一氧化氮合成的实验研究

目的　研究妊娠高血压综合征 (简称妊高征 ,PIH)患者的血浆对体外培养的内皮细胞一氧化氮 (NO)的影响。　方法　在体外培养的脐静脉内皮细胞中分别加入妊高征患者 (妊高征组 )和正常晚孕妇女 (晚孕组 )的血浆 ,测定 2 4h后培养液中NO代谢产物亚硝酸基 /硝酸基 (NO-2 /NO-3 )。　结果　加入妊高征组血浆的内皮细胞培养液中NO-2 /NO-3 含量为 (7.87± 0 .5 4 ) μmol/L ,加入晚孕组血浆的内皮细胞培养液中NO-2 /NO-3 含量为 (5 .93± 0 .5 9) μmol/L ,前者较后者显著增高 (P <0 .0 1)。　结论　妊高征患者的血浆能刺激培养的内皮细胞合成NO。     

内皮素/一氧化氮系统失调在妊高征发病中的作用

目的 :观察妊高征患者血浆一氧化氮 (NO)和内皮素 (ET)含量的变化并探讨其在妊高征发病中的意义。方法 :应用镉柱比色法和放射免疫法分别对 43例妊高征患者 (妊高征组 )、36例正常妊娠妇女 (对照组 )和 19例正常非孕妇 (正常组 )血浆中NO代谢产物亚硝酸盐 /硝酸盐 (NO-2 /NO-3 )及ET - 1含量进行了检测。结果 :正常妊娠妇女血浆中NO-2 /NO-3 含量 (34.2 9± 10 .15 ) μmol/L明显高于非孕正常组妇女 (11.98± 3 .99)μmol/L ,并随孕周的增加而增加 ,孕中期达高峰 (39.45± 9.16 ) μmol/L ,到孕晚期有所下降 (31.42± 7.86 5 )μmol/L。血浆中ET的含量有所上升 ,但与非孕正常组妇女相比则没有显著差异 (P >0 .0 5 ) ;与正常晚期妊娠对照组相比 ,轻、中度妊高征妇女血浆中NO-2 /NO-3 含量虽有所上升 ,但没有明显差异 (P >0 .0 5 ) ,而重度妊高征妇女则有明显上升 (P <0 .0 5 )。妊高征妇女血浆ET含量 (96 .0 5± 13 .5 7)ng/L与正常晚期妊娠妇女(36 .48± 6 .17ng/L)相比有极显著的上升 (P <0 .0 1) ,并且与妊高征的严重程度成正比 (r =0 .5 2 ,P <0 .0 1) ,ET/NO比值 (2 .47)明显大于正常晚期妊娠对照组妇女 (1.13,P <0 .0 5 )。结论 :妊高征患者内皮细胞损伤导致ET/NO系统平衡失调可能在妊高征的发病机     

一氧化氮在过敏性哮喘豚鼠发病机理中的作用

本文采用镉还原柱层析和比色法测定过敏性哮喘豚鼠模型血浆及支气管肺泡灌洗液中亚硝酸/硝酸根离子(NO_2~-/NO_3~-)水平,以探讨一氧化氮(NO)在过敏性哮喘发病机理中的作用。结果表明:过敏性哮喘豚鼠血浆中NO_2~-/NO_3~-水平与正常豚鼠组比较无明显变化(分别为21.551±2.278μmol/L;22.558±2.695μmol/L.t=0.807.p>0.05),而支气管肺泡灌洗液中NO_2~-/NO_3~-水平显著升高(分别为10.162±1.283μmol/L;6.196±0.824μmol/L.t=7.358.p<0.001)。本文显示:作为NO产生水平的良好指标,支气管肺泡灌洗液中NO_2~-/NO_3~-水平与过敏性哮喘密切相关;哮喘患儿基础型一氧化氮合成酶(NOS)缺陷,而诱导型NOS功能活跃.使NO产生过多导致气道水肿,高反应性而致哮喘发病。研究制备选择性诱导型NOS抑制剂对治疗和预防哮喘具有诱人的前景。     

哮喘患者血清可溶性细胞间黏附分子-1和白细胞介素-8的变化及意义

目的　探讨可溶性细胞间黏附分子 -1(sICAM -1)和白细胞介素 -8(IL -8)在哮喘发病中的作用。方法　应用酶联免疫吸附试验测定 3 0例哮喘和 2 0例健康对照组血清sICAM -1和IL -8。结果　急性发作期哮喘患者血清sICAM -1和IL -8明显高于缓解期哮喘患者及对照组〔sICAM分别为 (3 47 81± 81 2 3 ) μg/L ,(2 2 4 85± 17 1) μg/L ,(2 0 4 5 5± 2 7 43 ) μg/L ,P =0 0 0 0 ;IL -8分别为 (2 6 78± 16 19)ng/L ,(5 3 8± 4 7)ng/L ,(3 63± 0 5 3 )ng/L ,P =0 .0 0 0〕 ,而缓解期哮喘患者与对照组无明显差异 (P >0 0 5 )。结论　研究结果提示可溶性细胞间黏附分子 -1和白细胞介素 -8可能参与了哮喘急性发作期的发病过程。     

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.