内毒素耐受大鼠铜绿假单胞菌肺部感染炎症反应的动态变化

目的　动态观察内毒素耐受大鼠肺部感染铜绿假单胞菌(Pseudomonasaeruginosa ,PA)后肺部炎症反应与正常大鼠的异同。方法　SD大鼠随机分为正常对照组(NC组)和内毒素耐受组(ET组)。ET组每天腹腔注射脂多糖(lipopolysaccharide ,LPS) 0 .6mg/kg ,共4d ,建立内毒素耐受大鼠模型;NC组每天注射生理盐水。第5天气管内滴入0 .2mL (6×10 8)cfu/mLPA新鲜菌液。各组按滴入PA前(0h) ,滴入后6、2 4h分为3小组,进行外周血和支气管肺泡灌洗液(BALF)白细胞计数和分类,测定BALF白蛋白并计算其与血清白蛋白比值以评估肺部微血管通透性。结果　ET组滴入PA后体重下降幅度明显小于NC组,未出现类似NC组大鼠的肺部微血管通透性升高。在气管内滴入PA后NC组外周血中性粒细胞(polymorphonuclearneutrophilleukocyte,PMN)明显升高,而ET组仍以淋巴细胞为主;NC组BALF中PMN %在滴入后6h即明显升高,至2 4h有所下降,而ET组BALF中PMN %始终<1%。结论　内毒素耐受有助于减轻PA感染所致的以PMN浸润为主要特征的急性肺部炎症反应和急性肺损伤。     

TNF-α和CINC在内毒素耐受大鼠肺部炎症中的动态变化

目的　研究内毒素血症时内毒素耐受大鼠肺部肿瘤坏死因子 -α(TNF α)和细胞因子诱导的中性粒细胞趋化物 (CINC)表达的情况。方法　SD大鼠随机分入正常对照组 (NC组 )和内毒素耐受组 (ET组 )。腹腔注射脂多糖 (LPS) ,每日 0 .6mg/kg连续 4d建立内毒素耐受模型。第 5天腹腔注射 6mg/kg。各组按注射大剂量LPS前 (0h) ,注射后 2、6、2 4、4 8、72h分为 6小组 ,n =6。用ELISA测定BALFTNF α。用RT PCR半定量检测肺组织CINCmRNA的表达。用SPSS 10 .0医学统计软件分析数据。结果　NC组注射LPS(6mg/kg)前 ,BALF中有少量TNF α ,肺组织有微量CINCmRNA表达 ;给药后两者均迅速上升 ,前者的高峰为 6h ,(10 .79±3.5 3) μg/L ,P =0 .0 0 1,后者的高峰出现于 2～ 6h(相对值为 1.6左右 ,P <0 .0 0 1) ,持续至 2 4h。而ET组两者均无上升。结论　内毒素耐受时 ,大剂量内毒素引起的肺部炎症反应和肺损伤减轻与肺部TNF α和CINC低表达有关     

内毒素耐受对肺部E选择素和血管细胞间黏附分子1表达的影响

目的观察内毒素血症时内毒素耐受(ET)大鼠血清和肺部E选择素与血管细胞间黏附分子1(VCAM-1)的动态变化,及其与非内毒素耐受(non-ET)大鼠的异同。方法ET组SD大鼠腹腔注射脂多糖(LPS)0.6mg.kg-1.d-1,连续4d,建立ET模型。第5d两组大鼠均腹腔注射大剂量(6mg/kg)LPS诱导全身及肺部炎症反应。采用双抗体夹心酶联免疫吸附法测定注射大剂量LPS前(0h),以及注射后1,2,6和24h的血清、支气管肺泡灌洗液(BALF)及肺组织匀浆中E选择素与VCAM-1的蛋白水平。结果ET组和non-ET组在注射大剂量LPS后血清E选择素和VCAM-1的表达无显著差异(P>0.05)。ET组BALF中的E选择素的上升滞后于non-ET组:E选择素在non-ET组接受大剂量LPS后1h即出现明显升高,之后下降;ET组高峰则在6h;1h时ET组明显低于non-ET组[(36.66±10.24)pg/mL比(89.72±16.66)pg/mL,P<0.001]。肺组织E选择素表达与BALF中的变化趋势相似。BALF中的VCAM-1表达在ET组中0,1,2和6h四个时间点均低于non-ET组,其中1h时间点差异显著(P<0.01)。在2和6h时non-ET组肺组织的VCAM-1急剧升高,而ET组几乎无上升,non-ET组6h时较ET组明显升高(P<0.05)。结论在内毒素耐受状态下,大剂量LPS腹腔注射所致的肺部E选择素和VCAM-1早期表达被阻滞。     

己酮可可碱对内毒素诱导的大鼠急性肺损伤肺微血管通透性的保护

目的：探讨己酮可可碱(PTX)对内毒素(LPS)诱导的急性肺损伤肺微血管通透性的影响。方法：建立大鼠急性肺损伤模型,随机分为LPS组、LPS PTX组、对照组,检测3组的动脉血气并行支气管肺泡灌洗液计数白细胞和白蛋白,肺微血管通透性指数及肺组织学检查。结果：与对照组比较,LPS组及LPS PTX组的动脉氧分压均显著下降,白细胞计数增加,白蛋白含量及肺微血管通透性指数升高,肺组织学检查显示明显的炎症改变;与LPS组比较,LPS PTX组动脉氧分压有所改善,白细胞计数减少。白蛋白含量及肺微血管通透性指数降低,肺组织学检查明显好转。结论：PTX可降低肺微血管通透性,对LPS诱导的急性肺损伤有保护作用。     

气管滴入及腹腔注入内毒素致大鼠急性肺损伤机制的研究

目的 :探讨肺内因素及肺外因素致急性肺损伤 (ALI)的异同。方法 :气道内滴注及腹腔内注射内毒素(LPS ,10mg kg)建立大鼠ALI模型。 5 4只雄性SD大鼠随机分为对照组、气道组、腹腔组 ,每组 18只 (2h、6h、2 4h各6只 )。按时相处死并采集标本 ,观察大鼠动脉血气分析、支气管肺泡灌洗液 (BALF)总蛋白水平、细胞总数、细胞分类及TNF α水平、肺病理。结果 :和腹腔组比较 ,气道组大鼠动脉血氧分压 (PaO2 )明显降低 (P <0 0 0 1) ,BALF总蛋白水平、PMN明显增加 (P <0 0 0 1) ,BALF中TNF α水平明显升高 (2h、6hP <0 0 0 1,2 4hP <0 0 5 ) ,肺病理示肺内PMN大量浸润伴出血、透明膜形成。结论 :①气道内滴注LPS致大鼠PaO2 进行性降低 ,而腹腔内注射LPS对PaO2 无明显影响。②气道内滴注LPS致大鼠肺内PMN大量浸润 ,而腹腔内注射LPS肺内PMN数量明显少于前者     

内毒素致新生SD大鼠肺损伤模型的建立及鉴定

目的:探讨新生大鼠急性肺损伤模型的建立及其病理特征。方法:采用腹腔注射内毒素(LPS,5 mg/kg)的方法制备新生SD大鼠急性肺损伤动物模型,在光镜下观察肺的病理变化,观察支气管肺泡灌洗液(BALF)中细胞分类情况,用ELISA、RT-PCR法检测血清和肺组织中白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的表达。结果:LPS注射3 h后,光镜下可见明显的肺出血和中性粒细胞浸润;肺湿/干重比(W/D)增加,BALF中多形核白细胞(PMN)数量明显增加,血清中TNF-α和IL-6表达水平和肺组织中TNF-αmRNA水平均显著增高。结论:新生SD大鼠腹腔注射LPS后,能够引起显著的急性肺部炎症反应。     

血红素加氧酶-1重组乳酸乳球菌灌胃对内毒素诱导大鼠急性肺损伤的作用

目的:利用基因工程原理合成携带血红素加氧酶-1(HO-1)基因的乳酸乳球菌,给正常大鼠灌胃后,观察其对内毒素诱导大鼠急性肺损伤的保护效应。方法:随机将30只健康清洁级SD大鼠分为对照组(LPS组,n=10)、携带HO-1的乳酸乳球菌灌胃组(HO组,n=10,LPS模型建立前24 h灌胃)、拮抗剂组[锌原卟啉(ZnPP)组,n=10,HO灌胃24 h后,LPS模型建立前1 h腹腔注射ZnPP 10μmol/kg];LPS模型建立后4 h取材,比较各组动物支气管灌洗液(BALF)中髓过氧化物酶(MPO)活性、中性粒细胞(PMN)计数、肺组织湿干重比(W/D)、肺组织MPO活性,并在光镜下观察肺组织病理学改变。结果:与LPS组比较,HO组BALF中MPO、PMN计数和肺组织W/D均降低(P<0.05),肺组织病理学损伤减轻;与HO组比较,ZnPP组BALF中MPO、PMN计数和肺组织W/D均升高(P<0.05),肺组织病理学损伤加重;ZnPP组与LPS组比较差异无统计学意义(P>0.05)。结论:预先给大鼠用携带HO-1基因的乳酸乳球菌灌胃,可对内毒素诱导急性肺损伤大鼠产生一定的保护作用。     

内毒素对鼠肺／肠微血管及体外培养内皮细胞通透性的影响及凋亡在其中的作用

目的观察内毒素（LPS）对鼠肺和肠微血管及体外培养内皮细胞通透性的影响及凋亡在其中的可能作用。方法（1）观察内毒素血症时大鼠肺、肠组织微血管通透性的改变。（2）观察LPS对体外培养人脐静脉内皮细胞（HUVECs）通透性的影响。（3）观察LPS对体外培养HUVEC凋亡的影响，从而探讨凋亡在内皮细胞通透性改变中的作用。结果（1）在大鼠内毒素血症模型中，5ms／ks和10mg／kg LPS均可造成肺、回肠组织伊文氏兰含量增加（P〈0．01或0．05）。（2）100μg／ml LPS可显著增加体外单层HUVEC对牛血清白蛋白的通透性（P〈0．05或0．01）。（3）LPS可引起的体外培养内皮细胞的凋亡。结论（1）LPS能迅速提高体内肺微血管内皮细胞通透性，而LPS作用后6h肠微血管通透性开始增加。（2）LPS可剂量依赖性的引起体外培养脐静脉内皮细胞通透性升高。（3）细胞凋亡可能是引起内毒索血症时内皮细胞通透性的原因之一。     

急性肺损伤大鼠支气管肺泡灌洗液中CC16水平的变化及重组人生长激素的影响

目的 探讨肺源性抗炎因子CC16在内毒素(LPS)急性肺损伤(ALI)中的作用及重组人生长激索(rhGh)的影响。方法 64只继康雄性SD大鼠随机分为rhGh预处理组(rhGh组)和无菌生理盐水预处理组(NS组)。经rhGh或无菌NS连续预处理7d后，各组动物又分为两个亚组，即LPS伤前组(LPS0h组)和LPS致伤组(LPS24h组)。LPS24h组大鼠经股静脉注射5mg／kg体重LPS，于注射LPS后24h收集肺行病理学观察，并收集支气管肺泡灌洗液(BALF)。用Westernblot法半定量分析其中的CC16含量。LPS0h组以无菌生理盐水代替LPS，余处理同LPS致伤亚组。结果 LPS注射后24h两组动物均出现明显的炎性肺损伤，BALF中CC16水平较LPS注射前明显降低，同时间点两组大鼠CC16水平无显著性差异。结论 肺源性抗炎因子CC16水平下降可能是LPS致ALI的发病机制之一，rhGh预处理对BALF中CC16水平影响不明显。     

内毒素血症大鼠Clara细胞数量和形态学变化

目的目的探讨内毒素（LPS）血症对Clara细胞的影响。方法通过免疫组织化学染色、透射电镜分析，观察内毒素血症大鼠Clara细胞数量和形态学方面的变化。结果静脉注射LPS后0．5h肺开始出现急性肺损伤（ALI）病理改变，表现为肺小动脉充血，肺泡隔水肿，肺泡隔出现以中性粒细胞（PMN）为主的炎性细胞浸润，随着时间的推移，肺损伤程度逐渐加重，于6h达最重，6h后逐渐恢复。内毒素致伤后1h大鼠Clara细胞数量开始明显减少，6h达最少，24h后逐渐恢复。LPS致伤后24h，Clara细胞的超微结构明显受损。结论内毒素血症可引起Clara细胞受损，Clara细胞可能是LPS在肺内的作用靶点，Clara细胞受损可能是LPS诱导急性肺损伤的早期事件。     

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.