血管细胞黏附分子1及其与痛风和其他代谢性疾病的相关性

血管细胞黏附分子1(VCAM-1)为免疫球蛋白超家族成员之一,与其他黏附分子共同参与了白细胞或淋巴细胞与其他细胞相互作用,引导白细胞或淋巴细胞穿过血管壁进入组织,发挥炎症性损伤作用。VCAM-1还能促进血管的增生,促进新生血管的形成,促进损伤组织的修复过程,为缺血组织提供新的血液供应。痛风的急性发作,主要是血液中的白细胞与血管内皮的相互作用,最终白细胞经由血管内皮迁移到外周组织。而VCAM-1与白细胞的跨膜移动、内皮细胞的激活、炎症损伤等过程密切相关。近年来,VCAM-1与痛风的关系也受到研究人员更多的关注。     

β2-整合素与白细胞黏附

β2-整合素是一类介导细胞与细胞及细胞与细胞外基质间黏附的重要的细胞黏附分子。在炎症发生过程中,β2-整合素通过与其配体的相互作用,对于白细胞稳定粘附到血管内皮细胞具有重要作用,为白细胞穿越血管内皮提供了条件。本文就β2-整合素与炎症反应中白细胞的稳定黏附的关系做简要综述。     

脑缺血-再灌注损伤相关的免疫细胞因子

脑缺血的炎症免疫损伤是一个复杂的病理过程。在炎症反应发生之前可有细胞因子介导、参与免疫调节和趋化作用，促进白细胞黏附于血管内皮细胞，使白细胞自血管内向缺血脑组织迁移。这些因素均可引起并加重脑缺血损伤。细胞因子产生后进一步诱导黏附分子和趋化因子的表达，促使炎症免疫细胞浸润到损伤组织，炎症免疫细胞及其产生的细胞因子又相互诱导激活，进一步加重组织损伤。作者就以下几种重要的细胞因子作一综述。     

细胞黏附分子与冠心病相关性研究进展

冠心病是目前严重危害人类健康的重要疾病。迄今为止，虽然对动脉粥样硬化的发病过程基本有了清楚的认识，但是对其发病机制仍未完全阐明。近10余年来，随着分子生物学及免疫学等相关基础学科的迅速发展，炎症在冠心病发病机制中的作用日益受到重视。在炎症过程中，白细胞与血管内皮之间的黏附是炎症的起始步骤，这一过程由炎症细胞和血管内皮细胞表面的细胞黏附分子所介导；另外，在细胞黏附分子的介导下，炎症细胞沿血管内皮细胞滚动黏附，     

芪丹通脉片对肿瘤坏死因子-α诱导的心肌细胞的细胞间黏附分子-1表达的影响

近年来 ,冠心病发生发展中的细胞黏附机制日益受到重视 ,其中内皮细胞 ( EC) ,白细胞和血小板之间以及与血管内皮基质间相互黏附、相互作用而导致炎症反应和促凝异常、血栓形成 ,从而促进冠心病的形成和发展 ,而黏附分子和黏附蛋白是介导细胞黏附的分子基础。研究发现 ,细胞间黏附分子 - 1( intercellular adhesion molecule- 1 ,ICAM- 1 )参与中性粒细胞黏附心肌细胞 ,释放细胞毒过程 ,在心肌细胞坏死过程中起关键作用。一些细胞因子如肿瘤坏死因子 -α ( TNF-α) ,γ-干扰素 ( IFN-γ) ,胰岛素样生长因子 - 1 ( IGF- 1 ) ,白细胞介…     

全选择素拮抗可改善鼠和人的银屑病症状

血管细胞黏附分子选择素家族是由结构相关的糖结合蛋白组成,可介导白细胞向活化的血管内皮始动。由于这一过程是启动并维持炎症反应的关键步骤,人们认为选择素是研制新的抗炎疗法的重要靶标。本文作者证实合成的全选择素拮抗物bim osiam ose可有效治疗临床前银屑病模型及银屑病     

细胞间黏附分子-1基因与冠心病关系的研究进展

近年来炎症在冠心病发病机制中的作用已越来越引起人们的重视，动脉粥样硬化已被认为是一种慢性炎症的过程。冠心病发病过程的早期就有炎症细胞黏附内皮细胞并穿过内皮进入血管壁。细胞间黏附分子-l（intercellular adhesion molecule-1，ICAM-1，CD54）在介导白细胞与血管内皮细胞的黏附、进入血管壁的过程中起着关键的作用。很多研究表明，ICAM-1基因与冠心病的发生、发展密切相关。     

炎性细胞因子在脑外伤继发性脑损害中的作用及研究进展

脑外伤炎性反应在继发性脑损害中起重要作用。细胞因子作为体内重要的炎性介质,参与多种病理生理过程,在脑损伤后的炎症级联反应中起着重要的作用。核因子κB(NFκ-B)、肿瘤坏死因子α(TNFα-)、可溶性细胞间黏附分子1、血管内皮黏附分子1和白细胞介素1β(IL-1β)、IL-6、IL-8、IL-16等是几种主要的促炎性细胞因子,IL-2、IL-4、IL-10、IL-13等是抗炎性细胞因子,两类细胞因子参与了脑创伤后的继发性脑损伤及损伤修复。     

炎症与癌症：肿瘤的发生、进展和转移以及中药植物药

古往今来,癌症都被视为一个炎症过程。过去20多年的研究已经从分子水平证实大部分慢性疾病包括癌症都是由炎症反应失调所引起的。转录因子如核因子κB与信号转导和转录激活因子3以及它们的基因产物如肿瘤坏死因子、白细胞介素1、白细胞介素6、趋化因子、环氧合酶2、血管内皮生长因子、黏附分子等的发现为阐释炎症在癌症过程中的作用提供了分子基础。肿瘤的发生、发展和转移以及机体无法对其产生免疫抑制都可以部分地用慢性全身炎症反应来解释。中药用于治疗癌症及炎症具有悠久的历史。本文介绍了近期有关癌症与炎症的研究进展以及用于治疗癌症的中药和中药复方。     

活血化瘀注射液-I号对细胞因子体外诱发大鼠肺微血管内皮细胞E-选择素、P-选择素及细胞间黏附分子-1表达的影响

近年研究证明血管内皮细胞表达的黏附分子在炎症性疾病的发病过程中对白细胞与血管壁内皮细胞黏附、经内皮迁移及向组织浸润起了关键作用。内皮细胞黏附分子过度表达在多发性损伤、脓毒血症及多脏器功能不全的发生发展中起重要作用。肺损害在急性重症胰腺炎 (SAP)时极为常见 ,在多器官衰竭综合征 (MODS)中 ,肺损害发生最早 ,多表现为成人呼吸窘迫综合征 (ARDS) ,约 2 0 %SAP病人并发ARDS ,发病后一周内死亡的SAP病人约6 0 %与ARDS有关。本实验研究了细胞因子对肺微血管内皮细胞黏附分子表达的影响 ,并观察了活血化瘀注射液 Ⅰ号 …     

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.     

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.     

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.