大鼠坐骨神经切断后GDNF mRNA在其向心端及脊髓表达的变化

目的：探讨大鼠坐骨神经切断后胶质细胞源性神经营养因子（GDNF）mRNA在其向心端及脊髓表达的变化及其意义。方法：在切断SD大鼠双侧坐骨神经后的不同时间采用半定量RT－PCR方法，观察坐骨神经向心端及T12－L1段脊髓GDNF mRNA表达的变化。结果：坐骨神经切断前，GDNF mRNA在坐骨神经及L12－L1段脊髓微量表达，切断后其向心端及T12－L1段脊表达逐渐减少，伤后1，7，14，28d分别减少10％，38％，45％，52％和20％，68％，80％，85％。结论：从骨神经切断后其向心端及T12－L1脊髓GDNF mRNA表达减少，推测是由于失去靶组织转运GDNF mRNA所造成，为外源性GDNF应用于治疗脊髓损伤提供了实验依据。     

蛛网膜下隙局部应用GDNF对脊髓前角运动神经元的保护作用

目的 研究周围神经损伤后经蛛网膜下隙置管局部应用外源性胶质细胞源性神经营养因子(glial cell line-derived neu-rotrophic factor,GDNF)对脊髓前角运动神经元的保护作用. 方法 成年SD大鼠随机分为2组:GDNF组(坐骨神经切断术后给予GDNF)和NS组(术后给予生理盐水).切断两组大鼠左侧坐骨神经致相应脊髓前角运动神经元部分损伤,行蛛网膜下隙置管,实验组注入外源性GDNF(10 μg/ml),对照组注入同等剂量的生理盐水,于2,4,8周行坐骨神经功能指数检测;取L4-6节段脊髓标本冰冻切片,行胆碱酯酶(ChE)和酸性磷酸酶(ACP)染色并进行图像分析. 结果 GDNF组脊髓前角运动神经元ChE阳性颗粒面积比NS组有明显提高(P<0.05),ACP阳性颗粒面积低于NS组(P<0.05);GDNF组坐骨神经功能指数亦优于NS组. 结论 周围神经损伤后通过蛛网膜下隙注入外源性GDNF对相应的脊髓运动神经元有保护作用.     

成年大鼠坐骨神经切断后脊髓运动神经元死亡方式的研究

目的探索成年大鼠坐骨神经切断损伤后脊髓前角运动神经元的死亡方式.方法选择大鼠坐骨神经切断损伤模型,术后48 h、7 d、15 d、30 d动物经4%多聚甲醛常规灌注固定,取L4～L6脊髓节段,TUNEL染色和电镜观察.结果坐骨神经切断后TUNEL染色和电镜观察均检测到脊髓前角运动神经元典型的凋亡形态学改变.结论周围神经切断后脊髓前角运动神经元出现凋亡,表明神经元的凋亡可能为成年大鼠周围神经损伤引发神经元死亡的重要病理过程.     

联合应用神经营养素-4胶质细胞源性神经营养因子对脊髓前角运动神经元的保护作用研究

目的研究周围神经损伤后经蛛网膜下腔置管局部联合应用神经营养素（NT）-4和外源性胶质细胞源性神经营养因子（GDNF）对脊髓前角运动神经元的保护作用。方法成年SD大鼠随机分为3组,GDNF组、NT-4组和GDNF联合NT-4组。切断大鼠坐骨神经致相应脊髓前角运动神经元损伤,于第5、6腰椎椎间隙行蛛网膜下腔置管,并注入外源性GDNF（10μg/mL）和NT-4,不同时间处死动物并取材,对L4～6节段脊髓标本冰冻切片,行苏木素-伊红染色、尼氏体染色、胆碱酯酶染色。结果 GDNF联合NT-4组脊髓前角运动神经元的存活率、胆碱酯酶阳性颗粒面积均比前2组有明显提高,组间比较差异有统计学意义（P〈0.05）。结论周围神经损伤后通过蛛网膜下腔联合注入NT-4、GDNF较两者单独使用更有利于保护脊髓运动神经元。     

环孢素对大鼠坐骨神经损伤后脊髓运动神经元的保护作用

目的:通过观察应用环孢素对大鼠坐骨神经切断后脊髓前角运动神经元GAP-43mRNA的表达,研究环孢素对脊髓前角运动神经元的影响。方法:60只大鼠随机分为实验组和对照组,实验组进行环孢素干预,在3、7、14、21、28天,5个不同的时相点各从实验组和对照组中随机抽取6只大鼠,取下脊髓T12-L1节段,脊髓前角GAP-43mRNA的表达用荧光定量RT-PCR检测。结果:对照组GAP-43mRNA第3日呈低表达,第7天表达量增加,第14天表达量达到高峰,第21天表达量下降,第28天表达量接近第3天水平。实验组第3、7和14天表达量与对照组相似,第21和28天表达量较对照组有所提高,经统计学处理,第3、7和14天实验组与对照组比较,差异无显著性(P>0.05),第21天和28天实验组与对照组比较,差异有统计学意义(P<0.05)。结论:应用环孢素对坐骨神经损伤后脊髓运动神经元有一定的保护作用,可延缓神经元的退变。     

大鼠坐骨神经移植后脊髓相应节段运动神经元中P-Erk1/2的表达和变化

目的 研究成年大鼠坐骨神经损伤后脊髓相应节段运动神经元中P-Erk1/2的表达和变化.方法 健康成年雄性Wister大鼠共50只,坐骨神经切断组,将动物模型于术后1W、2W、4W、6W、8W处死后取患侧L4～L6脊髓,Western-Blot方法 检测P-ERK1/2在脊髓中的表达变化,并将两组所得数值进行统计学分析.结果 脊髓前角运动神经元中的P-ERK1/2在假手术组仅有少量表达并维持在一定的水平;在坐骨神经切断组中,术后1W内表达增加、2W达高峰、8W恢复正常水平.结论 大鼠坐骨神经切断后可能是通过激活MAPK/ERK1/2信号通路的方式,对脊髓前角运动神经元的凋亡进行调控.     

坐骨神经损伤诱导脊髓IL-1 mRNA的表达及其与星形胶质细胞、NOS阳性细胞的关系

目的 观察坐骨神经损伤不同时间脊髓内ＩＬ－１ ｍＲＮＡ表达及其与星形胶质细胞、ＮＯＳ阳性细胞间的关系。方法 采用坐骨神经切断所致大鼠脊髓前角运动神经元损伤模型,应用ＲＴ－ＰＣＲ和免疫组织化学技术。结果 （１）ＩＬ－１在脊髓内的表达直接与坐骨神经损伤及时程密切相关,损伤３ｄ在受累脊髓节段出现的ＩＬ－１ ｍＲＮＡ的表达,损伤７ｄＩＬ－１表达明显,１４ｄ时表达仍然存在。（２）坐骨神经损伤后,脊髓受累节段     

大鼠不同类型臂丛根性损伤后脊髓运动神经元NOS的表达

目的 研究成年大鼠不同类型臂丛损伤后脊髓运动神经元一氧化氮合酶（NOS）表达与神经元死亡之间的关系。方法 选用76只健康成年SD大鼠，分别造成臂丛神经根性切断伤与根性撕脱伤，于损伤后不同时间观察脊髓前角运动神经元的存活率，以及NOS在脊髓前角运动神经元中的表达情况。结果 臂丛神经根性切断伤后，损伤侧脊髓前角运动神经元无明显死亡，且未见NOS表达。臂丛神经根性撕脱伤后1周，损伤侧脊髓前角运动神经元数目开始减少，并出现NOS阳性表达。之后随着NOS阳性神经元增多，神经元死亡率也增加，6周后神经元数目基本维持稳定而NOS阳性神经元逐渐减少消失。结论 臂丛神经根性撕脱伤后，NOS参与损伤后脊髓运动神经元死亡，或在运动神经元死亡中起重要作用。     

针刺对大鼠脊髓损伤后脊髓前角运动神经元功能的影响

目的探讨针刺对脊髓损伤(SCI)大鼠前角运动神经元功能恢复的影响。方法成年雄性SD大鼠60只,改良Allen法压迫致伤T8、T9,随机分为实验组和对照组,伤后分别给予电针刺激大鼠双下肢足三里和悬钟、伏兔和三阴交穴,取治疗2,4,6周伤段脊髓进行PCR扩增和组织切片。利用RT-PCR技术检测伤区脊髓胶质源性神经营养因子(GDNF)mRNA基因体内表达的变化;应用尼氏染色、酶组织化学染色方法观察大鼠SCI后伤区脊髓前角运动神经元存活的数目和乙酰胆碱酯酶(AChE)的变化;采用斜板试验和BBB评分法观察大鼠后肢运动功能恢复情况。结果实验组较对照组AChE活性显著增加(P<0.01);实验组脊髓前角大、中型神经元的数目较对照组明显增加(P<0.05);实验组GDNF mRNA基因体内表达较对照组明显增加(P<0.01);大鼠SCI 3周后针刺治疗组后肢运动功能评分均明显高于对照组(P<0.05)。结论针刺治疗对脊髓损伤后前角运动神经元的功能恢复有一定的促进作用。     

GDNF基因活化的细胞外基质对大鼠坐骨神经损伤后神经元的保护作用

目的:探讨GDNF基因活化的细胞外基质对神经元的保护作用.方法:通过化学萃取获得大鼠坐骨神经细胞外基质,复合上编码GDNF的质粒DNA,构建成基因活化的细胞外基质支架.60只成年Wistar大鼠按随机数字法分为3组:A组(n=20)GDNF基因活化的细胞外基质桥接组,B组(n=20)ECM桥接组,C组(n=20)自体神经桥接组,术后3天、1周、4周、12周时用RT-PCR、激光共聚焦显微镜等形态学方法来评价神经元保护作用.结果:GDNF基因活化的细胞外基质能作为局部的基因缓释系统来释放GDNF,在脊髓中高效表达12周以上.GDNF mRNA的表达和Nissl染色阳性细胞的数量在脊髓中明显增加,而iNOS表达明显下降.神经元存活率明显优于对照组(78.04%±3.50%vs 56.09%±1.89%).结论:GDNF基因活化的细胞外基质可以促进GDNF mRNA在脊髓中表达,增加前角运动神经元的存活率,其机制可能与iNOS受抑制有关.     

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.