肾上腺髓质素在心、肺相关性疾病中的研究进展

肾上腺髓质素（adrenomedullin，ADM）是一种舒血管活性多肽物质，共由52 个氨基酸组成，其主要特点为第16 位与21 位半胱氨酸残基间由二硫键连接。它在心、肺等重要器官中具有高水平表达，其合成、分泌的主要部位为血管内皮细胞和平滑肌细胞，其中内皮细胞占主导地位。ADM 具有舒张血管、降压、利尿、抗炎、参与氧化应激、抑制平滑肌细胞增殖、迁移、分化等多种作用，在心肺相关性疾病中具有诸多研究，该文综述了ADM 在心、肺相关性疾病中的研究进展，以期为临床治疗提供新思路。     

肾上腺髓质素与充血性心力衰竭的研究进展

肾上腺髓质素(adrenomedullin，ADM)是1993年日本学者Kitamura等首先在人手术切除的嗜铬细胞瘤组织中分离出的一种具有扩血管和利尿活性的多肽。并证实它以相当浓度存在于正常人的血浆中，参与血压的调控。因最初从嗜铬细胞瘤组织中提取的，故命名为“肾上腺髓质素”。而后进一步证实该物质尚分布于正常肾上腺髓质、心脏、肺、肾、血浆和尿液中，具有强大的降压、舒张血管、扩张肺、肾动脉，解除支气管痉挛，调节机体内分泌和抑制血管平滑肌增生等多种生物学作用，     

肾上腺髓质素与细胞凋亡

肾上腺髓质素(adrenomedullin,ADM)是1993年由日本学者Kitamura等从人的嗜铬细胞瘤组织提取液中分离提纯的一种血管活性肽,广泛存在于多种组织、器官,以自分泌/旁分泌的方式发挥其血管活性作用,如扩张血管、降低血压及排钠利尿、抑制醛固酮的分泌、调节水盐代谢等.近年一系列研究发现肾上腺髓质素还具有调节细胞增殖与分化的功能,影响细胞的生长相凋亡.现就对ADM与细胞凋亡之间的关系及机制作一综述.     

肾上腺髓质与原发性高血压关系的研究进展

肾上腺髓质产生的肾上腺髓质素、肾上腺紧张素、肾上腺髓质素原 N －端20肽、pro －ADM（45～92）等多种血管活性物质具有共同协调血管张力,拮抗过高血压等生物活性,在原发性高血压中起着重要代偿作用,对于高血压的发现、治疗与疾病预防有着重要理论与临床意义。     

肾上腺髓质素的研究进展

肾上腺髓质素(adrenomedullin,ADM)是1993年日本学者Kitamura等[1]首先在入手术切除的嗜铬细胞瘤组织中分离出的一种具有扩血管和利尿活性的多肽,并证实它以相当浓度存在于正常人的血浆中,参与血压的调控.因最初从嗜铬细胞瘤组织中提取,故命名为"肾上腺髓质素".而后进一步证实该物质尚分布于正常肾上腺髓质、心脏、肺、肾、血浆和尿液中,具有强大的降压,舒张血管,扩张肺、肾动脉,解除支气管痉挛,调节机体内分泌和抑制血管平滑肌增生等多种生物学作用,它与降钙素基因相关肽(Calci-tonin gene-related peptide,CGRP)具有同源性.作为一种循环激素以自分泌和旁分泌方式参与机体的多种生理调节.目前寻求创伤后免疫功能紊乱调节措施正成为国内外众多学者探索的热点,而肾上腺髓质素(adrenomedullin,ADM)作为一种活性肽具有广泛的生物学作用,本文就ADM在生物学特性方面的研究进展作一综述.     

ADM的器官保护作用

1993年日本学者Kitamura等人从人的嗜铬细胞瘤中分离出一种新肽，叫作肾上腺髓质素（adrenomedullin，ADM）。大量的实验研究证明，ADM作为一种内源性保护肽广泛存在于血浆、肾上腺、肺、心、肾、脑和血管等组织或器官内，既起循环激素作用，又起旁（自）分泌因子作用。其通过扩血管降压、抗氧化应激、减少血管渗漏等功能，在多种疾病状态下发挥广泛的器官保护作用。     

肾上腺髓质素和心血管疾病

肾上腺髓质素（ADM）是日本学者Kitamura等1993年在嗜铬细胞瘤组织中发现的一种个氨基酸的多肽。随后的一52系列研究显示在体内多种组织、器官广泛存在，尤以ADM血管内皮、血管平滑肌、心脏、肾上腺、肾、肺、肝组织中含量高并发现有很强的扩血管、利尿、利钠、强心等 ,ADM多种生理或药理作用。在充血性心衰（）、急性心肌梗CHF塞（）等疾病状态下组织合成明显增加，提示AMIADM 可能作为一种新的体液因子在上述疾病中起重要作ADM用。本文对在心血管疾病中的研究进展作一综述。ADM　的结构、分布、生物合成及调节1ADM　　由…     

肾上腺髓质素与妇科恶性肿瘤

肾上腺髓质素是一种肽类物质，属于CGRP家庭成员，主要来源于血管内皮细胞（VEC）和血管平滑肌细胞（VSMC），以VEC为主。可以和CGRP受体和ADM特异性受体结合发挥生物学效应，ADM受体活化后通过多种信号转导通路实现其功能，其在体内分布广泛，功能多样，与肿瘤的生长关系密切。本文综述了其在妇科恶性肿瘤卵巢癌、子宫肉瘤、子宫内膜癌、宫颈癌、绒毛膜癌等发病机制中的作用，并展望了其可望成为肿瘤复发检测、判断肿瘤恶性程度、提示肿瘤预后指标及治疗肿瘤新靶点的临床应用前景。     

网膜素与呼吸系统疾病的相关研究进展

脂肪组织通过分泌各种脂肪因子发挥内分泌功能,网膜素是一种新发现的脂肪因子,主要在内脏脂肪组织中表达,其通过影响血管内皮细胞炎症反应、血管舒张功能、血管重建以及血管钙化,参与多种疾病的病理病生过程。网膜素参与了呼吸系统疾病如急性呼吸窘迫综合征、肺动脉高压、睡眠呼吸暂停综合征、恶性胸膜间皮瘤等的病程,研究网膜素在其中的作用可为今后寻求新的治疗策略和诊断方法等提供思路。     

一氧化氮逆转高肺血流量所致肺血管细胞外基质重建的实验研究

细胞外基质主要包括胶原、弹力蛋白和纤维连接素等。它们相互作用构成复杂的网状结构 ,不仅起到细胞结构支架的作用 ,也可直接或通过对血管平滑肌细胞功能的调节参与肺高压时的肺血管重建。目前研究已发现 ,在左向右分流型先天性心脏病并发的肺高压中存在着胶原、弹性蛋白及韧粘素的合成增加。那么 ,先天性心脏病并发的肺高压中细胞外基质的重建机制是什么呢 ?有研究表明 ,肺血流增多并不影响基质蛋白的合成与表达 ,而肺动脉压力才是基质蛋白合成增加的主要促成因素。Ｔｏｚｚｉ等也观察到给予肺动脉 4小时张力 ,则肺外肺动脉段的胶原ｍＲＮ…     

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.