胰岛移植对糖尿病大鼠周围神经病变的改善作用

目的：观察胰岛移植对糖尿病周围神经病变（DPN）的改善并探讨其可能机制。方法：SD大鼠采用腹腔注射单剂链脲菌素建立糖尿病模型，糖尿病模型建立12周后进行胰岛移植。分为正常对照组、假手术组、糖尿病组、糖尿病胰岛移植组。于糖尿病模型建立后16 周，观察各组大鼠痛敏反应时间，采用HE染色观察坐骨神经的病理变化，实时荧光定量PCR检测坐骨神经肿瘤坏死因子α（TNF-α）的mRNA表达，Westernblot观察B淋巴细胞瘤2 蛋白（BCL-2）、BCL-2 相关X蛋白（BAX）、半胱氨酸天冬氨酸蛋白酶3（caspase3）的表达。结果：与糖尿病组大鼠比较，糖尿病胰岛移植组大鼠坐骨神经纤维变性及断裂均有减少，痛敏反应时间明显缩短，坐骨神经内TNFα的mRNA表达明显下降，且BCL-2表达上调，BAX、caspase3表达下调（P＜0.05）。结论：胰岛移植后血糖下调，明显改善DPN，可能是通过下调TNFα的分泌、上调BCL-2，下调BAX、caspase3，抑制凋亡来实现的。     

依那普利及氯沙坦对糖尿病大鼠肾脏周期素激酶抑制剂p27kip1蛋白表达的影响

目的：研究应用依那普利和氯沙坦治疗后糖尿病大鼠肾脏p27^kipl蛋白表达的变化，探讨糖尿病肾病的发病机制。方法：实验大鼠分4组：正常对照组（A组）、糖尿病大鼠组（B组）、糖尿病大鼠应用依那普利治疗组（C组）和氯沙坦治疗组（D组）、B、C和D组腹腔一次性注射链脲佐菌素复制糖尿病模型，于4周内留取血液和肾脏标本，应用免疫组织化学方法检测肾脏组织中p27^kipl蛋白的表达，放射免疫方法检测肾脏和血浆中血管紧张素Ⅱ（AngⅡ）的水平。结果：B组大鼠肾小球固有细胞p27^kipl水平在第1周升高（P＜0．05），至4周时仍维持较高水平，肾小管细胞中p27^kipl表达无显著差异；肾重／体重比值和肾小球面积在该组大鼠第1周起即明显上升；肾脏AngⅡ水平亦呈显著性增加。依那普利和氯沙坦治疗组上述指标明显下降。结论：周期素激酶抑制剂p27^kipl可能参与糖尿病肾病肥大的病理过程，它与内源性AngⅡ水平密切相关，提示降低p27^kipl表达可能是ACEI及ATla延缓肾脏疾病进展的作用机制。     

荧光定量PCR法对糖尿病大鼠肾脏BAX基因表达的检测

目的:对单肾切除糖尿病大鼠肾脏中BAX基因mRNA的拷贝数进行精确定量,以探讨糖尿病肾病的发病机制。方法:以SYBRGreenI作为定量检测中荧光染料,采用实时荧光定量PCR法,对单肾切除糖尿病模型组和单肾切除对照组大鼠肾脏中BAX基因的转录水平进行检测。结果:糖尿病模型组中BAX转录拷贝数明显高于对照组。结论:糖尿病大鼠肾脏中存在BAX基因的转录异常,细胞凋亡亢进可能参与糖尿病肾病的发生发展。     

辛伐他汀对单肾切除糖尿病老龄鼠肾组织Fas/Fas-L基因表达的影响

目的:探讨辛伐他汀对单肾切除糖尿病老龄SD大鼠肾脏凋亡相关基因Fas/Fas-L表达的影响.方法:单肾切除老龄SD大鼠分为肾切除对照组(C组)、糖尿病模型组(D组)、糖尿病辛伐他汀治疗组(S组).12周后采用原位末端标记法检测各组肾组织细胞凋亡指数,使用实时荧光定量PCR和免疫荧光法,从转录和翻译水平观察各组大鼠肾皮质中凋亡相关基因Fas及Fas-L的变化规律.结果:D组相对C组细胞凋亡指数、Fas及Fas-L的蛋白表达水平和相对应的mRNA拷贝数均明显增高,S组相对D组减弱(P<0.05),Fas、Fas-L蛋白主要在肾小管表达.结论:Fas及Fas-L系统与DN发生发展相关,辛伐他汀可在分子水平调控Fas及Fas-L基因的转录和翻译,抑制细胞凋亡,发挥肾脏保护作用.     

在微量白蛋白尿前后应用氯沙坦治疗糖尿病肾病的实验研究

目的：观察在微量白蛋白尿发生前后应用氯沙坦对糖尿病肾病的治疗作用及其机制。方法：单侧肾切除的链脲佐菌素（STZ）糖尿病大鼠，随机分为糖尿病对照组、氯沙坦治疗1组和氯沙坦治疗2组。观测肾脏形态学及肾功能变化，并采用荧光实时定量RT-PCR检测肾脏转化生长因子β1（TGF-β1）、结缔组织生长因子（CTGF）、纤溶酶原激活物抑制剂1（PAI—1）等细胞因子的表达情况。结果：糖尿病对照组大鼠尿微量白蛋白（UAER）持续上升；血肌酐（Scr）、肾脏肥大指数（KW／BW）、肾小球平均体积（MGV）、系膜面积比（FMA）以及肾脏TGF-β1、CTGF、PAI-1和纤维连接蛋白（FN）的mRNA表达均明显升高，而肌酐清除率（Ccr）已开始下降。氯沙坦治疗1组和2组以上指标均明显改善，且两组之间无显著差异。结论：氯沙坦可通过下调肾脏细胞因子基因表达，起到保护肾脏作用，但在微量白蛋白尿出现之前进行干预的效果并不比之后更好。     

胰岛素对糖尿病大鼠海马神经元凋亡相关蛋白表达的影响

目的观察糖尿病大鼠海马神经元的病理形态学改变和BCL-2、BAX、caspase-3的异常表达及胰岛素干预后的影响。方法用链脲佐菌素（STZ）诱导制备糖尿病动物模型,每日长效胰岛素应用制备糖尿病胰岛素治疗动物模型。随机分为3组：高血糖组（DM组）、胰岛素治疗组（PDM组）、对照组（NC组）。12周后,用免疫组化法检测海马神经元凋亡蛋白BCL-2、BAX、caspase-3的表达,分别在光镜、透射电镜下观察各组海马神经元病理形态学改变及超微结构的变化。结果DM组BCL-2的表达较NC组显著下降,BAX、caspase-3显著升高（P〈0．05）,出现锥体细胞退变的典型病理改变。PDM组BCL-2的表达较DM组有所增高,BAX、caspase-3有所下降（P〈0．05）,病理改变较DM组有所改善。结论高血糖可引起海马神经元凋亡,胰岛素通过逆转糖尿病大鼠海马神经元caspase-3、BAX的表达,增加BCL-2的表达,对糖尿病脑病起保护作用。     

氯沙坦对糖尿病大鼠肾脏细胞因子表达的影响及意义

目的探讨氯沙坦治疗糖尿病肾病的作用及其机制。方法采用单侧肾切除的STZ诱导的糖尿病大鼠，观测其肾脏形态、功能的变化。同时，采用荧光实时定量RT-PCR方法检测TGF—β1、CTGF、PAI-1等细胞因子在糖尿病大鼠肾脏中的表达情况。结果与正常组（NC组）相比，8周时糖尿病肾病组（DN组）大鼠的肾脏肥大指数（KW／BW）、平均肾小球体积（VG）、尿白蛋白排泄率（UAER）、肌酐清除率（Ccr）均升高。DN组肾皮质CTGF、PAI—1、FN表达水平也显着增高（p〈0．05）；与DN组相比较，氯沙坦治疗组的上述指标则均明显下降（p〈0．05）。结论氯沙坦可通遏抑制TGF—β1、CTGF、PAI-1等细胞因子的表达，对糖尿病人鼠肾脏起到保护作用。     

醛糖还原酶抑制剂对大鼠肾脏醛糖还原酶基因表达的影响

目的：观察醛糖还原酶抑制剂（ARI）依帕司他对大鼠肾脏AR mRNA水平和肾功能相关指标的影响。方法：运用在单侧肾结扎的基础上注射STZ的方法建立大鼠糖尿病肾病模型，给予醛糖还原酶抑制剂依帕司他灌胃4周，RT—PCR的方法检测各组大鼠肾皮质AR mRNA水平．观察依帕司他对AR mRNA是否有影响以及血清和尿液中尿素氮（BUN）、肌酐（Cr）和总蛋白（TP）的变化。结果：给药组大鼠肾脏AR mRNA水平明显高于对照组（P〈0．05）；给予醛糖还原酶抑制剂依帕司他4周后，低剂量组（L组）、高剂量组（H组）AR mRNA水平低于模型对照组（M组）（P〈0．05），但L组和H组之间没有差别（P〉0．05）。结论：糖尿病肾病大鼠肾脏AR mRNA水平明显升高，说明AR与糖尿病肾病的发生有关：醛糖还原酶抑制剂依帕司他对糖尿病肾病大鼠肾功能没有影响，但可降低AR mRNA水平。     

辛伐他汀对糖尿病大鼠尿转化生长因子-β1排泄率的影响及对肾脏保护的研究

目的：观察他汀类药物辛伐他汀对链脲霉素(STZ)诱导的糖尿病大鼠早期糖尿病肾病(diabetic nephropathy，DN)的保护作用。方法：50只雄性SD大鼠分为3组：①正常对照组；②糖尿病对照组；③糖尿病辛伐他汀干预组。干预8周后检测肾重／体重比，观察肾结构病变，测大鼠尿蛋白及转化生长因子-β1(transforming growth factor-β1，TGF--β1)的排泄率。结果：糖尿病对照组尿TGF--β1及蛋白排泄量明显高于正常对照组，肾重／体重比增高，并出现了肾脏器质性损伤，而辛伐他汀则减轻了这种病变。结论：辛伐他汀可以延缓DN进展，这种作用可能是通过抑制TGF--β1的分泌实现的。     

p53基因与糖尿病肾病大鼠肾组织细胞凋亡相关性研究

目的：研究糖尿病肾病（Diabetes nephropathy,DN）大鼠p53基因与肾组织细胞凋亡的关系。方法：Wistar大鼠随机分为正常对照组、DN模型组。采用RT-PCR检测肾组织p53基因mRNA表达,琼脂糖凝胶电泳检测细胞凋亡。结果：DN模型组大鼠肾脏p53基因表达明显上调,且肾组织凋亡细胞明显增加。结论：DN模型组大鼠肾组织细胞凋亡增加,与p53基因mRNA呈正相关。     

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.