牛磺酸抑制肾性高血压大鼠心肌细胞凋亡的研究

目的:探讨牛磺酸对肾性高血压大鼠左室心肌细胞凋亡的影响。方法:75只大鼠随机分为3组,模型组、假手术组和给药组。其中模型组:采用二肾一夹(2KIC)法建立肾血管性高血压大鼠模型;给药组:高血压模型成功后,于术后4周末开始灌饲牛磺酸50mg/(kg·d)8周。采用末端脱氧核昔酸转移酶介导的dUTP缺口末端标记法(TUNEL)进行心肌细胞凋亡原位检测;放射免疫法检测心肌AngⅡ含量;分光光度计法检测心肌细胞DNA含量。结果:进入结果分析的模型组、假手术组及用药组分别为17、30和8只。与假手术组相比,模型组术后第4、12周末心肌细胞凋亡均明显增多(P<0.01);心肌细胞DNA含量和AngⅡ含量亦明显增多(P<0.01)。与4周末模型组相比,12周末模型组血压心肌细胞凋亡增多(P<0.05),心肌DNA含量明显增多(P<0.01),AngⅡ含量增多(P<0.01)。与12周末模型组相比,给药组心肌细胞凋亡减少(P<0.01),心肌DNA和AngⅡ含量明显减少(P<0.01)。结论:肾性高血压大鼠心肌细胞凋亡增多,牛磺酸治疗可抑制心肌细胞凋亡。     

牛磺酸对高血压大鼠心肌肥厚、心肌细胞凋亡、NO及血管紧张素Ⅱ含量的影响

目的探讨牛磺酸对肾血管性高血压大鼠心肌肥厚、心肌细胞凋亡、一氧化氮（NO）及血管紧张素Ⅱ（Ang Ⅱ）含量的影响。方法采用两肾一夹（2K1C）型肾血管性高血压大鼠模型。所有大鼠被随机分为3组（每组20只）：假手术对照组、高血压对照组、牛磺酸治疗组。于术后第5周开始给予牛磺酸50mg·kg^-1·d^-1。采用标准尾套法间接检测清醒大鼠血压。给药8周后,大鼠处死,分离其左室心肌以用于检测左室质量/体质量比、心肌细胞凋亡指数（AI）、NO和Ang Ⅱ含量。结果与假手术组大鼠相比,未给药2K1C高血压大鼠血压明显升高,左室质量体质量比、心肌AI和Ang Ⅱ含量均升高,心肌NO含量降低。应用牛磺酸治疗则明显降低了肾动脉狭窄术后大鼠的血压、左室质量/体质量比、心肌Ai和Ang Ⅱ含量;同时也升高了2K1C高血压大鼠心肌NO含量。结论长疗程牛磺酸治疗可抑制高血压大鼠心肌肥厚和心肌细胞凋亡发生,其作用机制与药物调控心源性活性物质分泌水平有关。     

牛磺酸对肾性高血压大鼠心肌细胞凋亡的影响

探讨牛磺酸对高血压大鼠左室心肌细胞凋亡的影响。方法：建立肾血管性高血压大鼠模型,心肌细胞凋亡检测采用ＴｄＴ介导的原位末端缺口标记法,ＡｎｇⅡ测定采用放免法。结果与相应假手术组相比,两级模型组（４周、１２周）心肌ＡｎｇⅡ含量增多,收肌细胞凋亡增多;与１２周模型组相比,给药组左收室／体重比和心肌ＡｎｇⅡ含心肌细胞凋亡减少,与正常组相近。结论高血压大鼠心肌细胞凋亡增多,牛磺酸高血压心肌细胞凋亡有抑制作用     

天麻钩藤饮对肾血管性高血压大鼠醛固酮和血管紧张素Ⅱ的影响

目的：观察天麻钩藤饮对肾血管性高血压大鼠醛固酮（aldosterone,ALDO）和血管紧张素Ⅱ（angiotension Ⅱ,AngⅡ）的影响。方法：将48只雄性SD大鼠随机分为假手术组、模型组、卡托普利组和天麻钩藤饮组,每组12只。模型复制后第5周开始给药,连续治疗8周。然后观察各组大鼠左室质量（left ventricular mass,LVM）、左室质量指数（lef tventrieular mass index,LVI）和心肌组织胶原（colloid,Coll）浓度,同时检测各组大鼠血浆和心肌组织中AngⅡ和ALDO水平。结果：12周后模型组大鼠的LVM、LVI和Coll均明显高于假手术组（P〈0．05,P〈0．01）;卡托普利组和天麻钩藤饮组大鼠的上述指标均有显著降低（P〈0．01）,而两药之间没有显著性差异（P〉0．05）。模型复制12周后,模型组大鼠血浆和心肌ALD0和AngⅡ水平显著高于假手术组（P〈0．01）;卡托普利显著降低血浆和心肌AngⅡ水平（P〈0．05）,而对血浆和心肌ALD0水平则无显著性影响（P〉0．05）;天麻钩藤饮则同时降低了血浆和心肌ALD0和AngⅡ水平（P〈0．05,P〈0．01）。结论：天麻钩藤饮能够缓解和逆转左室肥厚和心肌纤维化,其作用可能与降低血浆和心肌局部ALDO、AngⅡ水平有关。     

儿茶素对5／6肾切除大鼠肾脏微血管的保护作用及其机制

目的：探讨儿茶素对5／6肾切除大鼠血管紧张素转化酶（angiotensin—converting enzyme,ACE）、血管紧张素Ⅱ（angiotensinⅡ,AngⅡ）及肾脏组织微血管密度（microvessel density,MVD）的影响。方法：60只SD大鼠被分为假手术组、模型组和儿茶素组。模型组和儿茶素组大鼠切除5／6肾脏制作模型,假手术组不做肾切除。儿茶素治疗8周与12周后,应用免疫组织化学法检测CD34标记的肾局部微血管数并计算密度;紫外分光光度法检测血浆与肾皮质中ACE活性;放射免疫法测定血浆与肾皮质中AngⅡ浓度;苏木精和伊红（hematoxylin and eosin,HE）染色及过碘酸-希夫（periodic acid—Schiff,PAS）染色后,半定量积分法评价肾小球硬化指数（glomerular sclerosis index,GSI）与肾小管间质损伤指数（tubule interstitial score,TIS）。结果：儿茶素组GSI与TIS在第8、12周末均显著低于模型组（P〈0．05,P〈0．01）;模型组和儿茶素组肾小球及小管周围MVD在第8周与第12周末较假手术组均明显降低（P〈0．01）;儿茶素组血浆、肾皮质中ACE活性与AngⅡ浓度在实验第8与第12周末均显著低于模型组（P〈0．01）;Pearson相关分析发现,MVD与GSI、TIS、ACE、AngⅡ呈负相关（P〈0．01）,ACE、AngⅡ与GSI、TIS呈正相关（P〈0．01）。结论：儿茶素可有效阻止5／6肾切除大鼠肾脏微血管密度的减少,抑制肾小球硬化与肾间质纤维化的进展,这可能与儿茶素抑制ACE的活性,减少AngⅡ的生成有关。     

两肾-夹高血压大鼠肾脏血管紧张素转换酶2的表达

目的：观察两肾-夹（2K1C）高血压大鼠肾脏血管紧张素转换酶2（ACE2）蛋白和mRNA的表达。方法：30只雄性Wister大鼠随机分为2组,对照组和2K1C高血压组各15只。鼠尾容积法测定术前、术后1周、4周、8周的血压变化。8周后,免疫组化法检测肾脏ACE2蛋白表达,放射免疫分析法测定心肌组织AngⅡ水平,逆转录聚合酶链式反应（RT—PCR）法检测肾脏ACE2 mRNA表达。结果：①2K1C组术后血压明显高于术前和对照组（P〈0．01）;②与对照组相比,高血压模型组心肌局部AngⅡ浓度显著升高（P〈0．01）;③高血压模型组ACE2蛋白和mRNA表达较对照组明显降低（均P〈0．05）。结论：2K1C高血压大鼠心肌局部AngⅡ浓度升高,肾脏组织ACE2蛋白和mRNA表达降低,这可能是两肾-夹高血压大鼠血压发生的机理之一。     

胰激肽释放酶和缬沙坦对自发性高血压大鼠左室肥厚、一氧化氮及血管紧张素Ⅱ水平的影响

目的 探讨胰激肽释放酶单用或与缬沙坦联合应用对自发性高血压大鼠（SHR）左心室重构的作用及对血管紧张素Ⅱ（AngⅡ）水平、血清一氧化氮（NO）含量的影响。方法 选用雄性15周龄的SHR24只、WKY大鼠8只，分为4组：①SHR阳性对照组（SHR）；②胰激肽释放酶组（SHR-TPK组）；③缬沙坦＋胰激肽释放酶组（SHR—Val＋TRK（组）；④WKY阴性对照组（WKY）。实验期8周。放免法测定血管紧张素Ⅱ（AngⅡ）、化学法检测血浆一氧化氮（NO）水平，常规测量各组收缩压（SBP）、左心室重量指数（LVMI）、心肌胶原体积比例（CVF）和心肌血管周围胶原与管腔面积的比例（PVCA）。结果 SHR组的SBP，LVMI，CVF，PVCA，AngⅡ水平明显增高而血清NO含量明显下降，与WKY组相比差异有显著性（P〈0．01）；治疗组（TPK组；Val＋TPK组）SBP，LVMI，CVF及PVCA均显著下降（P〈0．01），血清NO水平明显升高（P〈0．01），Val＋TPK组血浆AngⅡ水平显著上升（P〈0、01），而心肌AngⅡ水平明显下降（P〈0．01），TPK组心肌局部和血浆AngⅡ变化不明显。结论 缬沙坦和胰激肽释放酶均能有效的改善高血压左室重构，两者合用效果佳。     

血府逐瘀汤对急性心肌缺血大鼠心肌细胞凋亡及其相关基因干预作用的实验研究

目的 观察血府逐瘀汤对缺血心肌细胞凋亡及其相关基因的干预作用。方法 采用结扎冠状动脉左前降支的方法复制急性心肌缺血模型，通过DNA末端标记法（TUNEL）和免疫组化技术分别观察心肌细胞凋亡及其相关调控基因的变化。结果假手术组仅见极少量凋亡阳性细胞心肌缺血组有明显心肌细胞凋亡增多，与假手术组比较差异显著（P〈0．01）；血府逐瘀汤组、地奥心血康组心肌细胞凋亡均显著减少，与心肌缺血组比较差异显著（P〈0．01，P〈0．05）。同时Bcl？和Bax蛋白的阳性表达支持心肌细胞凋亡的情况。结论 血府逐瘀汤与地奥心血康可有效抑制心肌细胞坏死凋亡，减轻心肌细胞损伤，对缺血心肌有保护作用。     

电针曲池穴对高血压模型大鼠血压及血管紧张素Ⅱ的影响

目的观察电针曲池穴对高血压模型大鼠血压及血管紧张素Ⅱ（AngⅡ）含量的影响,以对其降压机理作初步探讨。方法建立高血压大鼠模型,随机分为模型组、电针组,另设正常组。经过8周治疗后,测量血压,并测定血浆及主动脉AngⅡ含量。结果模型组血压明显高于正常组,治疗后电针组血压明显降低,与模型组比较有非常显著性差异（P〈0．01）;模型组血浆及主动脉AngⅡ含量明显高于正常组,治疗后电针组血浆及主动脉AngⅡ含量尚未恢复到正常组水平,但明显低于模型组（P〈0．01）。结论电针曲池穴可抑制两肾一夹高血压大鼠血压的升高,其降压机制可能与其综合抑制肾素一血管紧张素系统（RAS）有关。     

高血压心肌声学密度与血管紧张素Ⅱ和醛固酮的关系

目的 观察原发性高血压患者心肌声学密度的变化情况，以探讨心肌声学密度检测高血压心肌纤维化的临床价值及其与血浆血管紧张素Ⅱ（AngⅡ）和醛固酮的关系。方法 共入选原发性高血压患者75例（高血压组），并设立健康对照组75例。应用超声心动图测量计算心肌声学密度各项值（室间隔和左室后壁矫正的声学强度CAI1、CAI2及背向散射积分周期变化值CVIB1、CVIB2值），用放免法检测血浆AngⅡ和醛固酮浓度。结果 （1）高血压组的CAI1、CAI2显著高于健康对照组（P〈0．01），而高血压组的CVIB1、CVIB2显著低于健康对照组（P〈0．05）；（2）高血压组的血浆AngⅡ和醛固酮浓度均显著高于健康对照组（P〈0．01）；（3）血浆AngⅡ和醛固酮浓度与CAI1、CA12显著正相关，与CVIB1、CVIB2显著负相关（P〈0．01）。结论 心肌声学密度定量分析技术可用于评估高血压心肌纤维化的严重程度，并且心肌声学密度与血浆AngⅡ和醛固酮浓度均显著相关。     

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.