过氧化物酶增殖体激活受体α激活剂对急性肺损伤大鼠肺组织的影响及其机制

目的探讨过氧化物酶增殖体激活受体α(PPARα)激活剂WY14643对急性肺损伤(ALI)大鼠肺组织的保护作用及其可能机制。方法将104只雄性Wistar大鼠随机分为对照组、脂多糖(LPS)致伤组(ALI组)、WY14643 1 mg/kg处理组(LW 1 mg组)、WY14643 3 mg/kg处理组(LW 3 mg组)。用LPS(5 mg/kg)静脉注射复制大鼠ALI模型,在静脉注射LPS 15 min后再次静脉注射WY14643 1 mg/kg和3 mg/kg,分别在LPS后1、2、4及8 h时处死大鼠,测定用药前、后各时相点大鼠肺组织湿/干重比(W/D)及肺组织病理变化;采用逆转录聚合酶链反应(RT-PCR)检测肺组织中肿瘤坏死因子-α(TNF-α)mRNA的表达,酶联免疫吸附分析法检测肺组织匀浆中TNF-α浓度。结果WY14643 1 mg与3 mg组在2 h、4 h肺组织W/D比值及病理积分均较ALI组相应时相点下降显著(P均<0.01);WY14643 1 mg组在2、4及8 h,3 mg组在1、2、4及8 h TNF-αmRNA表达及肺组织匀浆上清中的TNF-α均较ALI组相应时相点显著下降(P<0.01);WY14643 1 mg与3 mg组间比较作用有显著性差异(P<0.05)。结论WY14643对ALI大鼠肺组织具有一定的保护作用,其机制可能是PPARα激活后抑制了TNF-α的释放,减轻肺部及全身的炎症反应。     

过氧化物酶增殖体激活受体β在急性肺损伤大鼠肺组织的表达及其意义

目的观察内毒素(lipopolysaccharide,LPS)复制的急性肺损伤(acutelunginjury,ALI)大鼠肺组织过氧化物酶增殖体激活受体β(peroxisomeproliferationactivatedreceptorβ,PPARβ)表达的变化,探讨PPARβ在ALI中可能的作用。方法将40只雄性Wistar大鼠随机分为对照组、LPS致伤1、2、4h组和8h组。用LPS(5mg/kg)静脉注射复制大鼠ALI模型,分别在LPS致伤后1、2、4、8h时活杀大鼠,测定各组肺组织湿/干重比(W/D)及肺组织病理变化;采用RTPCR法检测肺组织中PPARβmRNA的表达;采用免疫组化法检测肺组织中PPARβ的表达。结果LPS致伤后2、4、8h肺组织W/D较对照组均显著升高(F=19.61,P<0.01);LPS致伤后1、2、4hPPARβmRNA表达分别较对照组显著升高(F=86.96,P<0.01);而LPS致伤后2、4、8h组PPARβ表达阳性细胞光密度值较对照组显著升高(F=6.89,P<0.05)。结论PPARβ在ALI大鼠肺组织表达升高,提示其可能参与了急性肺损伤的发生发展。     

急性肺损伤大鼠肺组织PPAR-γ表达的研究

目的 在脂多糖(lipopolysaccharide,LPS)复制的急性肺损伤(acute lung injury,ALI)大鼠模型中,观察PPARγ表达的改变,探讨PPAR-γ在ALI发病中的作用.方法 在LPS复制的大鼠Au模型中,观察动脉血气、肺湿/干(W/D)比值、肺组织病理,用RT-PCR法检测肺组织PPAR-γ、TNF-α mRNA表达,用ELISA法检测TNF-α蛋白变化,并用免疫组化观察肺组织PPAR-γ的改变.结果 ALI大鼠,PaO2显著降低(P<0.05),肺W/D比值显著高于对照组(P<0.05),病理显示肺组织受损;肺组织TNF-αmRNA显著升高(P<0.05),与此同时血浆TNF-α亦显著升高(P<0.05).正常大鼠肺组织可表达PPAR-γ,LPS致伤后肺组织PPAR-γ mRNA在1 h即开始下降,2 h降至谷底,并持续至实验结束.免疫组化显示致伤后1、2 h与对照组无显著差异,从4 h显著降低并持续至8 h(P<0.05).结论 正常大鼠肺组织可表达PPAR-γ,LPS可引起ALI大鼠肺组织PPA-γ的基因和蛋白水平表达下降,这可能与ALI炎症持续和损伤有关.     

T0901317对急性肺损伤大鼠肺组织LXRα表达的影响及其抗炎作用

目的探讨肝脏X受体α(LXRα)激活剂T0901317对脂多糖(LPS)所致急性肺损伤(ALI)大鼠动物模型的保护效应。方法 72只雄性Wistar大鼠,按随机数字表法分为对照组、LPS组和T0901317干预组。观察各组大鼠PaO2、肺组织髓过氧化物酶(MPO)活性及肺组织病理变化;采用逆转录-聚合酶链反应(RT-PCR)检测肺组织中LXRα、肿瘤坏死因子α(TNF-α)mRNA表达;采用酶联免疫吸附法(ELISA)检测TNF-α蛋白变化;采用免疫组化染色观察肺组织LXRα蛋白变化。结果与对照组比较,LPS致伤后各时间点PaO2显著降低,肺组织干/湿重比值(W/D)、MPO活性均显著升高(P<0.05),组织病理显示肺组织受损;肺组织LXR-αmRNA表达下降,TNF-αmRNA升高(P<0.05),肺组织匀浆和动脉血清中TNF-α显著升高。免疫组化显示LXRα蛋白在对照组肺组织中表达较高水平,在LPS致伤后可见该蛋白表达较对照组显著下降(P<0.05)。T0901317干预组LXRα在基因和蛋白水平表达上调,TNF-α表达下降,差异均有统计学意义(P<0.05),同时观察到肺部炎症明显减轻。结论在LPS诱...     

黄芪对脂多糖诱导大鼠急性肺损伤^p38 MAPK表达的影响

目的探讨脂多糖（LPS）诱导急性肺损伤（ALI）大鼠肺组织磷酸化p^38 MAPK表达的变化以及黄芪对其之影响。方法静脉注射LPS复制大鼠ALI模型。随机分成3组：正常对照组、ALI组和黄芪组。采用蛋白质印迹检测肺组织磷酸化p^38 MAPK的表达,并观察大鼠动脉血氧分压（PaO2）、肺湿/干重比（W/D）、支气管肺泡灌洗液（BALF）白蛋白、血清TNF-α的变化以及肺组织病理学改变。结果LPS诱导大鼠ALI时肺组织磷酸化p^38 MAPK的表达较正常对照组显著增加（P〈0.01）。黄芪注射液可显著抑制大鼠肺组织磷酸化p^38MAPK表达,降低W/D、BALF白蛋白以及血清TNF-α含量,使下降的PaO2回升,减轻肺组织病理学损伤。结论ALI时肺组织p^38 MAPK磷酸化表达增加;黄芪注射液对内毒素性肺损伤有保护作用,其机制可能与抑制磷酸化p^38 MAPK的表达有关。     

糖皮质激素对内毒素致急性肺损伤大鼠肺组织Fractalkine表达的影响

目的动态观察内毒素（LPS）所致急性肺损伤（acute lung injury,ALI）大鼠肺组织内趋化因子Fractalkine（FKN）的表达变化,及糖皮质激素对其的影响。方法将42只大鼠随机分为空白对照组、模型组（LPS）及地塞米松干预组（DEX）,其中LPS组和DEX组再分为1h、2h、4h3个时相组,每组6只,LPS组和DEX组大鼠经尾静脉注射LPS（4mg／kg）建立ALI大鼠模型。采用ELISA、RT—PCR等方法,观察ALI大鼠模型肺组织病理学改变、肺湿干重比值（W／D）及血清TNF-a变化,并检测肺组织FKNmRNA的表达,同时观察地塞米松对上述指标的影响．结果模型组1h、2h与4h3个时相组肺损伤病理改变、肺W／D、血浆TNF—α均明显增高,地塞米松能减轻ALl大鼠肺组织炎症反应、肺W／D值及血清TNF—α水平（P均〈0．05）。正常大鼠肺组织FKNmRNA有表达,模型组3个时相亚组肺组织FKNmRNA表达较正常组明显增加（P〈0．05）,在2h时点达峰值,地塞米松能下调ALI大鼠肺组织FKNmRNA表达（P〈0．05）。FKNmRNA的表达量与血清TNF—α水平呈正相关（r=0．674,P〈0．05）．结论早期应用地塞米松可降低TNF-α水平,下调肺组织FKN mRNA的表达,这可能是糖皮质激素对内毒素致急性肺损伤实验大鼠保护作用机制之一。     

急性肺损伤大鼠肺组织中颗粒溶素的表达

目的在内毒素（LPS）诱导的急性肺损伤（ALI）大鼠模型中,观察颗粒溶素在不同时期的表达,探讨其在革兰阴性菌感染所致的ALI的细胞免疫中的地位和作用。方法采用36只健康Wistar大鼠,随机分为对照组（NS组）和实验组（LPS组）,每组18只。LPS组腹腔注射LPS 4 mg/kg制造ALI模型,NS组注射等量生理盐水。注药后6、18及30 h取材,行肺组织湿/干重比（W/D）分析,观察肺组织病理改变,以及免疫组织化学法检测肺组织颗粒溶素的表达。结果 ALI大鼠肺组织W/D比值显著高于NS组（P〈0.05）;病理显示LPS组肺组织受损,出血、渗出明显,达到ALI诊断标准;LPS组各时点肺组织颗粒溶素表达较NS组有不同程度增加。结论颗粒溶素可能参与ALI的炎症过程,有助于病原体的清除,在防治感染性因素所致ALI中有可能发挥一定的作用。     

血管紧张素转化酶2在内毒素诱导大鼠急性肺损伤中的作用

目的探讨血管紧张素转化酶2（ACE2）在内毒素（LPS）诱导大鼠急性肺损伤（ALI）中的治疗作用。方法 24只Wistar大鼠随机分为三组：对照组、ALI组和ACE2治疗组（ACE2组）。LPS静脉注射法复制大鼠ALI建立模型。ACE2组在接受LPS静脉注射后立即给予腹腔注射重组大鼠ACE2 0.1 mg/kg。于术后2 h取大鼠动脉血,全自动动脉血气分析仪测定动脉血气;测肺组织湿重/干重（W/D）比值;酶联免疫吸附试验法（ELISA）测定各组大鼠肺组织中TNF-α、IL-8和IL-1β含量;光学显微镜观察肺组织病理形态学改变。结果成功复制了大鼠LPS肺损伤模型。ACE2干预后可以明显改善ALI大鼠动脉血氧和水平（P〈0.05）、降低W/D比值（P〈0.05）、降低肺组织匀浆内TNF-α、IL-8和IL-1β质量浓度;改善ALI大鼠肺组织损伤及病理评分。结论 ACE2对大鼠LPS诱导肺损伤有治疗作用。     

甲泼尼龙对内毒素性急性肺损伤大鼠炎症介质的影响

目的探讨应用甲泼尼龙对内毒素所致急性肺损伤大鼠的防治作用及可能机制。方法静注脂多糖（6 mg/kg）制成ALI模型,54只大鼠随机分为生理盐水对照组、内毒素损伤组、甲泼尼龙组（内毒素＋甲泼尼龙）。采用放射免疫（ELISA）方法检测大鼠血清TNF-α、IL-8和IL-10水平,并进行肺湿/干重比（W/D）测定。结果与对照组比较,ALI组各时相点大鼠肺组织中3种炎症因子水平及W/D值均明显上升,差异有统计学意义（P〈0.05）,表达峰值时间：TNF-α为4 h,IL-8为2 h,而IL-10为8 h。结论甲泼尼龙可降低内毒素致大鼠ALI血清TNF-α、IL-8和IL-10水平,对大鼠ALI有防治作用。     

电针预处理对脂多糖诱导的急性肺损伤大鼠炎性细胞因子及水通道蛋白5的影响

目的 探讨电针足三里穴预处理对脂多糖（LPS）诱导的急性肺损伤（ALI）大鼠的干预作用及可能机制。方法 将SD大鼠随机分为正常、ALI4h、ALI6h、针刺+ALI4h和针刺+ALI6h组，ALI4h、ALI6h组大鼠气管内用LPS（2mg/kg）分别滴注4h和6h以诱导ALI，后两组大鼠在针刺预处理双侧足三里穴1周后于气管内分别滴注LPS4h和6h。各组均取血、支气管肺泡灌洗液（BALF）及肺组织，计算BALF中白细胞总数及肺湿/干比（W/D），HE染色观察肺组织形态，ELISA方法检测血浆中AQP5、IL-1β、IL-6、IL-10、TNF-α和BALF中AQP5水平，免疫组化方法观察肺组织AQP5表达。结果 与正常组比较，ALI4h组白细胞计数、W/D增高（P<0.05）、肺泡总面积和肺组织面积之比（A/t）降低（P<0.05）以及IL-1β、IL-10、TNF-α含量显著增高（P<0.001）；ALI6h组IL-6和IL-10含量明显增高（P<0.01）；ALI4h、ALI6h组AQP5含量显著降低（P<0.001）、积分光密度（IOD）明显降低（P<0.01）。与ALI4h组比较，针刺+ALI4h组白细胞计数与W/D降低（P<0.05）、IL-1β与TNF-α含量降低（P<0.05）、血浆及BALF中AQP5含量均升高（P<0.05），针刺+ALI6h组血浆AQP5含量有升高（P<0.05）。结论 电针足三里穴预处理对LPS诱导的ALI大鼠具有抗炎、降低肺水肿的保护作用，且在诱导4h时的ALI中更佳，其机制可能与电针下调炎性细胞因子和上调AQP5的表达有关。     

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.     

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.     

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.