气体分子硫化氢对自发性高血压大鼠主动脉结构重建的调节作用

目的: 研究新型气体分子硫化氢(H2S)对自发性高血压(SHR)大鼠高血压形成期主动脉几何形态和显微结构的影响并初步探讨其调节主动脉结构重建的作用机制.方法: 4周龄雄性SHR及正常血压(WKY)大鼠各自随机分为对照组、 NaHS(H2S供体)组及 PPG(H2S代谢酶抑制剂)组,5周以后,应用图像采集与分析系统对Weigert染色的胸主动脉显微形态结构做定量分析,应用免疫组织化学的方法检测细胞增殖核抗原(PCNA).结果: 9周龄SHR 对照组大鼠血压显著高于 WKY对照组大鼠[(184±12) mm Hg对(108±23) mm Hg],而SHR NaHS 组大鼠的血压[(158±12) mm Hg]显著低于SHR对照组.SHR对照组大鼠胸主动脉的血管内径、外径、中膜面积以及壁厚与内径的比均显著高于WKY对照组[血管外径(1 999±45) μm对(1 790±96) μm,内径(1 759±91) μm对(1 636±94) μm,中膜面积(0.60±0.06) μm2对(0.48±0.03) μm2,壁厚与内径的比(0.066±0.006)对 (0.060±0.004)],血管平滑肌细胞增殖指数也高于WKY对照组[(0.24± 0.06)对(0.11±0.05)].SHR NaHS组大鼠的多数血管结构指标低于SHR对照组大鼠[外径(1 864±66) μm,内径(1 634±66) μm,中膜面积 (0.53±0.06) μm2,只有壁厚内径比(0.063±0.003)与SHR对照组相比差异无显著性],血管平滑肌细胞增殖指数显著低于SHR对照组大鼠(0.151±0.028).结论: H2S是影响高血压主动脉结构重建的关键因素之一,外源性给予其供体NaHS有助于缓解自发性高血压形成期的主动脉结构重建.     

原发性高血压大鼠动脉血管重构的形态学研究

目的探讨自发性高血压大鼠(SHR)大动脉及肾小、细动脉血管重构(VR)的形态学改变,为进一步明确高血压状态下动脉VR的分子机制奠定基础。方法将4、16、24周龄组雄性SHR作为实验组,同周龄雄性Wistar大鼠(WKY)作为对照组,各组5只大鼠。进行主动脉和肾小、细动脉组织学测量和弹性纤维染色观察,高血压动脉VR情况。结果 SHR组主动脉中膜血管平滑肌细胞(VSMC)总数多于同周龄WKY组。24周龄SHR主动脉管壁中层弹性膜排列紊乱、松散、厚薄不均、断裂。SHR组肾小动脉相对内径随周龄增加逐渐减小,相对中膜厚度随周龄增加逐渐增加。24周龄SHR肾小动脉管壁纤维化,肾细动脉未见明显纤维化改变。结论 SHR各组动脉VR的形态学表现不一致,可能其具有不同的分子机制。     

P-MEK在高血压大鼠肾小动脉平滑肌细胞中的表达及意义

目的探讨高血压肾细动脉血管平滑肌细胞(VSMCs)中ERK1/2上游信号磷酸化MEK(p-MEK)的表达状态,为进一步阐明高血压状态下VSMCs功能状态改变的分子机制提供实验依据。方法将4、16、24周龄雄性自发性高血压大鼠(SHR)作为实验组,同周龄雄性Wistar大鼠(WKY)作为对照,各组5只大鼠。弹性纤维染色观察肾小动脉的结构变化,免疫组织化学分析各组动物肾小叶间动脉和入球动脉血管VSMCs中p-MEK的表达。结果 SHR肾小叶间动脉和入球动脉VSMCs增殖不明显,小叶间动脉相对内径随周龄增加逐渐减小。同级别动脉相比,SHR大鼠p-MEK阳性细胞数高于同周龄WKY大鼠。SHR组p-MEK增高的幅度高于同周龄WKY组。结论高血压状态下肾小动脉VSMCs功能状态的改变,可能与胞内MEK磷酸化活化有关。     

不同周龄高血压大鼠肾小动脉结构变化与细胞外信号调节激酶1/2关系的研究

目的:探讨高血压血管重构的特点及其机制。方法:采用组织病理学、组织化学和免疫组织化学方法,对比观察不同周龄自发性高血压大鼠肾小动脉形态学变化及细胞外信号调节激酶1/2(ERK1/2)磷酸化特点。结果:SHR16周龄和24周龄血压(分别为201±21mmHg和204±16 mmHg)明显高于4周龄和8周龄SHR组(P<0.01)。对照组和SHR4及8周龄组肾小动脉结构未见异常。SHR16周龄组少数小动脉管壁可见增厚。SHR24周龄组可见个别小叶间动脉细胞数目增多,并可见弓形动脉和小叶间动脉有内弹力膜增厚、分离及断裂现象。免疫组化结果显示,SHR16周龄、24周龄组叶间动脉、弓形动脉、小叶间动脉平滑肌细胞中磷酸化ERK1/2明显增加,阳性率显著高于对照组(P<0.05)。结论:自发性高血压大鼠在16周龄以后出现少数肾小动脉血管的重构改变,可能与ERK1/2磷酸化导致的级联改变有关。     

中药复方植物胰岛素对糖尿病大鼠肾血管重建的影响

观察中药复方植物胰岛素（ＣＰＩ）对糖尿病大鼠肾血管重的影响,并探讨糖尿病时肾血管重建的方式和机制。方法：以链脲佐菌素（ＳＴＺ）诱导ＳＤ大鼠建立糖尿病动物模型,应用形态学、计算机图像分析等方法,观察糖尿病大鼠肾内小动脉和肾小球毛细胞管基底膜的几何形态,以及ＣＰＩ和氨基胍对其的影响。结果：肾内小动脉表现为壁厚、壁面积增大,壁腔比（壁厚内径比、壁面积比径比）增大,肾毛细管管基底膜增厚。ＣＰＩ和氨基胍均可     

肾上腺髓质素对自发性高血压大鼠肾脏微小动脉的影响

目的探讨肾上腺髓质素（Adrenomedullin, ADM）对自发性高血压大鼠（SHR）肾脏微小动脉的影响及与磷酸化细胞外调
节蛋白激酶1/2（ERK1/2）的关系。方法4周龄雄性SHR随机分为ADM治疗组（ADM组）和高血压对照组（SHR组）,以WKY
大鼠作为空白对照,ADM组皮下注射ADM（1.0 nmol/kg·d,每周5 d）。采用组织学、组织化学、免疫组织化学和Western blot技
术,对比观察平均动脉收缩压、肾微小动脉组织学变化和磷酸化ERK1/2表达。结果从8周龄开始,SHR和ADM组血压开始升
高,16和24周龄平均动脉收缩压明显高于WKY组,ADM治疗组24周龄时平均动脉收缩压明显低于非治疗SHR组;在16和24
周龄,SHR组和ADM组大鼠肾脏微小动脉中膜/内径比值明显大于WKY组（P<0.05）;ADM组大鼠肾脏微小动脉中膜/内径比
值的增幅略低于SHR组,其中外径小于40 μm动脉中膜/内径比值在24 周龄时明显小于SHR组（P<0.05）。免疫组织化学和
Western blot显示16和24周龄SHR和ADM组大鼠肾脏组织磷酸化ERK1/2表达显著高于WKY组（P<0.05）,24周龄时ADM组
肾脏磷酸化ERK1/2表达显著低于SHR组（P<0.05）。结论较长时间使用ADM,在一定程度上能够减轻自发性高血压大鼠血
压升高程度,可能通过抑制ERK1/2的磷酸化减轻肾微小动脉的重构。
     

粉防己碱对肾性高血压大鼠小血管重构的影响

目的：探讨肾血管性高血压大鼠小血管重构特点及粉防己碱的预防作用。方法：用两肾一夹法制备肾血管性高血压大鼠病理模型，术后第5周给予粉防己碱（Tet,50mg.kg^-1.d^-1）或依那普利（Ena,6mg.kg^-1.d^-1)连续8周，观察两药对高血压大鼠小动脉血管结构的影响，结果：肾血管性高血压（RH）大鼠尾动脉和股动脉湿重增加；尾动脉，冠状动脉，肾小动脉管壁厚度和壁／腔比值均明显增大；肾小动脉管壁平滑肌细胞数明显增加，粉防己碱和依那普利用药后上述变化明显减轻。结论：肾血管性高血压大鼠小动脉主要呈肥厚性重构。粉防己碱烽依那普利可有效防止RH大鼠小血管重构。     

脑小血管平滑肌细胞表型标志及血管细胞外基质在肾性高血压大鼠中的改变

目的 探讨脑小血管病大鼠小动脉平滑肌细胞表型标志及细胞外基质的改变。方法 随机均分12只SD大鼠,6只行双肾双夹手术建造易卒中型肾血管性高血压大鼠模型（stroke-prone renovascular hypertensive rat,RHRsp）,6只为假手术组。术后7个月取脑组织,使用免疫荧光法观察脑小动脉血管平滑肌细胞表型标志物α-平滑肌肌动蛋白、平滑肌22α蛋白及细丝蛋白a改变,同时观察脑小动脉及脑小静脉血管壁基质胶原蛋白Ⅳ及层粘连蛋白的表达。结果 与假手术组大鼠相比,RHRsp大鼠小动脉平滑肌细胞收缩型标志α-平滑肌肌动蛋白、平滑肌22α蛋白显著增高,合成型标志细丝蛋白a表达也显著增高。同时,RHRsp大鼠脑小动脉及脑小静脉血管壁基质胶原蛋白Ⅳ及层粘连蛋白表达均显著增高。结论 RHRsp大鼠脑小动脉平滑肌细胞收缩型标志物及合成型标志物均显著增加,提示细胞处于活跃增殖及分泌状态,导致小动脉血管管壁增厚,内径减小;脑小静脉也出现血管壁基质增生表现。     

N-ras在自发性高血压和两肾一夹型高血压大鼠肾脏动脉丛表达的比较研究

目的比较观察N-ras在自发性高血压大鼠(SHR)和两肾一夹型高血压大鼠(2K1C)肾脏血管平滑肌细胞中的表达,探讨N-ras与高血压肾脏血管重构的关系及高血压血管重构发生的机制。方法用免疫组织化学和Western blot方法检测16周龄和24周龄SHR大鼠和2K1C大鼠肾脏血管丛平滑肌细胞以及肾小球内皮细胞中N-ras的表达,同周龄正常血压WKY大鼠作为对照。结果 N-ras在SHR组和2K1C组表达高于WKY组(P<0.05)。N-ras在16周龄和24周龄2K1C组各级肾脏血管丛,包括小叶间动脉、弓形动脉、叶间动脉和入球小动脉的血管平滑肌细胞,以及肾小球内皮细胞的表达均高于SHR组(P<0.05)。结论癌基因N-ras的高表达可能参与了高血压大鼠肾脏的血管重构,两肾一夹型高血压大鼠肾脏中的N-ras表达高于自发性高血压大鼠。     

自发性高血压大鼠硫化氢/胱硫醚γ-裂解酶体系的实验观察

目的　探讨硫化氢 /胱硫醚γ 裂解酶 (H2 S/CSE)体系在自发性高血压形成及发展中的变化及重要作用。方法　 4周龄雄性正常血压大鼠 (WKY) 8只 ,作为WKY对照组 (n =8) ,自发性高血压大鼠 (SHR) 16只 ,随机分为SHR对照组 (n =8)及SHR NaHS(外源性H2 S供体 )组 (n =8) ,其中SHR NaHS组每日腹腔注射NaHS ,WKY对照组及SHR对照组注射同样剂量的生理盐水。相同条件下饲养 5周后 ,检测其血压、左心与全心重量比 ,血浆H2 S水平、胸主动脉CSEmRNA转录水平以及胸主动脉显微结构。结果　 9周龄时SHR对照组大鼠血压显著高于WKY对照组大鼠 [(184±12 )mmHgvs (10 8± 2 3)mmHg ,1mmHg =0 .133kPa],左心与全心比值大于WKY对照组[(0 85 3± 0 0 2 1)vs (0 82 6± 0 0 2 4 ) ],胸主动脉CSEmRNA转录水平及血浆H2 S水平均低于WKY对照组大鼠 [(9 3± 0 7)× 10 -8fmolvs (16 1± 1 0 )× 10 -8fmol]及 [(2 0± 9) μmol/Lvs (4 8± 13)μmol/L],而胸主动脉显微结构结果显示胸主动脉外径、中膜面积、壁厚腔径比均大于WKY对照组大鼠 [外径 (1999± 4 5 ) μmvs (1790± 96 ) μm],中膜面积 (0 6 0± 0 0 6 )mm2 vs (0 4 8± 0 0 3)mm2 ,壁厚腔径比 (0 0 6 6± 0 0 0 6 )vs (0 0 6 0± 0 0 0 4 )。给予NaHS干预     

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.