大鼠局灶性脑缺血再灌注损伤中nNOS的表达

目的研究局灶性脑缺血再灌注损伤中神经元型NOS（nNOS）在同脑区的表达。方法用改良的血管内栓线技术制造大鼠局灶性脑缺血与再灌注模型，应用免疫组织化学技术检测脑组织中nNOS的表达。结果①脑缺血再灌注损伤后，脑组织中nNOS的表达显著性增强，与正常对照组比较，P〈0．05；②缺血侧在皮质、CA1区和CA3区的nNOS表达比对照侧显著性增强（P〈0．05）。结论一侧脑缺血再灌注后，也会引起对侧损伤，但缺血侧损伤更为严重。     

内毒素预处理对大鼠全脑缺血再灌注脑区一氧化氮合酶的影响研究

目的探讨内毒素预处理对大鼠前脑缺血再灌注后脑组织诱生型一氧化氮合酶(iNOS),神经型一氧化氮合酶(nNOS)的影响及意义.方法采用大鼠全脑缺血再灌注模型,动态观察大脑皮层、海马、小脑组织中iNOS、nNOS的活性及海马CA1区神经元计数的变化.结果脑缺血再灌注后大脑皮层、海马、小脑组织中iNOS和nNOS活性均显著高于正常对照组,缺血前24 h经尾静脉注入内毒素衍化物MPL(20 g/kg)可明显降低再灌注大脑皮层、海马、小脑组织中iNOS、nNOS的活性和海马CA1区神经元计数下降幅度.结论提示脑缺血再灌注后,大脑皮层、海马、小脑组织中iNOS、nNOS活性发生了明显变化,内毒素预处理显著抑制了缺血再灌注后脑组织中iNOS、nNOS的活性.     

电针对脑缺血再灌注大鼠海马神经细胞凋亡的影响

目的观察电针对脑缺血再灌注后大鼠海马神经元损伤的保护作用。方法将SD大鼠随机分为正常组、假手术组、模型24 h组、模型48 h组、模型72 h组、电针治疗24 h组、电针治疗48 h组、电针治疗72 h组。采用改良线栓法制备局灶型脑缺血(MCAO)再灌模型,电针大椎、双侧内关穴。观察各组大鼠缺血侧海马神经元TUNEL阳性细胞数的变化、神经体征的改变。结果模型组缺血侧海马CA1区神经细胞凋亡数随再灌注时间延长而增加,48 h达高峰并持续至72 h,电针治疗可明显减少神经细胞凋亡数,与同时相模型组比较一有显著性差异(P<0.01,P<0.05),并以72 h电针治疗组尤为明显。同时,电针可明显改善脑缺血再灌注大鼠的神经功能缺损,与模型组比较有显著性差异(P<0.05、P<0.01)。结论电针对脑缺血再灌注损伤后的神经细胞凋亡有一定的拮抗作用,对脑缺血再灌注后大鼠海马神经元有保护作用。     

Ku70和Bax在糖尿病全脑缺血再灌注大鼠海马CA1区的表达及意义

目的比较血糖正常大鼠和糖尿病大鼠全脑缺血再灌注后海马CA1区Ku70和Bax的表达变化,探讨Ku70和Bax在糖尿病加重脑缺血再灌注神经损伤中的作用。方法雄性SD大鼠72只,随机分为假手术(SO)组、血糖正常全脑缺血再灌注(NCI)组和糖尿病全脑缺血再灌注(DCI)组。DCI组采用链脲佐菌素诱导联合改良的Pulsineli 4血管阻断(4-VO)法制作糖尿病全脑缺血再灌注模型,NCI组不用链脲佐菌素诱导,其余处理同DCI组;SO组仅暴露血管。分别在缺血再灌注1、6、24和48h应用光镜观察海马CA1区神经细胞形态变化,免疫组织化学和免疫印迹法检测海马CA1区Ku70蛋白表达水平,免疫组织化学方法检测海马CA1区Bax蛋白表达水平。结果 NCI组大鼠海马CA1区细胞结构破坏,各时间点存活神经元密度与SO组比较均减少(P<0.05);DCI组大鼠海马CA1区神经元结构损伤加重,各时间点存活神经元密度较NCI组降低(P<0.05)。NCI组1h和6h时间点Ku70表达较SO组增强(P<0.05),24h和48h表达较SO组降低(P<0.05);DCI组各时间点Ku70表达均较NCI组降低(P<0.05)。NCI组各时间点Bax表达均较SO组增强(P<0.05),DCI组各时间点Bax表达均较NCI组增强(P<0.05)。结论糖尿病可加重全脑缺血再灌注后神经损伤,其机制可能与进一步加重Ku70低表达和Bax高表达有关。     

川芎嗪对成年大鼠脑缺血再灌注损伤后nNOS的表达和神经的影响

目的 探讨川芎嗪对大鼠脑缺血再灌注损伤后脑组织内神经元型一氧化氮合酶免疫阳性细胞表达变化,及其对海马齿状回、侧脑室室下区神经细胞增殖的影响.方法 动物分为正常组、假手术组、对照组、川芎嗪处理组.脑缺血再灌注损伤模型由线栓法阻塞大鼠大脑中动脉(MACO)制成.BrdU标记增殖细胞.免疫组化SABC法测定大鼠脑缺血再灌注损伤后,不同脑区在不同时间段的nNOS、BrdU免疫阳性细胞表达,Western blotting测定大鼠脑缺血再灌注损伤后,不同脑区在不同时间段的nNOS的表达.结果 免疫组化结果显示在大脑皮层、纹状体与尾壳核和海马均有nNOS的表达,Western blotting结果显示,对照组缺血侧各脑区内,nNOS表达较假手术组升高(P＜0.05),并随时间延长而递增.川芎嗪处理组大脑皮层、纹状区与尾壳核nNOS表达1、3 d组比对照组同时段表达降低(P＜0.05).川芎嗪处理组BrdU阳性细胞在侧脑室室下区(SVZ)缺血再灌注1、3 d组明显高于对照组(P＜0.05),川芎嗪处理组BrdU阳性细胞在海马齿状回(DG)缺血再灌注3 d、7 d组高于对照组(P＜0.05).结论 川芎嗪能抑制缺血后脑组织内早期nNOS的表达,对缺血后脑组织具有早期保护作用,并能促进SVZ和DG神经细胞增殖.     

电针对脑缺血再灌注大鼠额叶皮质和海马CA1区Bcl-2、Bax表达的影响

目的:观察电针对脑缺血再灌注损伤后大鼠额叶皮质和海马CA1区Bcl-2、Bax表达的影响。方法:将24只SD大鼠随机分为假手术组、模型组和电针组。采用大脑中动脉线栓法制备脑缺血再灌注模型。取百会和大椎穴给予电针刺激,频率2 Hz,持续30 min,每天1次,连续7 d。免疫组织化学方法观察额叶皮质和海马CA1区Bcl-2、Bax的表达。结果:假手术组大鼠神经功能缺损评分均为0分,模型组神经功能缺损评分高于电针治疗组,两组间有显著性差异(P<0.01)。模型组Bcl-2在额叶皮质和海马CA1区的表达与假手术组比较无明显变化(P>0.05),电针组Bcl-2的表达明显高于模型组(P<0.01)。模型组Bax在额叶皮质和海马CA1区的表达明显高于假手术组(P<0.01),电针组Bax的表达显著低于模型组(P<0.01或P<0.05)。结论:电针治疗可改善脑缺血再灌注大鼠神经功能,可能与其促进Bcl-2、抑制Bax的表达有关。     

高压氧治疗对沙土鼠脑缺血再灌注海马CA1区神经元凋亡的影响

目的:观察高压氧 (HBO) 作用下沙土鼠脑缺血再灌注海马CA1区神经元凋亡的变化,探讨HBO对脑缺血再灌注损伤的疗效及其机制.方法:建立沙土鼠脑缺血后再灌注模型,用HBO治疗连续3 d后,应用H-E和TUNEL染色方法,观察海马CA1区神经元的凋亡情况.结果:两种方法均显示沙土鼠脑缺血再灌注3 d后海马CA1区大量神经元凋亡,HBO治疗组凋亡细胞数明显减少(P<0.01),并以0.25 ATA HBO治疗组为佳.结论:HBO治疗对海马神经元缺血性损伤有保护作用,能减少其凋亡,是HBO治疗脑缺血性损伤的疗效机制之一.     

nNOS在缺血性老年大鼠海马及皮层神经元中的表达及超微结构变化

目的 研究神经型一氧化氮合酶（neuronal nitric oxide synthase,nNOS)在血性老年大鼠海马及皮层神经元中的作用并观察其超微结构变化。方法建立老年大鼠脑缺血动物模型,在不同的时间点进行nNOS免疫组化染色和透射电镜观察。检测海马及皮层神经元nNOS的观察其受损情况。结果 缺血30min后再灌注12h组nNOS活性显著升高。而假手术组、缺血30min即刻取材、再灌流1h,96h组nNOS几乎无表达;6h少量表达;24h和48h组中量表达;再灌流超过24h组神经元损伤较重。结论 NO在脑缺血发生中对海马及大脑皮层神经元具有毒性作用。     

钙蛋白酶抑制剂减少大鼠局灶性脑缺血再灌注模型海马CA1区神经元凋亡

目的:研究钙蛋白酶抑制剂calpeptin干预治疗对大鼠局灶性脑缺血再灌注模型海马CA1区神经元凋亡的影响及其可能机制。方法:选择健康成年雄性SD大鼠128只作为研究动物,采用随机数字表法将其分为MACO组、calpeptin组、DMSO组及sham组,制作大鼠左侧大脑中动脉缺血再灌注模型,缺血2 h后分别再灌注6、12、24 h及48 h后进行神经功能学评分,免疫组化检测海马CA1区神经元caspase-3的表达,TUNEL法检测原位细胞凋亡,观察海马CA1区神经元凋亡。结果:DMSO组的各项检测指标与MACO组比较差异无统计学意义(P>0.05);calpeptin组的神经功能评分及caspase-3表达均低于同时间点MCAO组及DMSO组,比较差异均有统计学意义(P<0.05);再灌注12、24、48 h后,calpeptin组神经元凋亡情况优于同时间点MCAO组及DMSO组,比较差异均有统计学意义(P<0.05)。结论:calpeptin可减少大鼠局灶性脑缺血再灌注模型海马CA1区的神经元凋亡,对脑缺血再灌注损伤有保护作用,其机制可能与抑制caspase-3的表达有关。     

葛根素预处理对局灶性脑缺血再灌注大鼠海马 CA1区神经元损伤的影响及其机制

目的：探讨葛根素预处理对局灶性脑缺血再灌注大鼠海马 CA1区神经元损伤的保护作用及其机制。方法雄性 SD 大鼠30只,随机均等分为假手术组、模型组、葛根素预处理组。采用线栓法阻断大鼠大脑中动脉血供,60 min 后拔出栓线造成局部脑缺血再灌注损伤。葛根素预处理组在缺血前1 h 腹腔注射葛根素（100 mg/ kg ）。脑缺血再灌注后第5天,HE 染色法观察海马 CA1区神经元的组织形态学变化,免疫组化法检测海马 CA1区半胱氨酸天冬氨酸蛋白酶-3（Caspase-3）及半胱氨酸天冬氨酸蛋白酶-9（Caspase-9）的表达。结果 HE 染色结果显示,与模型组相比较,葛根素预处理明显减少脑缺血再灌注引起的海马 CA1区神经元损伤（P<0.05）;免疫组化结果显示,与模型组相比,葛根素预处理使海马 CA1区 Caspase-3、Caspase-9的表达明显降低（ P <0.05）。结论缺血前1 h 葛根素预处理对局灶性脑缺血大鼠海马 CA1区神经元损伤有保护作用,其主要机制可能与抑制凋亡相关蛋白 Caspase-3、Caspase-9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.