异丙酚对兔缺血-再灌注损伤肝脏能量代谢的影响

目的:探讨异丙酚对免缺血-再灌注损伤肝脏能量代谢的影响.方法:实验兔30只,随机分为正常对照组(A组)、肝缺血再灌注组(B组)和肝缺血再灌注 异丙酚治疗组(C组),分别观察肝组织内三磷酸腺苷(ATP)、二磷酸腺苷(ADP)、一磷酸腺苷(AMP)含量、总腺苷酸量(TAN)、肝脏的细胞能荷(EC)及肝细胞形态学的变化.结果:C组与B组比较,肝组织内ATP含量及能荷(EC)均明显增高(P＜0.01);与A组比较差异无显著性;C组的肝细胞形态学异常改变较B组显著减轻.结论:异丙酚可通过改善肝细胞的能量代谢而减轻肝缺血再灌注损伤.     

氧化应激在肝缺血再灌注损伤中的作用

目的 观察氧化应激在肝缺血再灌注损伤中的作用.方法 60只SD大鼠随机分为对照组、HIRI模型组、十三味红花丸组,采用肝脏部分缺血再灌注模型,造模方法是肝左叶血管用动脉夹夹闭致缺血45 min,去除动脉夹再灌45 min.测定大鼠肝组织匀浆超氧化物歧化酶(SOD)活力、丙二醛(MDA)含量及血清谷丙转氨酶(SGPT)、谷草转氨酶(SGOT)活性.结果 肝缺血再灌注时血清SGPT、SGOT含量较对照组高(P＜0.05), 十三味红花丸组SGPT高于模型组(P＜0.05);肝组织MDA含量各组变化不明显;肝组织SOD活力:十三味红花丸组低于模型组,且较对照组低(P＜0.05).结论 氧化损伤是肝缺血再灌注损伤发生的机制,十三味红花丸对肝缺血再灌注损伤无明显保护作用,相反会引起肝脏抗氧化能力降低.     

注射用内给氧对肝缺血再灌注损伤兔血清ALT、AST、LDH和细胞凋亡的影响

目的 探讨注射用内给氧对肝脏缺血再灌注(I/R)损伤的保护作用.方法 48只健康新西兰长耳大白兔随机分为4组:假手术组(A组),缺血再灌注组(B组),缺血再灌注+周围静脉注射用内给氧组(C组),缺血再灌注+肝动脉注射内给氧组(D组),每组12只.采用Pringle氏法建立肝脏I/R模型.比较4组大白兔缺血再灌注后1小时、2小时、24小时肝功能(AST、AIT、LDH)及细胞凋亡情况.结果 与A组比较,B、C、D 3组肝功能损害重,血清AST、ALT、LDH升高(P＜0.01或P＜0.05);肝组织细胞凋亡明显(P＜0.05);B组以上各项指标差异更为显著;与B组比较,C、D二组肝功能损害较轻,血清AST、ALT、LDH较低(p＜0.05);肝组织细胞凋亡数明显减少(P＜0.05);C组与D组比较,各参数无显著性差异.结论 注射用内给氧对肝脏缺血再灌注损伤有保护作用,可降低AST,ALT,LDH的活性,减少肝细胞凋亡.     

九味牛黄散对大鼠肝缺血再灌注损伤的影响

目的观察藏药九味牛黄散对大鼠肝缺血再灌注损伤的影响。方法30只SD大鼠随机分为假手术对照组(6只)、HIRI模型组(缺血45min者6只、缺血-再灌注45min者6只)、九味牛黄散组(缺血45min者6只、缺血-再灌注45min者6只)。测定大鼠肝组织超氧化物歧化酶(SOD)活力、丙二醛(MDA)含量及测血清谷丙转氨酶(SGPT)、谷草转氨酶(SGOT)活性。结果HIRI组和九味牛黄散组大鼠血清SGPT、SGOT无显著差异;九味牛黄散组,缺血45min时肝组织MDA含量较HIRI组显著升高(P<0.05),肝组织SOD活力较正常对照组降低(P<0.05);再灌注45min时肝组织SOD活力较HIRI组明显降低(P<0.05)。结论九味牛黄散对肝缺血再灌注损伤无明显保护作用,反而引起肝脏抗氧化能力降低。     

维拉帕米和生脉注射液对大鼠肝脏缺血再灌注损伤的保护作用

目的 观察维拉帕米和生脉注射液对大鼠肝脏缺血再灌注损伤的保护作用.方法 将40只大鼠分为假手术组(A组)、缺血再灌注组(B组)、维拉帕米组(C组)和生脉注射液组(D组),每组10只.A组开腹后再关腹;B组开腹后夹闭左肝蒂30 min,再关腹;C组在开腹前静脉注射维拉帕米,开腹夹闭左肝蒂30 min,再关腹;D组在开腹前3 d每天经腹腔注射生脉注射液,开腹夹闭左肝蒂30 min,再关腹.各组均在关腹48 h后再开腹,每只大鼠取缺血肝组织检测查丙二醛(MDA)、热休克蛋白70(HSP70)的水平,光镜下观察肝组织的形态变化;取血检测谷丙转氨酶(ALT)、天门冬氨酸转氨酶(AST)、肿瘤坏死因子(TNF-α)的水平.结果 B、C、D组ALT、AST、TNF-α及MDA测定结果与A组比较均有显著性差异(F=5.10～53.01,q=1.38～17.58,P<0.05);C、D两组ALT、AST、TNF-α及MDA含量均低于B组,差异具有显著性(q=2.89～10.08,P<0.05),而C、D两组以上各指标除ALT比较差异有显著性(q=2.97,P<0.05)外,其他指标比较差异无显著性(P>0.05).C、D两组HSP70的表达明显少于B组,而C组HSP70的表达略少于D组;C、D两组肝细胞肿胀、坏死程度均较B组轻.结论 维拉帕米和生脉注射液可明显改善大鼠肝脏缺血再灌注后肝组织的损伤程度.     

乌司他丁联合高渗盐水对肝脏缺血再灌注损伤的影响及作用机制的实验研究

目的探讨乌司他丁联合高渗盐水预处理对大鼠肝脏缺血再灌注损伤的保护作用及作用机制。方法60只健康雄性SD大鼠,体重230g左右,随机分为五组,每组12只:假手术组(A组)、缺血再灌注组(B组)、乌司他丁预处理组(C组)、高渗盐水预处理组(D组)和乌司他丁联合高渗盐水预处理组(E组)。采用Pringle法分别建立大鼠肝脏缺血再灌注模型,观察肝脏缺血30min再灌注6h后血清中谷丙转氨酶(ALT)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)和肿瘤坏死因子-α(TNF-α)含量并观察肝组织病理学改变。结果B、C、D和E组血清中ALT、AST、LDH和TNF-α含量明显高于A组(P<0.05);C、D和E组明显低于B组(P<0.05);C组和D组明显高于E组(P<0.05);C组和D组之间差别无统计学意义(P>0.05)。肝组织病理学损害B组最重,C、D组次之,E组轻于C、D组。结论乌司他丁、高渗盐水预处理对大鼠肝脏缺血再灌注损伤具有保护作用,二药联用效果更好。     

乌司他丁联合17β雌二醇对大鼠肝脏缺血再灌注损伤保护作用的实验研究

目的 探讨乌司他丁联合17β雌二醇预处理对大鼠肝脏缺血再灌注损伤的保护作用.方法 将60只健康雄性SD大鼠随机等分为五组：假手术组（A组）、缺血再灌注组（B组）、乌司他丁预处理组（C组）、17β雌二醇预处理组（D组）和乌司他丁联合17β雌二醇预处理组（E组）.采用Pringle法阻断入肝血流30分钟,检测再灌注5小时后血清中谷丙转氨酶（ALT）、谷草转氨酶（AST）、乳酸脱氢酶（LDH）和肿瘤坏死因子-α（TNF-α）含量并观察肝组织病理学改变.结果 B、C、D和E组血清中ALT、AST、LDH和TNF-α含量明显高于A组（P＜0.01）;C、D和E组明显低于B组（P＜0.01）;C组和D组明显高于E组（P＜0.05）;C组和D组之间无明显差别（P＞0.05）.肝组织病理学损害B组最重,C、D组次之,E组最轻.结论 乌司他丁、17β雌二醇预处理对大鼠肝脏缺血再灌注损伤具有保护作用,两药联合应用效果更好.     

HSP70在大鼠肝移植缺血预处理中的变化及其保护效应

目的:研究热休克蛋白70(heat shock protein,HSP70)在大鼠肝移植供肝缺血预处理中的变化及其产生的保护效应.方法:建立大鼠原位肝移植缺血预处理模型.随机分成3组:未行肝移植对照组(C组)、肝移植(liver transplantation,LT)组和缺血预处理肝移植(ischemic precondition,IP)组.术后在分析各组供肝组织HSP70表达变化的同时,检测血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)活性,供肝组织超氧化物歧化酶(SOD)、ATP含量,并在光镜下观察各组肝细胞形态学改变.结果:与C组相比,LT组HSP70表达量轻度增高,而IP组显著升高(P＜0.05).LT组血清ALT、AST活性显著高于C组,肝组织SOD、ATP含量呈相反变化(P＜0.05);与LT组相比,IP组血清ALT、AST活性明显降低,肝组织SOD、ATP含量显著升高(P＜0.05).光镜下观察到LT组供肝细胞形态学出现明显损伤性改变,而IP组改变较小.结论:缺血预处理可以诱导大鼠原位移植肝高表达HSP70,后者可能是减轻缺血再灌注对供肝损伤的一个重要保护分子.     

高渗盐水联合牛磺酸预处理对肝脏缺血再灌注损伤的保护作用

目的 探讨高渗盐水联合牛磺酸预处理对大鼠肝脏缺血再灌注损伤的保护作用及其作用机制.方法 将30只SD大鼠随机等分为5组:假手术组(A组)、缺血再灌注组(B组)、高渗盐水预处理组(C组)、牛磺酸预处理组(D组)和高渗盐水联合牛磺酸预处理组(E组).参照Pringle法建立大鼠肝脏缺血再灌注损伤模型.再灌注6 h后检测血清谷丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST) 、乳酸脱氢酶(LDH) 、超氧化物歧化酶(SOD)和丙二醛(MDA)水平,并在光镜下观察肝组织病理学的改变和肝脏的原位细胞凋亡的变化.结果 缺血再灌注6 h后血清ALT、AST、LDH 和MDA水平比较,B、C、D和E组明显高于A组(P<0.01),C、D和E组明显低于B组(P<0.01),C组和D组明显高于E组(P<0.05);血清SOD水平比较,A、C、D和E组明显高于B组(P<0.01),E组明显高于C组和D组(P<0.01);肝组织病理学显示B组损害最重,C、D组次之,E组最轻.TUNEL法检测细胞凋亡显示大鼠肝细胞凋亡率B、C、D和E组明显高于A组(P<0.01),C、D和E组明显低于B组(P<0.01).结论 高渗盐水和牛磺酸联合应用可以改善大鼠肝脏缺血再灌注损伤.     

复方丹参对兔肝脏热缺血再灌注损伤保护作用的实验研究

目的 探讨复方丹参对兔肝脏热缺血再灌注损伤的保护作用及其相关机制.方法 采用Pringle's肝脏缺血再灌注模型,48只SD大鼠随机分成三组:假手术组(A组),肝脏缺血冉灌注组(B组)和复方丹参预处理组(c组).测定各组缺血30 min(T1)、再灌注120 min(T2)肝功能(ALT、AST)、肝组织的抗氧化能力(SOD)、脂质过氧化产物丙二醛(MAD)含量、肝指数(湿重/干重%),比较肝组织形态学改变.结果 (1)T1、T2相,B、C组与A组比较肝组织损害重:ALT、AST均升高(P<0.05);肝组织匀浆SOD含量降低;MDA含量升高(P<0.05);肝脏水肿程度上升(P<0.05);肝组织出现不同程度的病理学改变.2)在T1、T2相,C组与B组比较肝组织损害轻:ALT、AST均较低(P<0.05);肝组织匀浆SOD含量高,MDA含量减少(P<0.05);肝脏水肿程度较轻(P<0.05);肝组织出现较轻的病理学改变.结论 复方丹参通过改善肝脏微循环状况,改善缺血肝脏组织的能量代谢,提高肝组织抗氧化能力,减少肝脏细胞的变性坏死程度而对肝脏热缺血再灌注起保护作用.     

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.