丙酮酸乙酯对大鼠心肌缺血再灌注细胞凋亡及Bcl-2、Bax蛋白表达的影响

目的研究丙酮酸乙酯（EP）对缺血／再灌注（I／R）心肌细胞凋亡及Bcl-2、Bax蛋白表达的影响，探讨其抑制缺血／再灌注心肌细胞凋亡的可能机制。方法应用Langendorff主动脉逆行灌流的体外大鼠缺血／再灌注心脏模型，24只雄性大鼠随机分为3组（每组各8只）：对照组，K—H液持续灌流120min；缺血／再灌注组，平衡灌流30min，全心停灌30min，再灌60min；EP组，实验程序与缺血／再灌注组相同，平衡15min后和再灌注期间灌流使用含2mmol／LEP的K—H液。检测心肌丙二醛（MDA）含量，分别以缺口末端标记法（TUNEL法）及免疫组化法检测心肌细胞凋亡指数（AI）及Bcl-2、Bax蛋白表达的变化。结果缺血／再灌注组MDA含量，AI和Bcl-2、Bax蛋白表达水平均明显高于对照组（均P〈0．05）；与缺血／再灌注组比较，EP组MDA含量，AI与Bax蛋白表达水平均下降，而Bcl-2蛋白表达水平显著增高（均P〈0．05）。结论EP可抑制缺血／再灌注后心肌细胞凋亡，此作用可能与其减轻氧化应激、上调Bcl-2和下调Bax蛋白表达水平有关。     

PEP-1-SOD1对离体缺血再灌注损伤大鼠心肌Bax、Bcl-2蛋白表达的影响

目的:研究细胞穿透肽PEP-1介导人铜锌-超氧化物歧化酶(Cu,Zn-SOD,SOD1)对大鼠离体心肌缺血再灌注损伤(MIRI)细胞凋亡的影响。方法:采用Langendorff灌流系统对离体大鼠心脏进行停灌-复灌建立心肌缺血再灌注损伤模型。大鼠随机分为对照组、SOD1蛋白预处理组,25、50、100μmol/L PEP-1-SOD1蛋白预处理组。复灌结束后,TUNEL法检测心肌细胞凋亡,免疫荧光法检测心肌组织Bax、Bcl-2蛋白表达。结果:与对照组及SOD1组相比,各PEP-1-SOD1组心肌细胞凋亡指数(AI)显著下降,Bcl-2蛋白表达升高,Bax蛋白表达显著减少(P<0.01)。结论:PEP-1-SOD1融合蛋白可抑制离体心脏缺血再灌注损伤大鼠心肌细胞凋亡,其机制可能与上调Bax表达及下调Bcl-2表达有关。     

银杏叶提取物对肾缺血再灌注损伤肾小管细胞凋亡调控基因表达的影响

目的 观察银杏提取物（Egb）对大鼠肾缺血再灌注后肾小管细胞凋亡调控基因bcl-2和bax表达的影响,探讨Egb肾保护作用的分子生物学机制.方法 用动脉夹夹闭大鼠双侧肾蒂45 min再灌注24 h方法制成急性肾缺血再灌注损伤模型.采用脱氧核苷酸末端转移酶介导的DNA原位末端标记技术检测细胞凋亡的情况.免疫组化检测Bcl-2、Bax表达.结果 缺血再灌注组较假手术组肾小管凋亡细胞数明显增多,Bcl-2、Bax表达均增强,Bax/Bcl-2比值增高;银杏叶提取物处理组较缺血再灌注组凋亡细胞数明显减少,Bcl-2表达进一步增强,而Bax表达减弱,Bax/Bcl-2降低.结论 银杏叶提取物可能通过影响Bcl-2、Bax表达,抑制细胞凋亡,从而发挥对缺血再灌注损伤肾脏的保护作用.     

脂肪乳后处理对心脏缺血再灌注损伤的保护作用

目的 研究脂肪乳预处理和后处理是否具有心脏保护作用,并初步探讨其机理.方法 雄性SD大鼠20只.采用Langendorff 灌流模型,随机分为4组:持续灌注组(CTL组,持续灌注3 h 50 min),缺血再灌注组(ISCH 组,心脏平衡50 min, 37℃缺血45 min, 复灌3 h),脂肪乳预处理(I-preC组,脏平衡30 min, 给予含30%脂肪乳的灌注液预处理15 min,洗脱15 min, 37 ℃缺血45 min, 复灌3 h),和脂肪乳后处理组(I-postC组,心脏平衡50 min,37 ℃缺血45 min,复灌3 h,复灌开始给予含30%脂肪乳的灌注液15 min).基础和复灌期间连续监测心率(HR)和机械功能(LVDP).平衡20 min和复灌60min时测定流出液中LDH的含量.复灌结束, 剪下心脏左室前壁,做病理切片.余下的心肌组织液氮速冻后-70 ℃冰箱保存,做Western Blotting.结果 与ISCH组相比,I-postC组心脏做功增强,而I-preC并不增加左室做功.与ISCH 组相比,I-preC组和I-postC组复灌60 min时LDH的释放均降低,I-postC组心肌凋亡细胞指数降低(P＜0.05);I-preC组和ISCH组心肌凋亡细胞指数之间差异无统计学意义.与ISCH组相比,I-postC组的Bax表达量较低;I-postC组的Bcl-2的表达量较高.与ISCH组相比,I-preC组Bax的表达量比较高,I-postC组Bcl-2的表达量较低.结论 脂肪乳后处理通过抑制心肌细胞凋亡而增强心脏机械做功,并减少LDH 的释放而减轻心肌缺血再灌注损伤.     

缺血后处理缺血-再灌注损伤对大鼠肾脏的抗凋亡作用

目的研究缺血后处理减轻大鼠肾脏缺血-再灌注损伤的细胞凋亡的作用.方法大鼠右肾切除,左肾45min缺血再灌注6h,给予6个循环10s/10s再灌/停灌缺血后处理方案干预后,测定血肌酐和尿素氮水平评价肾功能;HE染色观察肾组织病理形态学变化;原位末端脱氧核苷酸转移酶标记（TUNEL）法检测肾组织中凋亡细胞,;Western blotting法检测肾组织Bcl-2和Bax蛋白表达.结果缺血后处理能明显减轻肾组织病理形态学损伤,降低血肌酐和尿素氮水平（P〈0.05）,减轻缺血-再灌注损伤后的细胞凋亡（P〈0.05）,增加Bcl-2的表达和降低Bax的表达（P〈0.05）.结论缺血后处理可减轻肾脏缺血-再灌注损伤,其保护作用可能与上调Bcl-2蛋白和下调Bax蛋白从而抑制再灌注损伤的细胞凋亡有关.     

缬沙坦后处理对离体大鼠心肌缺血再灌注细胞凋亡及Bcl-2、Bax表达的影响

目的观察缬纱坦后处理对离体大鼠心肌缺血再灌注(ischemia-reperfusion, I/R)细胞凋亡及凋亡相关蛋白Bcl-2、Bax表达的影响.方法利用Langendorff 离体心脏灌流装置,采用完全复灌/停灌的方法制备I/R模型.24只SD大鼠随机等分为:①对照(sham)组:K-H液持续灌流110min;②I/R组:停灌30 min,复灌60 min;③缬纱坦后处理(Po vst)组:I/R+缬沙坦1μmol/L(再灌注头15min给药).Hoechst 荧光染色观察凋亡情况,计算凋亡指数(AI);Western blot 检测Bcl-2、Bax的表达.结果 sham组凋亡细胞零星分布(AI=3.48±0.38),另两组均有大量凋亡细胞存在,且Povst组AI(25.87±1.04)明显低于I/R组(36.99±2.26)(P<0.05);Bcl-2、Bax的表达在I/R、Povst组均明显高于sham组(P<0.01),Povst组Bcl-2的表达明显高于I/R组(P<0.01),而Bax的表达与I/R组无显著差异(P>0.05).结论缬纱坦后处理抑制离体大鼠心肌再灌注细胞的凋亡,与上调Bcl-2表达、增加Bcl-2/Bax 比值有关.     

苯那普利对大鼠缺血再灌注的影响

目的 观察苯那普利对大鼠心肌缺血再灌注损伤的保护作用,并初步探讨其可能的作用机制.方法 32 只SD大鼠随机分为3 组:假手术组、缺血再灌注组、苯那普利预处理组.大鼠在体结扎冠状动脉前降支30 min后,松开结扎线再灌注120 min制备心肌缺血再灌注损伤模型,测定血清肌酸激酶(CK)的含量,TTC染色后计算心肌梗死范围(MIS),TUNEL法检测心肌细胞凋亡并用免疫组化方法测定抑凋亡基因(Bcl-2)和促凋亡基因(Bax)的表达.结果 缺血再灌注损伤组较假手术组的CK明显增高,其凋亡指数增多,Bcl-2的蛋白表达减少而Bax的蛋白表达增加.苯那普利预处理组的CK较缺血再灌注组明显降低,其凋亡指数减少,Bcl-2蛋白表达增加而Bax的蛋白表达降低;心肌梗死面积明显减小.结论 苯那普利预处理通过抑制心肌细胞的凋亡而对缺血再灌注的心肌起保护作用.     

大鼠心肌缺血-再灌注损伤与细胞凋亡的关系及缺血预适应对其的影响

日的制备不同缺血时间的大鼠心肌缺血-再灌注损伤模型,进行凋亡细胞定量检测及凋亡抑制基因bcl-2检测．以了解缺血预处理对心肌凋亡细胞数量的影响,并探讨其机制。方法SD大鼠随机分为A组为无缺血对照组．B组缺血10min．C组缺血20min。D组缺血30min,E组缺血60min,F组为预处理组。分别用TUNEL法检测缺血再灌注大鼠心肌细胞凋亡,用SP免疫组化方法和图像分析技术检测心肌细胞凋亡相关基因Bcl-2和Bax的表达。结栗发现心脏经缺血预处理后,缺血-再灌注损伤程度明显减轻。各组随着缺血时间延长,凋亡心肌细胞数目逐渐增多;Bcl-2蛋白表达光密度值（OD值）减少、Bax蛋白表达OD值增多。结论缺血预处理的心肌保护作用在一定程度上通过减少心肌缺血-再灌注细胞凋亡而实现,     

胰岛素样生长因子-1对大鼠局灶性脑缺血再灌注后神经细胞凋亡及Bcl-2,Bax蛋白表达的影响

目的研究胰岛素样生长因子-1(IGF-1)对大鼠局灶性脑缺血再灌注后神经细胞凋亡及Bcl-2,Bax蛋白表达的影响,探讨IGF-1对脑缺血再灌注损伤的保护作用机制.方法制作大鼠大脑中动脉缺血再灌注模型.30只Wistar雄性大鼠被随机分为假手术组、缺血组及IGF-1治疗组.于缺血10min后经尾静脉给予IGF-1 10μg,应用TTC染色观察梗死灶体积,应用免疫组化染色和TUNEL法检测Bcl-2,Bax蛋白表达及神经凋亡细胞.结果与缺血组比较,IGF-1治疗组梗死体积明显减少(P＜0.01),凋亡细胞数明显减少(P＜0.01),Bcl-2蛋白表达明显升高(P＜0.01),Bax蛋白表达明显降低(P＜0.01).结论IGF-1通过增加Bcl-2蛋白表达,减少Bax蛋白表达,减少神经细胞凋亡,对脑缺血再灌注损伤起保护作用.     

苯那普利对大鼠缺血再灌注的影响

目的观察苯那普利对大鼠心肌缺血再灌注损伤的保护作用,并初步探讨其可能的作用机制。方法32只SD大鼠随机分为3组：假手术组、缺血再灌注组、苯那普利预处理组。大鼠在体结扎冠状动脉前降支30 min后,松开结扎线再灌注120 min制备心肌缺血再灌注损伤模型,测定血清肌酸激酶（CK）的含量,TTC染色后计算心肌梗死范围（MIS）,TUNEL法检测心肌细胞凋亡并用免疫组化方法测定抑凋亡基因（Bcl-2）和促凋亡基因（Bax）的表达。结果缺血再灌注损伤组较假手术组的CK明显增高,其凋亡指数增多,Bcl-2的蛋白表达减少而Bax的蛋白表达增加。苯那普利预处理组的CK较缺血再灌注组明显降低,其凋亡指数减少,Bcl-2蛋白表达增加而Bax的蛋白表达降低;心肌梗死面积明显减小。结论苯那普利预处理通过抑制心肌细胞的凋亡而对缺血再灌注的心肌起保护作用。     

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.     

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.     

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.     

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.