白芍总苷对柯萨奇B3病毒感染大鼠原代心肌细胞的血清药理学干预

目的探讨白芍总苷（TGP）对柯萨奇B3病毒（CVB3）感染大鼠原代心肌细胞有无保护作用。方法取SD乳鼠心室肌制备大鼠原代心肌细胞,培养72h后,用不同剂量的TGP含药血清干预100 TCID50 CVB3感染心肌细胞,对比分析干扰素组、双黄连组、正常对照组。观察细胞病变,24h后测定细胞上清液中的cTnⅠ、CK、LDH以及用MTT法检测细胞存活率。结果TGP高剂量组可减轻心肌细胞病变,减少cTnⅠ、CK、LDH的释放。结论TGP对CVB3感染大鼠原代心肌细胞有保护作用。     

抗柯萨奇B病毒性心肌炎胶囊对柯萨奇B3病毒性心肌炎小鼠LDH、CK的影响

①目的 探讨抗柯萨奇B病毒性心肌炎胶囊(K-CoxB-JK复方)对实验性小鼠柯萨奇B3病毒(CVB3)性心肌炎的治疗作用.②方法 采用雄性BALB/C小鼠腹腔注射CVB3,建立实验性小鼠病毒性心肌炎模型.将84只雄鼠随机分为正常对照组、模型组、病毒唑组、复方组,每组21只.模型组、病毒唑组和复方组小鼠腹腔接种CVB3稀释液半小时后即给药,正常对照组给予一定量生理盐水.将接种当天定为第1天,每日1次,连续给药18天,于第19天处死.观察小鼠精神状态,统计小鼠死亡率并检测血清乳酸脱氢酶(LDH)、肌酸激酶(CK)浓度.③结果 复方组LDH、CK较模型组低,病毒唑组LDH、CK高于模型组、正常组.④结论 K-CoxB-JN复方对小鼠CVB3病毒性心肌炎的有治疗作用,且其治疗作用优于病毒唑.     

心肌营养素-1在柯萨奇病毒感染心肌细胞中的作用

目的探讨在柯萨奇病毒感染心肌细胞中心肌营养素-1(cardiotrophin-1,CT-1)是否通过STAT3途径发挥治疗作用。方法建立柯萨奇B3病毒(CVB3)感染心肌细胞模型,将SD大鼠原代心肌细胞培养48 h后随机分为5组:Con组、Virus组、CT-1组、AG490组、AG490+CT-1组。各组于相应处理后培养30 min,通过Western blot测定STAT3活化水平,分别于培养12 h、24 h、36 h时观察各组心肌细胞病变、搏动情况,测定乳酸脱氢酶(LDH)活性,观察细胞损伤程度。结果 Virus组、AG490+CT-1组、AG490组心肌细胞感染CVB3后,逐步出现细胞病变,细胞搏动停止,培养液中LDH水平明显高于Con组(P<0.05),心肌酶逐渐升高与前一时间点比较(P<0.05)。CT-1组磷酸化STAT3(P-STAT3)水平与Con组相比明显增高(P<0.05),心肌细胞病变明显减轻,LDH释放量显著减少,与Virus组比较差异显著(P<0.05)。AG490+CT-1组较Con组及CT-1组STAT3磷酸化水平显著减低,心肌细胞病变明显,LDH释放量明显增高(P<0.05),与Virus组比较无显著差异(P>0.05)。结论 CT-1在CVB3感染心肌细胞过程中具有心肌保护作用,STAT3磷酸化抑制剂AG490可阻断这一保护作用,提示在病毒感染时CT-1通过介导STAT3磷酸化发挥心肌细胞保护作用。     

雷帕霉素对柯萨奇病毒B3诱导的大鼠心肌细胞mTOR和eIF-4E表达的调控作用

目的:研究雷帕霉素对柯萨奇病毒B3(coxsackievirus B3,CVB3)诱导的心肌细胞哺乳类雷帕霉素靶蛋白(mammalian target of rapamycin, mTOR)和真核起始因子4E(eukaryotic initiation factor-4 E, eIF-4E)表达的调控,探讨mTOR/eIF-4E信号传导在病毒性心肌炎(viral myocarditis,VM)的作用.方法:CVB3感染原代培养的SD大鼠心肌细胞建立病毒性心肌炎的细胞模型.根据细胞毒力实验筛选10 nmol/L的雷帕霉素干预CVB3感染的心肌细胞,采用RT-PCR和Western免疫印迹方法检测mTOR和eIF-4E mRNA表达及蛋白质水平.结果:CVB3诱导心肌细胞变性,雷帕霉素可减轻其变性;CVB3使大鼠心肌细胞的mTOR和eIF-4E mRNA和蛋白表达上调,与对照组比较,有统计学差异(P<0.05),雷帕霉素可使CVB3感染的心肌细胞mTOR和eIF-4E mRNA和蛋白表达明显下调,与CVB3组比较,有统计学差异(P<0.05).结论:雷帕霉素能明显抑制CVB3感染的大鼠心肌细胞mTOR和eIF-4E表述,提示mTOR/eIF-4E信号传导在病毒性心肌炎中可能起重要作用.     

Role of cardiotrophin-1 in cardiomyocytes infected by coxsackievirus

目的 探讨在柯萨奇病毒感染心肌细胞中心肌营养素-1(cardiotrophin-1,CT-1)是否通过STAT3途径发挥治疗作用.方法 建立柯萨奇B3病毒(CVB3)感染心肌细胞模型,将SD大鼠原代心肌细胞培养48 h后随机分为5组:Con组、Virus组、CT-1组、AG490组、AG490+ CT-1组.各组于相应处理后培养30 min,通过Western blot测定STAT3活化水平,分别于培养12h、24h、36 h时观察各组心肌细胞病变、搏动情况,测定乳酸脱氢酶(LDH)活性,观察细胞损伤程度.结果 Virus组、AG490+ CT-1组、AG490组心肌细胞感染CVB3后,逐步出现细胞病变,细胞搏动停止,培养液中LDH水平明显高于Con 组(P＜0.05),心肌酶逐渐升高与前一时间点比较(P＜0.05).CT-1组磷酸化STAT3( P-STAT3)水平与Con组相比明显增高(P＜0.05),心肌细胞病变明显减轻,LDH释放量显著减少,与Virus组比较差异显著(P＜0.05).AG490+ CT-1组较Con组及CT-1组STAT3磷酸化水平显著减低,心肌细胞病变明显,LDH释放量明显增高(P＜0.05),与Virus组比较无显著差异(P＞0.05).结论 CT-1在CVB3感染心肌细胞过程中具有心肌保护作用,STAT3磷酸化抑制剂AG490可阻断这一保护作用,提示在病毒感染时CT-1通过介导STAT3磷酸化发挥心肌细胞保护作用.     

柯萨奇B3病毒mAb对心肌细胞形态及多种酶代谢的影响

目的 通过心肌细胞形态学及培养液中多种酶的变化，探讨柯萨奇B3病毒mAb对体外培养心肌细胞的作用。方法 应用间接免疫荧光法将培养小池中用冷丙酮固定的心肌细胞与自备的26种柯萨奇B3病毒mAb(CVB3-mAb)进行反应；并筛选出2种与大鼠心肌细胞结合的阳性mAb(2A3,2G12)，进一步与体外培养搏动的大鼠心肌细胞作用，观察mAb-大鼠心肌细胞培养液中心肌酶的改变，搏动百分比及细胞病变。结果 荧光显微镜下观察，有12本可与大鼠心肌细胞纤维结合，而另外14种无此结合反应。筛选出的2种CVB3－mAb加入搏动的大鼠心肌细胞中，取其不同时间细胞培养液检测。与对照组比较，心肌细胞培养液中心肌酶（CK，CK－MB，LDH，LDH－1，HBDH）及肌钙蛋白I（cTnI)等均增高（P＜0．05），并可引起心肌细胞形态改变。结论 部分病毒抗体可引起心肌细胞形态学及培养液中多种酶的改变，是引起心肌细胞进行性损伤的重要原因。     

心肌康对慢性病毒性心肌炎小鼠心肌细胞的保护作用

目的 观察心肌康对病毒性心肌炎小鼠心肌细胞的保护作用.方法 对清洁级Balb/c小鼠采用柯萨奇病毒(CVB3)腹腔注射染毒,制成慢性病毒性心肌炎动物模型,按照随机数字表法分为三组:A组为病毒性心肌炎(VMC)组、B组为心肌康组、C组氯沙坦组.另设20只腹腔接种不含病毒的Eagle's液小鼠为正常对照组,观察心肌康对模型鼠的生存率的影响及对CVB3 RNA表达、Ⅰ、Ⅲ型胶原含量的影响.结果 心肌康组、氯沙坦组小鼠的生存率明显高于病毒对照组,心肌康对CVB3感染鼠有保护作用,心肌康组对感染鼠的治疗作用要优于氯沙坦组.结论 心肌康可通过下调CVB3 RNA表达、抑制胶原增生而对心肌细胞产生保护作用.     

病毒性心肌炎心脏细胞因子mRNA的表达及生黄合剂防治机制的研究

目的:探讨病毒性心肌炎(VMC)小鼠心脏组织细胞因子白介素-2(IL-2)、白介素-4(IL-4)mRNA表达及生黄合剂免疫调节机制。方法:选用体重16~18g的雄性Balb/c小鼠200只,腹腔接种柯萨奇病毒B组3型(CVB3)建立VMC模型,随机分为正常组,生黄合剂治疗组、生脉饮组、抗病毒口服液组、病毒对照组。药物治疗组均灌胃给药,0.2ml/10g,2次/d。给药10d后,取小鼠心脏组织应用RT-PCR对IL-2、IL-4 mRNA进行半定量分析。结果:应用生黄合剂治疗VMC后,可显著抑制IL-2 mRNA,促进IL-4 mRNA表达。结论:生黄合剂可能通过调节细胞因子IL-2、IL-4 mRNA表达来发挥其对VMC有益的免疫调节作用。     

B组柯萨奇病毒对心肌细胞感染模式的研究

目的观察B组柯萨奇病毒（Coxsackie virusB,CVB）在原代心肌细胞中的感染特点,从而研究CVB对心肌细胞的致病机制。方法原代培养Balb／c乳鼠心肌细胞,并获得纯化的心肌细胞。使用B组柯萨奇病毒嗜心肌毒株3型（CVB3m）攻击原代心肌细胞,观察病毒感染心肌细胞后心肌细胞的细胞病变、超微结构和心肌酶的变化。结果成功原代培养了Balb／c乳鼠心肌细胞。心肌细胞在病毒感染后,细胞病变（CPE）不明显,与在HeLa等细胞中的典型CPE不同。心肌细胞在CVB3m感染后保持细胞形态和博动超过2周时间。电镜显示心肌细胞结构正常,细胞器数量增加,在心肌细胞胞质中可见晶格样病毒颗粒排列。培养细胞的上清液中心肌酶升高。结论CVB在原代心肌细胞中表现为持续感染,CVB在心肌细胞中的致病机制不同于HeLa细胞。     

牡荆素对CVB3病毒性心肌炎心肌细胞损伤的影响及机制

目的:研究牡荆素对柯萨奇B3病毒(CVB3)诱导的病毒性心肌炎心肌细胞凋亡和炎症的影响及其可能作用机制.方法:体外培养人心肌细胞AC-16,将细胞分为5组:正常组、病毒组、牡荆素低剂量组(10 mg/kg)、牡荆素中剂量组(30 mg/kg)和牡荆素高剂量组(50 mg/kg),正常组常规培养,病毒组和牡荆素组经CVB...     

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.