地氟烷对卵白蛋白致敏豚鼠气道平滑肌张力的影响

目的 观察地氟烷对卵白蛋白致敏的豚鼠高反应气道平滑肌张力的影响.方法 56只雄性豚鼠随机分为7组:正常组(N)、致敏组(S)、致敏对照组(SC)和致敏地氟烷组[致敏0.5 MAC(最低肺泡有效浓度)地氟烷组(SD 0.5)、致敏1.0 MAC地氟烷组(SD 1.0)、致敏1.5 MAC地氟烷组(SD 1.5)和致敏2.0 MAC地氟烷组(SD 2.0)],每组8只.N组与S组用于气道模型评价;SC组、SD0.5、SD 1.0、SD 1.5及SD2.0组用于气道平滑肌测定.通过应用卵白蛋白制备致敏豚鼠模型.测量肺阻力,根据肺阻力对不同剂量乙酰胆碱的峰反应值,得到肺阻力剂量反应曲线,评价致敏气道模型.记录离体致敏豚鼠气道平滑肌对10-8 mol/L、10-7 mol/L、10-6 mol/L、10-2 mol/L的卡巴胆碱刺激的峰反应值,评价地氟烷对高反应致敏气道的作用.结果 与N组相比,S组能显著升高豚鼠的肺阻力变化曲线;S组的肺阻力峰反应值比N组高40％(当乙酰胆碱剂量为6μg/kg时),P＜0.05.与SC组相比,SD0.5、SD 1.0、SD 1.5、SD 2.0组气道平滑肌张力峰值明显下降;卡巴胆碱剂量为10-5 mol/L时,SD 1.5和SD 2.0组峰值分别比SC组降低了12.1％和14.0％,比SD 0.5组降低了8.9％和11.0％,P均＜0.05.结论 地氟烷能够降低卵白蛋白致敏的豚鼠的离体气道平滑肌张力.     

VEGF、HIF-1α在大鼠慢性哮喘模型中的表达及地塞米松的干预效应

目的 观察缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)在慢性哮喘大鼠中的表达水平,探讨其在慢性哮喘气道重塑中的作用.方法 以卵清清蛋白(OVA)致敏及反复激发建立大鼠慢性哮喘模型,激发前30 min胃内灌注地塞米松1 mg/kg,最后一次激发12 h内处死大鼠,常规病理切片观察大鼠肺内炎症情况、总气管壁厚度、气管内壁厚度及气道平滑肌厚度.免疫组化检测气道壁HIF-1α、VEGF蛋白的表达,RT-PCR观察大鼠肺部HIF-1α、VEGF mRNA的表达.结果 慢性哮喘模型组大鼠气道支气管及血管周围大量炎症细胞聚集,总气管壁、气管内壁及气道平滑肌增厚,肺组织HIF-1α、VEGF mRNA及HIF-1α、VEGF蛋白的表达增高(P＜0.01).哮喘大鼠致敏前使用地塞米松后气道炎症较轻,减轻总气管壁、气管内壁及气道平滑肌增厚.各组大鼠肺组织内HIF-1α、VEGF蛋白的表达与气道壁厚度呈正相关.结论 HIF-1α、VEGF可能参与了慢性哮喘大鼠的气道重塑,早期使用地塞米松可以预防气道重塑.     

血管紧张素Ⅱ受体与气道重塑的相关性研究

目的探讨血管紧张素受体在远交群大鼠（SD）气道重塑模型中的表达及糖皮质激素对其表达的影响。方法建立大鼠哮喘模型，采用免疫组化技术结合计算机病理图像分析系统，测定大鼠气道支气管壁的血管紧张素Ⅱ受体1（AT1R）和血管紧张素Ⅱ受体2（AT2R）染色的积分光密度值（IOD）；测定完整的支气管横断面的基底膜周经BM（μm）和管壁面积Aw（μm2），计算气道壁厚度AW／BM（μm2／μm）。结果AT1R与气道壁厚度呈正相关（P〈0．01）；AT2R与气道壁厚度无相关（P〉0．05）。结论血管紧张素Ⅱ主要通过AT1R参与了SD大鼠哮喘气道重塑过程，且糖皮质激素可通过抑制AT1R的表达，干预气道重塑的形成。     

健脾补肺化痰方对幼龄哮喘大鼠EGF、MMP-9的含量影响

目的:研究表皮生长因子(EGF)、基质金属蛋白酶-9(MMP-9)在幼龄哮喘大鼠气道重塑中的表达及其之间的相关性分析,通过实验初步探讨健脾补肺化痰方对哮喘患儿平喘作用的机理,为中医药防治小儿哮喘提供新的研究思路。方法:48只SD幼龄大鼠随机分成正常对照组,哮喘模型组,辅舒酮组,健脾补肺化痰方高剂量、中剂量和低剂量组,以卵蛋白(OVA)致敏制备幼龄大鼠哮喘模型。采用HE染色观察肺病理组织学变化,采用酶联免疫法(ELISA)检测血清中EGF、肺组织MMP-9的含量变化。结果:正常对照组哮喘大鼠镜下无炎症反应,无气道重塑。模型组炎症反应很重;气道壁明显增厚,气道壁受损,气道管腔狭窄,气道平滑肌层和网状基底膜层增厚;气道上壁纤维化改变明显,具备气道重塑的特征。健脾补肺化痰方低中高剂组大鼠病理变化炎症程度依次减轻,高剂组与辅舒酮组炎症反应相当,炎症反应很轻。各组大鼠血清中EGF、肺组织MMP-9含量与模型组之间有差异性(P0.05或P0.01)。     

吸入布地奈德对哮喘大鼠气道重塑影响的研究

目的 通过观察哮喘大鼠吸入布地奈德后气道核转录因子(NF-κB)、基质金属蛋白酶-9(MMP-9)表达,探讨布地奈德治疗哮喘的气道重塑的机制.方法 正常Wistar大鼠随机分为:对照组、模型组、治疗组,除对照组外,余两组予抗原液致敏,对照组用生理盐水致敏;哮喘组和治疗组予卵蛋白激发,连续7天,治疗组激发后,均采用布地奈德雾化吸入治疗.模型组激发后以生理盐水雾化,对照组雾化生理盐水作为对照,正常对照组用等量的生理盐水进行激发和治疗.结果 NF-κB和MMP-9在模型组、激素治疗组和正常对照组大鼠肺组织中均有阳性表达,且模型组明显高于治疗组及对照组,激素组较模型组明显下降.结论 布地奈德作为治疗哮喘的有效药物,可以抑制NF-κB活性,使MMP-9水平降低,改善气道重塑.     

Cyclin D1和CDK4在哮喘大鼠气道重塑中的表达和盐酸氨嗅索的干预研究

目的探讨哮喘大鼠气道重塑的机制和细胞周期蛋白D1（Cyclin D1）、细胞周期素依赖性激酶4（CDK4）在哮喘气道重塑中的表达以及盐酸氨嗅索的干预效果。方法应用卵蛋白激发大鼠建立哮喘气道重塑模型。60只SD大鼠分为3组：正常组,哮喘组和干预组,每组20只。采用免疫组化技术和计算机图象分析系统对大鼠气道Cyclin D1、CDK4的表达和气道重塑进行研究。结果哮喘纽气道壁均可见明显炎症细胞浸润,气道壁厚度增加,Cyclin D1、CDK4阳性表达增加,与正常组和干预组比较差异具有统计学意义（P〈0．05）。结论Cyclin D1、CDK4参与哮喘气道重塑的发生,盐酸氨嗅索可减少气道壁炎症细胞浸润,预防气道重塑。     

间充质干细胞在哮喘大鼠气道炎症及气道重塑中的作用

目的 探讨间充质干细胞(MSCs)在哮喘大鼠慢性气道炎症及气道重塑中的作用.方法 将18只SD雌性大鼠随机分为:正常对照组、哮喘4周组和哮喘8周组,每组6只.卵清蛋白(OVA)致敏后,雾化吸入OVA制作哮喘模型.哮喘模型成功后,测定气道压力;通过HE染色、Image-ProPlus图像分析软件分析大鼠气道平滑肌的嗜酸性粒细胞(ESO)浸润情况,测定支气管管腔的内周长、管壁面积,支气管平滑肌面积、平滑肌细胞核数;采用密度梯度离心法分离外周血单个核细胞,通过流式细胞仪检测各组MSCs的含量,并分析其与哮喘气道炎症及气道重塑的关系.结果 哮喘4周组、哮喘8周组大鼠的气道反应性、气道壁EOS计数、支气管管壁面积、支气管平滑肌面积、平滑肌细胞核数目、外周血中MSCs比例均较正常对照组显著增加(P ＜0.01,P＜0.05);哮喘两组间上述指标差异均有统计学意义(P＜0.01);Pearson线性相关显示:各组大鼠外周血单个核细胞中MSCs的含量与气道反应性、EOS浸润数、支气管壁面积、支气管平滑肌厚度及支气管平滑肌细胞核数均呈正相关(P＜0.01).结论 MSCs在哮喘状态下含量增加,可能参与了哮喘的慢性气道炎症及气道重塑.     

地塞米松对支气管哮喘大鼠气道重塑及IL-8的影响

目的探讨支气管哮喘大鼠气道重塑与其血清白介素-8（IL-8）表达的关系以及地塞米松的干预作用。方法以卯白蛋白（OVA）致敏并吸入激发制备大鼠哮喘模型。采用计算机图像分析系统及免疫组化技术结合．测定对照组（C）、模型组（N）、地塞米松早期干预组（E）、地塞米松晚期干预组（L）大鼠气道形态学参数及血清IL-8含量。结果E组、L组、N组大鼠出现气道重塑。其中E组气道重塑程度及IL-8含量较轻、N组较重、L组居中,各组问差异有统计学意义（P〈0．05）。结论IL-8与支气管哮喘大鼠气道重塑程度呈正相关;地塞米松可抑制气道重塑。并且可能通过下调IL-8的表达干预气道重塑。     

哮喘大鼠血清、支气管肺泡灌洗液及肺组织中转化生长因子-β1与哮喘气道重塑

目的 观察哮喘大鼠模型血清、支气管肺泡灌洗液(BALF)中转化生长因子-β1(TGF-β1)的含量及肺组织中TGF-β1的表达,分析其相关性及与哮喘气道重塑的关系,为临床哮喘的诊断和治疗提供理论依据.方法 Wistar大鼠随机分为2组,正常对照组和哮喘模型组,每组20只.用卵蛋白(OVA)致敏和激发制成哮喘大鼠模型,用Elisa法测定血清及BALF中TGF-β1的含量,免疫组化法测定肺组织中TGF-β1的表达,Masson染色观察胶原沉积的情况,计算机图像分析系统评价呼吸性细支气管平滑肌厚度及上皮损伤程度评分等气道重塑指标.结果 造模后,与对照组相比模型组血清中TGF-β1的含量明显减低(P<0.05);BALF中TGF-β1的含量增加(P<0.01);肺组织中TGF-β1的表达增多(P<0.01).哮喘大鼠气道黏膜上皮损害、气道平滑肌厚度、气道胶原蛋白的沉积较对照组明显增加.结论 BALF中TGF-β1的含量增加、肺组织中TGF-β1的表达增加,加重了哮喘气道重塑;血清中TGF-β1含量减少,提示可以通过检测血清中TGF-β1为哮喘的诊断提供依据、间接了解气道重塑.     

NGF在哮喘大鼠模型中的表达及柴朴汤的干预研究

目的通过观察NGF在哮喘大鼠模型中的表达变化,并用柴朴汤进行干预,探讨柴朴汤在哮喘大鼠中的治疗作用,为哮喘的预防及治疗提供进步的思路。方法健康SD大鼠40只,随机分为对照组、哮喘组、NGF-抗体组及柴朴汤组。以卵清白蛋白致敏及反复激发复制哮喘大鼠模型,柴朴汤及NGF抗体进行干预,常规切片观察气道内管壁厚度及气道平滑肌厚度;RT-PCR检测NGFmRNA的表达;免疫组化法检测NGF蛋白的表达。结果哮喘组大鼠支气管及血管周围大量炎症细胞聚集,总气管壁、气管内壁及气道平滑肌增厚,肺组织NGFmRNA及NGF蛋白的表达增高,与对照组比较,差异有显著性(P<0.05)。柴朴汤组及NGF-抗体组与哮喘组相比炎症细胞浸润程度下降,气道壁结构改变如平滑肌增厚减轻,气道重塑程度降低,大鼠肺组织内NGF蛋白的表达降低。结论柴朴汤可减轻哮喘大鼠气道重塑,其机制可能与下调NGF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.