弥漫性脑损伤大鼠脑组织细胞间粘附分子-1的表达与神经元损伤

目的观察细胞间黏附分子-1(ICAM-1)在大鼠弥漫性脑损伤不同时程的表达与脑组织神经元损伤.方法荧光实时定量RT-PCR和免疫组化分别测定ICAM-1 mRNA和蛋白在大鼠弥漫性脑损伤不同时程的表达,光镜和电镜观察神经元的变化.结果外伤后6h脑组织中ICAM-1蛋白的表达开始升高(阳性微血管数4.8±0.8),72 h达高峰(17.2±2.4),高于假手术对照组(0.4±0.5)(P＜0.05).ICAM-1mRNA表达3h即明显升高(△Ct:13.48±3.93),72h达最高(20.59±0.97),7 d(15.60±0.01)仍高于假手术对照组(4.66±1.11)(P＜0.01).光镜及电镜下可见弥漫性神经元变性水肿和坏死,72h损伤最重.结论大鼠脑外伤后ICAM-1表达升高,介导了粒细胞与脑血管内皮黏附增强,ICAM-1可能参与了外伤后炎症反应和神经元损伤的病理过程.     

MMP-9/TIMP-1在大鼠弥漫性脑损伤后早期的表达及意义

目的探讨基质金属蛋白酶-9及其抑制剂TIMP-1在大鼠弥漫性脑损伤后早期的表达变化与继发脑损伤的关系。方法荧光实时定量RT-PCR分别测定MMP-9mRNA和TIMP-1mRNA在大鼠弥漫性脑损伤早期不同时程的表达，干湿重法测定脑水分含量，光镜和电镜观察血脑屏障结构的变化。结果与假手术对照组相比，外伤后1?h大鼠脑组织中MMP-9mRNA开始增加，伤后12h达到高峰并持续7?d（P<0.01）；TIMP-1mRNA表达6h明显升高，24h达高峰，表达量增加1倍，并持续7d（P<0.01）。脑组织含水量比假手术对照组明显增加，光镜及电镜下可见炎性反应和毛细血管的超微结构破坏、神经元变性水肿和坏死，72h损伤最重。 结论大鼠外伤后诱导MMP-9mRNA和TIMP-1mRNA表达增加，可能参与了弥漫性脑损伤后早期脑水肿和神经元损伤的继发脑损害病理过程。     

ET-1mRNA在弥漫性脑损伤中的表达

目的探讨弥漫性脑损伤脑组织不同时间段ET-1mRNA表达。方法依据Marmarou’s弥漫性脑损伤动物模型有改进，应用SD雄性大鼠55只，随机分为两组：假手术（对照组）（n=5）和弥漫性脑损伤组（n=50），损伤组再按照不同时间段分组（各组n=5只），损伤后大鼠自由进食饮水，按0．5、1、3、6、12、24、48、72h、1周、2周等时间段处死大鼠，提取大鼠皮层脑组织，一部分脑组织应用realtimeRT—PCR检测对照组与不同时间段外伤组ET—1mRNA表达，另取一部分脑组织蘸干脑组织血迹，应用分析天平测定脑组织测得脑组织湿重，放入C101型电热恒温鼓风干燥箱105℃烘干至恒重，应用分析天平测定组织干重，应用脑组织干湿重比表示脑组织含水量。结果对照组与0．5、1、3、6、12、24、48、72h、1周、2周时间段外伤组Er—mRNACt值分别为：30．83：0．38，31．21&#177;0．52，33．47&#177;0．44，34.15&#177;0．64，35.77&#177;0．42，33.35&#177;0.58，31．21&#177;0．58，31.16&#177;0、27，30.38&#177;0.58，30．38&#177;0．37，30.34&#177;0.37。采用Kurskal—Wallis秩和检验，P〈0．01，对照组与不同时间组之间比较差异有统计学意义。结论弥漫性脑损伤后ET—1mRNA表达短期增加，6h就达到高峰。     

胡黄连提取物对缺血再灌注肾脏黏附分子表达的影响

目的研究胡黄连提取物对缺血再灌注肾脏细胞黏附分子1(ICAM-1)、单核细胞趋化因子1(MCP-1)表达的影响。方法雄性SD大鼠分为假手术组、手术对照组、胡黄连提取物不同剂量给药组,采用切除右肾无创动脉夹夹闭左肾动脉60 min再灌注72 h的方法制备急性缺血再灌注(I/R)肾损伤大鼠模型,生化法测定血清肌酐、尿肌酐,并结合尿量计算内生肌酐清除率(Ccr),光镜电镜观察肾组织病理变化并肾小管计分,免疫组化观察肾脏ICAM-1,MCP-1的表达,实时定量荧光RT-PCR测定肾组织ICAM-1,MCP-1 mRNA表达。结果肾脏I/R损伤时大鼠Ccr明显降低,肾脏病理变化明显,肾脏ICAM-1,MCP-1表达明显,肾组织ICAM-1,MCP-1 mR-NA表达增加;与手术对照组相比,各胡黄连提取物组肾脏ICAM-1,MCP-1表达减弱,肾组织ICAM-1,MCP-1mRNA表达降低,肾小管计分降低,Ccr升高。结论胡黄连提取物可以抑制缺血再灌注损伤后肾脏ICAM-1,MCP-1表达,改善肾功能。     

大鼠脑出血后血肿周围核因子-кB的表达和意义

目的研究大鼠实验性脑出血后血肿周围脑组织核因子-кB(NF-кB)的表达及其在继发性脑损伤中的作用。方法采用自体不凝血注入大鼠尾状核制备脑出血模型,免疫组化染色法检测脑组织NF-кB、细胞间粘附分子-1(ICAM-1)的表达。结果脑出血后6 h血肿周围脑组织NF-кB开始表达,48 h达高峰,ICAM-1 12 h开始表达,72 h达高峰;各组与假手术组之间有显著差异(均P<0.01);脑出血后NF-кB与ICAM-1呈正相关关系(γ=0.868,P<0.05),NF-кB表达从开始到高峰均早于ICAM-1。结论脑出血后NF-кB表达增加,并通过ICAM-1参与了脑出血继发性脑组织损伤。     

弥漫性脑损伤中iNOSmRNA的表达及意义

目的探讨弥漫性脑损伤脑组织不同时间段iNOSmRNA的表达及意义。方法依据Marmarou’s弥漫性脑损伤动物模型有改进,应用SD雄性大鼠55只,随机分为两组：假手术（对照组）（n=5）和弥漫性脑损伤组（n=50）,损伤纽再按照不同时间段分组（n=5）,损伤后大鼠自由进食饮水,按0．5、1、3、6、12、24、48、72h、1周、2周等时间段处死大鼠,提取大鼠皮层脑组织,脑组织应用realtime RT—PCR检测对照组与不同时间段外伤组iNOSmRNA表达。结果对照组,损伤组0．5、1、3、6、12、24、48、72h、1周、2周时间段iNOSmRNACt值分别为：35．00&#177;0．44．35．93&#177;0．41．40．38&#177;0．55,41．26&#177;0．76,42．54&#177;0．39,44．33&#177;0．17,44．17&#177;0．26,41．51&#177;0．37．41．39&#177;0．16．41．32&#177;0．25．35．20&#177;O．50。用Kurskal—Wallis秩和检验,P〈0．05,对照组与不同时间组之间比较差异有统计学意义。结论弥漫性脑损伤后脑组织iNOSmRNA表达早期有升高趋势,12h达到高峰,24h仍然处于高水平状态,随后下降,持续时间长达1周,这可能是致继发损害的早期因素。     

大鼠弥漫性脑损伤后Homer蛋白的表达及其意义

目的研究大鼠弥漫性脑损伤后不同亚型Homer蛋白表达规律及其意义.方法SD大鼠105只,体质量(300±25)g,分为正常组、假手术组和弥漫性脑损伤(DBI)组,DBI组应用Marmarou大鼠致伤,假手术组不予以自由落体打击,其余处理同DBI组,分别在损伤后0.5,1,6,12,24,72,168h取大鼠主要脑区及核团裂解匀浆,进行各Homer蛋白的免疫印迹分析.结果DBI组神经组织中Homer1a蛋白的表达自伤后0.5h起持续至伤后168h,而正常及假手术组未见该蛋白阳性表达;Homer1b/c,Homer2a/b和Homer3在正常组、假手术组和DBI组均可见明确的阳性表达.结论大鼠弥漫性脑损伤后Homer1a蛋白的表达于损伤前后有显著变化,而Homer1b/c,Homer2a/b及Homer3于损伤前后无明显变化,提示Homer1a蛋白参与了神经元损伤过程,且可能对神经元损伤起到一定的保护作用.     

二次脑损伤大鼠脑皮层代谢性谷氨酸受体1a的改变

目的　研究二次脑损伤 (SBI)大鼠脑皮层代谢性谷氨酸受体 1α(m Glu R1α)的变化及意义 .方法　 SD大鼠 90只 ,随机分为假手术对照、单纯脑损伤、脑损伤合并 SBI3组 .在 Marmarou大鼠加速性弥漫性脑损伤模型基础上 ,以抽血造成低血压为 SBI指标 .在伤后不同时间进行免疫组化和病理学研究 .结果　与假手术对照相比 ,单纯脑损伤组脑皮层m Glu R1α阳性神经元在伤后 1h表达明显增加 ,为 13.9±3.2 (P<0 .0 5 ) ,2 4h达到 15 .3± 3.7的峰值 (P<0 .0 1) ;脑损伤合并 SBI组 m Glu R1α阳性神经元表达在伤后 0 .5 h即明显增加 :13.5± 3.8(P<0 .0 5 ) ,伤后 6 h达高峰 :15 .6± 3.7(P<0 .0 1) .结论　在弥漫性脑损伤发生、发展过程中 ,m Glu R1α改变可能是导致脑损害加重的因素之一 ,合并 SBI组脑皮层m Glu R1α阳性神经元表达的增强和高峰的提前提示m Glu R1α参与缺血过程 .     

亚低温对大鼠脊髓损伤后ICAM-1和VCAM-1表达的影响

目的观察亚低温对大鼠脊髓损伤后细胞间黏附分子-1(ICAM-1)和血管间黏附分子-l(VC-MA-1)表达的影响,并探讨亚低温对受损脊髓神经元的保护作用的机制。方法大鼠脊髓损伤模型,设实验组和对照组,分别置于冰毯机上和常温操作台上,使其肛温分别在(34±0.5)℃和(37±0.5)℃。12h后处死,取损伤处脊髓,采用免疫组化法检测损伤脊髓区灰质ICAM-1和VCMA-1阳性表达。结果实验组ICAM-1和VCMA-1阳性表达较对照组下降。结论亚低温可降低大鼠脊髓损伤区的ICAM-1和VCMA-1的表达,推测亚低温降低ICAM-1和VCMA-1的表达为亚低温减轻脊髓损害的神经保护作用机制之一。     

大鼠脑损伤后大脑皮层代谢型谷氨酸受体1a的表达变化及意义

目的　研究大鼠加速性弥漫性脑损伤后大脑皮层代谢性谷氨酸受体 1a(m Glu R1 a)的基因和蛋白表达变化与其拮抗剂 a-甲基 - 4-羧基苯氨基乙酸 (MCPG)的作用 .方法　SD大鼠 16 5只随机分为 m Glu R1 a变化和 MCPG作用 2组 .每组又分为不同的亚组 .采用 Marm arou大鼠加速性弥漫性脑损伤模型 .在伤后不同时间大鼠断头取脑进行免疫组化 ,RT- PCR技术和病理学研究 .结果　伤后 1h大脑皮层 m Glu R1 a的表达开始增加 ,2 4h达高峰 (13.9± 2 .3)· HP- 1 ,P<0 .0 1.在伤后 7d,MCPG治疗可使损伤神经元数量明显减少 (4 .2 2±1.6 3)· HP- 1 ,P<0 .0 5 .结论　 m Glu R1 a参与外伤后的神经元损伤 ,其拮抗剂 MCPG可能对脑损伤有治疗作用 .     

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.