缬沙坦对豚鼠心室肌细胞动作电位的作用

目的:观察缬沙坦对豚鼠心室肌细胞动作电位的直接作用,以探讨其可能的抗心律失常作用。方法:采用Langendorff主动脉逆行灌流酶解分离法分离单个心室肌细胞。采用全细胞膜片钳记录,电流钳模式记录单个心室肌细胞的动作电位。实验分3组:对照组(n=5),普通细胞外液灌流,不含缬沙坦;缬沙坦5μM组(n=5);缬沙坦100μM组(n=5)。结果:缬沙坦5μM对豚鼠心室肌细胞静息膜电位、动作电位幅度、动作电位时程均无明显影响。缬沙坦100μM可延长心室肌细胞动作屯位时程,尤其是APD50从(334.2±14.4)ms延长至(375.2士12.0)ms(P<0.01)及APD30从(395.4士13.3)ms延长至(451.4±9.5)ms(P<0.01),对细胞静息膜电位、动作电位幅度无显著影响。结论:高浓度缬沙坦延长心室肌细胞动作电位时程APD50及APD90,而不影响动作电位的静息膜电位及动作电位幅度。适度延长动作电位时程,从而延长心室有效不应期,有助于折返引起的快速室性心律失常的防治,类似Ⅲ类抗心律失常药物的作用。提示缬沙坦可能通过此机制起抗心律失常的作用。     

氧化苦参碱对豚鼠心室肌细胞动作电位的影响

目的研究氧化苦参碱对豚鼠心室肌细胞动作电位的影响,探讨氧化苦参碱的抗心律失常作用机制。方法酶解法分解豚鼠单个心室肌细胞,采用全细胞膜片钳技术记录氧化苦参碱对动作电位的影响。结果氧化苦参碱1μmol·L-1对豚鼠单个心室肌细胞静息膜电位和超射值无明显影响;但可使动作电位复极50%时程（APD50）从给药前（534.7±29.62）ms缩短至（490.3±47.39）ms（n=5,P〈0.01）,使动作电位复极90%时程（APD90）从给药前（572.1±49.98）ms缩短至（549.8±35.42）ms（n=5,P〈0.01）,冲洗后APD50恢复至（498.1±31.78）ms（n=5,P〈0.01）,APD90恢复至（554.2±61.28）ms（n=5,P〈0.01）。结论氧化苦参碱可缩短心室肌细胞动作电位时程,提示此机制可能参与氧化苦参碱的抗心律失常作用。     

黄芪皂甙对豚鼠心室肌细胞动作电位的作用

目的研究黄芪皂甙（saponins of astrag—alus,SA）对豚鼠心室肌细胞动作电位（AP）的作用。方法实验采用标准玻璃微电极细胞内记录心室肌细胞动作电位（AD）。结果应用9A20mg／L后心室肌细胞动作电位的幅度从给药前的（69.31±6．07）mV降低到（57．37±368）mV（n=6,p〈0．05）;动作电位时程（APD40）从给药前的（263.38±16.56）ms延长到（284.55±21．21）ms（n=6,P〈0.05）。应用SA40mg／L后心室肌动作电位的幅度从给药前的（71.37±56.54）mV降低到（47．23±8.67）mV（n=6,p〈0.05）;动作电位时程（APD90）的从给药前的（238．31±13.28）ms延长到（314.64±27．36）ms（n=6,p〈0.05）。结论SA可以降低心室肌动作电位幅值延长动作电位时程,并且有一定的剂量依赖性。     

间羟胺对大鼠心室肌细胞动作电位及L-型钙电流的影响

目的观察α肾上腺素能受体激动剂间羟胺对大鼠心室肌动作电位及L-型钙电流的影响。方法采用全细胞膜片钳方法,记录离体大鼠心室肌细胞动作电位和L-型钙电流。结果 200μmol/L间羟胺可使心室肌细胞L-型钙电流增大（P〈0.05）,动作电位时程（APD）明显延长（P〈0.01）,动作电位复极50%和90%时间（APD50and APD90）明显延长（P〈0.01）。100μmol/L酚妥拉明可使增大的的L-型钙电流和APD、APD50、APD明显恢复。结论间羟胺可明显延长大鼠心室肌动作电位时程,而酚妥拉明可不同程度地拮抗此效应。     

厄贝沙坦电生理作用的实验研究

目的:研究厄贝沙坦(Irbesartan)对正常豚鼠心室肌细胞L-型钙电流(ICa-L)、内向整流性钾电流(IK1)、快钠流(INa)以及跨膜动作电位的影响.方法:应用膜片钳全细胞记录方法记录各项离子流和跨膜动作电位.结果:①厄贝沙坦呈浓度依赖性阻断ICa-L,10,100和1000 nmol/L的厄贝沙坦分别使ICa-L密度 (pA/pF)从 (-9.8±1.1)减少到(-6.7±0.9),(-4.2±0.8)和(-2.1±0.4)(n=5,P<0.05或P<0.01).②厄贝沙坦可使ICa-L I-V曲线上移,但不改变其激活的电压依赖性和反转电位.③厄贝沙坦呈使用依赖性阻滞ICa-L.④厄贝沙坦对ICa-L激活曲线无明显影响,但可使钙电流稳态失活曲线左移,加速钙通道电压依赖性失活,对照组V1/2和κ值分别为(-30±5)mV,(8.2±0.7),厄贝沙坦组为(-39±7) mV,(11.6±1.3)(n=5,P均<0.05).⑤厄贝沙坦100 nmol/L使ICa-L失活后再激活的恢复时间常数(τ)从对照组(62.5±2.3) ms延长至(126.4±2.6) ms(P<0.01).⑥厄贝沙坦对IK1和INa无明显影响.⑦厄贝沙坦(100 nmol/L)可使单个心室肌细胞动作电位时程(APD30,APD50,APD90)从(106±10),(125±16),(178±23)ms缩短至(82±16),(99±6),(122±18) ms(n=5,P<0.05),对静息电位、动作电位幅度无影响. 结论:厄贝沙坦作用于L-型钙通道的失活态从而阻断ICa-L.     

普罗帕酮对豚鼠左心室流出道自律细胞与心室肌细胞电生理效应影响

目的:探讨普罗帕酮对心脏左心室流出道自律细胞与心室肌细胞电生理效应的影响。方法:应用常规的玻璃微电极细胞内记录技术,观察普罗帕酮对豚鼠左心室流出道自律细胞与心室肌细胞动作电位0相幅值(APA),最大除极速率(Vm ax),动作电位时程(APD),50%复极化时间(D50),90%复极化时间(D90)以及左心室流出道自律细胞最大除极速率(Vm ax)与自发电活动频率(HR)。结果:①用0.5μm o l/L的普罗帕酮灌流后与正常对照组相比左心室流出道自律细胞自发电活动频率(HR)显著下降(P<0.01);②用1μm o l/L的普罗帕酮灌流后与正常对照组相比左心室流出道自律细胞动作电位0幅值(APA)下降(P<0.05),动作电位时程(APD)及50%复极化时间(D50)升高(P<0.05),自发电活动频率(HR)显著下降(P<0.01);用1μm o l/L的普罗帕酮灌流对心室肌细胞的电生理效应影响并不明显。③用5μm o l/L的普罗帕酮灌流后左心室流出道自律细胞电生理活动减弱或消失;用5μm o l/L的普罗帕酮灌流后与正常对照组相比对心室肌细胞动作电位0幅值(APA)下降(P<0.05),动作电位时程(APD)及50%复极化时间(D50)升高(P<0.05)。④用10μm o l/L的普罗帕酮灌流后与正常对照组相比对心室肌细胞动作电位0幅值(APA)下降(P<0.05),动作电位时程(APD)明显升高(P<0.01),50%复极化时间(D50)及90%复极化时间(D90)升高(P<0.05)。结论:普罗帕酮能抑制左心室流出道自律细胞与心室肌细胞的动作电位0幅值,延长动作电位时程;使左心室流出道自律细胞自发电活动频率下降。     

甲醇对豚鼠单个心室肌细胞动作电位的影响

目的　研究甲醇对正常豚鼠心室肌细胞跨膜动作电位影响 ,旨在探讨甲醇对心肌细胞的电生理作用。方法　酶解法分离豚鼠单个心室肌细胞 ,应用全细胞膜片钳技术记录甲醇对豚鼠单个心室肌细胞动作电位的影响。结果　应用 0 .2 %甲醇使豚鼠单个心室肌细胞动作电位复极 5 0 %时程 (APD50 )从给药前 (12 92 .6 8± 2 98.0 3)ms缩短到 (75 0 .2 5± 6 8.0 5 )ms (n =6 ,P <0 .0 5 ) ;动作电位复极 90 %时程 (APD90 )从给药前 (132 8.13± 2 89.91)ms缩短到(783.2 5± 6 3.4 4 )ms (n =6 ,P <0 .0 5 ) ;动作电位幅度 (APA)从给药前 (12 6 .35± 3.2 0 )mV减少到 (113.2 0± 6 .0 8)mV(n =6 ,P <0 .0 5 )。结论　甲醇降低动作电位幅度 ,缩短动作电位时程 ,影响心肌正常工作 ,可能与它对心肌细胞钾通道的作用有关。     

银杏叶提取物对家兔心室肌细胞瞬时外向钾电流和动作电位的影响

目的:探讨银杏叶提取物(Egb761)对家兔心室肌细胞瞬时外向钾电流(Ito)和动作电位的作用,揭示其抗心肌缺血及缺血引起的心律失常的离子机制。方法:酶解法分离家兔的心室肌细胞。全细胞膜片钳技术记录心肌细胞的Ito和动作电位及其被Egb761作用后的变化。结果:①在电压钳制方式下,60μg/L Egb761作用心室肌细胞5 min后,各个钳制电位下的Ito均明显增大,在钳制电位为+50 mV时,Egb761使Ito的电流密度由对照组的(7.59±0.19)pA/pF增加到(11.18±0.89)pA/pF(P<0.01,n=8),Egb761还使Ito的I-V曲线比对照组Ito的I-V明显抬高,但I-V曲线方向没有发生改变,表明Egb761引起了心肌细胞Ito的明显外流。②在电流钳制下,对照组心室肌细胞动作电位都具有从0期到4期的动作电位形态,60μg/L Egb761使心肌细胞动作电位形态呈三角形尖锥锋形,动作电位时程(APD)明显缩短,其复极化50%时程(APD50)和复极化90%时程(APD90)分别由(83.6±4.3)ms缩短为(51.3±3.2)ms和由(168.7±4.1)ms缩短为(93.8±4.4)ms(分别与对照组相比,P<0.01,n=8),尽管Egb761使动作电位幅度(APA)和静息电位(RP)降低,但与对照组相比,没有显著性差异(P>0.05)。结论:Egb761可使心室肌细胞Ito显著增加和APD明显缩短,从而减轻心肌缺血时细胞内阳离子超载对心肌造成的损伤和心肌缺血引起的心律失常的发生,以及增加心脏泵血功能。     

高胆固醇血症对心脏电生理特性的影响

目的: 阐明高胆固醇血症对心脏电生理的影响.方法: 日本大耳白兔分为对照组和高胆固醇饮食组,饲养10 wk后,检测血脂水平,心电图和室颤阈值,并利用全细胞膜片钳技术记录心室肌细胞的ICa,L,组织化学技术检测动脉粥样硬化发生情况.结果: 高胆固醇饮食组兔血脂水平明显高于对照组(P<0.01),粥样硬化广泛分布在动脉血管中.高胆固醇饮食组兔室颤阈值为(11.1±1.3) V,明显低于对照组(14.4±1.6) V,P<0.05.高胆固醇饮食组兔QTc间期(334±14) ms,明显长于对照组(303±12) ms,P<0.05.高胆固醇饮食组心室肌细胞的ICa,L密度为(15.8±1.2)pA/pF,明显高于对照组(11.9±1.0) pA/pF,P＜0.01.结论: 高胆固醇血症对心肌细胞的电生理特性有影响,表现在ICa,L的增加,复极时程的延长和室颤阈值的降低.     

哇巴因诱发大鼠心律失常作用靶点的研究

目的　观察哇巴因对大鼠心室肌细胞动作电位时程、钾通道的作用 ,探讨哇巴因诱发心律失常的作用机制 ,为寻找新的抗心律失常药物提供依据。方法　应用全细胞膜片钳技术记录哇巴因对大鼠心肌细胞动作电位时程 (APD)、内向整流钾电流 (Ik1 )、瞬时外向钾电流 (Ito)的作用。结果　①哇巴因 5μmol/L使大鼠心室肌细胞动作电位时程从给药前的 86 .3ms± 2 5 .2ms(APD90 ) ,缩短至 58.9ms± 2 0 .8ms(n =5 ,P <0 .0 1 ,给药 1 0min) ;②哇巴因 5μmol/L可增加大鼠心室肌细胞内向整流钾电流 ,使Ik1 从 - 1 868pA± 1 88pA增加到 - 2 393pA± 367pA(刺激电压 - 1 2 0mV ,n=1 0 ,P <0 .0 1 ) ;③哇巴因 5μmol/L可增加大鼠心室肌细胞瞬时外向钾电流 ,使Ito从 1 2 73pA± 31 8pA增加到 1 70 7pA± 486pA(刺激电压 +60mV ,n =5 ,P <0 .0 1 )。结论　哇巴因诱发室性心律失常可能与它缩短心室肌细胞动作电位时程有关 ,而Ito的增加使二期平台期缩短 ,Ik1 的增加使三期复极加快 ,均参与了动作电位时程缩短的过程。同时增加Ik1 将影响静息膜电位 ,可能使膜反应性增强     

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.     

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.