低分子右旋糖酐对失血性休克家兔再灌注损伤血浆NO、SOD、MDA、MAP的影响

目的：观察失血性休克家兔休克前后及再灌流后血浆中NO、SOD、MDA、MAP动态变化。方法：复制失血性休克模型,将20只家兔随机分为两组,实验Ⅰ组即失血后再灌注组（自身血回输＋生理盐水）,实验Ⅱ组（低分子右旋糖酐＋地塞米松）分别检测休克前及休克后70min、再灌注1h、再灌注2h血浆中NO、SOD、MDA、MAP的变化。结果：休克前两组动物NO、SOD、MDA、MAP无统计学差异;休克后70min血浆SOD活性下降,NO和MDA含量明显升高,MAP下降;再灌注后实验Ⅰ组,血浆SOD、NO、MDA无显著改变,MAP明显升高,实验Ⅱ组,血浆SOD活性显著升高,MDA、NO显著下降,两组相比较（P〈0.05）MAP明显升高。结论：低分子右旋糖酐＋地塞米松对失血性休克家兔再灌注损伤有明显保护作用,其机制可能与提高血浆SOD活性,清除氧自由基抑制脂质过氧化有关。     

低分子右旋糖酐和地塞米松对失血性休克家兔血浆内皮素和一氧化氮含量影响的研究

目的 :观察失血性休克家兔血浆内皮素 (Endothelin ,ET)和一氧化氮 (NO)动态变化。方法 :复制家兔失血性休克模型 ,立即回输血液及静脉输入低分子右旋糖酐和地塞米松 ,观察各组动物失血前后血浆ET、NO含量变化 ,平均动脉压 (MAP)改变及生存时间。结果 :失血性休克家兔血浆ET、NO含量显著升高 ,于失血后12 1.0± 12 .5min内死亡。回输血液、低右 地塞米松联合应用组ET、NO变化不明显 ,动物生存时间明显处长。结论 :失血性休克家兔血浆ET、NO含量升高 ,低右、地塞米松抑制失血性休克ET、NO异常升高 ,回输血、低右、地塞米松联合应用 ,治疗失血性休克效果明显     

血定安对重症非控制性失血性休克再灌注期脂质过氧化反应的影响

目的 :研究血定安 (gelofusion)对重症非控制性失血性休克低压复苏期间脂质过氧化反应的影响。方法 :12只犬随机等分为平衡盐液 (LR)组 (组Ⅰ )和血定安 (GF)组 (组Ⅱ )。采用非控制性失血性休克模型 ,当MAP降到 2 0mmHg时 ,两组分别输注LR或GF并调节输液速度使MAP维持在 35～ 40mmHg。于放血前 (T1)、休克至MAP 40mmHg (T2 )、2 0mmHg (T3 )及复苏后 30min (T4 )、6 0min (T5)、12 0min (T6)时测血SOD和MDA ,记录HR、MAP、CO、CI,复苏 12 0min时计腹腔失血量。结果 :组Ⅰ输液量及腹腔失血量均显著大于组Ⅱ (P <0 .0 1,和P <0 .0 5 )。再灌注后组Ⅰ血SDO活性进行性下降 ,血MDA迅速上升 ,于T5时显著高于组Ⅱ ,而组Ⅱ再灌注期MDA与缺血期 (T3 )比较差异无显著性 ,且SOD呈上升趋势 ,其中T6SOD值显著高于组Ⅰ (P <0 .0 5 )。再灌注期间组ⅡMAP较组Ⅰ稳定。 12 0min组Ⅰ存活率低于组Ⅱ (P <0 .0 5 )。结论 :与LR比较 ,GF低压复苏重症非控制性失血性休克能显著降低再灌注期脂质过氧化反应程度 ,维持较稳定的血流动力学 ,降低动物死亡率。     

失血性休克再灌注心肌损伤机制及灵芝多糖的预防作用

目的　探讨失血性休克再灌注 (HS -R)过程中心肌损伤的机制及灵芝多糖 (GLP)的影响。方法　复制家兔HS -R模型 ,随机分成 3组 ,A组为假手术组 ,B组为生理盐水 (NS)再灌注组 ,C组为 1%GLP再灌注组 ,观察平均动脉血压 (MAP)、心功能、血清心肌酶及心肌超氧化物歧化酶 (SOD)活性、丙二醛 (MDA)含量的变化。结果　B、C组动物在失血性休克 4 0min时左心室功能明显降低 (P <0 .0 5 ) ,血清心肌酶显著升高 (P <0 .0 5 ) ,B组动物再灌注4 0min时 ,心功能进一步降低 (P <0 .0 5 ) ,血清心肌酶进一步升高 ,心肌SOD活性明显低于A组 ,MDA含量明显高于A组 (P <0 .0 5 ) ;C组动物再灌注 4 0min ,与B组相比 ,心功能明显改善 ,血清心肌酶、心肌MDA含量明显降低 ,心肌SOD活性明显升高 (P <0 .0 5 )。结论　HS -R过程中心肌损伤与脂质过氧化反应增强有关 ,GLP对此损伤有保护作用     

灵芝多糖对家兔缺血再灌注时血液抗氧化能力的影响

目的探讨灵芝多糖(GLP)对家兔缺血再灌注过程中脂质过氧化反应的影响。方法将家兔分为对照组(生理盐水组)、实验组(灵芝多糖组),建立低血容量性休克动物模型。分别于休克前、休克40min及再灌注40min后测定血清超氧化物歧化酶(SOD)及丙二醛(MDA)含量。结果实验组再灌注40min后,SOD活性高于对照组(P<0.01),MDA含量低于对照组(P<0.01)。结论GLP对缺血再灌注损伤具有保护作用。     

限制性液体复苏对失血性休克孕兔肺缺血再灌注损伤的保护作用

目的 探讨早期限制性液体复苏对未控制性重度失血性休克孕兔肺缺血冉灌注损伤的保护作用.方法 15只孕兔制成未控制重度失血性休克模型,随机分为假休克组(P组)、传统液体复苏组(TFR组)、限制性液体复苏组(LFR组),分别于实验0min、90min、180min和4h检测和比较各组血清SOD、MDA和TNF-α的含量,并在实验4h处死孕兔,比较各组左肺干湿质量比(DW/WW).结果 缺血再灌注后两个治疗组血清SOD含量持续下降,TNF-α和MDA的含量持续上升.LFR组SOD和肺DW/WW明显高于TFR组,但低于P组;而LFR组TNF-α和MDA含量明显低于TFR组,但高于P组.结论 早期限制性液体复苏能减少缺血再灌注时氧自由基的产生和炎症介质释放,减轻肺缺血再灌注损伤,是临床上产科未控制重度失血性休克早期救治的理想复苏方案.     

三七总皂甙对心肌缺血再灌注的保护效应

为研究三七总皂甙(PNS)预处理对大鼠心肌的保护效应及其与热休克蛋白(HSP)的关系,采用在体缺血再灌注模型。实验分空白组、对照组、PNS组。心肌缺血40min再灌注300min检查心肌的超氧化物歧化酶(SOD)活性及丙二醛(MDA)含量,用免疫组化法测缺血40min再灌120min的HSP70的表达。结果显示,与对照组相比.PNS组减少MDA的产生(P<0.01),保护SOD酶活性(P<0.01),HSP的表达,PNS组明显高于对照组(P<0.01)。结果表明三七总皂甙长时间处理可促进HSP70的表达,对心肌再灌注损伤有良好的保护效应。     

三七总皂苷对大鼠脑缺血再灌注损伤保护作用及机制的实验研究

目的:探讨三七总皂苷注射液对局灶性脑缺血再灌注损伤的保护作用及机制.方法:40只Wistar大鼠被随机分为4组:假手术组、缺血再灌注损伤模型组、尼莫地平对照(Nim)组、三七总皂苷注射液处理组(PNS).建立大鼠大脑中动脉缺血再灌注损伤模型,对脑水肿和脑梗死进行测量,并采用硫代巴比妥酸盐法测定MDA含量、邻苯三酚自氧化法测定SOD活性.结果:PNS组与模型组比较,脑组织含水量减少(P<0.01),脑梗死面积显著减小(P<0.05);SOD活力显著升高(P<0.05),MDA含量显著降低(P<0.05).结论:MDA是反映组织损伤程度的物质、SOD是体内重要的内源性保护物质,三七总皂苷注射液可降低缺血脑组织MDA的含量、增加SOD活性而发挥对脑的保护作用.     

失血性休克再灌注大鼠肾损伤时氧自由基的变化及丹参的保护作用

目的:探讨失血性休克再灌注大鼠肾损伤的机制及丹参的保护作用.方法:健康SD大鼠30只,随机均分成正常对照组(NC组)、失血性休克再灌注组(HS-R组)和丹参治疗组(SM组).实验结束时,取血进行肾功能检测,取肾组织测定超氧化物岐化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)、黄嘌呤氧化酶(XOD)活性、丙二醛(MDA)和一氧化氮(NO)含量,并作病理学检测.结果:与NC组相比较,HS-R组和SM组血浆BUN、Cr含量均明显升高,HS-R组和SM组肾组织的SOD、GSH-PX活性显著下降,而XOD活性、MDA含量明显增高,HS-R组肾组织的NO含量明显增高;SM组的血浆BUN和Cr含量明显低于HS-R组,SOD活性比HS-R组明显增高,MDA和NO含量明显低于HS-R组.肾组织病理学检测发现HS-R组肾组织病变明显,SM组的肾组织病变较HS-R组减轻.结论:大鼠失血性休克再灌注后,肾功能下降,氧自由基参与肾脏的损伤过程,丹参通过抑制氧自由基的产生、减轻脂质过氧化反应发挥对肾脏的保护作用.     

限制性液体复苏产兔失血性休克对肠缺血再灌注损伤的保护作用

目的应用产兔非控制性失血性休克模型,探讨限制性液体复苏对产兔肠缺血再灌注损伤的保护作用。方法 24只产后6 h的新西兰大白兔被随机分成4组,假休克组(P组)、休克未处理组(P0组)、传统液体复苏组(PNL组)、限制性液体复苏组(PLH组),建立未控制重度失血性休克模型,分别于休克30 min后接受不同的液体复苏方案,于休克后90 min接受手术止血和输血输液治疗。在实验结束后处死产兔,观察不同液体复苏方式对小肠组织超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量及肠粘膜形态损伤等情况。结果失血性休克时缺血再灌注损伤导致肠粘膜损伤加重、肠组织SOD活性降低及MDA含量上升,限制性输液能显著改善上述改变。结论限制性液体复苏较充分快速液体复苏显著缓解了肠组织缺血再灌注损伤。     

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.