冠心病不同临床类型患者血浆、血小板脂质过氧化损伤与TXA_2/PGI_2平衡的研究

作者观察98例正常人和109例不同临床类型冠心病人血浆、血小板LPO、SOD,SeGSHP_x,RBC—SOD及血浆TXB_2、6-keto-PGF_(1α)的变化,发现各型冠心病组均有LPO、PL—LPO、TxB_2、TxB_2/6-keto-PGF_(1α)比值明显升高,6-keto-PGF_(1α),SOD、PLSOD、RBC-SOD,SOD/LPO及SeGSHPX/LPO比值明显降低。但各型程度不同,以急性心肌梗塞和不稳定性心绞痛改变突出。血浆LPO与6-keto-PGF_(1α)呈显著负相关。提示脂质过氧化损伤与TXA_2/PGI_2平衡密切相关。认为SOD/LPO、SeGSHPx/LPO,TXB_2/6-keto-PGF_(1α)比值在冠心病诊断中是重要有意义的指标,血小板SOD/LPO比值能更敏感地反映冠心病人氧化与抗氧化能力的平衡状态。     

肾虚证病人血浆TxB2,6—keto—PGF1α水平的变化

本文观察了52例肾虚证病人及53例正常人血浆TxB_2、6-keto-PGF1α含量及其比值的变化。结果表明,肾虚证病人血浆TxB_2、6-keto-PGF1α水平明显低于正常对照组(P<0.001),而TxB_2/6-keto-PGF1α两者间无显著差异(P>0.05)。肾阴虚(32例)与肾阳虚(20例)间比较,血浆TxB_2和6-keto-PGF1α含量及其比值均无显著差异(P>0.05)。     

营养饮食引产产妇血浆前列腺素分析

营养饮食为一方便、安全、经济,有效的引产药物,并可缩短产程。对宫颈成熟或不成熟的孕妇均有引产作用。前列腺素与子宫收缩和宫颈成熟密切相关已获公认.本实验表明营养饮食引产成功并经阴道分娩的22例产妇,宫口开全后与服药前相比血浆PGE_2和6-keto-PGF_(1α)均有升高,PGE_2升高无显著性差异(0.2>P>0.1),6-keto-PGF_(1α)升高有非常显著性差异(P<0.01);营养饮食引产失败的11例产妇,服药前血浆PGE_2和6-keto-PGF_(1α)水平较低,但与引产成功组产妇相比无显著差异;自然分娩的产妇13例,在临产开始与宫口开全后血浆PGE_2和6-keto-PGF_(1α)无明显变化。结果提示营养饮食有促进孕妇体内前列腺素合成的作用,及促进宫缩发动,宫颈软化,宫口扩张,引产成功。     

肝肺综合征患者血浆前列环素和内皮素的检测及临床意义

目的探讨肝硬化患者并发肝肺综合征(HPS)时血浆内皮素-1(ET-1)和前列环素(PGI_2)水平的变化及其意义。方法选择HPS患者50例,无HPS的肝硬化患者90例,40例健康体检者作为健康对照组。采集动脉血进行血气分析,采用放射免疫分析法检测其血浆ET-1、PGI_2的稳定代谢产物6-酮-前列腺素F_(1α)(6-keto-PGF_(1α))的含量。结果 HPS组PaO_2、SaO_2均低于非HPS组和健康对照组,P(A-a)O_2高于非HPS组和健康对照组,血浆6-keto-PGF_(1α)含量显著高于非HPS组及健康对照组,差异有统计学意义(P<0.01),非HPS组与健康对照组之间比较差异无统计学意义(P>0.05);HPS组、非HPS组血浆ET-1含量显著高于健康对照组(P<0.01),HPS组与非HPS组之间差异无统计学意义(P>0.05)。HPS组中,ET-1与6-keto-PGF_(1α)呈正相关(r=0.61,P<0.05),6-keto-PGF_(1α)、ET-1与PaO_2之间均呈负相关(r=-0.58,P<0.05;r=-0.49,P<0.05)。结论血浆ET-1和PGI_2含量增高在肝硬化伴HPS的发生中起一定的作用。     

胆源性感染性休克兔血栓素、前列环素与血小板聚集率的变化

动态观察胆总管急性完全性梗阻并感染、继发休克兔的血浆血栓素(TXA_2)和前列环素(PGI_2)的稳定代谢产物 TXB_2和6-keto-PGF_(1α)含量及血小板聚集率的变化。结果,血浆 TXB_2呈进行性升高,20h 后(休克时)呈下降趋势,血浆6-keto-PGF_(1α)6h 升高,随后回降;血小板聚集率呈进行性下降。提示血栓素和前列环素、血小板聚集率的变化在重症急性胆管炎、胆源性感染性休克发病过程中起重要病理生理作用,与病情和预后转归有重要联系。     

咪苯嗪酮对花生四烯酸环氧酶途径代谢产物的选择性影响

兔iv咪苯嗪酮(CI—914)20mg/kg,用RIA法测定其皿浆中TxB_2和6—keto—PGF_(12)含量,给药后30min和60min,6—keto—PGF_(1α)/TxB_2比值显著升高(P<0.05)。在用放射性TLC法进行的洗涤大鼠血小板~(14)C—AA代谢实验中,CI-914在2～500μmol/L范围内以剂量依赖方式抑制大鼠血小板TxB_2生成,IC_(50)为5.15μmol/L,对IIIIT生成的抑制明显弱于对TxB_2生成的抑制作用;在相同剂量范围内,     

自身免疫病血清对培养人脐静脉内皮细胞释放反应及自由基影响的初步研究

用自身免疫病血清作用于培养的人脐静内皮细胞,观察其部分释放反应及自由基变化。结果显示,与小牛血清组比较,自身免疫病全血清组条件液中6-keto-PGF_(1α)含量及细胞液中GSH—Px活性显著升高(P<0.05.P<0.01);自身免疫病灭活补体血清组条件液中TxB_2含量及细胞液中GSH—Px活性升高明显(P<0.05);而细胞液中SOD活性6-keto-PGF_(1α)含量无明显变化(P>0.05),MDA含量虽呈升高趋势,但无统计学意义(P>0.05)。各组细胞形态在光学显微镜下均未见明显改变。提示,免疫反应及脂质过氧化反应可能参与了对血管内皮细胞的影响。     

前列环素,血栓素在缺血性肾损害中的作用

采用兔肾缺血模型,用放免方法测定血浆及组织内6-keto-PGF_(1α)和TXB_2的变化。结果提示肾缺血再灌流早期内、外髓质6-keto-PGF_(1α)及全肾组织TXB_2显著增加,6-keto-PGF_(1α)/TXB_2比值则显著下降。6-keto-PGF_(1α),TXB_2的异常代谢可能是缺血再灌流早期肾血流量减少和血流再分布的重要原因。     

血管内皮细胞功能相关指标在TAO辨证中的变化及意义

对56例TAO患者血浆中VEC功能相关指标进行检测,以38例正常人作为对照。结果发现,TAO各辨证组t-PA活性及6-keto-PGF_(1α)。含量下降,vWF水平升高,具有显著性意义(P<0.01)。其中阴寒组和血瘀组PAI活性升高不明显(P>0.05),湿热组以PAI活性显著升高和6-keto-PGF(1α)含量进一步下降为特点,热毒组则以t-PA、PAI活性及6-keto-PGF_(1α)含量的进一步改变为特点。提示:TAO患者存在VEC抗血栓功能改变。     

羧苯氧乙基咪唑对大鼠中性粒细胞和血小板释放6-keto-PGF_(1α)和TxB_2的选择性影响

用RIA法测定大鼠中性粒细胞培养液中TxB_2和6-keto-PGF_1α的含量,DAZ能选择性使A_(23187)刺激大鼠中性粒细胞释放的TxB_2减少,而使6-kto-PGF_1α释放增加,在0.1～5μmol/L的药物剂量范围内,该两种作用均呈剂量依赖性关系。采用放射性薄层色谱法检测洗涤大鼠血小板培养液中~(14)C-AA代谢产物,DAZ可以剂量依赖方式抑制大鼠血小板TxB_2及HHT的释放,与此同时,DAZ使血小板PGE_2、PGF_2α和PGD_2产生增加。结果提示,DAZ有可能从纠正TxA_2和PGI_2代谢紊乱方面产生有益于某些脑、心血管疾病的作用。     

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.     

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.