复方苦荞麦制剂对大鼠糖尿病心肌损伤的保护作用

目的: 观察复方苦荞麦制剂对大鼠糖尿病心肌损伤的保护作用,阐明其作用机制。方法: 腹腔一次性注射链脲佐菌素(STZ)建立大鼠糖尿病模型。糖尿病大鼠分为模型组﹑复方苦荞麦制剂组和贝那普利组,同时设正常对照组,观察各组大鼠体征变化,测定体质量(BW)、心脏质量指数(HWI)和心功能指标[心率(HR)、左心室收缩压(LVSP)、左心室舒张期末压(LVEDP)、左心室内压最大上升和下降速率(±dp/dt_max)],检测空腹血糖(FBG)和血清甘油三脂(TG)、总胆固醇(TC)及心肌组织中丙二醛(MDA )含量、超氧化物歧化酶( SOD)和谷胱甘肽过氧化物酶(GSH-Px)活性;光镜下观察各组大鼠心肌组织形态学改变。结果: 与正常对照组比较,模型组大鼠FBG、HWI、LVEDP、TG和TC升高(P<0.01),BW、LVSP、HR和±dp/dt_max下降(P<0.05或P<0.01);心肌组织MDA水平显著升高(P<0.01),而SOD和GSH-Px活性则显著降低(P<0.05或P<0.01)。与模型组比较,复方苦荞麦制剂组和贝那普利组大鼠FBG、HWI和LVEDP下降(P<0.05或P<0.01),BW、LVSP、HR和±dp/dt_max升高(P<0.05或P<0.01);心肌组织MDA水平显著降低(P<0.01),而SOD和GSH-Px活性则显著升高(P<0.05或P<0.01),但复方苦荞麦制剂组与贝那普利组大鼠上述各指标比较差异均无统计学意义(P>0.05)。大鼠心肌组织形态学,模型组大鼠心肌纤维紊乱,心肌细胞肿胀,而复方苦荞麦制剂组和贝那普利组大鼠心肌纤维紊乱和心肌细胞肿胀减轻,心肌细胞结构基本正常。结论: 复方苦荞麦制剂对大鼠糖尿病心肌损伤具有保护作用,可能与抑制心肌脂质过氧化反应有关。     

急性冠脉综合征患者心肌氧化损伤情况评估及与血清IMARs的关系

目的:研究急性冠脉综合征患者心肌氧化损伤情况及其与血清缺血修饰清蛋白和清蛋白比值(IMARs)的关系.方法:将稳定性心绞痛患者(SAP)、不稳定型心绞痛(UAP)、非ST段抬高的急性心肌梗死(NSTEMI)、ST段抬高的急性心肌梗死(STEMI)患者及体检的健康者纳入研究,检测抗氧化指标总抗氧化能力(TAS)、谷胱甘肽过氧化物酶(GSH)、超氧化物歧化酶(SOD),心肌氧化损伤指标髓过氧化物酶(MPO)、丙二醛(MDA)、晚期氧化蛋白产物(AOPP)以及清蛋白氧化修饰指标缺血修饰清蛋白(IMA)、清蛋白(Alb)、IMAR.结果:(1)抗氧化指标:UAP、NSTEMI、STEACS患者的MPO、MDA、AOPP含量均高于健康者、SAP患者(P＜0.05);(2)心肌氧化损伤指标:UAP、NSTEMI、STEACS患者的MPO、MDA、AOPP含量均高于健康者、SAP患者(P＜0.05);(3)清蛋白氧化修饰指标:UAP、NSTEMI、STEACS患者的IMA含量以及IMAR比值均高于健康者、SAP患者,Alb含量低于健康者、SAP患者(P＜0.05);(3)IMAR与TAS、GSH、SOD含量呈负相关,与MPO、MDA、AOPP含量呈正相关.结论:急性冠脉综合征患者存在心肌氧化损伤且血清中IMRA异常升高;IMRA与氧化指标和抗氧化指标具有良好的相关性,是反映急性冠脉综合征病情的理想指标.     

乙醇后处理心肌保护作用的抗氧化机制探讨

目的:探讨乙醇后处理(EtOH)的心肌保护作用与抗氧化应激损伤关系。方法:采用离体大鼠心脏Langendorff灌流法,局部结扎冠状动脉左前降支30 min,复灌120 min复制心肌缺血-再灌注损伤(I/R)模型。测定心室动力学指标及心肌组织超氧化物歧化酶(SOD)活力、丙二醛(MDA)含量,RT-PCR检测线粒体乙醛脱氢酶2(ALDH2)、Bax、Bcl-2 mRNA表达。结果:与I/R组相比,EtOH明显促进左心室发展压、左心室内压最大上升和下降速率的恢复,心肌组织中SOD活力增加,MDA含量降低,Bcl-2表达增加,Bax表达降低(P<0.01)。ALDH2阻断剂氨基氰减弱了EtOH的作用,抑制了心室动力学指标的恢复,心肌组织中SOD活力降低,MDA含量增加,Bcl-2表达降低,Bax表达增加(P<0.01)。结论:EtOH的心肌保护作用可能与激动ALDH2、降低I/R引起的氧化应激损伤和减少心肌细胞凋亡有关。     

Prdx1过表达通过Nrf2/HO-1信号通路抑制氧化应激减轻自发性高血压大鼠心肌肥厚和纤维化

目的 探讨过氧化物还原酶1(Prdx1)对自发性高血压大鼠心肌肥厚和纤维化的影响，并分析其作用机制。方法 45只SHR大鼠随机分为模型组(SHR组)、AAV9-NC组和AAV9-Prdx1组，每组15只。另取15只Wistar Kyoto大鼠设为对照组(Control组)。各组大鼠连续给药8周，超声心动图检测大鼠心功能指标；测定大鼠平均血压以及心肌肥厚指标；HE染色和Masson染色分别观察大鼠心肌组织形态学和纤维化情况；ELISA法检测大鼠血清中氧化应激指标；qRT-PCR法检测大鼠心肌组织中Prdx1 mRNA表达水平；Western blot法检测大鼠心肌组织中Prdx1蛋白和核因子E2相关因子2(Nrf2)/血红素氧合酶-1(HO-1)信号通路相关蛋白表达。结果 与Control组比较，SHR组大鼠心肌组织中Prdx1 mRNA和蛋白表达量、左心室射血分数(EF)、左心室缩短率(FS)降低(P<0.05),大鼠平均血压、心脏质量指数(HMI)、左心室质量指数(LVMI)升高(P<0.05),心肌组织存在明显的病理损伤和胶原纤维沉积；大鼠血清中超氧化物歧化酶(SOD)...     

脱白细胞温血灌注体外循环术中及主动脉开放早期心肌髓过氧化物酶的变化

目的 了解在脱白细胞温血灌注体外循环术中及主动脉开放早期人心肌髓过氧化物酶(MPO)的变化.方法 选择主动脉阻断时间在40 min以上的体外循环手术20例,随机分为实验组(脱白细胞组)和对照组,每组10例,检测不同时间点的人心肌中MPO水平.结果 两组在阻断30 min时与阻断前相比MPO无明显升高;主动脉开放后5 min有明显差异,实验组明显低于对照组,P＜0.05.结论 人心肌髓过氧化物酶水平可以反映体外循环术后早期心肌损伤程度.脱白细胞温血灌注可减轻心肌损伤.     

ACS患者PCI围手术期左心室超声功能参数的变化及其与血清心肌损伤程度的关系

目的:探讨ACS患者PCI围手术期左心室超声功能参数的变化及其与血清心肌损伤程度的关系。方法:收集在本院接受治疗的ACS患者76例,回顾其治疗方式并分为接受PCI治疗的观察组57例、符合PCI指征但本人或者家属坚决要求保守治疗的对照组19例。对比两组治疗前后左心室超声功能参数水平,血清心肌损伤指标含量差异。采用Pearson检测评估ACS患者治疗后左心室超声功能参数与心肌损伤程度的相关关系。结果:治疗前,两组左心室超声功能参数水平,血清心肌酶谱、心肌凋亡指标含量差异无统计学意义(P>0.05)。治疗后,观察组的左心室超声功能参数LVEDD、LVESD水平低于对照组,SV水平高于对照组;心肌酶谱cTnT、LDH、CK-MB、AST的含量低于对照组;心肌凋亡指标Fas、caspase-3、caspase-12的含量低于对照组,Bcl-2的含量高于对照组(P<0.05)。ACS患者治疗后左心室超声功能参数与心肌损伤程度直接相关。结论:ACS患者接受PCI治疗,可有显著改善左心功能并减轻心肌损伤。治疗后左心室超声功能参数与患者心肌损伤程度直接相关。     

心肌标志物的进展与应用

心肌损伤时的血中生化标志物检测异常,是急性心肌梗死(AMI)的重要诊断指标之一。随着科学研究的进展,临床实践中已陆续发现多种反映心肌损伤的标志物,包括反映心肌缺血损伤的标志物:如缺血修饰蛋白,髓过氧化物酶,CD40配体等;     

罗格列酮对压力超负荷大鼠左心室肥厚和功能的影响

目的:研究过氧化物酶体增殖物活化型受体γ(peroxisome proliferator-activated receptorγ,PPAR γ)配体-罗格列酮对心肌肥厚的影响.方法:用腹主动脉缩窄法建立压力超负荷性心肌肥大大鼠模型.40只雄性大鼠,实验分4组(空白对照组、假手术组、手术组、手术 罗格列酮组),手术 罗格列酮组术后即用罗格列酮5 mg/(kg·d)灌胃,持续16周,实验过程对血压、左心室功能等指标进行测定.结果:实验结束时手术组鼠尾血压、左心室重量/体重(LVMI)、左心室收缩末压(LVESP)和左心室舒张末压(LVEDP)均分别较假手术组增高(P＜0.01),左心室压力上升最大速率( dp/dtmax,P＜0.05)和左心室压力下降最大速率(-dp/dtmax,P＜0.01)较假手术组下降.罗格列酮治疗16周后与手术组比较血压、LVMI、LVEDP均下降(P＜0.01), dp/dtmax上升(P＜0.05).病理提示用罗格列酮后手术组心肌细胞肥厚改善.结论:PPAR γ激动剂罗格列酮具有抑制大鼠左心室肥大的形成和改善左心室功能的作用,可能与其降低血压,调整肥厚心肌的代谢以及抑制血管紧张素Ⅱ、内皮素Ⅰ参与的心肌肥厚过程有关.     

腺苷对大鼠心肌缺血再灌注损伤保护作用的研究

目的:观察腺苷(Ado)对大鼠心肌缺血再灌注损伤(MIRI)的保护作用,探讨其可能的作用机制。方法:健康Wistar大鼠36只,随机分成3组。假手术组:只穿线不结扎冠状动脉;腺苷组:于结扎前1min给予Ado(0.4ml/kg)左心室内注入;对照组:给予等量生理盐水左心室内注入。开胸结扎左冠状动脉前降支30min,再灌注45min,制作大鼠MIRI模型。实验结束后检测心肌组织超氧化物歧化酶(SOD)、丙二醛(MDA)含量;测量缺血前与再灌注45min后左心室收缩期峰压(LVSP)差值和左心室舒张期末压(LVEDP);HE染色观察心肌组织形态结构。结果:与对照组比较,腺苷组大鼠SOD活力提高(P<0.05)而MDA生成量减少(P<0.01),且LVSP差值及LVEDP均减小(P<0.05,P<0.01);与假手术组比较,对照组大鼠心肌组织SOD活力明显下降(P<0.05)而MDA生成量明显增高(P<0.01),且LVSP差值及LVEDP明显增高(P<0.05,P<0.01);对照组大鼠心肌纤维断裂坏死,大量炎性细胞浸润,而腺苷组无出血、坏死,有少量炎性细胞浸润。结论:心肌缺血再灌注可导致缺血心肌进一步损伤,Ado可通过抑制氧自由基的产生,减少炎性细胞的浸润,对缺血再灌注损伤心肌有保护作用。     

失血性休克复苏大鼠心脏P-选择素表达与心脏功能的关系

目的 观察失血性休克复苏大鼠左心室功能与心肌组织中P-选择素表达的关系以及左旋精氨酸(L-Arg)对其影响,探讨失血性休克复苏大鼠心脏的损伤及保护机制.方法 健康SD大鼠30只,随机均分成正常对照组(NC组)、失血性休克复苏组(HS组)和左旋精氨酸治疗组(L-Arg组),通过生理记录仪观察左心功能的变化,采用酶联免疫吸附试验测定血清、心肌组织P-选择素含量,免疫组化方法检测心肌P-选择素蛋白表达.结果 休克大鼠复苏后3 h,HS组和L-Arg组血浆、心肌的P-选择素含量明显高于NC组;左心室内压最大变化速率、左心室内收缩压明显低于NC组,左心室舒张末期压明显高于NC组.但L-Arg组血浆、心肌组织中的P-选择素含量低于HS组,上述心功能指标的异常变化明显减轻.结论 大鼠失血性休克复苏后,P-选择素参与心脏损伤过程,L-Arg对P-选择素表达有抑制作用,对心脏功能具有保护作用.     

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.