碱性成纤维细胞生长因子对大鼠局灶性缺血再灌注损伤脑组织Caspase-3表达及细胞凋亡的影响

目的 :探讨碱性成纤维细胞生长因子 (bFGF)对大鼠脑缺血再灌注损伤后神经细胞凋亡和Caspase 3表达的影响。方法 :应用线栓法制作大鼠局灶性脑缺血再灌注模型 ,大脑中动脉阻塞 1h再灌注损伤 2 4h ,用TUNEL法和免疫组化法分别检测假手术组、缺血再灌注组和bFGF治疗组的凋亡细胞数和Caspase 3阳性细胞数。结果 :假手术组偶见凋亡细胞和Caspase 3阳性细胞 ,缺血再灌注组凋亡细胞数和Caspase 3阳性细胞数分别为 2 5 .4 6± 5 .5 7和1 8.6 0± 3.77,bFGF组凋亡细胞数和Caspase 3阳性细胞数分别为 1 6 .72± 5 .6 3和 1 0 .5 4± 2 .0 4。与缺血再灌注组比较 ,bFGF组凋亡细胞数和Caspase 3阳性细胞数显著降低 (P <0 .0 5和P <0 .0 5 )。结论 :Caspase 3表达下降可能是bFGF减少大鼠脑缺血再灌注损伤后细胞凋亡的分子机制之一     

bFGF对大鼠脑缺血再灌注侧皮质区细胞凋亡及p-Akt(Ser473)表达的影响

目的：观察碱性成纤维细胞生长因子(bFGF)对大鼠脑缺血再灌注缺血半暗带侧皮质区p-Akt(Ser473)表达的影响,进一步探讨bFGF的神经保护机制。方法 应用栓线法建立大鼠脑缺血再灌注模型,36只实验大鼠随机分为3组：假手术组、缺血再灌注组和bFGF组,于缺血1h再灌注24h行神经功能评分,TTC染色测梗死面积,Tunel法检测细胞凋亡数目,免疫组化检测p-Akt表达,并进行图像分析。结果　缺血再灌注组及bFGF组的神经功能评分分别为（3.18±0.65）、（2.23±0.59）,两组比较差异有显著性(P相似文献   

促红细胞生成素对大鼠全脑缺血再灌注后海马 CA1区神经元的保护作用

目的　观察促红细胞生成素 (EPO)对短暂性全脑缺血再灌注后海马神经元凋亡的影响 ,探讨其对缺血脑组织的保护作用。方法　应用四动脉血流阻断法制作大鼠短暂性全脑缺血再灌注模型 ;于再灌注开始时经腹腔注入EPO(3 0 0 0U/Kg) ;48h后灌注取脑。H -E染色观察细胞死亡情况。应用末端脱氧核苷酸转移酶缺口标记 (TUNEL)法检测海马CA1区神经元凋亡情况。结果　全脑短暂缺血 15min再灌注后 48h ,H -E染色海马CA1区存活神经元细胞数正常组为 2 11.2 8± 7.95,假手术组为 2 0 9.2 8± 11.3 4 ,EPO治疗组为 170 .2 8± 8.12 ,缺血组为14 6.84± 8.3 5。EPO治疗组与缺血组比较有显著性差异 (P <0 .0 1)。TUNEL法凋亡细胞测定 ,正常组无阳性细胞 ,假手术组单位面积内阳性细胞为 152 .48± 18.52 ,EPO治疗组阳性细胞为 1797.51± 151.3 5,缺血组阳性细胞为2 2 50 .41± 180 .0 6,后两者比较有显著性差异 (P <0 .0 1)。结论　EPO可减少大鼠短暂性全脑缺血脑组织神经元的死亡和凋亡 ,对缺血神经元具有保护作用     

亚低温对脑缺血再灌注后缺血核心区皮质内IL-1β和MCP-1含量的影响

目的　探讨缺血过程中亚低温对大鼠脑缺血再灌注后缺血核心区皮质内白细胞介素1β(IL 1β)及单核细胞趋化蛋白 (MCP) 1含量的影响。 方法　选用 80只雄性Wistar大鼠 ,随机分为常温组 (37℃ )和亚低温组 (32～ 33℃ ) ,用ELISA法测定缺血 2h再灌不同时间缺血核心区脑皮质内IL 1β和MCP 1含量变化 ;用 2 ,3,5三苯基四氮唑 (TTC)染色法观察脑皮质梗死灶的变化。 结果　常温组再灌注后各时间点缺血核心区皮质内IL 1β含量无明显变化 ;MCP 1含量于再灌注 6h后开始升高 (2 2 5± 8 7)ng/g ,是假手术组的 17 0倍 (P <0 0 5 ) ,4 8h逐渐达到高峰 (110 9± 4 7 0 )ng/g ,是假手术组的 83 7倍 (P <0 0 0 1)。与常温组相比 ,亚低温组再灌注后缺血核心区皮质内IL 1β含量没有明显变化 ,但MCP 1的含量于再灌注后 6h为 (8 7± 7 6 )ng/g(P <0 0 0 5 ) ,再灌注后 4 8h为 (5 6 0± 4 0 3)ng/g(P <0 0 5 ) ,明显低于常温组 ,皮质梗死灶也显著小于常温组。 结论　降低缺血再灌注后脑皮质内MCP 1的含量 ,可能是亚低温发挥脑保护作用的重要途径之一。     

脑利钠肽后处理能减少在体大鼠缺血再灌注后的心肌损伤

目的 通过建立在体大鼠心肌缺血再灌注模型,在大鼠心肌缺血后给予脑利钠肽,探讨脑利钠肽后处理对在体大鼠心肌缺血再灌注损伤心肌的保护作用。方法 24只Sprague-Dawley（SD）大鼠,雄性,随机分为：（1）假手术组（SHAM）：只开胸,不结扎冠状动脉;（2）缺血再灌注组（I/R）：结扎冠状动脉左前降支45分钟、再灌注 3小时;（3）脑利钠肽组（BNP）：结扎冠状动脉左前降支45分钟、再灌注 3小时,在再灌注前10分钟、开始静脉予以BNP 0.01µg·kg - 1·min - 1, BNP静脉恒速维持至再灌注结束。用2,3,5,氯化三苯基四氮唑(triphenyltetrzolium chloride, TTC)检测缺血再灌注心肌的梗死面积;用TUNEL方法检测缺血再灌注心肌的凋亡;检测心肌组织SOD、MDA的浓度以评估缺血再灌注心肌活性氧的水平。结果 假手术组心肌无梗死,缺血再灌注组的大鼠心梗面积为（44.02±10.15）%,脑利钠肽组的心梗面积为（21.53±9.08）%(P<0.05)。假手术组、BNP组与缺血再灌注组的心肌细胞凋亡指数分别为(3.13±1.62)%、(19.45±9.62)%、(38.46±12.31)% (P<0.05)。与缺血再灌注组相比,BNP组的缺血再灌注心肌组织中MDA减少(P<0.05)、而SOD的增多(P<0.05)。结论 BNP后处理能减少在体大鼠缺血再灌注的心肌损伤,其机制与其减少心肌缺血再灌注损伤导致的心肌细胞凋亡及降低心肌缺血再灌注损伤时的活性氧水平相关。     

大鼠脑缺血再灌注后半暗带CAD基因的表达改变

目的　探讨大鼠局灶性脑缺血再灌注后缺血半暗带Caspase 3激活的DNA酶 (CAD)基因的表达变化规律。方法　线栓法建立大鼠大脑中动脉闭塞 (MCAO)及再通模型。应用RT PCR技术检测MCAO再通后不同时相缺血半暗带皮质CAD基因的表达。结果　脑缺血再灌注 6h ,缺血半暗带皮质CADmRNA显著升高 ,密度比值为 0 .74±0 .0 4 ,再灌注 2 4h达到高峰 ( 1.13± 0 .11) ,再灌注 72h后仍有较高表达 ( 0 .80± 0 .12 )。结论　脑缺血再灌注后CAD基因表达上调 ,可能参与了缺血后神经细胞损伤过程     

3-硝基丙酸预处理对大鼠局灶性脑缺血再灌注细胞凋亡的影响

目的 研究3-硝基丙酸预处理对大鼠局灶性脑缺血再灌注损伤细胞凋亡的影响。方法 采用线栓法建立大鼠局灶性脑缺血再灌注损伤模型，将20只大鼠随机分成4组，假手术组、缺血组、3-硝基丙酸预处理组、3-硝基丙酸预处理+5-羟癸酸盐组。观察各组凋亡细胞数和凋亡相关蛋白Bcl-2、Bax的变化。结果 与缺血组比较，3-硝基丙酸预处理组使凋亡细胞数明显减少（85.96±11.51） vs( 123.96±13.45）, Bcl-2表达增高(0.18±0.02 )vs (0.13±0.01)，Bax表达下降(0.14±0.02) vs( 0.20±0.03)，差异有显著性（P<0.01）。3-硝基丙酸预处理+5-羟癸酸盐组与缺血组比较差异无显著性（P>0.05）。结论 3-硝基丙酸预处理可通过开放线粒体ATP敏感性钾通道，上调缺血半暗带区Bcl-2蛋白表达，下调Bax蛋白表达，减少神经元凋亡，对脑缺血损伤起保护作用。     

亚低温对大鼠局灶脑缺血皮质神经元p53蛋白表达及凋亡的影响

目的 观察亚低温对大鼠局灶脑缺血再灌注后皮质神经元p53蛋白表达及凋亡的影响，探讨亚低温脑保护机制。方法采用改良法建立成年SD大鼠大脑中动脉闭塞（MCA0）局灶脑缺血再灌注模型，缺血时间2h。将实验大鼠随机分成常温组和亚低温组，2组再随机分成2％氯化2，3，5-三苯四氮唑（TTC）组和凋亡组2个亚组。各亚组再分成假手术组，再灌注6，24，72h组。TTC染色检测脑梗死体积、TUNEL染色观察细胞凋亡、免疫组织化学染色观察p53蛋白的表达水平。结果 与常温组相比，亚低温组大鼠脑梗死体积小、缺血灶周围皮质神经细胞凋亡少、p53蛋白表达下降。结论亚低温神经保护机制涉及下调p53蛋白表达，从而抑制神经元凋亡．缩小大鼠脑梗死体积，减轻神经功能缺损体征。     

大鼠脑缺血再灌注后Caspase-3的表达及纳洛酮的影响

目的:探讨Caspase-3在缺血再灌注大鼠海马神经元中的表达及纳洛酮的影响。方法:用插线法制作大鼠大脑中动脉闭塞(middlecerebralarteryocclusion,MCAO)局灶性脑缺血再灌注模型,左侧MCAO1h,再灌注23h后处死,对照组给予生理盐水,纳洛酮组给予纳洛酮,海马区Caspase-3的表达通过免疫组化来测定;缺血侧海马区凋亡细胞数采用TUNEL法测定。结果:对照组、纳洛酮组、假手术组缺血侧海马区平均密度值分别为0.130±0.012、0.062±0.004、0.053±0.006。对照组大鼠缺血侧海马区Caspase-3的表达较假手术组显著增强(P<0.01),给予纳洛酮处理后,Caspase-3的表达减弱(P<0.01)。对照组缺血侧海马区许多神经元有凋亡现象,纳洛酮组凋亡神经元减少,假手术组偶见凋亡神经元。结论:短暂的脑缺血可导致海马区Caspase-3的表达增加,凋亡神经元增多。海马区Caspase-3的激活与神经元的凋亡相关,纳洛酮可抑制海马区Caspase-3的表达,减少神经元的凋亡。     

雌激素对大鼠局灶性脑缺血神经细胞caspase-3表达的影响

目的:探讨雌激素对局灶性脑缺血大鼠神经细胞caspase-3表达的影响。方法:健康雌性Wistar大鼠30只,随机等分为假手术组、缺血对照组及雌激素用药组。采用栓线法阻断大脑中动脉建立局灶性脑缺血模型。缺血2 h再灌注24 h后断头取脑,用体积分数为1%四氮唑染色分别观察各组大鼠脑梗死灶的大小,应用免疫组织化学方法检测大鼠脑组织caspase-3的表达。结果:假手术组未发现脑梗死灶和caspase-3表达阴性;雌激素用药组(16.7±2.1)%脑梗死体积明显小于缺血对照组(21.9±4.3)%(P<0.01);caspase-3的表达雌激素用药组(131±15)个明显小于缺血对照组(86±11)个(P<0.01)。结论:雌激素可抑制大鼠脑神经细胞caspase-3活性,减少脑神经元凋亡,具有脑神经保护作用。     

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.     

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.