沙格列汀对糖尿病小鼠动脉粥样硬化和脂肪性肝炎的影响

目的：探讨二肽基肽酶4（dipeptidyl peptidase 4,DPP4）抑制剂沙格列汀对2型糖尿病（type 2 diabetes mellitus,T2DM）小鼠合并动脉粥样硬化和脂肪性肝病的影响及其机制。方法：ApoE-/-小鼠高脂喂养、高脂喂养+小剂量链脲佐菌素分别构建非糖尿病、T2DM合并动脉粥样硬化和脂肪性肝病小鼠模型,分为非糖尿病治疗组（HS,n=8）、对照组（HF,n=8）,糖尿病治疗组（DS,n=8）、对照组（DM,n=8）。HS、DS组予以沙格列汀15 mg/（kg·d）灌胃治疗,对照组等量生理盐水灌胃,12周后观察主动脉斑块、肝脏脂肪沉积、炎症浸润、纤维化程度以及炎症小体NLRP3活化和炎症介质IL-1β表达变化。结果：DS组较DM组血浆血糖、游离脂肪酸、甘油三酯和ALT、AST水平明显降低（P＜0.01）,肝重比明显减小（P＜0.01）,肝脏脂肪沉积、巨噬细胞浸润及纤维化程度显著减轻（P＜0.01）,肝组织内NLRP3炎症小体及IL-1β表达明显减少（P＜0.01）,HS组较HF组上述部分指标也出现明显降低,但HS、DS组较对照组动脉粥样硬化斑块均无明显变化。结论：沙格列汀通过降低血浆血糖和FFA水平,抑制肝脏巨噬细胞聚集、减少NLRP3炎症小体活化等作用抑制糖尿病性脂肪肝的发生和发展,但对动脉粥样硬化没有治疗作用。     

大花紫薇提取物对STZ致Ⅱ型糖尿病小鼠的降糖作用研究

[目的]探讨大花紫薇提取物对链脲佐菌素（STZ）致Ⅱ型糖尿病小鼠糖耐量的影响及降糖作用.[方法]采用ICR小鼠饲喂高糖高脂饲料加ipSTZ 70 mg·kg^-1诱导搪尿病模型.选取造模成功的小鼠随机分为模型组、盐酸二甲双胍组（550mg· kg^-1）、大花紫薇提取物三个剂量组（20、40、60 mg·kg^-1）1每组10只,灌胃给药连续7W.观察糖耐量,检测血糖、血清胰岛素（Ins）、糖化血红蛋白（HbA1c）、果糖胺（GSP）及肝糖原（Gly）,根据血糖和胰岛素（Ins）计算胰岛素敏感性指数（ISI）.[结果]与模型对照组相比,大花紫薇提取物三个剂量20、40、60 mg·kg^-1均能明显降低Ⅱ型糖尿病小鼠血糖、GSP水平（P＜0.01）及HbA1c水平（P＜0.05）,增加血清胰岛素和肝糖原含量（P＜0.01）,升高胰岛素敏感性指数（P＜0.01）;糖耐量试验结果显示,大花紫藿提取物三个剂量20、40、60 mg· kg^-1均能降低小鼠在给予葡萄糖后各时间点血糖值及血糖曲线下面积.[结论]大花紫薇提取物具有降血糖作用,并能改善糖耐量,其降糖作用可能与提高胰岛素敏感性、改善胰岛素相对分泌不足、促进肝糖原合成有关.     

脂肪乳剂灌胃建立实验性脂肪肝小鼠模型

目的：研究脂肪乳剂灌胃对小鼠形成脂肪肝的可能。方法：4月龄SD小鼠随机分为正常对照组（普通饲料＋NS）,高脂高糖组（普通饲食＋高脂高糖乳剂灌胃）和高脂组（普通饲食＋脂肪乳剂灌胃）,每组8只。灌胃量2 mL/kg,每日1次,连续8周,且每周称重1次。实验结束后,测小鼠血糖,眼眶取血处死小鼠,分离血清总胆固醇（TC）、甘油三酯（TG）和高密度脂蛋白胆固醇（HDL-C）,用公式计算低密度脂蛋白胆固醇（LDL-C）,并观察肝脏的肝质量指数、病理切片和生化指标的变化。结果：高脂组8周后与正常对照组比,TC、LDL-C水平显著升高（P〈0.01）,HDL-C明显下降（P〈0.01）,肝脏出现脂肪细胞和炎症浸润等病理变化。结论：长期脂肪乳剂灌胃可建立小鼠脂肪肝模型。     

肌肽对应激负荷小鼠糖代谢的影响

目的研究肌肽对应激负荷小鼠糖代谢的影响。方法将雄性KM小鼠分为正常对照组、应激对照组、150 mg/kg及300 mg/kg肌肽给药组,每天灌胃给药1次,连续给药7 d后拘束负荷应激20 h灌胃葡萄糖2 g/kg,检测血糖清除率、肝糖原合成能力、糖原合成酶基因表达及皮质酮水平。结果与应激负荷对照组比较,肌肽能提高应激小鼠血糖消除速率,促进糖原合成酶的基因表达,并增强肝糖原合成能力。此外,肌肽还能降低血浆皮质酮的水平。结论肌肽增强应激负荷小鼠肝糖原合成能力,其作用机制可能与肌肽降低体内糖皮质激素水平、激活糖原合酶有关。     

玛咖对一次力竭运动小鼠抗疲劳作用及T-SOD、肝糖原的影响

［摘要］目的　应用玛咖进行抗疲劳动物实验,为相关部门开发新型的运动补剂提供参考．方法　将30只SPF昆明种雄性小鼠随机分为安静对照组（A组）、力竭运动组（B组、高海拔）、玛咖+力竭运动组（C组）,每组各10只;另加力竭运动组（D组、低海拔）20只．C组在饮用水中溶入玛咖,浓度为5%．30 d后,进行一次力竭实验,测定力竭时间,即刻处死小鼠测试T-SOD、肝糖原等生化指标．结果　C组小鼠力竭游泳时间比B组长且差异有统计学意义（P＜0.05）,T-SOD比A组和B组高差异有统计学意义（P＜0.05）,肝糖原含量比B组高且差异有统计学意义（P＜0.05）．D组小鼠力竭游泳时间比B组长且有统计学意义（P＜0.01）．结论　玛咖能够提高T-SOD活性,提高肝糖原含量,具有较好的抗疲劳作用;低海拔地区小鼠力竭游泳运动时间高于高海拔地区小鼠．     

不同氨基酸对小鼠血糖影响的研究

目的观察不同氨基酸对昆明（KM）小鼠餐后血糖水平的影响。方法将KM小鼠按空腹血糖随机分为对照组和不同氨基酸组,每组15只;氨基酸组给予氨基酸（2g/kg）和葡萄糖（2g/kg）混合液灌胃,对照组仅给予葡萄糖（2g/kg）灌胃,测定灌胃后0.5h、1h、2h的血糖水平。结果 1）摄入D-亮氨酸或L-亮氨酸后0.5h、1h、2h血糖和血糖曲线下面积（AUC）明显低于对照组;与D-亮氨酸组相比,摄入L-亮氨酸后0.5h、1h和2h血糖及AUC降低,并具有显著性差异;摄入D-苯丙氨酸或L-苯丙氨酸后0.5h血糖和AUC明显低于对照组;与D-苯丙氨酸组相比,摄入L-苯丙氨酸后0.5h血糖水平有所降低,但无统计学差异。2）摄入苯丙氨酸0.5h血糖和AUC明显低于对照组（P〈0.01）;摄入缬氨酸、异亮氨酸、蛋氨酸、苏氨酸、赖氨酸后0.5h、1h血糖和AUC明显低于对照组（P〈0.01）;摄入亮氨酸、色氨酸后0.5h、1h、2h血糖和AUC明显低于对照组（P〈0.01）。3）摄入谷氨酰胺和丝氨酸后0.5h血糖水平显著低于对照组;摄入甘氨酸、精氨酸、丙氨酸、半胱氨酸、脯氨酸后0.5h、1h血糖和AUC显著低于对照组（P〈0.01）,而摄入天冬氨酸、酪氨酸、谷氨酸、组氨酸及天冬酰胺组0.5h血糖水平与其对照组相比无显著性差异（P〉0.05）。结论氨基酸可明显降低KM小鼠餐后血糖水平,其中亮氨酸降糖作用较强。     

针灸对运动性疲劳的能量代谢调节作用述评

综述近年来针灸干预运动性疲劳能量代谢的相关文献。结果显示针灸疗法可通过调节供能化合物、血糖和糖原代谢、氨基酸代谢、脂质代谢,从而延缓运动性疲劳。针灸调节能量代谢以治疗运动性疲劳可能途径如下:(1)提高肌糖原、肝糖原含量,增强机体糖储备;(2)提高肌酸激酶的活性,增加磷酸肌酸向三磷酸腺苷的转化,从而改善骨骼肌能量供应;(3)降低游离色氨酸与支链氨基酸的比值,减少脑内5-羟色胺的生成和积聚,进而延缓中枢疲劳;(4)抑制血浆游离脂肪酸含量的升高,提高骨骼肌肌质网的Na~+-K~+-ATP酶含量及Ca~(2+)-ATP酶的活性,调节肌质网Ca~(2+)循环,从而延缓急性运动性疲劳。有关针灸治疗运动性疲劳的机制研究亟待从分子水平、中枢整合机制、信号通路等方面继续深入探索。     

茶多糖对2型糖尿病小鼠降糖作用研究

目的:探讨茶多糖对2型糖尿病小鼠的降血糖作用及其机制.方法:将KK-Ay 2型糖尿病小鼠随机分为高、中、低3个剂量组和对照组,分别以等体积的50、100、150 mg/kg/d的茶多糖和生理盐水连续灌胃8周.4周末时检测各组小鼠的糖耐量,8周末时测其空腹血糖、胰岛素、果糖胺、血脂以及肝糖原等指标.结果:4周末时高剂量组小鼠的葡萄糖耐量得到显著改善(P＜0.01),至第8周时,中、高剂量组血糖、血清胰岛素、血清甘油三酯和果糖胺水平均较对照组显著降低(P＜0.05,P＜0.01),肝糖原显著升高(P＜0.01).结论:茶多糖可有效降低KK-Ay糖尿病小鼠的血糖水平,并对糖代谢、脂质代谢有改善作用,提示其作用机理可能与增加胰岛素的敏感性有关.     

刺梨提取物对小鼠的抗疲劳作用

目的：研究刺梨提取物对小鼠的抗疲劳作用.方法：100只健康昆明种小白鼠,按雌雄、体重随机分为空白、高、中和低剂量组4组,每组25只;空白组给予生理盐水灌胃,高、中及低剂量3个组分别给予1 g/（kg·d）、2 g/（kg·d）及3 g/（kg·d）刺梨提取物灌胃;连续灌服25 d后采用小鼠游泳耐力和小鼠低压缺氧实验测定小鼠负重游泳时间及低压耐氧的死亡数;并测定运动后小鼠的血清尿素氮、血乳酸和肝糖原.结果：经灌胃小鼠不同剂量刺梨提取物25 d后,能明显延长小鼠负重游泳时间,高、中剂量组力竭游泳时间明显长于空白组,差异有统计学意义（P＜0.05）;高剂量组小白鼠死亡只数少于空白组,差异有统计学意义（P＜0.05）,小鼠死亡数量随灌服刺梨提取物剂量的增加而减少;刺梨提取物可显著增强小鼠低压耐氧时间,降低运动时血清尿素氮水平,对小鼠运动后血乳酸升高有明显的抑制作用,可使小鼠体内肝糖原的储备量增加.结论：刺梨提取物能对抗小白鼠疲劳.     

氯原酸对db/db小鼠糖脂代谢紊乱的影响及其作用机制

目的 研究氯原酸(CGA)对自发性肥胖糖尿病db/db小鼠糖脂代谢紊乱的影响及其作用机制.方法 将13只5～6周龄雄性db/db小鼠随机分为db/db-CGA组(n=7)和db/db-CON组(n=6),13只5～6周龄雄性db/m小鼠随机分为db/m-CGA组(n=6)和db/m-CON组(n=7);CGA组均给予80mg/(kg·d)CGA灌胃,CON组均给予等体积PBS灌胃.12周后检测血浆、肝脏、骨骼肌中糖脂生化指标,内脏脂肪组织中脂联素和内脂素含量,肝脏葡萄糖-6-磷酸酶(G-6-Pase)和过氧化物酶体增殖物激活受体-α(PPAR-α)的mRNA水平及其蛋白表达.结果 给予CGA12周后,db/db-CGA组小鼠血浆、肝脏和骨骼肌中三酰甘油含量和空腹血糖均明显低于db/db-CON组(P均＜0.05),肌糖原含量明显高于db/db-CON组(P＜0.05);脂联素水平明显高于db/db-CON组(P＜0.01),低于db/m-CGA组(P＜0.05);内脂素水平明显低于db/db-CON组(P＜0.01),高于db/m-CGA组(P＜0.05);G-6-Pase mRNA表达水平较db/db-CON组明显下降(P＜0.05),PPAR-α mRNA和蛋白表达水平均较db/db-CON组明显升高(P＜0.05).结论 CGA可改善自发性肥胖糖尿病小鼠糖脂代谢紊乱,其机理可能与调节脂肪因子分泌,上调肝脏PPAR-α水平及抑制G-6-Pase表达有关.     

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.