无镁诱导培养的大鼠皮层神经元癫痫样放电

目的：观察无镁细胞外液短暂处理培养的胚胎鼠大脑皮层神经元能否诱导自发、反复的惊厥样放电。以期提供一种较好的研究发育中脑癫痫活动的细胞模型。方法：采用全细胞电流钳记录技术，记录体外培养12－18d的大脑皮层神经元在正常细胞外液、无镁细胞外液、无镁细胞外液处理3h继而恢复正常细胞外液后1－2h、24h、72h神经元电活动的变化。结果：（1）神经元在正常细胞外液中自发放电形式表现为兴奋性突触后电位（EPSP）及约16次／min左右的动作电位（n=29)。（2）无镁细胞外液孵育3h，孵育期间100％的细胞（n=25)放电形式发生改变，表现为两种形式：持续强直的高频爆发及“楔形”去极化。（3）经无镁细胞外液孵育3h恢复正常细胞外液后2h 100%的细胞发生异常放电（n=12),72h仍有近80％的细胞发生异常放电，主要表现为阵发性持续棘波样爆发、“楔形”去极化及PDSs样发作（paroxysmal depolarizing shifts)。结论：培养的胚胎鼠皮层神经元予短暂的无镁处理后可诱导自发、反复的惊厥样活动，且惊厥样活动可持续72h，为进一步研究发育中惊厥性脑损伤及保护提供了较好的癫痫细胞模型。     

发育中大鼠皮层神经元惊厥样放电中PSD-95 mRNA表达改变

目的探讨早期无镁细胞外液处理后惊厥样放电对发育中大鼠皮层神经元PSD-95 mRNA表达的影响。方法以原代培养的大鼠大脑皮层神经元无镁诱导的反复惊厥样放电为模型,根据对培养6d皮层神经元的不同处理分为三组：正常Neurobasal/B27培养液组（CONT组）、正常细胞外液组（PS组）和无镁细胞外液组（MGF组）。神经元分别在上述三种液体中孵育3h,然后换为正常Neurobasal/B27培养液继续培养,在处理后6,24,72h及处理后第6天时应用实时定量PCR测定PSD-95 mRNA的表达。结果与CONT组和PS组相比,MGF组PSD-95 mRNA表达在处理后24h明显增高（P〈0.05）。处理后6h,72h及第6天的皮层神经元PSD-95 mRNA表达三组中两两比较差异无统计学意义（P〉0.05）。结论发育中大鼠皮层神经元惊厥样放电可以导致神经元PSD-95 mRNA表达的改变。     

早期惊厥样放电对发育中大鼠皮层神经元Cx36 mRNA表达的远期影响

目的　探讨早期惊厥样放电对发育中大鼠皮层神经元缝隙连接蛋白Cx36mRNA表达的远期影响。方法　以原代培养的大鼠大脑皮层神经元无镁诱导的反复惊厥样放电为模型 ,根据对培养 6d皮层神经元的不同处理分为三组 :正常DMEM培养液组 (CONT1)、正常细胞外液组 (CONT2 )和无镁细胞外液组 (MGF)。神经元分别在上述三种液体中孵育 3h ,然后恢复正常DMEM培养液继续培养 ,在培养 7,12及 17d时测定了发育中大鼠皮层神经元早期惊厥样放电后不同时间Cx36mRNA表达。结果　分别与CONT1和CONT2组相比较 ,MGF组Cx36mRNA表达在培养 7d时无统计学差异 (P >0 .0 5 ) ,培养 12d时明显升高 ,17d时明显降低 (P <0 .0 5 )。结论　早期惊厥样放电可能导致发育中大鼠皮层神经元Cx36mRNA表达的远期影响     

早期惊厥样放电对发育中大鼠皮层神经元细胞内游离钙的远期影响

目的探讨早期惊厥样放电对发育中大鼠皮层神经元功能及NMDA激发后细胞内[Ca2 ]i的远期影响。方法以原代培养的大鼠大脑皮层神经元无镁诱导的反复惊厥样放电为模型。根据对培养6d皮层神经元的不同处理分为三组正常DMEM培养液组(CONT1)、正常细胞外液组(CONT2)和无镁细胞外液组(MGF)。神经元分别在上述三种液体中孵育3h,然后恢复正常DMEM培养基继续培养,在培养7,12及17d时测定皮层神经元噻唑蓝(MTT)代谢率及荧光数码扫描显微镜测定[Ca2 ]i信号的变化,100μmol/LNMDA刺激神经元。[Ca2 ]i反应通过静息钙、峰值和上升时间表示。结果与CONT2和CONT1组相比,MGF组MTT代谢率在培养7和12d皮层神经元均明显降低(P<0.05);不同培养时间各组静息钙和峰值钙水平均升高(P<0.05);上升时间在培养7和17d较短(P<0.05),而12d较长(P<0.05)。CONT2组与CONT1组相比无统计学差异(P>0.05)。结论发育中皮层神经元早期无镁诱导惊厥样放电对细胞内钙具有远期影响,提供了神经元早期惊厥样放电引起远期功能损伤的可能机制。     

新生大鼠海马神经元癫痫样放电模型的初步研究

目的:研究"无镁细胞外液"诱导海马神经元产生癫痫样放电形式,建立离体癫痫模型.方法:采用24h新生Wistar大鼠,取海马神经元原代培养,神经元特异性烯醇化酶Neuron specific enolase,NSE)免疫荧光鉴定神经元.体外培养至第9d时,用"无镁细胞外液"处理3h,使用全细胞膜片钳技术记录神经元在相应时间点的放电情况.结果:通过鉴定可见,所培养的海马神经元纯度接近100%.在"无镁细胞外液"处理3h后致恢复正常细胞培养液培养24h,神经元仍存在自发的"癫痫样放电".结论:采用本方法体外培养的海马神经元在"无镁细胞外液"的作用下可形成稳定的癫痫样放电,为今后进行癫痫发病机制的研究提供了一种的理想模型.     

早期惊厥样放电对发育中神经元NMDA受体1表达的远期影响

目的探讨早期惊厥样放电对发育中大鼠皮层神经元N-甲基-D-天冬氨酸受体1（N—methyl—D—aspartate receptor1，NR1）表达的远期影响。材料与方法以原代培养的大鼠大脑皮层神经元无镁诱导的反复惊厥样放电为模型。根据对培养6d皮层神经元的不同处理分为三组：正常DMEM培养液组（GONT1）、正常细胞外液组（CONT2）和无镁细胞外液组（MGF）。神经元分别在上述三种液体中孵育3h，然后恢复正常DMEM培养基继续培养，分别应用实时定量PCR与Westernblot方法在培养7、12及17d时测定皮层神经元NMDA受体1mRNA与蛋白表达的变化。结果在正常DMEM培养液中，NR1 mRNA与蛋白的表达在培养7d时处于较高水平，以后逐渐下降，以培养12d为最低。与GONT2和GONT1组相比，MGF组NR1 mRNA与蛋白的表达在培养7d皮层神经元均明显降低，在12d时明显增高（P〈0．05）。GONT2组与GONT1组相比无统计学差异（P〉0．05）。结论发育中皮层神经元早期无镁诱导惊厥样放电对NMDA受体1mRNA与蛋白表达具有远期影响，提供了神经元早期惊厥样放电引起远期功能损伤的可能机制。     

无镁诱导培养大鼠海马神经元癫痫放电模型中延迟整流钾电流的变化

 摘要：目的 利用无镁细胞外液诱导原代培养大鼠海马神经元癫痫放电模型来检测延迟整流钾电流的变化。方法 采用新生24h内Wistar大鼠,分离海马神经元进行原代培养。体外培养至12-16d时,无镁细胞外液处理神经元3h并恢复正常细胞外液,应用全细胞膜片钳技术记录神经元的放电情况及延迟整流钾电流。结果 无镁处理后的神经元存在自发的“癫痫样”放电;无镁诱导可使神经元延迟整流钾电流增大。结论 延迟整流钾电流增大可能与无镁诱导体外培养大鼠海马神经元自发异常放电的基础病理机制相关。     

无镁诱导培养大鼠海马神经元与SH-SY5Y细胞自发性放电的变化

  目的 利用无镁细胞外液诱导原代培养大鼠海马神经元和SH-SY5Y细胞建立癫痫放电模型。方法 采用新生24 h内Wistar大鼠,分离海马神经元进行原代培养。对于体外培养至10 d的神经元和传代培养的SH-SY5Y细胞,无镁细胞外液处理细胞3 h并恢复正常细胞外液,应用全细胞膜片钳技术记录2种细胞的放电情况。结果 无镁处理后的神经元存在自发性的“癫痫样”放电;SH-SY5Y细胞未出现“癫痫样”放电。结论 细胞间通过突触联系形成网状结构可能是诱导“癫痫样”放电的必要条件之一。     

体外癫痫神经元细胞膜显微结构的研究

目的 利用原子力显微镜观察体外癫痫神经元细胞膜显微结构.方法 将培养14 d的神经元放入"无镁"细胞外液处理3 h后,再重新放回含镁的正常细胞外液培养,利用膜片钳记录神经元的自发性电活动.将"无镁"细胞外液处理3h的神经元定为实验组,将未经"无镁"外液处理的神经元定为对照组.分别在80 μm×80 μm,2μm×2 μm和500 nm×500 nm扫描范围,对两组神经元细胞膜表面进行扫描,同时测量两组神经元表面相关结构的直径和深度.结果 膜片钳提示"无镁"细胞外液处理3 h和恢复正常外液14 d时,神经元存在自发的癫痫样放电.在扫描范围为80 μm×80 μm时,两组神经元细胞膜表面光滑;在2 μm×2 μm时,两组神经元细胞膜表面出现一些小凹;在500 nm×500 nm时,实验组神经元表面小凹的直径和深度分别为(114.86±9.33)nm和(5.71±0.69)nm,对照组为(116.4±9.13)nm和(5.69±0.71)nm,两组相比无显著性差异(P＞0.05).结论 原子力显微镜是进行细胞膜显微结构观察的良好工具;"无镁"外液处理神经元3 h,神经元细胞膜显微结构未发生改变.     

细胞内游离Ca2+在发育中大鼠皮层神经元无镁诱导惊厥性损伤中的作用

目的: 观察细胞内游离Ca2+([Ca2+]i)在培养的不同发育阶段皮层神经元无镁诱导惊厥性损伤中的作用,探讨惊厥性脑损伤年龄依赖性的可能机制.方法:体外培养6 d、17 d的胚胎大鼠皮层神经元用无镁细胞外液处理3 h,或于无镁处理前用NMDA(N-甲基-D-门冬氨酸)受体拮抗剂或Ca2+通道阻滞剂预处理,用MTT代谢率测定的方法检测神经元损伤,以Fluo-3作标记用激光共聚焦显微镜扫描的方法检测[Ca2+]i.结果:体外培养6 d、17 d的神经元单纯无镁组MTT代谢率较同期对照组降低.应用MK-801 10 μmol*L-1、AP-5 50 μmol*L-1、尼莫地平10 μmol*L-1预处理后再给无镁处理,培养6 d、17 d的神经元MTT代谢率均不同程度高于同期单纯无镁组.培养6 d、17 d的神经元相对荧光强度之间差异有显著性,两者与基线荧光强度比较差异亦有显著性.应用上述各种拮抗剂后,[Ca2+]i改变的峰值均明显低于同期单纯无镁组.结论: 在体外不同发育阶段的神经元,短暂无镁处理诱导惊厥样放电所引起的神经元线粒体功能损伤以及[Ca2+]i改变程度不同.这种[Ca2+]i改变的年龄依赖性可能是惊厥导致神经元损伤的年龄依赖性的机制之一.NMDA受体-Ca2+通道激活是导致这种[Ca2+]i改变及神经元损伤的关键环节.     

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.