低温HP100XD保存液对离体猪冠状动脉内皮依赖性舒张反应的影响

目的:评价新型保存液HP100XD对猪离体冠状动脉内皮的保护作用.方法:健康瑞典家猪7头,取出冠状动脉前降支远端血管,外径1.0～1.5 mm,并截成1 mm长的血管环.将所取的血管环随机分配到以下3组,每组7段.新鲜对照组,将血管环直接置入器官浴槽内行内皮依赖性舒张反应(EDR)测定;24 h保存组和48 h保存组,分别将血管环保存于4℃的HP100XD溶液中24 h和48 h,再行EDR测定.血栓烷A2受体激动剂U-46619和罂粟碱分别用来诱导平滑肌的收缩和舒张.通过蓄积方式在器官浴槽内加入浓度递增的P物质(10-15～10-7mol/L)测定血管EDR.结果:与新鲜对照组最大舒张反应值(97.6±0.3)%比较,24 h保存组血管环的(95.6±0.7)%无变化(P＞0.05),48 h保存组则下降为(87.2±3.8)%(P＜0.05).与新鲜对照组的50%最大舒张时P物质的浓度对数(pEC5o)(9.93±0.17)比较,24 h保存组的pEC5o(9.64±0.05)无变化(P＞0.05),48 h保存组则下降为(9.54±0.04)(P＜0.05).结论:在4℃条件下,HP100 XD溶液可以有效地保存离体猪冠状动脉内皮功能达24 h,是一种较好的心脏保存溶液.     

血管紧张素转换酶2在大鼠移植肝保存性损伤中的表达及意义

目的:观察血管紧张素转换酶2(ACE-2)在大鼠移植肝中的表达及其与移植后保存性损伤(PI)的相关性,初步探讨局部肾素-血管紧张素系统(RAS)在肝移植PI中的可能作用。方法:根据供体肝冷保存时间将移植大鼠分为冷保存(CP)组及未进行冷保存(NCP)组,未进行肝移植的假手术组作对照;组织学检查观察肝脏保存性损伤程度,实时定量RT-PCR、蛋白质印迹、免疫组化法分别检测术后1、24、48 h肝组织ACE-2的mRNA、蛋白水平表达及其组织定位,哌莫硝唑免疫组化染色检测组织缺氧程度。结果:肝移植后存在不同程度组织损伤,CP组更明显;与假手术组相比,肝移植组术后ACE-2 mRNA及蛋白水平均显著升高(P<0.01或P<0.05),且CP组明显高于NCP组(P<0.05);免疫组化染色显示移植组在肝静脉周围呈阳性表达,染色阳性程度与ACE-2 mRNA表达明显正相关(r=0.78,P<0.001)。结论: ACE-2表达与冷保存导致的移植肝保存性损伤的组织缺氧密切相关,局部RAS可能参与了移植肝保存性损伤。     

TRS液低温下长时间保存血管的效果

目的观察检测一种新型保存液（tongji rochester solution，TRS）在4℃下保存24h后对大鼠主动脉保护作用。方法用大鼠胸主动脉分别保存在4℃ TRS液、UW液、HTK液、生理盐水中保存24h，在甲氧胺和乙酰胆碱作用下分别检测其血管平滑肌细胞的收缩功能和舒张功能。未经保存的新鲜血管作为对照。结果保存24h后，血管平滑肌细胞的收缩功能和内皮依赖性舒张功能在TRS液、UW液、HTK液组之间差异无显著性（P〉0．05）。结论TRS在4℃、24h内对血管的保存效果与UW液、HTK液相当，为一种理想的保存液。     

骨髓单核细胞移植对脑梗死小鼠白质损伤及血管再生的影响

目的 探讨评价骨髓单个核细胞(bone marrow mononuclear cells,BMMNCs)移植对大脑中动脉栓塞小鼠脑白质损伤的疗效及梗死周围血管再生的影响.方法 线栓法将成年雄性小鼠制成大脑中动脉栓塞模型,模型成功后按随机表法随机分成假手术组,MCAO组,PBS组及BMMNCs移植组(BMMNCs组).梯度密度离心法提取分离BMMNCs,模型成功后24 h经尾静脉移植入0.5 ml含1×106个BMMNCs细胞悬液,PBS组给予等体积的PBS溶液,神经功能学评分(mNSS)评价小鼠神经功能,luxol fast blue(LFB)染色观察梗死周围脑白质损伤情况,免疫荧光染色观察梗死周围血管再生情况.结果 除假手术组外,其他各组均有不同程度的神经功能缺损.梗死后56 d,BMMNCs组LFB着色减少百分比[(24.06±5.48)％]明显低于MCAO组[(62.22±5.38)％]及PBS组[(61.22±5.48)％],BMMNCs组血管密度[(249.8±11.8)个/mm2]明显高于MCAO组[(119.1 ±11.2)个/mm2]及PBS组[(114.3±12.1)个/mm2],差异有统计学意义(P＜0.05),MCAO组与PBS组相比,LFB着色减少百分比和血管密度差异无统计学意义(P＞0.05).结论 BMMNCs移植可促进血管新生,增加梗死周围区血管密度,减轻脑白质损伤程度,显著改善脑梗死小鼠神经功能.     

非去极化心脏停搏液短时常温保存对猪冠状动脉内皮依赖性舒张功能的影响

目的 探讨短时常温(1h,37℃)条件下,非去极化心脏停搏液(NDP)对猪冠脉内皮源性超极化因子(EDHF)介导的血管舒张功能的影响.方法 根据保存液的不同,将血管环分成四组,分别为对照(CON)组、St.Thomas (ST)组、HTK组、NDP组.采用器官槽法,将血管环分别置于Krebs-Hensleit (KH)液、ST液、HTK液、NDP液中,37℃条件下保存1h,加入一氧化氮合酶阻滞剂N-硝基-L-精氨酸(L-NNA)和环加氧酶阻滞剂(Indomethacin),记录由前列腺素F2α(U46619)及缓激肽(Bradykinin)引起的血管收缩和舒张反应.结果 NDP组中EDHF介导的内皮依赖性血管舒张百分比最大,为(74.79±6.40)％,其余依次为HTK组(51.32±21.92)％、CON组(24.03±8.01)％、ST组(16.20±6.39)％.结论 短时常温(1h,37℃)条件下,NDP液对冠脉内皮的舒张功能具有保护作用,且优于HTK组、CON组和ST组.     

血管舒张药应用途径对皮瓣成活的影响

目的 探讨不同途径应用罂粟碱对新西兰兔下腹壁皮瓣成活的影响.方法 将24只体质量相近的雄性新西兰兔采用随机区组设计分成3组,每组8只;并采用双盲法,建立新西兰兔左侧下腹壁浅动脉皮瓣模型,通过不同部位注射罂粟碱(实验组为皮瓣蒂部皮下组织,对照1组为静脉注射,对照2组臀部肌肉注射),采用彩色多普勒观察在术前、术后1周内(注药前、注药后10、60 min)皮瓣的血管分布、血流和手术后1周皮瓣的成活情况.结果 皮瓣蒂部注射与静脉注射对皮瓣的血管显像无差异(P＞0.05).皮瓣蒂部皮下注射较肌肉注射效果好,有统计学意义(P＜0.05).结论 新西兰兔腹部移植皮瓣在皮瓣蒂部注射罂粟碱较肌肉注射效果有明显优势,可改善皮瓣的血运,提高皮瓣的存活率.     

HCA-Ⅱ肾保存液对肾脏低温保存效果的实验研究

目的:研究HCA-Ⅱ肾保存液对草犬肾脏低温保存的效果.方法:采用草犬肾脏非循环离体灌注模型,比较HCA-Ⅱ液、UW液和高渗枸橼酸盐嘌呤溶液(HC-A液)低温保存肾脏后其形态学及生物化学指标的改变,并进行自体肾脏移植,观察移植后肾功能恢复情况.结果:HCA-Ⅱ液组保存48、72 h后,形态学改变、肾脏线粒体呼吸控制率(RCR)和皮质ATP含量、移植肾功能指标明显优于HC-A液(P＜0.05),与UW液组无明显差异;低温保存供肾24 h,3组上述指标无显著差异.保存24、48、72 h后保存液pH值,HCA-Ⅱ液组均明显高于HC液组(P＜0.05).结论:HCA-Ⅱ液保存犬肾48 h及72 h效果优于HC-A液,与UW液相当.     

家兔睾丸移植模型研究

目的 比较不同睾丸血管吻合方式及睾丸保存方式对移植后睾丸存活率及生精功能的影响。方法 分别将睾丸血管与睾丸血管、腹壁下血管、隐血管吻合，建立器官移植模型；分别用UW液和HTK液保存睾丸，建立器官低温保存移植模型。术后监测睾丸存活率、精子生成及雄激素分泌水平。结果端端吻合睾丸动静脉、输精管的睾丸阴囊原位移植方法最为简单易行，存活率高，术后生精功能良好；在0℃～4℃条件下，UW液和HTK液分别可保存兔睾丸72h和60h。结论 睾丸原位移植最为方便可靠，存活率高，术后生精功能良好；在0℃～4℃条件下，UW液和HTK液保存兔睾丸不宜超过72h和60h。     

超极化与去极化保存液对冠状动脉内皮细胞的影响

目的:探讨超极化与去极化保存液对猪冠状动脉内皮细胞的影响.方法:将新鲜猪心外膜下冠状动脉前降支切成3段,长3 mm,共42条血管环,随机分6组,每组7条.①电镜观察内皮细胞超微结构变化.对照组:将从猪心取出的血管环直接制成电镜标本;超极化、去极化组:将血管环分别浸入于含尼可地尔 (0.1 mmol/L)的重碳酸盐缓冲液(KH液)、含氯化钾(20 mmol/L)的KH液,于4 ℃无氧条件下保存6 h后再制成标本;②器官槽法检测血管张力变化.对照组、超极化、去极化组,分别浸入KH液、含尼可地尔(0.1 mmol/L)的KH液、含氯化钾(20 mmol/L)的KH液,于4 ℃无氧条件下保存6 h.在消炎痛 (7 μmol/L) 和一氧化氮合成酶阻断剂N-硝基-L-精氨酸(300 μmol/L)作用下,前列腺素F2α(30 nmol/L)及非受体介导钙离子载体(10-10～10-6 mol/L)引发血管收缩舒张反应.结果:与对照组相比,超极化组冠状动脉内皮细胞超微结构受损程度较去极化组轻.前列腺素F2α引发的预收缩强度两组差异无统计学意义(P=0.323,P=0.214),非受体介导钙离子载体引发的舒张反应程度,保存于去极化组的明显下降(P=0.001),保存于超极化组的变化不明显(P=0.380).结论:对于冠状动脉内皮细胞的保存,超极化保存液优于去极化保存液.     

pH值对原代大鼠肝细胞冻存效果的影响

目的研究不同pH值的条件下原代大鼠肝细胞冻存的效果。方法将大鼠肝细胞保存在含有20%FSB和12%DMSO的UW液和RPMI 1640液中,并把两种保存液的pH值调节成7.1、7.4、7.7。于冻存7、14、28天后进行复苏,使用存活率、MTT、LDH漏出浓度3项指标进行对比分析。结果 7天时,pH值7.4组的各项指标明显优于其他两组,14天和28天时,pH值7.7组与pH值7.4组均明显优于pH值7.1组。结论 pH值7.4和pH值7.7的保存效果优于pH值7.1,且随着时间的延长,差距有扩大的趋势,说明中性或略偏碱性环境更利于肝细胞的长期保存。     

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.