大鼠脑出血后MMP-2和MMP-9的动态表达及七叶皂苷钠对其表达的影响

目的观察大鼠脑出血（ICH）后基质金属蛋白酶-2（MMP-2）、MMP-9蛋白动态表达及其与血肿周围脑组织含水量的关系,以及观察七叶皂苷钠对MMP-2、MMP-9表达的影响。方法Wistar大鼠250只随机分为4组：正常对照组10只、假手术组80只、ICH组80只和七叶皂苷钠治疗组80只,于制模后6、12、24、48、72、120h、7d和15d 8个时间点,测定各组血肿周围脑组织含水量、MMP-2和MMP-9的蛋白表达。结果治疗组神经功能缺失较ICH组明显改善（P〈0.05）;6-120h治疗组血肿周围脑组织含水量较ICH组明显减少（P〈0.05）;ICH后MMP-2蛋白表达在6h达到高峰,12h时下降,与正常对照组相比,MMP-2蛋白表达具有统计学意义（P〈0.01）;治疗组MMP-2蛋白表达在各时间点较ICH组明显减少（P〈0.01）;ICH后MMP-9蛋白表达在6h开始上升,24-48达高峰,72h时下降,与正常对照相比,具有统计学意义（P〈0.01）,其表达水平与血肿周围脑组织含水量呈正相关（r=0.949,P〈0.05）;治疗组MMP-9蛋白表达在各时间点ICH组明显减少（P〈0.01）。结论大鼠ICH后MMP-2、MMP-9蛋白的表达是ICH后早、中期脑水肿形成主要因素,七叶皂苷钠能降低MMP-2、MMP-9蛋白表达和脑组织含水量,对ICH具有保护作用。     

MMP-9对脑出血损伤实验研究

目的观察大鼠脑出血(ICH)后基质金属蛋白酶-9(MMP-9)蛋白动态表达及其与血肿周围脑组织含水量的关系。方法将雌雄各半的Wistar大鼠170只随机分为3组:正常对照组、假手术组、ICH组。每组均观察手术后6h、12h、24h、48h、72h、120h、7d、15d八个时间点,测定血肿周围脑组织含水量、MMP-9蛋白表达。结果ICH后MMP-9蛋白表达在24h~48h达高峰,与对照组相比,差异有统计学意义,与血肿周围脑组织含水量呈正相关(r=0.949,P<0.01)。结论大鼠ICH后MMP-9蛋白的表达是ICH后脑水肿形成主要因素。     

粒细胞集落刺激因子对脑出血大鼠神经保护作用及作用机制研究

目的 通过研究粒细胞集落刺激因子(G-CSF)对脑出血大鼠(ICH)基质金属蛋白酶-9(MMP-9)、胶质纤维酸性蛋白(GFAP)的影响,探讨G-CSF的神经保护作用及机制.方法 健康雄性SD大鼠随机分为假手术组、模型组、治疗组.断尾取自体血法制备大鼠ICH模型,治疗组于造模1h后腹腔注射重组粒细胞集落刺激因子(rhG-CSF)60μg/kg.三组大鼠于术后6h、24 h、48 h、72 h、7d和10d处死,免疫组化检测血肿周围MMP-9和GFAP的动态表达.结果 模型组各时点MMP-9表达明显高于假手术组(P＜0.05);模型组MMP-9表达在48 h、72 h最明显,与组内6h、24 h、7d、10d比较差异有显著性(P＜0.05);治疗组各时点MMP-9表达显著低于模型组(P＜0.05).假手术组未见GFAP阳性细胞的表达;模型组6h出现少量GFAP阳性细胞表达,48 h开始增多,72 h有大量表达,7d达高峰,10d阳性细胞表达减少;治疗组GFAP阳性细胞表达6h与模型组相似,24 h、48 h、72 h、7d和10d较模型组明显减少(P＜0.05).结论 G-CSF可有效抑制ICH大鼠MMP-9表达减轻脑水肿程度;并且可以抑制星形胶质细胞过度活化,参与G-CSF对ICH大鼠的神经保护作用.     

大鼠脑出血后脑肺组织NF-κB的表达及其在急性肺损伤中的作用

目的 探讨NF-κB在脑出血(intracerebral hemorrhage,ICH)后在脑、肺组织的表达及在急性肺损伤(acute lung injury ,ALI)中的作用.方法 采用自体血尾状核注入法制备脑出血大鼠模型.将35只大鼠随机分为假手术组(5只),脑出血组(30只),脑出血组又分为6 、12、 24 、48 h和3、5 d 6个亚组.应用HE染色观察各组脑出血周围组织与肺组织的炎症反应情况.RT-PCR法检测脑和肺组织中NF-κB p65 mRNA的表达.放射免疫法测定血清中TNF-α和IL-1β的含量.结果 脑出血后12 h脑水肿明显,24 h血肿周围炎症细胞浸润增多,48 h左右炎症反应最重;脑出血6 h即有间质性肺炎表现和局灶性肺气肿,48～72 h炎症反应达高峰,肺泡结构破坏明显;与假手术组相比,NF-κB p65 mRNA于脑出血6 h在脑血肿周围组织与肺组织中表达均开始增高(P＜0.01),48 h均达高峰(P＜0.01),3～5 d表达仍高于假手术组(P＜0.01);血清TNF-α含量在脑出血6 h开始增高(P＜0.01),48 h最高(P＜0.01),5 d时仍高于假手术组(P＜0.01);IL-1β在脑出血各组中含量均无增高.结论 脑出血可以通过引发炎症反应导致急性肺损伤,NF-кB在其病理生理学过程中起重要作用.     

安脑平冲汤对大鼠脑出血后脑水肿及MMP-2/9蛋白表达的影响

目的观察安脑平冲汤对大鼠脑出血后脑组织含水量和MMP-2/9蛋白表达的影响。方法以Ⅳ型胶原酶注射法建立大鼠脑出血模型,观察正常组及假手术组、模型组、治疗组术后12 h、24 h、48 h、72 h、120 h大鼠脑组织含水量及MMP-2/9蛋白的表达水平。结果 (1)脑组织含水量:模型组术后各时点均高于假手术组(P<0.05),而治疗组各时点均低于模型组(P<0.05)。(2)MMP-2/9水平:模型组术后各时点较假手术组均升高(P<0.01);而治疗组与模型组比较,MMP-2蛋白表达在24～120h时点降低(P<0.05),12 h时点差异不明显(P>0.05);MMP-9蛋白表达在24 h、48h、120 h时点降低(P<0.05),12h和72h时差异不明显(P>0.05)。结论安脑平冲汤可以在一定程度上减少MMP-2/9蛋白的表达,减轻脑出血后脑水肿。     

G-CSF对大鼠脑出血后脑水肿及基质金属蛋白酶-9的影响

目的:探讨粒细胞集落刺激因子(G-CSF)对大鼠脑出血(ICH)后脑水肿的影响及可能机制。方法:健康雄性SD大鼠随机分为假手术组、模型组、治疗组。断尾取自体血法制备大鼠ICH模型,治疗组于造模1h后腹腔注射重组粒细胞集落刺激因子(rhG-CSF)60μg/kg。3组大鼠于术后6h、12h、24h、48h、72h、7d处死,干湿重法测定脑组织含水量、免疫组化染色观察MMP-9的动态表达。结果:模型组脑组织含水量明显高于假手术组(P<0.05),在造模后48h、72h最明显,且与6h、12h、24h、7d相比差异显著(P<0.05);治疗组脑组织含水量明显低于模型组(P<0.05)。模型组脑组织MMP-9的表达明显高于假手术组(P<0.05);治疗组各时间点MMP-9的表达低于模型组(P<0.05)。结论:G-CSF可减轻ICH后脑水肿程度,其机制可能与G-CSF抑制MMP-9表达密切相关。     

大鼠脑出血后血肿周围脑水肿及其与NF-kB和IL-6表达的关系

目的 探讨大鼠脑出血( ICH)后核因子-kB(NF-kB)和白介素-6(IL-6)动态表达情况与血肿周围脑水肿的相互关系.方法 120只SD大鼠随机分为1个假手术组和5个ICH模型组,每组20只.采用右侧脑纹状体内注射新鲜自体不凝血建立大鼠脑出血模型.干/湿重法测定脑组织含水量(BWC),尼氏染色显微镜下观察脑组织病理学变化,免疫荧光检测NF-kB和IL-6蛋白的表达部位,免疫组织化学方法检测NF-kB和IL-6蛋白的表达变化.结果 ICH模型组神经细胞内尼氏体丢失明显,脑组织血肿周围NF-kB和IL-6在脑出血后6h开始表达,随时间延长蛋白表达增加,3d达到高峰.各ICH模型组与假手术组之间有统计学差异(P＜0.05);脑出血后NF-kB、IL-6表达量与脑水肿周围含水量呈正相关(P＜0.05).结论 脑出血后NF-kB高表达,说明活化的NF-kB可进一步诱导细胞因子IL-6表达,加重炎症反应,参与出血性脑水肿的病理过程.     

缺氧缺血性脑损伤新生鼠MMP-9 mRNA和紧密连接蛋白ZO-1 mRNA的表达

目的:研究基质金属蛋白酶-9(MMP-9)mRNA及紧密连接(TJ)蛋白ZO-1 mRNA的表达在缺氧缺血性脑损伤(HIBD)中的作用和意义.方法:36只7日龄新生SD大鼠按照完全随机化方法分为对照组、HIBD 3、6、24、48、72 h组,每组6只.观察HIBD后结扎侧大脑半球的大体形态变化,同时采用Real-time Q-PCR方法测定脑皮层组织MMP-9mRNA和ZO-1 mRNA表达.结果:(1)对照组大鼠MMP-9mRNA表达水平极低(与HIBD组比较P＜0.05),在HIBD 3 h组其表达开始增高,24 h达高峰,72 h仍维持较高的水平.(2)对照组大鼠ZO-1 mRNA表达水平较高(与HIBD组比较P＜0.05),在HIBD 3 h组其表达开始降低,24 h降至最低,72 h仍维持较低水平.(3)缺血缺氧后MMP-9mRNA的表达与ZO-1 mRNA的表达在时间上呈负相关(r=-0.659,P＜0.05).(4)新生大鼠HIBD后24～48 h结扎侧大脑半球脑水肿明显.结论:新生鼠脑缺氧缺血后MMP-9表达升高,TJ蛋白ZO-1表达减少,提示它们可能参与了HIBD的发病过程.     

破血化瘀填精补髓法对脑出血大鼠脑组织含水量的影响

目的观察破血化瘀,填精补髓法对实验性大鼠脑出血(ICH)后脑水含量的变化及灶周组织MMP-2/MMP-9蛋白表达的影响。方法选用Wistar大鼠,以自体血注入法制备ICH模型,观察脑出血方干预后脑水含量和MMP-2/MMP-9蛋白表达的变化。结果模型组ICH后脑水含量明显高于假手术组,P<0.01;治疗组与模型组相比,中剂量组1 d时和高剂量组各时间点脑水含量均明显降低,P<0.01。模型组与假手术组相比,MMP-2水平显著降低,P<0.01;MMP-2蛋白1 d开始表达,随时间持续增长;治疗组与模型组相比较,中剂量组在3、7 d时明显增高,P<0.05;高剂量组在3、7 d时显著增高,P<0.01。MMP-9水平:模型组与假手术组相比显著降低,P<0.01;MMP-9蛋白1 d开始表达,在3 d达高峰,7 d时降低;治疗组与模型组相比较,低剂量组7 d时显著降低,P<0.01;高剂量组1d时明显降低,P<0.05,3、7 d时显著降低,P<0.01。结论脑出血方能有效降低ICH后脑水含量,拮抗脑水肿的发生,可能是通过抑制MMP-2/MMP-9蛋白表达而减少脑水含量。     

大鼠脑出血后脑含水量的变化及水蛭素的干预作用

目的：探讨大鼠脑出血（ICH）后脑含水量与血脑屏障（BBB）通透性之间的变化及水蛭素对ICH后脑水肿的作用.方法：采用自体动脉血注入大鼠尾状核建立脑出血模型,将75只大鼠分成：对照组、脑出血组、水蛭素组,各实验组分6 h、1 d、3d、5 d、7 d等5个时间点.采用干湿重法测定不同时间点的脑含水量;按BELAYEV法使用伊文思蓝测定BBB通透性.结果：脑水含量和BBB通透性在ICH后6 h开始升高,3 d达到高峰,5 d到7 d开始下降,二者之间存在明显的相关性（r=0.815,P＜0.01）.水蛭素能够降低各个时间点的脑水含量和BBB通透性.结论：BBB通透性增高与脑水肿的形成密切相关;水蛭素可抑制ICH后的脑水肿形成,抗凝血酶治疗可能成为ICH后脑水肿的一种可行治疗方法.     

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.