同种异体肾上腺髓质植人蛛网膜下腔治疗大鼠慢性痛的实验研究

目的研究同种异体肾上腺髓质植入蛛网膜下腔对慢性痛模型大鼠痛行为的影响及其发生机制.方法将同种大鼠肾上腺髓质嗜铬细胞异体移植入脊髓背角蛛网膜下腔,6w后进行组织学检查,并用高压液相色谱法检测脑脊液中嗜铬细胞释放的肾上腺素(E),同时观察移植的嗜铬细胞在1～8w内减轻痛行为的表现.结果移植6w后,嗜铬细胞浆内有明显的嗜铬颗粒,分泌的肾上腺素明显高于对照组.移植后1～8w内动物的屈关节嘶叫反应评分、关节的肿胀程度、体重的减轻程度,移植组均明显低于对照组(P<0.05).结论移植的嗜铬细胞在蛛网膜下腔能够存活并释放肾上腺素镇痛活性物质,减轻慢性痛模型大鼠的痛表现.     

同种异体肾上腺髓质植入蛛网膜下腔治疗大鼠慢性痛的实验研究

目的：研究同种异体肾上朱髓质植入蛛网膜下腔对慢性痛模型大鼠痛行为的影响及其发生机制,方法：将同种大鼠肾上腺髓质嗜铬细胞异体移植入脊髓背角蛛网膜下腔,6w后进行组织学检查,并用高压液相色谱法检测脑脊液中嗜铬细胞释放的肾上腺素（E）,同时观察移植的嗜 细胞在1－8w内减轻痛行为的表现。结果：移植6W后,铬细胞浆内有明显的嗜铬颗粒,分泌的肾上腺素明显高于对照组。移植后1－8w内动物 屈关节嘶叫反应评分,关节的肿胀程度,体重的减轻程度,移植组均明显低于对照组（P＜0．05）,结论：移植的嗜铬细胞在蛛网膜下腔能够存活并释放肾上腺素镇痛活性物质,减轻慢性痛模型大量的痛表现。     

单涎酸神经节苷脂对嗜铬细胞的成活和形态学的影响

将同种大鼠的肾上腺髓质(AT组)和经单涎酸神经节苷脂(GM1)处理后的肾上腺髓质(AGT组)，分别移植到帕金森氏模型大鼠的纹状体内。移植后8周将实验动物的脑组织切片，用嗜铬颗粒A的免疫细胞化学染色法显示，发现在移植区内有许多嗜铬阳性细胞，AGT组细胞数目明显多于AT组，二者有极显著性差异(P<0．01)。     

嗜铬蛋白A和神经特异性烯醇化酶及突触素在肾上腺皮质中的分布特点

目的:通过免疫组化方法,研究肾上腺皮质分泌物嗜铬蛋白A(CgA)、神经特异性烯醇化酶(NSE)和突触素(SYN)在肾上腺皮质的分布特点,为进一步深入研究皮髓质之间的相互作用奠定基础. 方法:运用免疫组化方法对肾上腺髓质增生、嗜铬细胞瘤和嗜铬细胞癌56份组织标本进行CgA、NSE和SYN染色,以正常肾上腺作为对照,观察其在皮质中的分布特点. 结果:肾上腺嗜铬细胞瘤和嗜铬细胞癌的皮质中均可见CgA染色阳性细胞,髓质增生和正常肾上腺病例皮质CgA染色阴性;肾上腺髓质增生和嗜铬细胞癌皮质NSE染色呈阳性,嗜铬细胞瘤和正常肾上腺皮质NSE染色呈阴性;肾上腺髓质增生、嗜铬细胞瘤的皮质中SYN染色呈阳性,正常肾上腺嗜铬细胞癌皮质SYN染色呈阴性. 结论:①肾上腺皮质CgA、NSE和SYN分布特点可以帮助鉴别肾上腺髓质增生、嗜铬细胞瘤和嗜铬细胞癌的异同;②肾上腺皮髓质之间联系紧密,受共同机制所调控,除经典的下丘脑-垂体-肾上腺轴和肾素-血管紧张素-醛固酮系统外,肾上腺皮髓质之间存在相互调节的解剖学和内分泌学基础.     

肾上腺髓质脑内移植治疗震颤麻痹 Ⅰ.基础实验研究

将肾上腺髓质组织块植入同种拟震颤麻痹大鼠模型脑内,移植物成活并发挥功能,受体大鼠的不正常行为获得改善。应用诱发荧光组化技术(SPG 法)检查出植入的肾上腺髓质嗜铬细胞含儿茶酚胺。在成活的移植细胞中,有些仍保留典型的正常嗜铬细胞形态,而其他的却向着肾上腺素能神经元的形态变化,有的呈椭圆形甚或发出短粗的突起。应用荧光分光光度计分析受体脑组织各部的儿茶酚胺含量,移植区脑组织的多巴胺含量很高。移植物分泌的多巴胺不间断地弥散入纹状体,直接作用于多巴胺受体起作用。所谓“过量移植”比较常量移植更有效地校正动物的异常行为。本文结果对于将肾上腺髓质脑内移植术过渡到临床应用治疗震颤麻痹具有重要意义。     

帕金森病模型大鼠纹状体肾上腺髓质移植后突触结构的观察

目的 :对移植到帕金森病模型大鼠纹状体内的嗜铬细胞与脑细胞之间形成的突触结构进行观察。方法 :实验用Wistar大鼠 4 0只 ,注射 6羟多巴胺 ( 6 -OHDA)破坏大鼠一侧黑质纹状体系统 ,制成实验性帕金森病 (PD)动物模型。将肾上腺髓质植入PD模型大鼠纹状体内 ,移植后定期检测大鼠阿朴吗啡诱发旋转行为 ,并用电镜观察嗜铬细胞与脑细胞之间形成的突触结构。结果 :移植组大鼠的阿朴吗啡诱发旋转行为明显改善 (P <0 0 5)。电镜观察发现嗜铬细胞与脑细胞之间形成突触结构 ,以嗜铬细胞为突触前膜的占 72 88% ;以嗜铬细胞为突触后膜的占 2 7 12 %。结论 :移植肾上腺髓质后 ,模型大鼠阿朴吗啡诱发旋转行为明显改善 ,嗜铬细胞与宿主脑细胞之间形成突触联系 ,并以嗜铬细胞为突触前膜的为多。     

神经元特异性烯醇酶在肾上腺嗜铬细胞内超微结构定位

取生后7d、30d及成年大鼠和成年猫的肾上腺髓质,经HRP-SPA免疫细胞化学染色,观察嗜铬细胞内神经元特异性烯醇酶(NSE)的超微结构定位。结果显示:大鼠和猫的嗜铬细胞内NSE与胺共存于嗜铬颗粒内。生后早期的大鼠,嗜铬细胞内阳性反应产物为致密核心颗粒,如同合成和贮存去甲肾上腺素的NA细胞内所含的颗粒;在成年大鼠和猫的嗜铬细胞内,绝大部分阳性颗粒呈指环状,与合成、贮存肾上腺素的A细胞内的颗粒形态相似。提示:大鼠生后早期的嗜铬细胞主要是NA细胞。随着发育,成年后则以A细胞为主。作者对新发现的NSE与胺共存的意义进行了讨论。     

嗜铬细胞瘤手术治疗的护理体会

嗜铬细胞瘤多发生在年轻人。大多数为良性肿瘤，约6％～10％为恶性肿瘤。它起源于肾上腺髓质、交感神经节及其他部位的嗜铬组织。嗜铬细胞是分泌和贮存儿茶酚胺类激素(肾上腺素、去甲肾上腺索)的场所。这种肿瘤持续或间断地释放大量儿茶酚胺，引起持续性和阵发性高血压及多个器官功能和代谢紊乱。     

肾上腺髓质增生的研究进展

肾上腺髓质由嗜铬细胞（产生肾上腺素、去甲肾上腺素、嗜铬粒蛋白和神经肽）和神经节细胞组成.嗜铬细胞是起源于神经嵴的神经内分泌细胞,在交感神经节前纤维、背侧神经根和其他神经突触释放的胆碱能或肽能神经递质刺激下分泌儿茶酚胺.     

牛嗜铬细胞体外培养及其分泌多巴胺的测定

为给肾上腺髓质细胞移植治疗帕金森病提供理论依据 ,观察正常体外培养和冷冻复苏后牛肾上腺嗜铬细胞的形态变化 ,并检测培养液中的多巴胺含量。结果 :悬浮培养嗜铬细胞在培养液中集聚成团 ,始终保持圆形 ,并分泌多巴胺 ,在冷冻复苏后仍存活 ;单层贴壁培养嗜铬细胞于贴壁后开始变形 ,伸出短的突起 ,但于 1周后开始退化 ;体外培养嗜铬细胞分泌多巴胺在 5～ 6d达高峰。结果提示 :肾上腺嗜铬细胞可作为脑内移植治疗帕金森病的细胞来源     

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.