缺氧时家兔心钠素、醛固酮及血浆离子的变化

本实验观察了家兔在缺氧条件下血浆心钠素、醛固酮及血浆Na~+、K~+、Ca~(++)、 Mg~(++)、Zn~(++)离子的变化。结果表明:急性缺氧时血浆心钠素明显升高,而醛固酮升高不明显,但对照组血浆醛固酮升高具有统计学意义。低氧适应14天后再暴露于急性缺氧条件下,血浆心钠素升高不明显,而血浆醛固酮明显升高,并伴有血浆Mg~(++)升高,K~+降低。这些结果提示:心钠素参与缺氧应激反应;在缺氧不同时相里,调节水,电解质平衡的激素的反应各不相同。     

血管紧张素受体阻断剂对大鼠脑损伤致心肌损害的作用

【目的】探讨急性脑损伤后心肌损害、血浆和心肌局部血管紧张素Ⅱ及其受体的变化以及预先应用血管紧张素受体阻断剂对其的影响。【方法】建立颅脑损伤及血管紧张素受体阻滞剂（ARB）药物干预模型,测定血浆AngⅡ水平和血清肌酸磷酸激酶同工酶含量,免疫组织化学方法检测心肌AngⅡ和血管紧张素受体1表达,并观察心肌HE染色及超微结构病理形态学改变。【结果】大鼠颅脑损伤后血浆AngⅡ、心肌组织AngⅡ和AT1R水平显著升高。血清CK-MB含量显著增高,HE染色和超微结构的病理观察可见心肌损害。预先应用ARB心肌组织AT1R表达及血清CK-MB水平比单纯损伤大鼠显著降低,HE染色和超微结构可见心肌损伤程度减轻。【结论】颅脑损伤可引起明显的心肌损害。ARB具有防止颅脑损伤后心肌损害的作用。肾素血管紧张素系统可能是参与颅脑损伤后心肌损害的机制之一。     

大鼠颅脑损伤后血管紧张素及其受体变化与β受体阻断剂对其的影响

目的探讨颅脑损伤后心肌损害、循环和心肌局部血管紧张素Ⅱ(AngⅡ)及其受体的变化以及预先应用β受体阻断剂(β-RB)对其的影响。方法建立颅脑损伤及药物干预模型,测定血浆AngⅡ水平和血清肌酸磷酸激酶同工酶(MBisoen-zymeofcreatinekinase,CK-MB)含量,免疫组织化学方法检测心肌AngⅡ和血管紧张素受体1(AT1R)表达,并观察心肌HE染色及超微结构病理形态学改变。结果大鼠颅脑损伤后血浆AngⅡ、心肌组织AngⅡ和AT1R水平显著升高(P<0.05)。血清CK-MB含量显著增高,HE染色和超微结构的病理观察可见心肌损害。预先应用比索洛尔,血浆AngⅡ和血清CK-MB水平比单纯损伤大鼠显著降低(P<0.05),HE染色和超微结构可见心肌损伤程度减轻。结论颅脑损伤可引起明显的心肌损害。肾素-血管紧张素系统(RAS)可能是参与颅脑损伤后心肌损害的机制之一。β-RB具有防止颅脑损伤后心肌损害的作用。     

滋肾宁神胶囊对肾上腺皮质激素加夹尾激怒致肝肾阴虚模型大鼠的作用

目的 研究滋肾宁神胶囊对肝肾阴虚模型大鼠的作用.方法 通过灌服肾上腺皮质激素加夹尾激怒,诱导大鼠肝肾阴虚模型,并观察滋肾宁神胶囊对大鼠血浆β-EP、cAMP/cGMP,血清LH、FSH含量的影响.结果 与空白对照唛相比,模型组cAMP明显升高,cGMP明显降低,cAMP/cGMP明显升高,说明造模成功.与模型组相比,滋肾宁神胶囊能明显降低cAMP、cAMP/cGMP及FSH水平, 明显提高cGMP含量,对LH有一定的降低作用.结论 滋肾宁神胶囊具有滋补肝肾作用,可有效拮抗外源性糖皮质激素对HPA轴的抑制作用.     

缺血后处理对缺血再灌注大鼠心肌间质的保护作用

目的：探讨缺血后处理对缺血再灌注大鼠心肌间质的保护作用及与心功能的关系。方法：24只SD大鼠随机分为3组,假手术组（SC组）、缺血再灌注组（I/R组）和缺血后处理组（IPTC组）。观察各组心肌羟脯氨酸含量和胶原纤维含量,记录左室血流动力学变化、测定血浆中MDA和SOD浓度改变及观察心肌超微结构变化。结果：IPTC组心肌羟脯氨酸含量、胶原纤维含量、左室舒缩功能明显高于I/R组,心脏超微结构损伤明显减轻。同时,血浆SOD活力增强而MDA含量降低。结论：IPTC对I/R大鼠心肌间质有明显的保护作用,且与心功能的保护相关。其机制可能是通过清除体内自由基、增强机体的抗氧化能力、减少心肌胶原的降解,维持左室结构而起到改善心功能的作用。     

急性缺氧后心肌超微结构的变化及其与血浆内皮素含量关系探讨

用透射电镜观察了14只wistar大鼠在急性中度缺氧后的心肌超微结构变化,结果发现,急性缺氧后心肌超微结构改变明显,主要有线粒体固缩、水肿或空泡样变;肌原纤维排列紊乱、肌节断裂;核膜皱折消失、染色质边移和细胞核周围水肿等。这些变化可能是心肌功能减退的重要病理基础。另外,急性缺氧后血浆内皮素含量明显升高,提示内皮素在心肌超微结构改变中可能起重要作用。     

缺氧大鼠血管内皮功能的变化及通心络超微粉的干预作用

目的观察缺氧大鼠血管内皮功能的变化及通心络超微粉的干预作用。方法50只大鼠随机分为空白对照组、缺氧模型组、通心络大剂量组、通心络中剂量组和通心络小剂量组。缺氧模型组与通心络组大鼠灌胃后置于常压低氧舱内,每天7h,每周6d,共计5周。实验结束后检测大鼠动脉血气分析,HE染色观察大鼠胸主动脉的形态学改变,透射电镜观察主动脉内皮细胞超微结构的改变,放射免疫均相竞争法检测大鼠血浆内皮素(ET)含量,硝酸酶还原法检测大鼠血清一氧化氮(NO)含量,双抗夹心ELISA法测定大鼠血浆血管性假血友病因子(vWF)的含量。结果与空白对照组比较,缺氧模型组大鼠动脉血PaO2显著降低(P<0.05);血浆ET-1与血清vWF水平显著升高,血清NO水平显著下降,差异均有统计学意义(P<0.01);通心络超微粉可明显升高血氧分压(P<0.05),降低血浆ET-1与血清vWF水平(P<0.05),升高血清NO水平(P<0.01)。光镜下可见缺氧模型组大鼠胸主动脉结构改变明显,透射电镜下主动脉内皮细胞超微结构明显改变,而通心络组病变减轻。结论缺氧可造成大鼠血管内皮结构破坏和功能损伤,通心络超微粉对缺氧引起的血管内皮结构破坏和功能损伤具有明显改善作用。     

硝苯啶和硫氮酮对家兔动脉粥样硬化的影响

观察硝苯啶和硫氮酮对慢性食饵性高脂血症兔动脉粥样硬化(AS)形成的影响。结果两种药物均明显减轻AS斑块的严重程度.明显降低胆固醇诱致的血浆过氧化脂质(LPO)升高和主动脉内中膜TC和钙含量,硝苯啶亦显著升高血清HDL2-ch水平,降低主动脉内中膜磷脂含量:提示影响Ca~(++)活动的药物可以有效地防治AS形成.并为Ca~(++)代谢异常导致LPO代谢障碍、TXA_2-PGI_2失衡提供了有力证据。     

辅酶Q_(10)对盐酸异丙基肾上腺素所致的大鼠心肌环死的预防作用——阻止血浆cAMP含量增加和缩小心肌坏死面积

大剂量盐酸异丙基肾上腺素(简称异丙肾)可致大鼠发生非特异性心肌坏死。探讨预防这种心肌坏死的有效措施,对预防坏死性心肌疾病有实用意义。近年来,辅酶Q_(10)对心肌的保护作用引人注目。岳中典男用辅酶Q_(10)预防异丙肾所致的大鼠心肌坏死,明显减轻了心肌坏死的程度,并认为保护心肌线粒体是辅酶Q_(10)预防心肌坏死的主要机理。探讨异丙肾致大鼠心肌坏死机理的研究表明,注射异丙肾后,大鼠血浆和心肌的cAMP含量明显增加,并由此引起心肌代谢紊乱和功能异常。提示血浆和心肌cAMP含量的变化可能与心肌坏死的发生有关。Martorana以注射二丁酰cAMP的方法使大鼠发生与异丙肾所致者相同的心肌坏死,进一步提示cAMP在异丙肾致心肌     

强心汤对实验性心肌肥厚大鼠血管紧张素Ⅱ及心肌超微结构的影响

目的 探讨中药强心汤对实验性心肌肥厚大鼠的心肌局部和血浆血管紧张素Ⅱ的影响.方法 异丙肾上腺素皮下注射连续7 d建立大鼠心肌肥厚模型.30只大鼠随机分为对照组、模型组和造模后强心汤治疗组.造模第2 d起强心汤灌胃,连续用药12周,治疗12周后处死大鼠,测量各组大鼠左心室质量指数,放射免疫法测定血浆和心肌局部血管紧张素Ⅱ的水平,观察心肌超微结构.结果 强心汤组与模型组比较,模型组血浆及心肌局部血管紧张素Ⅱ含量、左心室质量指数升高,与对照组比较差别有显著性意义(P＜0.05);强心汤组血浆及心肌局部血管紧张素Ⅱ含量、左心室质量指数明显下降(P＜0.05,P＜0.01),与模型组比较差别有显著性意义(P＜0.05);心肌超微结构损伤程度明显减轻.结论 强心汤可通过抑制心肌局部血管紧张素Ⅱ含量和改善肥厚心肌细胞超微结构发挥逆转心肌肥厚的作用.     

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.