别嘌呤醇对环孢素A肾毒性的保护作用

目的 :研究环孢霉素A(CsA)对肾功能、肾小球内超氧化物、血栓素B2 (thromboxaneB2 ,TXB2 )形成的影响 ,探讨抗氧化药物别嘌呤醇对环孢素A肾毒性的保护作用 .方法 :4组成熟雄性Wistar大鼠分别接受CsA (30mg·kg-1·d-1)、别嘌呤醇 (10mg·kg-1·d-1)、CsA (30mg·kg-1·d-1)加别嘌呤醇 (10mg·kg-1·d-1)、CsA溶剂橄榄油治疗 30d .结果 :CsA使肾功能减退、肾小球内超氧化物、TXB2 形成增加 .别嘌呤醇降低CsA的肾毒性副作用 ,并使肾小球内超氧化物、TXB2 量减少 .结论 :CsA引起的急性肾功能衰竭可能与肾小球内超氧化物、TXB2 形成增加有关 .同时应用别嘌呤醇使肾小球内超氧化物、TXB2 量减少 ,对CsA的肾毒性有保护作用     

川芎嗪对缺血再灌注损伤肾脏细胞凋亡的影响

目的　探讨川芎嗪对缺血再灌注损伤大鼠肾脏细胞凋亡的影响及凋亡与再灌注损伤的关系 .方法　观察川芎嗪注射液干预下 ,大鼠肾脏缺血 6 0 min,再灌注 2 4h后 ,血浆超氧化物歧化酶 (SOD)、脂质过氧化物丙二醇 (MDA)、内皮素 - 1(ET- 1)变化 ,及其对肾脏细胞凋亡的影响 .结果　川芎嗪治疗组和缺血再灌注组血浆 SOD分别是 (10 3± 18) KNU· L- 1和 (88± 14) KNU· L- 1 ,MDA分别是 (9.0± 0 .8)μmol· L- 1和 (10 .7± 0 .9) μmol· L- 1 ,ET- 1分别是 (131± 43) ng· L- 1和 (175± 47) ng· L- 1 ,川芎嗪治疗组 SOD水平显著性高于缺血再灌注组 (P<0 .0 5 ) ,而 MDA和 ET- 1水平显著性低于缺血再灌注组 (P<0 .0 5 ) .川芎嗪组和缺血再灌注组肾脏细胞凋亡指数分别是 (5 .75± 3.0 2 ) %和 (8.97± 3.41) %,川芎嗪组显著性低于缺血再灌注组 (P<0 .0 5 ) .结论　川芎嗪减轻肾脏缺血再灌注损伤 ,降低肾脏细胞凋亡指数 .     

托吡酯对癫痫大鼠海马神经细胞凋亡的保护作用

目的 :探讨托吡酯 (TPM)对癫痫发作大鼠海马神经元凋亡的影响及其可能的机制。方法 :采用戊四氮致痫模型 ,大鼠癫痫发作后连续给予托吡酯 (80 mg· kg- 1 · d- 1 和 4 0 mg· kg- 1 · d- 1 ) ,共 14 d。以 TU NEL方法标记 DNA片段 ,原位检测海马 CA1和 CA3区的神经细胞凋亡。结果 :各组大鼠海马 CA1、CA3区均出现 TU NEL阳性细胞。对照组海马 CA1、CA3区 TUNEL阳性细胞数分别为 (35 .83± 4 .5 8)个和 (36 .83± 3.87)个 ;4 0 mg· kg- 1 · d- 1 托吡酯组分别为 (31.5 2± 3.4 3)个和 (32 .35± 4 .6 9)个 ;80 mg· kg- 1 · d- 1 托吡酯组为 (2 1.17± 3.0 6 )个和 (2 1.16± 3.87)个。 80 mg· kg- 1 · d- 1 托吡酯组与对照组比较存在极显著差异 (P<0 .0 0 1) ,4 0 mg· kg- 1 · d- 1 托吡酯组与对照组相比无显著差异 (P>0 .0 5 )。结论 :TPM对癫痫发作后神经元凋亡具有一定的保护作用。     

不同剂量吡咯列酮对单肾切除糖尿病大鼠作用的实验研究

目的　观察不同剂量盐酸吡咯列酮对单肾切除糖尿病大鼠模型慢性肾脏损害的作用。方法　采用单肾切除的小剂量链脲佐菌素诱导性糖尿病大鼠 ,随机均分为单肾切除对照 (CTR)组、糖尿病非治疗 (DM )组、3mg·kg-1·d-1吡咯列酮 (DM LP)治疗组、9mg·kg-1·d-1吡咯列酮治疗组和 2 0mg·kg-1·d-1吡咯列酮治疗组共 5组。药物灌胃 10周 ,收集2 4h尿液标本 ,测定血糖和动脉收缩压后处死大鼠 ,并留取血标本和肾脏组织。结果　与CTR组相比 ,另 4组糖尿病大鼠的血清胰岛素水平均明显降低 ,DM组表现出明显的高糖和高脂血症 ,动脉收缩压、2 4h尿蛋白量、肾小球细胞外基质(ECM)沉积和相对肾重均明显升高。 3mg·kg-1·d-1吡咯列酮在不影响血糖、血脂和血压的情况下 ,能明显减轻蛋白尿和肾小球ECM沉积 ,降低相对肾重 ;9mg·kg-1·d-1吡咯列酮能明显改善血糖和高三酰甘油血症 ,但不影响动脉收缩压和高胆固醇血症 ,其减轻蛋白尿和肾小球ECM沉积以及降低相对肾重的作用与 3mg·kg-1·d-1剂量治疗组的差异无显著性 ;2 0mg·kg-1·d-1吡咯列酮除有与 9mg·kg-1·d-1剂量相似程度改善高血糖和高三酰甘油血症的作用外 ,还能明显降低大鼠动脉收缩压 ;其减轻蛋白尿、肾小球ECM沉积和肾脏肥大的作用较 3和 9mg·kg-1·d-1剂量进一     

环磷酰胺治疗儿童肾病综合征型紫癜性肾炎体会

目的探讨环磷酰胺(CTX)治疗儿童肾病综合征型紫癜性肾炎的疗效。方法48例肾病综合征型紫癜性肾炎随机分为治疗组(n=25)与对照组(n=23),治疗组给予泼尼松1.5~2.0mg·kg-1·d-1口服,双嘧达莫1~2g·kg-1·d-1口服,并用CTX8~10mg·kg-1·d-1,加入生理盐水100ml中静滴,2d为1个疗程,每4周给予1个疗程,总累积量<150mg/kg;对照组用泼尼松1.5~2.0mg·kg-1·d-1口服,双嘧达莫1~2g·kg-1·d-1口服。4个疗程后观察比较2组疗效。结果治疗组总有效率为96.0%,疗效优于对照组的82.6%(P<0.05)。2组治疗前后24小时尿蛋白定量、血清白蛋白、总胆固醇、甘油三酯均有显著差异(P<0.05或P<0.01),且治疗组明显优越于对照组(P<0.01),无明显不良反应。结论采用小剂量、长间隔CTX治疗儿童肾病综合征型紫癜性肾炎疗效好,不良反应少。     

羟基喜树碱诱导大鼠肾脏移植免疫耐受机制的探讨

目的 :以羟基喜树碱 (HCPT)和环孢素A(CsA)诱导异基因大鼠肾脏移植免疫耐受 ,并探讨免疫耐受的形成机制 .方法 :以近交系DA大鼠为供者 ,近交系Lewis大鼠为受者行同种异体原位肾脏移植 .移植后受者大鼠接受不同剂量HCPT ,CsA治疗或二者联合应用 .应用RT PCR方法检测移植物内及受者脾内细胞因子mRNA表达情况 .结果 :各组移植后存活时间显著长于对照组 .C组 (HCPT 2mg-1·kg·d-1)中 4 /10和E组 (HCPT 1 0mg·kg-1·d-1+CsA 10mg·kg-1·d-1)中 5 /10受者大鼠形成特异性免疫耐受 .耐受组IL4 ,IL10mRNA表达明显高于排斥组 ,而IL2 ,IFNγ明显低于排斥组 .受者脾内细胞因子表达量近似于移植物内 .结论 :大剂量HCPT或小剂量HCPT与CsA合用可诱导异基因大鼠肾脏移植免疫耐受 .细胞因子偏向Th2亚类是免疫耐受形成机制之一 .受者脾内细胞因子mR NA表达与移植物内表达近似     

血管紧张素Ⅱ及其受体在慢性环孢素A肾毒性大鼠肾组织中的表达

\[摘要\]目的观察血管紧张素Ⅱ(AngⅡ) 及其受体在慢性环孢素A(CsA)肾毒性中的表达。方法Sprague-Dawley大鼠皮下注射CsA(15 mg·kg-1·d-1) 4周, 建立慢性CsA肾毒性模型;正常对照组皮下注射橄榄油。检测各组大鼠的体重、收缩期血压、血CsA浓度、血清肌酐、肌酐清除率;三色染色观察肾小管间质纤维化;免疫组织化学染色和蛋白质免疫印迹法分别检测AngⅡ及其受体AT1和AT2的表达。结果慢性 CsA 肾毒性组表现为体重减少、血肌酐上升、肌酐清除率下降、肾小管间质带状纤维化 (P<0.01)。与对照组相比,毒性组大鼠AngⅡ的免疫活性明显增加(47±7 vs 13±4, P<0.01),主要分布于入球动脉的肾小球旁器,与肾小管间质纤维化程度紧密相关(r=0.769, P<0.001)。免疫印迹显示毒性组AngⅡ受体 AT1 的表达明显减少\[(114±14)% vs (42±6)%, P<0.01\],而 AT2 的表达增加\[(129±23)% vs (469±43)%, P<0.01\]。结论在慢性CsA肾毒性中,肾内肾素血管紧张素被激活,表现为AngⅡ免疫活性增加,这种AngⅡ免疫活性与肾小管间质纤维化紧密相关。     

卡托普利对大鼠肺纤维化及肺上皮细胞凋亡的影响

目的:探讨卡托普利对实验大鼠肺纤维化的干预作用及可能的作用机制。方法:60只SD大鼠经气管内灌注博来霉素诱导肺纤维化,随机分为博莱霉素(BLM)组、卡托普利(CAP1)和CAP2组,分别给予生理盐水、卡托普利50mg·kg-1·d-1和60mg·kg-1·d-1灌胃,并于1,7,14,28d各处死5只,取肺组织行嗜伊红染色组织学观察及羟脯氨酸测定,评价肺泡炎和肺纤维化程度、免疫组织化学及电镜检查评价肺上皮细胞凋亡程度。结果:与BLM组比较CAP1组和CAP2组肺泡炎及肺纤维化程度明显减轻(P<0.05),气道上皮细胞和肺泡上皮细胞凋亡程度显著改善(P<0.01),CAP1和CAP2两组间无显著性差异。结论:卡托普利能有效抑制博来霉素诱导的肺纤维化,其可能的抗纤维化机制之一是抑制肺上皮细胞凋亡。     

线粒体膜通透性转换作用对再灌注损伤后肝细胞凋亡的影响

目的观察大鼠肝脏常温缺血再灌注后肝细胞线粒体通透性转换(mitochondrial permeability transition,MPT)作用及其与肝细胞凋亡的关系;同时观察线粒体膜通透性转换孔(mitochondrial permeability transition pore,PTP)开放抑制剂环孢素A(CsA)对MPT的抑制作用,以及对肝细胞凋亡的影响和可能的机制.方法将SD大鼠随机分为3组:假手术组、缺血再灌注组(I/R)、CsA组(I/R CsA).CsA组术前连续给予CsA 10 mg·kg-1·d-1灌胃4 d,其余组给予等量生理盐水.大鼠热缺血再灌注模型参考Nauta的方法,热缺血时间60 min,分别于再灌注0、1、6、24、72 h等不同时相收取肝组织标本,免疫组化法检测细胞质活性caspase-3;Western blot检测胞浆细胞色素C,TUNEL法检测肝细胞凋亡.结果缺血再灌注引起肝细胞线粒体发生MPT作用,细胞色素C由线粒体释放入细胞质,再灌注后0、1、6、24 h,I/R组及CsA组与假手术组相比,细胞质caspase-3的阳性程度明显增强,肝细胞凋亡明显增多(P<.01);CsA组与L/R组相比,再灌注1、6 h细胞色素C释放显著减少,再灌注1、6、24 h,caspase-3阳性程度明显下降(P<.01);再灌注后6、24、72 h,细胞凋亡明显减少(P<.05).结论缺血再灌注后肝细胞线粒体发生MPT作用可能是引起肝细胞凋亡的关键环节;CsA可能通过抑制PT孔的开放而抑制MPT作用、减少再灌注后细胞色素C释放、抑制caspase-3活化、缓解再灌注后大鼠肝细胞的凋亡.     

吡那地尔对大鼠心肌缺血/再灌注时细胞凋亡及fas基因表达的影响

目的　探讨 ATP敏感性钾通道 (KATP)开放剂吡那地尔对大鼠心肌缺血 /再灌注时心肌细胞凋亡及 fas基因蛋白表达的调节作用 .方法　 4 0只大鼠随机分成 4组 :1假手术组 (仅穿线而不结扎 ,观察 6 .5 h) ;2缺血 /再灌注组(缺血 30 min,再灌注 6 h) ;3吡那地尔组 (缺血前 10 m in静推吡那地尔 0 .2 mg· kg- 1 ,然后缺血 30 min/再灌注 6 h) ;4吡那地尔 +优降糖组 (缺血前 10 min静推吡那地尔 0 .2 m g·kg- 1 +优降糖 3mg·kg- 1 ,然后缺血 30 min/再灌注 6 h) .称质量法计算心肌梗死范围 ,以缺口末端标记法 (TUNEL)检测凋亡细胞 ,以 SABC免疫组化法检测 fas蛋白的表达 .结果　缺血 /再灌注组出现显著的心肌细胞凋亡 ,伴有 fas蛋白表达指数升高 (P<0 .0 1vs假手术组 ) ;吡那地尔可抑制心肌细胞凋亡 ,并显著下调 fas蛋白的表达 (P<0 .0 5 ) ,而优降糖可取消吡那地尔的作用 .结论　细胞凋亡及 fas基因表达改变参与了心肌缺血 /再灌注损伤过程 ,KATP开放剂 (吡那地尔 )可抑制心肌细胞凋亡、下调 fas基因的蛋白表达 .     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.