大鼠肺放射性损伤的超微结构观察

目的观察放射性肺损伤的超微病理变化,并探讨放射性肺炎和肺纤维化的发生机制。方法SD雄性大鼠77只,分实验组63只和正常对照组14只,实验组用8MV直线加速器30、20、10Gy3个剂量一次性照射右半胸,左半胸作为实验对照,分7个时相点(1、3、7、14、28、90、180d)活杀动物,取右肺中叶组织作光、电镜观察。结果各实验组放射损伤早期(1～30d)Ⅰ型上皮损伤,吞噬细胞增多、活跃;Ⅱ型上皮激活;肺泡隔毛细血管内皮损伤、增生,血小板、红细胞聚集,微血栓形成;间质水肿。后期(60～180d)Ⅱ型上皮异常增殖,成纤维细胞/胶原增生,血管萎缩减少,肺泡纤维化。各实验组损伤病变程度与照射剂量相关。结论肺泡隔血管内皮病变、血液循环障碍和间质水肿是放射性肺损伤早期的主要病理变化,是肺纤维化的始动因素;成纤维细胞激活、Ⅱ型上皮细胞异常增殖、吞噬细胞等分别参与肺纤维化进程,是多种因素综合作用的结果。     

CT引导下经皮穿刺气管内注射平阳霉素致大鼠肺纤维化模型的建立及其病理演变

目的探讨CT引导下经皮穿刺气管内注射平阳霉素诱导大鼠肺纤维化的可行性。方法 60只成年健康SD大鼠随机分为对照组和实验组（3d、7d、14d、28d、56d）,每组10只。大鼠固定、麻醉后,CT引导下用一次性无菌注射器经颈部穿刺气管,穿刺成功后,实验组向气管内注射5mg/ml平阳霉素溶液1ml/kg,对照组注入生理盐水1ml/kg。注药后3d、7d、14d、28d、及56d,对双肺标本行HE染色及Masson染色,在每张组织切片上对肺泡炎和肺纤维化进行半定量评分。结果实验组大鼠肺泡炎和肺纤维化明显较对照组严重,实验组炎症评分以7d组最高（11.53±2.81,P〈0.01）,纤维化评分以56d组最高（7.06±1.69,P〈0.01）。结论 CT引导下经皮穿刺气管内注射平阳霉素复制大鼠肺纤维化模型是切实可行的。     

Th9细胞相关因子在肺纤维化大鼠中的作用

目的研究Th9细胞相关因子PU.1、干扰素调节因子4(IRF4)、白细胞介素4(IL-4)在肺纤维化大鼠中的作用。方法将90只SPF级SD大鼠分为健康对照组、肺纤维化组和地塞米松干预组,每组30只。每组分别在饲养第7 d、第14 d、第28 d各处死10只。气管内注射博来霉素制作肺纤维化模型。实时荧光PCR检测支气管肺泡灌洗液(BALF)PU.1、IRF4 mRNA的含量,ELISA法检测外周血IL-4含量。结果健康对照组大鼠在各时间点肺组织结构完整,无炎症反应和纤维化改变。肺纤维化组大鼠肺组织早期为肺泡炎表现,肺间质和肺泡腔内可见大量巨噬细胞等炎症细胞浸润;第14 d部分肺泡结构消失,炎症细胞浸润稍减少,肺泡间隔增宽,成纤维细胞增生;第28 d肺泡结构破坏,部分肺泡壁塌陷,肺泡间隔明显增宽,细胞外基质增生,肺组织呈广泛纤维化改变。地塞米松干预组肺泡结构存在,炎症细胞浸润、肺泡间隔增厚、肺纤维化程度明显轻于肺纤维化组。肺纤维化组各时间点BALF中PU.1 mRNA含量明显高于健康对照组。与肺纤维化组比较,地塞米松干预组PU.1 mRNA含量第14 d和第28 d明显减低,差异有统计学意义(P0.05)。肺纤维化组PU.1mRNA在第7 d表达增加,第14 d达到高峰,第28 d有所下降。肺纤维化组各时间点BALF中IRF4mRNA含量明显高于健康对照组,差异有统计学意义(P0.05)。与肺纤维化组比较,地塞米松干预组第28 d IRF4 mRNA含量明显减低,差异有统计学意义(P0.05)。肺纤维化组第14 d BALF中IRF4 mRNA含量与外周血IL-4含量呈正相关(r=0.044,P0.05)。结论 Th9细胞在致大鼠肺纤维化中起作用,该作用与转录因子PU.1和IRF4有关,IL-4可能通过激活IRF4调控Th9细胞。     

肺纤维化形成过程中大鼠成纤维细胞对肺泡Ⅱ型上皮细胞的影响

目的:研究在平阳霉素诱导的大鼠肺纤维化形成过程中肺成纤维细胞对肺泡Ⅱ型上皮细胞的影响。方法:先将大鼠分成平阳霉素组和生理盐水组,平阳霉素组气管内给药复制大鼠肺纤维化动物模型(平阳霉素3mg/kg),生理盐水组气管内注射等量生理盐水,分别于7,28 d处死平阳霉素组大鼠10只,生理盐水组大鼠4只,其中平阳霉素组及生理盐水组各取3只提取肺成纤维细胞,平阳霉素组6只提取大鼠原代Ⅱ型肺泡上皮细胞,分别进行培养。待两种细胞均已贴壁后,再进行如下分组即:①实验组:用平阳霉素组肺成纤维细胞上清液加入平阳霉素组肺泡Ⅱ型上皮细胞并培养48 h;②对照组:用生理盐水组肺成纤维细胞上清液加入平阳霉素组肺泡Ⅱ型上皮细胞并培养48 h。用半定量RT-PCR法检测实验组和对照组中肺泡Ⅱ型上皮细胞SP-A、TGF-β及HGF mRNA表达的变化。结果:①SP-A mRNA和HGF mRNA的表达实验组低于对照组(P相似文献   

化淤理肺方对肺纤维化大鼠MMP 2和TIMP 1表达的影响

目的探讨化淤理肺方对肺纤维化的干预作用和对MMP 2/TIMP 1表达的影响。方法肺纤维化Wistar雄性大鼠84只,随机分成4组:中药组、激素组、模型组和对照组。所有大鼠第7、14、28天各处死7只。经HE染色评价肺组织肺泡炎和肺纤维化程度,免疫组化检测法检测MMP 2与TIMP 1的表达。结果① 肺泡炎、肺纤维化程度评价：模型组肺泡炎和肺纤维化程度较重,且胶原纤维沉积较多;中药组可见炎性细胞较少,肺泡结构基本正常,肺泡炎与肺纤维化较轻;激素组肺泡炎及纤维化与中药组相似。 ② MMP 2蛋白的表达：中药组第7、14、28天较模型组表达明显减轻,于第14天达到高峰,此后降低,表达水平与激素组相似。③ TIMP 1蛋白表达：中药组在这3个时段的表达均较对照组增高, 但均较模型组低,且呈逐渐升高趋势。结论化淤理肺方能减轻博来霉素诱导的大鼠肺纤维化,可能是通过调节MMP 2、TIMP 1途径起作用。     

γ-干扰素对新生大鼠高氧肺纤维化的影响

目的研究γ-干扰素(IFN-γ)对新生大鼠高氧肺损伤的影响,以观察转化生长因子transforming growth factor-β(TGF-β)在新生大鼠高氧肺纤维化中的作用.方法新生大鼠随机分为:Ⅰ组-高氧对照组,Ⅱ组-高氧 IFN-γ组,Ⅲ组-空气对照组.检测暴露7d、14d、21d及28d时各组的肺组织病理学变化,肺组织TGF-β免疫组织化学染色.结果 7d时高氧对照组表现为明显的急性炎症,肺泡间隔轻度增宽,TGF-β表达强阳性;28d时出现明显的纤维化改变;高氧 IFN-γ组与空气对照组的肺组织病理改变类似,TGF-β表达弱阳性,无明显纤维增生反应.结论 IFN-γ减轻高氧诱导的纤维增生及肺泡发育与结构异常,TGF-β在高氧诱导的肺纤维化损伤过程中可能起了重要作用.     

放疗性舌炎与其病损组织血管内皮细胞损伤的相关性研究

目的 观察放射性舌炎病损局部病损组织血管内皮细胞损伤的动态变化.分析其与放射性舌炎病损程度的相关性.方法 建立放射性舌炎SD大鼠动物模型;观察其放射性口腔黏膜炎指数(oral mucositisindex,OMI);应用免疫组织化学方法(CD34)鉴定放射性舌炎病损局部病损组织血管内皮细胞:TUNEL检测RTG大鼠舌体病损组织内血管内皮细胞凋亡:统计学分析血管内皮细胞凋亡百分数与RTG口腔黏膜炎指数(OMI)间的时相变化关系.结果 放射照射后3 d可观察到明显的血管内皮细胞损伤和细胞凋亡.放射照射后的血管管腔变得明显不规则,管腔中可见有血栓形成,管腔内膜凹凸不平,血管扩张,管径变大,血管内皮细胞与基底膜分离脱落到管内,并可看到部分血管狭窄严重、闭塞.血管内皮细胞TUNEL检测到血管内皮细胞凋亡,5 d组凋亡内皮细胞百分数(%)为(78.3±0.31),8 d组为(89.3±0.83),14 d组为(83.5±0.41),21 d组为(69.3±0.57),28 d组为(47.3±0.59).5 d、8 d、14 d、21 d、28 d时RTG 13腔黏膜炎指数(OMI)与大鼠舌组织血管内皮细胞凋亡百分比的相关系数R=0.67(P=0.034).结论 RTG病损组织内血管内皮细胞损伤与RTG的病情相关,提示血管内皮细胞损伤可能在RTG病理过程中起作用并有潜在应用价值.     

清肺化纤汤对博莱霉素所致大鼠肺间质纤维化的实验观察

目的研究清肺化纤汤对大鼠肺间质纤维化形成过程中的治疗作用。方法将90只大鼠随机分成4组：空白组、模型组、清肺化纤汤组、强的松组。气管内滴注博莱霉素复制肺纤维化动物模型，造模后第2天开始给药，分别在7d、14d、28d各处死7只，取肺组织进行病理组织学观察、形态定量分析、免疫组化以及ELISA法测定肺泡灌洗液中TGF-β1蛋白水平。结果清肺化纤汤通过抑制肺组织中的TGF—β1水平从而对大鼠肺纤维化进行有效治疗。‘结论清肺化纤汤具有较好的抗肺纤维化作用。     

RT-PCR方法分析益气养阴活血法对肺纤维化大鼠肺组织TGF-β1mRNA影响

目的:观察益气养阴法中药组方——抗纤合剂对博莱霉素诱导的肺纤维化大鼠肺组织中TGF-β1 mRNA蛋白质表达的影响,在分子层面探讨抗纤合剂的可能作用机制。方法:将健康雄性Wistar大鼠120只随机分为对照组、模型组、强的松组、抗纤合剂组。每组30只。除正常对照组,其他3组采用博莱霉素(BLM)致肺纤维化大鼠模型。模型建成后,强的松组以6.25 mg·kg~(-1)的强的松溶液灌胃,抗纤合剂组以5 g·kg~(-1)灌胃。正常对照组与模型组以等溶生理盐水灌胃,观察大鼠一般状态,分别于7、14、28 d 3个时间点处死大鼠并取材。每个时间点每组大鼠10只。取肺组织固定包埋切片后,应用病理图像分析系统对病理切片进行扫描,观察大鼠组织病理学改变,用HE染色观察肺组织肺泡炎变化程度,用胶原纤维的特异染色Masson染色观察肺组织纤维化变化程度;用RTPCR方法,动态观察肺组织TGF-β1 mRNA的表达。结果:HE染色及Masson染色显示:正常组肺内结构清晰,肺泡间隔未见增厚,模型组:各时期均表现有程度不等的肺泡炎,大量炎性细胞浸润,28 d时肺组织以胶原沉积为主,呈中、重度肺纤维化改变。强的松组、抗纤合剂组肺组织炎细胞浸润区域较模型组明显减少,28 d时胸膜和肺泡间隔胶原纤维沉积呈束状,显示轻、中度肺纤维化改变。除正常组外,其他各组TGF-β1 mRNA表达于第7天明显增强,模型组14 d达到高峰,其余两组与模型组相比,差异显著,强的松组、抗纤合剂组统计无明显差异。结论:以益气养阴活血法立方的抗纤合剂可降低BLM致肺纤维化大鼠肺组织炎症和肺纤维化程度,下调BLM致肺纤维化大鼠TGF-β1 mRNA表达,对肺纤维化有一定的治疗作用。     

百草枯致大鼠肺纤维化肺组织内质网相关凋亡基因Caspase-12的表达

目的 观察内质网相关凋亡基因半胱氨酸天冬氨酸蛋白酶12（ Caspase-12） 在百草枯诱导肺纤维化模型大鼠肺组织中的表达。方法 30 只Spragne-Dawley（ SD） 大鼠随机分为对照组、14 d模型组和28 d 模型组。采用百草枯灌胃法复制肺纤维化模型。逆转录-聚合酶链反应（ RT-PCR）检测肺内Caspase-12 mRNA 表达, 免疫组化检测其蛋白表达。HE 和Masson 染色判断肺组织肺泡炎及肺纤维化程度。结果 HE 和Masson 染色结果证实成功复制肺纤维化模型。模型组大鼠肺泡炎和肺纤维化程度较对照组严重（ P 〈0. 01） 。与对照组比较, Caspase-12 表达在14 d 模型组中明显升高（ P 〈0. 01） , 在28 d 模型组中更高（ P 〈 0. 01） 。结论 百草枯中毒大鼠肺内质网相关凋亡基因Caspase-12 表达增高, 提示内质网应激在百草枯中毒引起的肺纤维化中发挥重要作用。     

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.     

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.