IDO与Treg在支气管哮喘小鼠中的相互作用及其意义

目的 探讨吲哚胺2,3双加氧酶(indoleamine 2,3-dioxygense,IDO)与CD4+ CD25+ Foxp3+调节性T细胞(Treg)之间的相关性及在支气管哮喘发病机制中的作用.方法 BALB/c小鼠用随机数字表法分成对照组和哮喘组,每组8只.哮喘组以鸡卵清蛋白(ovalbumin,OVA)致敏,激发小鼠建立哮喘模型,无创肺功能仪检测气道反应性,支气管肺泡灌洗液(BALF)进行细胞学分析,ELISA检测BALF中INF-y、IL-4、IL-10浓度,实时荧光定量PCR检测肺组织IDO和Foxp3 mRNA表达,免疫组织化学方法检测IDO蛋白表达,流式细胞仪检测Treg占CD4+细胞的百分率.结果 哮喘组小鼠气道反应性、BALF中细胞总数、嗜酸性粒细胞比例及IL-4浓度明显高于对照组(P＜0.01);而INF-γ与IL-10浓度、IDO和Foxp3的mRNA表达、IDO蛋白表达、Treg占CD4+细胞的百分率明显低于对照组(P＜0.01);对照组与哮喘组IDO与Foxp3的mRNA表达呈正相关(r=0.819,r=0.807,P＜0.05),对照组与哮喘组IDO蛋白表达与Treg占CD4+细胞的百分率呈正相关(r =0.783,r=0.765,P＜0.05).结论 哮喘小鼠IDO和Foxp3表达降低,Treg数量减少,且IDO蛋白表达与Treg占CD4+细胞的百分率呈正相关,表明IDO与Treg相互调节,打破免疫耐受,诱导哮喘发生.     

哮喘中Th1/Th2类细胞因子免疫失衡对神经生长因子表达的影响

目的:初步探讨支气管哮喘Th1/Th2类细胞因子免疫失衡对脾淋巴细胞神经生长因子(NGF)mRNA表达的影响.方法:采用鸡清卵蛋白建立SD大鼠哮喘模型,分离脾淋巴细胞并培养,通过逆转录-聚合酶链反应(RT-PCR)半定量法测定细胞在刀豆素A(ConA)刺激下表达NGF mRNA的基础水平,并观察予γ-干扰素(IFN-γ)和白细胞介素-4(IL-4)干预后NGF mRNA表达的改变.结果哮喘大鼠脾淋巴细胞在基础状态下具有表达NGF mRNA的功能,并在ConA刺激下呈时间依赖性增强.50 μg/L IL-4干预12 h、24 h、36 h及48 h时NGF mRNA相对表达量随时间延长逐渐增高,并分别与同时间点的基础值比较有统计学意义(均P＜0.01);0,10,50,100 μg/L的IL-4干预24 h时NGF mRNA表达量依次增高,分别比前一梯度低浓度干预组有显著增高(P＜0.05).10 μg/L IFN-γ干预12 h、24 h、36h、48 h时NGF mRNA相对表达量分别与同时间点的基础值相比有显著下降(均P＜0.01);0,1,10,50μg/L的IFN-γ干预24 h时NGF mRNA表达量依次减低,分别比前一梯度低浓度干预组有显著降低(P＜0.05).结论:在哮喘中Th2类细胞因子IL-4可上调淋巴细胞NGF mRNA表达,Th1类细胞因子IFN-γ可下调淋巴细胞NGF mRNA表达,两者均呈时间和浓度依赖性;Th1/Th2类细胞因子免疫失衡可能通过调控NGF mRNA表达间接促进其诱导神经源性炎症.     

哮喘小鼠气道上皮高表达mCLCA3及其与趋化因子和Th1/Th2细胞因子的关系

目的 研究哮喘相关基因mCLCA3在哮喘小鼠模型气道的梯度变化及其与趋化因子和Th1/Th2细胞因子的关系.方法 30只SPF级BALB/c小鼠随机分为5组,每组6只(n=6):D(致敏而未激发),E(激发1 d),F(激发3 d),G(激发5 d),H(激发7 d).通过RT-PCR和免疫组织化学检测肺组织中mCLCA3表达.采用肺组织切片的苏木精-伊红染色炎性评分、肺泡灌洗液(BALF)中炎症细胞分类计数来评价肺部炎症细胞浸润情况.RT-PCR法检测肺组织IL-4和IFN-γ的mRNA.ELISA检测炎症局部不同趋化因子水平.结果 RT-PCR和免疫组化检测结果均表明激发后小鼠mCLCA3表达显著增加,且mCLCA3的增加具有激发时间依赖性.肺组织苏木精-伊红染色炎性评分及BALF中炎性细胞分类计数表明激发后小鼠炎症细胞浸润主要表现为嗜酸性粒细胞和淋巴细胞增加.随着激发次数的增多,肺组织中IL-4和IFN-γ水平均有不同程度升高,其中H组IL-4与其余各组差异均有统计学意义,而各组IFN-γ差异无统计学意义.ELISA 结果显示随着激发次数的增加小鼠BALF CCL17、CCL22均有增加趋势,其中G、H组CCL17,H组CCL22较其余组差异有统计学意义.Pearson相关性分析表明:mCLCA3与BALF中CCL17(r=0.584,P＜0.01)、CCL22(r=0.461,P＜0.05)及E、F、G组CCL5(r=0.586,P＜0.05)均呈正相关;mCLCA3与BALF中总炎症细胞(r=0.393,P＜0.05)、嗜酸性粒细胞(r=0.529,P＜0.01)正相关.结论 哮喘小鼠气道上皮中增加的mCLCA3表达可能通过参与调节气道上皮细胞趋化因子的分泌而介导炎症局部炎症细胞的浸润,从而在气道炎症的发生发展中起作用.     

不同配比麻杏甘石汤对哮喘大鼠Th1／Th2类细胞因子分泌的影响

目的：观察不同配比麻杏甘石汤对哮喘大鼠Th1/Th2类细胞因子分泌的影响。方法：选取Wistar大鼠,随机分为正常对照组、哮喘模型组、地塞米松组、麻杏甘石汤1高剂量组（简称麻1组）、麻杏甘石汤2高剂量组（简称麻2组）。观察不同配比麻杏甘石汤对哮喘大鼠BALF中IL-4、IFN-γ水平及IL-4/IFN-γ比值比较、外周血中IL-4、IFN-γ水平及IL-4/IFN-γ比值比较、肺组织中IFN-γ、IL-4和内参照激动蛋白cDNA扩增后半定量和电泳结果的影响。结果：与哮喘模型组比较,不同配比的麻杏甘石汤组大鼠BAIF和外周血中IL-4水平下降（P〈0.05,P〈0.01）,效果与地塞米松组相似（P〉0.05）、IL-4/IFN-γ比值也相应降低,IFN-γ水平升高。麻杏甘石汤组大鼠RT-PCR结果显示,IFN-γmRNA表达水平明显高于地塞米松组的IFN-γmRNA（P〈0.05）,而地塞米松组IL-4 mRNA与正常组相比表达减少（P〈0.05）,与哮喘组相比IL-4 mRNA的表达明显减少（P〈0.01）。IFN-γmRNA的表达与正常组相比表达无明显差异（P〉0.05）,与麻杏甘石汤组相比IFN-γmRNA的表达明显减少（P〈0.01）。麻1、2高剂量组间比较无显著差异（P〉0.05）。结论：不同配比麻杏甘石汤可能通过抑制IL-4水平及提高IFN-γ水平,使Thl/Th2失衡得到一定程度的纠正,从而控制气道炎症,减缓哮喘发作。不同配比比较无显著差异（P〉0.05）。     

复方甘草酸苷对哮喘大鼠的免疫调节作用

目的探讨复方甘草酸苷对哮喘大鼠的免疫调节作用。方法Wistar大鼠随机分成健康对照组（Ⅰ组）、哮喘模型组（Ⅱ组）、复方甘草酸苷哮喘治疗组（Ⅲ组）、地塞米松哮喘治疗组（Ⅳ组）,采用卵清蛋白（ovalbumin,OVA）氢氧化铝混合液腹腔注射致敏和OVA超声雾化吸入激发建立哮喘大鼠模型。所有大鼠在末次激发后6h取中心静脉血及左肺支气管肺泡灌洗液（bronchoalveolar lavage fluid,BALF）,行细胞计数与分类,并测定细胞因子IL-4和IFN-γ含量。结果Ⅱ组静脉血及BALF中中性粒细胞、淋巴细胞、嗜酸性粒细胞计数和IL-4含量显著高于Ⅰ组、Ⅲ组和Ⅳ组（P〈0.01）,IFN-γ含量显著低于Ⅰ组、Ⅲ组和Ⅳ组（P〈0.01）;②Ⅲ组与Ⅰ组相比,静脉血及BALF中中性粒细胞、淋巴细胞、嗜酸性粒细胞计数和IL-4含量升高,IFN-γ含量降低,但均无统计学意义（P〉0.05）;③Ⅲ组与Ⅳ组相比,静脉血及BALF中中性粒细胞、淋巴细胞、嗜酸性粒细胞计数和IL-4含量升高（P〉0.05）,IFN-γ含量显著升高（P〈0.01）。结论复方甘草酸苷能明显促进Th1细胞因子IFN-γ的产生,减少Th2细胞因子IL-4的产生,减轻哮喘大鼠气道炎症反应,其机制可能与调节Th1／Th2细胞免疫平衡有关。     

CD8mAb对呼吸道合胞病毒诱导的哮喘小鼠气道炎症的影响

目的:观察CD8mAb对呼吸道合胞病毒(RSV)诱导哮喘小鼠气道炎症的影响. 方法:Balb/c小鼠50只,随机分成5组(n=10):磷酸盐缓冲液(PBS)对照组;卵白蛋白(OVA)组;OVA/RSV模型组;CD8mAb治疗组;IgG2αmAb治疗对照组. 应用OVA腹腔注射致敏、OVA气道雾化结合RSV滴鼻激发复制小鼠哮喘模型,观察实验动物气道炎症和气道反应性变化,支气管肺泡灌洗液(BALF)作细胞分类计数,测定BALF上清中白细胞介素(IL)-4, IL-5, 干扰素(IFN)-γ含量并采用三色光流式细胞分析法检测气管旁淋巴结(PBLN)中CD4 , CD8 T细胞及细胞内细胞因子IFN-γ, IL-4, IL-5表达. 结果:与模型组相比,CD8mAb可明显减轻小鼠气道炎症和气道高反应. CD8mAb治疗后BALF中嗜酸性粒细胞及上清中细胞因子IFN-γ, IL-4, IL-5含量明显减少(P均<0.01),CD8 (IFN-γ , IL-4 , IL-5 )T细胞百分比及Tc2/Tc1比值明显下降(P均<0.01). PBLN中CD8 (IFN-γ , IL-4 , IL-5 )T细胞百分比与BALF中IFN-γ, IL-4, IL-5含量呈显著正相关(分别rs=0.765, P<0.01; rs=0.825, P<0.01; rs=0.893, P<0.01). 结论:CD8mAb对RSV诱导的哮喘小鼠气道炎症和气道高反应具有抑制作用,其部分机制可能与致敏条件下病毒感染引起CD8 T细胞功能发生转化,即由产生IFN-γ为特征的细胞毒CD8 T细胞转化为产生IL-4, IL-5为特征的非细胞毒CD8 T细胞有关.     

肺炎链球菌3型多糖对支气管哮喘小鼠气道炎症及Treg/Th17细胞的影响

目的观察肺炎链球菌3型多糖(T3P)对支气管哮喘小鼠气道炎症以及Treg/Th17细胞的影响,探讨T3P对哮喘小鼠的免疫调节作用。方法 BALB/c小鼠随机分成对照组、哮喘组和T3P组,每组8只。哮喘组以卵清蛋白(OVA)致敏、气道激发建立哮喘模型,对照组以PBS代替,T3P组在OVA致敏前皮下注射T3P进行干预。观察小鼠肺组织病理改变,对支气管肺泡灌洗液(BALF)进行细胞计数及分类,ELISA法检测血清OVA特异性IgE(OVA-IgE)以及BALF中白介素4(IL-4)、干扰素γ(IFN-γ)、IL-10、IL-17浓度,实时荧光定量PCR法检测肺组织中转录因子Foxp3和RORγt mRNA表达水平,流式细胞术检测Treg和Th17细胞占CD4~+细胞百分比。结果 T3P组小鼠肺组织炎症反应程度弱于哮喘组,血清OVA-IgE,BALF中细胞总数、嗜酸粒细胞比例以及IL-4、IL-17浓度均低于哮喘组(P<0.05),IFN-γ、IL-10浓度高于哮喘组(P<0.05),小鼠肺组织Foxp3 mRNA表达水平及Treg占CD4~+细胞百分比均高于哮喘组(P<0.05),RORγt mRNA表达水平和Th17细胞占CD4~+细胞百分比均低于哮喘组(P<0.05)。哮喘组和T3P组小鼠肺组织Foxp3-mRNA/RORγt-mRNA比值及Treg/Th17细胞比例与BALF中嗜酸粒细胞数量呈负相关。结论 T3P可以通过抑制过敏原特异性IgE表达调节Th1/Th2、Treg/Th17细胞平衡,抑制气道炎症。     

神经生长因子及其受体在哮喘大鼠肺组织的变化以及对气道炎症的影响

目的：探讨神经生长因子（NGF）和其受体酪氨酸激酶受体A (trkA)和总神经营养因子受体( p75)变化对哮喘大鼠气道炎症的影响。方法：通过鸡卵蛋白致敏激发建立哮喘模型,并将32只SD大鼠随机分为4组：正常对照组、哮喘组、外源性NGF干预组（NGF组）及抗NGF抗体干预组（抗NGF组）。各组测定支气管肺泡灌洗液(BALF)总细胞及细胞分类计数,并行支气管肺组织切片HE染色观察病理改变;通过逆转录-聚合酶链反应（RT-PCR）半定量检测哮喘组和对照组肺组织NGF mRNA,4组肺组织trkA和p75 mRNA表达变化。结果：哮喘组与对照组比较,BALF总细胞计数、嗜酸性粒细胞（Eos）计数及淋巴细胞（Lym）计数显著增多（均P<0.001）,支气管肺组织炎症表现显著;肺组织NGF mRNA及trkA和p75 mRNA表达明显增强（均P<0.01）;哮喘组NGF mRNA与BALF细胞总数、Lym数呈正相关（均P<0.001）。NGF组与哮喘组比较,BALF总细胞、Eos及Lym计数均显著增多（均P<0.01）,支气管肺组织炎症表现更为显著,p75和trkA mRNA表达明显增强（均P<0.05）。抗NGF组与哮喘组比较,BALF总细胞、Eos及Lym计数显著减少（均P<0.001）,支气管肺组织炎症表现显著减轻,p75和trkA mRNA表达明显减弱（均P<0.01）。结论：致敏哮喘大鼠肺组织内NGF mRNA表达水平显著增高,并与气道炎症密切相关;NGF上调trkA和p75 mRNA表达,从而增强NGF的功能效应,共同参与哮喘的气道神经源性炎症。     

地塞米松对哮喘大鼠Th1/Th2失衡及嗜酸细胞fas、bcl-2 mRNA表达的影响

目的:观察地塞米松(DXM)对哮喘大鼠Th1/Th2失衡以及嗜酸细胞(EOS)fas、bcl-2 mRNA表达的影响,探讨糖皮质激素治疗哮喘气道炎症的作用机制.方法:清洁级雄性SD大鼠30只,随机分为3组:正常对照组(C),哮喘组(A),地塞米松治疗组(T),每组10只.采用卵清白蛋白制作大鼠哮喘模型.用夹心酶联免疫吸附试验(sandwich ELISA)法检测血浆及支气管肺泡灌洗液(BALF)中IL-4、IFN-γ的水平;用原位杂交法检测fas和bcl-2 mRNA在气道壁EOS上的表达.结果:A组大鼠IFN-γ表达水平较C组明显下调(P＜0.01),同时IL-4表达水平则有明显上调(P＜0.01),表现出明显的Th1/Th2失衡.fas mRNA的表达在A组明显下降(P＜0.01),bcl-2 mRNA的表达则有明显上调(P＜0.01).地塞米松治疗在纠正A组大鼠Th1/Th2失衡的同时可上调fas mRNA的表达,下调bcl-2 mRNA的表达.结论:纠正哮喘大鼠Th1/Th2失衡,调节EOS fas、bcl-2 mRNA的表达是地塞米松减轻哮喘气道炎症的可能机制之一.     

地塞米松对变应性哮喘小鼠胸腺活化调节趋化因子及mRNA表达的影响

目的 探讨地塞米松对哮喘小鼠胸腺活化调节趋化因子(TARC)及其mRNA表达的影响.方法 30只清洁级雄性BALB/C小鼠分为3组:正常对照组、哮喘组和地塞米松组.以卵清白蛋白(OVA)致敏激发法制备小鼠哮喘模型,末次激发24 h后留取支气管肺泡灌洗液(BALF)及肺组织.BALF行嗜酸性粒细胞(EOS)计数及分类;采用酶联免疫吸附法(ELISA)测BALF中TARC和IL-4水平;免疫组化法和逆转录-聚合酶链反应(RT-PCR)法分别检测TARC蛋白和TARC mRNA在肺组织中的表达.结果 ①哮喘组BALF中细胞总数,EOS绝对数和EOS占细胞总数的百分数(EOS%)均显著高于正常对照组,地塞米松组上述指标均显著低于哮喘组(均P＜0.01);②哮喘组BALF中TARC,IL-4浓度均显著高于对照组,地塞米松干预后BALF中TARC,IL-4浓度均显著低于哮喘组(均P＜0.01).③免疫组化及RT-PCR结果显示,肺组织中TARC蛋白及其mRNA的表达,哮喘组显著高于对照组,地塞米松组较哮喘组显著减弱(均P＜0.01),免疫组化显示,TARC蛋白主要表达于支气管上皮细胞.④相关性分析显示,小鼠BALF中TARC浓度与EOS绝对值、IL-4浓度均呈显著正相关(均P＜0.01).结论 糖皮质激素(地塞米松)可抑制TARC在哮喘小鼠气道上皮中的表达,可能是其治疗哮喘气道炎症的部分作用机制.     

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.