高浓度氧暴露与新生鼠肺过氧化能力关系的研究

目的研究新生鼠暴露于不同浓度氧时不同时间肺组织脂质过氧化过程和抗氧化能力的变化.方法 4组新生鼠分别暴露于>95%O2、60%O2、40%O2和正常空气(21%O2)中,取暴露于12、24、48h和72h 4个时相点的肺组织,硫代巴比妥酸法检测肺组织匀浆中丙二醛含量(malondiadehyde,MDA),化学比色法检总抗氧化能力(total anti-oxygen capability,TAOC).结果各时相点新生鼠肺组织MDA含量和氧浓度呈显著正相关(P<0.01),TAOC与氧浓度呈显著负相关(P<0.01);随着氧浓度的升高和时间延长,DMA含量逐渐增高,TAOC逐渐降低,任何两组新生鼠肺组织MDA含量和TAOC在部分或全部时相点均存在显著差异(P<0.05,P<0.01).结论新生鼠暴露于＞95%O2、60%O2、40%O2一定时间均可引起肺组织抗氧化能力显著降低,脂质过氧化程度增强,抗氧化能力与氧浓度呈显著负相关,脂质过氧化程度与氧浓度呈显著正相关.     

不同浓度氧暴露不同时间对新生鼠肺组织一氧化氮生成的影响

目的研究新生鼠暴露于不同浓度氧不同时间肺组织一氧化氮(nitric oxide,NO)含量,内皮型一氧化氮合酶(endothelial nitric oxide synthase,eNOS)和诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)表达的变化.方法四组新生鼠分别暴露于>95%O2、60%O2、40%O2和正常空气(21%O2)中,取暴露12、24、48和72h的肺组织,硝酸还原酶法检测肺组织匀浆中NO含量,免疫组化研究eNOS和iNOS的表达,并采用MIG2000图像分析测量系统进行半定量分析.结果各时相点新生鼠肺组织NO含量、eNOS和iNOS表达与吸氧浓度呈显著正相关(P<0.01),3个高氧组和正常空气对照组NO含量、eNOS和iNOS的表达在部分或全部时相点有显著差异(P<0.05,P<0.01).结论新生鼠暴露于不同浓度氧不同时间对肺组织NO含量、eNOS和iNOS表达均有影响,过量的内源性NO可能与高氧肺损伤有关.     

转化生长因子-β1在中浓度氧致新生鼠支气管肺发育不良模型中的作用

目的：探讨中浓度氧（60%O2）暴露对新生小鼠发育的影响及损伤,并观察转化生长因子-β1（TGF-β1）在新生鼠慢性肺部疾病支气管肺发育不良（BPD）肺损伤中的作用。方法：30只新生雌性KM小鼠,随机分为实验组和对照组,每组15只。对照组置于空气中（FiO20.21）;实验组置于封闭氧箱中（FiO20.6）,制备中浓度氧致新生雌性小鼠BPD模型,记录吸氧后2 d、7 d、14 d、21 d、28 d小鼠体重,应用HE染色观察不同时间点HE染色肺组织病理改变,免疫组化技术观察TGF-β1蛋白表达水平。结果：实验组小鼠体重吸氧7 d后明显降低,HE染色下正常肺泡结构消失、肺泡融合、肺泡间隔增厚。高氧暴露72 h后,TGF-β1的表达升高,随着吸氧时间的增长TGF-β1的表达逐渐升高。结论：持续较高浓度吸氧可致新生雌性小鼠生长障碍和肺泡化阻滞,出现类似人类支气管肺发育不良的肺部改变。TGF-β1在肺纤维化的发生和持续过程中均发挥重要作用。     

低浓度吸氧对福尔马林暴露大鼠气管及肺组织的保护作用

目的 给予福尔马林暴露大鼠吸入低浓度氧气后,观察其气管及肺组织的光、电镜形态学改变,为预防及治疗福尔马林对呼吸系统的损伤提供理论基础.方法 18只雄性SD大鼠随机分成对照组、福尔马林暴露组、福尔马林暴露+吸氧组,每组6只.对照组大鼠呼吸自然空气,福尔马林暴露组大鼠及福尔马林暴露+吸氧组大鼠每天吸入福尔马林12h,福尔马林暴露+吸氧组大鼠福尔马林暴露完毕后立即吸入浓度为29%的氧气,1次/d,1h/次.对照组和福尔马林暴露组大鼠此时呼吸自然空气.连续吸入25d后处死大鼠取气管、肺组织,通过光学显微镜和透射电镜观察其形态学改变.结果 与福尔马林暴露组相比,福尔马林暴露+吸氧组大鼠光学显微镜下可见气管及肺组织的水肿及炎性改变均有所减轻,透射电镜下虽然板层小体结构仍显紊乱,但Ⅱ型肺泡上皮细胞胞浆内未见空泡;肺泡腔内虽仍可见红细胞及少量坏死细胞碎片,但也未见空泡.结论 低浓度吸氧可改善福尔马林暴露所导致的大鼠气管及肺组织的病理损伤.     

转化生长因子-β_1在新生大鼠高浓度氧致肺损伤中的作用研究

目的 观察应用外源性抗转化生长因子-β1(TGF-β1)抗体作用下TGF -β1在新生鼠高浓度氧(高氧,>95%O2)致肺损伤的表达.方法 将足月SD新生大鼠随机分为3组:空气对照组(Ⅰ组),高氧(>95%O2)组(Ⅱ组),高氧(>95%O2)+抗TGF-β1抗体0.4mg/kg组(Ⅲ组).每组20只,观察及检测高氧暴露3、7、14和28d时各组动物肺组织病理改变、TGF-β1免疫组织化学染色.结果 Ⅱ组3和7d时表现为明显的急性炎症改变,肺组织水肿、渗出、出血、肺泡间隔轻度增厚,14d时急性炎症减轻,而肺组织中TGF-β1表达呈强阳性;28d时出现明显的胶原沉积,形成纤维化;Ⅲ组3和7d时仍有轻度炎症反应,14和28d无明显成纤维细胞增生及胶原生成,未形成肺纤维化,Ⅲ组各时相点TGF-β1的表达明显减弱,与Ⅰ组比较差异无统计学意义.结论 新生鼠持续吸入高氧后可导致急、慢性肺损伤.高氧暴露可刺激肺部产生过量的TGF-β1,提示TGF-β1在肺纤维化过程中起重要作用;高氧暴露时给予外源性抗TGF-β1抗体对新生鼠高氧暴露有明显保护作用,可减轻高氧急性肺损伤,能有效阻断高氧肺纤维化损伤的发生、发展,从而减轻肺纤维化损伤.     

高氧致新生鼠肺结构及VEGF的变化及相关分析

目的探讨新生大鼠高氧肺损伤后肺组织结构,血管密度及VEGF蛋白的表达变化及相关性。方法新生Sprague-Dawley大鼠72只随机分为高氧实验组和空气对照组,高氧组吸入95%高氧建立高氧肺损伤模型。分别采用HE染色和免疫组化法观察新生大鼠3d、7d、14d肺组织形态改变并作肺泡辐射状记数(Radial alveolar countsRAC),检测Ⅷ因子及VEGF蛋白表达。结果对照组大鼠生后随着肺发育,肺泡化逐渐完善,RAC计数、VEGF蛋白及Ⅷ因子表达逐渐增加。高氧组随着吸氧时间延长RAC计数、肺组织VEGF蛋白及Ⅷ因子表达均出现降低,并出现肺泡化阻滞,VEGF与Ⅷ因子始终具有相关性。结论 VEGF促进新生大鼠肺发育,新生大鼠高氧可抑制VEGF及Ⅷ因子在鼠肺内的表达,致肺泡化阻滞,出现类似早产儿支气管肺发育不良的肺组织形态学特征,VEGF在新生鼠肺发育和高氧肺损伤机制中起重要作用。     

前列腺素E1在高氧肺损伤中的保护作用

目的：研究前列腺素El对高氧诱导的急性肺损伤是否有保护作用。方法：40只雄性SD大鼠被随机分成四组。分别予腹腔注射生理盐水或前列腺素El(PGEl)后暴露于21％O2或95％O272h，分别测定支气管肺泡灌洗液(BALF)中的总蛋白(TP)、乳酸脱氢酶(LDH)、粒细胞数及血清总蛋白，并作肺组织形态学观察。结果：PGEl腹腔注射组暴露于高氧后BALF中的TP，LDH及粒细胞数量较使用生理盐水的高氧暴露组显著下降，而血清总蛋白无显著性差异。肺组织石蜡包埋切片HE染色，光镜下观察高氧暴露组肺组织水肿。结论：高氧可诱导急性肺损伤：PGEl对高氧诱导的肺损伤有保护作用。     

新生鼠高氧肺损伤中肺泡内白介素8含量的变化

目的:探讨新生鼠吸入高浓度氧所致肺损伤时肺泡内白介素8(IL-8)的变化.方法:生后24 h内的SD新生鼠100只,随机分为空气组和高氧组,每组50只.空气组常规饲养,高氧组置常压高氧箱内,吸入＞95%氧,两组分别于实验进行后24 h,3、6、10、14 d取肺组织观察病理变化,并进行肺泡灌洗获取肺泡灌洗液(BALF),ELISA方法检测灌洗液中IL-8含量.结果:与空气组比较,高氧组肺组织24 h开始出现炎症细胞反应,肺泡内见巨噬细胞、极少量中性粒细胞及红细胞,随着吸氧时间延长,肺发育受阻,肺泡数量减少,有纤维样物质增生;从第3天起,BALF中IL-8含量显著增高,与相应同日龄空气对照组比较,差异有统计学意义(P＜0.01).结论:高浓度氧可导致肺组织损伤并影响肺发育;IL-8可能参与了高氧肺损伤的发生发展过程,是导致高氧肺损伤的重要炎症介质之一.     

高氧性急性肺损伤大鼠模型的建立与评价

目的建立高氧性急性肺损伤大鼠模型并进行评价。方法 80只大鼠随机分为空气组和高氧组,各组又随机分为12、24、36、48及60 h五个亚组。检测高氧(浓度在95%以上)暴露过程中大鼠动脉血气变化;肺组织HE染色观察肺损伤情况;测定肺湿/干(W/D)比、肺系数、肺通透指数及支气管肺泡灌洗液(BALF)中乳酸脱氢酶(LDH)活性、WBC计数。比较不同高氧暴露时间下大鼠的肺损伤程度,确定复制高氧性急性肺损伤大鼠模型的最佳条件。结果组织病理学显示随着高氧暴露时间的延长,大鼠肺组织损伤逐渐加重,在高氧暴露48～60 h时,出现典型的急性肺损伤的病理学特征。肺W/D比、肺系数、肺通透指数和BALF中LDH活性、WBC计数均进行性升高,于48 h升至5个观察时相的最高峰,60 h上述指标虽然与48 h比较无显著性差异,但数值上已开始有下降的趋势;PaO2呈进行性下降。结论高氧(浓度在95%以上)暴露48～60 h能够成功复制典型的高氧性急性肺损伤大鼠模型。     

PDTC对实验性重症急性胰腺炎肺损伤的保护作用

目的观察二硫代氨基甲酸吡咯烷(PDTC)对重症急性胰腺炎肺损伤(PALI)的保护作用。方法 SD大鼠60只,分为对照组、重症急性胰腺炎(SAP)组、PDTC预处理组,每组再分为3h、6h、9h及12h四个时间组。采用5%牛磺胆酸钠胰胆管逆行注射诱发大鼠SAP模型。PDTC预处理组在建立SAP模型前1h腹腔内注射PDTC。检测血清淀粉酶并通过透射电镜观察肺组织超微结构改变。结果透射电镜下SAP各组可见Ⅱ型肺泡上皮细胞线粒体肿胀、核浓缩等现象。PDTC预处理组与相对应的SAP各组比较均有不同程度减轻。结论 PDTC预处理各组大鼠胰、肺组织病理学改变减轻,提示PDTC对SAP肺损伤具有保护作用。     

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.     

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.