二磷酸盐在抑制聚乙烯微粒刺激破骨细胞骨吸收中的作用

目的:研究帕米磷酸钠对聚乙烯微粒刺激破骨细胞功能的影响,探讨帕米磷酸钠防治人工关节无菌性松动的可能性.方法:分离新生新西兰兔长骨中的破骨细胞与骨片共同培养.观察帕米磷酸钠、聚乙烯微粒对破骨细胞功能的影响.观察不同剂量的聚乙烯微粒对破骨细胞的影响;观察聚乙烯微粒与帕米磷酸钠共同培养对破骨细胞的作用.结果:三种浓度的微粒(103/ml、106/ml和109/ml)与破骨细胞共培养后都能够刺激破骨细胞的骨吸收,10μg/ml的帕米磷酸钠可以抑制聚乙烯微粒对破骨细胞骨吸收的增强作用.结论:帕米磷酸钠可以抑制聚乙烯微粒对破骨细胞的刺激作用,可能用于防治人工关节无菌性松动.     

细菌脂多糖对破骨细胞发育的抑制作用研究

目的:寻找调节破骨细胞分化成熟的途径.方法:采用细胞核因子-KB受体活化因子配体(RANKL)和巨噬细胞集落刺激因子(M-CSF)体外诱导骨髓单核细胞分化为成熟破骨细胞的培养方法,在培养体系中加入不同浓度细菌脂多糖(LPS),用抗酒石酸酸性磷酸酶(TRAP)染色观察成熟破骨细胞形成情况;实时定量RT-PCR检测LPS处理后破骨细胞前体表达核因子-κB受体活化因子(RANK)和M-CSF受体mRNA.结果:LPS不能刺激骨髓单核细胞形成TRAP阳性的破骨细胞;减少了RANKL诱导的TRAP阳性破骨细胞形成数量;0.2ng/ml和20ng/ml LPS降低了30％和90％RANKL诱导TRAP阳性细胞形成数量(与未加LPS组比较,均P＜0.01);降低破骨细胞前体表达RANK和M-CSFR mRNA.结论:LPS能够抑制RANKL诱导的破骨细胞分化成熟,抑制破骨细胞前体表达RANK和M-CSFR,能够阻断其向成熟分化.     

二磷酸盐对破骨细胞的影响

二磷酸盐自30多年前被发现对破骨细胞有抑制作用以来,已成为临床上重要抗骨吸收药物。二磷酸盐分为含氮二磷酸盐和不含氮二磷酸盐两类。含氮二磷酸盐对抑制破骨细胞骨吸收机制是通过抑制甲羟戊酸途径实现的,而不含氮二磷酸盐则通过竞争性抑制ADT/ATP移位酶而发挥作用。同时二磷酸盐对成骨细胞与破骨细胞间信号的调节也有重要作用,但其对破骨细胞的具体调节机制尚存在较大争议,仍有待进一步研究。     

阿仑膦酸钠对人工关节磨损微粒刺激破骨细胞分化形成的影响

目的:观察二磷酸盐类药物阿仑膦酸钠对人工关节磨损微粒刺激破骨细胞分化形成的影响,探讨二磷酸盐防治人工关节无菌性松动的可能机制.方法:体外用巨噬细胞集落刺激因子(M-CSF)诱导小鼠骨髓造血干细胞分化为破骨前体细胞(osteoclast precursors,OCPs),然后用核因子-κB受体活化因子配体(RANKL)和M-CSF两种细胞因子协同诱导OCPs向成熟破骨细胞分化,同时在培养体系中加入高分子聚乙烯微粒(103/ml)和不同浓度的阿仑膦酸钠(0.4、2.0、10.0、50.0 μg/ml),对获得的各组破骨细胞行抗酒石酸酸性磷酸酶(TRAP)染色计数阳性破骨细胞(核≥3)的数目;提取总RNA用逆转录-聚合酶链反应(RT-PCR)检测TRAP mRNA的表达.结果:高分子聚乙烯微粒组TRAP阳性破骨细胞数目和TRAP mRNA的表达显著高于空白对照组(P＜0.05);阿仑膦酸钠组TRAP阳性破骨细胞数目和TRAP mRNA的表达均显著低于高分子聚乙烯组(P＜0.05),且随着阿仑膦酸钠浓度增高TRAP阳性破骨细胞数目和TRAP mRNA的表达呈递减趋势,组间差异均有统计学意义(P＜0.05).结论:阿仑膦酸钠可以抑制人工关节磨损微粒刺激破骨细胞分化形成.     

小檗碱对大鼠骨髓源性破骨细胞的分化及骨吸收功能的影响

目的：研究小檗碱对破骨细胞分化及骨吸收功能的影响,探讨小檗碱抑制骨吸收的细胞学基础。 方法：采用原代培养的成骨细胞和骨髓单核细胞联合培养的方法,在1,25-（OH）2维生素D3和地塞米松作用下,使骨髓单核细胞分化形成破骨细胞。通过相差显微镜观察细胞形态,通过抗酒石酸酸性磷酸酶（tartrate—resistant acid phosphatase,TRAP）染色和观察骨片上骨吸收陷窝的形成鉴定破骨细胞。磷酸苯二钠法测定破骨细胞抗酒石酸酸性磷酸酶的活性,计算机图像分析技术测定骨片上破骨性骨吸收陷窝的面积。 结果：小檗碱在0．1～10μmol／L范围内,浓度依赖性地抑制TRAP阳性多核破骨细胞的形成和TRAP活性,减少破骨性骨吸收陷窝的面积;在10μmol／L浓度下,对破骨细胞的抑制作用最强,对TRAP阳性多核破骨细胞的形成和TRAP活性的抑制率分别达到了60．45％和42．12％,骨吸收陷窝面积减少72．69％。 结论：小檗碱通过抑制破骨细胞的形成、分化和骨吸收功能减少骨质的丢失。     

阿仑磷酸钠?辛伐他汀对体外成骨细胞和破骨细胞的作用

目的:观察阿仑磷酸钠联合辛伐他汀对体外成骨细胞?破骨细胞的影响,探讨2种药物联合应用治疗骨质疏松的可行性?方法:分离新生大鼠成骨细胞和破骨细胞,给予阿仑磷酸钠?辛伐他汀刺激,观察药物对成骨细胞增殖率?碱性磷酸酶活性及破骨细胞骨吸收的影响?结果:联合应用阿仑磷酸钠和辛伐他汀较单独用药更明显增强成骨细胞活性和抑制破骨细胞的骨吸收?结论:联合应用阿仑磷酸钠和辛伐他汀比单独应用阿仑磷酸钠可能对骨质疏松有更好的防治作用?     

国产因卡磷酸钠对体外破骨细胞性骨吸收的作用

目的 研究国产因卡磷酸钠（ICD）对破骨细胞性骨吸收的作用。方法 采用破骨细胞与骨片的体外共培养法和显微摄片、显微光密度仪扫描及计算机图像分析技术。结果 ICD（0．5,5与50μmol/L）使体外破骨细胞性骨吸收陷窝数目呈剂量依赖性减少,中等浓度（5μmol/L）的抑制作用明显高于阳性对照药帕屈磷酸钠（APD）,两药均可使吸收陷窝表面积明显降低,而且ICD作用更明显。结论 ICD具有较强的直接抑制破骨细胞性骨吸收的作用,对骨质疏松症可能有一定的治疗作用。     

IL—1α促进骨巨细胞瘤中破骨样细胞体外骨吸收研究

目的：比较骨巨细胞瘤中的多核巨细胞与破骨细胞骨吸收的功能特点。方法：体外分离骨巨细胞瘤中的多核巨细胞与骨片共同培养，观察ＩＬ－１α对多核巨细胞体外骨吸收的影响。结果：ＩＬ－１α可使多核巨细胞骨吸收陷窝的数目和面积增加；其作用随剂量增加而增强；ＩＬ－１α对多核巨细胞的促进作用具有长效性。结论：ＩＬ－１α具有促进多核巨细胞体外骨吸收作用，说明多核巨细胞与破骨细胞在骨吸收功能方面有相似性。     

IL-1α促进骨巨细胞瘤中破骨样细胞体外骨吸收研究

目的：比较骨巨细胞瘤中的多核巨细胞与破骨细胞骨吸收的功能特点。方法：体外分离骨巨细胞瘤中的多核巨细胞与骨片共同培养，观察ＩＬ１α（５０μｇ／Ｌ，１００μｇ／Ｌ）对多核巨细胞体外骨吸收的影响。结果：ＩＬ１α可使多核巨细胞骨吸收陷窝的数目和面积增加；其作用随剂量增加而增强；ＩＬ１α对多核巨细胞的促进作用具有长效性。结论：ＩＬ１α具有促进多核巨细胞体外骨吸收作用，说明多核巨细胞与破骨细胞在骨吸收功能方面有相似性。     

骨巨细胞瘤中多核巨细胞的来源

目的：研究骨巨细胞瘤中多核巨细胞的来源,探讨骨巨细胞瘤是破骨细胞或者是肿瘤细胞。方法：本次试验标本30例为解放军222医院病理科经病例证实的手术标本。采用链菌素亲生物素一过氧化物酶连接法（sp）免疫组化技术。抗体 PCNA、P53、P21、CD68、AACT 以及 SP 染色试剂均为即用型,阳性判断以细胞浆、细胞膜或细胞核着棕色颗粒为阳性反应,以缓冲液 PBS 代替一抗作阴性对照,确定骨巨细胞瘤中多核巨细胞的来源。结果：30例骨骨细胞瘤中的多核巨细胞均不表达 PCNA、p53及 c －erBb2、有8例表达 p21,其包浆课件棕褐色的阳性颗粒,所有标本中的巨细胞均呈现 CD68强阳性,棕褐色的颗粒绝大多数位于细胞浆中,少数多核巨细胞呈 Vimentin 阳性反应,还有一部分多核巨细胞呈 Lysozyme 中性或阳性反应。结论：巨细胞瘤中的多核巨细胞与破骨细胞在形态学及酶组织化学与免疫组织化学与破骨细胞相似。多核巨细胞具有一定的破骨能力,由此可见,多核巨细胞是破骨细胞,属于终末细胞,而不是肿瘤细胞。     

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.