脑梗死大鼠原位神经干细胞的增殖和分化

目的研究成年大鼠脑梗死后原位神经干细胞的增殖和分化。方法运用BrdU标记法检测脑局灶梗死大鼠侧脑室下区(SVZ)与海马齿状回颗粒细胞层下区(SGZ)原位神经干细胞的增殖情况,运用荧光双标法检测其分化的细胞表型。结果SVZ BrdU 细胞数量于脑梗死后1 d开始升高(P<0.01),而SGZ BrdU 细胞则于梗死后4 d开始升高。SVZ与SGZ BrdU 细胞均于7 d达到高峰(P<0.01),14 d开始下降(P<0.01),至28 d后与对照组差异无显著性意义(P>0.05)。半定量显示脑梗死7 d后,SVZ与SGZ BrdU 细胞数分别较假手术组升高5倍和8倍。对原位神经干细胞分化的研究发现,脑梗死后35 d在梗死侧大脑半球,BrdU 细胞总数中约(73.5±15.7)%表达神经元细胞表型NeuN,(37.6±9.9)%表达胶质细胞表型GFAP。结论大鼠脑梗死能刺激原位神经干细胞的增殖并促进了神经再生。     

槲皮素对成年大鼠局灶性脑缺血后侧脑室室管膜下区神经干细胞增殖的影响

摘要：目的观察槲皮素对成年大鼠局灶性脑缺血后侧脑室室管膜下区（SVZ）细胞增殖的影响。方法线栓法制作大鼠右
侧大脑中动脉阻塞模型,术后6 h腹腔注射槲皮素（50 mg/kg,1次/3 d）,术后4 h腹腔注射BrdU（50 mg/kg,1次/d）,分别于
缺血第7、14、21天采用免疫荧光染色观察侧脑室SVZ BrdU阳性细胞数。结果脑缺血第7天,缺血侧SVZ BrdU阳性细
胞较假手术组明显增多,第14天达峰值,第21天减少（P<0.01）。槲皮素组第7天时,缺血侧SVZ BrdU阳性细胞亦明显增
多,并随着缺血时间延长明显增加;与缺血组比较,槲皮素组7、14 和21 d 缺血侧SVZ BrdU阳性细胞数均显著增加（P<
0.01）,至21 d仍保持高水平。结论槲皮素可维持成年大鼠局灶性脑缺血后侧脑室SVZ的细胞增殖在较高水平。     

大鼠创伤性颅脑损伤后脑室下区内源性神经干细胞的增殖与分化

目的探讨创伤性脑损伤后脑室下区（SVZ）神经干细胞（NSCs）的增殖分化的时程变化。方法采用随机数字表法将大鼠 分为3组,对照组不做任何处理,假手术组仅切开头皮和颅骨开窗,实验组采用Feeney氏法造成颅脑损伤（TBI）。选用Nestin与 BrdU两种细胞标志物及神经元特异标志物神经元特异性烯醇化酶（NSE）及胶质细胞标志物GFAP,采用免疫荧光化学方法对3 组脑组织标本分别行双标蛋白抗体免疫荧光染色,检测TBI 后SVZ 内源性NSCs 的增殖、分化变化。结果TBI 后,伤侧 SVZNestin/NSE 、Nestin/GFAP、BrdU/NSE、BrdU/GFAP标记阳性细胞均明显增多,伤后第1天开始升高,第3天达峰值,第14天 恢复正常,实验组4个时间点间及实验组与对照组对应时间点间的比较差异均有显著性意义,其中以Nestin/GFAP标记的增殖分 裂阳性细胞升高最显著。结论TBI后,动员了伤侧SVZ中的NSCs,诱导该区内源性NSCs的增殖分化,提示SVZ是NSCs增殖 分化的重要的生发中心之一。     

通心络对脑缺血再灌注损伤后大鼠内源性神经巢蛋白和碱性成纤维生长因子表达的影响

目的探讨通心络对脑缺血再灌注损伤后大鼠内源性神经巢蛋白(Nestin)和碱性成纤维生长因子(bFGF)表达的影响。方法改良线栓法制作大鼠大脑中动脉缺血再灌注损伤模型,分为模型组、通心络大剂量组(1.0 g·kg~(-1)·d~(-1))、通心络小剂量组(0.5 g·kg~(-1)·d~(-1))和假手术组。免疫荧光法检测各组大鼠缺血再灌注损伤后第3、5、7、14、21、30天病灶侧侧脑室下区(SVZ)、海马齿状回(DG)区5-溴脱氧尿嘧啶核苷(BrdU)和Nestin的变化,逆转录聚合酶链式扩增(RT-PCR)方法检测相应时间点病灶侧碱性成纤维生长因子信使核糖核酸(bFGF mRNA)的表达。结果假手术组几乎检测不到BrdU+Nestin和bFGF mRNA的表达。通心络大剂量和小剂量组第5、7、14、21、30天病灶侧SVZ、DG区BrdU+Nestin荧光强度值与模型组比较差异均有统计学意义(P<0.05)。第5、7、14、21、30天通心络大剂量组与通心络小剂量组BrdU+Nestin荧光强度值比较有统计学意义(P<0.05)。通心络大剂量和小剂量组第5天BrdU+Nestin阳性荧光强度值增加,第14天达最高(P<0.05),并持续到缺血再灌注后第30天。缺血再灌注后各时间点通心络大剂量和小剂量组分别与模型组bFGF mRNA表达比较差异均有统计学意义(P<0.05)。通心络大剂量和小剂量组bFGF mRNA表达在缺血再灌注后第3天开始增高,第7天表达值最高(P<0.05),并持续到第30天仍然有较高水平,而模型组第30天已恢复到基线水平。模型组、通心络大剂量组和通心络小剂量组组内不同时间BrdU+Nestin荧光强度值和bFGFmRNA表达比较差异均有统计学意义(P<0.05)。结论大鼠脑缺血再灌注损伤可引起病灶侧SVZ、DG区神经干细胞反应和增殖;通心络可显著增加大脑中动脉缺血及再灌注模型大鼠神经干细胞的增殖分化能力。通心络促使病灶侧bFGFmRNA表达上调可能为促进神经干细胞增殖分化的机制之一。     

康复训练对脑出血大鼠室管膜下区NSCs增殖与分化的影响

目的 探讨康复训练对大鼠脑出血后室管膜下区(SVZ)神经干细胞(NSCs)增殖和分化的影响.方法 75只SD大鼠随机分为康复组、制动组和假手术组(每组25只),康复组和制动组用胶原酶诱导脑出血模型,假手术组用生理盐水替代胶原酶.康复组每天予以抓握、平衡、旋转等训练,制动组置于网状笼内固定,假手术组在笼内自由活动.每组大鼠康复前后进行神经功能评分,分别于康复训练后1、4、7、14和28天处死动物.应用免疫组织化学方法检测大鼠SVZ神经细胞巢蛋白(Nestin)和5-溴脱氧尿核苷(BrdU)表达的变化.结果康复组神经功能缺损评分低于制动组(P﹤0.05).康复组大鼠SVZ BrdU阳性、Nestin阳性细胞在不同时间点均多于制动组大鼠(P<0.05),第7天康复组SVZ BrdU阳性、Nestin阳性细胞表达达到高峰,14天时表达逐渐减少(P<0.05,P<0.01).结论 康复训练可促进脑出血后大鼠NSCs增殖,并向神经元分化.     

亚低温对局灶性脑缺血大鼠内源性神经干细胞增殖、迁移的影响

目的:探讨亚低温对局灶性脑缺血大鼠内源性神经干细胞增殖及迁移的影响。方法:采用改良线栓法制作大鼠永久性大脑中动脉闭塞模型,模型成功大鼠随机分为对照组和亚低温组。两组大鼠均于术后3,7,14,21 d处死,处死前1 d腹腔注射5-溴脱氧尿核苷(BrdU)标记增殖的神经干细胞。采用免疫组织化学方法并动态观察侧脑室下区(SVZ)及梗死灶周围皮质BrdU阳性细胞的变化。结果:对照组SVZ区及梗死灶周围BrdU阳性细胞在梗死后3 d开始增多,7 d达高峰,14 d后开始下降,21 d进一步减少。亚低温组各个时间点SVZ区及梗死灶周围BrdU阳性细胞显著性高于对照组。与对照组相比,亚低温组在各个时间点均能显著提高BrdU阳性细胞。结论:亚低温能促进局灶性脑缺血大鼠内源性神经干细胞增殖、迁移。     

补阳还五汤对去势脑缺血雌性大鼠海马神经干细胞增殖及ERK/CREB信号通路的影响

目的：探讨补阳还五汤对去势脑缺血雌性大鼠海马神经干细胞（neural stem cells, NSCs）增殖及ERK/CREB信号通路的影响。方法采用双侧卵巢切除术(OVX)结合大脑中动脉阻塞（MCAO)法复制去势雌性大鼠脑缺血复合模型,将造模后的36只大鼠随机分为双假手术组、复合模型组、雌激素组、雌激素+G15组、补阳还五汤组及补阳还五汤+G15组6组,每组6只,术后24 h给予相应药物灌胃连续干预14 d,同时每天腹腔注射BrdU、G15分别标记增殖细胞和阻断GPER-1。采用免疫荧光BrdU/ Nestin双标法检测各组大鼠缺血侧海马齿状回NSCs增殖情况,免疫组化SP法检测ERK1/2、CREB1磷酸化蛋白表达水平。结果补阳还五汤组和雌激素组缺血侧海马DG区BrdU/Nestin双标阳性细胞及pERK1/2、pCREB1阳性细胞表达均增加,与复合模型组比较有显著性差异(P<0.05）,但补阳还五汤组要多于雌激素组(P<0.05)。与补阳还五汤组比较,补阳还五汤+G15组缺血侧海马DG区BrdU/Nestin双标阳性细胞及及pERK1/2、pCREB1阳性细胞表达均减少（P<0.05）。结论补阳还五汤可以促进去势脑缺血雌性大鼠缺血侧海马 DG 区神经干细胞增殖,激活ERK/CREB信号通路,可能是其发挥类雌激素作用、促进内源性神经再生作用机制之一。     

缺血再灌注损伤大鼠脑内神经巢蛋白的变化及通心络对它的影响

目的 探讨神经巢蛋白（nestin）在脑缺血再灌注损伤后神经细胞的活化增殖情况及通心络对其影响。方法 采用大鼠缺血再灌注损伤（MCAO）模型，应用免疫组织化学方法观察缺血后3、7、14以及21d缺血侧室管膜及室管膜下区（SVZ）、海马齿状回（HDG）神经巢蛋白的变化。给予模型大鼠通心络灌胃，观察神经干细胞增殖分化的变化。结果 神经巢蛋白阳性细胞随缺血再灌注时间的延长，荧光强度值增加，第7、14、21天组与假手术组比较，差异具有显著性（P〈0．05）。造模后通心络组BrdU阳性细胞荧光强度值和BrdU＋nestin免疫双标荧光强度值均高于脑缺血再灌注模型组,差异显著（P〈0．05）。结论 大鼠缺血再灌注损伤后可引起其缺血侧SVZ、HDG区神经干细胞反应和增殖；而通心络可显著增加MCAO大鼠神经干细胞增殖分化能力。     

川芎嗪对大鼠脑缺血再灌注损伤脑室下区细胞增殖的影响

目的:观察川芎嗪(ligustrazine)对大鼠局灶性脑缺血再灌注损伤侧脑室室下区(subventricular zone,SVZ)细胞增殖的影响.方法:将雄性Sprague-Dawley(SD)大鼠随机分为正常组、假手术组、川芎嗪治疗组和对照组.采用线栓法制作局灶性脑缺血再灌注模型,5-溴脱氧尿嘧啶(5-bromodeoxyuridine,BrdU)标记增殖细胞并用免疫组织化学方法检测BrdU阳性细胞并对SVZ区BrdU阳性细胞计数.采用Western blot检测神经元型一氧化氮合酶(neuro nitric oxide synthase,nNOS)的表达,并测定吸光度值.结果:正常组、假手术组SVZ有少量BrdU阳性细胞,川芎嗪治疗组、对照组SVZ区BrdU阳性细胞再灌注后1 d开始出现,逐渐增加,7 d达到峰值,持续至14 d,在21 d时下降.川芎嗪治疗1 d和3 d组BrdU阳性细胞明显多于对照组(P＜0.01).在缺血对侧SVZ也有细胞增殖,川芎嗪治疗组、对照组在各时间点的变化与缺血侧相似.川芎嗪治疗1 d,3 d组nNOS表达量明显低于对照组(P＜0.05),川芎嗪治疗7 d组与3 d组相比nNOS表达量增加,但与缺血对照组相比无统计学差异.结论:川芎嗪促进局灶性脑缺血再灌注损伤后SVZ区的细胞增殖,其机制可能与nNOS的表达下降有关.     

脑络欣通对神经干细胞增殖分化及β-tubulinⅢ/GFAP的影响

目的观察脑络欣通对β-tubulinⅢ/GFAP及神经干细胞（NSCs）增殖分化的影响。方法将NSCs细胞株分为空白模型 （MC）组、10%脑络欣通含药血清（NLXT组）、10%脑络欣通含药血清+抑制剂Y27632组（Y-27632组）。采用MTT法检测NSCs 细胞活性,Transwell小室观察NSCs迁移,免疫印迹法观察β-TubulinⅢ、GFAP、MAP-2蛋白表达。免疫荧光标记DCX、NEUN、 β-TubulinⅢ表达。结果与MC组比较,1 d和3 d NLXT组、Y-27632组迁移细胞数增多（P<0.05）;7 d后NLXT组、Y-27632组细 胞存活率及迁移细胞数显著增多（P<0.01）。与MC组比较,第3 天、第7 天NLXT组和Y-27632组β-tubulinⅢ、MAP2、GFAP蛋 白表达显著升高（P<0.01或P<0.05）。NLXT组、Y-27632组脑组织β-tubulinⅢ/GFAP、BrdU/DCX、BrdU/NEUN标记细胞数目较 MC组明显增多。结论脑络欣通通过调节β-tubulinⅢ/GFAP促进NSCs增殖、分化。     

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.