骨形态形成蛋白-7在实验性肾间质纤维化大鼠模型中作用的研究

目的:观察单侧输尿管梗阻(UUO)大鼠模型中骨形态形成蛋白-7(BMP-7)在肾小管间质中的表达部位、动态变化及其与肾间质纤堆化的 关系。方法:60只Wistar大鼠随机分为正常大鼠组、假手术组和单侧输尿管梗阻组,分别于术后1d、3d、7d、14d处死大鼠,采用RT-PCR检测BMP-7mRNA、 转化生长因子-β1(TGF-β1)mRNA表达水平,用免疫组化检测肾小管间质中BMP-7、TGF-β1蛋白的定位和表达及其与输尿管梗阻后肾间质损害的关系。 结果:与时照组相比,BMP-7mRNA于术后第1天即出现表达下降并随梗阻时间延长递减,而TGF-β1mRNA则随着梗阻时间延长增加(P均<0.05)。BMP -7蛋白在对照组中高度表达,髓质区表达明显高于皮质区,主要分布在肾小管及肾间质,肾小球内基本无表达。在梗阻组BMP-7蛋白表达呈进行性下 降,而TGF-β1蛋白表达则逐渐增加(P均<0.01)。结论:BMP-7蛋白于肾小管间质病变早期即出现表达下调,早于肾间质纤维化的出现,且随间质病变进 展进行性下降。BMP-7表达下调可能参与介导肾小管间质损害的发生发展。     

骨形态形成蛋白-7在实验性肾间质纤维化大鼠模型中作用的研究

目的：观察单侧输尿管梗阻(UUO)大鼠模型中骨形态形成蛋白-7(BMP-7)在肾小管间质中的表达部位、动态变化及其与肾间质纤维化的关系．方法：60只Wistar大鼠随机分为正常大鼠组、假手术组和单侧输尿管梗阻组．分别于术后1d、3d、7d、14d处死大鼠．采用RT-PCR检测BMP-7mRNA、转化生长因子-β1(TGF-β1)mRNA表达水平．用免疫组化检测肾小管间质中BMP-7、TGF-β1蛋白的定位和表达及其与输尿管梗阻后肾间质损害的关系．结果：与时照组相比，BMP-7mRNA于术后第1天即出现表达下降并随梗阻时间延长递战，而TGF-β1mRNA则随着梗阻时间延长增加(P均＜0.05)．BMP-7蛋白在对照组中高度表达，髓质区表达明显高于皮质区，主要分布在肾小管及肾间质，肾小球内基本无表达．在梗阻组BMP-7蛋白表达呈进行性下降，而TGF-β1蛋白表达则逐渐增加(P均＜0.01)．结论：BMP-7蛋白于肾小管间质病变早期即出现表达下调，早于肾间质纤维化的出现，且随间质病变进展进行性下降．BMP-7表达下调可能参与介导肾小管间质损害的发生发展。     

骨形态发生蛋白7在单侧输尿管梗阻大鼠肾组织中的表达

目的:观察单侧输尿管梗阻(UUO)大鼠模型中骨形态发生蛋白7(BMP-7)在肾组织中的表达部位、动态变化及其与肾小管间质损害的关系。方法:制备UUO大鼠模型,采用免疫组化ABC法检测UUO术后第1,3,7,14,21,28d肾组织中BMP-7和转化生长因子β(1TGF-β1)的表达。结果:随梗阻时间延长,BMP-7在肾小管中的表达有一过性增加,之后表达逐渐下降。而TGF-β1的表达逐渐增加,到21d达高峰,28d略回落。BMP-7阳性染色面积与肾间质相对面积呈负相关(r=-0.601,P<0.05),而TGF-β1阳性染色面积与肾间质相对面积呈正相关(r=0.864,P<0.05)。结论:UUO大鼠中,随梗阻时间的延长,TGF-β1在梗阻侧肾组织中的表达有逐渐增加的趋势,与肾间质损害的程度呈正相关;BMP-7在梗阻侧肾组织中的表达有逐渐减少的趋势,与肾间质损害的程度呈负相关。     

BMP-7在UUO模型大鼠肾组织的表达及意义

目的观察骨形态发生蛋白-7(BMP-7)在单侧输尿管梗阻(UUO)肾间质纤维化大鼠模型中的表达情况及与肾损伤的关系。方法将雄性Wistar大鼠48只随机分为正常对照组、假手术组、UUO模型组,分别采用免疫组化和原位杂交方法检测肾组织中BMP-7及BMP-7 mRNA的表达和定位。结果与正常对照组和假手术组相比,UUO模型组BMP-7在肾小管上皮细胞和肾间质中表达明显下降,而肾小球中均未见表达;且术后3d BMP-7表达即有下降,随梗阻时间延长,其表达量进行性下降。结论BMP-7在肾间质纤维化早期即出现表达量下降,随病程进展而进行性降低。BMP-7表达下调可能是肾间质纤维化发生发展的机制之一。     

BMP-7在UUO模型大鼠肾组织的表达及意义

目的观察骨形态发生蛋白-7（BMP-7）在单侧输尿管梗阻（UUO）肾间质纤维化大鼠模型中的表达情况及与肾损伤的关系。方法将雄性Wistar大鼠48只随机分为正常对照组、假手术组、UUO模型组，分别采用免疫组化和原住杂交方法检测肾组织中BMP-7及BMP-7mRNA的表达和定位。结果与正常对照组和假手术组相比，UUO模型组BNP-7在肾小管上皮细胞和肾间质中表达明显下降，而肾小球中均未见表达；且术后3dBMP-7表达即有下降，随梗阻时间延长，其表达量进行性下降。结论BMP-7在肾间质纤维化早期即出现表达量下降，随病程进展而进行性降低。BMP-7表达下调可能是肾间质纤维化发生发展的机制之一。     

依那普利对大鼠肾间质损害中骨成形蛋白-7及其受体表达的影响

目的 研究血管紧张素转化酶抑制剂(ACEI)依那普利对单侧输尿管梗阻大鼠肾组织骨成形蛋白-7(BMP-7)及其受体BMPR-Ⅱ、ALK-2、ALK-3、ALK-6表达的影响.方法 采用单侧输尿管梗阻(UUO)大鼠模型,治疗组于造模前24 h～造模后7 d以依那普利10 mg/(kg·d)灌胃,另设假手术组为正常对照,造模7天后,应用免疫组织化学法观察肾脏BMP-7、TGF-β1蛋白表达,半定量RT-PCR法检测肾脏BMP-7及其受体BMPR-Ⅱ、AIX-2、ALK-3、ALK-6mRNA表达水平.结果 与假手术对照组相比,UUO大鼠肾脏BMP-7及其受体BMPR-Ⅱ、ALK-2和ALK-3mRNA表达明显减少,TGF-β1蛋白表达明显增高,而给予依那普利治疗后能够显著上调BMP-7及其受体BMPR-Ⅱ、ALK-2和ALK-3的表达,下调TGF-β1的表达,减轻肾间质纤维化.结论 依那普利可显著上调BMP-7及其受体表达,减轻梗阻肾间质纤维化,这一作用可能与抑制TGF-β1的致纤维化活性有关.     

动态观察依那普利对单侧输尿管梗阻大鼠TGF-β1,CTGF,Smad7和α-SMA的影响

目的：动态观察血管紧张素转换酶抑制剂依那普利对单侧输尿管梗阻大鼠肾组织转化生长因子（transforming growth factor-β,TGF-β1)、结缔组织生长因子（connective tissue growth factor,CTGF）、Smad7和平滑肌肌动蛋白（α-smooth muscle actin, α-SMA)表达的影响,探讨依那普利对肾小管上皮细胞转分化的影响。方法：雄性SD大鼠64只,采用单侧输尿管梗阻模型,将实验大鼠分为假手术组（16只）、模型组（24只）和治疗组（24只）,治疗组从造模前24 h开始以依那普利10 mg/（kg·d）灌胃。分别于造模后3,7,14,21 d取梗阻侧肾组织进行HE染色,观察肾脏组织病理结构变化,并进行肾间质损伤指数评分;应用real-time PCR法检测肾组织TGF-β1和CTGF mRNA的表达,应用Western 免疫印迹检测肾组织α-SMA,Smad7和CTGF蛋白的表达。结果：随着梗阻时间的延长,单侧输尿管梗阻模型鼠肾间质损伤指数评分逐渐增加。TGF-β1和CTGF mRNA以及α-SMA和CTGF蛋白表达逐渐增加,Smad7蛋白表达逐渐减少。依那普利治疗后,肾间质损伤指数下降,TGF-β1和CTGF mRNA以及α-SMA和CTGF蛋白表达较模型组降低,Smad7蛋白表达较模型组增加,依那普利对各时间点 TGF-β1 mRNA的表达均有明显的下调作用,对 CTGF mRNA,α-SMA,CTGF和Smad7蛋白对以单侧输尿管梗阻术后3,7,14 d作用最明显。结论：依那普利可减轻梗阻肾间质纤维化, 以单侧输尿管梗阻后14 d内效果最好,这一作用可能与抑制肾组织TGF-β1,CTGF和α-SMA的表达,增加肾组织Smad7的表达有关。     

傣药雅盼对单侧输尿管梗阻大鼠TGF-β1/Smads信号转导通路的影响

目的 观察傣药雅盼对单侧输尿管梗阻(UUO)大鼠转化生长因子(TGF)-β1/Smads信号转导通路的影响,从而探讨该药对肾间质纤维化抑制作用的可能机制.方法 120只雄性大鼠行单侧输尿管结扎建立UUO大鼠模型,生理盐水灌胃或给药28 d后收集血清检测尿素氮(BUN)、肌酐(Scr),处死大鼠,取其肾组织行HE染色和Masson染色,免疫组织化学法检测TGF-β1、Smad2、Smad7在肾组织的表达;反转录-聚合酶链反应(RT-PCR)检测mRNA的表达;Western blot检测蛋白表达.结果 傣药雅盼各剂量组能降低大鼠BUN、Scr水平,并减轻肾小管-间质炎性细胞及肾间质纤维化程度,同时使TGF-β1、Smad2 mRNA和蛋白表达上调(P＜0.05),而Smad7 mRNA和蛋白表达下调(P＜0.05).结论 傣药雅盼备浓度组均可以在一定程度抑制Smad2 mRNA的表达,上调Smad7 mRNA的表达,通过干预TGF-β1/Smads信号转导通路抑制了TGF-β1在肾组织的表达从而对UUO大鼠肾间质纤维化.     

补肾解毒通络方对肾间质纤维化大鼠TGF-β1 BMP-7表达的影响

目的：观察补肾解毒通络方对肾间质纤维化大鼠转化生长因子-β1（TGF-β1）、骨形态发生蛋白-7（BMP-7）及两者mRNA表达的影响。方法：通过腺嘌呤灌胃建立大鼠肾间质纤维化模型,利用免疫组织化学方法、半定量RT-PCR分别检测大鼠肾脏TGFβ1、BMP-7及两者mRNA的表达。结果：补肾解毒通络方能下调TGF-β1和TGF-β1mRNA的表达、上调BMP-7和BMP-7mRNA的表达,治疗组与模型组比较有统计学差异（P〈0.01）。结论：补肾解毒通络方可以通过下调TGF-β1和TGF-β1mRNA表达、上调BMP-7和BMP-7mRNA的表达来减轻肾间质纤维化。     

依那普利对大鼠肾间质纤维化中TGF-β1,p-Smad2/3及Smad7的作用

目的:观察依那普利对肾间质纤维化大鼠肾组织中TGF-β1,p-Smad2/3及Smad7的影响,探讨依那普利抗肾间质纤维化的作用机制.方法:将30只雌性SD大鼠随机分为假手术组、模型组和依那普利治疗组.对治疗组和模型组大鼠行左侧输尿管结扎术建立单侧输尿管梗阻的动物模型.术后14 d处死大鼠,留取梗阻侧肾组织行HE和Masson染色以观察各组大鼠肾组织病理改变,用免疫组织化学方法检测Col Ⅰ,TGF-β1,P-Smad2/3和Smad7的蛋白水平表达,用RT-PCR方法检测TGF-β1,和Smad7mRNA水平表达.结果:模型组肾间质损伤指数、胶原相对面积及间质内Col Ⅰ表达均较假手术组增高(P<0.01),依那普利治疗后好转.假手术组肾组织TGF-β1蛋白及mRNA表达、p-Smad2/3蛋白表达较低,模型组表达明显增强(P<0.01),依那普利治疗后明显减弱(P<0.01).假手术组肾组织可见较多的Smad7蛋白及mRNA表达,模型组肾组织Smad7表达明显减弱(P<0.01),依那普利治疗后Smad7表达较模型组增强(P<0.01).结论:依那普利可以通过影响单侧输尿管梗阻大鼠肾组织中TGF-β/Smads信号通路中的TGF-β1,p-Smad2/3和Smad7而起到抑制纤维化的作用.     

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.     

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.