不同海拔高度严重烧伤延迟复苏大鼠脑组织中氨基酸的变化及其意义

目的探讨不同海拔高度严重烧伤延迟复苏大鼠脑组织氨基酸变化及其意义。方法雄性Wistar大鼠120只，在海拔3800M与海拔1517M制作实验动物模型(TBSA30％，Ⅲ度)，并随机分为延迟、即时复苏组和正常对照组，分别于伤后1h、6h、12h、24h、72h、7d取材。应用高效毛细管电泳法检测脑组织中兴奋性氨基酸(谷氨酸)和抑制性氨基酸(甘氨酸、γ-氨基丁酸)含量。结果高原延迟复苏组(HDFR)兴奋性氨基酸(谷氨酸)伤后较对照组(HNC)和即时复苏组(HIFR)显著降低，抑制性氨基酸(γ-氨基丁酸、甘氨酸)较HNC组、HIFR组显著升高。HIFR组伤后3d基本恢复至对照水平，HDFR组伤后7d，尚未恢复正常。高原地区与兰州地区各时相点比较兴奋性氨基酸降低，抑制性氨基酸升高，兰州地区即时复苏组(LIFR)伤后12h～24h基本恢复正常，兰州地区延迟复苏组(LDFR)伤后72h恢复正常。结论高原地区严重烧伤延迟复苏大鼠脑组织中兴奋性氨基酸增多，抑制性氨基酸减少，此变化加重了脑损伤。     

高原大鼠严重烧伤后氧化应激反应对小肠凋亡相关基因Bax，Bcl-2表达的影响

目的：探讨高原大鼠严重烧伤延迟复苏后氧化应激反应对肠上皮细胞凋亡相关基因Bax和Bcl-2表达的影响.方法：将Wistar大鼠132只分为兰州组（15171m）和高原组（3840m）,兰州组包括兰州即时复苏组（LIFR,n=30）、兰州延迟复苏组（LDFR,n=30）、假伤组（LCG,n=6）,高原组包括高原即时复苏组（HIFR,n=30）、高原延迟复苏组（HDFR,n=30）、假伤组（HCG,n=30）。大鼠背部30％TBSA（总体表面积）Ⅲ度烫伤后,立即或伤后6h液体复苏。观察伤后肠黏膜中丙二醛（MDA）和总巯基（TSH）变化及凋亡相关基因Bax,Bcl-2表达变化。结果：高原地区MDA和TSH变化较兰州地区明显,免疫组化观察到伤后肠上皮Bax阳性细胞较兰州地区增多;HDFR组肠上皮Bax阳性表达早于LDFR组且更严重;MDA变化与肠上皮细胞Bax阳性表达成正相关（立即复苏组r=0.939,P〈0.01;延迟复苏组r=0.938,P〈0.05）;TSH变化与肠上皮细胞Bax阳性表达成负相关（立即复苏组r=-0.949,P〈0.01;延迟复苏组r=-0.934,P〈0.01）.Bcl-2基因表达高原地区均为阴性结果,兰州地区伤后6,12h为阴性表达,其他情况为弱阳性表达.结论：高原大鼠烧伤延迟复苏后肠上皮细胞的严重氧化应激反应及Bax基因表达,可能是其凋亡增加的重要原因之一。     

不同时间甘精胰岛素干预对烧伤延迟复苏大鼠脏器氧化应激的影响

目的探讨不同时间低剂量甘精胰岛素干预在烧伤延迟复苏大鼠中的抗氧化效应, 明确烧伤延迟复苏时较好的抗氧化干预时机。方法将50只雄性SD大鼠按随机数字表法分为假伤组、延迟复苏组、烧伤后即刻甘精胰岛素治疗组(即刻治疗组)、烧伤后2 h甘精胰岛素治疗组(2 h治疗组)、烧伤后6 h甘精胰岛素治疗组(6 h治疗组)等5组, 每组各10只。甘精胰岛素各治疗组分别于烧伤后即刻、2 h、6 h皮下注射甘精胰岛素(1.0 U·kg-1·d-1), 延迟复苏组于伤后6 h皮下注射等量生理盐水。延迟复苏组及各治疗组均于伤后6 h腹腔注射生理盐水(40 ml/kg)模拟液体延迟复苏;假伤组不给药且不进行液体复苏。假伤组于伤后即刻、其余各组于伤后24 h分别采集大鼠腹主动脉血及心脏、肾脏组织。分光光度法测定各组大鼠血糖及心肌和肾脏组织中铜锌超氧化物歧化酶(CuZn-SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)、总抗氧化能力(T-AOC)、黄嘌呤氧化酶(XOD)和髓过氧化物酶(MPO)的活性, 分析抗氧化干预的时机。结果与假伤组相比, 延迟复苏组血糖升高[(10.72±0.80)比(6.57...     

脑微透析法研究大鼠脊髓损伤后脑内兴奋性氨基酸的动态变化

目的研究大鼠脊髓损伤后大脑中枢兴奋性氨基酸水平的变化,探讨微透析技术在脊髓损伤中的应用,以及脊髓损伤与大脑中枢反应的关系。方法将Wistar大鼠分为损伤组、对照组和正常组,损伤组定位脑内纹状体,运用微透析技术检测大鼠脊髓损伤前1 h,损伤后0.5 h,2 h,6 h,24 h,72 h其脑细胞外液(ECF)兴奋性氨基酸含量的变化,选取谷氨酸含量([Glu]d)和天门冬氨酸含量([Asp]d)为兴奋性氨基酸的主要参考值。结果大鼠脊髓损伤0.5 h后脑内[Glu]d和[Asp]分别为损伤前基础值的(402±10)%、(642±7)%(P<0.01),然后逐步回落,于伤后24 h大致恢复正常。结论由于谷氨酸,天门冬氨酸是大脑内重要的兴奋性氨基酸递质,因此脊髓损伤后脑内兴奋性氨基酸水平的一过性升高提示大脑皮质、脑干网状结构正常状态对脊髓易化作用在脊髓损伤后所依赖的神经递质水平受到显著影响,而且微透析技术可以较好地检测其动态变化。     

实验性大鼠颅脑损伤后兴奋性氨基酸及脑血流量的变化研究

目的观察流体冲击致大鼠脑损伤后不同时相点脑组织兴奋性氨基酸(excitatory amino acids,EAA)和局部血流量(regional cerebral blood flow,rCBF)的变化,及它们在脑损伤和继发性脑损伤中的作用.方法用流体冲击装置制作中度脑损伤,氨基酸微量分析系统检测谷氨酸(glutamate,Glu)和天门冬氨酸(aspate,Asp)含量,氢清除法检测大脑局部血流量.结果中度脑损伤后rCBF明显低于伤前和正常对照组;脑组织Glu、Asp的含量在伤后30min即可见明显增加,1h有所回落,2h又有所升高,4h至6h趋于稳定.结论结果显示脑损伤后脑血流量的下降可能与氨基酸释放有着一定的关系,氨基酸大量释放可能在脑损伤和继发性脑损伤中起着主要作用.     

脑脉康颗粒剂对大脑中动脉缺血再灌注大鼠脑的保护作用

探讨益气活血开窍复方脑脉康颗粒对缺血再灌注脑保护作用的机理.用线栓法制成大鼠脑缺血再灌注模型,采用全自动氨基酸分析仪、干湿重法、原子吸收分光光度计测量脑组织中兴奋性氨基酸(EAA)含量、含水量及钙离子(Ca2+)含量,HE法观察脑组织形态学改变.结果显示中药组谷氨酸 (Glu)含量下降(P<0.01),谷氨酸/ γ-氨基丁酸(Glu/ GABA)趋向于正常比值,脑组织含水量及Ca2+含量下降(P<0.05).中药可减轻由于缺血再灌注所导致的脑细胞形态学的改变.证明益气活血开窍方脑脉康颗粒通过抑制EAA释放,Ca2+内流而发挥脑保护作用.     

急进高原大鼠形态学变化与早期脑水肿关系的研究

目的 为阐明急进高原脑组织病变发病机制,对急进高原大鼠在高原环境下脑组织形态学变化和脑含水量的改变进行相关研究.方法 解剖、观察Wister大鼠高原1、3 、7 d组脑组织大体形态变化.H-E染色,光镜观察脑组织学变化;电镜观察脑组织超微结构变化.测定脑组织含水量.结果 光镜下,脑组织出现明显炎症反应,脑组织充血水肿,内有大量的炎性细胞.电镜下,神经元细胞出现凋亡.脑组织含水量与对照组比较,1、3、7 d组含水量增加（P＜0.05）.结论 高原脑组织损伤的发生与高原缺氧有关.推测缺氧使脑毛细血管壁通透性增加、脑水转运功能障碍;脑细胞发生凋亡,脑组织内液体大量聚集,引发脑水肿.     

心肺复苏大鼠脑基质金属蛋白酶9的表达和血脑屏障的变化

【目的】 探讨心肺复苏后早期大鼠脑组织基质金属蛋白酶9(MMP9)的表达和血脑屏障的变化规律&#65377;【方法】 将80只大鼠随机分为假手术组(n = 40)和复苏组(n = 40)&#65377;假手术组仅进行麻醉和气管插管&#65380;血管穿刺,不进行窒息,复苏组用气管夹闭窒息法致使心跳骤停后进行复苏,其他与对照组相同,分别在0&#65380;3&#65380;9&#65380;24 h和48 h 5个时间点处死大鼠后,取样,测定脑组织MMP9的表达&#65380;MMP9 mRNA&#65380;脑含水量与脑组织伊文思蓝含量的变化,电镜观察脑组织的超微结构&#65377;【结果】 复苏组心肺复苏后3&#65380;9&#65380;24和48 h脑组织MMP9表达明显高于假手术组,MMP9 mRNA含量与假手术组相比差异有统计学意义,脑含水量与假手术组比较明显升高,与假手术组比较,脑组织伊文思蓝含量明显升高;超微结构发生改变&#65377; 【结论】 在心肺复苏大鼠脑缺血模型中MMP9蛋白和MMP9mRNA的表达明显升高;脑组织的脑含水量和伊文思蓝含量明显升高,血脑屏障受到破坏;电镜超微结构观察证实脑组织损伤明显;这些变化在心肺复苏后24 h达高峰&#65377;     

高渗氯化钠右旋糖酐对大鼠心肺复苏后脑组织的作用

目的 探讨高渗氯化钠右旋糖酐(HSD)对大鼠心搏骤停心肺复苏(CPR)后脑组织的作用.方法 40只雄性SD大鼠随机分为4组:正常组、假手术组、复苏对照组、HSD干预组,每组10只.建立窒息型大鼠心肺复苏模型.复苏即刻,复苏对照组给予4 mL/kg NS静脉注射,HSD干预组给予4 mL/kg的HSD静脉注射.检测ROSC后24 h大鼠脑组织含水量、脑海马齿状回及CA1区S100的表达,光学显微镜观察脑海马组织病理改变情况.结果 正常组、假手术组大鼠脑组织含水量与HSD干预组比较,差异均无统计学意义(均P>0.05),且明显低于复苏对照组(P<0.01).复苏对照组、HSD干预组大鼠脑海马齿状回、海马CA1区S100阳性细胞数较正常组、假手术组均增多(P<0.05 或P<0.01),而HSD干预组明显少于复苏对照组(P<0.01).光学显微镜观察显示,正常组、假手术组脑组织结构相似,HSD干预组脑组织病理学损伤较复苏对照组轻.结论 HSD能减少复苏后大鼠脑海马组织S100的表达,减轻脑水肿及脑组织病理学损伤,对大鼠心搏骤停心肺复苏后脑组织有一定保护作用.     

单唾液酸神经节苷脂对创伤性脑水肿大鼠水通道蛋白4表达的影响

目的研究神经节苷脂对脑水肿大鼠水通道蛋白4表达的影响。方法建立大鼠重度颅脑损伤模型,随机分成正常组、模型组和治疗组。考察大鼠伤后不同时间点神经节苷脂对脑含水量和脑组织AQP 4mRNA表达水平的影响。结果模型组和治疗组大鼠脑组织含水量在造模4 h后逐步上升,治疗组在24 h到达峰值后下降,72 h大鼠脑组织含水量值与正常组接近,而模型组大鼠脑组织含水量一直升高,72 h含水量高达80%。两组大鼠造模后1 h后AQP 4 mRNA表达水平开始上调,逐步增加,治疗组在12 h达峰值,然后表达持续回落,72 h与正常组表达水平接近;模型组在24 h达峰值,且表达维持在高位,明显高于治疗组(P<0.05)。结论神经节苷脂能抑制脑水肿的发生,减轻脑水肿形成。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.