IL-10、IL-1 8在实验性脑出血血肿周围的表达

目的 研究大鼠脑出血(ICH)后血肿周围白细胞介素10(IL-10)、白细胞介素18(IL-18)的表达.方法 将65只SD大鼠随机分为正常对照组、假手术组和ICH组,应用肝素化Ⅶ型胶原酶建立大鼠ICH模型,免疫组化检测脑组织血肿周嗣IL-10、IL-18的表达.结果 (1)ICH组大鼠12h脑组织IL-10表达即开始上升,7d明显升高,14d达高峰,各时间点与正常对照组和假手术组相比均有统计学意义(P<0.05);(2)ICH组大鼠12h脑组织IL-18表达即开始上升,7d达高峰,各时间点与正常对照组和假手术组比较均有统计学意义(P<0.01);(3)ICH组IL-18与IL-10呈显著正相关(r=0.909,P<0.01).结论 ICH后血肿周围存在着IL-10、IL-18介导的炎性反应,两者的相互作用可能接近于一个相对动态的平衡点,有利于疾病的恢复.     

脑出血血肿周围脑组织的糖代糖、氧自由基及血脑屏障的变化与脑水肿形成的关系

目的 研究脑出血（intracerebral hemorrhage,ICH）血肿周围脑组织的糖代谢、氧自由基及血脑屏障（blood-brain barrier,BBB）的变化与脑水肿形成的关系，从而进一步阐明脑水肿形成的机制。方法 60只SOD雄性大鼠从尾动脉采血100μL，在立体定向仪下洲主大鼠右侧大脑内囊处，制成脑出血模型，按脑出血形成的时间分为假手术组、4、8、12、16、24、48、72、120、168h组共10组。干湿重法测量脑组织含水量。BBB的通透性采用伊文思蓝法。并测定及脑组织MDA（丙二醛）、SOD（超氧化物歧化酶）和糖、LDH（乳酸脱氢酶）的水平。结果 血肿周围脑组织含水量在ICH形成4h就开始升高（P＜0.05），48－72h达到高峰，5－7d逐步恢复正常。EB（伊文思蓝）在8h开始升高，12h迅速升高，24－48h到达高峰。SOD、MDA在12h开始变化，72h最明显。而糖也在72h达高峰（P＜0.01）。LDH在8h开始升高，72h达到高峰，以后缓慢下降。结论 ICH脑水肿形成早期（4－8h）主要由于血肿本身释放的毒性物质引起，中期（24－48h）主要是由于BBB的破坏引起，晚期（72h）则主要由于血肿周围脑组织代谢紊乱及氧自由基的损伤引起。     

实验性脑出血大鼠脑组织形态学的动态变化

目的研究大鼠脑出血后神经元改变及胶质增生的动态变化特征以及变化规律对行为学的影响。方法将SD大鼠随机分为正常对照组、假手术组、出血组（分12h组、24h组、48h组、72h组4个时相组，每组5只）。采用自体股动脉血注入尾状核建立大鼠脑出血模型，通过对脑血肿周围脑组织坏死神经元计数和Longa行为学评分，动态观察各组大鼠脑血肿周围组织形态学的变化及神经功能状态。结果脑出血组12h即出现血肿周围脑组织部分神经元变性坏死，少数炎性细胞浸润，48h达高峰，72h后可见血肿周围胶质细胞、血管增生。脑出血组各时点的神经功能障碍评分均高于正常对照组和假手术组（P均〈0．05）。结论脑出血后神经元变性、坏死，胶质细胞和血管增生可能是脑水肿加重和病情加重的主要原因之一；神经行为学变化与神经元病变及神经胶质细胞的增生性反应之间存在明显相关。     

脑出血血肿周围脑组织的糖代谢、氧自由基及血脑屏障的变化与脑水肿形成的关系

目的　研究脑出血 (intracerebralhemorrhage ,ICH)血肿周围脑组织的糖代谢、氧自由基及血脑屏障 (blood brainbarrier ,BBB)的变化与脑水肿形成的关系 ,从而进一步阐明脑水肿形成的机制。方法　 60只SD雄性大鼠从尾动脉采血 10 0 μL ,在立体定向仪下注入大鼠右侧大脑内囊处 ,制成脑出血模型 ,按脑出血形成的时间分为假手术组、4、8、12、16、2 4、4 8、72、12 0、168h组共 10组。干湿重法测量脑组织含水量。BBB的通透性采用伊文思蓝法。并测定脑组织MDA(丙二醛 )、SOD(超氧化物歧化酶 )和糖、LDH(乳酸脱氢酶 )的水平。结果　血肿周围脑组织含水量在ICH形成 4h就开始升高 (P <0 .0 5 ) ,4 8～ 72h达到高峰 ,5～ 7d逐步恢复正常。EB(伊文思蓝 )在 8h开始升高 ,12h迅速升高 ,2 4～ 4 8h到达高峰。SOD、MDA在 12h开始变化 ,72h最明显。而糖也在 72h达高峰 (P<0 .0 1)。LDH在 8h开始升高 ,72h达到高峰 ,以后缓慢下降。结论　ICH脑水肿形成早期 ( 4～ 8h)主要由于血肿本身释放的毒性物质引起 ,中期 ( 2 4～ 4 8h)主要是由于BBB的破坏引起 ,晚期 ( 72h)则主要由于血肿周围脑组织代谢紊乱及氧自由基的损伤引起     

MMP-9对脑出血损伤实验研究

目的观察大鼠脑出血(ICH)后基质金属蛋白酶-9(MMP-9)蛋白动态表达及其与血肿周围脑组织含水量的关系。方法将雌雄各半的Wistar大鼠170只随机分为3组:正常对照组、假手术组、ICH组。每组均观察手术后6h、12h、24h、48h、72h、120h、7d、15d八个时间点,测定血肿周围脑组织含水量、MMP-9蛋白表达。结果ICH后MMP-9蛋白表达在24h~48h达高峰,与对照组相比,差异有统计学意义,与血肿周围脑组织含水量呈正相关(r=0.949,P<0.01)。结论大鼠ICH后MMP-9蛋白的表达是ICH后脑水肿形成主要因素。     

脑出血后继发血管源性脑水肿的机制研究

目的　研究自发性脑出血 (Intracerebralhemorrhage,ICH)后血管源性脑水肿 (vasogenicbrainedema ,VBE)的发生机制。方法　采用立体定向技术制作实验性ICH模型 ,免疫组化、组化染色和HE染色分别观察血肿周围脑组织的内皮细胞粘附因子 (CD3 4 )、小胶质细胞、白细胞的动态变化。结果　①假手术组大鼠脑组织未见白细胞浸润及小胶质细胞染色 ,而CD3 4 阳性微血管数最多 ;ICH 12h见血肿周围CD3 4 有所下降 ,72h达最低 ,7天后缓慢恢复到假手术组水平 ;②于ICH 6h血肿周围开始表达小胶质细胞 ,至 4 8h达高峰 ,持续 2周仍可见其少量表达 ;③ICH 12h可见白细胞浸润 ,4 8h数量最多 ,以后逐渐减少 ,2周时基本消失。各组之间及各组与假手术组之间比较差异显著 (P <0 .0 1) ;④ICH后小胶质细胞和CD3 4 表达呈负相关关系 (r =- 0 .770 ,P <0 .0 5 )。结论　ICH后血肿周围的炎症细胞介导的炎症反应参与了继发性血管源性脑水肿的形成。     

姜黄素对大鼠脑出血后血肿周围脑组织含水量的影响

目的:探讨姜黄素对大鼠脑出血(ICH)后脑水肿形成的影响.方法:将120只SD大鼠随机分为姜黄素治疗组(Cur治疗组,n=40)、脑出血对照组(ICH对照组,n=40)和假手术组(n=40).每组分为手术前、术后6h、12h、24h、48h、72h、96h、120h等8个时点,每个时点5只大鼠.采用立体定向自体血注入大鼠尾状核建立ICH模型,观察各组术前及术后各时点神经功能障碍评分和血肿周围脑组织含水量变化.结果:Cur治疗组术后12～120h各时点神经功能障碍评分均高于ICH对照组(P＜.05).Cur治疗组术后24～96h各时点含水量均低于ICH对照组(＜0.05).Cur治疗组术后各时点神经功能障碍评分与相应血肿周围脑组织含水量呈负相关(r=-0.791,P＜0.001).结论:Cur治疗能改善ICH大鼠神经功能,减轻脑水肿.Cur减轻ICH后脑损伤可能与减轻脑水肿有关.Cur对大鼠ICH后脑水肿及脑损伤可能有保护作用.     

黄芪注射液对实验性脑出血大鼠行为学及脑含水量变化的影响

目的研究黄芪注射液对大鼠脑出血后行为学及脑含水量变化的影响。方法90只SD大鼠随机分为假手术组、脑出血组、黄芪组,应用肝素化Ⅶ型胶原酶建立大鼠ICH模型,以Berderson评分评定行为学变化、干／湿重法测定脑含水量。结果①脑出血组和黄芪组在大鼠脑出血后即出现神经功能缺损,并逐渐加重,48h行为学评分最高,之后逐渐恢复,至7d基本恢复正常;黄芪干预组48h、72h行为学评分明显低于相同时间点脑出血组（P〈0．05）差异有统计学意义。②脑出血组和黄芪组在大鼠脑出血后脑含水量即开始增加,48h达高峰,以后逐渐下降,7d基本恢复正常;黄芪干预组48、72h脑含水量明显低于相同时间点脑出血组（P〈0．05）,差异有统计学意义。结论黄芪注射液对脑出血后大鼠的行为学及脑含水量变化有干预作用。     

粒细胞集落刺激因子对脑出血大鼠神经保护作用及作用机制研究

目的 通过研究粒细胞集落刺激因子(G-CSF)对脑出血大鼠(ICH)基质金属蛋白酶-9(MMP-9)、胶质纤维酸性蛋白(GFAP)的影响,探讨G-CSF的神经保护作用及机制.方法 健康雄性SD大鼠随机分为假手术组、模型组、治疗组.断尾取自体血法制备大鼠ICH模型,治疗组于造模1h后腹腔注射重组粒细胞集落刺激因子(rhG-CSF)60μg/kg.三组大鼠于术后6h、24 h、48 h、72 h、7d和10d处死,免疫组化检测血肿周围MMP-9和GFAP的动态表达.结果 模型组各时点MMP-9表达明显高于假手术组(P＜0.05);模型组MMP-9表达在48 h、72 h最明显,与组内6h、24 h、7d、10d比较差异有显著性(P＜0.05);治疗组各时点MMP-9表达显著低于模型组(P＜0.05).假手术组未见GFAP阳性细胞的表达;模型组6h出现少量GFAP阳性细胞表达,48 h开始增多,72 h有大量表达,7d达高峰,10d阳性细胞表达减少;治疗组GFAP阳性细胞表达6h与模型组相似,24 h、48 h、72 h、7d和10d较模型组明显减少(P＜0.05).结论 G-CSF可有效抑制ICH大鼠MMP-9表达减轻脑水肿程度;并且可以抑制星形胶质细胞过度活化,参与G-CSF对ICH大鼠的神经保护作用.     

实验性蛛网膜下腔出血大鼠儿茶酚胺氧位甲基转移酶表达的变化及意义

目的观察实验性蛛网膜下腔出血(SAH)后早期大鼠儿茶酚胺氧位甲基转移酶(catechol-O-methyltrans-ferase,COMT)mRNA和蛋白表达、血浆儿茶酚胺(catecholamine)含量、基底动脉管径和管壁厚度的变化规律,探讨SAH后早期大鼠COMT表达变化的意义。方法以视交叉前池单次注血法构建大鼠SAH模型。采用RT-PCR、Western blot法检测大鼠SAH后早期各个时相点(SAH后6、12、24、48、72 h)纹状体组织内COMT mRNA和蛋白表达。采用高效液相色谱法测定大鼠相应时相点血浆CA含量。HE染色后测量大鼠相应时相点基底动脉管径和管壁厚度。结果与健康对照组和假手术组比较,SAH组大鼠在建模后6 h见COMT mRNA和蛋白表达开始增高(P<0.01),12 h时达到高峰(P<0.01),24 h后开始下降(P<0.01),48 h时仍高于健康对照组和假手术组相应时相点水平(P<0.01),至建模后72 h时接近正常水平(P>0.05)。SAH组大鼠在建模后6 h即见血浆CA含量升高,24 h时达到峰值,24 h后开始下降,至72 h后仍高于健康对照组和假手术组相应时相点水平。SAH组大鼠在建模后12 h基底动脉的管径明显缩小和管壁明显增厚(P<0.01),至建模后24 h最明显(P<0.01)并持续至建模后48 h(P<0.01);建模后72 h,基底动脉的管径和管壁厚度已接近正常大小(P>0.05)。结论实验性SAH可以诱导SAH后早期大鼠纹状体COMT表达增高;SAH后早期CA含量明显升高并伴有CVS发生;SAH后早期CVS和血浆CA含量增高可能与SAH后早期COMT表达增高不够充分和持久有关。     

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.