贝那普利对肝纤维化大鼠Ang-(1-7)、ACE2及Mas受体mRNA的影响

目的 观察血管紧张素转换酶抑制剂(ACEI)贝那普利抗大鼠肝纤维化的疗效,研究贝那普利对肝纤维化大鼠肝组织血管紧张素-(1-7)[Ang-(1-7)]、血管紧张素转换酶2(ACE2)mRNA及Mas受体mRNA的影响.方法 制备四氯化碳(CCl4)诱导的大鼠肝纤维化模型,同时应用贝那普利灌胃,共8w.对肝组织进行常规HE及Masson染色,ELISA测定肝匀浆血管紧张素Ⅱ(AngⅡ)、Ang-(1-7)浓度,计算AngⅡ/Ang-(1-7)比值,实时荧光定量PCR测定肝组织ACE2mRNA和Mas受体mRNA的水平.结果 造模6、8周末,贝那普利治疗组大鼠的肝纤维化程度均较模型组减轻;肝匀浆AngⅡ的浓度较模型组降低(P<0.05),肝匀浆Ang-(1-7)的浓度较模型组增加(P<0.05),肝匀浆AngⅡ/Ang-(1-7)的比值较模型组降低(P<0.05);贝那普利治疗组肝组织ACE2及Mas受体mRNA的水平均较模型组增加(P<0.05).结论 贝那普利具有良好的抗肝纤维化作用,其机制可能与AngⅡ浓度降低,Ang-(1-7)浓度增加,AngⅡ/Ang-(1-7)比值降低有关,亦可能与ACE2和Mas受体表达增加有关.     

血管紧张素-(1-7)对血管紧张素Ⅱ诱导培养乳鼠非心肌细胞增殖的影响

[目的]探讨血管紧张素-(1-7)[Ang-(1-7)]对血管紧张素Ⅱ(AngⅡ)诱导培养乳鼠非心肌细胞增殖的影响.[方法]在AngⅡ诱导培养的SD乳鼠非心肌细胞中,应用Ang-(1-7),通过测定非心肌细胞DNA、蛋白质合成、细胞数目等指标,观察非心肌细胞增殖情况.[结果]Ang-(1-7)呈剂量依赖性抑制AngⅡ诱导培养的乳鼠非心肌细胞的DNA及蛋白质合成,与单纯AngⅡ组相比,Ang-(1-7)10、10-8、10-7、10-6mol/L分别减少[3H]thymidine掺入21%、31%、35%、36%,减少[3H]Leucine掺入15%、25%、31%、32%.Ang-(1-7)还能减少AngⅡ诱导培养的乳鼠非心肌细胞数目(AngⅡ组吸光度0.86±0.10;AngⅡ+Ang-(1-7)组0.78±0.09,P＜0.05),其作用能被非选择性血管紧张素Ⅱ拮抗剂[Sar1Thr8]AngⅡ抑制.[结论]Ang-(1-7)能抑制AngⅡ诱导的乳鼠非心肌细胞增殖.     

血管紧张素-(1-7)抑制血管紧张素Ⅱ诱导的大鼠系膜细胞基质分泌

目的探讨血管紧张素-(1-7)[Ang-(1-7)]对血管紧张素Ⅱ(AngⅡ)诱导大鼠系膜细胞(GMC)细胞外基质分泌的影响。方法在AngⅡ诱导培养的GMC中,应用Ang-(1-7),通过放射免疫法检测细胞培养上清液中Ⅲ型前胶原(PcⅢ)和透明质酸(HA)的含量,观察GMC细胞外基质分泌情况。分别用非特异性AngⅡ受体拮抗剂[Sar1,Ile8]-AngⅡ和血管紧张素Ⅱ受体2(AT2受体)拮抗剂PD123319与Ang-(1-7)共同培养,了解Ang-(1-7)的受体特点。结果Ang-(1-7)呈剂量依赖性抑制AngⅡ诱导GMC PcⅢ和HA的分泌,其作用可被[Sar1,Ile8]-AngⅡ抑制,PD123319对Ang-(1-7)的上述作用无影响。结论Ang-(1-7)能抑制基础和AngⅡ诱导的GMC细胞外基质分泌,该作用可部分被非特异性AngⅡ受体拮抗剂[Sar1,Ile8]-AngⅡ抑制。     

血管紧张素-(1-7)对血管紧张素Ⅱ诱导大鼠系膜细胞增殖与细胞外基质分泌的影响

目的 探讨血管紧张素-(1-7)[Ang-(1-7)]对血管紧张素Ⅱ(AngⅡ)诱导大鼠系膜细胞(GMC)增殖与细胞外基质分泌的影响。方法在AngⅡ诱导培养的GMC中，应用Ang-(1-7)，通过[^3H]-Thynfidine及[^3H]-Leucine掺入分别测定GMC的DNA、蛋白质合成；结晶紫染色检测细胞数目，观察系膜细胞增殖睛况；放免法检测细胞培养上清液中Ⅲ型前胶原(pcⅢ)和透明质酸(HA)的含量，观察GMC细胞外基质分泌情况。分别用特异性Ang Ⅱ受体1(AT1)拮抗剂[Sar^1，IIe^8]AngⅡ和AngⅡ受体2(AT2受体)拮抗剂PD123319与Ang-(1-7)共同培养，了解Ang-(1-7)的受体特点。结果Ang-(1-7)呈剂量依赖性抑制AngⅡ诱导GMC的DNA、蛋白质合成及细胞数目增加；Ang-(1-7)／还能呈剂量依赖性减少系膜细胞PcⅢ和HA的分泌。AT1和AT2受体拮抗剂对Ang-(1-7)的上述作用无影响。结论Ang-(1-7)能抑制基础和AngⅡ诱导的GMC增殖与细胞外基质分泌，该作用不通过AT1和AT2受体介导。     

Ang(1-7)与2型糖尿病合并冠心病的研究进展与展望

血管紧张素(1-7)[angiotensin1-7,Ang(1-7)]是肾素-血管紧张素(renin-agiotensin system,RAS)系统中新近发现的一种重要活性肽物质,与Mas受体结合,形成血管紧张素转换酶2(angiotensin-converting enzyme2,ACE2)-Ang(1-7)-Mas轴拮抗血管紧张素转换酶(angiotensin-converting enzyme,ACE)-血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)-AT1R轴参与2型糖尿病及冠心病的功能调控。最近来自体外、体内和临床研究的证据反映了Ang(1-7)具有抗氧化、抗纤维化、抗炎、抗动脉粥样硬化等特性。本文结合国内外相关文献就RAS系统新成员Ang(1-7)与2型糖尿病及冠心病的最新研究进展做一综述,旨在延缓疾病的发展,为临床实践提供更好的治疗思路及治疗靶点。     

AngⅡ/Ang-(1-7)/Mas系统通路与脑心综合征关系的实验研究

目的研究AngⅡ/Ang-(1-7)/Mas系统通路在脑心综合征发生及发展中的作用,探讨脑心综合征的发病机制。方法健康成年雄性Wistar大鼠64只,随机分为空白对照组、模型对照组、氯沙坦组、氯沙坦+A779组,每组内再分别分为4 h组、24 h组(n=8)。用线栓法栓塞大脑中动脉制作脑梗死模型,监测各组大鼠心电图。脑氯化三苯基四氮(TTC)染色确定模型是否成功。化学发光法检测组织和血浆中血管紧张素Ⅱ(AngⅡ)的含量,用酶联免疫吸附法(ELISA)法检测组织和血浆中血管紧张素1-7(Ang-(1-7))的含量。用苏木素伊红染色(HE)观察各组大鼠心肌损伤程度。结果模型对照组心肌损伤严重,氯沙坦组心肌损伤有所减轻。氯沙坦+A779组心肌损伤较氯沙坦组较重。心肌损伤程度随着时间的延长相应加重。模型对照组血浆中AngⅡ的含量相比空白对照组增加(P<0.01),氯沙坦组AngⅡ的含量相比模型对照组显著增加(P<0.01),氯沙坦+A779组AngⅡ的含量与氯沙坦组相比显著降低(P<0.01)。模型对照组血浆中Ang-(1-7)的含量相比空白对照组显著降低(P<0.01),氯沙坦组Ang-(1-7)的含量相比模型对照组升高(P<0.01),氯沙坦+A779组Ang-(1-7)的含量相比氯沙坦组降低(P<0.01)。血浆AngⅡ、Ang-(1-7)的含量分别随着时间的延长相应增加(P<0.01)。心肌局部AngⅡ、Ang-(1-7)的含量变化趋势分别与血浆中AngⅡ、Ang-(1-7)含量的变化趋势一致。结论 Ang-(1-7)通过Ang-(1-7)特异性受体(D-Ala-7-Ang-(1-7),Mas)参与脑心综合征的发生及发展,并对脑梗所致的心肌损伤起到保护作用。     

Research on the relationship between Ang Ⅱ/Ang-( 1-7 )/Mas and cerebro-cardiac syndrome

目的 研究AngⅡ/Ang-( 1-7)/Mas系统通路在脑心综合征发生及发展中的作用,探讨脑心综合征的发病机制.方法 健康成年雄性Wistar大鼠64只,随机分为空白对照组、模型对照组、氯沙坦组、氯沙坦+ A779组,每组内再分别分为4h组、24h组(n=8).用线栓法栓塞大脑中动脉制作脑梗死模型,监测各组大鼠心电图.脑氯化三苯基四氮(TTC)染色确定模型是否成功.化学发光法检测组织和血浆中血管紧张素Ⅱ( AngⅡ)的含量,用酶联免疫吸附法(ELISA)法检测组织和血浆中血管紧张素1-7(Ang-(1-7))的含量.用苏木素伊红染色(HE)观察各组大鼠心肌损伤程度.结果 模型对照组心肌损伤严重,氯沙坦组心肌损伤有所减轻.氯沙坦+ A779组心肌损伤较氯沙坦组较重.心肌损伤程度随着时间的延长相应加重.模型对照组血浆中AngⅡ的含量相比空白对照组增加(P＜0.01),氯沙坦组AngⅡ的含量相比模型对照组显著增加(P＜0.01),氯沙坦+A779组AngⅡ的含量与氯沙坦组相比显著降低(P＜0.01).模型对照组血浆中Ang-(1-7)的含量相比空白对照组显著降低(P＜0.01),氯沙坦组Ang-( 1-7)的含量相比模型对照组升高(P＜0.01),氯沙坦+A779组Ang-(1-7)的含量相比氯沙坦组降低(P＜0.01).血浆AngⅡ、Ang-(1-7)的含量分别随着时间的延长相应增加(P＜0.01).心肌局部AngⅡ、Ang-(1-7)的含量变化趋势分别与血浆中AngⅡ、Ang-( 1-7)含量的变化趋势一致.结论 Ang-(1-7)通过Ang-(1-7)特异性受体(D-Ala-7-Ang-( 1-7),Mas)参与脑心综合征的发生及发展,并对脑梗所致的心肌损伤起到保护作用.     

中枢血管紧张素转化酶2-血管紧张素1-7-Mas轴对心血管活动的调节

肾素-血管紧张素系统(renin-angiotensin system,RAS)对于血压的调节、电解质和体液平衡的维持均有重要作用.血管紧张素转化酶(angiotensin converting enzyme,ACE)、血管紧张素Ⅱ(angiotensin Ⅱ,AngⅡ)及其受体AT1R组成了经典的ACE-AngⅡ-AT1R轴.而近年来发现的存在于该系统的许多新成分,特别是Mas受体和血管紧张素转化酶2(angiotensin converting enzyme 2,ACE2),它们与Ang 1-7共同构成ACE2-Ang 1-7-Mas轴,拮抗经典的ACE-AngⅡ-AT1R轴,成为RAS的新分支.     

血管紧张素(1～7)在心血管中的作用

血管紧张素(1～7)的G蛋白耦联受体Mas的发现对其有了更进一步的认识。心血管系统是血管紧张素(1～7)生成和作用的重要部位。血管紧张素(1～7)具有扩张血管、降压、抑制细胞增殖和抗凝血等效应,能拮抗血管紧张素Ⅱ等物质的生物活性。血管紧张素Ⅰ和血管紧张素Ⅱ经过特异的肽链内切酶变为血管紧张素(1～7)。在此,就血管紧张素(1～7)的形成及在心血管中的作用予以综述。     

血管紧张素Ⅱ受体拮抗剂与心肌缺血/再灌注损伤的关系

血管紧张素Ⅱ(AngⅡ)是肾素-血管紧张素系统中最主要的活性物质,与受体结合后可激活蛋白激酶C(PKC),活化的PKC可以通过各种信号转导途径,促进心肌成纤维细胞增殖,诱导心肌纤维化,导致心室重构。血管紧张素Ⅱ受体(AT1受体)拮抗剂,可以阻滞AngⅡ促心血管细胞增殖肥大作用,同时AT1受体被阻断后,反馈性地使血浆肾素增加2～3倍,导致血浆中的AngⅡ浓度升高。由于AT1受体已经被阻滞,这些反馈作用难以表现。但血浆中升高的AngⅡ通过激活AT2受体,进而激活缓激肽-一氧化氮途径,产生舒张血管、降低血压、抑制心血管重构等作用。     

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.