舒芬太尼对大鼠心肌缺血再灌注心肌组织超氧化物歧化酶活性及丙二醛水平的影响

目的探讨舒芬太尼对大鼠心肌缺血再灌注损伤的保护作用。方法 Wistar雄性大鼠56只随机分为对照组(n=8)、缺血再灌注组(n=24)和舒芬太尼预处理组(n=24),其中缺血再灌注组和舒芬太尼预处理组分别于再灌注30 min、1、2 h处死大鼠(每组每次处死大鼠8只),取心脏分离心肌,测定并比较各组心肌组织超氧化物歧化酶(SOD)活性及丙二醛(MDA)水平。结果再灌注30 min、1、2 h时,缺血再灌注组和舒芬太尼预处理组心肌组织SOD活性显著低于对照组(P<0.05),MDA含量显著高于对照组(P<0.05);而舒芬太尼预处理组心肌组织SOD活性显著高于缺血再灌注组(P<0.05),MDA含量显著低于缺血再灌注组(P<0.05)。结论舒芬太尼预处理对大鼠心肌缺血再灌注损伤具有一定的保护作用。     

褪黑素对大鼠缺血再灌注后心脏功能的影响

目的探讨外源性褪黑素(MLT)对急性缺血再灌注后在体大鼠心脏功能的影响及机理。方法36只大鼠随机分为对照组、缺血再灌注(I/R)组及缺血再灌注+褪黑素(I/R+MLT)组,I/R组及I/R+MLT组在体大鼠心脏左冠状动脉前降支完全阻断10min,再灌15min,术中监测记录心电及血流动力学的变化,随后测定局部受损心肌中MDA(丙二醛)的含量和SOD(超氧化物歧化酶)的活性。结果心脏血流动力学指标I/R+MLT组好于I/R组(P<0.01);I/R组MDA的含量明显高于对照组及I/R+MLT组(P<0.01),SOD活性明显低于对照组及I/R+MLT组(P<0.01),I/R+MLT组MDA含量及SOD活性与对照组差异无显著性(P>0.05)。结论褪黑素对急性缺血再灌注后在体大鼠心脏功能具有保护作用,其机理可能与其清除自由基抗氧化作用有关。     

丙酮酸乙酯预处理对大鼠心肌缺血再灌注损伤和HMGB1表达的影响

目的:探讨丙酮酸乙酯预处理在大鼠心肌缺血再灌注损伤中的保护机制.方法:50只成年雄性SD大鼠随机分为4组:假手术组（SO组）、假手术组+丙酮酸乙酯组（SO-EP组）、缺血再灌注组(I/R组)、丙酮酸乙酯+缺血再灌注组（EP-I/R组）.缺血前1h给予丙酮酸乙酯(50 mg/kg,ip),结扎冠脉前降支缺血30 min后...     

人重组促红细胞生成素预处理对缺血再灌注心肌血流动力学、心肌酶谱和超微结构的影响

目的研究人重组促红细胞生成素(rHuEPO)对离体缺血再灌注心脏的血流动力学、心肌酶谱和超微结构的影响.方法利用Langendorff离体心灌注模型平衡30 min,给予停搏液使心脏停跳90 min,再灌注60 min.16只Wistar大鼠(雌雄不拘)随机分为两组:对照组、rHuEPO预处理组.预处理组大鼠实验前24 h于腹腔给予rHuEPO 5 000 U/kg.观察两组再灌注后血流动力学指标、冠脉流出量、心肌酶谱(CK、LDH),电镜观察心肌超微结构.结果预处理组大鼠血流动力学、冠脉流出量及心肌酶谱改善情况显著优于对照组(P＜0.01);电镜示:预处理组大鼠心肌肿胀轻,线粒体及肌丝等超微结构损伤小.结论 rHuEPO预处理对离体心肌缺血再灌注损伤有良好保护作用,可望成为心外科极具应用前景的促进造血、心肌保护和脑保护的药物.     

褪黑素对心肌缺血再灌注损伤保护作用的实验研究

为探讨褪黑素增补于停搏液中对缺血再灌注离体鼠心的影响,将24只Wistar大鼠随机分为褪黑素组和对照组.离体鼠心在改良的Langendorff-Neely灌注模型上30 min预灌注,120 min停搏、30 min再灌注.缺血前及再灌注期间测定血流动力学指标、心肌酶(CPK,LDH),再灌注30 min测心肌超氧化物歧化酶(SOD)、过氧化脂质(LPO)含量.电镜观察心肌超微结构.再灌注后发现,褪黑素组心功能、心肌超微结构的改善明显优于对照组;心肌酶(CPK,LDH)和LPO含量显著低于对照组(P＜0.01);SOD含量显著高于对照组(P＜0.01).结果表明褪黑素增补于停搏液中可显著减轻心肌缺血再灌注损伤,具有良好的心肌保护作用.     

纳洛酮对大鼠心肌缺血再灌注损伤的影响

目的 观察纳洛酮(naloxone, NAL)对大鼠心肌缺血再灌注损伤的影响,并探讨其机制. 方法36只雄性SD大鼠随机分为空白对照组(Con组) 、缺血再灌注组(I/R组)、缺血预处理组(IPC组)和纳洛酮预处理组(Nal+I/R组),观察各组在缺血再灌注后的血流动力学变化、心肌梗死面积和心律失常发生情况,光镜下观察各组心肌超微结构的改变,用TUNEL检测法检测各组细胞凋亡情况. 结果与IR组相比,IPC组和Nal+I/R组均能明显改善缺血再灌注后心功能(P<0.05),减少心肌梗死面积(P<0.01)及心律失常的发生(P<0.01),保护心肌超微结构,减少凋亡指数(P<0.01). 结论纳洛酮对在体大鼠心肌缺血再灌注损伤心脏有保护作用,该研究拓宽了纳洛酮的临床用途,为防治缺血性心脏病提供了理论依据.     

从心肌力学观察银杏酮酯抗心肌缺血再灌注损伤的作用

目的研究银杏酮酯(GBE50)对大鼠离体心肌缺血再灌注(I/R)损伤的保护作用,并探讨心肌力学和血流动力学信息对其的评价作用。方法55只SD大鼠随机分为6组:模型组,GBE50低、中、高剂量组,丹参组,地尔硫卓组。进行Langendorff离体心脏灌流,各组均平衡灌注15 min,停灌造成全心缺血30 min,再复灌40 min。记录左心室内压力,观察药物对心脏心肌力学和血流动力学的影响。结果I/R后各组HR、mLVSP、DP、±dp/dt_(max)都明显低于缺血前,mLVDP、t-dp/dt_(max)明显升高(P0.05～0.001);随着再灌注时间的延长,各指标呈逐渐恢复的趋势。GBE50中剂量组、丹参组、地尔硫卓组DP、±dp/dt_(max)显著高于模型组(P0.05),t-dp/dt_(max)、mLVDP显著低于模型组(P0.05)。结论GBE50对心肌缺血再灌注损伤后心功能的下降具有明显的预防和保护作用,以心肌力学和血流动力学信息进行评价是稳定和可靠的。     

黄芪注射液预处理对大鼠急性心肌缺血再灌注损伤的保护作用

目的研究黄芪注射液对急性心肌缺血再灌注损伤(MIRI)的保护作用。方法 30只成年Sprague Dawley大鼠随机分为黄芪组、缺血再灌注(I/R)组和对照组。黄芪组大鼠腹腔注射黄芪注射液40 mg·kg~(-1),每日1次,连续6 d,第7天复制大鼠左冠状动脉前降支I/R模型;I/R组大鼠腹腔注射等量生理盐水,其余实验操作同黄芪组;对照组大鼠腹腔注射等量生理盐水,不复制I/R模型。记录各组大鼠结扎前、结扎30 min、再灌注120 min及再灌注180 minⅡ导联心电图;透射电子显微镜观察大鼠心肌细胞的超微结构;反转录-聚合酶链反应检测大鼠心肌组织Na~+-K~+-三磷腺苷(ATP)酶α1亚型mRNA表达。结果与对照组比较,黄芪组和I/R组大鼠心电图ST段在结扎30 min、缺血再灌注120 min、缺血再灌注180 min时均出现缺血性改变。黄芪组大鼠心电图ST值在各时间点均显著低于I/R组(P<0.05)。黄芪组和I/R组大鼠心肌超微结构均受损,黄芪组大鼠心肌超微结构受损程度轻于I/R组;黄芪组大鼠心肌Na~+-K~+-ATP酶α1亚型mRNA表达水平显著低于对照组(P<0.01),但高于I/R组(P<0.05)。结论黄芪注射液预处理可以减轻大鼠急性MIRI,保护大鼠心功能。     

扶芳藤丹参合剂预处理对AS大鼠心肌缺血再灌注损伤中TNF-α及NF-κB的影响

[目的]观察扶芳藤丹参合剂对动脉粥样硬化（AS）大鼠心肌缺血再灌注损伤中肿瘤坏死因子（TNF-α）及核转录因子（NF-κB）的影响。[方法]选用Wistar大鼠建立冠状动脉粥样硬化模型,造模成功后随机分4组：假手术组、缺血再灌注（I/R）组、缺血预处理（IPC）组及扶芳藤丹参合剂预处理组。假手术组冠脉穿线不结扎;缺血再灌注（I/R）组结扎冠脉60 min后恢复冠脉血流120 min;缺血预处理（IPC）组先结扎冠脉5 min,再灌注10 min,共反复4次,然后结扎冠脉60 min后恢复冠脉血流120 min;扶芳藤丹参合剂预处理组：AS造模结束后第2日开胸前先灌胃给予扶芳藤丹参合剂,然后结扎冠脉60 min后恢复冠脉血流120 min;缺血再灌注后观察各组心肌梗死面积,CK,LDH,TNF-α及NF-κB含量。[结果]扶芳藤丹参合剂预处理及缺血预处理均能显著减少心肌梗死面积,与I/R组比较有显著性差异（P〈0.01）。I/R组CK,LDH,TNF-α及NF-κB的水平明显增高,扶芳藤丹参合剂预处理及缺血预处理后,与I/R组相比,CK,LDH,TNF-α及NF-κB明显降低（P〈0.01）。[结论]扶芳藤丹参合剂预处理能够通过抑制炎症反应而减少心肌缺血再灌注损伤。     

龙血竭总黄酮预处理对心肌缺血再灌注损伤大鼠细胞焦亡的影响

目的 探讨中药龙血竭总黄酮(sanguis draconis flavones,SDF)对心肌缺血再灌注损伤(myocardial ischemia reperfusion injury,MIRI)大鼠的可能保护机制。方法 取健康成年雄性SD大鼠24只,体质量(250±20) g,按照随机数字表法分为4组:正常组(Control组)、假手术组(Sham组)、缺血/再灌注组(I/R组)、龙血竭总黄酮+缺血/再灌注组(SDF组),每组6只。I/R组和SDF组大鼠建立心肌缺血/再灌注(ischemia/reperfusion,I/R)损伤模型,即结扎冠状动脉左前降支(left anterior descending,LAD) 30 min,再灌注120 min。Sham组行与I/R组相同操作,但只穿线不结扎LAD。采用实时监测心电图判断大鼠心肌I/R损伤模型构建成功与否。取各组大鼠腹主动脉血检测心肌损伤标志物CK-MB及LDH含量; HE染色法观察各组大鼠心肌组织病理学改变; TTC染色法检测各组大鼠心肌梗死面积; TUNEL染色检测各组大鼠心肌组织TUNEL阳性细胞率;采用RT-qPCR检...     

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.