镇肝熄风汤对自发性高血压大鼠脑保护作用的研究

目的观察镇肝熄风汤对自发性高血压大鼠(SHR)的降压效果及其对血浆、脑组织中内皮素(ET)含量,脑组织中过氧化物酶体增殖物激活受体γ(PPARγ)mRNA表达的影响。方法将24只14周龄的雄性SHR随机分为SHR对照组、镇肝熄风汤组、依那普利组,同时以同源雄性WKY大鼠8只作为对照组。灌胃给药8周后,用16导生理记录系统记录血压,放射免疫法测血浆、脑组织中ET含量,逆转录-聚合酶链反应(RT-PCR)测脑组织中PPARγ mRNA表达。结果与WKY组相比,SHR血压升高,且脑组织中ET含量增加,PPARγ mRNA表达减弱。镇肝熄风汤可使SHR脑组织中ET含量减少,PPARγ mRNA表达增强。结论镇肝熄风汤可能通过激活PPARγmRNA表达,降低SHR脑中ET含量,从而保护脑组织。     

PPA Rα与自发性高血压大鼠主动脉重构的关系研究

目的：阐明自发性高血压大鼠（SHR）主动脉血管重构（VR）与PPARα的关系,为进一步明确高血压动脉VR的分子机制奠定理论基础。方法：10只雄性SHR大鼠为实验组,10只同周龄雄性Wistar大鼠（WKY）为对照组,于16周龄和24周龄进行主动脉组织学观察和弹性纤维染色,观察VR的形态学表现,测定 PPARα蛋白在各组动物中的表达水平。结果：（1）16周龄SHR大鼠主动脉中膜血管平滑肌细胞（VSMC）总数无明显增加,24周龄SHR大鼠VSMC总数多于同周龄WKY组。（2）16周龄SHR主动脉管壁中层弹性膜排列紊乱,24周龄SHR弹性膜松散、断裂、厚薄不均。（3）PPARα蛋白在SHR组表达高于相同周龄WKY组,在16周龄SHR大鼠PPARα蛋白表达明显高于16周龄WKY大鼠。结论：PPARα蛋白的高表达在SHR主动脉VR中发挥重要作用。     

参芪复方对糖尿病血管氧化应激相关蛋白表达的影响

目的 观察参芪复方对糖尿病病变血管的保护性作用,并探讨其部分作用机理.方法 选取5月龄无特定病原体（SPF）级别雄性GK大鼠55只,随机分为空白组、模型组、西药组、中药组,另设15只Wistar大鼠为正常组;采用一氧化氮合成酶（eNOS）抑制剂Nw-硝基-L-精氨酸甲酯（L-NAME）诱导糖尿病血管并发症,并连续给药4周后,观察大鼠血糖、腹主动脉病理学改变、腹主动脉组织P38丝裂原活化蛋白激酶（p38MAPK）及血红素氧合酶-1（HO-1）蛋白表达.结果 中药组大鼠腹主动脉病理学病变程度较其他组轻,氧化应激损伤呈低水平,腹主动脉组织中HO-1蛋白高表达,而p38MAPK蛋白呈低表达.结论 参芪复方对糖尿病血管有保护性作用,其机理可能是通过降低血管组织p38MAPK 蛋白表达和升高HO-1蛋白表达,调整氧化应激水平,减少氧化应激血管损伤,进而对糖尿病血管起到保护性作用.     

腹主动脉缩窄大鼠模型左室心肌血管紧张素Ⅱ-1型受体及其mRNA的表达

目的通过建立腹主动脉缩窄大鼠模型,研究腹主动脉缩窄大鼠左室心肌血管紧张素Ⅱ-1型（AT1）受体mRNA表达及其受体蛋白的改变。方法30只雄性SD大鼠随机分为假手术组（14只）和模型组（16只）。模型组根据Doering等的方法,用银夹造成腹主动脉部分狭窄（银夹内径0．7mm）。8周后免疫组化法进行AT1受体蛋白染色,并用灰度值作为其含量指标行图像分析,即时PCR扩增后分析并测定其mRNA表达。结果模型组造模8周时AT1受体蛋白及其mRNA表达较假手术组显著升高（P〈0．01）。结论腹主动脉缩窄大鼠所致心肌纤维化心肌AT1基因转录与翻译水平发生改变,通过AT1下游信号通路传导作用,促进心肌纤维化。     

葡萄籽原花青素对自发性高血压大鼠主动脉重构的改善作用研究

目的  探讨葡萄籽原花青素（GSP）对自发性高血压大鼠（SHR）主动脉重构的改善作用。方法  8周龄雄性SHR 24 只随机分为4组，每组6只：SHR组、GSP低剂量（50 mg/kg）、高剂量组（200 mg/kg）以及卡托普利组（30 mg/kg）。6只同龄雄性Wistar-Kyoto大鼠设为对照组。每周测定尾动脉收缩压（SBP）；治疗6周后HE染色下测定胸主动脉中膜横截面积（MCSA）、管腔面积（LA）及MCSA/LA；Masson三色法测量胸主动脉胶原容积分数（CVF）；ELISA法测定胸主动脉中Ⅰ型胶原（ColⅠ）含量；生化法检测大鼠胸主动脉中过氧化氢酶（CAT）活力及丙二醛（MDA）含量；蛋白免疫印迹法（Western blot）检测胸主动脉中ERK1/2蛋白表达。结果  GSP能显著降低SHR SBP（P <0.01），改善血管重构参数，减少胸主动脉MDA含量以及ERK1/2蛋白的表达，提高CAT活力。结论  GSP能够改善SHR胸主动脉重构，其作用可能是通过降压、对抗氧化应激和抑制ERK1/2蛋白表达实现的。

     

镇肝熄风汤对帕金森模型小鼠脑黑质 Bcl-2家族mRNA 表达的影响

目的：观察镇肝熄风汤对1-甲基-4-苯基-1,2,3,6-四氢吡啶（1-methy-4-phenyl-1,2,3,6-tetrahy-dropyridine ,MPTP）诱导的帕金森病（ PD）模型小鼠脑黑质Bcl-2家族蛋白表达的影响。方法采用连续灌胃给予C57BL/6小鼠不同剂量镇肝熄风汤（12．5、25和50 g/kg）14天,于第11天开始,给药前1 h皮下注射MPTP（30 mg/kg）,连续4天,造模后运用实时定量PCR法检测Bax、Bad、Bcl-2和Bcl-xl mRNA的表达。结果 PCR结果显示,镇肝熄风汤下调了Bax mRNA表达（P＜0．05）,同时上调了Bcl-2和Bcl-xl mRNA表达（P＜0．05）,对Bad mRNA表达无影响。结论镇肝熄风汤具有抑制PD模型小鼠脑黑质Bax mRNA表达,促进Bcl-2和Bcl-xL mRNA表达的作用。     

镇肝熄风汤对帕金森病肝阳上亢证模型大鼠脑组织谷胱甘肽抗氧化系统的影响

目的:观察镇肝熄风汤对帕金森病肝阳上亢证模型大鼠脑组织谷胱甘肽(glutathione,GSH)水平的影响,并分析其作用机制。方法:105只Wistar大鼠随机分为正常对照组,假手术组,模型对照组,镇肝熄风汤低剂量组、中剂量组、高剂量组,司来吉兰组,每组15只。采用附子汤灌胃加6-羟基多巴胺(6-hydroxydopamine,6-OHDA)单侧损毁黑质法双因素制备大鼠帕金森病肝阳上亢证模型。镇肝熄风汤干预4周后,采用紫外分光光度法检测GSH和氧化型谷胱甘肽(glutathione oxidized,GSSG)的含量,实时定量PCR法分析谷氨酸半胱氨酸连接酶修饰亚基(glutamate cysteine ligase modifier subunit,GCLm)和谷氨酸半胱氨酸连接酶催化亚基(glutamate cysteine ligase catalytic subunit,GCLc)mRNA表达,免疫印迹法分析GCLm和GCLc蛋白表达。结果:与模型对照组(0.26±0.23)比较,镇肝熄风汤低剂量组、中剂量组和高剂量组显著增加帕金森病肝阳上亢证模型大鼠中脑GSH/GSSG(1.62±0.24、2.02±0.23、3.54±0.40)。与模型对照组(Western blot:118.8±10.1,PCR:1.20±0.11)比较,镇肝熄风汤低剂量组、中剂量组和高剂量组显著上调了帕金森病肝阳上亢证模型大鼠中脑组织GCLc蛋白(140.8±8.3、150.4±7.6、158.6±9.1)和mRNA(1.80±0.19、1.98±0.13、2.08±0.17)表达,但并没有影响GCLm基因表达。结论:镇肝熄风汤可增加帕金森病肝阳上亢证大鼠脑组织GSH含量,在转录和翻译水平上调GCLc表达,这些作用可能是镇肝熄风汤抗帕金森病的机制之一。     

麻杏石甘汤对哮喘模型大鼠肺组织STAT4及其mRNA表达的影响

目的研究麻杏石甘汤对哮喘模型大鼠肺组织STAT4及其mRNA表达的影响,探讨其在哮喘治疗中的作用及可能机制。方法将55只SPF级SD大鼠随机分为5组,对照组（A组）、哮喘组（B组）、高、中、低剂量麻杏石甘汤+哮喘组（C组、D组、E组）,每组11只。采用卵蛋白(OVA)腹腔注射致敏与雾化吸入激发法制作哮喘模型。留取肺泡灌洗液（BALF）测定IL-12及IL-13水平;并取肺组织标本HE染色后观察气道炎症,免疫组化法及原位杂交法分别检测STAT4及其mRNA表达。结果（1）哮喘组大鼠BALF中IL-13水平升高,IL-12水平下降,肺组织炎症细胞浸润明显。（2）STAT4及STAT4mRNA在各组大鼠气道平滑肌及血管肌层中均有表达,正常对照组呈阳性表达,哮喘组阳性表达最弱。（3）麻杏石甘汤干预后哮喘大鼠IL-13水平下降,IL-12水平上升,炎症反应减轻;STAT4表达上调,其中高剂量组与哮喘组比较差异有统计学意义（P＜0.05）;高剂量、中剂量麻杏石甘汤组STAT4mRNA表达与哮喘组比较差异均有统计学意义（均P＜0.05）。结论卵蛋白致敏大鼠气道及血管肌层STAT4表达受抑制,麻杏石甘汤可能通过上调STAT4及其mRNA的表达,减轻哮喘大鼠气道炎症反应。     

镇肝熄风汤对实验性心肌缺血大鼠的治疗作用及其机制探讨

目的:观察镇肝熄风汤对大鼠实验性心肌缺血损伤的保护作用。方法:采用结扎冠脉左前降支的方法复制大鼠心肌缺血模型,将造模成功的大鼠随机均分为模型组、阳性对照组、镇肝熄风汤低、中、高剂量组,每组10只,另取假手术组10只,连续灌胃28 d,分别监测各组大鼠手术前及手术后即刻、1、3、7、10、14、21、28 d的心电图,并测定给药28 d后的心肌梗死率及血清中NO、ET的含量。结果:镇肝熄风汤各剂量组大鼠心电图S-T段的抬高程度均显著下降,心肌梗死范围明显缩小,血清NO水平明显升高,ET含量明显降低。结论:镇肝熄风汤能有效改善大鼠实验性心肌缺血损伤,其作用可能与改善血管内皮活性物质释放,保护血管内皮功能有关。     

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.     

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.