骨化三醇对单侧输尿管梗阻大鼠肾的保护作用

目的:探讨骨化三醇[1,25(OH)2D3]对单侧输尿管梗阻大鼠肾的保护作用。方法:24只雄性6周龄SD大鼠,建立单侧输尿管梗阻(UUO)模型,并分为四组:①治疗组6只,1,25(OH)2D3溶于无水乙醇中腹腔注射,3ng/(100 g.d)。②无水乙醇对照组6只,等容积无水乙醇腹腔注射。③空白对照组6只,仅行左侧输尿管结扎术。④假手术组6只。于第7天处死各组大鼠,采用光镜和RT-PCR观察肾组织纤维化和核因子-κB(NF-κB)表达的变化。结果:①UUO模型第7天时大鼠肾组织NF-κB明显升高,采用1,25(OH)2D3治疗后,肾组织NF-κB的异常升高能得到有效抑制,肾组织炎性细胞浸润明显减少。②治疗组大鼠肾间质纤维化程度较空白对照组和无水乙醇对照组明显减轻。结论:1,25(OH)2D3具有阻抑慢性肾疾病进行性发展的潜能,而这一作用与其能有效降低肾组织NF-κB的异常升高和减少肾组织炎性细胞浸润有一定关系。     

选择性环氧化酶2抑制剂对梗阻性肾病大鼠肾组织中核因子κB和转化生长因子β1的调节

目的：探讨塞来昔布与吲哚美辛比较对单侧输尿管梗阻（UUO）大鼠模型肾脏的保护作用及可能机制。方法：将塞来昔布和吲哚美辛应用于UUO大鼠，4周后测定血清肌酐及尿素氮水平，放射免疫法测定大鼠尿液血栓烷素B2（TXB2）浓度，免疫组化法检测肾脏核因子κB（NF-κB）和转化生长因子β1（TGF-β1）的表达。结果：塞来昔布及吲哚美辛均降低尿TXB2浓度，塞来昔布组更为显著；与对照组相比，其余3组NF-κB及TGF-β1的蛋白表达水平均显著上升，肾间质纤维化严重；塞来昔布治疗后，上述蛋白表达水平显著下调，肾间质纤维化程度明显减轻。结论：塞来昔布能减轻UUO大鼠肾间质纤维化，下调NF-κB的表达，减少肾间质单核巨噬细胞浸润可能是其机制之一。     

他莫昔芬对肾间质纤维化影响的实验研究

目的：探讨他莫昔芬对肾组织纤维化的影响及作用机制.方法：雌性SD大鼠,建立单侧输尿管梗阻模型（UUO）,设置3组：①模型组（n=6）,行左侧输尿管结扎术,0.3ml无菌等渗盐水灌胃,每天2次;②治疗组（n=6）,他莫昔芬5mg/kg （0.3ml无菌等渗盐水配置） 灌胃,每天2次;③假手术组（n=6）.术后第9d处死各组大鼠.采用光镜和免疫组化观察肾间质纤维化、炎细胞浸润和α平滑肌肌动蛋白（α-SMA）表达的变化.结果：①治疗组大鼠肾间质纤维化程度较模型组明显减轻.②模型组第9d时大鼠肾组织α-SMA表达明显增强,采用他莫昔芬治疗后,肾组织α-SMA表达的异常增强能得到有效抑制,肾组织炎细胞浸润明显减少.结论：昔芬类药物具有减轻肾间质纤维化的作用,而这一作用与其能有效阻抑肾组织上皮细胞-间充质细胞转分化和减少肾间质炎细胞浸润有关.     

1,25-二羟维生素D_3对大鼠肾间质纤维化的作用研究

目的：研究1,25-二羟维生素D3〔1,25-（OH）2D3〕对单侧输尿管梗阻（UUO）大鼠肾间质纤维化的影响。方法：45只大鼠随机分为假手术组（n=15）、UUO组（n=15）和1,25-（OH）2D3干预组（n=15）,建立UUO大鼠肾间质纤维化模型,干预组于术后第1天起每天腹腔注射1,25-（OH）2D3,假手术组及UUO组腹腔注射等量生理盐水。分别于术后第3天、第7天和第14天处死大鼠,每次5只,取梗阻侧肾脏行HE、Masson染色及α-平滑肌肌动蛋白（α-SMA）免疫组化标记,观察肾损伤程度和肾间质纤维化程度;取血测定肌酐和尿素氮水平观察肾功能;处死前1天收集24 h尿液,检测尿中蛋白含量。结果：与假手术组相比,UUO组和干预组各时间点HE、Masson染色和α-SMA表达变化明显,呈逐渐加重趋势,差异有统计学意义（P〈0.05）;肌酐、尿素氮及24 h尿蛋白含量术后第3和第7天时表现为升高,术后第14天时出现下降,差异有统计学意义（P〈0.05）。与UUO组相比,干预组各时间点各项指标变化明显改善,差异有统计学意义（P〈0.05）。结论：1,25-（OH）2D3可抑制UUO大鼠肾间质纤维化进程,改善肾功能。     

活性维生素D3抑制UUO模型大鼠肾间质纤维化作用的研究及其对TGF-β1，α—SMA表达的影响

目的：探讨活性维生素D3对单侧输尿管梗阻模型（UUO）大鼠肾小管间质纤维化的抑制作用,研究该病理过程中转化生长因子β1（TGF—β1）,α-平滑肌肌动蛋白（α—SMA）的表达变化。方法：36只雄性Wistar大鼠,随机分为三组,活性维生素D。组、假手术组、模型组,每组12只。造模后活性维生素D。组给予罗盖全（骨化三醇）灌胃（3ng／100g）,假手术组及UUO模型组给予等量生理盐水灌胃。三组大鼠于给药后第14天,28d分批（n=6）处死,留取造模侧肾脏。用HE染色及Masson染色法观察肾小管间质纤维化程度,用免疫组化法测定TGF-β1,α-SMA在各组大鼠造模侧肾脏的表达情况。结果：免疫组织化学显示：UUO模型组大鼠的肾脏组织中TGF—β1及α—SMA的表达显著高于假手术组（P〈0．05）,而在活性维生素D3治疗组中,TGF—β1及的n—SMA表达低于UUO模型组（P〈0．05）,肾脏组织形态学显示：模型组肾间质纤维化程度明显高于假手术组,活性维生素D3组肾间质纤维化程度明显小于模型组（P〈0．05）。结论：活性维生素D3能有效抑制UUo大鼠肾间质中TGF—β1及Ⅱ-SMA的表达,从而减轻UU0大鼠肾间质纤维化程度。     

泽兰对UUO大鼠肾脏核转录因子及血管内皮生长因子的影响

目的观察泽兰对单侧输尿管结扎(UUO)大鼠肾小管间质纤维化及肾功能的影响。方法采用UUO大鼠模型,将32只雄性SD大鼠随机分为4组,即假手术组、模型组、泽兰组和替米沙坦组,术后每日1次灌胃,假手术组和模型组给予5mL生理盐水,泽兰组按6g/(kg·d)给药,替米沙坦组按10mg/(kg·d)给药,14d后处死大鼠,收集血清测定血肌酐(Scr)和尿素氮(BUN),进行HE染色观察肾组织病理改变,Masson染色进行肾间质纤维化评估,应用免疫组织化学方法检测梗阻侧肾组织核转录因子(NF-κB)和血管内皮生长因子(VEGF)的表达。结果模型组与两治疗组大鼠血清Scr、BUN上升,与假手术组比较有显著性差异(P0.05);模型组、泽兰组、替米沙坦组肾间质纤维化程度均较假手术组明显增高(P0.05);模型组NF-κB表达增加,VEGF表达减少,与假手术组相比差异有显著意义(P0.01);泽兰组与模型组相比,NF-κB表达下降,VEGF表达上升,差异显著(P0.05);泽兰组与替米沙坦组各指标比较均无显著性差异(P0.05)。结论泽兰能通过下调NF-κB和增加VEGF表达而抑制单侧输尿管梗阻大鼠肾间质纤维化,其改善肾纤维化作用与替米沙坦无明显差异。     

西红花酸对单侧输尿管大鼠肾组织结缔组织生长因子表达的影响

目的：研究西红花酸对单侧输尿管结扎（UUO）大鼠肾组织结缔组织生长因子（CTGF）表达及肾间质纤维化的影响。方法：采用UUO大鼠模型，将大鼠随机分为3组：假手术组（SHAM组）、模型组（UUO组）、西红花酸组（C组）。SHAM组和UUO组给予标准资料30g／d，C组于术前3d至术后9d每天分别给予西红花酸50rag／kg.d灌胃，第9天处死各组大鼠。免疫组化法检测各组肾组织CTGF；HE、Masson染色评定各组肾小管间质损害程度。结果：UUO组CTGF的表达及肾小管间质损伤指数明显高于SHAM组（P〈0.05），而C组上述指标明显低于UUO组（P〈0.05）。结论：西红花酸可以一直肾纤维化CTGF表达，从而遏制肾纤维化的进展。     

NF-κB在大鼠肺缺血—再灌注损伤中的作用研究

目的观察大鼠肺缺血再灌注中核因子-κB（NF-κB）在大鼠肺缺血中的作用。方法采用120只雄性Wistar大鼠,随机分为肺再灌注组（I/R,n=40）、甲基强的松龙组（MP,n=40）、对照组（CG,n=40）,每组又分为1、2、3、6h四个亚组,建立肺缺血再灌注模型,分别于缺血再灌注后1、2、4和6h取材。测定肺组织湿干质量比值（W/D）、髓过氧化物酶（MPO）活性,采用组织病理学、组织芯片技术、免疫组织化学染色技术与图象分析技术,观察肺组织病理学改变及NF-κB的表达。结果 NF-κB的阳性表达位于肺泡上皮细胞胞核或胞浆,其表达强度肺再灌注组高于甲基强的松龙组与对照组,随缺血再灌注时间的延长NF-κB表达增强,再灌注组的表达强度高于甲基强的松龙组与对照组（P〈0.05）。结论 NF-κB参与肺缺血再灌注损伤后的损伤。     

替米沙坦对2型糖尿病大鼠肾组织MCP-1、NF-κB表达的影响

目的观察替米沙坦对2型糖尿病大鼠肾脏病变中单核巨噬细胞趋化蛋白-1（MCP-1）、核因子-κB（NF-κB）表达的影响。方法雄性Wistar大鼠30只,随机分成正常对照组（A组,n=10）和糖尿病模型组（n=20）。A组给予常规饲料;模型组给予高糖高脂饲料,4周后腹腔注射链尿佐菌素（STZ）30mg/kg,造模成功后模型组再随机分成糖尿病组（B组,n=10）和替米沙坦治疗组（C组,n=10）,C组每天给予替米沙坦5mg/kg灌胃。替米沙坦干预12周后,用免疫组化法检测各组大鼠MCP-1、NF-κB在肾脏表达的变化。结果与A组比较,B、C组大鼠肾组织中MCP-1、NF-κB表达明显增加（P〈0.01）;C组比B组MCP-1、NF-κB表达明显降低（P〈0.01）。结论2型糖尿病大鼠肾组织中MCP-1、NF-κB表达明显增加,替米沙坦可通过降低肾组织MCP-1、NF-κB表达,从而减轻肾脏的炎症反应。     

尿激酶联合黄芪对环孢素A大鼠慢性肾纤维化组织中核因子-κB表达的影响及意义

目的探讨尿激酶（uPA）联合黄芪（AM）对环孢素A（CsA）大鼠慢性肾纤维化组织中核因子-κB（NF-κB）表达的影响及意义。方法采用1：7服灌胃CsA（25mg·kg^-1·d^-1）制备大鼠慢性肾纤维化模型,将大鼠随机分为5组：对照组、模型组、uPA组、AM组及联合治疗组,4周末取标本。HE染色观察肾脏组织结构变化;采用试剂盒测定肾组织羟脯氨酸的含量;应用免疫荧光观察P-p65的表达及定位;采用Western印迹法检测大鼠肾组织P—065、p65、IκBα和IκBβ的蛋白表达水平。结果与对照组相比,模型组肾小管损伤程度加重,羟脯氨酸含量增加,肾组织中NF-κB活化显著增强,p65由细胞质转移至细胞核,P-p65表达显著上调,IκBα降解明显增加（P均〈0．05）。与模型组相比,各治疗组肾小管损伤程度减轻,羟脯氨酸含量减少,P-p65表达被显著抑制,IκBα降解减少（P均〈0．05）,且联合组的治疗效果更显著。IκBβ的蛋白表达水平各组间差异无统计学意义（P〉0．05）。结论NF-κB信号通路介导了肾脏纤维化的发生发展,uPA与AM能减轻肾脏纤维化,这可能与其能抑制NF-κB通路激活有关。     

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.