CCl4和脂多糖诱导的急性肝损伤中肝细胞凋亡病理特点比较

目的比较CCl4和脂多糖诱导的两种急性肝损伤模型中肝细胞凋亡的病理特点。方法雄性BABL/c小鼠随机分为正常组、CCl4模型组与脂多糖模型组。CCl4和脂多糖模型小鼠分别腹腔注射0.03 mL/kg 50?l4/橄榄油混合液和10μg/kg脂多糖与900μg/kg半乳糖胺。9 h后采集标本,检测肝细胞凋亡,血清ALT、AST活性,肝组织SOD活性、MDA含量。结果与正常组比较,CCl4和脂多糖模型小鼠血清ALT与AST活性均明显升高(P<0.01),且脂多糖模型高于CCl4模型(P<0.01);模型小鼠均有明显肝细胞凋亡(P<0.01),且两组间无显著差异,但CCl4模型呈局灶性,以中央静脉周围为主;脂多糖模型呈弥漫性,肝细胞坏死与肝组织炎症更显著(P<0.01)。CCl4和脂多糖模型肝组织均SOD活性升高、而MDA含量下降(P<0.01),但CCl4模型更显著(P<0.05)。结论CCl4与脂多糖诱导的急性肝损伤小鼠模型均有明显的肝细胞凋亡,但CCl4模型以中央静脉区为主,脂质过氧化损伤更为明显;脂多糖模型呈弥漫性,肝细胞坏死与肝组织炎性反应较重。     

茅梅提取物对肝损伤保护作用的研究

目的:探讨茅梅提取物对四氯化碳( CCl4)所致大鼠急性化学性肝损伤的保护作用.方法:采用CCl4制备大鼠急性化学性肝损伤模型,将模型小鼠随机分为4组:模型组、甘利欣组(5 mL/kg)、茅梅醇提取物高剂量组(5 mL/kg)及低剂量组(2.5 mL/kg).测定各组大鼠血清ALT、AST、ALP、GGT及病理组织学等指标的变化.结果:茅梅提取物及18a-甘草酸二铵(甘利欣)对照组能明显降低CCl4致急性肝损伤大鼠血清ALT、AST、ALP、GGT活性(P＜0.05),减轻炎性细胞浸润及损伤(P＜0.05).结论:茅梅对CC14所致大鼠急性化学性肝损伤具有保护作用.     

秃疮花提取物对CCl4诱导的小鼠急性肝损伤的影响

目的 探讨秃疮花提取物(DLE)对CCl4诱导的小鼠急性肝损伤的影响.方法 给予小鼠不同剂量的DLE灌胃,连续10 d.小鼠腹腔注射CCl4造成急性肝损伤,16 h后测定血清谷丙转氨酶(ALT)、谷草转氨酶(AST)活性;制备肝组织匀浆测定丙二醛含量及超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)活性;同时进行肝组织病理观察.结果 与模型组相比,不同剂量的DLE给药组小鼠血清ALT、AST活性显著降低,肝组织匀浆中丙二醛含量显著减少;SOD、GSH-Px活性显著升高;病理切片表明DLE作用后肝组织损伤不同程度减轻,其中剂量为2.0 g生药/kg体重时,肝组织的损伤程度较轻.结论 DLE对CCl4诱导的小鼠急性肝损伤具有很好的保护作用,其作用机制可能与DLE抑制抗氧化酶活性和抗自由基活性有关.     

Protective effects of suberect spatholobus total flavonoids on acute hepatic injury in mice

目的 研究鸡血藤总黄酮对四氯化碳诱导小鼠肝损伤的保护作用.方法 60只雄性小鼠随机分为6组,每组10只.除正常组外,其余各组均腹腔注射0.2%的CCl4橄榄油溶液诱导小鼠急性肝损伤,测定血清丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)、肝组织超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)的活性及丙二醛(MDA)的含量,HE染色观察肝组织病理学变化.结果 鸡血藤总黄酮明显抑制CCl4 致血清ALT、AST活性的升高和肝组织SOD、GSH-Px 活性的降低及MDA水平的升高.肝组织形态学观察显示鸡血藤总黄酮能显著改善肝组织的病理变化.结论 鸡血藤总黄酮对CCl4诱导小鼠急性肝损伤具有一定的保护作用.     

抑制NF-κB活性可减轻CCl4诱导的小鼠急性肝损伤

目的研究核因子-κB(nuclear factor kappa B,NF-κB)活性抑制剂对CCl4诱导急性肝损伤小鼠肝组织中细胞间黏附分子-1(intercellular ashesion molecule-1,ICAM-1)表达及肝功能的影响.方法30只雄性昆明小鼠(28±2.2)g随机分为3组,即正常对照组、急性肝损伤模型组和NF-κB活性抑制剂组.正常对照组腹腔注射生理盐水0.1 mL/10 g,实验组腹腔注射0.1?l4 0.1 mL/10 g,NF-κB活性抑制剂组于腹腔注射0.1?l4 0.1mL/10 g前15 min腹腔注射脯氨酸二硫代氨基甲酸酯(prothiocarbamates DTC,ProDTC 150μg/10 g)1次,其后1次/d,共5次.结果模型组ALT、AST及MDA较正常组显著升高(P ＜0.01),SOD降低明显(P＜0.01).在正常组中肝脏无NF-κB、ICAM-1表达,肝损伤模型组中NF-κB有较强表达,ICAM 1在肝细胞坏死区强表达.NF-κB抑制剂组ALT、AST及MDA较模型组显著降低,NF-κB、ICAM 1表达均较肝损伤组减弱,肝组织坏死程度较轻.结论 NF-κB在CCl4诱导小鼠急性肝损伤中表达明显增强,NF-κB抑制剂可减少NF-κB及ICAM-1表达并减轻肝损伤程度.     

重组人MG53对CCl4诱导的急性肝损伤的保护作用

目的 研究重组人MG53(rhMG53)对四氯化碳(CCl4)诱导的急性肝损伤的保护作用及其相关机制.方法 40只雄性C57小鼠采用完全随机化分组法分成4组:正常对照组、rhMG53组、CCl4组、rhMG53+CCl4组,每组10只.CCl4组、rhMG53+CCl4组小鼠予0.1％ CCl4花生油溶液2 mL/kg腹腔内注射,rhMG53+CCl4组在注射CCl4前30 min予rhMG53 1 mg/kg肌肉注射.rhMG53组予rhMG53 1 mg/kg肌肉注射.正常进食进水24 h后眼球取血分离血清,测定谷丙转氨酶(ALT)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)活性.取小鼠肝脏,观察肝脏的组织学改变.以体外培养的人肝癌细胞(HepG2)为靶细胞,观察rhMG53对CCl4诱导的细胞损伤的保护作用.结果 rhMG53降低小鼠血清ALT、AST、LDH水平,病理镜检显示rhMG53可改善肝脏的病理结构,差异均有统计学意义(P＜0.05);rhMG53可以修复HepG2细胞膜,保护CCl4对HepG2细胞的损伤.结论 rhMG53改善CCl4诱导的急性肝细胞损伤,保护肝脏功能.     

金针菇多糖对小鼠急性肝损伤的保护作用

目的探讨金针菇多糖（polysaccharides of Flammulina velutipes,FVP）对CCl4诱导的急性肝损伤的保护作用。方法小鼠腹腔注射CCl4橄榄油溶液（0.5%,5 mL.kg^-1）12、24、48、72 h后测定血清ALT,确定CCl4急性肝损伤造模最佳时间为24 h。FVP（75,150,300 mg.kg^-1）连续口服给药8 d,第7天采用CCl4制备小鼠急性化学性肝损伤模型,24 h后测定FVP对血清ALT、AST活性,肝匀浆SOD活性、MDA含量的影响。结果 FVP能显著降低CCl4致急性肝损伤小鼠血清ALT、AST活性,提高肝匀浆SOD的活性,降低MDA的含量。结论金针菇多糖对CCl4诱发的小鼠应激性肝损伤有一定的保护作用。     

异绿原酸B对四氯化碳致小鼠急性肝损伤的保护作用

目的 研究异绿原酸B(ICAB)对四氯化碳(CCl4)致小鼠急性肝损伤的保护作用.方法 建立CCl4诱导小鼠急性肝损伤实验模型并评价ICAB的保护作用,测定小鼠血清丙氨酸转氨酶(ALT)、天冬氨酸氨基转移酶(AST)水平和肝组织丙二醛(MDA)含量,以及超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)的活性.采用HE染色对肝组织细胞形态进行观察;Western印迹法测定ICAB对肝损伤小鼠肝细胞中核因子E2相关因子2(Nrf2)、血红素氧合酶-1(HO-1)和醌氧化物还原酶1(NQO1)表达的影响.结果 ICAB各给药组(5、10和20 mg/kg)均可不同程度抑制CCl4所致小鼠血清ALT、AST和MDA的升高(P<0.01),ICAB高剂量组(20 mg/kg)明显提高肝细胞中SOD(P<0.01)和GSH-Px活性水平(P<0.05),降低MDA含量.同时,ICAB能改善CCl4造成的肝组织病理学损伤.此外,ICAB可促进Nrf2的表达及Nrf2的核转位,进而促进Nrf2下游靶蛋白HO-1和NQO1的表达.结论 ICAB对CCl4引起的小鼠急性肝损伤具有明显的保肝降酶作用,其作用机制可能与参与调节Nrf2信号通路、缓解氧化应激相关.     

鸡血藤总黄酮对小鼠急性肝损伤的保护作用

目的研究鸡血藤总黄酮对四氯化碳诱导小鼠肝损伤的保护作用。方法 60只雄性小鼠随机分为6组,每组10只。除正常组外,其余各组均腹腔注射0.2%的CCl4橄榄油溶液诱导小鼠急性肝损伤,测定血清丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)、肝组织超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)的活性及丙二醛(MDA)的含量,HE染色观察肝组织病理学变化。结果鸡血藤总黄酮明显抑制CCl4致血清ALT、AST活性的升高和肝组织SOD、GSH-Px活性的降低及MDA水平的升高。肝组织形态学观察显示鸡血藤总黄酮能显著改善肝组织的病理变化。结论鸡血藤总黄酮对CCl4诱导小鼠急性肝损伤具有一定的保护作用。     

鬼针草提取物对小鼠实验性肝损伤的预防作用

目的研究鬼针草提取物对四氯化碳(CCl4)致小鼠肝损伤的影响,并探讨其作用机制。方法昆明种小鼠50只随机分为正常对照组、模型组、联苯双酯组、鬼针草提取物低剂量10 g/(kg.d)、鬼针草提取物高剂量组20 g/(kg.d)5组。用四氯化碳(CCl4)建立小鼠肝损伤模型,测定小鼠血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、肝匀浆丙二醛(MDA)含量及谷胱甘肽过氧化物酶(GSH-Px)活性为指标观察鬼针草提取物对肝脏损伤的保护作用。结果鬼针草提取物能明显降低动物模型的血清ALT、AST和肝匀浆MDA含量,提高肝脏GSH-Px活性。结论鬼针草提取物对化学性肝损伤具有明显的保护作用,且与药物剂量有关。     

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.     

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.     

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.