大鼠大脑中动脉永久性缺血和缺血再灌注模型的比较

目的:比较大鼠大脑中动脉永久性阻塞模型和缺血再灌注模型的差异,寻找一种制作简单,成功率高的脑缺血模型。方法:将150只SD雄性大鼠随机分为:永久性大脑中动脉阻塞60只,线栓阻塞大脑中动脉4h、8h、24h后生理盐水灌注后取脑;大脑中动脉缺血再灌注60只,线栓阻塞大脑中动脉100min后,拔出线栓形成再灌注,分别在再灌注4h、8h、24h后灌注取脑;对照组30只。比较模型制作的成功率、术后存活率、神经功能缺失评分、脑梗死体积及模型稳定性。结果:脑缺血再灌注组模型成功率高于永久性脑缺血组,差异有统计学意义(P<0.05);永久性脑缺血模型组死亡率较脑缺血再灌注模型组死亡率有升高趋势,但无统计学意义;TTC染色:永久性大脑中动脉阻塞梗死灶随着缺血时间的延长逐渐扩大,大脑中动脉缺血再灌注梗死灶随再灌注时间的延长无明显变化;结论:大鼠大脑中动脉缺血再灌注模型手术方式简单、结果稳定、缺血时间可控,是一种较理想的模拟脑梗死的动物模型。     

益脑灵胶囊对大鼠局灶性脑缺血再灌注损伤的抗氧化作用

目的：探讨益脑灵胶囊对大鼠脑缺血再灌注损伤的保护作用。方法：采用线栓法制作大鼠大脑中动脉缺血再灌注损伤模型;采用TTC染色及神经功能评分等方法,分别观察假手术组、缺血再灌注组、益脑灵胶囊组的大鼠缺血后神经功能缺失征象、再灌注后缺血脑梗死面积、鼠脑组织匀浆、胞浆、线立体中超氧化物歧化酶、黄嘌呤氧化酶、丙二醛的含量。结果：益脑灵胶囊明显缩小了脑梗死面积,提高缺血再灌注脑组织中的超氧化物歧化酶的活性,降低黄嘌呤氧化酶活性和丙二醛的含量。结论：益脑灵胶囊通过增强机体清除自由基的能力而发挥对抗缺血再灌注损伤的作用。     

醒脑通脉胶囊对局灶性脑缺血再灌注损伤大鼠TNF-a的影响

[目的]观察醒脑通脉胶囊对局灶性脑缺血再灌注损伤大鼠的肿瘤坏死因子(TNF-a)含量变化,探讨其在急性脑梗死发病机制研究中的神经保护价值和临床意义。[方法]将234只老年Wistar大鼠随机分组,采用线栓法制作大鼠大脑中动脉栓塞的局灶性脑缺血及再灌注模型,并分别于脑缺血30min再灌注2h、脑缺血2h再灌注6h、脑缺血2h再灌注48h后用醒脑通脉胶囊及尼莫地平干预。应用神经功能行为学评分、HE染色技术和TNF-a酶联免疫吸附法,计算脑梗塞面积和水含量、检测各缺血区的TNF-a水平,观察疗效。[结果]醒脑通脉胶囊小剂量(0.25g/kg)、大剂量(1g/kg)组均能降低模型大鼠神经功能行为学评分,降低大鼠的脑水含量,减少模型大鼠脑组织脑梗死范围,降低脑组织中TNF-a的含量(P<0.05或P<0.01)。[结论]醒脑通脉胶囊对大鼠局灶性脑缺血再灌注后脑损伤有保护作用,其作用机制与降低模型大鼠脑组织中TNF-a的含量有关,从而减轻TNF-a介导的神经损伤,及缺血区的炎症反应而获效。     

通脉醒脑滴丸对局灶性脑缺血模型大鼠的保护作用

目的:探讨通脉醒脑滴丸对局灶性脑缺血模型大鼠的保护作用及机制。方法:将大鼠随机分为假手术组、模型组、药物组及对照组;线栓法制备大鼠大脑中动脉局灶脑缺血再灌注模型(MCAO),评价神经功能状态,测定脑含水率和脑梗死比率,并测定过氧化损伤相关指标。结果:通脉醒脑滴丸能显著减轻缺血再灌注后神经功能损害,降低脑水肿程度和脑梗死比率,降低脑组织丙二醛(MDA)、一氧化氮(NO)含量,升高超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)活性。结论:通脉脑醒滴丸对大鼠脑缺血再灌注损伤具有明显保护作用,其机理与其减轻过氧化损伤,减轻组织缺血坏死程度和脑水肿有关。     

灯盏生脉胶囊对脑缺血再灌注损伤大鼠的保护作用

目的：研究灯盏生脉胶囊对脑缺血再灌注损伤的保护作用。方法：将大鼠随机分为假手术组、模型组和灯盏生脉胶囊组。采用改良的Zea Longa线栓法制作大鼠大脑中动脉阻塞模型,缺血后24 h灌胃给予灯盏生脉胶囊,于缺血后7、14、21 d分别测定神经功能缺损评分和体重增长率,于缺血后21 d采用TTC法测定脑梗死体积百分比,免疫组织化学法检测脑组织血管内皮生长因子（VEGF）的表达。结果：与模型组比较,灯盏生脉胶囊组神经功能缺损评分、体重增长率、脑梗死体积百分比及VEGF的表达差异均有统计学意义（均P〈0.05）。结论：灯盏生脉胶囊对大鼠脑缺血再灌注损伤有明显的保护作用,可能与其促进VEGF表达有关。     

细冰合剂滴鼻对大鼠脑缺血再灌注损伤保护作用的实验研究

目的观察细冰合剂滴鼻对大鼠脑缺血再灌注脑梗死体积及脑含水量的作用。方法SD雄性大鼠随机分为假手术组、模型组、细辛组、冰片组、细冰合剂及尼莫地平阳性对照组。术前各治疗组连续滴鼻3d,对照组给予腹腔注射尼莫地平,均于末次给药30min后行手术,采用线栓法制备大鼠大脑中动脉缺血再灌注损伤模型,缺血1h再灌注24h后进行神经功能学评分 测脑组织梗死体积、脑指数及脑含水量。结果与假手术组比较,模型组神经功能学评分、脑组织梗死体积、脑指数及脑含水量差异有统计学意义（P〈0.01） 与模型组比较,细冰合剂组脑梗死范围有一定缩小（P〈0.05）,脑指数、脑含水量及神经功能学评分明显降低（P〈0.05）。结论细冰合剂能减轻脑缺血再灌注大鼠的脑水肿程度,减少脑组织的梗死体积,对脑缺血再灌注损伤有一定的保护作用。     

缺血后适应对大鼠急性脑缺血的影响

目的：探讨缺血后适应（ IP）对大鼠急性脑缺血的保护作用及机制。方法54只雄性SD大鼠随机分为3组,每组18只：Sham组、I／R组、IP组,分别予假手术、阻塞大脑中动脉2 h后长时间灌注以及在阻塞大脑中动脉再灌注时作IP处理,比较3组大鼠神经功能缺损评分、脑含水量、脑梗死体积、海马CA1区细胞形态学变化和凋亡细胞水平。结果与I／R组比较,IP组脑缺血再灌注损伤减轻,神经缺损评分降低,脑含水量减少,脑梗死体积减小,锥体细胞损伤明显减轻,退变神经元明显减少,凋亡细胞水平降低,差异有统计学意义（ P＜0.05）。结论 IP在脑血管缺血急性期具有神经保护作用,其机制可能是降低神经细胞的凋亡水平。     

脑栓通对脑缺血再灌注大鼠神经血管单元的保护作用

目的：观察中药脑栓通对脑缺血再灌注大鼠神经血管单元主要成分神经元、星形胶质细胞以及脑血管内皮细胞的保护作用。方法：30只雄性Sprague-Dawley大鼠随机分为假手术组、缺血再灌注组和1g/（kg·d）脑栓通组。采用大脑中动脉线栓法建立局灶性脑缺血损伤模型,1.5h后拔出线栓实施再灌注。再灌注24h时后进行大鼠神经功能缺损评分,采用末端脱氧核苷酸转移酶介导的脱氧尿苷原位末端标记法结合神经元核抗原、胶质纤维酸性蛋白及CD31免疫荧光双染检测缺血再灌注24h时缺血灶周边的神经元、星形胶质细胞以及脑血管内皮细胞的凋亡情况。结果：脑栓通能显著改善脑缺血损伤大鼠的神经功能缺损,减少缺血灶周边星形胶质细胞、脑血管内皮细胞和神经元的凋亡。结论：脑栓通通过保护脑缺血再灌注后大鼠的神经血管单元促进神经功能的改善。     

丹参注射液对脑缺血再灌注损伤大鼠的保护作用

目的观察丹参注射液对线栓法所致大脑中动脉缺血损伤再灌注大鼠的影响。方法采用大鼠大脑中动脉线栓法制备脑缺血再灌注损伤模型,将建模的SD大鼠随机分为模型组、尼膜同组及丹参注射液高、中、低剂量组等5组,每组10只,假手术大鼠10只设为对照组。观察丹参注射液对缺血再灌注损伤大鼠的行为学、脑梗死率、脑含水量、脑指数及血清丙二醛（MDA）、超氧化物歧化酶（SOD）含量的影响。结果丹参注射液高、中剂量组可以升高缺血再灌注大鼠的行为学评分,降低脑梗死率及脑含水量,降低血清MDA含量,升高SOD含量,与模型组比较差异均有统计学意义（P〈0.05或P〈0.01）。且高剂量的丹参注射液对脑缺血再灌注大鼠的各种效应与尼膜同组相似。结论丹参注射液对脑缺血再灌注大鼠具有一定的保护作用。     

促红细胞生成素对脑缺血再灌注大鼠脑内NF-κB表达的影响研究

目的研究促红细胞生成素(EPO)对大鼠缺血再灌注后核因子-κB(NF-κB)表达的影响。方法将45只SD大鼠随机分为假手术组、脑缺血再灌注模型组(模型组)以及EPO治疗组(治疗组)。构建SD大鼠大脑中动脉闭塞脑缺血/再灌注模型,观测缺血再灌注后4、12、24h的神经功能缺损评分;比较脑梗死体积,免疫组织化学检测NF-κB蛋白的表达,TUNEL法检测神经元凋亡率。结果与模型组比较,治疗组12、24h的神经功能缺损评分降低;脑梗死体积显著减小;脑内NF-κB蛋白的表达与神经元凋亡率明显降低。结论 EPO可通过降低NF-κB蛋白表达对大鼠脑缺血再灌注损伤起保护作用。     

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.     

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.