酒精性肝损伤过程中经CYP2E1代谢的探针药物氯唑沙宗镇痛效应的变化

目的:通过观察酒精性肝损伤过程中经CYP2E1代谢的探针药物氯唑沙宗镇痛效应的变化,建立一种有效反映CYP2E1代谢活力变化的方法.方法:采用白酒灌胃法复制大鼠酒精性肝损伤模型,采用肝脏组织HE染色法及血清中ALT和AST水平测定检测大鼠肝损伤情况,通过热板实验判定氯唑沙宗镇痛效应的变化,从而反映氯唑沙宗的特异性代谢酶CYP2E1代谢活力的变化.结果:酒精性肝损伤模型组大鼠肝脏表现为轻度到中度脂肪变性和炎性细胞浸润,并且酒精性肝损伤模型组大鼠CYP2E1代谢活力明显增强(P＜0.01).结论:白酒灌胃法成功地复制了大鼠酒精性肝损伤模型,通过热板实验观察氯唑沙宗镇痛效应的变化可以作为判断CYP2E1代谢活力变化的一种方便、有效、快捷的方法.     

壮骨关节丸对大鼠肝微粒体P450的影响

[目的] 考察壮骨关节丸对大鼠肝微粒体细胞色素P450的影响。[方法] 壮骨关节丸及其两个新工艺按含生药2.1 g/kg连续给大鼠灌胃7 d,末次药后24 h断头处死大鼠并取肝脏,用钙沉降法制备肝微粒体。在体外用含氨苯砜、非那西丁、奥美拉唑、氯唑沙宗的cocktail探针代谢来考察肝微粒体CYP3A、CYP1A2、CYP2C19、 CYP2E1的活性。[结果] cocktail探针在体外肝微粒体系统中代谢1 h后,包括壮骨关节丸及其两个新工艺的给药组剩余氯唑沙宗浓度显著高于对照组,而奥美拉唑、非那西丁、氨苯砜浓度与对照组之间差异无统计学意义。[结论] 壮骨关节丸可以抑制大鼠肝脏CYP2E1活性,但对CYP1A2、CYP3A及CYP2C19无显著影响。     

探针药物法评价苦参对大鼠细胞色素P4502E1代谢活性的影响

目的 以氯唑沙宗作为探针药物,研究苦参对大鼠细胞色素P450 2E1（CYP 2E1）体内代谢活性的影响。方法 将Wistar大鼠随机分为对照组、苦参组、苯巴比妥阳性对照组。苦参组大鼠ig给予苦参颗粒（100 mg/kg）溶液,对照组ig给予等体积的生理盐水,阳性对照组ip苯巴比妥注射液50 mg/kg,各组均每日给药1次,连续5 d。第6天各组大鼠尾iv氯唑沙宗（5 mg/kg）溶液,于给药前及给药后不同时间点眼内眦静脉取血0.8 mL,HPLC法测定氯唑沙宗血药浓度。结果 与对照组相比,苦参组给予苦参5 d后,氯唑沙宗的AUC和C_max明显降低（P＜0.05、0.01）,CL明显升高（P＜0.05）;而苦参组的主要药动学参数与苯巴比妥组比较无显著差异（P＞0.05）。结论 苦参可明显诱导大鼠CYP 2E1的体内代谢活性,其作用强度与苯巴比妥相当。     

探针药物法评价柚皮苷对人肝微粒体CYP2E1酶代谢活性的影响

目的：考察柚皮苷对CYP2E1酶代谢活性的影响,以探讨与其它以CYP2E1为主要代谢酶的药物联用时,是否可能产生潜在的相互作用.方法：在人肝微粒体代谢体系中,以氯唑沙宗作为底物探针,建立表征CYP2E1酶代谢活性的HPLC检测方法,分别考察体外代谢体系的最适宜底物浓度、代谢时间、pH值以及孵育温度.在确定的条件下,将柚皮苷稀释成不同浓度,分别与氯唑沙宗共同孵育于人肝微粒体代谢体系中,测定在有或无柚皮苷存在下氯唑沙宗的剩余量,以评估柚皮苷对CYP2E1酶代谢的影响.结果：在人肝微粒体孵育体系中,氯唑沙宗代谢最适宜的体外代谢条件为底物浓度2.4 g/L,代谢时间3.5h,pH7.5,孵育温度37℃.柚皮苷对CYP2E1酶代谢活性有一定的抑制作用,IC50为10.07 μmol/L.结论：柚皮苷对经CYP2E1酶代谢的药物可能会产生微弱的药物相互作用.     

LC-MS/MS法研究苯环喹溴铵对大鼠肝微粒体CYP450酶的抑制作用

建立同时测定大鼠肝微粒体中7种特异性底物对应代谢产物（对乙酰氨基酚、4″-羟基美芬妥英、右啡烷、4-羟基甲苯磺丁脲、6-羟基氯唑沙宗、1-羟基咪达唑仑和6β-羟基睾酮）的LC-MS/MS法,并应用探针底物法研究苯环喹溴铵对大鼠肝微粒体CYP450酶的抑制作用。将CYP450酶6种亚型的7种特异性探针底物非那西丁（CYP1A2）、S-美芬妥英（CYP2C11）、右美沙芬（CYP2D1/2）、甲苯磺丁脲（CYP2C6）、氯唑沙宗（CYP2E1）、咪达唑仑（CYP3A1/2）和睾酮（CYP3A1/2）分别与大鼠肝微粒体及系列浓度的苯环喹溴铵溶液进行温孵反应,合并处理后的微粒体溶液,采用LC-MS/MS法同时测定对应底物代谢产物的含量,计算相应的IC₅₀,评价是否有抑制作用。并应用已知抑制剂对所建立的探针底物法进行验证。在大鼠肝微粒体温孵体系中,苯环喹溴铵对CYP1A2,CYP2C11,CYP2C6,CYP2E1和CYP3A1/2的IC₅₀均大于100 μmol/L,对CYP2D1/2的IC₅₀为（2.16±0.22）μmol/L。结果表明,苯环喹溴铵对CYP2D1/2可能有抑制作用,对CYP450酶的其他亚型无抑制作用。     

粗叶悬钩子粗多糖对模型大鼠急性肝损伤药物代谢酶的影响

目的观察粗叶悬钩子粗多糖对模型大鼠急性肝损伤药物代谢酶的影响。方法用四氯化碳（CCl4）腹腔注射法造模。观察粗叶悬钩子粗多糖对大鼠血清谷丙转氨酶（ALT）、谷草转氨酶（AST）和大鼠肝组织CYP450、CYP2E1、CYP3A1酶含量与活性变化。结果与CCl4模型组相比。粗叶悬钩子粗多糖治疗各组均不同程度地降低了CCl4所致大鼠ALT、AST的升高：不同程度地增高了肝药物代谢CYP450含量及活性。降低了CYP2E1含量及活性．对CYP3A1含量及活性的影响无统计学意义。结论粗叶悬钩子粗多糖通过改变肝药物代谢酶保护CCl4所致的大鼠急性肝损伤。     

葛黄颗粒对酒精性肝损伤大鼠醇、醛脱氢酶 及细胞色素P450 2E1 活性的影响

目的 观察葛黄颗粒对酒精性肝病大鼠醇脱氢酶（ADH）、醛脱氢酶（ALDH）及细胞色素P450 2E1（CYP450 2E1）活性的影响。方法 白酒灌胃加普通饲料饮食复制酒精性肝病大鼠,复制成功后,白酒灌胃继续, 除模型组外,葛黄颗粒高、中、低剂量干预组同时分别给予不同浓度的葛黄颗粒灌胃,正常组一直采用相同剂 量蒸馏水灌胃,13 周后处死大鼠,行肝组织HE 染色、血清丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）、 ADH、ALDH 含量检测,Western blot 检测肝CYP450 2E1 蛋白表达。结果 与正常组比较,模型组的肝脏指数、 肝功能指标、ADH 及CYP450 2E1 均升高（P <0.01）,而ALDH 却降低（P <0.01）;与模型组比较,不同剂量（高、中、 低）葛黄颗粒干预组均可逆转以上检测指标,且存在一定的量效关系,即高、中剂量组逆转效果较好（P <0.01）。 结论 一定剂量葛黄颗粒可通过调节ADH 等乙醇代谢酶活性延缓或逆转酒精性肝损伤的发生。     

茅台酒对大鼠肝组织中CYP2E1基因及蛋白质表达的影响

目的：探讨茅台酒对大鼠肝组织中细胞色素P4502El（CYP2E1）基因及蛋白质表达的影响。方法：40只雄性Wistar大鼠随机分为空白对照组、茅台酒组、乙醇组,各组大鼠分别予蒸馏水、茅台酒和乙醇灌胃,每天1次,每周6次,连续12周。末次灌胃12h后处死大鼠,肝组织切片行HE染色观测病理改变,并检测肝组织匀浆中超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）与丙二醛（MDA）含量,RT—PCR、免疫组织化学法和WesternBlot检测大鼠肝组织中CYP2E1mRNA及蛋白质表达。结果：茅台酒组及乙醇组大鼠肝组织切片HE染色均可见不同程度肝细胞脂肪变性及炎性细胞浸润,但茅台酒组的病理改变程度明显低于乙醇组,差异有统计学意义（P〈0．05）;茅台酒组大鼠肝组织匀浆中SOD、GSH—P。比空白对照组和乙醇组高,差异有统计学意义（P〈0．01）,与乙醇组比,茅台酒组大鼠肝组织匀浆中MDA显著较低（P〈0．01）;茅台酒组与空白对照组比较,大鼠肝组织中CYP2E1mRNA及蛋白质表达差异无统计学意义（P〉0．05）,茅台酒组与乙醇组比较＋大鼠肝组织CYP2E1mRNA及蛋白质表达显著较低（P〈0．01）。结论：饮用一定量的茅台酒12周后可致大鼠酒精性脂肪肝,但比饮用相同剂量单纯乙醇程度较轻,可能与茅台酒所含的非酒精性物质抑制了CYP2E1表达,对抗氧化应激有关。     

CPUHY002对人肝微粒体CYP450酶体外抑制作用研究

目的：评价CPUHY002在体外对人肝微粒体细胞色素P450（CYP450）酶6种亚型酶活性的影响.方法：将CPUHY002与CYP450酶6种亚型的特异性探针底物非那西丁、双氯酚酸钠、奥美拉唑、右美沙芬、氯唑沙宗、丙酸睾酮与人肝微粒体进行孵育,采用LC-MS/MS法测定对应6种代谢产物对乙酰氨基酚、4-羟基双氯酚酸、5-羟基奥美拉唑、右啡烷、6-羟基氯唑沙宗、6β-羟基睾酮的浓度,求算出IC50.结果：CPUHY002对CYP2C19和CYP2E1的IC50值分别为48.02 μmol/L和47.19 μmol/L,对CYP1 A2、CYP2D6、CYP3A4和CYP2C9的IC50值＞100 μmol/L.结论：CPUHY002对于CYP2C19和CYP2E1具有弱抑制作用,对CYP1A2、CYP2D6、CYP3A4和CYP2C9无抑制作用.     

纯化当归多糖有效干预急性酒精性肝毒作用及其机制

目的观察纯化当归多糖对小鼠急性酒精性肝毒作用的影响，并探讨其机制。方法酒精灌胃法造模，经口给予纯化当归多糖（Angelica sinensis polysaccharides，ASP）100mg／kg、200mg／kg进行干预。观察小鼠sAUF，sAST和肝脏指数变化，测定乙醇脱氢酶（ADH）、血糖及肝糖原含量。以苯胺羟化酶（ANH）反映CYP2E1活性，以GSH、SOD、MDA活性反映抗氧化功能的改变。结果与酒精模型组相比，当归多糖两个剂量组均明显抑制酒精所致小鼠sALT、sAST及肝脏指数的升高：使ADH活性维持在正常范围；减轻酒精所致的血糖及肝糖原下降程度。同时，ASP显著降低了酒精对CYP2E1活性的诱导；ASP亦部分逆转GSH、SOD和MDA水平的异常改变。结论当归多糖能有效干预小鼠急性酒精性肝毒效应。其机制可能与下调ADH、CYP2E1活性，增加肝能量储备及对抗脂质过氧化有关。     

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.     

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.