高强度聚焦超声作用下兔脑的病理转归

目的：通过研究高强度聚焦超声（High intensity focused ultrasound, HIFU）对正常兔脑组织作用后损伤灶的病理转归,探讨其治疗脑肿瘤的安全性和可行性。方法：选取合适的HIFU作用剂量,对12只新西兰兔左右两侧脑组织分别照射5s和10s,于即刻、3天、7天、14天、28天及60天处死取材,大体和组织学观察照射后损伤灶的生物学特性及靶区组织病理学变化,并在电镜下观察损伤即刻的超微结构变化。结果：大体与光镜观察发现在作用时间为5s和10s的不同情况下,二者损伤程度以28天差异最大,最终10s区转归为神经胶质瘢痕,5s区则未见明显损伤痕迹。在HIFU损伤即刻,电镜下可见10s区出现细胞、血管结构完整性受破坏,而5s作用区仍具有完整性。结论：HIFU能定位损伤大脑深部组织,对浅表组织的影响较小。损伤灶的修复方式与照射的剂量有关,提示用适当剂量HIFU治疗脑肿瘤是安全的和可行的,为将来应用HIFU临床治疗脑肿瘤提供了实验依据。     

高强度聚焦超声应用于在体兔脑病理实验研究

目的 通过研究高强度聚焦超声(high intensity focused ultrasound,HIFU)毁损在体兔脑组织后损伤灶及其相邻组织的病理改变,探讨HIFU将来应用于脑肿瘤治疗的有效性和安全性.方法 以JC型高强度聚焦超声肿瘤治疗系统作为HIFU聚能器.将48只新西兰兔按声功率随机分为A、B组,每组再按辐照时间分为6小组,即1、3、5、7、9、11s组;A、B组分别以声功率50、100W单次定点损伤兔脑组织.7d后,完整取出脑组织,观察损伤灶的大体特征和组织学的生物学特性;取正常与坏死交界区域组织送病理检查(光镜、电镜观察).结果 除1s组外,靶区脑组织的完整性均受到破坏.在一定的治疗参数下,声功率50W时,辐照时间3、5、7、9s和声功率100W时辐照时间3、5、7s对兔脑组织的作用比较理想.结论 适当剂量HIFU毁损正常脑组织是有效的和安全的,为将来HIFU应用临床脑肿瘤治疗提供了一定的实验参考数据.     

乳腺癌高强度聚焦超声消融后残留肿瘤增殖能力的变化

目的 探讨兔乳腺种植瘤经高强度聚焦超声(HIFU)消融后残留肿瘤增殖能力的变化.方法 兔鳞癌细胞株VX＿2肿瘤组织块接种于新西兰兔乳腺,建立兔乳腺种植瘤模型,2周后行HIFU治疗,通过控制探针侧温度,造成肿瘤残留.56只兔子随机分为对照组(n=16)和HIFU组(n=40),经电子显微镜和琥珀酸脱氢酶(SDH)组织化学染色检查确认消融效果和残留肿瘤组织消融后不同时间点检测增殖细胞核抗原(PCNA)的表达情况,同时观察动物生存时间和肿瘤脏器转移的情况.结果 HIFU组消融后,残留肿瘤的PCNA表达呈-过性降低,21 d后恢复至消融前水平.HIFU组的生存时间明显长于对照组,而肺部及腹腔脏器出现转移的时间明显晚于对照组(P<0.05).结论 即使HIFU未能一次完全消融肿瘤,在短时间内也能有效抑制残留肿瘤的生长和转移,延长机体的生存时间.     

乳腺癌高强度聚焦超声消融后残留肿瘤增殖能力的变化

目的探讨兔乳腺种植瘤经高强度聚焦超声（HIFU）消融后残留肿瘤增殖能力的变化。方法兔鳞癌细胞株VX2肿瘤组织块接种于新西兰兔乳腺,建立兔乳腺种植瘤模型,2周后行HIFU治疗,通过控制探针侧温度,造成肿瘤残留。56只兔子随机分为对照组（n=16）和HIFU组（n=40）,经电子显微镜和琥珀酸脱氢酶（SDH）组织化学染色检查确认消融效果和残留肿瘤组织消融后不同时间点检测增殖细胞核抗原（PCNA）的表达情况,同时观察动物生存时间和肿瘤脏器转移的情况。结果HIFU组消融后,残留肿瘤的PCNA表达呈一过性降低,21d后恢复至消融前水平。HIFU组的生存时间明显长于对照组,而肺部及腹腔脏器出现转移的时间明显晚于对照组（P〈0．05）。结论即使HIFU未能一次完全消融肿瘤,在短时间内也能有效抑制残留肿瘤的生长和转移,延长机体的生存时间。     

顺铂致兔急性肾损伤的序贯观察

目的探讨单次静脉注射顺铂致兔急性肾损伤(AKI)的病程进展规律。方法雄性新西兰兔40只,随机分为5组,每组8只。经耳缘静脉单次注射顺铂(5 mg/kg)制作急性肾损伤模型,按照观察时间点分为注射顺铂后6 h组(T6)、12 h组(T12),24 h组(T24),36 h组(T36)及48 h组(T48),分别于注射前及注射后相应时间点检测兔静脉血血尿素氮(BUN)及血肌酐(SCr)值。应用SPSS 22.0统计软件对数据进行统计分析,P0.05为差异具有统计学意义。在各实验节点,处死实验兔,获取各组兔肾组织标本,常规石蜡切片,HE染色光镜下观察。结果与注射前相比,注射顺铂后各组BUN及SCr值均明显升高,建模24 h以后各组所有实验兔达到急性肾损伤标准,损伤呈进行性加重。HE染色光镜下观察以T48组变化更明显。结论单次静脉注射顺铂可引起兔急性肾功能损害,48 h内呈进行性加重。     

MRI监控HIFU损伤活体兔肝VX2瘤的影像学观察

目的观察高强度聚焦超声(HIFU)损伤20例活体兔肝VX2瘤的磁共振成像(MRI)监控图像,探讨MRI图像变化及其与实际损伤的关系。方法 HIFU以点辐照的方式逐层覆盖20例活体兔肝VX2瘤,并在HFIU术前及术后即刻扫描快速自旋回波(TSE)序列T1加权像(T1WI)、T2WI及增强T1WI。观察MRI图像变化,并取瘤体组织作2,3,5-氯化三苯基四氮唑(TTC)染色及苏木素-伊红染色,进行病理检查。结果 MRI图像改变能较准确地反映HIFU术后即刻瘤体内部损伤情况。结论 MRI能有效监控及评价HIFU损伤活体兔肝VX2瘤的效果。     

高强度聚焦超声损伤兔肝脏的剂量及二维超声实时监控

目的:探索高强度聚焦超声损伤兔肝脏的剂量和二维超声实时监控的可行性.方法:HIFU发射功率、工作频率、辐照深度恒定,以HIFU定点损伤40例兔肝脏,二维超声实时观察损伤靶区的回声及其随时间的变化,测量回声变化的范围,解剖测量损伤靶区凝固性坏死区的大小,留取凝固性坏死组织标本行病理学检查.结果:HIFU体外辐照兔肝脏可在靶区形成凝固性坏死,能效因子为9.22±1.57J/mm3,靶区的回声增强,凝固性坏死体积、最大剖面面积与二维超声测量的回声增强区体积、面积呈线性关系.结论:HIFU损伤组织的剂量需大量的实验研究,二维超声可实时监控凝固性坏死的出现,并可预测凝固性坏死体积大小.     

溴酚蓝对大鼠脑胶质瘤模型的染色作用

目的研究溴酚蓝对大鼠胶质瘤模型的染色作用,为手术精确切除人脑胶质瘤提供实验基础。方法建立Fischer 344大鼠胶质瘤模型,MRI检查证实。静脉注射不同剂量（30～360mg/kg）溴酚蓝,15min后处死取脑,检查溴酚蓝对脑肿瘤的染色情况;并注射相同剂量（180mg/kg）的溴酚蓝,在不同时间处死取脑,检查溴酚蓝对脑肿瘤的染色情况。对无瘤实验大鼠注射不同剂量溴酚蓝,观察其毒性反应。结果溴酚蓝对大鼠胶质瘤有明显的染色作用,其染色与周围脑组织有清晰的界限,染色时间出现在注射后10min～6h。30d未观察到溴酚蓝的任何毒性反应。结论溴酚蓝在不同时间点能够清晰染色大鼠胶质瘤,有可能作为人脑胶质瘤的术中染色剂来区别肿瘤组织和正常脑组织。     

复方核黄素眼用即型凝胶的兔眼内药效学研究*

目的 考察复方核黄素眼用即型凝胶的药效作用。方法 在钴蓝光下观察经荧光素纳染色后的复方核黄素眼用即型凝胶在新西兰兔眼表的滞留时间;采用眼刺激评分量表进行评分,考察复方核黄素眼用即型凝胶单次给药后1、24、48和72 h的眼表刺激性及多次给药后第7和14天对眼表造成的累积或持续损害;用0.25%氢氧化钠溶液复制角膜损伤模型,将12只新西兰兔随机分为模型组、滴眼液组和即型凝胶组,模型复制后每组兔右眼分别滴入相应的药物,左眼作为正常空白对照。分别在模型复制后第1、3、5、7天观察 兔的眼角膜损伤恢复情况,第7天将兔处死,取角膜组织进行HE染色,观察组织形态学变化,评估药物对角膜损伤恢复的疗效。结果 复方核黄素眼用即型凝胶眼表滞留时间（306.0±33.3）s比滴眼液的眼表滞留时间（9.67±2.52）s长（P?<0.05）;即型凝胶对兔眼表无刺激性;模型复制成功后,即型凝胶组与模型组比较,损伤恢复状况在第5和第7天差异均有统计学意义（P?<0.05）;模型复制后第7天,与正常空白对照比较,即型凝胶组和滴眼液组的眼表损伤已逐渐恢复。结论 复方核黄素眼用即型凝胶能延长药物的眼表保留时间,不具有眼部刺激性,可促进角膜损伤恢复。     

射频热凝对兔脑皮层损伤的凋亡作用

目的　探讨射频热凝对兔脑皮层损伤过程中凋亡的作用。方法　兔脑分别以 5 1～ 80℃ 60s和70℃ 15～ 12 0s射频热凝 ,术后 2 4h或 14d处死动物 ,取出兔脑 ,固定、包埋、切片。对大体标本进行HE染色 ,采用透射电镜 (TEM )、原位末端标记法凋亡检测 (TUNEL染色 )观察病理变化。结果　 2 4h组兔脑组织均表现出由中心向外周的坏死、凋亡、正常的梯度变化。 14d组可见坏死、胶质增生及正常组织的梯度变化。结论　射频热凝兔脑皮层过程中 ,凋亡参与细胞损害过程。在特定温度区间 ,主要表现在坏死与正常脑组织的交界区 ,区带宽度为 ( 1.2 96± 0 .481)mm ,2 4h病理变化显著 ,14d后被胶质细胞增生取代     

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.