VEGF在大鼠重症急性胰腺炎中的表达及意义

目的观察血管内皮生长因子(VEGF)在重症急性胰腺炎(SAP)大鼠胰腺中的动态表达情况和组织病理改变的关系,初步探讨VEGF在SAP病理机制中的作用。方法将36只SD大鼠随机分成假手术组(Sham组)和SAP组各18只。5%牛磺胆酸钠逆行胆胰管注射制备SAP模型。每组分别于术后3、6、12h检测各组腹水量、血清淀粉酶的水平,免疫组织化学染色及蛋白印迹法检测胰腺组织VEGF的表达水平。结果 SAP组血清淀粉酶较Sham组明显升高(P<0.05);SAP组的水肿、炎症浸润、出血、坏死情况及Schmidt评分较Sham组严重(P<0.01);SAP组大鼠各时间点的胰腺组织VEGF的阳性表达水平较Sham组明显增加(P<0.01)。结论 VEGF与SAP的病理改变密切相关,可能是胰腺出血坏死的重要机制之一。     

改良逆行胆胰管注射法制备轻重不同两种大鼠急性胰腺炎模型

目的:采用不同浓度的牛磺胆酸钠逆行胆胰管注射,复制轻重不同两种实验性大鼠急性胰腺炎(AP)模型.方法:64只大鼠随机分为假手术(SO)组、0.5%牛磺胆酸钠(ST)组和5% ST组,胆胰管逆行注射浓度分别为0.5%和5%的ST诱导AP,采用酶法检测血淀粉酶、血糖、肌酐,化学比色法检测血钙和速率法检测丙氨酸转氨酶,观察24 h病死率及胰腺组织病理学改变.结果:与SO组相比,0.5% ST组血淀粉酶升高(P<0.01),血糖、血钙、肌酐及丙氨酸转氨酶数值无显著差异,病理检查胰腺轻度肿胀,间质水肿,属轻型急性胰腺炎(MAP);5% ST组血淀粉酶、血糖、肌酐及丙氨酸转氨酶均显著升高 (P<0.05或P<0.01),血钙降低(P<0.05或P<0.01),病理检查胰腺组织有明显出血坏死,符合重型急性胰腺炎(SAP). 0.5% ST组和5% ST组24 h病死率分别为0和35%(7/20).结论:采用浓度为0.5%和5%的ST逆行大鼠胆胰管注射,可复制出理想的MAP和SAP模型.     

大鼠重症急性胰腺炎模型制备方法的建立与探讨

目的 建立一种操作简单,诱导成功率高且病变典型的重症急性胰腺炎(SAP)大鼠模型.方法 36只健康雄性SD大鼠随机分为模型组(n=18)和对照组(n=18).模型组用微量输液泵经胰胆管逆行注入3.5%牛磺胆酸钠诱导SAP大鼠模型;对照组仅翻动胰腺和十二指肠.观察两组大鼠术后3h、6h、12h腹水及血清淀粉酶、脂肪酶的变化,观察胰腺组织大体形态以及病理改变,并进行评分.结果 模型组胰腺组织结构破坏明显,其大体及病理评分均显著高于对照组(P<0.01),腹水量、血清淀粉酶、脂肪酶也均较对照组显著增加(P<0.01).结论 逆行胰胆管注射牛磺胆酸钠能成功诱导大鼠SAP,具有创伤小、操作简便、可重复性好及诱导成功率高的特点,是一种较为理想的SAP动物模型制备方法.     

围胰腺区域性微创治疗大鼠重症急性胰腺炎的实验研究

目的 观察围胰腺区域性微创治疗方案对重症急性胰腺炎(SAP)大鼠的影响.方法 72只SD大鼠随机分为自然病程组(SAP组)、常规治疗组(R组)、DDFA治疗组(DDFA组)、微创治疗组(W组),各组分配18只.每组分6、12、24 h三个时间点,每时间点分配6只.采用5%牛黄胆酸钠逆行胰管注射法建立大鼠SAP模型.建模后按时间点分批采血并测血白细胞、血淀粉酶,提取血清测IL-6、TNF-α、PL-A2,吸取腹腔液测淀粉酶,取胰腺组织制作病理切片.结果 各组各时间点间腹腔液淀粉酶含量及血淀粉酶含量、白细胞计数、血清IL-6、TNF-α、PL-A2含量、病理评分比较均有显著性差异.结论 围胰腺区域性微创治疗方案能显著降低大鼠血白细胞、淀粉酶、IL-6、TNF-α、PL-A2、腹水淀粉酶、胰腺组织病理评分,是阻止SAP进展的有效方法.     

重症急性胰腺炎大鼠模型制作方法的改进

目的:探讨4%牛磺胆酸钠逆行胆胰管注射诱导重症急性胰腺炎(SAP)大鼠模型的相关技术的改良。方法:将36只健康SD大鼠随机分为模型组(n=18)和假手术组(n=18),应用细针经胆胰管近十二指肠开口端逆行刺入注射4%牛磺胆酸钠,诱导重症急性胰腺炎动物模型;2组均在模型诱导后3、6、12h后检测腹水量及血淀粉酶,观察胰腺组织形态变化,光镜下进行胰腺病变程度评分。结果:模型组在模型诱导后3、6、12h腹水量、血淀粉酶、胰腺组织学评分均较假手术组明显升高(P<0.05)。结论:该方法可成功诱导重症急性胰腺炎,具有创伤小、操作简便及模型诱导成功率高的特点,是较为理想的SAP动物模型。     

重症胰腺炎大鼠血清TNF-α浓度的变化及与肺损伤的关系

目的:测定实验性重症胰腺炎大鼠血清TNFα浓度,并探讨其与肺损伤的关系.方法:SD大鼠55只,随机分为SAP组(再分为0.5、3、6、12、24h组,各组n=8)和对照组(n=15).采用逆行胰胆管注射5%牛磺胆酸钠复制重症胰腺炎模型,取肺组织行病理观察,ELISA法测血清TNF-α浓度.结果:SAP各组血清淀粉酶水平与对照组比较,P＜0.05;血清TNF-α浓度除0.5h组外,其余各组与对照组比较,均有显著性差异(P＜0.05),至12h达高峰,随后下降.结论:血清TNF-α浓度在急性胰腺炎早期即显著升高并可能与肺损伤密切相关.     

逆行性胰胆管注射法制作重症急性胰腺炎大鼠模型

目的 建立一种重复性好，标准化程度高，病理变化典型，适合评价药物疗效的重症急性胰腺炎（SAP）动物模型。方法 28只大鼠逆行胰胆管注射牛磺胆酸钠，观察死亡率，血淀粉酶，血Ca^2 和胰腺组织病理结构变化。结果 与假手术组相比，SAP组血淀粉酶升高（P＜0．01），血Ca^2 降低（P＜0．05），部分大鼠死亡（63．1％），病理检查胰腺组织明显坏死。结论 采用逆行胰胆管注射法建立SAP大鼠模型具有重要性好，标准化程度高，病理变化典型等优点，适合重症急性胰腺炎发病机制和药物疗效的研究。     

乌司他丁对急性重症胰腺炎大鼠血清TNF-α及IL-1β水平的影响

目的:探讨乌司他丁对重症胰腺炎大鼠TNF-α和IL-1β水平的影响。方法:胰胆管逆行注射牛磺胆酸钠制作大鼠SAP模型,wistar大鼠60分为3组,乌司他丁治疗组,重症胰腺炎(SAP)组,对照(NC)组,每组20只。术后6h对各组大鼠行血清淀粉酶、TNF-α及IL-1β的检测,并取各组大鼠胰腺组织标本行病理学观察。结果:乌司他丁治疗组血清淀粉酶、TNF-α及IL-1β较SAP组明显降低,胰腺组织坏死程度减轻(P0.05)。结论:乌司他丁可调节细胞因子水平,改善胰腺组织微循环,减轻全身炎症反应,对SAP有治疗作用。     

乌司他丁对急性重症胰腺炎大鼠血清TN F－α及I L－1β水平的影响

目的：探讨乌司他丁对重症胰腺炎大鼠TNF－α和IL－1β水平的影响。方法：胰胆管逆行注射牛磺胆酸钠制作大鼠SAP模型,wistar大鼠60分为3组,乌司他丁治疗组,重症胰腺炎（SAP）组,对照（NC）组,每组20只。术后6h对各组大鼠行血清淀粉酶、TNF－α及IL－1β的检测,并取各组大鼠胰腺组织标本行病理学观察。结果：乌司他丁治疗组血清淀粉酶、TNF－α及IL－1β较SAP组明显降低,胰腺组织坏死程度减轻（P＜0．05）。结论：乌司他丁可调节细胞因子水平,改善胰腺组织微循环,减轻全身炎症反应,对SAP有治疗作用。     

罗格列酮对重症急性胰腺炎的保护作用

目的:探讨罗格列酮对重症急性胰腺炎(SAP)的保护作用及其作用机制。方法:72只健康SD大鼠随机分为3组:假手术组(SO组)、SAP组及罗格列酮处理组。采用经十二指肠胰胆管逆行注射5%牛磺胆酸钠诱导大鼠SAP模型,于模型制作前30min腹腔内注射罗格列酮(10mg/kg)进行预处理,各组于术后3h、6h和12h分批处死动物,观察各组大鼠血浆淀粉酶、TNF-α、IL-6、胰腺组织髓过氧化物酶(MPO)水平的变化以及胰腺组织病理改变,并进行病理学评分。结果:SAP组血浆淀粉酶、TNF-α、IL-6、胰腺组织MPO、胰腺组织病理学评分较SO组均明显升高(P<0.05),罗格列酮处理组各时间点血浆淀粉酶、TNF-α、IL-6、胰腺组织MPO水平均较SAP组显著降低(P<0.05),6h、12h胰腺组织病理评分均显著低于SAP组(P<0.05),各时间点胰腺组织病理损伤较SAP组明显减轻。结论:罗格列酮可能通过减少TNF-α、IL-6的产生,减轻胰腺组织损伤,从而改善SAP病情。     

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.