豹皮樟总黄酮对大鼠酒精性脂肪性肝炎的防治作用及部分机制

目的探讨豹皮樟总黄酮（TFLC）对大鼠酒精性脂肪性肝炎的防治作用及部分机制。方法以酒精联合脂肪乳剂灌胃,每天2次,连续6周,制备大鼠酒精性脂肪性肝炎模型。给药组同时灌服相应药物。于实验的第6周末采血,检测血清丙氨酸氨基转移酶（ALT）、天门冬氨基转移酶（AST）、γ-谷氨酰基转移酶（γ-GT）、碱性磷酸酶（ALP）、总胆固醇（TC）、甘油三酯（TG）、超氧化物歧化酶（SOD）、丙二醛（MDA）、谷胱甘肽过氧化物酶（GSH-PX）及肝脏TG、TC、SOD、MDA、GSH-PX,并行肝脏病理学检查。结果TFLC（200、400mg／kg）组能明显降低酒精性脂肪性肝炎大鼠血清AST、ALT、ALP、γ-GT水平;降低血清和肝匀浆中TC、TG、MDA含量,增强SOD和GSH-PX活性;同时病理组织学显示TFLC能明显改善酒精性脂肪性肝炎大鼠的肝细胞脂肪变性。结论 TFLC对大鼠酒精性脂肪性肝炎具有较好的防治作用。其作用机制与抗氧化和调节脂质代谢有关。     

MEK抑制剂PD98059对大鼠非酒精性脂肪性肝病的影响

目的 观察MEK抑制剂PD98059对大鼠非酒精性脂肪性肝病(NAFLD)的影响及可能机制.方法 应用高脂饮食复制非酒精性脂肪性肝病模型.32只雄性Wister大鼠随机分成正常对照组(N组)、PD98059+普通饲料组(P组)、高脂模型组(M组)和PD98059+高脂组(PM组)共4组,每组8只.于分组喂养的第4、6、8周末分别给予P组和PM组大鼠鼠尾静脉注射MEK抑制剂PD98059干预.10周末结束实验.检测血清丙氨酸转移酶(ALT)、门冬氨酸转移酶(AST)、甘油三酯(TG)、总胆固醇(TC)、极低密度脂蛋白(VLDL),肝组织TG、TC、丙二醛(MDA)、超氧化物歧化酶(SOD);光镜观察大鼠肝脏的病理改变,免疫组化法检测肝脏磷酸化细胞外信号调节激酶1/2(p-ERK1/2)表达.结果 与N组比较,P组血清转氨酶、血脂、肝组织TG、TC、MDA、SOD以及肝脏病理学和p-ERK1/2表达无明显差异(P>0.05),M组所有大鼠肝细胞脂肪变性范围均超过50%并伴有不同程度的炎性细胞浸润和坏死,p-ERK1/2表达增强,ALT、AST、TC、肝组织TG、TC、MDA显著升高,SOD明显降低(P<0.05,P<0.01).与M组比较,PM组p-ERK1/2表达减少(P<0.01),ALT、肝组织TG、TC、MDA降低,SOD升高(P<0.05,P<0.01),同时大鼠的肝脏病理学得到了改善.结论 PD98059通过抑制MEK/ERK信号通路对非酒精性脂肪性肝病大鼠发挥保护作用.     

大鼠实验性非酒精性脂肪性肝炎模型的研究

目的建立非酒精性脂肪性肝炎实验动物模型。方法SD大鼠30只,随机分为对照组(n=10)和模型组(n=20)。对照组喂普通饲料,模型组喂普通饲料并给予脂肪乳剂灌胃(10ml／kg)。动态观察血清TG、TC、ALT、AST、MDA、SOD、FFA和肝脏TG、TC、MDA、SOD、FFA的变化,并行肝脏病理学检查。结果2周后,随机处死模型组中的10只,与正常组相比,发现血清TG、TC、ALT和肝脏MDA均明显升高,而肝脏SOD则明显降低,病理显示有2只轻度脂肪变性,尚无炎症病灶出现。第3周处死剩余动物,发现肝指数、血清脂质、ALT、AST、MDA、FFA和肝脏TG、MDA、FFA与对照组相比均显著升高,而SOD则明显降低;光镜下所见模型组出现弥漫性肝细胞脂肪变性,并有炎症病灶。结论通过3周脂肪乳剂的喂养,形成了非酒精性脂肪性肝炎。     

建立脂肪肝动物模型的实验研究

目的建立酒精灌胃配合高脂饲料的脂肪肝动物模型。方法 SD大鼠40只,随机分为正常对照组(n=10)、模型组1(n=15)、模型组2(n=15)。模型组给予特殊高脂饲料;模型组1予30%酒精(1 ml·100 g)/d,7天后根据大鼠情况增加酒精浓度,至第3周为50%酒精(1 ml·100 g)/d。模型组2和正常对照组予等体积的生理盐水灌胃。4周末检测血清TG、TC、ALT、AST、LDL-C、HDL-C、MDA、SOD、肝脏TG、TC,肝脏行HE病理切片制作。结果4周后与正常组相比,血清TG、TC、ALT、MDA、LDL-C、肝脏TG、TC均明显升高,SOD、HDL-C则明显降低,光镜下所见模型组1均出现弥漫性肝细胞脂肪变性,呈中重度脂肪肝变,并有炎症病灶。模型组2部分(3只)出现轻度脂肪肝变。结论通过4周混合喂养的大鼠出现明显的脂肪肝病变,成功造模。     

硒蛋白P对非酒精性脂肪肝病大鼠肝脏的保护作用研究

目的探讨硒蛋白P(Sepp1)对非酒精性脂肪肝病(NAFLD)大鼠肝脏的保护作用及其可能的机制。方法30只Wistar大鼠随机分为对照组(n=10)、模型组(n=10)、补硒组(n=10),分别喂食标准饲料、高脂饲料和补硒(亚硒酸钠)干预饲料。第16周末安乐死法处死全部大鼠,观察肝脏病理组织学改变,检测血浆中Sepp1含量与肝功能指标丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和血脂指标游离脂肪酸(FFA)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)变化情况。结果与对照组比较,模型组肝组织Sepp1含量降低,ALT、AST、FFA、TC、TG、LDL-C含量升高,HDL-C含量降低,差异均有统计学意义(P0.05);与模型组比较,补硒组Sepp1含量升高,ALT、AST、FFA、TC、TG、LDL-C含量降低,HDL-C含量升高,差异均有统计学意义(P0.05)。结论 Sepp1可改善肝功能及血脂紊乱,对NAFLD大鼠的肝脏损害起保护作用。     

肝脂康胶囊对大鼠非酒精性脂肪性肝病SREBP-1表达的影响

目的观察肝脂康胶囊对大鼠非酒精性脂肪性肝病（NAFLD）及固醇调控元件结合蛋白-1（SREBP-1）的影响。方法采用高脂饮食复制大鼠NAFLD模型。SD大鼠40只雌雄各半,随机分为正常对照组、模型组、低、中、高剂量肝脂康胶囊干预组,每组各8只。干预组大鼠在进行高脂饮食同时每日给予不同剂量肝脂康胶囊灌胃。药物干预12周末结束实验。分别检测血清丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）、甘油三酯（TG）、总胆固醇（TC）、肝组织TG、TC以及免疫组化法检测肝脏SREBP-1表达。结果与正常对照组相比,模型组大鼠血清ALT、AST、TG、TC及肝组织TG、TC显著升高（P〈0.01）。与模型组相比,肝脂康干预组大鼠血清AST、ALT、TC、TG和肝组织中TG、TC降低（P〈0.05）。模型组SREBP-1的表达明显高于正常组,肝脂康干预组SREBP-1的表达较模型组明显减少。结论肝脂康胶囊对高脂饮食诱导的大鼠NAFLD有治疗作用,并降低肝脏SREBP-1表达。     

酒精复合性肝纤维化大鼠模型的建立及动态观察

目的 建立大鼠酒精复合性肝纤维化动物模型,观察肝纤维化的动态病变情况.方法 雄性SD大鼠随机分成对照组、酒精性肝纤维化模型组.模型组大鼠灌胃酒精、橄榄油、吡唑的混悬液,并间断饲喂高脂饲料,结合微量CCl4腹腔注射的复合方式造模.分别于2、4、6、8周时检测造模大鼠血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、胆固醇(TC)、甘油三酯(TG)水平,并根据肝脏病理切片分析肝脏纤维化病变程度.结果 在造模2周末,肝细胞轻、中度脂肪变:4周末,重度脂肪肝,轻度的纤维组织增生;6周末,肝细胞严重脂变,纤维隔形成,中度界面肝炎;8周末,多个假小体形成,达早期肝硬化程度.模型组大鼠的体重、血清ALT、AST、TG、TC水平与对照组比较,差异均有统计学意义.结论 运用酒精灌胃为主的复合方式造模,8周内可建立形成不同程度(酒精性脂肪肝、肝炎、肝纤维化)的酒精性肝纤维化的动物模型.该模型可靠且复制时间短,肝纤维化进展稳定.     

蜕皮甾酮对大鼠非酒精性脂肪性肝病核因子κB与PPAR-γmRNA表达的影响

目的 研究蜕皮甾酮对非酒精性脂肪性肝病大鼠模型核因子κB与PPAR-γ mRNA表达的影响,并探索其可能的作用机制.方法 采用改良高脂膳食喂养法,建立大鼠非酒精性脂肪性肝病模型.健康成年雄性SD大鼠48只,随机分为正常对照组、模型组、蜕皮甾酮处理组与吡格列酮处理组,每组12只.模型组应用改良高脂饲料喂养,蜕皮甾酮组与吡格列酮组在高脂饲料喂养同时应用药物灌胃,正常对照组应用基础饲料喂养.实验16周末,处死所有大鼠,观察检测肝脏指数、血清与肝组织生化指标及肝组织病理改变;免疫细胞化学法检测各组大鼠肝组织中核因子κB蛋白表达情况;实时荧光定量PCR技术检测PPAR-γmRNA 水平变化.结果 蜕皮甾酮组和吡格列酮组血清胆固醇(TC)、甘油三酯(TG)、丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)明显低于模型组(P<0.05);蜕皮甾酮和吡格列酮组与模型组相比,肝组织丙二醛(MDA)水平降低明显,超氧化物歧化酶(SOD)活力增加显著;蜕皮甾酮肝脏指数显著降低;肝组织脂肪变性程度和炎症活动度明显减轻(P<0.05).蜕皮甾酮和吡格列酮组与模型组相比核因子κB水平明显降低(P<0.01),PPAR-γ mRNA显著增加(P<0.05).结论 蜕皮甾酮具有改善高脂饮食诱发的非酒精性脂肪性肝病大鼠肝脏酶学,通过增加肝组织SOD的含量和减少MDA的含量来减轻肝组织氧化应激水平,增加肝组织PPAR-γmRNA和减少核因子κB改善胰岛素抵抗,减轻肝脏炎症,发挥防治非酒精性脂肪性肝病的作用.     

丹参对非酒精性脂肪性肝炎大鼠脂质代谢及脂肪细胞因子影响

目的:观察丹参注射液对非酒精性脂肪性肝炎大鼠脂质代谢、肝组织病理变化及脂肪细胞因子的影响,探讨其防治非酒精性脂肪性肝炎(Non-alcoholic steato-hepatitis,NASH)的可能作用机制。方法:采用高脂饮食16周建立大鼠非酒精性脂肪性肝炎模型,并用丹参注射液5 m L/(kg·d)进行干预治疗,观察各组大鼠肝湿质量、肝指数,血清及肝组织匀浆TG、TC含量,HE染色光镜观察肝组织脂肪变和炎症程度,ELISA法检测血清脂联素、TNF-α水平。结果:模型组大鼠肝湿质量、肝指数,血清及肝组织匀浆TG、TC含量升高,血清TNF-α水平升高,脂联素水平下降,肝组织炎症积分升高(P0.01);丹参治疗后肝组织炎症程度较模型组明显减轻,血清及肝组织匀浆TG、TC含量较模型组明显降低,血清脂联素水平较模型组增高,TNF-α水平较模型组显著下降(P0.01)。结论:丹参注射液能通过上调脂联素水平、下调TNF-α水平,降低肝脏脂质蓄积,从而抑制肝细胞炎症,防止NASH的进展。     

酒精性与非酒精性脂肪肝模型大鼠肝脏脂质及血脂等指标的比较

目的:比较酒精性脂肪肝(AFL)和非酒精性脂肪肝(NAFL)模型大鼠肝脏脂质(肝脂)及血脂等指标的异同。方法:Wistar大鼠随机分为正常对照组、AFL组和NAFL组,10周造模成功,制备病理切片,测定各组血脂、酶学等指标,制备肝匀浆测定肝脏脂质含量。结果:NAFL组大鼠部分肝细胞内出现大小不等的脂滴,AFL组出现大泡状脂滴。与正常对照组比较,AFL组血清甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(BIL)及肝脏TG、TC显著升高(P<0.01);NAFL组血清TG、TC、LDL、BIL、ALT及肝脏TC水平与正常对照组比较差异有统计学意义。AFL组与NAFL组高密度脂蛋白(HDL)与γ-谷氨酰转肽酶(-γGGT)指标与正常对照组比较差异均无统计学意义。AFL组血清TG、AST及肝脏TG、TC显著高于NAFL组(P<0.01)。结论:相同的实验周期内,AFL模型大鼠血清TG及肝脏脂质升高比NAFL模型更显著。     

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.