气管内滴入MARCKS相关多肽和硫氦卓酮对气道黏液高分泌的影响

目的研究在大鼠气管内滴入豆蔻酰化富丙氨酸激酶C底物相关多肽（MANS）或／和硫氮卓酮对气道黏液分泌的影响并探讨其可能的作用机制。方法通过雾化吸入丙烯醛建立大鼠气道黏液高分泌模型后，依组别不同分别在气管内滴入MANS或硫氮卓酮以及二者同时滴入，对照组气管内滴入生理盐水，经匹罗卡品刺激后获取支气管肺泡灌洗液（BALF）。用酶联凝集素分析法（ELLA）对BALF中的黏蛋白（mucin）进行定量。结果MANS组、联用组（MANS与硫氮卓酮联合滴入）分别同对照组比较，黏蛋白的量均减少（P均〈0．05），且联用组较MANS组减少更为明显（P〈0．05）；硫氮卓酮组与对照组比较差异无统计学意义。结论在丙烯醛诱导的大鼠气道黏液高分泌模型中，气管内滴入MANS可以减少气道黏液的分泌，单用硫氮卓酮气管内滴入不能减少气道黏液的分泌，但二者联合滴入时硫氮卓酮对MANS抑制气道黏液的分泌可能具有协同作用。     

大环内酯类抗生素对气道黏液高分泌过程的调控作用及其机制研究

目的了解十四环大环内酯类抗生素对气道黏液高分泌过程的调控作用及其可能的机制。方法大鼠气道内注入脂多糖（LPS）建立气道黏液高分泌模型。分别给予罗红霉素（1—10mg／kg）、交沙霉素（10mg／kg）和阿莫西林（40mg／kg）管喂4d。提取肺组织和支气管肺泡灌洗液（BALF），采用ELLA、ELISA、免疫组化、RT-PCR及Western Blot等方法检测炎性细胞因子[白细胞介素1β（IL-1β）、IL-8和肿瘤坏死因子-α（TNF-α）]、黏蛋白、Muc5ac和核因子-κB（NF-κB）等的表达水平。结果LPS刺激可以使大鼠气道上皮Muc5ac蛋白和mRNA表达增高，使BALF中性粒细胞增高、黏蛋白含量增多、炎性细胞因子（IL-1β、1L-8和TNF-α）表达增加。同时气道上皮细胞胞浆NF-κB表达和NF-κB入核率均增高。罗红霉素（5和10mg／kg）可以抑制由LPS导致的Muc5ac高表达和NF-κB的核内转移，抑制肺组织内中性粒细胞聚集和肺泡灌洗液中性粒细胞的数量以及炎性细胞因子水平。NF-κB的入核率与细胞因子、Muc5acn mRNA水平呈正相关关系。交沙霉素组和阿莫西林组未观察到类似结果。结论罗红霉素可以抑制LPS所致的肺组织炎症反应和气道黏液高分泌状态，其机制可能是部分通过抑制NF-κB活化、中性粒细胞聚集和炎性细胞因子释放而发挥作用。     

罗格列酮对大鼠气道黏液高分泌的影响

目的探讨过氧化物酶体增殖物激活受体γ（PPARγ）激动剂罗格列酮对丙烯醛所致大鼠气道黏液高分泌的影响及其机制。方法将36只雄性SD大鼠随机分为6组，即对照组（A组）、罗格列酮自身对照组（B组）、模型组（C组）、低剂量罗格列酮组（D组）、中剂量罗格列酮组（E组）和高剂量罗格列酮组（F组）。采用酶联免疫吸附测定（ELISA）法检测支气管肺泡灌洗液（BALF）中肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）和IL-8浓度。分别用阿辛蓝．过碘酸雪夫（AB-PAS）和免疫组化染色检测气道黏蛋白和MUCSAC的表达。结果丙烯醛吸入各组BALF中TNF-α、IL-1β和IL-8浓度，以及气道黏蛋白、MUCSAC表达与A组比较明显增加（P〈0．01，P〈0．05），TNF-α、IL-1β、IL-8浓度与黏蛋白、MUCSAC表达分别呈正相关（r分别为0．827，0．795，0．924,0．805，0．812和0．917；P〈0．01或P〈0．05）。给予低、中、高剂量罗格列酮治疗后，D组、E组和F组BALF中TNF-α和IL-8浓度，以及气道黏蛋白和MUCSAC表达均逐渐降低，其中E、F组与C、D组比较，F组与E组比较，差异均有统计学意义（P〈0．01或P〈0．05）。结论罗格列酮能够下调TNF-α和IL-8的表达，减轻气道黏液高分泌。     

依拉普利对大鼠气道粘液高分泌的干预作用

目的 本研究观察依拉普利对吸入丙烯醛诱导的大鼠气道粘液高分泌的作用,并探讨其可能的机制.方法 24只SD大鼠随机分为4组(n=6):[1]对照组;[2]依拉普利自身对照组;[3]模型组;[4]依拉普利干预组.于21d处死大鼠,采集标本.采用HE染色和阿辛兰-过碘酸雪夫染色(AB-PAS)的组织学检查;免疫组化检测气管和肺内气道的Muc5ac、肺内血管紧张素Ⅱ、肺内气道的核转录因于NF-kB.实时荧光定量PCR(Real-time PCR)法检测肺内气道Muc5acmRNA.结果 模型组肺内AngⅡ的表达、气管和肺内气道的Muc5sc的表达,肺组织Muc5acmRNA、NF-kB入核率明显高于空白对照组和依拉普利干预组,差异均有统计学意义.AB-PAS染色得到与免疫组化相似的结果 .结论 丙烯醛刺激可以增加大鼠肺内AngⅡ的表达;增加Muc5ac的表达;也可以增加气道上皮的AB-PAS染色的面积百分比,增加NF-kB入核率.应用依拉普利干预后可抑制上述改变.本研究结果 表明依拉普利具有抑制气遭粘液高分泌的作用,其机制可能与核转录因子NF-kB的活化有关.     

不同药物对COPD大鼠Clara细胞和CC16表达的影响

目的观察N-乙酰半胱氨酸（NAC）、红霉素和地塞米松干预对大鼠慢性阻塞性肺疾病（COPD）模型Clara细胞数量及其分泌蛋白CC16表达的影响。方法单纯熏香烟法建立Wistar大鼠COPD模型。将大鼠随机分为正常对照组、COPD组、NAC组、红霉素组和地塞米松组，每组10只。免疫组织化学方法检测各组大鼠肺组织Clara细胞数量。酶联免疫吸附法检测支气管肺泡灌洗液（BALF）和血清中CC16含量。RT-PCR法检测各组大鼠肺组织中CC16mRNA的含量。结果COPD组大鼠终末细支管上皮Clara细胞占上皮细胞的百分比明显低于对照组，差异有显著性（P〈0．01）；NAC组和红霉素组Clara细胞百分比与COPD组相比有所增加（分别为P〈0．01，P〈0．05）；而地塞米松组与COPD组无统计学差异（P〉0．05）。COPD组大鼠BALF和血清中CC16蛋白水平（A）明显低于对照组，差异有显著性（P〈0．01）；NAC组及红霉素组BALF和血清中CC16蛋白水平明显高于COPD组，差异也有显著性（P〈0．05）；而地塞米松组大鼠BALF和血清中CC16蛋白水平与COPD组比较差异无显著性（P〉0．05）。COPD组大鼠肺组织中CC16 mRNA的含量明显低于对照组，NAC干预组和红霉素组明显高于COPD组（分别为P〈0．01．P〈0．05），而地塞米松组与COPD组比较差异无显著性（P〉0．05）。结论被动吸烟所致COPD大鼠的慢性气道炎症可导致Clara细胞数量及CC16的合成及分泌量减少，NAC和红霉素可能通过促进CC16的合成和分泌抑制气道炎症反应，地塞米松对CC16的合成及分泌量未见明显影响。     

甘利欣对哮喘大鼠核因子NF-kB及Th2类细胞因子的影响

目的 研究甘利欣对哮喘大鼠肺组织中核因子-kB（NF-kB）及Th2类细胞因子的影响。方法 将Wistar大鼠随机分为4组：对照组（A组）10只、模型组（B组）10只、甘利欣组（C组）10只和地塞米松组（D组）10只。用卵蛋白复制大鼠哮喘模型；免疫组织化学技术观察气道上皮细胞NF-kB的表达；肺组织病理观察炎症细胞的浸润情况；行支气管肺泡灌洗液（BALF）细胞因子测定。结果①哮喘模型组支气管周围明显炎细胞浸润，甘利欣组较哮喘模型组明显减轻（P〈0．01），正常对照组无明显炎细胞浸润。②甘利欣组BALF液中的IL-4、IL-5含量明显低于模型组（P〈0．01），而IFN-λ水平明显高于哮喘模型组（P〈0．01），且与地塞米松组无显著性差异（P〉0．05）。③4组NF-kB细胞核阳性表达的细胞占气道上皮细胞的百分比分别为（12．10±2．21）％、（27．70±3．58）％、（16．66±2．88）％和（14．94±1．96）％。模型组明显高于对照组（P〈0．01）；甘利欣组明显低于模型（P〈0．01），且与激素组无显著性差异（P〉0．05）。结论 甘利欣可以有效阻断肺组织中NF-kB的激活，减轻气道炎症。     

阿奇霉素治疗小儿支原体肺炎的临床疗效观察

目的探讨阿奇霉素治疗小儿支原体肺炎的疗效。方法将82例小儿支原体肺炎患儿分为：阿奇霉素治疗组（n=42）和红霉素（n=40）对照组，分析其临床疗效。结果阿奇霉素治疗组显效率95．2％，红霉素组77．5％，阿奇霉素组与红霉素组比较差异有显著性（P〈0．05）；阿奇霉素组退热、止咳、哆音消失时间均比红霉素组短（P〈0．05）；阿奇霉素组不良反应。结论阿奇霉素是治疗小儿支原体肺炎的一种安全有效的抗菌药物，值得进一步推广应用。     

丙烯醛致大鼠气管和肺损伤中内源性Muc5ac的表达变化

目的 探讨内源性黏蛋白5ac(Muc5ac)在丙烯醛所致大鼠气道损伤中的表达变化及其作用机制.方法 用丙烯醛雾化吸入造成大鼠气道黏液高分泌,模拟慢性阻塞性肺疾病.造模后分别用免疫组织化学、Western blot、RT-PCR和原位杂交检测气道Muc5ac的表达变化及定位分布.结果 丙烯醛吸入后第1周气道中Muc5ac的基因及蛋白水平均明显上调,并继续上调至第6周达最高水平.Muc5ac表达主要分布于气管、支气管上皮及肺泡上皮细胞中.结论 内源性Muc5ac在丙烯醛处理致大鼠气道黏液高分泌中明显增加,提示其在慢性阻塞性肺疾病黏液高分泌发病机制中可能是一个重要分子.     

阿奇霉素经 TLR-4／NF-κB信号通路干预COPD大鼠炎症的机制研究

目的：探讨阿奇霉素通过TLR‐4／NF‐κB信号通路干预慢性阻塞性肺疾病（COPD）大鼠炎症的机制。方法36只SD大鼠分为健康对照组、模型组、阿奇霉素组。模型组及阿奇霉素组采用烟熏联合气管内滴入脂多糖1个月建立COPD大鼠模型。阿奇霉素组烟熏前30 min给予50 mg／kg阿奇霉素灌胃,健康对照组及模型组给予等量生理盐水。1个月后,处死大鼠,苏木素‐伊红（HE）染色观察肺组织病理形态;ELISA法检测肺组织匀浆中肿瘤坏死因子‐α（TNF‐α）、IL‐1β、IL‐6水平;RT‐PCR检测Toll样受体4（TLR4）及核因子‐κB（NF‐κB）、磷酸化p65（pp65） mRNA表达;Western blot检测 TLR4、pp65、基质金属蛋白酶2（MMP‐2）及MMP‐9表达水平。并对大鼠支气管肺泡灌洗液进行细胞分类和计数。结果与模型组比较,阿奇霉素组能改善肺组织形态,降低中性粒细胞数（P＜0．01）,减少肺组织匀浆中 TNF‐α、IL‐1β、IL‐6、MMP‐2及MMP‐9的分泌（P＜0．01）,并抑制TLR4表达及pp65（P＜0．01）。结论阿奇霉素能通过TLR‐4／NF‐κB信号通路干预COPD大鼠炎症。     

大鼠慢性阻塞性肺病模型体内TNF-α和VEGF含量的变化及其意义

目的探讨肿瘤坏死因子-α（TNF—α）及血管内皮生长因子（VEGF）在慢性阻塞性肺病（COPD）发病中的作用。方法香烟熏吸法复制COPD大鼠模型。将20只清洁级Wister大鼠随机分为对照组和COPD模型组，每组各10只。肺组织切片行苏木精-伊红染色，测定两组大鼠血清、肺组织匀浆及支气管肺泡灌洗液（BALF）中TNF—α和VEGF的含量，并用RT-PCR法测定肺组织中VEGF mRNA的表达。结果模型组大鼠血清、肺组织匀浆及BALF中TNF-α含量较对照组明显升高（P〈0．01），而VEGF的含量较对照组有明显降低（P〈0．01，P〈0．05）。模型组大鼠肺组织内VEGF的表达较对照组有明显下降（P〈0．05）。结论TNF-α和VEGF参与了COPD的发病过程且在COPD细胞凋亡过程中起重要作用。     

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.     

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.