阿米替林对大鼠局灶性脑缺血-再灌注损伤的保护作用

目的研究阿米替林(amitriptyline,Ami)对大鼠局灶性脑缺血-再灌注损伤的保护作用.方法60只大鼠分6组.除假手术组,其余5组分别用线栓法建立大鼠局灶性脑缺血-再灌注损伤模型,其中4组在缺血前2h分别腹腔注射3个不同剂量Ami,即20mg·kg-1,15mg·kg-1,10mg·kg-1,及Nim2mg·     

托吡酯对沙土鼠脑缺血再灌注损伤保护作用的研究

目的　探讨托吡酯对脑缺血再灌注所致脑损伤的保护作用及机制。方法　取沙土鼠 4 0只 ,随机分为 :⑴假手术组 ;⑵脑缺血再灌注组 ;⑶缺血再灌注 +托吡酯 5 0mg·kg-1组 ;⑷缺血再灌注 +托吡酯 10 0mg·kg-1组。采用短暂夹闭双侧颈总动脉法复制沙土鼠脑缺血再灌注模型 ,术后 2 4h取脑组织测定SOD、MDA、NO的改变 ,以及含水量的变化。结果　托吡酯 5 0mg·kg-1、托吡酯 10 0mg·kg-1脑组织中SOD活力明显增高、MDA、NO含量明显减少、脑组织含水量明显降低 ,与缺血再灌注组比较均有显著性差异 (P <0 0 1)。结论　托吡酯能使脑缺血再灌注损伤后脑组织中自由基的含量明显减少 ,能明显减轻脑组织水肿 ,对脑缺血再灌注损伤有保护作用。     

黄芪提取物对大鼠局灶性脑缺血再灌注血脑屏障损伤的影响

目的 研究黄芪提取物(extract of astragalus,EA)对大鼠局灶性脑缺血(MCAO)再灌注的血脑屏障损伤的影响。方法 采用线栓法制备MCAO再灌注模型,观察EA对缺血再灌注大鼠的神经功能障碍、脑梗死体积和脑含水量、外周血循环内皮细胞(CEC)含量、缺血脑组织中细胞间粘附分子(ICAM-1)的表达、缺血侧脑组织皮质血脑屏障超微结构的病理学变化的影响。结果 EA80 mg·kg^-1,EA(40,80 mg·kg^-1)、EA(20,40,80 mg·kg^-1)可分别改善缺血再灌注2,8,24 h大鼠的神经功能障碍;能明显降低外周血中的CEC含量,明显减轻缺血脑组织的脑水肿和脑梗死体积,对脑缺血再灌注后血脑屏障超微结构的病理改变有一定的改善作用;能减少ICAM-1免疫反应阳性血管数。结论 EA对局灶性脑缺血再灌注损伤大鼠有一定的保护作用,作用机制可能与其保护血管内皮细胞,减轻脑缺血再灌注后的血脑屏障损伤有关。     

黄芩苷对大鼠局灶性脑缺血再灌注损伤的保护作用

目的 研究黄芩苷对大鼠局灶性脑缺血再灌注损伤的保护作用,并初步探讨其作用机制.方法 Wistar大鼠随机分为假手术组、脑缺血再灌注模型组、黄芩苷组(50,100,200 mg&#183;kg-1)以及尼莫地平0.4 mg&#183;kg-1组.线栓法制备大鼠局灶生脑缺血再灌注损伤模型.脑缺血1 h再灌注24 h后,观察黄芩苷对大鼠神经功能缺损症状、脑梗死体积、脑组织病理形态学改变、神经细胞内Ca2+含量以及热休克蛋白(HSP)70表达的影响.结果 黄芩苷50,100,200 mg&#183;kg-1均可明显改善脑缺血再灌注损伤所致的大鼠神经功能缺损症状以及脑组织病理形态学改变,脑梗死体积从模型组的(370.14&#177;60.40)mm3分别降至(283.63&#177;81.37)、(216.29&#177;74.37)及(186.65&#177;47.67)mm3,神经细胞内Ca2+含量也较模型组有明显降低,HSP70 mRNA表达水平从模型组的(0.74&#177;0.14)分别上升至(0.79&#177;0.13)、(0.92&#177;0.08)及(0.96&#177;0.08),其蛋白表达水平比模型组分别上升6.82%、37.88%及49.38%.结论 黄芩苷对大鼠局灶性脑缺血再灌注损伤具有明显保护作用,其作用机制可能与黄芩苷降低神经细胞内Ca2+含量,促进HSP70的表达有关.     

帕瑞昔布预先给药对大鼠局灶性脑缺血-再灌注损伤及脑组织水通道蛋白4表达的影响

目的探讨帕瑞昔布预先给药对大鼠局灶性脑缺血-再灌注损伤及脑组织水通道蛋白4(aquaporim 4,AQP4)表达的影响。方法将108只大鼠按随机数字表法分为3组:假手术组(S组)、脑缺血-再灌注+帕瑞昔布组(P组)和脑缺血-再灌注组(IR组),每组36只。P组、IR组采用线栓法进行大鼠脑缺血2h、再灌注建立局灶性脑缺血-再灌注损伤模型。P组在缺血前15min经尾静脉注射帕瑞昔布钠10mg·kg-1,IR组在缺血前15min经尾静脉注射等容量生理盐水。S组只分离、结扎右侧颈总动脉、颈内动脉及颈外动脉,不置入线栓。3组大鼠分别于再灌注后2、24h时进行神经功能缺陷评分(NDS评分),并取脑组织,进行脑梗死体积及其百分比率、脑组织含水量和脑组织中AQP4表达水平的测定。结果与S组比较,IR组大鼠再灌注后2、24h时NDS评分、脑梗死体积增大、脑梗死体积百分比率、脑组织含水量及脑组织中AQP4表达水平均升高(均P<0.05);与IR组比较,P组大鼠再灌注后2、24h时NDS评分、脑梗死体积缩小、脑梗死体积百分比率、脑组织含水量及脑组织中AQP4表达水平均降低(均P<0.05)。结论帕瑞昔布预先给药可减轻大鼠局灶性脑缺血-再灌注损伤,其机制可能与下调AQP4表达从而减轻脑水肿有关。     

氯沙坦对脑缺血再灌注损伤大鼠血脑屏障通透性和MMP-9表达的影响

目的：观察血管紧张素Ⅱ受体阻断药氯沙坦对大鼠局灶性脑缺血再灌注损伤后血脑屏障通透性和基质金属蛋白酶-9（MMP-9）表达的影响。方法：采用血管内栓线阻断法制备大鼠局灶性脑缺血再灌注损伤模型， 于脑缺血2h、再灌注24h后测定脑组织含水量、伊文斯蓝（EB）含量， 免疫组织化学方法测定MMP 9表达。结果：脑缺血2h、再灌注24h， 大鼠脑组织含水量及EB含量增加， MMP-9呈现高表达。 而氯沙坦组脑组织含水量、 EB含量及MMP-9表达明显低于脑缺血再灌注组（P＜0.05）。 结论：氯沙坦通过降低脑缺血再灌注大鼠基质金属蛋白酶 9的活性及血脑屏障通透性， 从而发挥其脑缺血再灌注损伤的保护作用。     

黄芪提取物对局灶性脑缺血再灌注损伤的保护作用

目的探讨黄芪提取物(EA)对实验性局脑缺血再灌注损伤的保护作用.方法用栓线法复制大鼠局灶性脑缺血(MCAO)再灌注模型,观察神经功能评分、脑梗死体积和脑含水量、病理组织学及血液流变学变化.结果与模型组比较,EA(20、40、80 mg/kg)对大鼠MCAO 2 h再灌注24 h的神经功能学评分均有明显的改善作用,能减轻大鼠脑缺血再灌注后的脑组织含水量的增加,减小MCAO 2 h再灌注后大鼠的脑梗死体积; EA各组均能不同程度的改善大鼠脑缺血再灌注后的脑组织病理变化;EA(80 mg/kg)对脑缺血再灌注后大鼠全血黏度、高切还原黏度、高切相对黏度、低切相对黏度的升高有一定的抑制作用.结论 EA对局灶性脑缺血再灌注损伤大鼠有一定的保护作用,其机制可能与其抑制脑缺血再灌注后血液流变学改变有关.     

丹参酮ⅡA对大鼠局灶性脑缺血再灌注损伤的保护作用

目的:观察丹参酮ⅡA对大鼠局灶性脑缺血再灌注损伤的保护作用.方法:采用线栓法制备大鼠局灶性脑缺血再灌注模型,以水溶性的丹参酮ⅡA纳米制剂灌胃给药,观测其对脑缺血大鼠的神经行为、脑梗塞范围和脑含水量以及脑组织SOD活力、MDA含量和NO水平的影响.结果:丹参酮ⅡA(25 mg/kg)能使脑缺血大鼠的神经行为明显改善,脑梗塞范围和脑含水量显著降低;丹参酮ⅡA亦能拮抗脑缺血再灌注引起的SOD活力的下降及MDA含量的升高,并使脑组织NO水平显著下降.结论:丹参酮ⅡA对大鼠局灶性脑缺血再灌注损伤具有很好的保护作用.     

氧化苦参碱对大鼠局灶性脑缺血再灌注损伤的保护作用及其机制研究

目的 探讨氧化苦参碱(OMT)对大鼠局灶性脑缺血再灌注损伤的作用及其初步机制.方法 采用结扎大脑中动脉的方法制备大鼠局灶性脑缺血再灌注损伤模型.实验大鼠随机分为假手术组、脑缺血再灌注模型组、路路通(31.25 mg/kg)组及OMT(35、70、105 mg/kg)组,以神经学评分及脑梗死面积作为观察指标,同时检测OMT对大鼠脑组织髓过氧化物酶(MPO)活性及环氧酶2(COX-2)水平的影响.结果 与脑缺血再灌注模型组相比,OMT 105 mg/kg组可降低神经学评分(P<0.05),缩小脑梗死面积(P<0.05);与脑缺血再灌注模型组比较,OMT 105 mg/kg组大鼠脑组织中MPO活性降低(P<0.05),COX-2表达减少(P<0.01).结论 OMT对大鼠局灶性脑缺血再灌注损伤具有保护作用,OMT抑制脑缺血再灌注所致炎症反应可能为其保护作用的机制之一.     

金丝桃苷对大鼠局灶性脑缺血再灌注损伤的防护作用

目的:探讨金丝桃苷(hyperin,Hyp)对大鼠局灶性脑缺血再灌注损伤的防护作用。方法:60只Wistar雄性大鼠随机分为假手术组、模型组、金丝桃苷高(50mg·kg-1·d-1)、中(25mg·kg-1·d-1)、低(12.5mg·kg-1·d-1)剂量组、银杏叶胶囊对照组。给药组术前连续灌胃5d,于末次给药30min后行手术,采用线栓法制备大鼠大脑中动脉缺血模型,缺血2h再灌注24h后进行神经病学评分;氯化三苯四氮唑(triphenyltetrazoliumchloride,TTC)染色检测脑组织梗死面积;干湿法测脑含水量。结果:模型组神经病学评分、脑组织梗死面积、脑含水量与假手术组比较差异有统计学意义(P<0.01);Hyp高、中剂量组与模型组比较脑梗死范围明显缩小(P<0.05或P<0.01),脑含水量及神经病学评分明显降低(P<0.01或P<0.01)。结论:Hyp能够明显减轻局灶性脑缺血再灌注大鼠的脑水肿程度,减少脑组织的梗死范围。Hyp对脑缺血再灌损伤有显著防护作用。     

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.     

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.