压力超负荷大鼠心肌营养素-1表达对贝那普利干预的反应

目的 探讨心肌营养素-1(cardiotrophin-1,CT-1)在腹主动脉缩窄所致大鼠压力超负荷心肌肥大模型表达的变化及其与心肌肥大的关系,以及贝那普利(benazepril,Ben)对CT-1表达及心肌肥大的影响.方法 用腹主动脉缩窄术建立大鼠压力超负荷性心肌肥厚模型,术后随机分为左室肥厚组(n=7)和贝那普利干预组(n=7,贝那普利1 mg·kg-1·d～,灌胃3周),另设一假手术组(n=7)为对照.干预3周后测定血流动力学指标、左心室质量指数,应用放射免疫分析法测定心肌血管紧张素Ⅱ(AngⅡ)水平,逆转录聚合酶链式反应(RT-PCR)检测心肌中CT-1 mRNA表达.结果 与假手术组比较,左室肥厚组动物的血压与左心室质量指数显著升高(P＜0.05);心肌组织AngⅡ含量和CT-1 mRNA表达水平明显增加(P＜0.01).贝那普利干预可显著降低血压和左心室质量指数(P＜0.05),同时降低肥厚心肌组织AngⅡ浓度与CT-1 mRNA表达水平(P＜0.01).结论 CT-1的过度表达参与了压力超负荷性大鼠心肌肥大的发病过程;贝那普利对CT-1的表达及心肌肥大有抑制作用.     

GP130在压力超负荷性大鼠心肌中的表达变化及替米沙坦干预影响

目的观察糖蛋白130(GP130)9在压力超超负荷性大鼠心肌中的表达变化与心室重构的关系,以及替米沙坦对心室重构及GP130表达的影响。方法20只雄性SD大鼠行腹主动脉缩窄术后2周造成压力负荷性心肌肥厚模型,随机分为左室肥厚组(LVH)和替米沙坦组(Telmisartan,Tel),另设8只作为假手术组(Sham)。替米沙坦组灌胃给药(3mg·kg-·1d-1),连续4周。测定血流动力学指标和心室质量指数,放免法测定心肌血管紧张素Ⅱ(AngⅡ)含量,免疫组化法检测心肌中GP130蛋白水平表达。结果与假手术组比较,肥厚组SBP、DBP和MBP显著升高(P<0.05),LVMI和RVMI亦明显升高(P<0.05);心肌组织AngⅡ含量和GP130蛋白表达水平明显增加(P<0.05￣0.01)。相关分析表明,心肌组织中GP130的蛋白表达与AngⅡ水平及LVMI呈显著正相关(P<0.05￣0.01)。替米沙坦改善血流动力学指标(P<0.05￣0.01),降低LVMI和RVM(IP<0.05),AngⅡ含量显著降低(P<0.01),GP130蛋白表达明显下降(P<0.05)。结论压力超负荷性大鼠心肌中GP130蛋白的过度表达与心室重构的发生密切相关;替米沙坦逆转心室重构的机制还可能与抑制GP130蛋白的过度表达相关。     

缬沙坦对超负荷大鼠心肌细胞凋亡、ASK1的影响

目的:探讨压力超负荷模型下血管紧张素Ⅱ(AngⅡ)受体拮抗剂缬沙坦对凋亡信号调节激酶(ASK1)介导心肌肥厚信号通路的影响.方法:复制腹主动脉缩窄高血压大鼠模型,TUNEL法检测心肌细胞凋亡,免疫印迹和免疫组化法检测心肌ASK1蛋白含量并测定左室质量指数.结果:缬沙坦组左心室质量指数、心肌细胞凋亡指数、ASK1表达均显著低于高血压组(P＜0.05).结论:AngⅡ参与激活压力负荷下ASK1通路,缬沙坦能干预ASK1介导通路并抑制心肌细胞凋亡从而预防心肌肥厚.     

福辛普利对压力超负荷性心肌肥厚大鼠左心室心肌细胞凋亡的影响

目的：研究福辛普利（fosinopril）对压力超负荷性心肌肥厚大鼠左心室心肌细胞凋亡的影响。方法：将36只Wistar大鼠随机分为假手术组、腹主动脉缩窄组、腹主动脉缩窄＋福辛普利给药组。以左心室重量指数作为心肌肥厚的指标;以DNA荧光染色方法测凋亡率研究心肌细胞凋亡的情况。后者采用流式细胞术测试。结果：与假手术组相比,腹主动脉缩窄组大鼠心肌细胞凋亡率明显升高（P〈0.01）;腹主动脉缩窄＋福辛普利给药组同腹主动脉缩窄组相比,心肌细胞凋亡率下降（P〈0.05）。结论：（1）心肌细胞凋亡是压力超负荷性心肌肥厚发生的一个重要因素;（2）福辛普利能有效地抑制心肌细胞凋亡,从而使心肌肥厚发生逆转。     

钙蛋白酶参与压力超负荷下肥厚心肌的信号调控机制探讨

目的 探讨压力超负荷下,血管紧张素受体(AT1及AT2)拮抗剂对肥厚心肌组织中钙敏感的钙蛋白酶系统的信号调节.方法 采用腹主动脉缩窄法建立大鼠压力超负荷模型,实验动物分为手术组、手术 缬沙坦(valsartan,1 mg/kg·d)组、手术 PD123319(30 mg/kg·d)组和假手术组,每组大鼠10只.免疫沉淀法检测大鼠左室间隔心肌组织钙蛋白酶系统(calpains)、钙调神经磷酸酶(CaN)及其抑制蛋白(cain/cabin1)的表达、CaN磷酸化.RT-PCR检测大鼠室间隔心肌组织肌球蛋白(β-MHC)mRNA表达.结果 手术后14 d, valsartan组大鼠血浆AngⅡ浓度高于假手术组及PD123319组(P＜0.05),valsartan组心肌AngⅡ浓度则低于假手术照组及PD123319组(P＜0.05).手术组大鼠左室间隔心肌组织u-calpain蛋白表达、CaN磷酸化、β-MHC mRNA表达高于假手术组(P＜0.01).手术组大鼠左室间隔心肌组织cain/cabin1蛋白表达低于假手术组(P＜0.01);valsartan组大鼠心肌u-calpain蛋白表达、CaN磷酸化、β-MHC mRNA表达显著低于手术组及PD123319组(P＜0.05),valsartan组cain/cabin1高于手术组及PD123319组(P＜0.05),u-calpain蛋白表达及CaN磷酸化、cain/cabin1蛋白表达及β-MHC mRNA表达手术组与PD123319组间差异无统计学意义(P＞0.05).结论 压力超负荷下, 心肌组织中的calpain降解cain/cabin1,进而激活CaN信号通路,参与心肌肥厚的病理过程,主要通过AT1起作用.     

细胞骨架与细胞因子在压力超负荷性心肌肥厚过程中的作用

目的探讨细胞骨架与细胞因子在心肌肥厚过程中的作用。方法用腹主动脉缩窄的方法建立压力超负荷性心肌肥厚大鼠模型，应用放射免疫分析法测定肥厚心肌ANF（心钠素）、AngⅡ水平，RT-PCR法半定量TGF-β1（转化生长因子β1）的表达变化，观察细胞骨架解聚剂与血管紧张素受体拮抗剂对心肌肥厚的影响。结果发现腹主动脉缩窄4周后心脏重量指数、心肌ANF、AngⅡ含量及TGF-β1的表达均明显升高，经过细胞骨架解聚剂与血管紧张素受体拮抗剂4周干预后可显著降低心脏重量指数、心肌ANF、AngⅡ含量及TGF-β1的表达。结论细胞骨架与细胞因子共同参与了压力超负荷性心肌肥厚的发生、发展，细胞骨架是细胞因子发挥作用的基础。     

法舒地尔对压力超负荷大鼠左心室肥厚的改善作用

目的:探讨法舒地尔对压力超负荷大鼠左心室肥厚的影响及可能的作用机制。方法:42只6周龄SD大鼠行腹主动脉缩窄术制备压力超负荷模型作为手术组,另取8只大鼠作为假手术组(Sham组)。术后4周将存活的28只腹主动脉缩窄大鼠随机分为模型组(Model组)、法舒地尔高剂量组(FH组)和法舒地尔低剂量组(FL组)。4周后,计算各组大鼠左心室质量指数(LVMI),观察心肌病理改变,检测心肌细胞直径(MD),碱水法测定心肌羟脯氨酸(HYP)含量,酶联免疫吸附试验测定血浆和心肌血管紧张素Ⅱ(AngⅡ)浓度,免疫组织化学法半定量分析心肌磷酸化肌球蛋白磷酸酶靶蛋白亚基1(p-MYPT1)、基质金属蛋白酶9(MMP9)和组织金属蛋白酶组织抑制剂1(TIMP1)的表达水平。结果:与Sham组比较,Model组心肌细胞肥大,间质大量胶原沉积,LVMI、MD、HYP含量和AngⅡ浓度均明显升高,p-MYPT1、MMP9和TIMP1的表达显著上调,MMP9/TIMP1比值明显下降(P<0.01);与Model组比较,FH组和FL组心肌细胞肥大和胶原沉积有所改善,LVMI、MD、HYP和AngⅡ含量均下降(P<0.05~P<0.01),p-MYPT1、MMP9和TIMP1的表达均明显下调(P<0.01)。结论:法舒地尔改善压力超负荷大鼠左心室肥厚的作用可能与调节心肌MMP9和TIMP1表达有关。     

化痰活血益心方对压力负荷性心肌肥厚大鼠AngⅡ,Trx的影响

[目的]研究血管紧张素Ⅱ(AngⅡ),硫氧还蛋白(Trx)在大鼠压力负荷性心肌肥厚中的表达及化痰活血益心方的干预作用.[方法]采用部分缩窄腹主动脉方法制作大鼠压力负荷性心肌肥厚模型,模型对照组造模不给药,中药组(大、中及常规剂量组)造模2周后给予化痰活血益心方(10倍常规剂量、5倍常规剂量及常规剂量,常规剂量为0.12 g/kg),卡托普利组造模2周后给予卡托普利6.75 mg/kg,每日灌胃1次,共4周.观察各组大鼠心肌AngⅡ,Trx的含量.[结果]与模型对照组比较,中药大、中、常规剂量组及卡托普利组均能显著降低压力负荷性大鼠心肌AngⅡ含量(P＜0.01),中药大剂量组、卡托普利组降低AngⅡ与中药常规剂量、中剂量组比较,差异有显著性意义(P＜0.01或P＜0.05).各组心肌Trx蛋白表达比较,与模型对照组比较,中药大、中、常规剂量组及卡托普利组Trx蛋白明显增加(P＜0.01),中药大剂量组Trx蛋白表达与中药中、常规剂量组比较,差异有显著性意义(P＜0.01).[结论]化痰活血益心方能通过升高Trx及降低AngⅡ发挥抗氧化应激损伤作用,且化痰活血盖心方大剂量升高rx及降低AngⅡ作用更显著.     

福辛普利对压力超负荷性心肌肥厚大鼠左心室心肌细胞bcl-2及bax基因表达的影响

目的：研究福辛普利（fosinopril）对压力超负荷性心肌肥厚大鼠bcl-2、bax基因表达的影响。方法：将36只Wistar大鼠随机分为A组（假手术组）、B组（腹主动脉缩窄组）、C组（腹主动脉缩窄组＋福辛普利给药组）。实验中以左心室重量指数（LVW/BW）作为判断心肌肥厚的指标;心肌细胞bcl-2、bax基因表达的变化用间接免疫荧光标记法比较。心肌细胞bcl-2、bax基因表达用流式细胞仪（Flow Cytometry FCM）测试。结果：B组与A组相比,心肌细胞bcl-2基因表达下降（P〈0.01）,bax基因表达增多（P〈0.01）;C组与B组相比,bcl-2基因表达增多（P〈0.01）,bax基因表达下降（P〈0.05）。结论：福辛普利可促进压力超负荷性心肌肥厚大鼠bcl-2基因的表达,抑制bax基因的表达,从而使心肌肥厚发生逆转。     

培哚普利对急性心肌梗死后大鼠心肌组织中AngⅡ、ERK1/2、c-fos mRNA含量的影响

目的:探讨大鼠急性心肌梗死后心肌组织中AngⅡ、ERK1/2、c-fos mRNA含量的变化及培哚普利的干预作用.方法:结扎大鼠左冠状动脉前降支建立心肌梗死模型,随机分为心肌梗死组(A组,n＝14)和培哚普利干预组(B组,n＝14),另设假手术组为对照(C组,n＝14).术后24 h B组给予培哚普利灌胃,A、C组给予蒸馏水灌胃,6周后处死,取心脏并计算左心室质量指数;分别采用放射免疫法、免疫组织化学法、实时荧光定量PCR法测定各组大鼠非梗死区心肌组织中Ang Ⅱ含量、ERK1/2含量及原癌基因c-fos mRNA的含量.结果:6周后A、B组左心室质量指数、Ang Ⅱ、 ERK1/2及c-fos mRNA含量均较C组明显升高(P均＜0.05);与A组相比,B组左心室质量指数、Ang Ⅱ、 ERK1/2及c-fos mRNA含量均明显下降(P均＜0.05).结论:培哚普利能降低Ang Ⅱ, ERK1/2, c-fos mRNA的表达,改善左心室重塑.     

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.