氟伐他汀抑制Rho激酶信号通路减少HK-2细胞纤维连接蛋白表达

目的:探讨Rho激酶信号通路在糖尿病肾病(diabetic nephropathy,DN)肾间质纤维化中的作用,以及氟伐他汀在防治DN肾间质纤维化中的作用机制?方法:体外培养人近端肾小管上皮细胞(HK-2细胞),Rho激酶底物肌球蛋白磷酸酶目标亚单位-1(MYPT-1)的磷酸化作为Rho激酶活化的标志?高糖刺激HK-2细胞0?6?12?24 h,不同浓度(10-7?10-6?10-5 mol/L)氟伐他汀干预12 h,Western blot检测p-MYPT-1和纤维连接蛋白(fibronectin,FN)的表达?后续实验中Western blot检测Rho激酶选择性激动剂(lysophosphatidic acid,LPA)对氟伐他汀调节HK-2细胞p-MYPT-1和FN表达的影响?结果:相对于0 h,高糖刺激HK-2细胞6?12?24 h均可以激活p-MYPT-1,其中12 h到达高峰?高糖刺激FN的表达呈时间依赖性,氟伐他汀抑制高糖诱导的HK-2细胞p-MYPT-1的活化并抑制FN的表达,并呈浓度依赖性?LPA可以拮抗氟伐他汀的作用?结论:Rho激酶信号通路可能是DN肾间质纤维化发生的始动信号之一?氟伐他汀可能通过抑制Rho激酶磷酸化进而抑制FN的表达,从而起到一定的防治DN肾间质纤维化的作用?     

大蒜素对HEK293细胞HERG电流的阻滞作用

目的研究大蒜素对HEK293 细胞HERG电流的作用,探讨其抗心律失常的可能机制。方法采用瞬时转染的方法,将
HERG通道质粒转入HEK293细胞上,应用细胞外局部灌流法于膜片钳高阻抗封接形成后给予大蒜素,使其终浓度为30 μmol/L。
室温下,采用全细胞膜片钳技术在电压钳形模式下记录电流和门控动力学,观察大蒜素对HERG电流的作用。结果30 μmol/L
大蒜素对正常大鼠心室肌细胞HERG电流有显著的阻滞效应,使其尾电流密度由73.5±4.3 pA/pF降低至42.1±3.6 pA/pF（P<
0.01,n=14）。其作用呈浓度依赖性。半数抑制浓度为34.74 μmol/L,Hill系数为1.01。大蒜素可使HERG的电流-电压曲线降
低,且随着去极化电位的增加,作用更加明显,提示其作用具有电压依赖性,门控机制研究发现大蒜素可以使通道激活曲线向更
正的方向移动,进而延迟激活;使通道稳态失活更负的方向移动,导致失活加速。同时,使通道灭活的慢时间常数缩短,从而加
速通道的灭活。结论大蒜素抑制HEK293细胞上HERG电流,提示这可能是其治疗心律失常的细胞电生理基础。
     

KATP通道激动剂吡那地尔对哇巴因诱发大鼠离体心脏心律失常的影响

目的 应用哇巴因在大鼠离体心脏建立稳定的心律失常模型,观察KATP通道激动剂吡那地尔(pinacidil)对哇巴因诱发心律失常的影响. 方法 采用健康成年SD大鼠建立离体心脏Langendorff主动脉逆行灌流系统.实验分5组:正常对照组,哇巴因模型组和吡那地尔1,3,10 μmol/L干预组.每组8只动物.应用5 μmol/L哇巴因和低K+台式液([K+]o=2.7 mmol/L)灌流心脏诱发室性心律失常,分别观察1,3,10 μmol/L吡那地尔对药物性心律失常的影响,全程记录心电图的变化. 结果在正常台式液中加入5 μmol/L哇巴因灌流大鼠离体心脏仅引起一过性心律失常,而降低台式液中KCl浓度(2.7 mmol/L),则相同浓度哇巴因可诱发出稳定的室性心律失常,包括室性早搏、室速和室颤.给药30 min内,期前收缩(PVB)达到(386±49)个,室速(VT)和室颤(VF)发生率分别为100%(8/8)和87.5%(7/8)(n=8,P<0.01).待哇巴因诱发出心律失常后立即应用吡那地尔可浓度依赖性抑制哇巴因诱发的期前收缩,降低室速和室颤的发生率(n=8,P<0.01). 结论作为KATP通道激动剂,1-10 μmol/L吡那地尔可拮抗哇巴因所致心律失常,其电生理机制可能为增大心肌外向离子流,缩短动作电位时程并使心肌细胞膜超极化.     

AngⅡ对人心房肌细胞膜钾通道电流的影响及替米沙坦的拮抗作用

目的: 观察AngⅡ对人心房肌细胞膜钾电流的作用,揭示其参与房性心律失常的电生理机制,为应用AngⅡ受体拮抗剂治疗房性心律失常提供实验基础.方法: 急性分离单个人心房肌细胞,采用全细胞膜片钳方法记录内向整流钾电流(Ik1)、短暂外向钾电流(Ito).实验分4组:对照组,AngⅡ(0.1 μmol/L)组,替米沙坦(0.01 μmol/L)组,AngⅡ 替米沙坦组.结果: 与对照组相比,0.1 μmol/L AngⅡ使人心房肌细胞膜Ito峰值电流密度明显下降(pA/pF, 6.55±0.52 vs 12.65±1.06,P＜0.01), 在-100mV电压下使IK1 峰值电流密度显著升高 (pA/pF, -9.31±1.02 vs -5.23±0.98, P<0.01).0.01 μmol/L替米沙坦对人心房肌细胞膜Ito IK1无明显影响,但可拮抗AngII的作用;AngⅡ 替米沙坦组的Ito峰值电流密度 (pA/pF,11.74±1.28 )和IK1 峰值电流密度(pA/pF, -6.13±1.15) 与AngⅡ组相比有显著差别(P＜0.01).结论: AngⅡ对人心房肌细胞具有明显的电生理学作用,0.1 μmol/L AngⅡ可促进人心房肌细胞膜IK1并抑制Ito,替米沙坦可拮抗AngⅡ对人心房肌细胞膜钾电流的作用.     

稳定微管减少心肌缺血再灌注损伤

目的 探讨稳定微管能否减少心肌缺血再灌注损伤.方法 (1)将离体大鼠心脏分为对照组、缺血组、缺血+0.1 μmol/L泰素和缺血+1 μmol/L泰素组(n=15).每组先给予15 min平衡后,对照组继续给予50 min常氧灌注;缺血组给予20 min常氧灌注+30 min缺血处理;缺血+0.1 μmol/L(或1 μmol/L)泰素组给予20 min常氧灌注,30 min缺血处理,整个过程中均给予0.1 μmol/L(或1 μmol/L)泰素灌流.比较各组心律失常情况,观察微管形态结构并进行断裂评分.(2)将离体大鼠心脏分为正常对照组、缺血再灌注组和1 μmol/L泰素组(n=8).缺血再灌注组进行Langendorff灌流,结扎左前降支30 min,再灌注120 min;1 μmol/L泰素组给予1μmol/L进行灌流,其余处理同缺血再灌注组.灌流结束即刻冠脉内灌入伊文思蓝进行染色,比较各组心肌梗死面积.结果 (1)0.1和1 μmol/L泰素均能有效降低缺血性室性心律失常的发生,降低室性心律失常评分,且呈剂量依赖性(P＜0.05);并均能降低室性心动过速的发生率(P＜0.05).(2)0.1 μmol/L泰素灌流能降低微管断裂评分.(3)1 μmol/L泰素灌流能明显缩小缺血再灌注心脏梗死区面积(P＜0.05).结论 稳定微管能减少心肌缺血再灌注损伤.     

氟哌啶醇对豚鼠心室肌细胞IK的影响

目的 观察氟哌啶醇对豚鼠单个心室肌细胞延迟整流钾电流(IK)通道的作用,探讨氟哌啶醇致心律失常的离子基础.方法 应用全细胞膜片钳技术记录氟哌啶醇对豚鼠单个心室肌细胞IK的影响.结果 在获得单个细胞后,分别给予0.3、1.0 、3.0 μmol/L的氟哌啶醇.延迟整流钾电流在试验电压+70 mV时,从给药前的(16.660 4±1.571 7)分别减少至(5.025 5±1.937 2)、(9.857 2±3.900 2)、(7.179 4±1.816 0)pA/pF (n=7,P＜0.01).结论 氟哌啶醇可抑制IK,使动作电位时程延长而引发心律失常,其致心律失常作用可能与其对钾通道的作用有关.     

氟哌啶醇季铵盐衍生物(F2)对缺血再灌注心律失常的拮抗作用

目的:研究氟哌啶醇季铵盐衍生物(F2)对心肌缺血再灌注引发的心律失常的拮抗作用。方法:采用大鼠Langendorff灌流心脏模型,通过结扎冠状动脉左前降支缺血20 min,解除结扎再灌注,可引出长时间(至少5 min)室性心动过速,在灌流液中加入不同浓度F2,观察其对室性心动过速的拮抗作用。结果:F2可浓度依赖地翻转缺血再灌注引发的室性心动过速,半最大效应浓度为0.46μmol/L。结论:F2对大鼠心脏缺血再灌注心律失常具有拮抗作用。     

阿托伐他汀对老年大鼠心肌缺血再灌注损伤及多器官功能的保护作用

摘要：目的观察阿托伐他汀对老年大鼠心肌缺血再灌注过程中心脏的影响,并进一步关注此过程中肝、肾功能的变化。方法
10月龄Wistar大鼠饲养至20月龄,阿托伐他汀灌胃至24月龄,分为大剂量他汀组、小剂量他汀组、老年对照组,并设立青年对照
组。采用结扎冠状动脉方法建立心肌缺血再灌注模型,纪录缺血再灌注过程中大鼠死亡率、血流动力学变化、心肌梗塞面积变
化,及肝肾功能指标。结果与老年对照组相比,青年对照组及大剂量他汀组在缺血再灌注过程中死亡率明显降低（P<0.05）、血
流动力学紊乱减少、心梗面积减小（P<0.05）;青年对照组及大剂量他汀组在缺血再灌注后,肝肾功能无明显恶化,小剂量他汀组
肝脏功能显著恶化（P<0.05）,老年对照组肝肾功能均出现显著恶化（P<0.05）。结论阿托伐他汀对老年大鼠心肌缺血再灌注过
程中的心、肝、肾多器官产生保护作用。
     

法舒地尔对大鼠动脉粥样硬化及Rho激酶表达的影响

目的 探讨Rho激酶抑制剂-法舒地尔对大鼠动脉粥样硬化的防治作用及其相关机制.方法 以普通饮食喂养大鼠作为对照组(n=10);链脲佐菌素诱导的糖尿病大鼠内膜损伤存活后,高脂饮食8周,分为动脉硬化组、瑞舒伐他汀组及法舒地尔组(n=10),继续高脂饮食4周,药物干预2个月,行血脂、血管细胞黏附分子-1(VCAM-1)、细胞间黏附分子-1(ICAM-1)及Rho激酶mRNA检测.结果 与对照组相比,动脉硬化组大鼠血脂增高,VCAM-1、ICAM-1及Rho激酶mRNA表达增加(P<0.05);与动脉硬化组对比,瑞舒伐他汀组各指标均改善,而法舒地尔组除对血脂无明显影响外,与瑞舒伐他汀具有相似的抗动脉粥样硬化作用(P<0.05).结论 法舒地尔具有抗动脉粥样硬化作用,其机制可能在于通过干预Rho/Rho激酶信号通路表达,抑制动脉内皮的炎症反应.     

阿托伐他汀对老年大鼠多器官内皮型一氧化氮合酶的影响及其在心肌缺血再灌注中的作用

目的观察阿托伐他汀对多器官内皮型一氧化氮合酶（eNOS）合成及eNOS mRNA表达的影响,探讨阿托伐他汀在心肌缺
血再灌注过程中对多器官保护作用的可能机制。方法20月龄Wistar大鼠应用阿托伐他汀灌胃至24月龄,采用结扎冠状动脉
方法建立心肌缺血再灌注模型,并设立未用药未手术组、未用药手术组、用药未手术组及用药手术组。应用Western blot方法检
测eNOS在各组大鼠心、肝、肾组织的含量,应用RT-PCR方法检测eNOS mRNA的表达情况。同批次同处理24月龄大鼠,分为
大剂量他汀组、小剂量他汀组并老年对照组。采用同上方法检测eNOS在各组大鼠心、肝、肾组织的含量,应用Western blot方法
检测eNOS在各组大鼠心、肝、肾组织的含量,应用RT-PCR方法检测eNOS mRNA的表达情况。结果阿托伐他汀能显著提高
老年大鼠心、肝、肾器官内eNOS合成（P<0.05）及eNOS mRNA的表达（P<0.05）,且与心肌缺血再灌注无关。引入药物剂量分组
后,与老年对照组相比,他汀组eNOS合成及eNOS mRNA的表达显著增加（P<0.05）;其中,大剂量他汀组较小剂量他汀组增加
更为显著（P<0.05）。结论阿托伐他汀可使老年大鼠多器官内eNOS合成及eNOS mRNA的表达增加,部分解释了阿托伐他汀
在心肌缺血再灌注过程中对多器官功能的保护作用。
     

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.     

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.