肺动脉高压肺血管重建大鼠基质金属蛋白酶3基因l表达

目的探讨基质金属蛋白酶3(MMP-3)mRNA转录在肺动脉高压肺血管重建中的可能作用.方法利用野百合碱(MCT)诱导的大鼠肺动脉高压动物模型,经右心导管介入测定大鼠肺动脉平均压,RT-PCR法检测不同时间点大鼠肺组织MMP-3 mRNA表达水平以及比色法测定主肺动脉段羟脯氨酸含量. 结果实验第21d肺动脉压力已明显升高,以第28d为最高,而大鼠肺组织MMP-3 mRNA表达水平以第7d最高,第14、21、28d依次逐渐下调,第21d已接近正常组水平,而主肺动脉段羟脯氨酸含量第14d异常降低,以后随肺动脉压力的升高而升高.结论 MMP-3早期转录水平升高可能与肺血管基底膜降解有关,参与对肺血管重建的触发作用,实验后期转录水平下调可能是导致细胞外基质积聚的重要原因之一.     

肺动脉高压肺血管重建大鼠基质金属蛋白酶3基因表达

目的 探讨基质金属蛋白酶3（MMP－3）mRNA转录在肺动脉高压肺血管重建中的可能作用。方法 利用野百合碱（MCT）诱导的大鼠肺动脉高压埃,药右心导管介入测定大鼠肺动脉平均压,RT－PCR法检测不同时间点大鼠肺组织MMP－3mRNA表达水平以及比色法测定主肺动脉段羟脯氨酸含量。结果 实验第21d肺动脉压力已明显升高,以第28d为最高,而大鼠肺组织MMP－3mRNA表达水平以第7d最高,第14、21、28d依次逐渐下调,第21d已接近正常水平,而主肺动脉段羟脯氨酸含量第14d异常降低,以后随肺动脉压力的升高而升高。结论 MMP－3早期转录水平升高可能与肺血管基底膜降解有关,参与对肺血管重建的触发作用,实验后期转录水平下调可能是导致细胞外基质积聚的重要原因之一。     

肺动脉高压肺血管重建大鼠基质金属蛋白酶3基因l表达

目的探讨基质金属蛋白酶3(MMP-3)mRNA转录在肺动脉高压肺血管重建中的可能作用.方法利用野百合碱(MCT)诱导的大鼠肺动脉高压动物模型,经右心导管介入测定大鼠肺动脉平均压,RT-PCR法检测不同时间点大鼠肺组织MMP-3mRNA表达水平以及比色法测定主肺动脉段羟脯氨酸含量.结果实验第21d肺动脉压力已明显升高,以第28d为最高,而大鼠肺组织MMP-3mRNA表达水平以第7d最高,第14、21、28d依次逐渐下调,第21d已接近正常组水平,而主肺动脉段羟脯氨酸含量第14d异常降低,以后随肺动脉压力的升高而升高.结论MMP-3早期转录水平升高可能与肺血管基底膜降解有关,参与对肺血管重建的触发作用,实验后期转录水平下调可能是导致细胞外基质积聚的重要原因之一.     

缺氧性肺动脉高压大鼠肺组织NOS基因表达的变化

为探讨一氧化氮在缺氧性肺动脉高压发病中的作用，观察了不同时间缺氧后大鼠肺动脉平均压、肺组织ＮＯ合成酶基因ｍＲＮＡ表达及ｃＧＭＰ含量的变化及其相互关系。结果显示：缺氧８小时￣２８天，ｍＰＡＰ逐渐升高，而ｃＧＭＰ含量随缺氧时间延长而呈下降趋势，ｍＰＡＰ与ｃＧＭＰ含量变化呈明显负相关；Ｎｏｒｔｈｅｒｎ和斑点印迹杂交表明ＮＯＳ基因ｍＲＮＡ转录水平随缺氧时间的延长而呈下降趋势，而内参照β－ａｃｔｉｎ基因ｍＲ     

BQ123对左向右分流肺动脉高压大鼠肺组织Ⅰ、型胶原合成的影响

目的：研究内皮素-1(ET-1)受体拮抗剂BQ123对左向右分流肺动脉高压大鼠肺组织Ⅰ、Ⅲ型胶原合成的影响，并探讨左向右分流肺动脉高压的发生机理。方法：选择Wistar大鼠34只，随机分为实验Ⅰ组(n=15)．实验Ⅱ组(n=9)，对照组(n=10)。实验组大鼠采用套管连接法建立颈部左向右分流肺动脉高压模型，实验Ⅱ组大鼠术后4周开始给予BQ123，每次50μg／kg，每周3次，连用12周，术后16周测取大鼠肺动脉收缩压。放射免疫法测定大鼠肺组织ET-1含量变化。RT-PCR检测BQ123对大鼠肺组织Ⅰ、Ⅲ型前胶原mRNA表达的影响。免疫组化法检测BQ123对大鼠肺组织Ⅰ、Ⅲ型胶原表达及相对含量的影响。结果：左向右分流大鼠肺动脉收缩压及肺组织ET-1含量升高，肺组织Ⅰ、Ⅲ型前胶原mRNA的表达增强，胶原蛋白相对含量增加；应用BQ123后大鼠肺动脉压力及肺组织ET-1含量降低，Ⅰ、Ⅲ型前胶原mR-NA的表达及胶原相对含量降低。结论：BQ123可降低肺组织ET-1含量，抑制胶原合成，ET-1和胶原合成增加均参与了肺动脉高压的形成过程。     

缺氧性肺动脉高压大鼠肺组织NOS基因表达的变化

为探讨一氧化氮（ＮＯ）在缺氧性肺动脉高压（ＨＰＨ）发病中的作用，观察了不同时间（８小时～２８天）缺氧后大鼠肺动脉平均压（（ｍＰＡＰ）、肺组织ＮＯ合成酶（ＮＯＳ）基因ｍＲＮＡ表达及ｃＧＭＰ含量（血浆、肺组织）的变化及其相互关系。结果显示：缺氧８小时～２８天，ｍＰＡＰ逐渐升高，而ｃＧＭＰ含量随缺氧时间延长而呈下降趋势，ｍＰＡＰ与ｃＧＭＰ含量变化呈明显负相关；Ｎｏｒｔｈｅｒｎ和斑点印迹杂交表明ＮＯＳ基因ｍＲＮＡ转录水平随缺氧时间的延长而呈下降趋势，而内参照β－ａｃｔｉｎ基因ｍＲＮＡ表达无明显变化。提示缺氧抑制了ＮＯＳ基因表达，ＮＯ释放减少，可能是介导ＨＰＨ发生、发展的重要机理。     

慢性阻塞性肺疾病肺动脉压和一氧化氮合酶的变化

目的 观察慢性阻塞性肺病大鼠模型肺动脉压力及肺组织一氧化氮含量和一氧化氮合酶表达的变化.方法 Wistar雄性大鼠40只,随机分为COPD组和对照组,应用气道内注入脂多醣和香烟熏吸法制备COPD模型,测定两组大鼠肺动脉平均压力(mPAP)及肺组织匀浆的一氧化氮(NO)含量和诱生型一氧化氮合酶(iNOS)及内皮型一氧化氮合酶(eNOS)的表达情况.结果 COPD组大鼠肺动脉压升高,肺组织的i-NOS表达增强,而NO含量降低、eNOS表达减弱.结论 COPD大鼠肺组织的NO含量降低,eNOS表达减弱,而iNOS表达增强,参与COPD的发生过程,可能是引起肺动脉高压、肺心痛的因素之一.     

益气活血药对低氧性肺动脉高压大鼠神经肽Y、降钙素基因相关肽的影响

目的：探讨由黄芪、川芎组方的益气活血药对低氧性肺动脉高压大鼠神经肽Y（NPY）、 降钙素基因相关肽（CGRP）的影响。方法：采用常压低氧21天复制大鼠肺动脉高压模型,应用放射免疫技术测定大鼠血浆、肺组织中NPY、CGRP的含量变化。结果：益气活血药可降低肺动脉压,改善心功能及血液流变学。益气活血药中剂量组血浆及肺组织中NPY含量与缺氧组比较明显降低;而CGRP含量较缺氧组有所回升,肺组织中CGRP含量与缺氧组比较则趋于下降。结论：益气活血药可防止低氧性肺动脉高压的形成,也提示益气活血药的降压作用可能通过影响NPY、CGRP的含量来调节肺血管舒缩,从而降低肺动脉压。     

BQ123对左向右分流肺动脉高压大鼠肺组织Ⅰ、Ⅲ型胶原合成的影响

目的:研究内皮素-1(ET-1)受体拮抗剂BQ123对左向右分流肺动脉高压大鼠肺组织Ⅰ、Ⅲ型胶原合成的影响,并探讨左向右分流肺动脉高压的发生机理.方法:选择Wistar大鼠34只,随机分为实验Ⅰ组(n=15),实验Ⅱ组(n=9),对照组(n=10).实验组大鼠采用套管连接法建立颈部左向右分流肺动脉高压模型,实验Ⅱ组大鼠术后4周开始给予BQ123,每次50μg/kg,每周3次,连用12周,术后16周测取大鼠肺动脉收缩压.放射免疫法测定大鼠肺组织ET-1含量变化.RT-PCR检测BQ123对大鼠肺组织Ⅰ、Ⅲ型前胶原mRNA表达的影响.免疫组化法检测BQ123对大鼠肺组织Ⅰ、Ⅲ型胶原表达及相对含量的影响.结果:左向右分流大鼠肺动脉收缩压及肺组织ET-1含量升高,肺组织Ⅰ、Ⅲ型前胶原mRNA的表达增强,胶原蛋白相对含量增加;应用BQ123后大鼠肺动脉压力及肺组织ET-1含量降低,Ⅰ、Ⅲ型前胶原mR-NA的表达及胶原相对含量降低.结论:BQ123可降低肺组织ET-1含量,抑制胶原合成,ET-1和胶原合成增加均参与了肺动脉高压的形成过程.     

高二氧化碳对大鼠慢性常压低氧性肺动脉高压模型的影响

为研究高二氧化碳对大鼠慢性常压低氧性肺动脉高压模型的影响,建立大鼠缺氧性肺动脉高压模型及缺氧高二氧化碳肺动脉高压模型,测定大鼠肺动脉压及右心室压力和心脏重量,分析肺血管肌化程度:结果提示缺氧引起大鼠肺动脉压及右心室压力升高,右心室肥厚、肺血管肌化增强、红细胞压积增高。缺氧合并高二氧化碳引起肺血管肌化及右心室肥厚更明显,并出现左心室肥厚,但肺动脉压与缺氧组相似,而红细胞压积与正常对照无差异。研究说明,高二氧化碳加重大鼠缺氧引起的心脏肥厚和肺血管肌化程度。在肺动脉高压及肺心病发生发展中起重要作用。     

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.     

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.