川芎嗪对肾缺血再灌注时c—fos bcl—2 ICAM—l蛋白表达的影响

目的 探讨大鼠肾缺血再灌注损伤不同时间c-fos、细胞淋巴瘤／白血病-2、细胞间粘附分子-1蛋白的表达及川芎嗪对其影响。方法 用免疫组化法检测大鼠急性肾缺血再灌注不同时间内及川芎嗪干预后c-fos、细胞淋巴瘤／白血病-2、细胞间粘附分子-1蛋白表达的分布及强度变化。结果 c-fos蛋白分布于近曲小管、远曲小管、集合管上皮细胞的细胞核、细胞浆内，再灌注后1h表达明显增强，3h达高峰，6h锐减。细胞淋巴瘤／白血病-2蛋白主要分布于近曲小管上皮细胞的细胞浆，再灌注后1h表达明显增强，6h达高峰，24h仍有较强表达。细胞间粘附分子-1蛋白分布在肾血管、肾小管等部位，其中以肾血管为著，其表达增强于再灌注后1h，直到24h仍有增高趋势。川芎嗪干预后c-fos、细胞间粘附分子-1蛋白表达明显下降(P＜0．01)。细胞淋巴瘤／白血病-2表达明显增高(P＜0．01)。结论 川芎嗪对肾缺血再灌注损伤有较好的保护作用。     

地塞米松对肾缺血再灌注时c—fos bcl—2 ICAM—l蛋白表达的影响

目的：探讨大鼠肾缺血再灌注损伤不同时间c—fos、bcl—2、ICAM—1蛋白的表达及地塞米松对其影响。方法：用免疫组化法检测大鼠急性肾缺血再灌注不同时间内及地塞米松干预后c—fos、bcl—2、ICAM—1蛋白表达的分布及强度变化。结果：c—fos蛋白分布于近曲小管、远曲小管、集合管上皮细胞的细胞核、细胞浆内，再灌注后1h表达明显增强，3h达高峰，6h锐减。bcl—2蛋白主要分布于近曲小管上皮细胞的细胞浆，再灌注后1h表达明显增强，6h达高峰，24h仍有较强表达。ICAM—1蛋白分布在肾血管、肾小管等部位，其中以肾血管为著，其表达增强于再灌注后1h，直到24h仍有增高趋势。地塞米松干预后c—fos、ICAM—1蛋白表达明显下降(P＜0．01)。bcl—2表达明显增高(P＜0．01)。结论：地塞米松对肾缺血再灌注损伤有较好的保护作用。     

川芎嗪对肾缺血再灌注时c-fos bcl-2 ICAM-1蛋白表达的影响

目的　探讨大鼠肾缺血再灌注损伤不同时间c -fos、细胞淋巴瘤 /白血病 - 2、细胞间粘附分子- 1蛋白的表达及川芎嗪对其影响。方法　用免疫组化法检测大鼠急性肾缺血再灌注不同时间内及川芎嗪干预后c -fos、细胞淋巴瘤 /白血病 - 2、细胞间粘附分子 - 1蛋白表达的分布及强度变化。结果　c -fos蛋白分布于近曲小管、远曲小管、集合管上皮细胞的细胞核、细胞浆内 ,再灌注后 1h表达明显增强 ,3h达高峰 ,6h锐减。细胞淋巴瘤 /白血病 - 2蛋白主要分布于近曲小管上皮细胞的细胞浆 ,再灌注后 1h表达明显增强 ,6h达高峰 ,2 4h仍有较强表达。细胞间粘附分子 - 1蛋白分布在肾血管、肾小管等部位 ,其中以肾血管为著 ,其表达增强于再灌注后 1h ,直到 2 4h仍有增高趋势。川芎嗪干预后c -fos、细胞间粘附分子 - 1蛋白表达明显下降 (P <0 0 1 )。细胞淋巴瘤 /白血病 - 2表达明显增高 (P <0 .0 1 )。结论　川芎嗪对肾缺血再灌注损伤有较好的保护作用     

大鼠实验性肾缺血/再灌注引起肾小管上皮细胞凋亡及其与Bcl-2,Fas/FasL表达变化的关系

目的：探讨大鼠实验性肾缺血再灌注引起肾脏损伤、肾小管上皮细胞凋亡情况及其与Bcl—2，Fas／FasL表达变化的关系．方法：建立大鼠肾缺血再灌注损伤模型，在不同时间点处死动物取肾组织石蜡包埋切片，HE染色分析肾组织病理损伤程度，用TUNEL法标记检测肾小管上皮细胞凋亡的变化，SABC免疫组化方法检测Bcl—2，Fas与FasL蛋白表达的变化．结果：缺血再灌注后肾组织的病理损伤主要发生在肾小管，肾小管上皮细胞凋亡指数增加，且随缺血再灌注时间延长而进一步上升，48h达高峰(P＜0．05).Bcl—2蛋白在对照组呈弱阳性表达，缺血30min，60min后再灌注0h有少量表达，再灌注24，48及72h呈阳性表达，48h达高峰(P＜0.05)，并以远曲小管为主．Fas，FasL蛋白在对照组呈阴性表达，缺血30，60min后再灌注0h有少量表达，再灌注24，48及72h呈阳性表达，以72h时达高峰(P＜0.05)，多表达在远曲小管．HE染色可见肾缺血再灌注后各组均有不同程度的肾小管上皮组织片状坏死灶，以近曲小管为主，坏死灶周围有炎性细胞浸润．结论：肾缺血再灌注可诱导肾小管上皮细胞凋亡，Bcl—2，Fas／FasL系统可能在肾小管上皮细胞凋亡过程中发生着重要的调控作用．     

雷帕霉素对大鼠缺血再灌注肾Fas,bcl-2蛋白表达的影响

目的:探讨雷帕霉素(Rapamycin,RPM)对肾缺血再灌注不同时间Fas,bcl-2蛋白表达的影响.方法:Wistar大鼠54只,随机分为3组:假手术组(切除右肾,分离左肾动脉,不阻断血流,缺血前灌胃给等量生理盐水)、手术组(切除右肾,分离左肾动脉,阻断血流,缺血前灌胃给等量生理盐水)、药物组(切除右肾,分离左肾动脉,阻断血流,缺血前灌胃给RPM 4mg/(kg·d)×3d,术日术前2h灌胃,术后给药至各个观察日.采用HE染色分析肾组织病理损伤程度,免疫组化SABC法检测bcl-2,Fas蛋白表达的变化.结果:Fas蛋白在假手术组呈阴性表达,手术组再灌注Oh有少量表达,再灌注24、48及72h呈阳性表达,以48h时达高峰(P<0.05),主要表达在皮质肾小管;药物组肾组织Fas蛋白水平显著低于手术组(P<0.05).bcl-2蛋白在假手术组呈弱阳性表达,手术组再灌注Oh有少量表达,再灌注24、48及72h呈阳性表达,48h达高峰(P<0.05);皮质肾小管表达为主;药物组肾组织bcl-2蛋白水平显著高于手术组(P<0.05).HE染色可见手术组肾小管上皮细胞有不同程度的片状坏死灶,肾小管中可见大量死亡脱落细胞残留物质;药物组肾组织损伤明显减轻.结论:RPM可能通过下调Fas,上调bcl-2蛋白表达水平,减轻肾缺血再灌注损伤.     

梗阻性黄疸大鼠肾脏缺血再灌注损伤中热休克蛋白70的表达

目的 探讨梗阻性黄疸大鼠在短暂性肾缺血再灌注过程中肾功能改变与脂质过氧化反应及大鼠肾脏热休克蛋白70(Heat-shock protein 70，HSP70)表达之间的关系。方法 实验大鼠分为正常对照组(S组)、正常肾缺血再灌沣组(SRI组)、梗阻性黄疸组(J组)、梗阻性黄疸肾缺血再灌注组(JRI组)。在胆道梗阻1周后行双侧肾动脉夹闭10min后放开，观察再灌注后0、4、12、24h等不同时相点观察肾功能的变化，采用免疫组织化学SP法观察大鼠肾脏HSP70的表达。结果 梗阻性黄疸肾缺血冉灌注组内生肌酐清除率随冉灌注时间延长呈持续性下降，梗阻性黄疸组及梗阻性黄疸肾缺血再灌注组肾组织丙二醛明显升高而超氧化物歧化酶含量下降。JHI组大鼠肾脏HSP70表达主要分布于肾近曲小管上皮细胞胞浆中，其表达量以再灌注后4h最多，12h次之，24h有所减少。结论 梗阻性黄疸状态下大鼠肾脏对缺血再灌注损伤的敏感性明显升高，缺血再灌注损伤可能与梗阻性黄疸术后急性肾功能衰竭的发生有关，脂质过氧化反应参与了这一过程。HSP70的表达是机体对梗阻性黄祖肾缺血再灌注损伤的一种保护性反应。     

延肾1号冲剂对肾缺血再灌注大鼠肾组织肿瘤坏死因子和细胞间黏附因子的影响

目的 探讨延肾1号冲剂抗肾缺血再灌注损伤的作用机理.方法 将72只大鼠随机分为假手术组、对照组、治疗组,各24只.治疗组给予延肾1号冲剂,假手术组及对照组灌胃相应量的自来水.检测大鼠肾缺血1 h,再灌注24、48 h后肾功能(BUN、Cr)的变化及肾组织肿瘤坏死因子(TNF-α)和细胞间黏附因子(ICAM-1)的变化情况.结果 假手术组大鼠肾小管上皮细胞内可见微量TNF-α、ICAM-1表达.与假手术组相比,治疗组、对照组TNF-α、ICAM-1分子表达增强,在肾缺血再灌注24、48 h有显著差异(P<0.01);与对照组比较,治疗组TNF-α、ICAM-1分子表达下调,肾缺血1 h无显著差异(P>0.05),再灌注24、48 h有显著差异(P<0.01).结论 延肾1号冲剂能够保护肾缺血再灌注大鼠的肾功能并抑制其肾组织中TNF-α、ICAM-1的蛋白表达.     

缺血再灌注损伤对新生鼠肾小管上皮细胞细丝蛋白的影响

目的：通过研究缺血再灌注不同时段细丝蛋白在肾小管上皮细胞中的分布变化，探讨细丝蛋白在肾脏缺血再灌注损伤中所起的作用。方法：建立新生大鼠不同时段的肾脏缺血再灌注模型，通过免疫荧光法检测细丝蛋白在肾小管上皮细胞上的分布及其表达量。结果：细丝蛋自在正常时主要分布在肾小管上皮细胞基底都附近，缺血0．5h时其分布变化不明显，再灌注O.5h后，细丝蛋白开始向胞浆转移，并出现在细胞顶部和肾小管腔内，再灌注2h这种改变最明显并伴肾小管结构的破坏；从再灌注24h起开始进入恢复阶段，细丝蛋白逐渐重新回到基底部，再灌注120h后恢复阶段基本结束，肾小管结构正常。结论：细丝蛋白在缺血再灌注时分布发生改变，这种变化出现在肌动蛋白细胞骨架和整合素的改变之前。     

缺血再灌注后胆管上皮细胞凋亡和bcl-2/bax的表达及意义

目的探讨肝脏经不同时间热缺血再灌注后胆管上皮细胞的凋亡和bcl-2／bax的表达及意义。方法以大鼠肝脏原位缺血再灌注为模型，经15、30和60min缺血再灌注6h后取材，用TUNEL法原位检测胆管上皮细胞的凋亡，免疫组织化学方法检测bcl-2／bax在胆管上皮细胞中的表达。结果随着缺血时间延长，经再灌注后发生凋亡的胆管上皮细胞逐渐增多，bcl-2／bax蛋白表达指数呈进行性降低，bax则随凋亡细胞的增多表达增强。结论热缺血再灌注损伤引起胆管上皮细胞的凋亡，并随缺血时间的延长而加重，bcl-2／bax凋亡基因介导了缺血再灌注后损伤引起的胆管上皮细胞的凋亡，bcl-2对细胞凋亡具有抑制作用。     

c-fos在急性肾缺血再灌注后大鼠脑组织中的表达

目的研究c-fos在急性肾缺血再灌注后大鼠脑组织中不同时间段的表达及调控作用。方法取SD大鼠90只,建立肾缺血再灌注大鼠模型,采用免疫组化染色,光镜下观察肾及蓝斑、杏仁核、海马的病理改变,用c-fos免疫组化染色,观察c-fos于不同时间段在蓝斑、杏仁核、海马的阳性细胞数。结果 I、I/R 0～8 h组间比较c-fos表达差异均有统计学意义(P<0.05)。肾缺血再灌注损伤诱导c-fos表达,在杏仁核、蓝斑于8 h时达高峰,c-fos表达在海马于4 h时达高峰。结论肾缺血再灌注可引起脑组织损伤。c-fos在肾缺血再灌注引起脑组织损伤中发挥调控作用,其中杏仁核、蓝斑、海马参与调控。     

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.