东方田鼠三个脂肪肝相关基因的克隆及分析

目的以C57BL／KsJ—db／＋表型正常小鼠为对照组,研究自发性Ⅱ型糖尿病动物C57BL／KsJ—db／db小鼠的体生长曲线、糖代谢曲线、血清胰岛素水平变化、主要脏器重量、脏器系数等部分生物学特性,并探讨其肝脏、肾脏和胰腺等组织病理学变化。方法实验为期20周,从第4周开始,每周测定db／db以及db／＋小鼠体重、血糖,每2周测定血清胰岛素水平,20周龄处死,脏器、脂肪称重,部分组织用10％中性甲醛固定,制作病理切片。结果①db／db小鼠体重、血糖和血清胰岛素水平比同龄对照组高（P〈0．01）;②db／db小鼠各脂肪系数明显大于db／＋小鼠（P〈0．01）,而脾脏、胰腺以及肾脏则相对萎缩,特别是脾脏和雌性小鼠的胰腺与对照组相比差异极显著（P〈0．01）;③db／db小鼠肝细胞大片坏死、脂肪变性、炎细胞浸润、纤维组织增生;肾问质组织充血、水肿,肾小管内见蛋白管型、上皮细胞脂肪变性;胰岛数量明显减少、体积缩小,岛内细胞数量也相对减少。结论db／db小鼠是一种肥胖的,伴有高血糖、高度胰岛素抵抗,肝脏、肾脏病变和胰岛功能不足的适用性Ⅱ型糖尿病动物模型。     

C57BL/KsJ-db/db、+/db小鼠主要脏器重量及脏器系数的测定

目的 测定纯合子db／db和杂合子（＋／db）小鼠主要脏器的重量和脏器系数。方法选用2—3月龄纯合子（db／db）和杂合子（＋／db）小鼠各26只，分别测定体重和10个主要脏器重量。计算脏器系数，并对雌雄纯合子和杂合子脏器重量和脏器系数进行比较，对纯合子雌雄之间和杂合子雌雄之间脏器重量进行比较。结果雌性db／db、＋／db小鼠之间心、脾重量差异显著（P〈0．05）；肝、肾、脑、胰、肾上腺、子宫重量差异极显著（P〈0．01）；雄性db／曲、＋／db之间肝、脑、睾丸差异显著（P〈0．01）。db／db和＋／db之间肝、肺脏器系数差异显著（P〈0．05），脾、脑、胰、子宫、睾丸脏器系数差异极显著（P〈0．01）。雄雌db／db小鼠间脾、肺重量差异不显著（P〉0．05）。心、肾、胰、肾上腺重量差异极显著（P〈0．01），肝重量差异显著（P〈0．05）；雄雌＋／db小鼠间肾重量差异极显著（P〈0．01）。胰重量差异有显著性（P〈0．05），其他差异不显著（P〉0．05）。结论db小鼠纯合子与杂合子间及同基因型不同性别个体之间脏器重量及系数有一定的差异。     

依折麦布对db/db糖尿病小鼠胰岛自身胰岛素信号通路的影响

目的：研究依折麦布对db／db糖尿病小鼠胰岛自身胰岛素信号通路的影响。方法：将40只8周龄db／db小鼠随机分为依折麦布组和db／db对照组,每组20只,分别予依折麦布10mg·（kg·d）^-1和安慰剂灌胃。另设20只同周龄db／m小鼠,予安慰剂灌胃作为非糖尿病对照（db／m对照）组。每周监测体重、血糖,投药前及投药后6周测量生理及代谢指标,投药后6周后用蛋白质印迹法检测各组小鼠胰岛中蛋白酪氨酸磷酸酶1B（PTP1B）、葡萄糖转运子（GLUT-2）、葡萄糖激酶（GCK）表达的变化。结果：依折麦布组治疗6周后空腹血糖显著下降,同时总胆固醇及低密度脂蛋白胆固醇低于对照组（P〈0．05）。依折麦布组治疗6周后与db／db对照组比较,PTP1B的表达水平明显下降（P〈0．05）,GLUT-2、GCK表达水平明显升高（P〈0．05）。结论：依折麦布除降低血脂外,还可以改善db／db糖尿病小鼠胰岛自身胰岛素抵抗,促进胰岛素分泌,降低血糖。     

Ay基因对KK/Upj-Ay/J小鼠繁殖性能与血糖的影响

目的 探讨遗传因子A^y基因对KK／Upj-A^y／J小鼠繁殖性能及血糖的影响，并确定最好的繁殖方式。方法 KK／Upj-A^y／J小鼠保持在SPF状态，采用3种繁殖方式，分别为：杂合子雄鼠与隐性纯合子雌鼠交配；杂合子雌鼠与隐性纯合子雄鼠交配；杂合子雌鼠与杂合子雄鼠交配，同时尾尖取血测量小鼠血糖。结果 3种繁殖方式中，杂合子雄鼠与隐性纯合子雌鼠交配的受孕率，平均窝产子数最高，分别为92．6％；6．38只。杂合子雌鼠与杂合子雄鼠繁殖方式的离乳率最高为91．67％。仔鼠A／a杂合子与a／a隐性纯合子的比例为1：1。结论 （1）杂合子雄鼠与隐性纯和子雌鼠交配繁殖性能具有较大的优势。（2）遗传因子A，黄色肥胖糖尿病基因对小鼠血糖的影响显著。     

基础胰岛素联合二肽基肽酶4抑制剂治疗2型糖尿病患者临床观察

目的：探讨基础胰岛素（甘精胰岛素，商品名来的适，赛诺菲安万特公司生产）联合二肽基肽酶4抑制剂（磷酸西格列汀，商品名捷诺维，默沙东公司生产）治疗单用基胰岛素血糖控制不佳的2型糖尿病患者的临床疗效。方法：将120例单用基础胰岛素、体重指数（BMI）≥26、血糖控制不理想的2型糖尿病患者随机分成两组：（甘精胰岛素＋西格列汀）组60例，在使用甘精胰岛素的基础上应用西格列汀100mg／d口服，根据血糖水平适时调整基础胰岛素用量；基础胰岛素组60例，继续应用甘精胰岛素治疗。观察治疗前、治疗后8周、12周两组患者的体重指数（BMI）、空腹血糖（FBG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbAlc）、胰岛素用量的改变。结果：治疗后8、12周时，两组血糖、HbAIC均有下降；8周时，基础胰岛素组BMI增加，基础胰岛素＋西格列汀组体重增加不明显，两组间同期比较差异有统计学意义，组内治疗前后胰岛素组比较差异有统计学意义（P〈0．05或P〈0．01）；治疗8周时，甘精胰岛素＋西格列汀组胰岛素用量减少。而基础胰岛素组用量继续增加，治疗12周时，甘精胰岛素＋西格列汀组胰岛素用量进一步减少，组间同期及组内治疗前后比较均有统计学意义（P〈0．05或P〈O．01）。结论：基础胰岛素治疗血糖控制不理想的2型糖尿病患者加用西格列汀可使血糖得到良好控制，同时可以减少胰岛素剂量，更好地控制血糖，减少低血糖的发生，治疗安全有效。     

慢性应激对大鼠葡萄糖耐量及胰岛素抵抗的影响

目的：探讨慢性应激对大鼠葡萄糖耐量及胰岛素抵抗的影响。方法：将40只SD大鼠按体重随机分成应激组和对照组各20只。应激组通过8周的慢性复合应激刺激作为慢性应激动物模型，对照组在此期间正常饲养。在试验4、8周监测大鼠体重、旷场实验、24h尿皮质醇，在实验8周采尾血检测葡萄糖耐量（酶氧化法）、空腹胰岛素（化学发光法）．并计算胰岛素抵抗和B细胞功能。结果：慢性应激大鼠4、8周后体重下降显著（P〈0．05），有明显的行为学改变。应激组大鼠OGTT曲线高峰前移，下降缓慢，在0、30min时两组血糖差异显著（P〈0．05）。应激组大鼠空腹胰岛素、30min胰岛素、胰岛素抵抗、B细胞功能以及24h尿皮质醇与对照组之间差异显著（P〈0．01）。结论：慢性应激引起大鼠糖耐量异常，胰岛素抵抗增加。     

生脉散对db／db小鼠心肌组织病理变化的影响

目的：探讨生脉散对糖尿病心肌病小鼠心肌组织病理变化的影响。方法：将8周龄db／db小鼠随机分为模型组和生脉组,另设背景系小鼠C57BLKS／J为正常组。生脉组给予4．5g·kg^-1·d^-1生脉散灌胃,干预24周后检测小鼠空腹血糖、体质量、心脏质量、血流动力学指标,并以HE染色及透射电镜观察心肌组织形态变化、Masson染色观察心肌组织胶原纤维。结果：与正常组比较,模型组db／db小鼠空腹血糖、体质量、心脏质量及心肌胶原容积分数（CVF）显著升高（P〈0．05）,左室内压最大下降速率（-dp／dt）明显下降（P〈0．05）;生脉组db／db小鼠心脏质量与CVF较模型组明显减轻（P〈0．05）,而-dp／dt较模型组明显增加（P〈0．05）。组织学检查显示,模型组db／db小鼠存在心肌细胞肥大、室壁增厚、间质纤维化、微血管病变及线粒体损伤,生脉组上述变化有一定程度的改善。结论：生脉散对db/db小鼠心肌损伤具有保护作用。     

BALB/c-nu裸小鼠繁殖中杂合仔鼠剔除时间对纯合裸仔鼠生长发育的影响

目的 研究屏障设施下裸小鼠繁殖生产时,在不同时间段剔除杂合仔鼠对纯合裸仔鼠的成活率及生长发育情况的影响.方法 选取25窝头胎生BALB/c-nu新生裸小鼠按剔除杂合仔鼠的时间不同分成五组,以24 h剔除组为对照比较纯合裸仔鼠生长发育及死亡率、离乳率的差异性,统计分析其生长发育过程中的体重增长等.结果 剔除组生长发育及死亡率与对照组之间均存在差异性,其中14 d剔除组和21 d剔除组差异极显著.结论 剔除杂合仔鼠的时间对纯合裸仔鼠的成活率及生长发育情况的有很大影响.为了保证SPF级裸鼠生长发育要求,生产繁殖出合格的实验用裸小鼠,剔除全部杂合仔鼠的最佳时间应该在新生仔鼠出生24 h内,超过3 d则会极大地影响纯合裸小鼠的正常生长发育.     

替米沙坦对老年维持性血液透析患者胰岛素抵抗的影响

以11例稳定规律透析且近4周未用血管紧张素IIAT1受体阻滞剂或血管紧张素转化酶抑制剂药物的老年血液透析患者为研究对象,逐步换用替米沙坦降压并使血压保持基本稳定,分别于换用替米沙坦降压治疗前及治疗6周和12周时,透析当天空腹抽血检测血生化、空腹血糖和空腹胰岛素,评估胰岛素抵抗指数,并比较治疗前后体重及血压。结果提示替米沙坦治疗后患者体重、高密度脂蛋白、甘油三酯、血肌酐、尿素氮、白蛋白、血钾和甲状旁腺素无明显变化,总胆固醇、低密度脂蛋白有所下降。空腹血糖无明显变化,但空腹胰岛素从（13．9±3．6）mU／ml下降到（9．9±2．7）mU／ml（6周）和（9．1±2．3）mU／ml（12周）,均P〈0．01;胰岛素抵抗指数从3．5±1．4下降至2．4±0．8（6周）和2．2±0．8（12周）,均P〈0．05。提示替米沙坦可改善老年血液透析患者胰岛素抵抗状态。     

XGY对糖尿病小鼠的降血糖作用及其机制研究

目的观察XGY对糖尿病小鼠血糖的影响。方法采用链脲菌素（STZ）和肾上腺素（Adr）复制小鼠糖尿病模型，0．1、0．2、0．4g／kgXGY灌服，观察其给药不同时间的降血糖作用。结果（1）0．2、0．4g／kgXGY组灌服8d后血糖即明显降低，与模型组比较差异显著（P〈0．05）；15d后，0．1、0．2、0．4g／kgXGY组血糖降低更明显（P〈0．01）。在注射STZ后，STZ糖尿病小鼠血清胰岛素水平显著下降，与正常组比较差异显著（P〈0．01）；灌服XGY15d后，血清胰岛素有增加的趋势，XGY大剂量组能显著增加血清胰岛素水平（P〈0．01）。（2）0．2、0．4g／kgXGY组可明显对抗Adr升高血糖的作用（P〈0．05）。（3）0．1、0．2、0．4g／kgXGY组能降低正常小鼠口服糖负荷后血糖的峰值（P〈0．05～0．01），并加快已升高的血糖水平回落的速度；同时能显著增加动物肝糖元含量（P〈0．05～0．01）。结论XGY可对抗STZ和Adr引起的血糖升高，改善糖耐量，增加肝糖元合成；作用机制可能与其促进胰岛素分泌或增加组织对糖的转化利用有关。     

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.