1，6—二磷酸果糖预处理对离体大鼠心肌缺血再灌注损伤的保护作用

目的:观察1,6-二磷酸果糖(FDP)预处理对离体大鼠心肌缺血再灌注损伤的保护作用。方法:随机分成两组应用Iangendorff灌注装置用Krehs-Ring(K-R)液和K-R液加FDP5mmol·L~(1)对大鼠心脏进行缺血前预处理10分钟,缺血20分钟和再灌注20分钟实验,观察每期左室舒张未期压(LVEDP)、心肌组织内二醛(MDA)含量、超氧歧化物酶(SOD)的活性。Wistar大鼠心脏48个,每8个一组进行对照组和FDP组对比观察。结果:在缺血前期FDP组LVEDP和MDA无明显差异,缺血期FDP组MDA变化与对照组比较明显下降(P<0.01),再灌注期FDP组LVEDP和MDA明显下降(P<0.05),在FDP组SOD活性明显增高(P<0.01)。结论:FDP预处理具有提高大鼠心肌耐缺氧力,对大鼠心肌缺血再灌注损伤具有保护作用,该保护作用的机制可能与清除氧自由基功能有关。     

FDP 预处理对离体大鼠心脏LVEDP和 MDA、SOD的影响

目的:观察1,6-二磷酸果糖(fructose 1,6-b isphosphate,FDP)预处理对离体大鼠心肌组织MDA、SOD的变化,FDP对心肌缺血再灌注损伤的保护效果。方法:用W istar大鼠建立Langendorff模型,实验随机分为2组,灌注液应用Krebs-R ing液和Krebs-R ing液加FDP 5mmol.L-1两组分别分成缺血前期、缺血期和再灌注期,每8只大鼠1组,共6组。进行对照组和FDP组对比,观察指标左室舒张末压(LVEDP)、心肌组织丙二醛(MDA)的含量、超氧化物歧化酶(SOD)的活性。结果:对照组大鼠缺血再灌注后LVEDP明显增高(P<0.05)。MDA增高以对照组缺血期最为明显,且对照组缺血期及再灌注期与FDP组缺血期和再灌注期相比较差异显著(P<0.01、P<0.05)。对照组缺血期、再灌期与缺血前期相比较差异明显(P<0.05)。FDP组缺血期、再灌期与缺血前期比较无明显差异。SOD活性FDP组均较对照组增强且具有显著差异(P<0.01)。结论:FDP预处理对心肌具有良好的保护效应,具有明显增加心肌组织对缺氧的耐受,减轻缺血再灌注损伤,减少脂质过氧化物—氧自由基的生成,促进心功能的恢复。     

二氮嗪与1,6-二磷酸果糖心麻痹液对大鼠心肌细胞的保护作用

目的 观察含二氮嗪(DZ)与1,6-二磷酸果糖(FDP)心麻痹液对冷保存大鼠心脏心肌细胞凋亡的影响.方法 SD大鼠24只,分为3组(n＝8):对照组、STH组和DF组.离体心脏在4 ℃条件下保存6 h后,在Langendorff装置灌注20 min,转为离体左心脏工作模型10 min.实验终了取心肌组织,检测心肌细胞凋亡指数;心肌丙二醛(MDA)含量,心肌线粒体钙离子含量([Ca2 ]m)、细胞质细胞色素C(Cyt c)含量、细胞质caspase-3活性;部分心肌液氮保存,采用RT-PCR检测心肌细胞caspase-3 mRNA含量.结果 与对照组比较,STH组与DF组再灌注后心肌细胞凋亡指数较明显升高(P＜0.01),但DF组明显低于STH组(P＜0.01).STH组心肌MDA含量、[Ca2 ]m、细胞质 Cyt c 含量显著增高,细胞质caspase-3 mRNA表达增加,caspase-3活性明显高于对照组(P＜0.01).DF组较STH组各项指标显著改善(P＜0.01).结论 含二氮嗪与1,6-二磷酸果糖心麻痹液能减少缺血再灌注引起的心肌细胞凋亡.     

1.6-二磷酸果糖对缺血再灌注心肌能量代谢和超微结构的影响

目的 :研究 1.6-二磷酸果糖 ( FDP)对缺血再灌注心肌能量代谢和超微结构的影响 ,并探讨其作用机制。方法 :2 4只家兔随机平分为两组 ,1组 (体外循环组 12只 ) , 组 (体外循环 1.6-二磷酸果糖组 12只 ) ,常规建立兔体外循环模型 ,用高效液相色谱法 ( HPLC)检测兔心肌缺血前后 ( ATP)含量的变化 ,并观察心肌超微结构的改变。结果 :缺血再灌注后 , 组心肌 ATP含量明显低于 组 ,分别是 1.65± 1.10 nmol/ g·心肌组织和 3 .91± 1.45 nmol/ g心肌组织 ,两组比较差异有极显著性 ( P<0 .0 1) ;心肌超微结构观察显示 , 组保存优于 组。结论 :FDP对缺血再灌注心肌能量代谢和超微结构有显著的保护作用。     

雌二醇预处理对离体大鼠缺血-再灌注心肌细胞Ca2+和肌钙蛋白Ⅰ的影响

目的:探讨雌二醇预处理对离体大鼠缺血-再灌注心肌细胞Ca2+和肌钙蛋白Ⅰ(TnI)的影响.方法:采用Langendorff装置建立大鼠离体心脏缺血-再灌注模型,将24只雄性大鼠随机分为对照、治疗及预处理组.治疗组在缺血期给雌二醇3.3 mg·L-1,预处理组于灌注期给予雌二醇3.3 mg·L-1,对照组不给药.观察心肌细胞内Ca2+含量和心脏灌洗液中TnI含量的变化.结果:再灌注结束后,预处理组心肌细胞内Ca2+水平低于对照组和治疗组(P＜0.01或0.05).预处理组缺血早期心脏灌注液中TnI含量低于其他2组(P＜0.05),在缺血及再灌注期,预处理组及治疗组TnI含量均低于对照组.电镜观察预处理组心肌细胞损伤小于其他2组.结论:雌二醇预处理对缺血-再灌注心肌具有更好的保护作用.     

附加二氮嗪与1,6-二磷酸果糖心麻痹液对冷保存大鼠心脏能量代谢的作用

目的观察附加二氮嗪(DZ)与1,6-二磷酸果糖(FDP)心麻痹液对冷保存大鼠心肌能量代谢的作用.方法42只SD大鼠随机分为4组,正常对照组6只;其余各组每组12只,分别为STH组(单纯St.ThomasⅡ号液),DF组(St.ThomasⅡ号液 DZ 50 μmol/L FDP 5 mmol/L),DF 5-HD组(St.ThomasⅡ号液 DZ50μmol/L FDP5mmol/L 5-羟基葵酸盐100μmol/L),在4℃条件下保存心脏6 h后,6只取左心室,测定心肌ATP、ADP、AMP含量,计算能荷;提取线粒体,测定线粒体内游离Ca2 浓度([Ca2 ]m)及线粒体呼吸功能;另外6只建立离体左心工作模型,再灌注30 min后,测量上述指标.结果与正常对照组比较,冷保存后STH组心肌ATP含量及能荷显著下降,[Ca2 ]m显著增高,线粒体Ⅲ态呼吸速率(ST3)及呼吸控制比(RCR)明显降低(P＜0.01);再灌注后心肌ATP含量及能荷没有明显改善,[Ca2 ]m进一步增高,RCR进一步降低(P＜0.01).DF组各项指标显著优于STH组(P＜0.01);线粒体ATP敏感性钾通道阻断剂5-HD可部分降低附加DZ与FDP的保护效果.结论附加DZ与FDP可显著改善St.Thomas液冷保存大鼠心脏的能量代谢.     

雌二醇预处理对离体大鼠缺血-再灌注心肌细胞Ca2+和肌钙蛋白Ⅰ的影响

目的探讨雌二醇预处理对离体大鼠缺血-再灌注心肌细胞Ca2+和肌钙蛋白Ⅰ(TnI)的影响.方法采用Langendorff装置建立大鼠离体心脏缺血-再灌注模型,将24只雄性大鼠随机分为对照、治疗及预处理组.治疗组在缺血期给雌二醇3.3 mg·L-1,预处理组于灌注期给予雌二醇3.3 mg·L-1,对照组不给药.观察心肌细胞内Ca2+含量和心脏灌洗液中TnI含量的变化.结果再灌注结束后,预处理组心肌细胞内Ca2+水平低于对照组和治疗组(P＜0.01或0.05).预处理组缺血早期心脏灌注液中TnI含量低于其他2组(P＜0.05),在缺血及再灌注期,预处理组及治疗组TnI含量均低于对照组.电镜观察预处理组心肌细胞损伤小于其他2组.结论雌二醇预处理对缺血-再灌注心肌具有更好的保护作用.     

腺苷预处理的心肌保护效果

目的：研究心肌腺苷预处理和缺血预处理对离体大鼠心脏缺血/再灌注后心肌功能的影响。方法：以离体大白鼠工作心脏模型，比较经腺苷预处理和缺血预处理，心肌缺血再灌前后左室压、左室舒张末期压、左心室内压上升及下降最大速率、主动脉压、冠脉流量、主动脉流量和测定冠脉流出液乳酸脱氢酶（LDH），心肌ATP含量、超氧化物歧化酶（SOD）活性、脂质过氧化物含量及自灌注停搏液至完全停搏的时间。结果：腺苷预处理和缺血预处理产生相似的心肌保护作用，明显促进心肌缺血再灌后心肌功能的恢复，增进心脏的收缩功能、心肌ATP含量和SOD活性的恢复，减少LDH的漏出。结论：腺苷预处理对心脏模拟体外循环的缺血再灌损伤具有保护作用，该方法有临床应用价值。     

腺苷预处理的心肌保护效果

【目的】研究心肌腺苷预处理和缺血预处理对离体大鼠心脏缺血 /再灌注后心肌功能的影响。【方法】以离体大白鼠工作心脏模型 ,比较经腺苷预处理和缺血预处理 ,心肌缺血再灌前后左室压、左室舒张末期压、左心室内压上升及下降最大速率、主动脉压、冠脉流量、主动脉流量和测定冠脉流出液乳酸脱氢酶 (LDH) ,心肌ATP含量、超氧化物岐化酶 (SOD)活性、脂质过氧化物含量及自灌注停搏液至完全停搏的时间。【结果】腺苷预处理和缺血预处理产生相似的心肌保护作用 ,明显促进心肌缺血再灌后心肌功能的恢复 ,增进心脏的收缩功能、心肌ATP含量和SOD活性的恢复 ,减少LDH的漏出。【结论】腺苷预处理对心脏模拟体外循环的缺血再灌损伤具有保护作用 ,该方法有临床应用价值。     

二氮嗪对大鼠心肌缺血再灌注损伤的影响

目的研究二氮嗪(DZ)开放线粒体ATP敏感性钾通道对缺血再灌注损伤所致大鼠心肌组织ICAM-1和TNF-α表达的影响。方法采用离体工作心脏灌注模型,大鼠随机分为正常对照组,缺血再灌注组,DZ治疗组,DZ抑制剂-格列苯脲组。采用RT-PCR法测定心肌ICAM-1mRNA表达,ELISA检测试剂盒检测TNF-α蛋白含量。结果与正常对照组相比,心肌组织ICAM-1表达和TNF-α含量在缺血再灌注后有显著性增加(P<0.01)。DZ处理后,ICAM-1表达和TNF-α含量与缺血再灌注组相比有明显下降(P<0.05);格列苯脲组ICAM-1表达和TNF-α含量明显高于DZ治疗组(P<0.05)。结论心肌缺血再灌注损伤使ICAM-1和TNF-α表达明显升高,二氮嗪(DZ)开放线粒体ATP敏感性钾通道可下调心肌组织ICAM-1和TNF-α的表达,这可能有助于减轻缺血再灌注所致心肌损伤。     

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.