绞股蓝总皂甙对内毒素休克家兔血压及一氧化氮的影响

目的　探讨绞股蓝总皂甙(GPS) 对休克家兔血压及一氧化氮的影响。方法　动物静脉麻醉后,随机分为3 组,即对照组、内毒素组、内毒素+ 绞股蓝总皂甙组。取血测定NO 水平并测量血压。给动物注射内毒素引起家兔休克为动物模型,动物处死后,取血再次测定NO 水平。结果　对照组实验前后NO 没有出现明显的变化( P0 .05) 。内毒素(LPS) 组平均动脉血压(MAP) 在实验后4h、6h 时明显低于实验前和对照组( P< 0 .01) ,实验后NO 明显高于实验前。GSP组实验后6h 时,MAP低于实验前和对照组( P< 0 .05) ,但高于LPS组( P< 0 .05) ,实验后的NO 浓度高于实验前和对照组( P< 0.05) ,但低于LPS组实验后的NO浓度( P< 0 .05) 。结论　绞股蓝总皂甙对休克家兔血压有保护作用,对NO 的释放具有抑制作用     

地塞米松对新生大鼠内毒素休克时心肌NO、MDA和SOD的影响

目的：探讨不同剂量地塞米松（Dex)对新生大鼠内毒素休克的干预作用，测定新生大鼠内毒素休克时心肌一氧化氮（NO）、超氧化物歧化酶（SOD）及丙二醛（MDA）的变化。方法：健康7日龄新生大鼠175只，随机分为5组，每组35只。对照组（A组）注入与其它4组等量的0．9％氯化钠液；内毒素组（B组）腹腔注射精制内毒素（LPS 5mg/kg)；治疗组（C、D、E组）于注入内毒素后立即分别注入不同剂量的Dex(5、10、15mg/kg)，于0、1、2、4、6及24h、随机选取7只断头处死，留取心肌组织。测定不同时间心肌组织NO、MDA、和SOD的活性。结果：与A组相比，B组NO和MDA明显升高（P＜0．01），SOD明显降低（P＜0．01），C和D组NO和MDA有相同改变趋势，但明显低于B组（P＜0．01），SOD部分降低，E组各指标与A组基本相同（P＞0．05），B组24小时死亡率显高于治疗组。结论：NO、MDA及SOD均参与了内毒素休克病理变化过程，地塞米松能抑制心肌NO及MDA的产生，提高SOD的活性，降低24小时死亡率，表明Dex对感染性休克新生儿的心功能有保护作用。     

胸腺肽β4提高内毒素休克小鼠存活率并下调炎症介质释放

目的:研究胸腺肽β4(thymosinβ4,Tβ4)对内毒素休克小鼠72h存活率的影响,检测TNF-α及IL-1α变化,初步探讨Tβ4治疗内毒素休克的机制.方法:选用清洁级昆明小鼠腹腔注射脂多糖(LPS)制备内毒素休克动物模型,①观察内毒素休克前后Tβ4变化情况.②Tβ4对内毒素休克小鼠存活率的影响.动物随机分为4组,每组30只,均腹腔注射LPS(25mg/kg),Ⅰ组为LPS对照组,Ⅱ、Ⅲ、Ⅳ组分别于LPS腹腔注射后0h;0h、2h;0h、2h、4h尾静脉注射Tβ4(5mg/kg),观察72h存活率.③ELISA法检测Tβ4对内毒素休克小鼠血浆TNF-α及IL-1α变化情况.结果:Tβ4在内毒素休克小鼠的血浆中明显降低,Tβ4可提高内毒素休克小鼠72h存活率,并下调TNF-α及IL-1α的释放.结论:Tβ4治疗内毒素休克应在LPS腹腔注射后0h、2h、4h连续注射Tβ4(5mg/kg),实验提示Tβ4可能是通过下调炎症介质的释放来治疗内毒素休克的.     

内毒素血症对糖尿病大鼠氧化应激及一氧化氮的影响

目的观察内毒素血症对糖尿病大鼠氧化应激及一氧化氮(NO)的影响。方法SD大鼠腹腔注射链脲佐菌素(STZ,50 mg/kg)建立糖尿病动物模型,在此基础上再以脂多糖(LPS,0.5 mg/kg)腹腔注射诱导内毒素血症模型,观察注射LPS后6 h、12 h、24 h及72 h各时间点血糖、胰岛素、氧化应激指标(SOD、MDA、GSH)及一氧化氮水平的变化。结果内毒素血症糖尿病大鼠血清NO水平显著升高,于注射LPS后24 h达峰值(P<0.05);而血清SOD、GSH水平却明显降低(P<0.05),MDA水平则明显升高(P<0.05),分别于注射LPS后24 h达峰值或谷值;注射LPS后的血糖(12、24、72 h)及胰岛素水平(24、72 h)变化有统计学意义。结论内毒素血症可显著降低糖尿病大鼠抗氧化应激能力,增加NO的生成,同时加重糖代谢紊乱。     

重组人促红细胞生成素对感染性休克大鼠脑组织的保护作用

目的 研究重组人促红细胞生成素(recombinant human erythropoietin,rhEPO)对感染性休克(septic shock,SS)大鼠脑组织的保护作用.方法 将健康雄性Vistar大鼠36只按随机数字表法分为正常对照组(n=12)、感染性休克组(n=12)、rhEPO治疗组(n=12),每组再分成2个时间点(6、12 h),各时间点6只.感染性休克组和rhEPO治疗组以尾静脉注射内毒素(LPS)5 mg·kg-1制备感染性休克模型,rhEPO治疗组在出现休克症状时立刻腹腔注射rhEPO 5 000 U·kg-1;正常对照组大鼠给予等量生理盐水.术后各组各时间点大鼠分批腹腔麻醉后行眼球摘除术采血及断头取脑组织:取血清行NSE检测、脑组织匀浆行NO检测;提取右半侧脑组织海马区进行病理切片,行HE染色和TUNEL染色检查.结果 与正常对照组比较,感染性休克组脑海马CA1区神经元损伤明显,可见大量TUNEL阳性细胞,NO、NSE含量显著升高(均P＜0.01);rhEPO治疗组TUNEL阳性细胞和NO、NSE含量较感染性休克组明显降低(P＜0.01或P＜0.05).结论 rhEPO可减轻感染性休克时脑组织损伤及海马区神经元细胞的凋亡,其机制可能与抑制NO的过量生成有关.     

人参二醇组皂苷对感染性休克大鼠血清一氧化氮合酶及一氧化氮的影响

目的观察人参二醇组皂苷（PDS）对感染性休克大鼠血清中一氧化氮合酶（NOS）活性及一氧化氮（NO）含量的影响，探讨其抗感染性休克的作用机制。方法大鼠舌下静脉注射PDS进行预治疗，10rain后注射细菌内毒素（LPS5mg／kg）复制感染性休克模型。实验动物随机分为对照（Control）组；内毒素休克（LPS）组；地塞米松（LPS＋Dex）组；人参二醇组皂苷（LPS＋PDS）组。颈动脉插管记录平均动脉压（MAP）。分别于休克后2h和4h腹主动脉取血，用硝酸还原酶法测定血清中NOS活性和N02^-／NO3^-的含量，间接反映N0的水平。结果注射内毒素后，模型组的MAP迅速下降，在低水平维持，LPS＋Dex组和LPS＋PDS组的MAP未见明显下降，优于模型组（P〈0．01）；注射内毒素2h后模型组的血清NOS和NO明显升高，LPS＋Dex组和LPS＋PDS组NOS活性、NO2^-／NO3^-含量显著低于LPS组（P〈0．05）。结论PDS能够明显改善内毒素休克大鼠的低血压状态，降低NOS活性、NO含量，并对其NO的生成具有抑制作用。     

肿瘤坏死因子和丙二醛对内毒素休克新生大鼠心肌改变的影响

目的 :通过测定内毒素休克时新生大鼠血清TNF -α ,心肌丙二醛 (MDA) ,超氧化物歧化酶 (SOD)及观察心肌细胞超微结构的变化 ,探讨内毒素休克新生大鼠心肌改变的部分发生机制。方法 :健康 7d龄新生大鼠12 6只随机分为 3组 ,每组 4 2只。对照组 :腹腔注入与其它 2组等量的 0 .9%氯化钠液 0 .1ml;内毒素 (LPS)组 :腹腔注射LPS(5mg/mg) ;治疗组 :于注入内毒素后立即分别注入地塞米松 (Dex) 10mg/kg。于 0 ,1,2 ,4 ,6及 2 4h随机选取 7只断头取血 ,测定血清TNF -α ,心肌MDA及SOD的浓度 ,用透射电镜观察心肌细胞超微结构的变化。结果 :与对照组相比 ,LPS组血清TNF -α ,心肌MDA明显升高 (P <0 .0 1) ,SOD明显降低 (P <0 .0 1)。电镜下可见心肌细胞空泡变性 ,心肌纤维断裂。Dex组血清TNF -α ,心肌MDA升高程度明显低于B组 (P <0 .0 1) ,SOD部分降低 ,心肌损害明显减轻。结论 :TNF -α ,MDA及SOD均参与了内毒素休克心肌损害的病理变化过程 ,Dex能抑制TNF -α及MDA的产生 ,提高SOD的活性 ,对心肌细胞起保护作用。     

异丙酚对内毒素血症兔肠道的作用

目的 探讨异丙酚对内毒素血症兔肠道的作用.方法 连续静脉内注射内毒素复制内毒素血症模型.新西兰大白兔40只,随机分为5组,每组8只.A组为空白对照组;B、C、D、E组均给予内毒素(600 μg/kg).C、D、E组均为内毒素注入后30 min后予以异丙酚持续静脉泵入[C组5 mg/(kg·h)、D组10 mg/(kg·h)、E组15 mg/(kg·h)].4 h后测定血浆二胺氧化酶(DAO)的活性.测定小肠髓过氧化物酶(MPO)活性、超氧化物歧化酶(SOD)活性、脂质过氧化产物丙二醛(MDA)的含量.结果 与B组相比C、D、E组均能不同程度的降低DAO的活性、小肠MPO活性,增加小肠SOD活性,降低小肠MDA含量(P＜0.05).结论 异丙酚对内毒素血症兔肠道具有保护作用,并非异丙酚剂量越大效果越好.     

胸腺素β4治疗脂多糖诱导小鼠内毒素休克的实验研究

目的研究胸腺素β4(thymosin β4,Tβ4)对内毒素休克小鼠72 h存活率的影响,并初步探讨Tβ4治疗内毒素休克的机制.方法选用清洁级昆明小鼠腹腔注射脂多糖(LPS)制备内毒素休克动物模型,(1)观察内毒素休克前后Tβ4变化情况;(2)观察注射LPS后不同时间给予Tβ4对内毒素休克小鼠存活率的影响;(3)观察不同剂量Tβ4对内毒素休克小鼠存活率的影响;(4)ELISA法检测Tβ4对内毒素休克小鼠血浆TNF-α及IL-1β变化情况的影响;(5)用RT-PCR的方法检测外周血单核细胞(PBMC)的TNF-α mRNA及IL-1β mRNA表达情况.结果 Tβ4在内毒素休克小鼠的血浆中明显降低,A、B、C组内毒素休克小鼠72 h存活率均明显低于D组(P＜0.01,P＜0.05),Tβ4预处理LPS组TNF-α及IL-1β血浆水平明显低于LPS组(P＜0.01),LPS组TNF-α mRNA及IL-1α mRNA的表达明显高于Tβ4预处理LPS组(P＜0.01).结论 Tβ4治疗内毒素休克应在LPS腹腔注射后0 h、2 h、4 h连续注射Tβ4(5 mg/kg),Tβ4可降低PBMC表达TNF-α mRNA及IL-1β mRNA.实验提示Tβ4可能是通过下调炎症介质的基因表达来治疗内毒素休克的.     

赤芍对大鼠内毒素性急性肺损伤时肺iNOS和eNOS表达的影响

目的 :观察赤芍对内毒素性急性肺损伤 (ALI)时肺iNOS和eNOS表达的影响 ,并探讨其保护作用机制。方法 :采用大鼠内毒素ALI模型。 4 0只Wistar大鼠随机分为生理盐水对照组 (NS)、内毒素组 (LPS)、赤芍治疗组、赤芍预防组和iNOS阻断剂氨基胍 (AG)组。应用免疫组织化学方法和图像分析系统检测肺组织中iNOS和eNOS的表达 ,检测血清NO及肺组织丙二醛 (MDA)含量 ,同时观察肺组织病理形态学改变。结果 :与NS组比较 ,LPS组iNOS表达显著增强而eNOS表达明显降低 (均P <0 .0 1) ;赤芍治疗组和赤芍预防组iNOS表达较LPS组明显降低而eNOS表达明显升高 (均P <0 .0 5 ) ;与LPS组比较 ,AG组仅iNOS表达明显降低。LPS组肺组织MDA和血清NO较NS组明显增加 (P <0 .0 1) ;与LPS组比较 ,赤芍治疗组和赤芍预防组MDA含量和血清NO显著降低 (P <0 .0 5或P <0 .0 1)。病理学检查显示赤芍治疗组和赤芍预防组肺组织损伤程度较LPS组明显减轻。结论 :肺组织iNOS表达增强和eNOS表达降低是内毒素性ALI的重要机制 ,赤芍对内毒素性ALI的防治作用可能与抑制肺组织iNOS异常高表达和增加eNOS表达有关。     

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.