自发性高血压大鼠压力反射敏感性与血压变异性的关系

目的:研究自发性高血压大鼠(SHR)动脉血压变异性(BPV)和压力反射敏感性(BRS)的改变及两者间相关性.方法:清醒、自由活动状态下测定SHR及对照WKY大鼠24 h收缩压(SBP)、舒张压(DBP)、心率(HR)及其各自变异性的改变;单次静脉注射去氧肾上腺素(5 μg/kg)以测定压力反射对心率的控制功能(BRSHR);化学切除自主神经阻断压力反射传出通路后,比较静注去氧肾上腺素后的升压曲线下面积差异,测定压力反射对血压的控制功能(BRSBP).     

活血潜阳方对高血压大鼠血压和左室心肌间质重构的影响

目的:观察活血潜阳方对自发性高血压大鼠(SHR)血压和左室心肌间质重构的影响。方法:72只SHR随机分SHR对照组、活血潜阳方组、缬沙坦组及两药合用组。20只京都Wistar大鼠(WKY)作为正常对照组。治疗前测大鼠尾动脉收缩压(SBP)、舒张压(DBP);分别于治疗7周及14周后测定SBP、DBP和左心室重量指数(LVMI),光镜观察并计算胶原容积分数(CVF)。结果:SHR的SBP、DBP、LVMI和CVF均高于同龄WKY大鼠(P<0.05或P<0.01)。活血潜阳方治疗14周可抑制SHR的SBP、DBP增高(P<0.05或P<0.01),可降低SHR的LVMI和CVF(P<0.05或P<0.01),较7W效果更明显;活血潜阳方与缬沙坦合用治疗14周可进一步降低SHR的CVF(P<0.01)。结论:长疗程(14W)的活血潜阳方治疗具有缓和的降压作用,并改善心肌间质重构,可能是其逆转高血压左室肥厚的机制。     

p-MEK1/2与原发性高血压大鼠左心室肥厚关系的研究

目的动态观察p-MEK1/2在原发性高血压大鼠(SHR)左心室表达,进一步探讨MEK1/2-ERK1/2通路在高血压左心室重构中的作用。方法对比观察各周龄SHR大鼠与WKY大鼠血压,心脏/体重比值变化;免疫组织化学方法检测左心室p-MEK1/2的表达。结果整个实验过程中,WKY血压保持在正常水平,SHR16、SHR24组动脉收缩压均明显高于同周龄WKY组(P<0.05);与同周龄WKY相比SHR24组的心脏/体重比值增加明显(P<0.05);SHR24左心室相对壁厚度明显高于SHR8和WKY24大鼠(P<0.05);WKY和SHR大鼠左心室p-MEK1/2蛋白表达量均随着周龄的增加而增加,但SHR16、SHR24明显高于同周龄WKY(P<0.05)。结论 MEK1/2-ERK1/2通路可能有促进高血压左心室心肌肥厚发展的作用。     

自发性高血压大鼠血压波动、昼夜模式及靶器官损伤

分析造成高血压靶器官损伤的多元因素。方法 :以自发性高血压大鼠 (SHR)为动物模型 ,进行 2 4h动态血压监测 ,分析血压波动性、血压昼夜模式与靶器官损伤的关系。结果 :SHR不同的时间段的收缩压波动性、舒张压波动性均与靶器官损伤显著正相关 ,且相关程度较血压水平与靶器官损伤的相关更为密切 ;非勺型血压SHR的靶器官损伤较勺型血压SHR明显严重。结论 :血压波动性、血压昼夜模式是影响SHR靶器官损伤的重要因素     

大鼠中枢5-HT1A受体的结合容量与高血压

目的:探讨5-HT1A受体结合容量改变对高血压发病的影响.方法:通过放射性配体与受体结合实验,探讨不同周龄自发性高血压大鼠(SHR)和对照组Wistar-Kyoto (WKY)大鼠在脑区不同部位5-HT1A受体的结合特征.结果:SHR不同脑区脑组织膜的Bmax随着大鼠周龄的增加而增大,且有显著差异;WKY鼠差异不明显.相同脑区不同周龄SHR的Bmax均大于WKY大鼠,且随着周龄的增加血压呈上升趋势,其5-HT1A受体的Bmax与血压成正比,WKY无此现象.4～5周龄的SHR为高血压未形成期,10～12及以上周龄的SHR处于高血压的形成期.结论:当血压发生变化时,中枢5-HT1A受体结合容量发生继发性改变.不同脑区中枢5-HT1A受体结合容量可能与高血压疾病的发生相关.     

不同年龄自发性高血压大鼠心脏AT2R的表达与心肌纤维化

目的 观察不同年龄自发性高血压大鼠(SHR)心脏AT2R的表达水平及心肌胶原含量,探讨AT2R在高血压发生、发展过程中的作用.方法 1月龄组(Sl)、2月龄组(S2)、3月龄组(S3)、6月龄组(S6)和9月龄组(S9)雄性SHR共五组,每组各6只.各组均有相应月龄的Wistar-Kyoto大鼠(WKY)作对照.采用RBP-I型大鼠血压心率测定仪侧量大鼠动脉收缩压(SBP);放免法(RIA)测定血浆血管紧张素Ⅱ(Ang Ⅱ);免疫组化染色结合计算机图像分析方法测定心脏AT2R的表达水平,天狼星红胶原染色大鼠的心脏切片.结果 1.SHR SBP随着月龄的增加呈持续上升(P<0.05),SHR的SBP均高于相应配对的WKY组(P<0.05),2.一个月后SHR血浆Ang Ⅱ浓度均高于Sl(P <0.05),一个月后SHR血浆Ang Ⅱ浓度均高于相应配对的WKY组(P<0.05),3.SHR心脏AT2R免疫染色阳性面积比随着月份的增加而降低,SHR心脏AT2 R免疫染色阳性面积比均低于相应配对的WKY组(P＜0.05)4.SHR心肌中的胶原含量随着月龄的增加而增加.结论 SHR心脏AT2R表达水平比WKY低,并随着年龄的增加而降低.SHR心肌中的胶原含量随着月龄的增加而增加,而WKY无类似趋势.     

血压变异与心率变异及心电异常相关性分析

目的：研究血压变异(BPV)与心率变异(HRV)及心电图(ECG)异常相关性，方法：对157例未经治疗的早期高血压患者及167例未服过影响血压及心率药物的正常人，进行BPV、HRV及ECG异常的相关分析，各种数据在同一时刻得到，结果：当血压昼夜节律消失(非杓型)，BPV及HRV不正常，ECG异常明显高于其他组，当高血压患者血压昼夜节律存在时HRV各项指标接近正常，ECG异常率较低，HRV降低与血压负荷升高呈明显正相关，与心电异常也呈明显正相关，结论：对高血压治疗的目的。不仅仅是降压，还应尽量恢复昼夜血压的规律性，降低夜间血压负荷，调节植物神经功能，对于血压正常的患者。血压昼夜节律消失也应投以关照给予植物神经功能调节，达到或降低靶器官损伤或延缓靶器官损害的目的，提高患者的生活质量。     

儿童高血压合并早期肾功能损害与血压变异性及心率变异性的相关性研究

目的:探讨儿童高血压合并早期肾功能损害与血压变异性(BPV)及心率变异性(HRV)的相关性研究。方法:根据尿白蛋白与尿肌酐比值(UACR)将90例高血压患者分为高血压合并早期肾功能损害组(A组,UACR>30 mg/g)和单纯高血压组(B组,UACR≤30 mg/g),同时收集60例正常儿童作为对照组,观察各组的血压变异性,心率变异性之间的关系,并对各指标之间进行相关性进行分析。结果:A组和B组的SDNN、SDANN、RMSSD、PNN50和HF均显著低于对照组,LF和LF/HF则显著增加;A组SDNN、SDANN、RMSSD和PNN50均显著高于B组,差异有统计学意义(P<0.05)。A和B组各时段的SBP、DBP均显著高于对照组,而相应的BPV均显著高于对照组,差异有统计学意义(均P<0.05)。A组各时段的SBP、DBP均显著高于B组,而相应的BPV均显著低于B组,差异有统计学意义(均P<0.05)。结论:高血压的患者存在着HRV和BPV异常,合并有高血压的早期肾功能损害的患者可加重HRV和BPV的异常程度。     

高血压大鼠延髓头端腹外侧区GABA_B受体中介的心血管效应

目的 :证实自发性高血压大鼠延髓头端腹外侧区 ( RVL M) γ-氨基丁酸 ( GABA) B受体中介的紧张性抑制作用。方法 :于大鼠双侧 RVL M微量注射 2 -羟基 -saclofen,观察其平均动脉血压( MAP)和心率 ( HR)变化。结果 :在 SD、WKY、SHR大鼠均引起 MAP升高和 HR加快 ,但 SHR大鼠明显低于正常对照组的 SD、WKY大鼠 ( P<0 .0 5)。结论 :GABAB受体参与中介 RVL M的紧张性抑制作用 ,SHR大鼠 RVL M的此紧张性抑制作用明显低于正常血压大鼠。     

钙敏感受体在高血压大鼠心肌重塑和视网膜血管病变中的作用研究

背景 临床中对于高血压靶器官损害主要以全身降压辅以局部用药治疗为主,但因各组织对药物的反应不同甚至相斥,治疗效果不佳。现已关注到钙敏感受体(CaSR)与高血压的关系,然而其在高血压视网膜疾病中的作用和机制仍缺乏相关研究。目的 探讨CaSR在高血压视网膜中的表达水平以及其与高血压心肌重塑、视网膜血管改变的关系。方法 2021年5—12月选取10只8周龄健康正常血压大鼠(WKY)作为WKY组,20只同周龄同源的自发性高血压大鼠(SHR)随机分为SHR组及抑制剂(SHR+NPS2143)组。SHR+NPS2143组腹腔注射CaSR抑制剂NPS2143,WKY组和SHR组注射等量的0.9%氯化钠溶液,共注射16周。干预0周、16周通过无创血压仪监测大鼠血压;干预0周、16周分别选取5只大鼠处死,通过马松(Masson)染色观察大鼠心肌胶原沉积,通过苏木素-伊红(HE)染色检测视网膜病理变化;通过免疫组织化学染色、实时荧光定量PCR (qRT-PCR)观察CaSR和血管内皮生长因子A (VEGFA)在视网膜的分布和表达。结果 SHR组干预0周、16周收缩压(SBP)、舒张压(DBP)、平均动脉压...     

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.