金雀异黄素、己烯雌酚对去势雄性大鼠骨代谢的影响

目的探讨金雀异黄素、己烯雌酚对雄性骨质疏松大鼠骨代谢的影响。方法雄性SD大鼠40只,按体重随机分为5组：假去势组（Sham）8只、去势组（Orch）8只、去势＋己烯雌酚组（Orch＋DES,5μg/d）8只、去势＋金雀异黄素组（Orch＋GenⅠ1 mg/d,Orch＋GenⅡ2 mg/d）16只。饲养16周后处死,测量血清骨钙素（BGP）、血清碱性磷酸酶（AKP）、尿吡啶酚（PYR）、尿羟脯氨酸（HYPRO）以及血清睾酮（T）、雌二醇（E2）的含量。结果雄性大鼠去势后,和假手术组相比,血清BGP和尿PYR、HYPRO显著升高（P〈0.05）,血清AKP有升高的趋势（P〉0.05）,血清T水平显著降低（P〈0.05）,E2水平有下降趋势（P〉0.05）。补充己烯雌酚后血清BGP、AKP含量有下降趋势（P〉0.05）,尿PYR、HYPRO含量显著下降（P〈0.05）;血清T和E2含量未见明显改善（P〉0.05）。补充金雀异黄素后血清BGP水平和尿PYR、HYPRO水平显著降低（P〈0.05）,血清AKP含量有下降趋势（P〉0.05）;血清T和E2含量未见明显改善（P〉0.05）。结论金雀异黄素和己烯雌酚可以明显改善去势雄性大鼠的血尿骨代谢生化指标,对雄性骨质疏松大鼠有较好的疗效。两者对血清睾酮和雌二醇含量未见明显改善。     

预防颈动脉成形术后再狭窄的实验研究进展

颅外颈动脉硬化闭塞性疾病是多种缺血性脑血管病的重要危险因素,目前临床上应用的颈动脉内膜切除术（CEA）、血管成形支架置入术（CAS）等方法近期虽可获得理想的血液再灌注,但各种血管成形术后3～6个月内高达25％～50％的再狭窄率,严重影响了临床效果,且没有有效的防治方法。因此,近年来有关抑制颈动脉成形术后血管再狭窄的基因、药物和放射等方面的试验研究日渐增多。     

金雀异黄素、己烯雌酚对去势雄性大鼠骨结构的影响

目的 探讨金雀异黄素、己烯雌酚对雄性大鼠骨结构的影响.方法 3～4月龄雄性SD大鼠40只,随机分为5组:假去势组(Sham)8只、去势组(Orch)8只、去势+己烯雌酚组(Orch+DES,5g/d)8只、去势+金雀异黄素组(Orch+GenⅠ1 mg/d,Orch+GenⅡ2 mg/d)16只,去势后低钙饲料喂养16周处死,剥离干净右肱骨留行3点弯曲疲劳试验后观测微损伤及骨组织细胞情况.结果 肱骨疲劳损伤后每组均可见微损伤,以微破裂多见,微破裂平均长度和微破裂面积密度在Orch组显著高Sham组.成骨细胞(osteoblast)数及密度由高到低分别为Orch+DES组,Sham 组,Orch+GenⅡ组,Orch+GenⅠ组,Orch组,其中Orch+DES组和Sham组均显著高于其他3组(P<0.05).结论 本次实验表明大鼠肱骨微损伤可作为药物治疗骨质疏松症疗效的评价指标.乙烯雌酚对雄性骨质疏松大鼠作用肯定,能改善骨的结构和性能;金雀异黄素能对雄性骨质疏松大鼠有一定的作用,但不能证实其优于乙烯雌酚,有待进一步研究.     

血管成形术后再狭窄中细胞增殖与凋亡的研究

目的　动态观察血管成形术后不同时间段增生内膜细胞凋亡、增殖的变化过程。方法　将新西兰大白兔 35只随机分成 7组 ,应用 2次损伤法建立兔髂动脉再狭窄模型 ,检测血管成形术后 5 6d内 7个不同时间段 ( 0、3、7、14、2 8、42、5 6d)增生内膜的细胞增殖、凋亡指数及内膜面积、内膜细胞数。结果　血管成形术后内膜细胞凋亡与增殖的变化并不是同步的 ,术后第 7天凋亡指数达到高峰 ,为 ( 2 2 .81± 4.19) % ,增殖指数在术后第 14～ 2 8天最高 ,但峰值较低 ,分别为( 16 .2 1± 1.78) %、( 15 .49± 1.6 1) %。结论　内膜细胞增殖与凋亡的失衡是决定再狭窄的重要因素。     

联用c myb ASON与VEGF防治血管成形术后再狭窄的研究

目的：评估联合应用c myb反义寡核苷酸（ASON）和血管内皮生长因子（VEGF）对血管成形术后再狭窄的效果。方法：28只中国长耳白兔随机分成狭窄对照（Ⅰ）组, 狭窄c myb ASON处理（Ⅱ）组, 狭窄VEGF处理（Ⅲ）组和狭窄c myb ASON +VEGF处理（Ⅳ）组。测定治疗后各组血管狭窄程度, 并进行比较分析。结果：处理后各组均呈不同程度的血管内膜及血管平滑肌增生, 以Ⅰ组最重, Ⅱ, Ⅲ组增生情况较Ⅰ组明显减轻, 差异有统计学意义(P＜0.01)。Ⅳ组增生情况较Ⅱ, Ⅲ组更轻, 差异均有统计学意义(P＜0.01), 但Ⅱ, Ⅲ组间差异无统计学意义（P＞0.05）。Western blotting结果显示, 各组间灰度均有明显差别。结论：c myb ASON与VEGF联合应用能显著减轻血管成形术后的再狭窄, 但两者之间无协同作用。     

血管重建术后再狭窄的研究进展

PTCA、支架植人、血管移植等是血管疾病治疗的有效手段，但术后再狭窄率30％～40％，严重地影响手术远期效果。再狭窄主要由于血管内膜损伤后导致的细胞增殖、凋亡、迁移以及细胞外基质降减和合成，实际上是血管壁调控失衡的自我修复过程，与血管活性物质、细胞生长因子等因素的刺激有关。     

胶原在血管成形术后再狭窄中表达和意义的实验研究

目的观察PTA后胶原含量在血管壁各层随时间的演变规律,探讨胶原在血管再狭窄过程中的表达及意义。方法30只大鼠制作成颈动脉再狭窄动物模型,取损伤后1、3、7、14、28和42天6个观察点,对胶原纤维进行Masson染色。分析胶原与内膜增生和血管重塑的关系。结果①内膜的胶原第7天即开始表达并逐渐增多,第28天基本稳定。中膜胶原含量在整个过程中无统计学差异。外膜胶原第7天达高峰,后逐渐下降。②内膜、外膜胶原密度分别与内膜、外膜面积有相关性,内膜、中膜、外膜胶原密度都与管腔面积丢失率具有明显的相关性。中膜、外膜胶原密度与外弹力板面积缩小率具有明显的相关性。内膜、外膜胶原密度与内膜面积增长率具有明显的相关性。内膜胶原密度与内膜PCNALI有负相关性。③内膜胶原光密度在第7天即达高峰,随后逐步下降。中膜胶原光密度整个过程中无显著差异。外膜的胶原光密度PTA后第1天即开始上升,到第7天达高峰,随后逐步降至对照水平。结论再狭窄过程中胶原在内膜、外膜含量明显升高,中膜胶原含量基本保持不变。它们共同参与狭窄,内膜的胶原主要与内膜增生有关,中膜和外膜胶原主要与重塑有关。     

卡托普利对血管成形术后再狭窄作用的实验研究

目的探讨卡托普利对血管成形术后再狭窄的干预作用。方法SD雄性大鼠60只,分单损组、干预组和对照组。单损组采用改良导丝法制作大鼠颈动脉再狭窄模型。干预组将卡托普利研磨成粉状,生理盐水稀释配制成5mg/ml溶液,分别于制模前6 d开始按10 mg/(kg.d)剂量经灌胃针给予大鼠至术后各时间点。对侧颈总动脉作为假手术对照组。每组各时间点6只大鼠,于制模后1天、4天、7天、14天及28天原位灌注固定取材。根据HE染色标本情况,选血管形态结构完整的50个标本,进行HE染色,采用病理图像分析系统染色片进行形态计量分析。结果损伤后从第7天起新生内膜厚度和面积逐渐增加,到28天达峰值;与单损组比较,干预组血管壁三层厚度无显著差别,干预组第14、28天新生内膜面积显著减低。狭窄率于血管损伤后逐渐增加,到28天达峰值,与单损组比较,干预组在14天和28天狭窄率明显变小,各时间点内弹力板面积、外弹力板面积及重塑指数两组之间无显著差别。结论卡托普利减小大鼠颈动脉损伤后新生内膜面积及狭窄率,抑制新生内膜形成,但不改变内、外弹力板面积及重塑指数,不影响血管收缩性重塑。     

核因子-κB与血管成形术后再狭窄

目的探讨核因子-kappaB(NF—κB)在血管成形术后再狭窄中的作用。方法对国内、外近5年的有关文献进行综述。结果在血管成形术后NF-κB可引起平滑肌细胞增生及凋亡减少，导致血管内膜过度增生。结论NF—κB在血管成形术后再狭窄中起着重要作用。     

Percutaneous Transluminal Angioplasty of Failing Arteriovenous Dialysis Fistulae

Percutaneous transluminal angioplasty (PTA), a method combiningdiagnostic and therapeutic procedures, was studied prospectivelyin 40 patients with clinically failing a-v fistulae. Forty-sevenprocedures were performed in 40 patients with a variety of a-vfistulae (26 Cimino, five saphenous loops, five goretex grafts,and four upper-arm fistulae). In 43 cases the procedure wasinitially successful. The mean time of fistula patency afterfirst PTA was 10.06±2.10 months. Primary failures weredue either to technical inability to pass the stenosis (twopatients) or to vessel perforation during the attempt (two patients).Surgical intervention had to follow both perforations. Restenosisat the dilatation site occurred in six patients, and in onea new stenosis at a different site occurred; the mean time offistula patency in these patients was 5.8 months. Our results suggest that PTA is a highly effective therapy forthe majority of cases of shunt stenosis. The success rate ofthe method is excellent and the complication rate low. The combinationof this interventional approach with the mandatory angiographicprocedure if stenosis of a fistula is suspected makes PTA afavourable first-line treatment and appears to save a considerablenumber of surgical interventions.     

肾素-血管紧张素检测在经皮腔内肾动脉成形术中的临床价值

目的：探讨经皮腔内肾动脉成形（ percutaneous transluminal renal angioplasty ,PTRA）术前肾素-血管紧张素系统（ renin-angiotensin system ,RAS）检测的临床价值。方法采用回顾性队列研究的方法分析2009年10月～2013年10月76例我院PTRA的病历资料,以高血压危险等级下降为治疗有效的评价标准,评价术前血压分级、RAS水平、肾血流灌注情况、小肾图及肾动脉狭窄程度等指标对PTRA适应证选择和预后的价值。结果 RAS阳性患者发生高血压降级的可能（比值比, odd ratio,OR）是RAS阴性患者的3．927倍（χ2＝4．354,P＝0．037）;与高血压一级相比,高血压二级患者发生高血压降级的可能是4.050倍（确切logistic回归法,P＝0．089）,高血压三级患者发生高血压降级的可能为12．424倍（确切logistic回归法, P＝0.016）。其余血流灌注延迟、小肾图、肾动脉狭窄程度等指标在2组间差异均无显著性。结论 RAS检测在PTRA术中具有重要临床价值。不同级别的高血压降级比率明显不同,伴有三级和二级高血压的肾动脉狭窄PTRA术后预后较好。     

维持性血液透析患者前臂动静脉内瘘狭窄的球囊导管扩张治疗

目的：探讨球囊导管扩张（PTA）治疗维持性血液透析患者前臂动静脉内瘘（AVF）狭窄的临床效果。方法：自2006年01月～2010年06月,对5例前臂AVF的维持性血液透析患者进行了10次PTA治疗。结果：5例患者PTA术后即血流量恢复,但分别在3～24个月后复发,再次PTA治疗后血流量恢复;较短时间发生第1次复发的2例患者分别又在术后3、4个月发生第2次复发,其余患者目前尚未发生狭窄。结论：前臂AVF狭窄形成后,及时采用PTA治疗是修复失功能内瘘的一种行之有效的方法,PTA治疗后复发时间较长的患者,如发生再次复发可继续行PTA治疗。     

Long-term Results of Percutaneous Transluminal Angioplasty for Symptomatic Iliac In-stent Stenosis

OBJECTIVE: This study describes the long-term results of endoluminal therapy for iliac in-stent obstructions. DESIGN: This is a retrospective study. MATERIALS AND METHODS: From 1992 to 2005, 68 patients (22 women), with a mean age of 61+/- 13 years and 16 bi-iliac in-stent obstructions, underwent 84 endovascular interventions for focal iliac in-stent stenoses (n = 61) or occlusions (n = 23). Primarily, only uncovered stents were placed. All patients were symptomatic: 70% had disabling intermittent claudication, 23% had resting pain, and 7% had trophic changes. All had in-stent diameter reduction exceeding 50% that was confirmed by duplex scanning and angiography. Procedures were performed under local anesthesia via the femoral route. RESULTS: All interventions were initially technically successful, with a minor complication of pneumonia in one patient (2%). Initial clinical success was achieved in 86% of patients. PTA alone was used to treat 72 (86%) in-stent obstructions, the other 12 (14%) had PTA and renewed stent placement. The 30-day mortality rate was 0%. Mean follow-up was 35 months (range, 3 months to 10 years) and included duplex scanning. Primary clinical patency was 88% at 1 year, 62% at 3 years, and 38% at 5 years follow-up. During follow-up, 28 (33%) of 84 extremities required secondary reinterventions because of symptomatic renewed in-stent stenosis, and 11 were treated successfully with repeated endovascular interventions. Secondary patency at 1 year was 94%, 78% at 3 years, and 63% at 5 years. Surgical intervention was eventually needed in 17 (20%) of the 84 extremities. CONCLUSIONS: Endoluminal therapy for iliac focal in-stent obstructive disease seems to be a safe technique with acceptable long-term outcome and therefore a true alternative to primary surgical reconstruction.     

Prevention of Restenosis after Coronary Angioplasty with Low-Density Lipoprotein Apheresis

Abstract: A prospective study was performed to determine whether low-density lipoprotein (LDL) apheresis, when performed only immediately before and after percutaneous transluminal coronary angioplasty (PTCA), is effective in preventing restenosis of coronary artery lesions following PTCA. Thirty-six patients with coronary heart disease (CHD) and hypercholesterolemia were divided into 2 groups. The 9 patients in the LDL group underwent LDL-apheresis 1 day before and 5 days after PTCA while the 27 patients of the control group underwent PTCA but did not undergo LDL-apheresis. Follow-up coronary angiography (CAG) was performed 4 months after PTCA. The rate of restenosis of coronary artery lesions was significantly lower in the LDL group (0%) than in the control group (30%). These findings suggest that LDL-apheresis, when performed before and after PTCA, is effective in preventing restenosis of coronary artery lesions in patients with CHD and hypercholesterolemia.     

Percutaneous Transluminal Angioplasty of Renal Transplant Artery Stenosis in Patients with Rejection Nephropathy

A total of 13 procedures of percutaneous transluminal angioplastywere performed in 11 kidney graft recipients with renal transplantartery stenosis. Nine procedures were technically successfulin eight patients (one redilatation was necessary because ofrestenosis). Graft biopsy confirmed rejection nephropathy inall cases. The outcome could not be evaluated in one patientwho died of a concomitant disease shortly after angioplasty.The remaining seven patients (eight percutaneous transluminalangioplasties) showed improvement in hypertension in 63% andin glomerular filtration rate in 50% of procedures, persistingfor 6–13 months. A single major complication encounteredwas a loss of graft related to unsuccessful percutaneous transluminalangioplasty. The results suggest that percutaneous transluminalangioplasty may bring prolonged increase in effective renalplasma flow and glomerular filtration rate even in patientsexperiencing rejection nephropathy.     

手术去势对前列腺癌患者血脂代谢的影响

目的：探讨前列腺癌患者去势手术后雄激素水平降低及对血脂代谢的影响。方法：对诊断明确的36例进展期前列腺癌患者行双侧睾丸切除术,分别于术前、术后1、3、6个月及1年测定血清睾酮（T）、游离睾酮（FT）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A1（APO-A1）、载脂蛋白B（APO-B）。结果：去势术后1个月,T、FT较术前明显降低（0．45±0．05ng／mlVS4．88±0．21ng／ml,P〈0．01;2．09±0．56pmol／I。VS35．25±4．20pmol／I,,P〈0．01）,以后持续下降,术后6个月降至最低。TG于术后1个月开始较术前显著升高（1．88±0．28mmol／L,VS1．38±0．20mmol／L,P〈0．01）。FC、LDL-C于术后3个月开始较术前明显升高（5．29±0．7lmmol／L VS3．6l±0．59mmol／L,P〈0．01;3．13±0．44mmol／L VS1．72±0．26mmol／L,P〈0．01）,以后呈继续上升趋势。HDL-C于术后3个月开始较术前明显降低（1．47±0．28rnmol／L VS1．86±0．24mmol／L,P〈0．01）。APO-A1、APO—B在手术前后无明显变化。结论：前列腺癌患者去势手术后,随着雄激素水平的降低,出现血脂代谢异常,TG、TC、LDL-C升高,HDL-C降低,可能使相关心血管疾病的发生率增加。     

去势后大鼠腹叶前列腺微循环的改变

目的:探讨去势后大鼠腹叶前列腺微循环的改变,及微循环的改变对前列腺细胞凋亡的作用。　方法: Sprague Dawley雄性大鼠36只,随机分为6组,一组作正常对照,其余5组分别于去势后12h、24h、72h、7d和14d 采用D95生理信号采集系统行活体微循环测量,然后再行墨汁灌注示踪微血管床变化。　结果:去势后大鼠腹叶前 列腺微循环发生显著改变,微血管密度和直径下降,流速减慢,以远端腺管最为显著。　结论:大鼠去势后前列腺微 循环的改变参与了前列腺细胞凋亡的机制,可能是前列腺“凋亡漂移现象”的机制。     

Periodic Duplex Ultrasonography Screening Together with Elective Percutaneous Transluminal Angioplasty in the Management of Graft Arteriovenous Fistulas for Hemodialysis

Purpose To evaluate the effectiveness of regular duplex ultrasonography in the management of graft arteriovenous fistulas for hemodialysis. Methods Between March 1997 and December 2004, we prospectively studied consecutive patients who underwent polytetrafluoroethylene graft arteriovenous (AV) fistulae in the upper extremity with a subsequent regular duplex ultrasound examination for the identification of stenosis. The main ultrasound-guided indication for percutaneous transluminal angioplasty (PTA) was the identification of 50% or more venous stenosis. The assisted primary and secondary patency rates of vascular access were calculated in these 36 patients and were then compared with those in 19 patients who had undergone graft AV fistula before the start of regular ultrasonographic screening. Results The mean follow-up lasted 25 months. PTA procedures were performed in 24 patients, of which 13 patients received multiple PTAs. The half survival time (secondary patency) of the graft was 49 ± 3.8 months in patients who had undergone ultrasound screening followed by elective PTA, which was significantly (P < 0.01) longer than the 22 ± 7.1 months observed in patients who had not undergone regular duplex ultrasound screening. Conclusion The prospective monitoring of AV fistula with ultrasound is a simple and reliable technique for detecting graft AV outflow stenosis. Elective PTA is therefore considered to be an effective therapy for the maintenance of hemodialysis access.     

Effect of Castration on Lectin Staining in Rat Epididymis

Seven rhodamine-conjugated lectins (PNA, RCA I, Con A, WGA, UEA I, SBA, DBA) were used to follow the staining pattern of the rat epididymis at different time points after castration. The affinity of the intratubular sperm mass for the lectins increased rapidly with concurrent augmentation of the staining in the principal cells but a decline of the reaction in the light cells. The light cells showed some differences in their response to castration, which was compatible with secretory/absorptive activity in caput and absorptive activity in cauda. The active phase of sperm mass destruction and epithelial involution was accompanied by local accumulation of macrophages and round cells, which also acquired an increased affinity for most of the lectins. It is concluded that the androgen-deprived epididymis is rapidly programmed for autolytic and phagocytic processes, which include the destruction of macromolecules including glycoproteins of the spermatozoa.