抗肿瘤坏死因子-α单克隆抗体对大鼠溃疡性结肠炎的影响

目的观察抗肿瘤坏死因子-α(TNF-α)单克隆抗体对大鼠溃疡性结肠炎(UC)的影响。方法将30只雄性大鼠随机分为3组:正常对照组、模型组和实验组,各10只。模型组和实验组大鼠用三硝基苯磺酸.乙醇液灌肠诱导建立UC大鼠急性期模型。然后实验组大鼠采用抗TNF-α单克隆抗体治疗,模型组和正常对照组大鼠从尾静脉注射0.9%氯化钠溶液。6 d后同时处死3组大鼠,观察其结肠质量、结肠组织髓过氧化物酶(MPO)活性、血清TNF-α水平及结肠组织TNF-α mRNA表达量,并以此评价炎症和损伤程度。结果3组大鼠结肠质量/体质量(mc/mb)、MPO活性、血清TNF-α水平和结肠组织TNF-α mRNA表达量间两两比较,差别均有统计学意义(P均<0.01)。mc/mb、MPO活性、血清TNF-α水平、结肠组织TNF-α mRNA表达量两两之间呈正相关(P<0.01)。结论抗TNF-α单克隆抗体可以减少UC大鼠血清TNF-α水平和结肠组织MPO活性及TNF-α mRNA表达量,使UC大鼠炎症反应减轻。     

益气活血化痰汤对溃疡性结肠炎大鼠结肠组织VEGF和ICAM-1基因表达的影响

【目的】观察益气活血化痰汤对溃疡性结肠炎(UC)模型大鼠结肠黏膜血管内皮细胞生长因子(VEGF)和细胞间黏附分子-1(ICAM-1)基因表达的作用。【方法】采用三硝基苯磺酸(TNBS)法复制UC大鼠模型,将60只大鼠分为正常组,模型组,中药高、中、低剂量组(剂量分别为52、26、13 g·kg~(-1)·d~(-1))和美沙拉嗪组(剂量为0.5 g·kg~(-1)·d~(-1)),分别检测各组大鼠体质量、结肠黏膜病理变化,以及肠黏膜VEGF、ICAM-1基因表达水平。【结果】模型组体质量显著降低,结肠黏膜出现明显病理改变,VEGF和ICAM-1基因相对表达量均显著高于正常组(P0.01)。中药各剂量组均可显著升高大鼠体质量,改善结肠黏膜病理变化,显著降低VEGF、ICAM-1表达水平(P0.01),其中中药高剂量组作用更佳。【结论】益气活血化痰汤对VEGF和ICAM-1基因表达有下调作用,这可能是其治疗UC作用的机理之一。     

溃结2号方对溃疡性结肠炎大鼠溃疡组织中IL-1β及IL-10 mRNA表达的影响

【目的】观察溃结2号方对实验性溃疡性结肠炎(ulcerative colitis,UC)模型大鼠结肠溃疡组织白细胞介素1β(IL-1β)、白细胞介素10(IL-10)mRNA表达的影响。【方法】采用2,4,6-三硝基苯磺酸(2,4,6-trinitrobenzene sulfonic acidTNBS)及免疫诱导法复制UC大鼠模型,将造模成功的36只大鼠随机分为模型组、中药组(剂量为16.76 g.kg-1.d-1)、柳氨磺吡啶(SASP)组(剂量为0.206 g.kg-1.d-1),每组各12只。观察各组大鼠治疗14 d及21 d后结肠组织的病理改变,采用逆转录—聚合酶链反应(RT-PCR)方法检测大鼠结肠组织中IL-1βmRNA、IL-10 mRNA的表达。【结果】给药14 d时,中药组大鼠结肠组织中IL-1βmRNA、IL-10 mRNA表达与模型组及SASP组比较差异均无统计学意义(P>0.05);给药21 d时,中药组大鼠结肠组织中IL-1βmRNA表达量显著低于模型组(P<0.01),IL-10 mRNA表达显著高于模型组(P<0.01)。中药组对UC大鼠结肠组织病理损伤具有修复作用,且效果优于SASP组。【结论】溃结2号方对UC的治疗作用与其能调节结肠组织IL-1βmRNA、IL-10 mRNA表达水平有关。     

溃结灵对溃疡性结肠炎大鼠结肠粘膜NF-κB p65蛋白表达及血清TNF-α含量的影响

【目的】观察溃结灵对溃疡性结肠炎(UC)大鼠结肠粘膜核因子-κB(NF-κB)p65蛋白表达及血清肿瘤坏死因子-α(TNF-α)的影响。【方法】将SD大鼠60只随机分为6组,即正常组,模型组,柳氮磺胺吡啶(SASP)组(剂量为0.5 g.kg-1.d-1),溃结灵高、中、低剂量组(剂量分别为18.3、9.2、4.6 g.kg-1.d-1)。除正常组外,其他各组均采用三硝基苯磺酸(TNBS,100 mg.kg-1)复制UC模型;采用酶联免疫(ELISA)法检测血清样本中TNF-α的含量;处死动物,取结肠组织固定,组织切片进行免疫组织化学染色,光镜下计数NF-κB p65阳性细胞表达率,并进行统计学分析。【结果】溃结灵高、中剂量组血清TNF-α含量及结肠粘膜NF-κB p65蛋白阳性细胞表达率显著性低于模型组(均P<0.01)。【结论】溃结灵可降低大鼠结肠粘膜NF-κB p65蛋白表达及血清TNF-α的含量,这可能是其治疗UC作用的机理之一。     

英夫利昔单抗对溃疡性结肠炎大鼠的疗效评价与作用机制研究

目的评价英夫利昔单抗治疗溃疡性结肠炎(UC)实验大鼠的效果,并初步探讨其作用机制。方法40只健康雄性Wistar大鼠随机分成正常对照组、损伤组、泼尼松组和英夫利昔组,每组10只,其中后3组建立三硝基苯磺酸(TNBS)UC大鼠模型。英夫利昔组给予英夫利昔30 mg/kg腹腔注射,造模第7天、14天各给药1次;泼尼松组给予泼尼松6 mg/kg灌胃,正常对照组和损伤组给予等体积生理盐水灌胃,造模第7～20天每日1次灌胃;造模第21天处死大鼠。观察各组大鼠结肠黏膜的病理改变,并用酶联免疫法(ELISA)检测各组大鼠的外周血清、结肠黏膜及脾脏中肿瘤坏死因子α(TNF-α)、白介素-10(IL-10)的含量。结果病理组织学观察显示,正常对照组结肠黏膜结构基本正常,损伤组可见典型黏膜炎症表现,泼尼松组和英夫利昔组炎症病变明显减轻。TNF-α、IL-10检测显示,与正常对照组比较,损伤组外周血清、结肠黏膜、脾脏中的TNF-α含量升高、IL-10含量降低(P<0.05);与损伤组比较,英夫利昔组外周血清、结肠黏膜、脾脏中的TNF-α降低,外周血清、结肠黏膜的IL-10含量升高(P<0.05),其中英夫利昔组血清及肠黏膜的TNF-α含量较泼尼松组降低(P<0.05);各组脾脏组织中IL-10含量的差异无统计学意义(P>0.05)。结论英夫利昔单抗能改善UC大鼠结肠黏膜的炎症病理改变,对UC大鼠有较好的治疗效果;其作用是通过抑制体内TNF-α的表达及提高IL-10的表达而实现的。     

益生菌对溃疡性结肠炎大鼠结肠黏膜中IL-1和TNF-α表达的影响

目的 观察益生菌对溃疡性结肠炎(UC)大鼠结肠黏膜IL—1β mRNA和TNF-α mRNA表达的影响。方法 用乙酸制备UC大鼠模型，将24只大鼠分为正常对照组、模型组、柳氮磺胺吡啶(SASP)组、益生菌组，10d后各组所得结肠标本，行HE染色，观察镜下结肠病理变化，并应用原位杂交技术检测结肠黏膜中IL-1β mRNA和TNF-α mRNA表达。结果 SASP和益生菌均可显著改善UC大鼠结肠黏膜的病理变化，且明显降低黏膜中IL-1β mRNA和TNF-α mRNA的表达。结论 益生菌可通过抑制IL-1β mRNA和TNF-α mRNA炎症因子的表达而减轻大鼠结肠黏膜的损伤，达到治疗UC的目的，其疗效与SASP相当。     

清热祛湿法联合培菲康对溃疡性结肠炎大鼠疗效及IL-10、TNF-α表达的影响

【目的】探讨清热祛湿法联合培菲康对2,4,6-三硝基苯磺酸(TNBS)诱导的溃疡性结肠炎(UC)大鼠的疗效,以及对结肠组织中白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平的影响。【方法】选用成年雌性SD大鼠40只,随机分为正常组、模型组、培菲康组(剂量为175 mg/kg)、中药组(肠涤清3.6 g/kg灌肠+肠炎清1号方10 g/kg灌胃)、中药+培菲康组。经不同处理和治疗后,观察各组结肠黏膜损伤程度;采用免疫组织化学染色观察各组结肠组织中IL-10、TNF-α的表达水平。【结果】与正常组比较,模型组结肠黏膜损伤程度最严重,炎症反应最明显(P0.01);与模型组比较,各治疗组结肠黏膜损伤程度和炎症反应均显著减轻(P0.01);各治疗组间比较,中药联合培菲康组可显著降低大鼠结肠黏膜损伤指数(CMDI),能有效抑制炎症反应,促进肠黏膜愈合(P0.05)。与正常组比较,模型组结肠黏膜TNF-α表达水平显著增加(P0.01),IL-10表达水平显著降低(P0.01);与模型组比较,各治疗组可显著降低结肠黏膜TNF-α表达水平(P0.01),增加IL-10表达水平(P0.01);各治疗组间比较,中药联合培菲康组、中药组可显著降低结肠黏膜TNF-α表达水平,增加IL-10表达水平,其作用优于培菲康组(P0.05);中药联合培菲康组作用优于中药组,差异有统计学意义(P0.05)。【结论】清热利湿法联合培菲康对溃疡性结肠炎大鼠有良好的治疗作用,其作用机制可能与增加IL-10表达水平、降低TNF-α表达水平有关。     

针刺对腹部术后大鼠胃肠动力及炎症反应的影响

【目的】观察针刺对腹部术后大鼠胃肠动力及炎症反应的影响。【方法】选用SD大鼠,随机分为空白组、假手术组(行开腹关腹操作)、模型组(行结肠吻合术)、针刺组,针刺组及假手术组术后均针刺双侧足三针(足三里、三阴交、太冲),连续3d。检测各组大鼠排便情况、核扫描胃液相排空实验及结肠组织病理变化。【结果】针刺组与假手术组均能显著缩短腹部术后首次排便时间,增加排便粒数和质量,降低60min胃残留率(均P0.05或P0.01);针刺能促进结肠吻合术后结肠组织的溃疡愈合,减轻炎症水肿。【结论】针刺足三针对腹部术后胃肠运动功能的调整作用与其能促进胃排空及减轻结肠组织病理损害有关。     

黄芪多糖对溃疡性结肠炎大鼠结肠黏膜的修复作用及其作用机制研究

目的研究黄芪多糖对溃疡性结肠炎(UC)大鼠结肠黏膜的修复作用及对肠道炎症反应、黏膜屏障的影响,旨在阐明黄芪多糖治疗UC的分子机制。方法将60只Wister雄性大鼠随机分为空白组,模型组,柳氮磺胺吡啶组,黄芪多糖高、中、低剂量组,每组10只。采用三硝基苯磺酸诱导UC大鼠模型,空白组及模型组予生理盐水灌胃,各药物组分别予柳氮磺胺吡啶及高、中、低剂量的黄芪多糖灌胃,连续灌胃7 d后,取结肠组织进行病理组织学观察、评分和髓过氧化物酶(MPO)活性测定,并采用酶联免疫吸附法(ELISA)测定结肠组织中肿瘤坏死因子-α(TNF-α)、表皮生长因子(EGF)和转化生长因子-β(TGF-β)的含量,通过免疫印迹实验测定结肠紧密连接蛋白Occludin及ZO-1的表达。结果黄芪多糖可剂量依赖性地降低UC大鼠结肠病理组织学评分,结肠组织中的MPO活性及TNF-α、TGF-β含量,升高EGF含量及Occludin、ZO-1蛋白表达水平(P0.05或P0.01),改善大鼠结肠黏膜的病理改变。结论黄芪多糖对UC的治疗作用与减轻肠道炎症反应、促进肠道黏膜修复、改善肠道黏膜屏障功能有关。     

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.     

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.