大鼠严重烧伤早期心肌线粒体Ca2+转运变化及其机制研究

目的 探讨严重烧伤早期心肌线粒体Ca^2 转运变化及其发生机制。方法 复制30%Ⅲ度烫伤大鼠模型,测定伤后1、3、6、12、24h大鼠心肌线粒体Ca^2 转运速率,同时检测影响Ca^2 转运的相关指标--心肌细胞胞浆Ca^2 浓度（[Ca^2 ]c）、线粒体膜电位及ATP含量。结果 伤后1h心肌线粒体Ca^2 摄取速率明显升高,而Ca^2 释放速率无明显改变,但3、6、12、24h心肌线粒体Ca^2 摄取与释放速率、线粒体膜电位、ATP含量均显著降低,且烧伤后线粒体Ca^2 摄取速率与膜电位呈明显正相关,Ca^2 释放速率与线粒体ATP含量呈显著正相关。而伤后3、6、12、24h[Ca^2 ]c均明显高于正常对照组。结论 ①烧伤初始心肌线粒体Ca^2 摄取加强,伤后续阶段线粒体Ca^2 转运紊乱;②线粒体膜电位下降、ATP含量降低是烧伤后续阶段心肌线粒体Ca^2 转运紊乱的主要原因,伤后[Ca^2 ]c升高或有升高趋势也参与严重烧伤早期心肌线粒体Ca^2 转运变化的发生。     

妊娠高血压综合征患者胎盘滋养细胞线粒体ATP酶和氧自由基变化的研究

目的 测定妊高征患者胎盘滋养细胞线粒体ATP酶活性及氧自由基的变化，探讨其在妊高征发病机制中的作用。方法 选取妊高征患者（53例）及正常妊娠妇女（32例）胎盘，匀浆后提取线粒体。分别测定线粒体Ca^2＋-Mg^2＋-ATP酶、SOD的活性及MDA含量变化。结果 重度妊高征患者胎盘滋养细胞线粒体Ca^2＋-Mg^2＋-ATP酶、SOD活性与正常孕足月胎盘相比明显降低，而MDA含量却明显升高（P〈0．05）；Ca^2＋-Mg^2＋-ATP酶活性与MDA含量呈负相关，而与SOD呈正相关。结论 重度妊高征患者胎盘滋养细胞线粒体ATP酶活性显著降低，自由基增多，提示自由基抑制ATP酶活性。促进妊高征病情进展。     

阿霉素对实验兔心肌细胞内游离钙和肌浆网Ca2+-ATP酶活性的影响

目的：探讨治疗剂量阿霉素（ADR）对心脏血流动力学及心肌肌浆网Ca^2 －ATP酶活性的影响。方法：实验兔每周静脉注射ADR（2mg/kg）1次，共8周，以健康同龄兔静脉注射等量生理盐水为对照组。这药3周后多普勒测定降主动脉血流量，以代表心输出量（CO），左颈总动脉和左心室插管测定血压（BP），平均动脉压（MAP），左心室收缩压（LVSP），左心室舒张末压（LVEDP）。应用荧光分光光度计测定心肌细胞内游离钙（MyoCa^2 ）浓度，无机磷酸根法测定心肌肌浆网（SR）Ca^2 －ATP酶活性。结果：阿霉素组CO、BP、MAP、LVSP均较对照组低，而VEDP则明显增高。阿霉素组使MyoCa^2 浓度显著增高，同时SR Ca^2 -ATP酶活性明显低于对照组。结论：治疗剂量阿霉素可使心脏功能下降，心肌细胞内钙超载及SR Ca^2 －ATP酶活性降低。     

原发性高血压患者红细胞[Ca2+]i浓度变化及影响因素

目的：观察原发性高血压患者红细胞[Ca^2 ]i,多巴胺β羟化酶及ATP含量变化并分析其结果。方法：测定35例高血压患者的红细[Ca^2 ]i、ATP、血清多巴胺β羟化酶活性,血糖及血浆胰岛素含量,并以30例健康成年人为对照。结果：高血压患者的红细胞[Ca^2 ]i、ATP、多巴胺β羟化酶均明显高于对照组（P＜0．05,P＜0．01）,但血糖与胰岛素未见明显变化。结论：高血压患者血清多巴胺β羟化酶活性增强伴随ATP与[Ca^2 ]i升高。     

Ca2+在严重烧伤早期心肌线粒体呼吸功能损害中的作用及其机制研究

目的 探讨Ca^2 在严重烧伤早期心肌线粒体呼吸功能损害中的作用及其机制。方法 复制30％TBSAⅢ度烧伤大鼠模型，取正常及伤后1、3、6、12、24h大鼠心肌分离线粒体，测其Ca^2 浓度（[Ca^2 ]m）、线粒体PLA2（mPLA2)、一氧化氮合酶(mtNOS）、F0F1－ATPase和细胞色素c氧化酶活性，同时观察心肌线粒体呼吸功能变化。结果 ①伤后1h[Ca^2 ]m与线粒体呼吸控制率（RCR）均明显升高，且RCR与[Ca^2 ]m呈显著正相关；伤后3、6、12、24h心肌[Ca^2 ]m、mtPLA2及mtNOS活性均显著高于正常组，但线粒体呼吸功能反而下降，RCR与[Ca^2 ]m呈明显负相关，mtNOS、mtPLA2活性与[Ca^2 ]m呈明显正相关。②伤后1h线粒体F0F1－ATPase合成活性明显升高，但3、6、12、24h其合成活性与细胞色素c氧化酶活性均显著低于正常组；F0F1－ATPase水解活性除伤后3h显著升高外，其余各时相点均明显低于正常对照组。结论 [Ca^2 ]m改变是烧伤后心肌线粒体呼吸功能变化的重要原因，烧伤初始[Ca^2 ]m适度升高，促进线粒体呼吸功能加强；烧伤后续阶段Ca^2 严重超载激活mtPLA2、mtNOS在线粒体呼吸功能损害中起重要作用。     

川芎嗪对大鼠心肌缺血损伤的保护作用

目的：探讨川芎对大鼠心肌缺血损伤保护作用。方法：大鼠随机分对照组、缺血组和川芎嗪保护组。采用皮下注射异丙肾上腺素（ISP，5mg/kg),24h后再注射同剂量一次，造成心肌缺血损伤模型。观测心肌线粒体中Ca^2 －ATP酶、Ca^2 -Mg^2 -ATP酶活力，以及心肌组织和线粒体中Ca^2 、Mg^2 含量。结果：川芎嗪保护组心肌线粒体Ca^2 －ATP酶、Ca^2 -Mg^2 －ATP酶活力较缺血组均有显著性升高（P＜0．01），且川芎嗪可稳定心肌组织及线粒体Ca^2 、Mg^2 含量。结论：川芎嗪对大鼠心肌缺血损伤有保护作用，其机理可能与抑制钙超载有关。     

热休克蛋白70对兔未成熟心肌和心肌间质的影响

目的: 探讨热休克蛋白70(HSP70)对未成熟心肌和心肌间质的影响. 方法:健康新生长耳大白兔12只随机分为2组. 对照组(C组):ip生理盐水0.4 mL,24 h后取离体心脏,常规建立Langendorff离体心脏灌注模型,灌注15 min转为工作心15 min后停灌45 min,恢复灌注15 min改为工作心30 min;实验组(E组):ip去甲肾上腺素, 24 h后取离体心脏,方法同对照组. 测定心肌细胞中HSP70含量、血流动力学指标、心肌含水量(MWC)、心肌肌酸激酶(CK)和乳酸脱氢酶(LDH)漏出率、三磷酸腺苷(ATP)含量、超氧化物歧化酶(SOD)和丙二醛(MDA)含量、心肌组织羟脯氨酸(HP)含量、内皮素(ET) 含量、心肌细胞内Ca2 含量、心肌线粒体Ca2 -ATPase活性及其Ca2 含量、心肌线粒体合成ATP能力[ATP]m,心肌超微结构. 结果:E组HSP70含量明显高于C组(P<0.01);MWC低于C组(P<0.05);ATP含量、SOD活性、心肌线粒体Ca2 -ATPase活性、[ATP]m, HP含量优于C组(P<0.01),MDA含量、CK, LDH漏出率、心肌细胞内Ca2 含量、心肌线粒体Ca2 含量、ET含量低于C组(P<0.01),心肌超微结构损伤较C组明显减轻. 结论:HSP70对缺血再灌注未成熟心肌和心肌间质具有明显的保护作用.     

定心方对大鼠缺氧及正常心肌细胞内[Ca~(2+)]_i、细胞膜电位和线粒体膜电位的影响

目的 :探讨定心方抗心律失常的分子机制。方法 :大鼠击晕后取心脏 ,用链酶蛋白酶消化分离单个心肌细胞 ,再用不同荧光染料分别标记细胞 ,在激光共聚焦显微镜上测定定心方血清对心肌细胞内 [Ca2 + ]i、细胞膜电位和线粒体膜电位的影响。结果 :缺氧使心肌细胞内钙浓度和线粒体膜电位升高 ,而使细胞膜电位降低 ,定心方血清降低了正常和缺氧心肌细胞内 [Ca2 + ]i,改善了缺氧引起的膜电位降低 ,使缺氧状态下细胞线粒体膜电位保持在基线水平。结论 :定心方使细胞内 [Ca2 + ]i 降低 ,维持细胞膜电位和线粒体膜电位接近于正常水平     

逆行灌注心脏不停跳心肌保护的实验研究

目的：探讨逆行灌注心脏不停跳心肌保护的效果。方法：中国大白兔32只随机分为4组，每组8只，A组（对照组），B组（心脏不停跳组，血温34℃），C组（温血心脏麻痹液组，血温34℃），D组（冷血心脏麻痹液组，血温4℃）。采用离体兔心左室做功模型，经冠状静脉窦逆行灌注稀释血液或血停搏液60min。比较观察心功能、冠脉排出液心肌酶谱、心肌组织乳酸、心肌细胞内游离钙浓度、心肌细胞膜ATP酶活性、心肌细胞膜脂质过氧化产物丙二醛含量的变化。结果：B组心功能恢复、心肌细胞膜ATP酶活性显著优于C组和D组，C组优于D组；B组心肌酶漏出、乳酸生成量、心肌细胞内游离钙浓度、心肌细胞膜丙二醛（MDA）含量低于C组和D组，C组低于D组。结论：常温氧合血逆灌心脏不停跳良好的心肌保护效果与其减轻自由基损伤，较好地保持细胞内外Ca^2 平衡，减轻细胞内钙超载，保护细胞膜酶功能有关。     

心肌保护方法的实验研究

【目的】评价4种心肌保护方法的心肌保护作用。【方法】杂种犬20只，随机分成4组，分别使用4种心肌保护方法：冷晶体心停搏液灌注(G1)、冷血心停搏液灌注(G2)、常温血心停搏液连续灌注(G3)、含血利多卡因高钾心停搏液双向性灌注(G4)。每组动物均经历120min心脏缺血和30min复灌。观察心脏停搏情况，心肌酶水平，心肌细胞内钙离子(Ca^2 )、丙二醛(MDA)、及三磷酸腺苷(ATP)含量及心肌形态改变。【结果】①G3缺血后肌酸激酶同酶(CK—MB)升高无统计学意义；再灌注后Ca^2 与缺血后Ca^2 含量相比无显性差异，并明显低于G1和G4；再灌注后ATP含量无进一步下降。②G1再灌注后MDA含量显高于其他3组。③缺血及再灌注后心肌形态学改变在4组间无明显差异。【结论】常温血心停搏液连续灌注对减轻心肌酶泄漏和再灌注心肌Ca^2 超负荷及ATP下降有明显优势；冷晶体心停搏液灌注对心肌能量保存效果较差，缺血．再灌注性损伤明显。     

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.