参附对大鼠肠缺血再灌注时肠上皮细胞Caspase-3,Bcl-2基因表达的影响

目的研究参附注射液(简称参附)对大鼠肠缺血再灌注期间黏膜上皮细胞凋亡的影响,并探讨其可能机制.方法采用大鼠肠缺血再灌注模型.24只大鼠随机分为对照组(C组)、缺血再灌注组(I/R组)和参附治疗组(SF组),SF组于阻断前30 min静注SF液2 mL/100g.再灌注2 h检测回肠黏膜上皮细胞Cas-pase-3,Bcl-2蛋白的表达及细胞凋亡;同时观察小肠黏膜病理形态学改变.结果凋亡细胞检测显示I/R组凋亡细胞显著增多,SF组凋亡细胞数较I/R组显著减少而多于C组(均P＜0.05);Caspase-3,Bcl-2蛋白的表达Caspase-3表达I/R组显著多于SF组和C组(P＜0.01),SF组与C组无明显差异;Bcl-2表达SF组显著高于I/R组(P＜0.05),后者显著低于C组(P＜0.05);SF组小肠黏膜病理损伤程度明显减轻I/R组(P＜0.01).结论参附注射液通过抑制Caspase-3表达和促进Bcl-2基因表达减少缺血再灌注期间肠黏膜上皮细胞的凋亡,从而减轻肠黏膜缺血再灌注损伤.     

参附对大鼠缺血再灌注心肌损伤炎症反应的影响

探讨参附对大鼠心肌缺血再灌注损伤的炎症反应的影响。方法 30只健康SD大鼠随机分为假手术组(S组)、缺血再灌注组(I/R组)和参附组(SF组),每组10只。采用结扎左冠状动脉前降支的方法制备缺血再灌注模型。观察各实验组心肌组织病理形态变化,检测心肌组织匀浆中超氧化物歧化酶(SOD)活性和丙二醛(MDA)含量。结果 1)I/R组心肌组织结构紊乱,可见局灶性坏死,明显炎性细胞浸润;与I/R组相比,SF组心肌损伤程度明显减轻,炎性病变显著减轻。2)与I/R组相比,SF组大鼠心肌组织匀浆中SOD活性升高,MDA水平降低。结论 参附能够降低缺血再灌注心肌炎性反应,从而减轻心肌组织缺血再灌注损伤。 更多还原     

腺苷A1受体激动剂延迟预处理对兔心肌缺血再灌注损伤的保护作用

目的:探讨腺苷A1受体激动剂2-氯环戊腺苷(2-chloro-N6-cyclopentyladenosine,CCPA)延迟预处理对兔心肌缺血再灌注损伤的保护机制.方法:30只健康新西兰雄性大白兔随机分成3组:假手术组(C组)、缺血再灌注组(I/R组)、CCPA组(P组),每组10只.C组仅行左冠脉套线而不阻断160min,I/R组行左冠脉阻断40min,再灌注120min,P组在静注CCPAO.1mg/kg24 h后处理同I/R组.各组分别于左冠前降支阻断前加min(T1)、左冠前降支阻断20min(T2)、左冠前降支阻断40min(T3)、心肌再灌注I h(T4)心肌再灌注2 h(T5)5个时点抽取颈内动脉血测定血清中IL-10含量.再灌注120 min后,测心肌热休克蛋白70(Heat shock protein 70,HSP70)蛋白表达和心梗面积,电镜下观察细胞超微结构变化.结果:与I/R组比,P组IL-10含量和HSP70表达增高(p＜0.05),心肌梗死面积减少(P＜0.05),细胞结构损伤减轻.结论:CCPA延迟预处理通过增高心肌HSP70表达和IL-10水平来减轻缺血再灌注损伤发挥心肌保护作用.     

吗啡预处理对兔心肌缺血再灌注损伤的延迟相保护作用

目的:探讨吗啡预处理对兔心肌缺血再灌注损伤的延迟相保护作用机制.方法:30只雄性新西兰大白兔随机分成3组:假手术组、缺血再灌注组(I/R组)、吗啡组,每组10只.假手术组仅行左冠脉套线而不阻断160 min,I/R组行左冠状动脉前降支阻断40 min,再灌注120 min,吗啡组静注吗啡1.0 mg/kg,24 h后处理同I/R组.再灌注结束后抽血测超氧化物歧化酶(SOD)活性和丙二醛(MDA)含量,观察心肌超微结构,测心梗面积和热休克蛋白-27(HSP27)的表达.结果:与I/R组比,吗啡降低心肌梗死面积,上调HSP27表达和SOD活性,降低MDA含量,改善细胞超微结构.结论:吗啡预处理可能通过HSP27对兔心肌产生延迟相保护作用,其机制与HSP27抗过氧化损伤有关.     

参附注射液对大鼠肠缺血再灌注时肠上皮细胞Caspase-3、Bcl-2基因表达的影响

目的 :研究参附注射液对大鼠肠缺血再灌注期间粘膜上皮细胞凋亡的影响 ,并探讨其可能机制。方法 :采用大鼠肠缺血再灌注模型。 2 4只大鼠随机分为对照组 (C组 )、缺血再灌注组 (I/R组 )和参附治疗组 (SF组 ) ,SF组于阻断前 30min静注SF液 2ml·(1 0 0 g) -1 。再灌注 2h检测回肠粘膜上皮细胞casapse 3、Bcl 2蛋白的表达及细胞凋亡 ;同时观察小肠粘膜病理形态学改变。结果 :①凋亡细胞检测显示 :I/R组凋亡细胞显著增多 ,SF组凋亡细胞数较I/R组显著减少而多于C组 (均P <0 .0 5 )。②casapse 3、Bcl 2蛋白的表达 :caspase 3表达I/R组显著多于SF组和C组 (P <0 .0 1 ) ,SF组与C组无明显差异 ;Bcl 2表达SF组显著高于I/R组 (P <0 .0 5 ) ,后者显著低于C组 (P <0 .0 5 )。③SF组小肠粘膜病理损伤程度明显减轻I/R组 (P <0 .0 1 )。结论 :参附注射液通过抑制caspase 3表达和促进Bcl 2基因表达减少缺血再灌注期间肠粘膜上皮细胞的凋亡 ,从而减轻肠粘膜缺血再灌注损伤     

参附注射液对大鼠缺血再灌注心肌Bcl-2、Bax与c-fos基因蛋白表达的影响

目的 观察大鼠急性缺血再灌注损伤与凋亡相关基因Bcl-2、c-fos和Bax蛋白表达的关系及参附注射液(SF)的影响.方法 采用整体缺血再灌注(ischemia-reperfusion,IR)模型,35只大鼠分为假手术组(C组)、生理盐水30 min对照组(IR 30)、生理盐水120 min对照组(IR 120)、SF 30 min组(SF 30)和SF 120 min组(SF 120),心肌缺血40 min再灌注30 min或120 min后,用免疫组化法检测Bcl-2、Bax和c-fos在心肌中的表达量.结果 与C组比较,IR组心肌Bcl-2、Bax和c-fos蛋白表达显著升高(P＜0.01),Bcl-2/Bax比值显著下降(P＜0.01);与IR组比较,SF组Bcl-2蛋白表达显著升高(P＜0.01),Bax和c-fos蛋白表达显著降低(P＜0.01),Bcl-2/Bax比值显著升高(P＜0.01).结论 SF对IR心肌保护效应可能与其促进Bcl-2蛋白高表达、抑制Bax与c-fos蛋白表达、增加Bcl-2/Bax比值,从而抑制心肌细胞凋亡有关.     

脑利钠肽后处理对在体大鼠缺血再灌注后心肌损伤的影响

目的 探讨脑利钠肽(BNP)后处理对在体大鼠心肌缺血再灌注损伤心肌的保护作用.方法 24只雄性Sprague-Dawley大鼠,随机分为:(1)假手术组(SHAM组):只开胸,不结扎冠状动脉;(2)缺血再灌注组(I/R组):结扎冠状动脉左前降支45 min,再灌注 3 h;(3)脑利钠肽组(BNP组):结扎冠状动脉左前降支45 min,再灌注 3 h,在再灌注前10 min,开始静脉予BNP 0.01 μg/(kg ·min),BNP静脉恒速维持至再灌注结束.用2,3,5,氯化三苯基四氮唑检测缺血再灌注心肌的梗死面积,用TUNEL方法检测缺血再灌注心肌的凋亡,检测心肌组织超氧化物歧化酶(SOD)、丙二醛(MDA)的浓度以评估缺血再灌注心肌活性氧的水平.结果 SHAM组心肌无梗死,I/R组的大鼠梗死面积为(44.02±10.15)%,BNP组的梗死面积为(21.53±9.08)%(P＜0.05).SHAM组、BNP组与I/R组的心肌细胞凋亡指数分别为(3.13±1.62)%、(19.45±9.62)%和(38.46±12.31)% (P＜0.05).与I/R组相比,BNP组的缺血再灌注心肌组织中MDA减少(P＜0.05),而SOD增多(P＜0.05).结论 BNP后处理能减少在体大鼠缺血再灌注的心肌损伤,其机制与其减少心肌缺血再灌注损伤导致的心肌细胞凋亡及降低心肌缺血再灌注损伤时的活性氧水平相关.     

热休克蛋白70在瑞芬太尼后处理减轻大鼠肝脏缺血再灌注损伤中的作用

目的 探讨热休克蛋白70（HSP70）在瑞芬太尼后处理减轻大鼠肝脏缺血再灌注损伤（HIRI）中的作用。 方法 将24只SD大鼠随机分为4组（n＝6）：假手术组（S组）、HIRI组（I/R组）、瑞芬太尼组（R组）和槲皮素组（Q组）。制备大鼠HIRI模型。R组再灌注开始10 min内给予瑞芬太尼4 g/kg;Q组在给予瑞芬太尼前先给予槲皮素7 mg/kg。再灌注结束检测血清丙氨酸氨基转移酶（ALT）和天门氨酸氨基转移酶（AST）活性以及肝组织超氧化物歧化酶（SOD）活性、丙二醛（MDA）和HSP70含量。 结果 与S组比较,其余3组血清ALT、AST活性和肝组织MDA、HSP70含量均升高,而肝组织SOD活性I/R组和Q组降低,R组升高（P＜0.05）。与I/R组比较,R组血清ALT、AST活性和MDA含量降低,而肝组织SOD活性和HSP70含量升高（P＜0.05）。 结论 瑞芬太尼后处理可减轻大鼠HIRI的急性肝损伤,抑制肝脏脂质过氧化反应,其作用机制与增强肝组织HSP70表达有关。     

参附注射液对缺血再灌注心肌炎症反应的影响

目的探讨参附注射液对大鼠缺血再灌注心肌组织内核转录因子-кB (NF-кB)活性、细胞间粘附分子-1(ICAM-1)和白细胞介素-6(IL-6)水平的影响.方法健康SD大鼠36只随机分为三组,空白对照组(S组)、缺血再灌注组(I/R组)、参附注射液组(SF组),每组12只.采用钳闭左冠状动脉前降支制备心肌缺血再灌注模型.电镜观察超微改变,免疫组织化学法检测心肌NF-кB活性和ICAM-1水平,ELISA法检测大鼠心肌IL-6水平.结果 1.电镜观察超微改变:I/R组部分肌纤维断裂,肌节模糊,线粒体肿胀,部分线粒体膜破裂,核膜完整高度皱缩,染色质浓缩边聚、呈块状;但SF组上述病变程度明显减轻.2.S组和SF组NF-кB活性、ICAM-1和IL-6水平显著低于I/R组 (P＜0.01),但SF组NF-кB活性和IL-6水平高于S组(P＜0.05).结论参附注射液能抑制缺血再灌注心肌NF-кB活性和降低ICAM-1和IL-6水平,减轻缺血再灌注心肌炎症反应.     

当归对大鼠缺血再灌注心肌HSP70和NF-κB的影响

目的观察当归注射液对缺血再灌注(I/R)过程心肌热休克蛋白70(HSP70)和核转录因子κB(NF-κB)表达的影响,探讨当归抗心肌缺血再灌注损伤的可能作用机理.方法45只SD大鼠随机分成3组(每组n=15)假手术组(Ⅰ组),缺血再灌注组(Ⅱ组),当归治疗组(Ⅲ组),建立在体心肌缺血再灌注动物模型.每组5只动物再灌注40 min用化学扩增法测定SOD活性,TBA法测定MDA含量;10只动物再灌注120 min测定HSP70免疫组化SP法观察心肌细胞HSP70蛋白表达,用ESMA法观察NF-κB的变化,在电镜下观察心肌细胞的超微结构.结果再灌注前注射当归注射液显著降低了再灌注心肌MDA水平(P<0.01),增强了SOD活性(P<0.01)和HSP70的表达(P<0.01),减低NF-κB的活性,同时减轻了心肌的超微结构损伤.结论当归注射液可通过抗氧化作用、增加HSP70的表达和减低NF-κB的活性发挥抗心肌缺血再灌注损伤,对心肌有明显的保护作用.     

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.