牛磺酸对烧伤后早期心肌细胞Fas信号通路的影响

目的 观察牛磺酸对大鼠严重烧伤后早期心肌细胞Fas系统活性的影响。方法 用健康Wistar大鼠，随机分为对照组、烧伤组（造成30％TBSAⅢ度烫伤）、牛磺酸治疗组（烧伤后腹腔注射牛磺酸，剂量300mg／kg）和牛磺酸加SB202190治疗组。于伤后1、3、6、12和24h检测血浆cTnT含量和免疫组化法分析心肌细胞Fas、Caspase-8及Caspase-3蛋白表达变化，荧光分析法测定Caspase-3活性。结果 大鼠烧伤后3h心肌中Fas、Caspase-8及Caspase-3蛋白及其活性即呈显著性升高，伤后24h仍高于对照组（P〈0．05）；牛磺酸治疗组大鼠心肌中各时相点的Fas、Caspasc-8、Caspase-3蛋白水平及Caspase-3活性较烧伤组均有显著性降低（P〈0．05）。结论 牛磺酸对严重烧伤大鼠心肌中Fas、Caspase-8、Caspase-3蛋白的表达及Caspase-3活性升高均有较好的拮抗作用。     

牛磺酸对烫伤大鼠血浆及心肌组织肿瘤坏死因子和血管紧张素Ⅱ含量的影响

目的 观察牛磺酸对大鼠严重烧伤后心肌损害的影响。方法 用健康Wistar大鼠．随机分为对照组、烧伤组(造成30％TBSAⅢ度烫伤)和治疗组(烧伤后腹腔注射牛磺酸．剂量400mg/kg体重)。于伤后l、3、6、12和24h检测血浆TNFα、AngⅡ和cTnT含量与心肌中TNFα、AngⅡ含量。结果 烧伤组伤后3h血浆cTnT即呈显著升高，12h达峰值．24h仍显著高于对照组；烫伤后6h血浆和心肌组织TNFα含量显著高于对照组(P＜0．01)，12h达峰值；伤后lh血浆AngⅡ即显著升高，伤后24h血浆及心肌中AngⅡ仍显著高于对照组；牛磺酸治疗组血浆cTnT、TNFα和AngⅡ水平较烧伤组均有显著性降低。血浆TNFα、AngⅡ含量与血浆cTnT变化密切相关。结论 牛磺酸对严重烫伤后心肌损伤有较好的保护作用。     

Fas系统参与介导烧伤后心肌细胞凋亡及牛磺酸的影响

目的观察Fas系统在烧伤后心肌细胞凋亡中的作用及牛磺酸的影响。方法选健康Wistar大鼠,随机分成对照组(Sham)、烧伤组(造成40%TBSAⅢ度烧伤)和牛磺酸保护组(烫伤后即刻腹腔注射牛磺酸400 mg/kg)。用原位末端标记(TUNEL)法检测凋亡细胞,RT-PCR检测Fas mRNA表达,免疫组化检测Fas/FasL和Caspase-8/3蛋白表达和荧光法分析Caspase-3活性。结果烧伤组大鼠伤后6 h和24 h心肌细胞凋亡指数分别为8.96±2.10和18.67±2.48,较对照组(0.92±0.34)有显著性升高,Fas蛋白阳性表达指数分别为13.51±1.56和14.55±1.89,也显著性高于对照组(2.46±0.75);Caspase-3活性分别为1.38±0.16和1.96±0.71,较对照组(0.35±0.06)有显著性差异。烧伤组凋亡指数与Fas表达之间有良好的相关性(r=0.86)。牛磺酸保护组细胞凋亡指数为2.14±0.68,Fas蛋白表达为3.71±0.82,Fas mRNA表达为0.17±0.03,Caspase-3活性为0.88±0.16,较烧伤组均有显著性降低。结论Fas系统参与了介导烧伤后心肌细胞凋亡,牛磺酸对烧伤后心肌细胞Fas表达及其信号转导有较好的拮抗作用。     

牛磺酸对缺血-再灌注大鼠血浆心肌肌钙蛋白T及心肌GRP78、Caspase-12表达的影响

目的探讨牛磺酸(taurine,Tau)对心肌缺血-再灌注损伤时血浆心肌肌钙蛋白T(cardiac troponin T,cT-nT)及心肌葡萄糖调节蛋白78(glucose-regulated protein 78,GRP78)、胱天蛋白酶(Caspases)-12表达的影响及其意义。方法将50只大鼠按随机数字表法分为5组:假手术组(对照组,Sham组)、缺血-再灌注组(I/R组)和Tau保护1组(Tau 1组)、Tau保护2组(Tau 2组)、Tau保护3组(Tau 3组),每组10只。采用结扎大鼠冠状动脉左前降支1h,随后再灌注24h以建立心肌缺血-再灌注损伤动物模型;Tau 1组、Tau 2组、Tau 3组分别在结扎冠状动脉前1h腹腔注射Tau 100、200、300mg·kg-1,余操作同I/R组;Sham组大鼠冠状动脉左前降支仅穿线,不结扎。采用酶联免疫法测定血浆cTnT水平,TUNEL法检测心肌细胞凋亡,RT-PCR法和免疫组织化学法分析心肌细胞GRP78、Caspase-12基因表达,荧光分析法测定Caspase-3活性。结果与Sham组比较,I/R组大鼠血浆cTnT、心肌组织中GRP78、Caspase-12mRNA和蛋白表达、细胞凋亡指数及Caspase-3活性均显著升高(均P<0.01);与I/R组比较,Tau 1组、Tau 2组、Tau 3组大鼠血浆cTnT水平、心肌组织中GRP78mRNA、Caspase-12mRNA和蛋白表达、细胞凋亡指数及Caspase-3活性均呈显著降低(均P<0.05)。结论 Tau可显著减轻心肌缺血-再灌注损伤,其作用机制可能是Tau能下调缺血-再灌注心肌中GRP78和Caspase-12过表达。     

HSP70在严重烧伤大鼠心肌中的表达及其保护作用的研究

目的 研究热休克蛋白70(HSP70)在严重烧伤大鼠心肌中的表达变化规律，并观察诱导热休克反应对烧伤后心肌损害的保护作用。方法 72只Wistar大鼠随机分为单纯烫伤组(B组)、亚砷酸钠预处理组(SA组)，于致伤前及30％TBSAⅢ度烫伤后3、6、12、24、48h检测血清心肌钙蛋白Ⅰ含量变化，Western blot检测心肌组织HSP70蛋白表达情况。结果 大鼠严重烧伤后3h心肌组织HSP70蛋白表达显著升高，伤后48h达高峰。大鼠烫伤后3h血清心肌钙蛋白Ⅰ(cTnⅠ)含量即开始明显升高，伤后12h达高峰。亚砷酸钠预处理可显著诱导机体的热休克反应，SA组伤后多数时相点血清cTnⅠ含量显著低于B组，且波动幅度较小。结论 严重烧伤早期即可引起心肌组织HSP70蛋白表达显著增强，HSP70蛋白可能在烧伤后早期心肌损害中发挥其内源性抗损伤机制。     

严重烧伤休克期CGRP、NPY变化与心肌损伤的关系

目的 探讨严重烧伤休克期降钙素基因相关肽（CGRP）、神经肽Y（NPY）与心肌损伤的关系。方法 采用放射免疫法测定60例严重烧伤患者不同时相点血中CGRP、NPY、心肌肌钙蛋白（cTnT）含量变化，并分析CGRP、NPY与cTnT相关性。结果 严重烧伤休克期后3hCGRP降低，12h达最低值，伤后48h仍低于正常对照组（P〈0．05）；NPY和cTnT与伤后1h升高，12h达峰值，48h仍高于正常对照组（P〈0．05）；CGRP与cTnT变化呈负相关（P〈0．01），NPY与cTnT变化呈正相关（P〈0．01）。结论 CGRP降低、NPY升高在严重烧伤休克期心肌损伤中起重要作用。     

白虎加人参汤对烧伤大鼠早期心肌保护作用的实验研究

[目的]观察白虎加人参汤对严重烧伤大鼠心肌损害的作用。[方法]将96只SD大鼠随机分为空白组(32只)、中药治疗组(32只)和西药对照组(32只),造成大鼠30%TBSAⅢ度烧伤,中药治疗组伤后灌胃白虎加人参汤,西药治疗组灌胃卡托普利,空白组灌胃等渗盐水;各组烧伤大鼠于伤前和伤后3,6,12,24h检测其血浆中心肌钙蛋T(cTnT)的含量,光镜观察心肌组织形态结构变化。[结果]各组肌钙蛋白水平伤后12h达到峰值,伤后24h仍现增高水平。空白组伤后各时相血浆的肌钙蛋白含量明显高于中药治疗组及西药对照组(P<0.01),中药治疗组及西药对照组之间对比无显著性差异(P>0.05)。镜下显示中药及西药组均较空白组的心肌损伤轻。[结论]白虎加人参汤和卡托普利在烧伤后早期应用,均能有效地降低血浆中肌钙蛋白的含量,对严重烧伤造成的心肌损害具有保护作用。     

丙泊酚通过减轻炎症反应和内质网应激缓解烧伤后急性肾损伤

摘要:目的 探讨丙泊酚(propofol)是否通过减轻炎症反应和内质网应激缓解大鼠烧伤后急性肾损伤(acutekidney injury,AKI)。方法 采用热损伤法构建大鼠烧伤后 AKI模型,实验分为5组:假烧伤组、AKI组、丙泊酚组、4-PBA(内 质网应激抑制剂)组和4-PBA+丙泊酚组。苏木精-伊红(HE)染色观察造模后48h肾脏组织形态;生化检测仪检测血清 中BUN 和Cr含量;ELISA 法检测血清中炎症因子 TNF-α、IL-1β和IL-6水平;Westernblot法检测肾脏组织中内质网应 激相关蛋白 PERK、GRP78、CHOP和 Caspase-12的表达。结果 与假烧伤组相比,AKI组大鼠肾脏组织呈现明显的组 织病理学损伤,血清中 BUN、Cr、TNF-α、IL-1β和IL-6水平显著升高(均 P<0.05),肾脏组织中 PERK、GRP78、CHOP 和 Caspase-12蛋白表达量显著升高(均P<0.05)。与 AKI组相比,丙泊酚组和4-PBA 组大鼠肾脏组织病理学损伤明显 减轻,血清中BUN、Cr、TNF-α、IL-1β和IL-6水平显著降低(均P<0.05),肾脏组织中PERK、GRP78、CHOP和Caspase12蛋白表达量显著降低(均P<0.05)。结论 丙泊酚可通过降低炎症因子水平和内质网应激相关蛋白的表达来缓解烧 伤后急性肾损伤。     

快速补液对大鼠烧伤延迟复苏心肌血管内皮经细胞的保护作用

目的：探讨快速补液对烧伤延迟复苏大鼠心肌微血管通透性，心肌局部内皮素－1（ET－1）和一氧化氮等细胞因子产生和分泌的改善及其心肌损害的保护作用。方法：采用大鼠30％TBSA Ⅲ度烧伤模型，动态观察烧伤延迟复苏快速补液和均匀补液后，大鼠心肌微血管通透性和心肌局部内皮素－1和一氧化氮等细胞因子含量及血浆中心肌肌球蛋白轻链－1浓度的改变。结果：伤后1h，心肌微血管通透性，心肌局部内皮素－1和一氧化氮含量即显著升高，6h达高峰，补液后，微血管通透性，心肌局部内皮素－1和一氧化氮含量均明显降低，快速补液组的心肌微血管通透性和心肌局部内皮素－1含量的降低幅度显著大于均匀补液组，而一氧化氮含量则两组间无明显差异，血浆中心肌肌球蛋白轻链－1的浓度变化与心肌局部内皮素－1含量改变呈正相关。结论：烧伤延迟复苏快速补液能够改善心肌血管内皮细胞功能，减轻心肌受损程度，因此，对烧伤延迟复苏是有益的。     

缺氧复氧诱导大鼠心肌细胞内质网应激反应

目的:观察大鼠心肌细胞缺氧复氧时内质网应激蛋白表达的改变及其意义,以探讨心肌缺血再灌注损伤与内质网应激的关系.方法:原代培养乳鼠心肌细胞,缺氧5.5 h后复氧2～24 h制备缺氧复氧损伤模型,用Western blot和RT-PCR方法测定内质网应激蛋白GRP78表达水平.2-脱氧葡萄糖作为本实验的阳性对照,2-脱氧葡萄糖孵育心肌细胞10 h,用Western blot和RT-PCR检测GRP78表达水平.结果:缺氧复氧处理的心肌细胞活力减低,胞内乳酸脱氢酶漏出.与对照组比较,缺氧复氧组心肌细胞内质网应激蛋白GRP78在蛋白及mRNA水平表达均于复氧后2 h开始增加,4 h达峰值,蛋白水平为对照组的142%,mRNA水平为对照组的200%,表达的增加可持续到复氧24 h.结论:缺氧复氧可以诱导心肌细胞内质网应激.     

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.