缺血再灌注对脑组织水肿和ATP酶活性影响的实验研究

目的：研究缺血再灌注对脑组织水肿和ATP酶性的影响。方法：闭塞大鼠四条动脉造成急性全脑缺血,松开颈总动脉夹闭制成再灌注模型。以组织学方法观察缺血再灌注后脑组织水肿变化,同时测定脑组织中ATP酶尖性和丙二醛（MDA）的含量,结果：缺血30min组与假手术组的组织学结构基本相同,仅出现软脑毛细血管轻度充血,神经细胞无明显肿胀,形态结构亦无损伤性,产质细胞分布正常,而缺血再灌注组神经元和胶质细胞显著肿胀,部分神经细胞变性坏死,（2）与假手术组比较,缺血30min组脑组织胞液和膜ATP酶活性均显著下降,再灌注24h后酶性进一步下降;（3）与假手术组比较,缺血30min组脑组织胞液和膜MDA含量显著升高,再灌注24h后MDA含量继续升高,结论：缺血及再灌注造成的神经元损伤与能量代谢,膜脂质过氧化和膜两侧阳离子动态平衡 失调密切相关。     

雌激素对去卵巢沙土鼠脑缺血再灌注脑组织SOD和MDA的影响

目的观察雌激素对沙土鼠脑缺血再灌注自由基损伤的影响。方法雌性沙鼠40只，随机分为假手术组、缺血再灌注组、去卵巢组、补充雌激素组。采用夹闭双侧颈总动脉法复制沙鼠脑缺血再灌注模型，缺血7min再灌注12h，取脑组织测定脑组织中SOD活力、MDA含量的变化，并观察海马CA1区神经细胞的病理改变。结果缺血再灌注组、去卵巢对照组脑组织中SOD活力明显降低，MDA含量明显增高，与假手术组比较有显著性差异（P〈0．01）；补充雌激素组脑组织中SOD活力明显增高，MDA含量明显减少，与缺血再灌注组、去卵巢对照组比较有显著性差异（P〈0．01）；缺血再灌注组脑组织海马CA1区神经细胞损伤明显，脑组织水肿明显；补充雌激素组神经细胞损伤明显减轻。结论预防性应用雌激素能明显减轻缺血再灌注所造成的神经细胞损伤，对脑缺血再灌注自由基损伤有保护作用。     

雌二醇对去势沙鼠脑缺血再灌注损伤后脑组织中NO和NOS的影响

目的　观察雌二醇对去势沙鼠脑缺血再灌注脑损伤的保护作用。方法　去势雌性沙鼠 30只 ,随机分为假手术组、缺血再灌注组和雌二醇干预组。采用夹闭双侧颈总动脉法复制沙鼠脑缺血再灌注模型 ,缺血 7min再灌注 12h ,取脑组织测定脑组织中一氧化氮 (NO)含量、一氧化氮合酶 (NOS)活力的变化 ,并取脑组织观察海马CA1区神经细胞的病理改变。结果　缺血再灌注组脑组织中NO含量明显增高 ,NOS活力明显降低 ,与假手术组比较有显著差异 (P <0 . 0 1) ;雌二醇干预组脑组织中NO水平明显降低 ,NOS活力有所增高 ,与缺血再灌注组比较有显著差异 (P <0 . 0 1) ;缺血再灌注组脑组织海马CA1区神经细胞损伤明显 ,脑组织水肿明显 ;雌二醇干预组神经细胞损伤明显减轻。结论　预防性应用雌二醇能明显减轻缺血再灌注所造成的神经细胞损伤 ,对脑缺血再灌注损伤有保护作用。     

表没食子儿茶素没食子酸酯对缺血再灌注损伤大鼠心肌脂质过氧化及心肌酶活性的影响

目的：观察表没食子儿茶表没食子酸酯（EGCG）对缺血再灌注损伤大鼠心肌脂质过氧化及心肌酶活性的影响。方法：雄性Wistar大鼠50只分为5组，假手术组、缺血再灌注组（IR），丹参（SM，100mg/kg）组，EGCG1（10mg/kg)组和EGCG2（20mg/kg）组，每组10只动物，采用结扎大鼠左冠状动脉前降支30min后再灌注60min的方法建立在体缺血再灌注损伤模型，分别测定心肌丙二醛（MDA）含量，超氧化物歧化酶（SOD）及ATP酶活性和血浆乳酸脱氢酶（LDH）水平。结果：与假手术组比，IR组大鼠心肌MDA及血浆LDH明显升高，SOD及ATP酶活性则显著降低（P＜0．01）；EGCG和SM均能显著，降低MDA与LDH，明显增加SOD与ATP酶活性（与IR组比，P＜0．01），并且EGCG（20mg/kg)，降低MDA与LDH的作用较SM（100mg/kg)更明显（P＜0．05）。结论：EGCG通过抑制脂过氧化反应和提高心肌SOD与ATP酶活性，对大鼠缺血再灌注损伤心肌有显著的保护作用。     

GM1对大鼠脑缺血再灌注损伤的乳酸及葡萄糖含量的影响

目的探讨GM1对脑缺血再灌注损伤的神经细胞的保护作用.方法仿照Pulsinelli四血管闭塞法建立大鼠全脑缺血再灌注损伤模型,观测外源性GM1对脑缺血再灌注损伤后脑细胞外液乳酸及葡萄糖含量的影响.结果:急性缺血再灌注组、GM1治疗组乳酸缺血后迅速升高,再灌注30 min达高峰,其后逐渐下降.再灌注组在30～120 min内显著高于对照组,治疗组在30～90 min内显著高于对照组,但低于再灌注组(P<0.05).急性缺血再灌注组、GM1治疗组葡萄糖缺血后迅速降低,再灌注30 min达低谷,其后逐渐上升.再灌注组在30～120 min内显著低于对照组,治疗组在30～90min内低于对照组,但显著高于再灌注组(P<0.05).结论脑缺血再灌注损伤后,早期使用GM1治疗,明显减轻脑组织中乳酸的堆积,增加葡萄糖含量,增强神经元细胞的存活,为探索GM1在脑缺血再灌注后的神经保护提供了新的途径.     

雌激素对去卵巢大鼠脑缺血再灌注后脑组织内MDA和TChE的影响

目的观察去卵巢大鼠脑缺血再灌注后自由基损伤程度,探讨雌激素对脑组织的保护作用。方法取Wistar大鼠60只,随机分为假手术组（A组）、雌激素预防组（B组）、缺血组（C组）,采用四管法复制大鼠缺血模型,于术后30天处死动物取脑组织,测定脑组织丙二醛（MDA）含量和乙酰胆碱酯酶（TChE）活力变化,并取脑组织观察海马CA1区神经细胞的病理改变。结果假手术组和脑缺血再灌注组MDA含量明显低于雌激素组,而前两组TChE活力均高于雌激素组,雌激素组与缺血组、假手术组比较均有显著性差异（P〈0.01）;缺血组脑组织海马CA1区可见固缩的或形态不规则的神经元及核,并见神经元缺失现象;雌激素组脑组织神经细胞损伤明显减轻。结论预防性应用雌激素能减少氧自由基的产生,对由缺血再灌引起的脑组织损伤有保护作用。     

银杏叶提取物(EGb761)对鼠脑缺血半暗带神经细胞凋亡及超微结构的影响

目的:探讨银杏叶提取物(EGb761)对鼠脑缺血半暗带神经细胞凋亡及细胞超微结构的影响。方法:雄性Wistar大鼠30只,随机分为假手术组、对照组(包括缺血90 min和缺血90 min再灌注12 h两个亚组)、治疗组(亦包括缺血90 min和缺血90 min再灌注12 h两个亚组),每组6只。治疗组于缺血前和缺血后即刻经腹腔注射EGb761溶液(每次20 mg/kg),假手术组和对照组均于相同时限腹腔注射等容量的生理盐水。建立大鼠大脑中动脉闭塞(MCAO)/再灌注模型。采用原位末端标记法,观察各组鼠脑缺血半暗带神经细胞凋亡,并结合电镜观察缺血神经细胞超微结构的改变。结果:对照组缺血90 min再灌注12 h缺血半暗带可见大量凋亡细胞,凋亡细胞计数为21.2±3.8,较药物治疗组缺血90 min再灌注12 h缺血的9.1±2.3显著增加(P<0.01)。对照组缺血90 min再灌注12 h鼠脑组织电镜检查可见神经元细胞核染色质边聚,呈团块状,线粒体可见絮状结构改变;相同时限药物治疗组脑组织神经元细胞核染色质分布比较均匀,胞质内线粒体及其它细胞器基本正常。结论:血小板活化因子受体拮抗剂EGb761具有显著的缺血后脑保护作用。     

Apelin对急性局灶性脑缺血再灌注损伤大鼠脑神经细胞的保护作用

目的 利用apelin在大鼠急性局灶性脑缺血再灌注早期进行干预处理,观察大脑神经细胞凋亡情况及脑组织抗氧化应激能力的变化.方法 取成年雄性Wistar大鼠随机分成假手术对照(sham)组12只、缺血再灌注(I/R)组72只、缺血再灌注+ apelin干预(I/R+AP)组72只.I/R组和I/R+ AP组又根据灌注时间分为再灌注3、6、12、24、72、120 h亚组,每亚组12只.I/R+AP组在再灌注早期(30 min)用10-7 mol/L apelin(10 μ1)进行侧脑室注射给药干预处理.利用RT-PCR测定各组大鼠损伤侧大脑皮质caspase-3、caspase-12 mRNA表达的变化;用流式细胞术检测各组大鼠大脑神经细胞凋亡率;用试剂盒测定脑组织丙二醛(MDA)含量、总谷胱甘肽过氧化物酶活性以及总抗氧化能力.结果 RT-PCR检测结果显示,与假手术组比较,I/R组和I/R+AP组caspase-3、caspase-12 mRNA在损伤侧大脑皮质的表达升高;apelin干预可下调caspase-12mRNA的表达,而caspase-3 mRNA的表达变化不明显.流式细胞术检测结果显示,apelin+ AP组缺血区神经细胞凋亡率较I/R组降低(P＜0.05),且随时间增加变明显.脑组织氧化应激功能检测结果显示,与假手术组比较,I/R组脑组织MDA含量升高(P＜0.05),总谷胱甘肽过氧化物酶活性和总抗氧化能力降低(P＜0.05);apelin干预后,MDA含量下降,总谷胱甘肽过氧化物酶活性和总抗氧化能力升高,与I/R组比较差异有统计学意义(P＜0.05).结论 大鼠急性局灶性脑缺血再灌注后apelin的早期干预对脑神经细胞有一定的保护作用.     

川芎嗪对大鼠局灶性脑缺血再灌注损伤的影响

目的 观察川芎嗪对大鼠局灶性脑缺血再灌注损伤的影响.方法 大鼠随机分为假手术组(Sham)、缺血再灌注组(IR)、川芎嗪组(TMP).采用经大鼠右侧翼腭动脉线栓Willis环30 min后再灌注的方法 ,建立大鼠局灶性脑缺血再灌注损伤的动物模型.动态观测局部脑血流(rCBF)及脑电图(EEG)的变化.测定血清丙二醛(MDA)、ATP酶(ATPase)、内源性超氧化物歧化酶(SOD)含量.结果 与缺血再灌注组相比,川芎嗪组异常增高的MDA显著降低(P<0.05),血清和脑组织中SOD含量增加,ATP酶活性提高(P<0.05);川芎嗪组脑血流量(rCBF)提高,脑电图恢复至正常水平时程缩短.结论 川芎嗪对局灶性脑缺血再灌注损伤大鼠有保护作用,其作用机制可能是减少大鼠局灶性脑缺血再灌注脂质过氧化、清除氧自由基、扩血管等作用.     

麦芽醇治疗大鼠不完全性脑缺血再灌注损全国各地的实验研究

目的：研究麦芽醇对大鼠海马组织不完全性脑缺血再灌注损伤的保护作用。方法：Wistar大鼠双侧颈总动脉夹闭30min,造成不完全脑缺血,松开动脉夹即为再灌注。大鼠随机分为三组：①假手术对照组（SOC）,相同手术操作,但不夹闭动脉;②缺血再灌注组（IR）,再灌注1h;③麦芽醇治疗组（MT）,夹闭动脉前后静脉注射700μmol/L麦芽醇生理盐水。3组动物均于再灌注后测海马组织中的丙二醛（MDA）值、超氧化物歧化酶（SOD）和ATP酶活性。结果：缺血再灌注组MDA明显升高（P＜0.01),SOD、ATP酶活性明显降低（P＜0.01)。MT能降低升高的MDA值,改善ATP酶活性（P＜0.01),但不能改善SOD活性。结论：麦芽酶能清除氧自由基,减轻脂质过氧化反应,改善ATP酶活性,从而减轻海马组织缺血再灌注损伤。     

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.