KIF3A在单侧输尿管梗阻小鼠肾脏中的表达及意义

目的 通过研究KIF3A在单侧输尿管梗阻（UUO）小鼠和TGF-β1诱导的NRK-52E细胞中的表达情况,探讨KIF3A在肾间质纤维化中的作用。方法 将36只C57BL/6J小鼠随机分为假手术组（Sham, n=18）和单侧输尿管梗阻组（UUO, n=18）,分别于术后7、14、21 d 处死小鼠。苏木素-伊红（HE）染色、马松（Masson）三色法染色和天狼星红（Sirius Red）染色观察小鼠肾间质纤维化程度,RT-PCR、免疫组织化学（IHC）和免疫印迹（Western blot）检测小鼠肾组织KIF3A的表达和分布。免疫印迹检测小鼠肾组织KIF3A、E-cadherin 和α-SMA 蛋白的表达。TGF-β1诱导NRK-52E细胞转分化后,免疫印迹检测KIF3A、E-cadherin 、α-SMA、Wnt4和β-catenin 蛋白的表达。结果 与Sham组相比,UUO小鼠肾间质纤维化程度随着梗阻时间延长而增加,表明造模成功。同时,KIF3A mRNA和蛋白表达均增高,于21 d达到高峰,α-SMA蛋白表达显著上调,E-cadherin蛋白表达明显降低。NRK-52E细胞发生转分化时,KIF3A蛋白的表达增多（P<0.001）,同时wnt/β-catenin信号通路中Wnt4和β-catenin蛋白表达增加（P<0.05,P<0.0001）。结论 KIF3A可能通过wnt/β-catenin信号通路介导的上皮细胞-间充质转化参与肾纤维化的发生发展过程。     

五味子乙素减轻博莱霉素诱导的肺纤维化

[目的]观察五味子乙素对小鼠肺纤维化的保护作用,并初探其可能的作用机制。[方法]将96只小鼠随机分为4组:空白对照(N)组,模型(M)组,地塞米松(DM)组,五味子乙素(Sch-B)组,每组24只。N组气管内滴入0.9%氯化钠注射液,其余各组小鼠经气管给予博莱霉素溶液建立肺纤维化模型。造模后第2天,N组和M组每日灌胃给予橄榄油,DM组给予地塞米松腹腔注射3 d,Sch-B组灌胃给予五味子乙素治疗。各组分别于治疗后第7、14、28天随机处死8只,进行肺组织苏木精-伊红(HE)染色和Masson染色观察小鼠肺组织病理形态变化,用酶联免疫吸附(ELISA)试剂盒检测小鼠血清中白介素-6(IL-6)水平,试剂盒检测肺组织超氧化物歧化酶(SOD)、谷胱甘肽(GSH)和羟脯氨酸(HYP)含量,用免疫组化检测肺组织中转化生长因子β1(TGF-β1)、磷酸化Smad2(p-Smad2)以及α平滑肌肌动蛋白(α-SMA)的表达量来评价治疗效果。[结果]Sch-B组小鼠肺泡炎及肺纤维化程度较M组均明显减轻(P0.05),血清中IL-6水平明显下降(P0.05),抗氧化指标较M组有所升高(P0.05),肺组织TGF-β1、pSmad2及α-SMA蛋白表达明显减少(P0.05)。[结论]五味子乙素能减轻小鼠肺纤维化程度,可能是通过减轻炎症反应,增强机体抗氧化能力和通过调节TGF-β1、p-Smad2和α-SMA蛋白发挥作用。     

胰岛素样生长因子结合蛋白相关蛋白1在硫代乙酰胺诱导的肝纤维化小鼠中的作用

目的：我们的前期研究发现胰岛素样生长因子结合蛋白相关蛋白1（IGFBPrP1）可以激活体外培养的肝星状细胞分泌细胞外基质（ECM）。为了明确IGFBPrP1在肝纤维化小鼠中的作用和机制,设计了本实验。 方法：采用经典的腹腔注射硫代乙酰胺（TAA）的方法制备小鼠肝纤维化模型,同时腹腔给予抗IGFBPrP1抗体。取肝组织,分别对肝组织石蜡切片做HE染色和Masson染色观察肝组织病理学变化及胶原纤维形成情况;通过免疫组织化学染色和Western blotting观察肝组织IGFBPrP1、α-平滑肌肌动蛋白（α-SMA）、ECM以及转化生长因子-β1（TGF-β1）、Smad3表达的变化。 结果：Masson染色结果显示：TAA5周组较正常对照组胶原纤维形成增多（P<0.01）,TAA5周+抗IGFBPrP1抗体组胶原纤维的形成少于TAA5周组（P<0.01）。与正常对照组相比,TAA5周组肝组织IGFBPrP1、α-SMA、TGF-β1和Smad3、Collagen I、纤维连接蛋白（FN）表达显著增强（P<0.01）,抗IGFBPrP1抗体的使用可以减轻上述改变（P<0.01）。 结论：IGFBPrP1在肝纤维化的发展过程中起重要作用;抗IGFBPrP1抗体通过抑制肝纤维化小鼠肝星状细胞的活化、减少ECM的主要成分Collagen I与FN的合成等途径发挥抗纤维化作用,其作用机制可能与TGF-β1/Smad3信号通路有关。     

α-硫辛酸对大鼠腹膜纤维化的作用及机制

目的 观察α-硫辛酸(α-LA)对高糖腹膜透析液诱导大鼠腹膜纤维化(PF)的作用及机制。方法 30只SD大鼠随机均分为空白对照组、模型组、α-LA腹腔注射高剂量组(400μmol/L)、α-LA腹腔注射中剂量组(300μmol/L)、α-LA腹腔注射低剂量组(200μmol/L)、α-LA灌胃组(300μmol/L),空白对照组大鼠腹腔注射生理盐水、后5组大鼠腹腔注射高糖腹膜透析液制作PF模型、后4组大鼠同时按分组设计给予相应药物,连续4周。取各组大鼠腹膜组织,苏木素伊红(HE)、Masson’s染色观察腹膜组织学形态及纤维化,免疫组化染色检测α-平滑机动蛋白(α-SMA)及Ⅰ型胶原蛋白(CollagenⅠ)表达,蛋白质印迹法(Western blot)检测转化生长因子β1(TGF-β1)、磷酸化Smad2(p-Smad2)及p-Smad3蛋白表达。结果 处理前各组大鼠体质量组间差异均无统计学意义(P> 0.05),处理后α-LA高剂量腹腔注射组较对照组、模型组和α-LA灌胃组体质量低(P <0.05);纤维化表达面积百分比、腹膜组织α-SMA、CollagenⅠ表达、腹膜...     

非诺贝特治疗单侧输尿管结扎小鼠肾纤维化的机制研究

  目的  探讨非诺贝特在单侧输尿管结扎诱导的小鼠肾纤维化中的作用机制,为肾纤维化提供潜在的治疗靶点。  方法  成年雄性C57BL/6J小鼠31只,随机分为假手术组（Sham组,n=9）、单侧输尿管结扎组（UUO组,n=10）和单侧输尿管结扎+非诺贝特治疗组（UUO+Feno组,n=12）。UUO组及UUO+Feno组小鼠均结扎左侧输尿管,Sham组小鼠仅游离左侧输尿管,不做结扎处理。术后第二日起,UUO+Feno组每日给予10 mg/kg （终浓度为0.08 mg/mL）的非诺贝特溶液灌胃,持续14 d;其余两组每日灌胃等量生理盐水。术后第15 天灌胃结束后处死小鼠取材,检测血清肌酐和尿素氮,肾组织行HE染色、Masson染色和Sirius Red染色,检测肾组织羟脯氨酸含量,免疫组化染色检测肾组织α-平滑肌肌动蛋白（α-SMA）、Ⅰ型胶原（COLⅠ）蛋白表达,Western blot法检测肾组织α-SMA、COLⅠ蛋白表达变化,实时荧光定量（RT）- PCR法检测肾组织纤维化相关基因基质金属蛋白酶（MMP）2、MMP9、COLⅠA1、COLⅠA2、基质金属蛋白酶组织抑制因子-1（TIMP-1）、转化生长因子-β1（TGF-β1）、α-SMA mRNA的表达变化。  结果  与Sham组相比,UUO组小鼠血清肌酐及尿素氮水平升高（P<0.05）;与UUO组相比,UUO+Feno组小鼠血清肌酐及尿素氮水平降低（P<0.05）。HE染色、Masson染色、Sirius Red染色以及肾羟脯氨酸含量的结果均表明UUO组较Sham组胶原沉积明显增多,炎性细胞浸润明显,UUO+Feno组较UUO组胶原沉积程度显著减轻,炎性细胞浸润程度显著改善,对肾纤维化的启动阶段有抑制作用。免疫组化结果显示:与Sham组相比,UUO组 α -SMA、COLⅠ在肾组织中的表达水平升高（P<0.05）;与UUO相比,UUO+Feno组α-SMA、COLⅠ在肾组织中的表达水平降低（P<0.05）;RT-PCR和Western blot结果显示:与Sham组相比,UUO组纤维化相关因子的mRNA及α-SMA、COLⅠ蛋白表达水平均升高（P<0.05）;与UUO组相比,UUO+Feno组纤维化相关因子的mRNA及蛋白表达水平均降低（P< 0.05）。  结论  非诺贝特通过调控与肾脏纤维化相关因子的表达水平改善肾脏纤维化。     

柴胡皂苷D对人肾小管上皮细胞转分化的影响及机制

目的探讨柴胡皂苷D(SSD)对人肾小管上皮细胞转分化的影响及其作用机制。 方法将人肾小管上皮细胞HK-2细胞分为对照组、空白溶剂对照组、肾间质纤维化(RIF)组(5 μg/L TGF-β1)、阳性对照组(5 μg/L TGF-β1+10 μmol/L贝那普利)、SSD组(5 μg/L TGF-β1+10.00 μmol/L SSD)、SSD+DKK-1组(5 μg/L TGF-β1+10.00 μmol/L SSD+100 μg/L DKK-1)。光学显微镜观察各组细胞形态变化,免疫荧光检测细胞E-钙黏素(E-cadherin)、α-平滑肌肌动蛋白(α-SMA)表达,Western blotting检测细胞基质金属蛋白酶(MMP)-7、Snail、E-cadherin、α-SMA、β-catenin蛋白表达,qRT-PCR检测细胞胶原蛋白Ⅰ(Collagen Ⅰ)相对表达量。 结果对照组、空白溶剂对照组细胞有序、紧密排列,RIF组细胞呈现出长梭形且细胞排列分散；阳性对照组、SSD组和SSD+DKK-1组中长梭形细胞较RIF组减少且细胞分散程度降低。RIF组E-cadherin荧光斑低于对照组(P＜0.05),α-SMA荧光斑和MMP-7、Snail、E-cadherin、α-SMA、β-catenin蛋白表达、Collagen Ⅰ基因相对表达量高于对照组(P＜0.05)。阳性对照组、SSD组E-cadherin荧光斑和蛋白表达高于RIF组(P＜0.05),α-SMA荧光斑和MMP-7、Snail、α-SMA、β-catenin蛋白表达、Collagen Ⅰ基因相对表达量低于RIF组(P＜0.05)。SSD+DKK-1组E-cadherin荧光斑和蛋白表达高于SSD组(P＜0.05),α-SMA荧光斑和MMP-7、Snail、α-SMA、β-catenin蛋白表达、Collagen Ⅰ基因相对表达量低于SSD组(P＜0.05)。 结论SSD可抑制人肾小管上皮细胞转分化,可能与抑制Wnt/β-catenin途径活化有关。     

Apelin对单侧输尿管结扎小鼠肾脏纤维化的影响研究

目的 探讨生物活性肽Apelin对单侧输尿管结扎（UUO）小鼠肾脏纤维化的影响及相关机制,分析在肾脏纤维化时血清和肾脏局部Apelin/APJ系统的代偿性变化。方法 2014年1月选取7周龄雄性C57Bl/6j小鼠共60只,构建UUO的小鼠模型,并设立假手术组（Sham）作为对照。术后每天给小鼠腹腔注射Apelin-13（0.1 μmol/kg）或等量0.9%氯化钠溶液（vehicle）。根据小鼠手术方式和术后用药情况分为4组（15只/组）：Sham+vehicle组、Sham+Apelin组、UUO+vehicle组、UUO+Apelin组。术后2周将小鼠处死,取手术侧肾脏进行检测。采用Masson染色观察肾脏纤维化程度;采用实时荧光定量PCR（RT-PCR）法检测肾脏细胞外基质胶原〔纤维连接蛋白（Fibronectin）、Ⅰ型胶原（Collagen I）、Ⅲ型胶原（Collagen Ⅲ）〕表达水平以及肾脏Apelin、APJ表达水平;采用Western blotting法检测肾小管上皮细胞标志物上皮细胞钙黏蛋白（E-cadherin）、间充质细胞标志物α平滑肌肌动蛋白（α-SMA）表达水平以及转化生长因子β（TGF-β）/Smads信号通路的主要信号分子（TGF-β1、TGF-βR1、p-Smad2）表达水平;采用ELISA法检测小鼠血清Apelin表达水平。结果 4组小鼠肾脏纤维化程度比较,差异有统计学意义（P＜0.05）。UUO+vehicle组和UUO+Apelin组小鼠肾脏纤维化程度均高于Sham+vehicle组和Sham+Apelin组（P＜0.05）;UUO+Apelin组小鼠肾脏纤维化程度低于UUO+vehicle组（P＜0.05）。4组小鼠肾脏Fibronectin、CollagenⅠ、Collagen Ⅲ表达水平比较,差异均有统计学意义（P＜0.05）。UUO+vehicle组和UUO+Apelin组小鼠肾脏Fibronectin、CollagenⅠ、Collagen Ⅲ表达水平高于Sham+vehicle组和Sham+Apelin组（P＜0.05）;UUO+Apelin组小鼠肾脏Fibronectin、CollagenⅠ、Collagen Ⅲ表达水平低于UUO+vehicle组（P＜0.05）。4组小鼠肾脏E-cadherin、α-SMA表达水平比较,差异均有统计学意义（P＜0.05）。UUO+vehicle组和UUO+Apelin组小鼠肾脏E-cadherin表达水平低于Sham+vehicle组和Sham+Apelin组,α-SMA表达水平高于Sham+vehicle组和Sham+Apelin组（P＜0.05）;UUO+Apelin组小鼠肾脏E-cadherin表达水平高于UUO+vehicle组,α-SMA表达水平低于UUO+vehicle组（P＜0.05）。4组小鼠肾脏TGF-β1、TGF-βR1、p-Smad2表达水平比较,差异均有统计学意义（P＜0.05）。UUO+vehicle组和UUO+Apelin组小鼠肾脏TGF-β1 、TGF-βR1、p-Smad2表达水平均高于Sham+vehicle组和Sham+Apelin组（P＜0.05）;UUO+Apelin组小鼠肾脏TGF-β1 、TGF-βR1、p-Smad2表达水平均低于UUO+vehicle组（P＜0.05）。4组小鼠肾脏Apelin表达水平比较,差异无统计学意义（P＞0.05）;4组小鼠肾脏APJ、血清Apelin表达水平比较,差异有统计学意义（P＜0.05）。UUO+vehicle组和UUO+Apelin组小鼠肾脏APJ表达水平高于Sham+vehicle组和Sham+Apelin组,血清Apelin表达水平低于Sham+vehicle组和Sham+Apelin组（P＜0.05）;UUO+Apelin组小鼠肾脏APJ表达水平低于UUO+vehicle组,血清Apelin表达水平高于UUO+vehicle组（P＜0.05）。结论 Apelin通过干扰经典的TGF-β/Smads信号通路抑制UUO小鼠肾脏的肾小管上皮-间充质转分化,进而减轻肾脏纤维化。在肾脏纤维化时,小鼠血清Apelin表达水平降低,肾脏APJ表达水平升高,可能对慢性肾脏病的进展起到一定的代偿作用。     

益气、化瘀、化痰中药制剂及其合剂对肾间质纤维化大鼠TGF-β1/Smad通路及TRB3的影响

目的：观察益气、化瘀、化痰中药制剂及其合剂———益气化瘀化痰制剂对单侧输尿管结扎（unilateral ureteral obstruc－tion,UUO）模型大鼠肾间质纤维化的影响及其可能机制。方法：42只雌性SD大鼠,随机分为假手术组、模型组、替米沙坦组、益气组、化瘀组、化痰组及益气化瘀化痰组,每组6只。除假手术组外,其余各组采用UUO法建立肾间质纤维化模型。UUO术后3周,模型组及假手术组以等量生理盐水灌胃,其余各组以相应制剂灌胃治疗,每日1次,连续用药12周后处死大鼠。检测大鼠血清尿素氮（blood urea nitrogen,BUN）、肌酐（serum creatinine,Scr）水平。取大鼠术侧肾组织,HE染色观察组织形态学改变,Masson染色观察胶原纤维沉积情况,Western blot检测转化生长因子-β1（transforming growth factor-β1,TGF-β1）、α-平滑肌肌动蛋白（α-smooth muscle actin,α-SMA）、E-钙黏蛋白（E-cadherin）蛋白表达水平;qRT-PCR 检测TGF-β1、Smad3、Smad7、TRB3、α-SMA、E-cadherin mRNA 表达水平。结果：与假手术组比较,模型组肾间质纤维化明显,BUN、Scr水平明显升高（P<0.01）,而各药物干预组肾间质纤维化程度及BUN、Scr水平均较模型组明显改善,其中益气化瘀化痰组、替米沙坦组及益气组改善较明显（P<0.05）。与模型组相比,益气化瘀化痰组、替米沙坦组及益气组TGF-β1、Smad3、TRB3、α-SMA mRNA表达明显降低（P<0.05）,E-cadherin mRNA表达明显升高（P<0.05）。各组间Smad7 mRNA表达无显著差异。TGF-β1、α-SMA、E-cadherin的蛋白表达与其mRNA表达趋势一致。结论：益气、化瘀、化痰及益气化瘀化痰中药制剂和替米沙坦均能改善UUO大鼠肾间质纤维化,且以益气化瘀化痰制剂、替米沙坦及益气制剂的改善作用较为明显,其机制可能是通过调控TRB3、TGF-β1/Smad信号通路,进而抑制肾小管上皮细胞向间充质细胞转化。     

绞股蓝总皂苷对CCl_4诱导的大鼠肝纤维化TGF-β_1/Smad信号通路的影响

目的：观察绞股蓝总皂苷对大鼠肝纤维化转化生长因子-β1（TGF-β1）/Smad信号通路的影响。方法：将Wistar雄性大鼠设为正常组、模型组、绞股蓝总皂苷组、秋水仙碱组,除正常组外采用CCl4诱导大鼠肝纤维化模型。造模第7周开始予相应的药物干预,每日给药剂量为股蓝总皂苷200 mg/kg、秋水仙碱0.1 mg/kg,共3周。观察大鼠一般情况变化,肝组织羟脯氨酸（Hyp）含量,肝组织病理及胶原沉积;检测肝组织肝星状细胞（HSC）活化标志物α-平滑肌肌动蛋白（α-SMA）表达,肝组织TGF-β1/Smad信号通路指标TGF-β1、TGF-β1受体1（TβR-Ⅰ）、TGF-β1受体2（TβR-Ⅱ）、Smad2/p-Smad2、Smad3/p-Smad3蛋白表达。结果：模型组大鼠一般状态较差,肝组织Hyp含量较正常组显著增高,肝小叶被破坏,肝细胞脂肪变性伴炎性细胞浸润,并有大量纤维结缔组织增生;大鼠肝组织α-SMA、TGF-β1、TβR-Ⅰ、TβR-Ⅱ、Smad2、p-Smad2、p-Smad3蛋白表达均显著升高,而Smad3蛋白表达与正常组比较无差异。绞股蓝总皂苷组及秋水仙碱组大鼠肝组织Hyp含量显著降低,肝组织病理改善;绞股蓝总皂苷组大鼠肝组织α-SMA、TGF-β1、Smad2、p-Smad2、p-Smad3蛋白表达均较模型组显著下降,TβR-Ⅰ、TβR-Ⅱ及Smad3蛋白表达无显著变化;秋水仙碱组大鼠肝组织α-SMA、TGF-β1、Smad2、p-Smad3蛋白表达均较模型组显著下降,TβR-Ⅰ、TβR-Ⅱ、p-Smad2及Smad3蛋白表达无显著变化。结论：绞股蓝总皂苷对CCl4诱导的大鼠肝纤维化有显著的干预作用,其作用机制可能与抑制HSC活化、TGF-β1分泌及其信号通路中p-Smad2、p-Smad3表达有关。     

芪贞降糖颗粒对糖尿病肾病大鼠TGF-β1/Smad信号通路的调控作用

目的 观察芪贞降糖颗粒对糖尿病肾病大鼠TGF-β1/Smad信号通路的调控作用,探讨其改善糖尿病肾病的作用机制。方法 采用高脂饲料喂养联合链尿佐菌素腹腔注射方法复制2型糖尿病肾病大鼠模型,选取模型复制成功的大鼠,随机分为模型组,二甲双胍组,芪贞降糖颗粒低、中、高剂量组,每组10只,另取10只正常大鼠作为正常对照组。灌胃给药8周,检测各组大鼠尿α1微球蛋白、β2微球蛋白和白蛋白含量。苏木素-伊红染色观察大鼠肾组织的损伤程度,免疫荧光染色观察大鼠肾组织转化生长因子β1（transforming growth factor beta 1,TGF-β1）和转化生长因子βⅠ型受体（transforming growth factor beta type Ⅰ receptor,TGF-βRⅠ）的表达分布。RT-PCR检测肾组织TGF-β1、TGF-βRⅠ、Smad3和Smad7 mRNA的表达水平,Western blot检测肾组织TGF-β1、TGF-βRⅠ、Smad3、p-Smad3、Smad7和p-Smad7的蛋白表达水平。结果 与正常对照组相比,模型组大鼠尿α1微球蛋白、β2微球蛋白及白蛋白含量均明显增加（P＜0.05）,肾组织损伤明显,TGF-β1和TGFβ-RⅠ表达增加;TGF-β1、TGF-βRⅠ、Smad3 mRNA表达水平显著增高（P＜0.05）,Smad7 mRNA表达水平显著降低（P＜0.05）,TGF-β1、TGF-βRⅠ、Smad3和p-Smad3蛋白表达水平显著增加（P＜0.05）,Smad7和p-Smad7蛋白表达水平显著降低（P＜0.05）。与模型组相比,芪贞降糖颗粒组上述指标均具有不同程度的逆转,差异具有统计学意义（P＜0.05）。结论 芪贞降糖颗粒能够改善糖尿病大鼠肾组织的损伤程度,其机制可能与调控TGF-β1/Smad信号通路的蛋白表达有关。     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.