衰老对离体大鼠主动脉内皮依赖性血管舒张反应的影响

目的 研究增龄对离体大鼠主动脉内皮依赖性舒张的影响.方法 成年及老年大鼠各20只,利用组织器官水浴系统,通过乙酰胆碱(Ach)、N-硝基左旋精氨酸,测量离体主动脉环的舒张反应变化(%).结果 1)老年组大鼠主动脉环对10-8～10-4mol/L Ach诱发的内皮依赖性血管舒张反应均较成年组明显减弱,两组之间差异有非常显著性意义(P< 0.01).2)离体大鼠主动脉环经10-4mol/L L-NNA预处理20分钟,阻断一氧化氮合酶(NOS)后,同样剂量的Ach不再诱发上述内皮依赖性舒血管反应.结论 随增龄血管内皮分泌的一氧化氮(NO)逐渐减少,导致血管内皮依赖性舒张减弱;NOS的异常表达对NO 减少起着重要的作用,eNOS随增龄表达减弱,而iNOS 随增龄表达则明显增强.     

Iso,Ach,Ami对不同年龄、性别大鼠主动脉血管反应性的影响

目的观察异丙肾上腺素(Iso)、乙酰胆碱(Ach)、氨茶碱(Ami)对不同年龄、性别大鼠主动脉血管反应性的影响。方法采用离体血管张力实验方法,观察Iso,Ach,Ami对20mmol/LKCl引起的1,3,6,12月龄大鼠胸主动脉收缩的影响。结果Iso(10-9-10-5mol/L)对1月龄大鼠主动脉的舒张在雄性、雌性大鼠分别为(44.02±7.89)%和(63.83±9.50)%,随年龄的增加舒张作用减弱,甚至有收缩作用。Ach(10-8-3×10-5mol/L)对1月龄大鼠主动脉舒张作用最大,在雄性、雌性分别达到(68.17±7.02)%和(81.24±4.64)%,其余各年龄组舒张作用明显减少。Ami(10-5-3×10-4mol/L)对1月龄大鼠主动脉舒张在雄性、雌性分别达到(83.25±4.34)%和(82.83±7.71)%,其舒张作用随年龄的增加而减弱。结论Iso,Ach,Ami对大鼠主动脉环的舒张作用在雌性明显,并随着年龄的增加而降低。     

槲皮素对大鼠主动脉环的舒张作用及机制

目的:探讨槲皮素(Que)对大鼠离体胸主动脉环的舒张作用及其舒张机制.方法:采用离体血管环技术制备大鼠胸主动脉环,使用累积加药法,检测Que对去甲肾上腺素预收缩的胸主动脉环张力的影响.结果:Que对离体大鼠内皮完整和去内皮的胸主动脉环均呈剂量依赖性扩血管作用.在小剂量Que(1×10-6,3×10-6,1×10-5mol/L)浓度,内皮完整和去内皮胸主动脉环的扩血管作用之间差异无显著统计学意义,但在较大剂量Que (3×10-5,6×10-5mol/L),去内皮后其舒血管作用显著性减弱(P<0.05).用环氧合酶抑制剂吲哚美辛,钙激活钾通道抑制剂CHTX分别预处理后,Que在各剂量组引起的舒张血管作用与不加阻滞剂比较无统计学意义(P>0.05).用一氧化氮合酶抑制剂L-NAME预处理后,Que在较大剂量(3×10-5,6×10-5mol/L)引起的舒张血管作用明显减低,与不加阻滞剂比较,有统计学差异(P<0.05).结论:槲皮素具有剂量依赖性的舒张血管作用.其舒张作用与前列腺素、钙激活钾通道无关,而与内皮一氧化氮有关.     

西红花酸部分内皮依赖性血管舒张作用及其机制

目的:研究西红花酸(crocetin,CCT)血管舒张作用及其可能机制.方法:采用RM6240C型多道生物信号采集处理系统,记录灌流大鼠胸主动脉环张力变化.结果:CCT(10-9 ～10-4mol/L)对苯肾上腺素(PE,10-5 mol/L)预收缩的内皮完整血管环产生浓度依赖性的舒张作用;CCT(3×10-9～10-4mol/L)对苯肾上腺素(PE,10-5 mol/L)预收缩的去内皮血管环产生浓度依赖性的舒张作用,但内皮完整组血管舒张作用比去内皮组更明显,两者相比,在10-8～10-4mol/L时,具有显著性差异(P<0.01).CCT对高浓度KCl(6×10-2mol/L)预收缩的血管环无明显的舒张作用.一氧化氮合酶抑制剂左旋硝基精氨酸甲酯(10-4 mol/L)或前列环素合成酶抑制剂吲哚美辛(10-5 mol/L)预处理,对CCT诱导的内皮完整动脉环舒张作用具有明显的抑制效应.ATP敏感性K+通道阻断剂格列苯脲(3×10-6 mol/L )预处理后,CCT的舒血管作用均无显著变化(P >0.05),但Ca2+ 激活K+通道抑制剂四乙胺(5×10-3 mol/L )或电压敏感性K+通道抑制剂4-氨基吡啶(10-3 mol/L)预处理,可明显减弱CCT引起的无内皮血管舒张作用(P<0.01).结论:CCT对大鼠胸主动脉具有部分内皮依赖性舒张作用,其内皮依赖性血管舒张作用的机制,与其促进内皮一氧化氮合酶或环氧合酶途径,从而增加一氧化氮和前列环素的生成有关;其内皮非依赖性舒血管效应的作用机制涉及Ca2+激活K+通道或电压敏感型K+通道的激活.     

磷酸二酯酶在鼠胸主动脉中的表达及其对血管张力的调节作用

目的 观察磷酸二酯酶(PDE)1和PDE3亚型在大鼠胸主动脉中的表达及其对血管张力的调节作用.方法 采用RT-PCR检测PDE1和PDE3亚型mRNA的表达.将大鼠胸主动脉制备成2～3 mm的血管环,苯肾上腺素(PE)诱导血管环收缩后,分别用特异性PDE1抑制剂IC86340和PDE3抑制剂milrinone处理去除内皮组和保留内皮组的血管环,测定两组舒张血管的作用.结果 ①PDE1A、PDE1B、PDE1C、PDE3A和PDE3B亚型mRNA在大鼠胸主动脉均有表达.②在保留内皮组和去除内皮组,IC86340均舒张PE诱发的血管收缩(P<0.01);并且对去除内皮组的舒张作用小于保留内皮组(P<0.01).③在保留内皮和去除内皮组,milrinone均可舒张PE诱发的血管收缩(P<0.01);但milrinone在低浓度时(1×10-6.5～1×10-6 mol/L),去除内皮组舒张血管的作用大于保留内皮组(P<0.05),而高浓度(1×10-5.5～1×10-5 mol/L)时两组差异无统计学意义(P>0.05).结论 PDE1和PDE3亚型mRNA在大鼠胸主动脉表达并参与血管张力的调节.PDE1部分通过血管内皮依赖的机制调节血管张力,PDE3则通过内皮非依赖的途径调节血管张力.     

ZnPPⅪ对肺动脉内皮依赖性舒张反应的影响

目的 :通过观察血红素氧化酶抑制剂锌原卟啉Ⅸ (zineprotoporphyrinⅨ ,ZnPPⅨ )对乙酰胆碱 (acetyl choline,Ach)内皮依赖性血管舒张反应的影响 ,探讨内源性一氧化碳 (carbonmonoxide,CO)对肺血管的舒张作用。方法 :取Wistar大鼠肺动脉环 ,制备Ach浓度效应曲线 ,冲洗后平衡 6 0min ,分别加入一氧化氮 (nitricoxide,NO)合成酶抑制剂L NAME 30 μmol/L或L NAME 30 μmol /L +ZnPPⅨ 10 μmol/L ,孵育 30min后 ,重复制备Ach浓度效应曲线 ,观察给药前后Ach浓度效应关系的变化。结果 :用去氧肾上腺素收缩肺动脉后 ,Ach能对内皮完整的肺动脉引起浓度依赖性舒张 ,血管环用L NAME孵育后 ,舒张反应受抑 ,10 -5mol/L的Ach只引起 (40 .3± 5 .1) %的舒张反应 ,而用ZnPPⅨ及L NAME共同孵育后 ,舒张反应进一步受抑或消失 ,10 -5mol/L的Ach只能引起 (11.1± 8.4 ) %的舒张反应或不引起舒张反应。结论 :ZnPPⅨ可抑制Ach的内皮依赖性舒张反应 ,提示内源性CO与NO共同参与了Ach的内皮依赖性血管舒张反应 ,CO对肺血管平滑肌有舒张作用     

ZnPP Ⅸ对肺动脉内皮依赖性舒张反应的影响

目的: 通过观察血红素氧化酶抑制剂锌原卟啉Ⅸ(zine protoporphyrin Ⅸ,ZnPP Ⅸ)对乙酰胆碱(acetylcholine, Ach)内皮依赖性血管舒张反应的影响,探讨内源性一氧化碳(carbon monoxide, CO)对肺血管的舒张作用.方法:取Wistar大鼠肺动脉环,制备Ach浓度效应曲线,冲洗后平衡60 min,分别加入一氧化氮(nitric oxide, NO)合成酶抑制剂L-NAME 30 μmol/L或L-NAME 30 μmol /L+ZnPP Ⅸ 10 μmol/L,孵育30 min后,重复制备Ach浓度效应曲线,观察给药前后Ach浓度效应关系的变化.结果:用去氧肾上腺素收缩肺动脉后,Ach能对内皮完整的肺动脉引起浓度依赖性舒张,血管环用L-NAME孵育后,舒张反应受抑,10-5mol/L的Ach只引起(40.3±5.1)%的舒张反应,而用ZnPP Ⅸ及L-NAME共同孵育后,舒张反应进一步受抑或消失,10-5mol/L的Ach只能引起(11.1±8.4)%的舒张反应或不引起舒张反应.结论:ZnPP Ⅸ可抑制Ach的内皮依赖性舒张反应,提示内源性CO与NO共同参与了Ach的内皮依赖性血管舒张反应,CO对肺血管平滑肌有舒张作用.     

三七总皂甙对低氧高二氧化碳性肺血管收缩的影响

目的:探讨三七总皂甙(PNS)对肺动脉平滑肌的舒张作用及其与肺动脉内皮细胞的关系。方法:采用大鼠离体肺主动脉环灌流模型。分别在常氧及低氧高二氧化碳条件下,观察PNS对氯化钾(KCl)及去甲肾上腺素(NE)预收缩内皮完整血管和去内皮血管的舒张作用。结果:①在常氧及低氧高二氧化碳条件下,累积浓度的PNS对60mmol/LKCl及10-5mol/LNE预收缩的血管环均产生剂量依赖性舒张作用(P<0.05)。②低氧高二氧化碳增强了PNS的肺血管舒张作用,与相应浓度各常氧组相比,均有统计学意义(P<0.05或P<0.01)。③常氧条件下,去内皮组与内皮存在组相比,PNS的血管舒张效应无明显差异(P>0.05);但低氧高二氧化碳条件下,去内皮组的PNS血管舒张效应远大于内皮完整组(P<0.05或P<0.01)。结论:PNS可减轻低氧高二氧化碳性肺血管收缩,且去除肺动脉内皮后这种作用更加明显,其机制可能与内皮介导作用的缺失有关。     

黄芪对过氧亚硝酸盐阴离子导致的血管反应性异常的保护作用

目的 探讨黄芪对过氧亚硝酸盐阴离子(ONOO-)导致的血管反应性异常的影响.方法 32只SD大鼠随机分为2组,正常对照组与黄芪灌胃组,每组16只.大鼠喂养4周后处死,取胸主动脉,制备离体血管环标本.每组大鼠血管随机分为不同处理组(ONOO-组、未处理组)孵育.完成孵育后采用大鼠离体主动脉环灌流模型观察2组大鼠血管对苯肾上素(PE)/乙酰胆碱(Aeh)诱导的收缩/舒张反应性的变化.结果 正常对照组不同处理血管在PE的作用下收缩反应性均呈浓度依赖性增高;在高浓度(10、100 μmol/L)时,ONOO-处理组血管对PE的最大收缩力明显高于未处理组(P均<0.05);2组血管在Ach的作用下舒张反应性均呈浓度依赖性增高,在高浓度(100 μmol/L)时,ONOO-处理组血管对Ach的最大舒张率明显低于未处理组(P<0.05).在黄芪灌胃ONOO-处理组与未处理组大鼠血管上述改变均无明显差异(P>0.05).表明ONOO-导致的血管舒缩功能异常可以被黄芪改善.结论 黄芪可改善ONOO-导致的血管反应性异常,因此对血管功能具有保护作用.     

黄芪舒张血管平滑肌的作用及机制

目的:探讨黄芪对血管平滑肌的舒张作用及其机制.方法:采用大鼠离体胸主动脉环灌流模型.在去除血管环内皮后,观察累积浓度黄芪对基础状态(基础组)、苯肾上腺素(PE)预收缩(苯肾上腺素组)、氯化钾预收缩(氯化钾组)的血管环的作用和黄芪对经无钙液(无钙液组)、无钙液加肝素(肝素组)、普萘洛尔(普萘洛尔组)预处理后的血管环的作用.结果:在血管内皮被去除后,黄芪对基础状态或氯化钾预收缩的血管环无影响;当黄芪浓度累积达(10-1、3×10-1、100、3×100)g/L时,对PE(3×10-7mol/L)预收缩的血管环产生剂量依赖性舒张作用(P<0.05).经无钙液预处理后,黄芪(3×100 g/L)对血管环的舒张作用未被阻断;但经无钙液加肝素预处理后,该作用被显著抑制(P<0.01);而普萘洛尔预处理不影响黄芪对PE预收缩血管环的舒张作用.结论:黄芪对去除内皮的血管具有舒张作用.其机制可能与阻断血管平滑肌细胞内质网上的三磷酸肌醇敏感的钙离子通道,抑制内钙的释放有关.     

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.     

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.     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.