黄芪甲甙对病毒性心肌炎细胞凋亡作用的研究

目的　研究黄芪甲甙对病毒性心肌炎的细胞凋亡作用。方法　Balb/c小鼠腹腔接种CVB3建立病毒性心肌炎模型 ,随机分为黄芪甲甙治疗组及生理盐水对照组 ,心肌HE染色观察心肌病理改变 ,原位末端标记法与流式细胞仪方法观察细胞凋亡指数。结果　黄芪甲甙治疗组心肌病理积分明显低于对照组 (P <0 .0 1 ) ,细胞凋亡指数 [( 7.6± 3.2 ) %vs ( 1 2 .3± 3.6) % ,t=3.2 6,P <0 .0 5 ]及凋亡率[( 9.5± 5 .3) %vs ( 2 7.8± 9.2 ) % ,t=6.5 8,P <0 .0 1 ]均明显低于对照组。结论　黄芪甲甙对Balb/c小鼠CVB3病毒性心肌炎有显著的抗细胞凋亡的作用。     

Balb/c小鼠CVB3病毒性扩张型心肌病并心力衰竭模型的建立

目的 建立慢性病毒性心肌炎、扩张型心肌病并心力衰竭的实验模型。方法 用CVB3反复感染Balb／c小鼠，分别于感染后第1、3、6、9个月不同时点，采用超声心动图观察小鼠左心室收缩期及舒张末期内径及射血分数。取心肌经HE染色观察其病理形态特征，VG染色观察心肌纤维化，及原位末端标记法观察细胞凋亡。结果B超发现，感染病毒后小鼠左心室收缩末期及舒张末期内径增大，左心室射血分数(EF)下降，与正常小鼠相比P＜O．050反复感染病毒3个月内组织病理学特征与慢性心肌炎类似，而3个月后则呈现出典型的扩张型心肌病理特征。在慢性期主要是病变部位的炎症细胞及心肌细胞凋亡，而扩张型心肌病期出现心肌细胞散在性凋亡。结论 Balb／c小鼠反复感染病毒可能是慢性心肌炎演变为扩张型心肌病并心力衰竭的良好的实验模型；心肌间质纤维与细胞凋亡在心肌炎演变为扩张型心肌病发病过程中起重要的作用。     

病毒性心肌炎小鼠心肌细胞凋亡与外周血淋巴细胞凋亡的研究

目的:研究心肌炎小鼠柯萨奇B3(CVB3)病毒性心肌炎模型外周血淋巴细胞凋亡与心肌细胞凋亡的关系。方法:采用AnnexinV/PI双参数法在流式细胞仪上定量检测CVB3心肌炎小鼠外周血淋巴细胞凋亡及心肌细胞凋亡百分率。结果:CVB3感染所致心肌炎小鼠外周血淋巴细胞凋亡以及心肌细胞凋亡均显著高于正常对照小鼠(P<0.001),且两者呈显著正相关(r=0.80,P<0.01);外周血淋巴细胞及心肌细胞凋亡百分率与心肌病理积分亦呈明显正相关(r=0.72,P<0.01;r=0.85,P<0.01)。结论:病毒性心肌炎外周血淋巴细胞凋亡可以反映心肌细胞凋亡情况,而且两者均与心肌炎病理损害程度密切相关。     

病毒性心肌炎心肌细胞凋亡研究进展

病毒性心肌炎是临床心血管常见病之一,各种感染均有可能导致心肌炎,但柯萨奇病毒B3 (CVB3 )感染最为常见.最近几年来,有诸多研究发现,心肌细胞凋亡在病毒性心肌炎发生、发展过程中起重要作用,尤以发病早期心肌细胞凋亡最明显[1] .在一项临床病例对照研究中,更是证明了心肌细胞凋亡在心肌炎中的作用[2] .绝大多数心肌炎预后良好,约25%～30%的心肌炎患者可演变为扩张性心肌病[3] ,而心肌细胞凋亡也是病毒性心肌炎向扩张性心肌病发展的重要机制之一.另有研究发现,急性重症病毒性心肌炎较高的心肌凋亡率与致死性心力衰竭密切相关[4] .本文对近几年有关病毒性心肌炎心肌细胞凋亡研究进展做如下综述.     

静注免疫球蛋白对病毒性心肌炎小鼠的疗效及机理研究

目的:探讨静注免疫球蛋白(intravenous immunoglobulin,IVIG)对病毒性心肌炎的疗效及其机理。方法:320只5周龄雄性BALB/c小鼠随机分为8组,感染组腹腔接种柯萨奇B3病毒(CVB3)制成心肌炎动物模型,在接种病毒后3、7 d分别腹腔注射IVIG(500 mg/kg.d-1)5 d和10 d,流式细胞仪定量检测心肌细胞凋亡率和坏死率,与心肌病理组织学积分和病毒滴度进行相关分析,并与中药黄芪疗效对比。结果:静注免疫球蛋白治疗组小鼠心肌内病毒滴度、心肌病理积分和心肌细胞凋亡率与坏死率明显低于病毒对照组和黄芪治疗组,以早期(感染后3 d)长程(10 d)治疗组效果最好。结论:静注免疫球蛋白通过抑制柯萨奇B3病毒,降低心肌细胞凋亡率和坏死率对病毒性心肌炎发挥疗效,其疗效高于传统中药黄芪。     

细胞凋亡在小鼠病毒性心肌炎中的作用

目的 :探讨柯萨奇病毒 B3(CVB3)所致小鼠病毒性心肌炎 (VM)心肌细胞损伤的变化 ,观察细胞凋亡在心肌损伤中的作用。方法 :采用 CVB3制备小鼠病毒性心肌炎动物模型 ,分别于腹腔接种 CVB3后第 5、7、10、14、2 1、2 8d,取心肌组织切片 HE染色了解心肌损伤 (坏死 )情况 ;电镜和流式细胞仪检测 ,观察心肌中的细胞凋亡。结果 :心肌坏死方面 :光镜观察见对照组小鼠心肌组织无异常改变 ,实验组病鼠可见心肌细胞坏死和单核、淋巴细胞浸润 ,后期可见纤维化 ;心肌细胞凋亡方面 :电镜观察对照组心肌中未检出凋亡细胞 ,而病鼠心肌凋亡细胞检出率较高 5 8.33% (7/12例 ) ,且细胞凋亡多存在于炎症病灶周围的心肌细胞及病灶处炎性浸润细胞 ;各期病鼠心肌组织中的细胞凋亡比率较对照组明显增加 ,流式细胞仪检测平均心肌细胞凋亡百分率为 2 6 .74± 15 .2 2 % ,感染后第 7～ 14 d心肌细胞凋亡百分率明显高于其余时间 (P<0 .0 0 1)。结论 :小鼠病毒性心肌炎中心肌损伤坏死与凋亡共存 ,其中异常的心肌细胞凋亡与病毒性心肌炎的发病过程有关     

扩张型心肌病心肌细胞色素氧化酶活性半定量分析

本实验应用细胞化学立体计量学方法对扩张型心肌病和病毒性心肌炎病人心肌细胞色素氧化酶活性进行了半定量分析。结果表明,扩张型心肌病心肌该酶活性明显低于病毒性心肌炎组(P<0.01),而心肌线粒体数、体密度测定结果较心肌炎组明显增高(P<0.01)。     

抗FasL抗体在小鼠病毒性心肌炎治疗中的作用

目的：探讨抗FasL抗体对小鼠柯萨奇B3（CVB3）病毒性心肌炎心肌细胞凋亡及病毒滴度的调节作用。方法：随机将80只Balb／c小鼠分为空白对照组、病毒对照组、IgG对照组及抗FasL抗体治疗组,于感染后第10天每组处死8只并取其心脏,光镜检查的心肌病理变化,原位末端标记法（TUNEL）检测小鼠心肌组织的细胞凋亡,用空斑形成技术（PFU法）测定心肌病毒滴度。结果：抗FasL抗体治疗组小鼠死亡率、心肌病变积分、心肌细胞凋亡率、心肌病毒滴度均明显低于病毒对照组及IgG对照组（P均〈0．01）。结论：抗FasL抗体可降低小鼠CVB,病毒性心肌炎心肌内病毒滴度、减少心肌细胞凋亡和心肌损伤．     

柯萨奇病毒B3感染小鼠早期TNF-α的表达与心肌细胞凋亡的关系

目的:探讨柯萨奇病毒B3(CVB3)感染小鼠肿瘤坏死因子的表达与细胞凋亡的关系。方法:用CVB3感染小鼠建立病毒性心肌炎感染模型,测定血清中肿瘤坏死因子-α(TNF-α)的含量,同时采用末端脱氧核苷酸转移酶介导dUTP缺口末端标记法(TUNEL)检测心肌细胞凋亡情况。结果:与对照组比较,CVB3感染小鼠血清中TNF-α的含量明显升高,感染后5d,心肌细胞凋亡率与对照组比较差异显著(P<0.0001)。TNF-α与细胞凋亡之间有关联性(r=0.8276,P<0.05)。结论:在CVB3感染中心肌细胞凋亡与TNF-α明显升高有关,两者在病毒性心肌炎发病的早期起到了重要作用。     

急性病毒性心肌炎和原发性扩张型心肌病IL-1及TNF的改变

目的 :观察急性病毒性心肌炎和原发性扩张型心肌病患者白细胞介素 1 (IL- 1 )和肿瘤坏死因子 (TNF)的变化。方法 :采用 ELESA检测方法。结果 :IL- 1、TNF在这两种疾病中均有不同程度的升高。结论 :急性病毒性心肌炎时这两种细胞因子若持续不降 ,可能会导致慢性化 ,以致出现慢性心功能不全 ;急性病毒性心肌炎与原发性扩张型心肌病可能为同一种疾病不同时期的表现。合理免疫抑制剂治疗可能会改善病毒性心肌炎和扩张型心肌病的预后     

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.     

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.     

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.