TLR4、MyD88、NF-κB在乙型肝炎病毒肝硬化患者中的表达及其临床意义

目的 探讨Toll样受体4（TLR4）、髓样分化因子88（MyD88）、核转录因子-κ（NF-κB）信号通路在乙型肝炎病毒所致肝硬化中的表达及临床意义。方法 选取2017年1月—2019年1月华北石油管理局总医院收治的130例乙型肝炎肝硬化患者为研究对照（肝硬化组），选择同期130例乙型肝炎患者为乙型肝炎组，选择130例健康人群为对照组。其中肝硬化组进一步根据ChildPugh分为A级（49例），B级（47例），C级（34例）；根据肝硬化程度分为：代偿期肝硬化（49例），失代偿期肝硬化（48例），原发性肝癌（33例）。比较3组丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、总胆红素（TBIL）的差异，比较3组单核细胞表面TLR4阳性率及血清MyD88、NF-κB水平，以及不同程度肝硬化患者TLR4、MyD88、NF-κB表达水平。采用Spearman或Pearson分析法分析TLR4、MyD88、NF-κB与ChildPugh分级、AST、ALT及TBIL的相关性，采用受试者工作特征（ROC）曲线分析ALT、AST、TBIL、TLR4、MyD88及NF-κB对肝硬化致原发性肝癌的诊断价值。结果 肝硬化组、乙型肝炎组、对照组AST、ALT、TBIL水平比较，差异有统计学意义（P <0.05）；TLR4、MyD88、NF-κB水平比较，差异有统计学意义（P <0.05）；ChildPughA级、B级、C级患者TLR4、MyD88、NF-κB水平比较，差异有统计学意义（P <0.05）；不同程度肝硬化患者TLR4、MyD88、NF-κB比较，差异有统计学意义（P <0.05）。TLR4、MyD88及NF-κB与ChildPugh分级、AST、ALT及TBIL均呈正相关（P <0.05）。ROC曲线结果显示，ALT截断值为101.44 u/L时，AUC为0.738；AST截断值为136.74 u/L时，AUC为0.706；TBIL截断值为51.86 μmol/L 时，AUC为0.746；TLR4截断值为32.342%时，AUC为0.896；MyD88截断值为931.402 pg/ml时，AUC为0.897；NF-κB截断值为1 243.620 pg/ml时，AUC为0.875。结论 TLR4、MyD88、NF-κB信号通路与乙型肝炎病毒所致肝炎及肝硬化病理进程密切相关，且TLR4、MyD88、NF-κB的检测在诊断肝硬化致原发性肝癌中具有一定临床价值。     

右美托咪定对博莱霉素诱导的肺纤维化小鼠TLR4/MyD88信号通路的影响

目的：　探究右美托咪定（dexmedetomidine,DEX）对博莱霉素（bleomycin,BLM）诱导的肺纤维化小鼠的保护作用以及对Toll样受体4/髓样分化因子（toll-like receptor 4/myeloid differentiation factor88,TLR4/MyD88）信号通路的影响。方法：　通过注射BLM诱导实验性小鼠肺纤维化。将小鼠分为生理盐水（Sham）组、BLM组、BLM+DEX组、BLM+PFD组和BLM+DEX+LPS组。苏木素-伊红（hematoxylin and eosin,HE）染色和Masson染色分析肺组织病理学变化;免疫组织化学检测纤连蛋白（fibronectin,Fn）、α-平滑肌肌动蛋白（α-smooth muscle actin,α-SMA）和Ⅰ型胶原蛋白（collagenⅠ）表达情况;原位缺口末端标记法（TdT mediated dUTP nick end labeling,TUNEL）检测肺组织中细胞凋亡;检测支气管肺泡灌洗液（bronchoalveolar lavage fluid,BALF）中总细胞数量及蛋白质含量;Western blot检测肺组织中TLR4/MyD88信号通路和细胞凋亡相关蛋白水平。结果：　与Sham组相比,BLM刺激后肺组织中肺泡炎评分[（2.56±0.24）分vs.（0.15±0.02）分]和Ashcroft评分[（5.68±0.52）分vs.（0.09±0.01）分]明显增高,Fn[（63.63±5.48）% vs.（25.12±2.16）%]、α-SMA[（58.63±5.03）% vs.（17.56±1.25）%]和collagen Ⅰ[（55.32±5.16）% vs.（12.03±1.20）%]表达升高（P<0.05）,肺部炎症程度和纤维化程度增加;同时TUNEL阳性细胞率增高,细胞中bcl-2相关X蛋白（bcl-2 associated X protein,Bax）水平增高,B淋巴细胞瘤-2蛋白（B-cell lymphoma-2 protein,Bcl-2）水平降低（P<0.05）;BALF中总细胞数量[（3.54±0.06）×10⁵个/mL vs.（0.98±0.07）×10⁵个/mL]和蛋白质含量[（2.85±0.20）mg/mL vs.（0.29±0.03）mg/mL]升高（P<0.05）;肺组织中TLR4和MyD88蛋白水平升高（P<0.05）。DEX治疗可减轻BLM诱导的小鼠肺纤维化和炎症,降低TUNEL阳性细胞率,并逆转Fn、α-SMA、collagen Ⅰ、Bax和Bcl-2表达（P<0.05）;同时DEX也降低BLM诱导的小鼠BALF中总细胞数量和蛋白质含量（P<0.05）。此外,DEX降低BLM诱导的小鼠肺组织中TLR4和MyD88蛋白水平（P<0.05）。吡非尼酮（pirfenidone,PFD）与DEX具有相似的作用效果。脂肪酶（lipase,LPS）可以部分逆转DEX对BLM诱导的肺纤维化小鼠保护作用（P<0.05）。结论：　DEX可能通过抑制TLR4/MyD88信号通路改善BLM诱导的小鼠肺纤维化。     

TLR4特异性抑制剂对大鼠心脏死亡器官捐献供肝缺血再灌注损伤的作用

目的 探讨TLR4特异性抑制剂调控HMGB1/TLR4信号通路对大鼠心脏死亡器官捐献供肝缺血再灌注（IR）损伤的作用。方法 将8周龄Balb/c雄性大鼠分为对照组［术前30 min经腹腔注射二甲基亚砜（DMSO）无菌生理盐水］、对照抑制组（术前30 min经腹腔注射含TLR4抑制剂的DMSO无菌生理盐水）、模型组（术前30 min经腹腔注射DMSO无菌生理盐水）、模型抑制组（术前30 min经腹腔注射含TAK242的DMSO无菌生理盐水）,每组6只。收集肝脏组织标本,采用苏木精-伊红染色检测肝脏细胞形态结构,Suzuki评分评估肝脏细胞损伤情况;TUNEL染色法检测细胞凋亡率,Western blotting检测肝细胞HMGB1/TLR4及下游炎症因子相对表达量;免疫荧光和Western blotting测定TLR4与HMGB1的共表达作用。结果 病理结果显示,模型组肝脏损伤情况较对照组严重,模型抑制组肝脏损伤情况优于模型组;模型组Suzuki评分高于对照组（P <0.05）,模型抑制组Suzuki评分低于模型组（P <0.05）。模型组、模型抑制组HMGB1、TLR4、IL-1β、IL-6蛋白相对表达量高于对照组（P <0.05）;模型抑制组HMGB1、TLR4、IL-1β、IL-6蛋白相对表达量低于模型组（P <0.05）。模型组肝脏组织细胞凋亡率高于对照组和模型抑制组（P <0.05）。模型组HMGB1蛋白相对表达量高于对照组和模型抑制组（P <0.05）。免疫荧光结果显示,模型组大鼠肝细胞HMGB1的免疫活性显著增加,且主要位于细胞浆内;但对照组HMGB1免疫活性无显著变化。结论 TLR4特异性抑制剂可显著下调HMGB1/TLR4信号通路及相关信号分子,减轻供肝氧化应激和炎症反应,对供肝IR损伤具有保护作用。     

全胃肠外营养对幼鼠肠道炎症损伤作用研究

目的 探讨全胃肠外营养对幼鼠肠道炎症损伤的作用及机制。方法 选取18只6～8周龄雄性SD幼鼠，随机分为正常组、对照组和观察组，每组6只。观察组幼鼠行右颈静脉置管后给予全胃肠外营养治疗，并禁食、水；对照组幼鼠行右颈静脉置管后给予生理盐水治疗；正常组不予以置管。正常组和对照组幼鼠均喂食标准鼠粮和水，14 d后处死幼鼠，获取肠道组织。采用HE染色观察各组幼鼠肠道组织的病理变化，TUNEL染色观察各组幼鼠小肠上皮细胞凋亡情况，实时荧光定量聚合酶链反应（qRT-PCR）和Western blotting检测各组幼鼠肠道组织中的肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）和白细胞介素-10（IL-10）、Occludin和ZO-1的mRNA和蛋白表达，免疫组织化学检测各组幼鼠肠道组织中的Occludin、ZO-1的表达。结果 观察组幼鼠的肠道组织均出现不同程度的损伤；与正常组和对照组比较，观察组肠上皮细胞凋亡率升高（P <0.05），TNF-α、IL-1β的mRNA和蛋白表达升高（P <0.05），而IL-10、Occludin、ZO-1的mRNA和蛋白表达降低（P <0.05）；免疫组织化学结果显示，Occludin、ZO-1表达下降（P <0.05）。结论 持续2周的全胃肠外营养可导致幼鼠肠道功能受损，促炎因子增加，肠道机械屏障功能受损，尽可能恢复肠内营养对于减少肠道并发症具有重要意义。     

曲美他嗪对重症肺炎大鼠的肺保护作用及其机制研究

目的 观察曲美他嗪（TMZ）对重症肺炎大鼠的肺保护作用，并探讨其可能机制。方法 45只SD雄性大鼠中，取35只大鼠复制重症肺炎模型，死亡5只，30只模型大鼠随机分为重症肺炎（SP）组、TMZ组、TMZ联合磷脂酸（PA）［哺乳动物雷帕霉素靶蛋白（mTOR）激活剂］组，每组10只；余10只仅注射无菌生理盐水，设为对照组。TMZ组灌胃TMZ生理盐水溶液5 mL，剂量20 mg/kg，尾静脉注射生理盐水1 mL；TMZ联合PA组灌胃TMZ生理盐水溶液5 mL，剂量20 mg/kg，尾静脉注射PA生理盐水溶液1 mL，剂量1 mg/kg；对照组、SP组分别灌胃、尾静脉注射等体积生理盐水。4组大鼠均1次/d，连续干预6 d。检测外周血辅助性T细胞17（Th17）和调节性T细胞（Treg）细胞、肺功能指标、肺泡灌洗液（BALF）中白细胞介素-1β（IL-1β）水平；采用Western blotting检测肺组织蛋白激酶B（Akt）、p-Akt、mTOR、p-mTOR蛋白的表达。结果 对照组、SP组、TMZ组、TMZ联合PA组Th17/Treg、BALF中IL-1β水平、肺容积变换量、静息通气量、肺组织p-Akt/Akt比较，经方差分析，差异有统计学意义（P <0.05）；与对照组比较，SP组外周血Th17/Treg、BALF中IL-1β水平、肺组织p-Akt/Akt升高（P <0.05），肺容积变换量、静息通气量减少（P <0.05）；与SP组比较，TMZ组外周血Th17/Treg、BALF中IL-1β水平、肺组织p-Akt/Akt降低（P <0.05），肺容积变换量、静息通气量增加（P <0.05）；与TMZ组比较，TMZ联合PA组外周血Th17/Treg降低（P <0.05），BALF中IL-1β水平、肺组织p-Akt/Akt升高（P <0.05），肺容积变换量、静息通气量减少（P <0.05）。结论 TMZ可改善重症肺炎大鼠肺功能及Th17/Treg平衡，减轻肺部炎症反应及病理变化，其作用可能通过抑制PI3K/Akt信号通路来实现。     

GPR30对大鼠椎间盘退行性病变的作用及其机制研究

目的 探讨G蛋白偶联受体30（GPR30）通过Nrf2/ARE信号通路抑制白细胞介素1β（IL-1β）诱导的大鼠椎间盘髓核细胞的凋亡、炎症反应和氧化应激。方法 使用IL-1β处理大鼠椎间盘髓核细胞复制体外椎间盘退变模型,将椎间盘髓核细胞分为空白对照（Control）组、IL-1β组、IL-1β+过表达GPR30阴性对照质粒（oe-NC）组、IL-1β+过表达GPR30质粒（oe-GPR30）组、IL-1β + oe-GPR30+干扰Nrf2表达阴性对照质粒（si-NC）组、IL-1β + oe-GPR30+干扰Nrf2表达质粒（si-Nrf2）组,IL-1β的处理浓度为10 ng/mL。实时荧光定量聚合酶链反应检测GPR30 mRNA表达;Western boltting检测GPR30、抗重组与合成蛋白（Nrf2）和抗醌NADH脱氢酶（NQO1）和抗血红素加氧酶1（HO-1）蛋白表达;流式细胞术检测细胞凋亡情况;酶联免疫吸附试验检测肿瘤坏死因子-α（TNF-α）和IL-6水平;使用ELISA法检测活性氧（ROS）、分光光度法检测超氧化物歧化酶（SOD）水平,比色法检测丙二醛（MDA）水平。结果 IL-1β组髓核细胞GRP30 mRNA、蛋白相对表达量较Control组降低（P <0.05）,IL-1β + oe-GPR30组较IL-1β + oe-NC组升高（P <0.05）。IL-1β组髓核细胞核中Nrf2蛋白相对表达量较Control组升高（P <0.05）,IL-1β + oe-GPR30组较IL-1β + oe-NC组升高（P <0.05）。IL-1β组Nrf2、HO-1及NQO1蛋白相对表达量较Control组降低（P <0.05）,IL-1β + oe-GPR30组较IL-1β + oe-NC组升高（P <0.05）。IL-1β组髓核细胞Nrf2蛋白相对表达量较Control组降低（P <0.05）,IL-1β+ oe-GPR30组较IL-1β + oe-NC组升高（P <0.05）,IL-1β + oe-GPR30 + si-Nrf2组较IL-1β + oe-GPR30 + si-NC组降低（P <0.05）。IL-1β组髓核细胞凋亡率较Control组升高（P <0.05）,IL-1β + oe-GPR30组较IL-1β + oe-NC组降低（P <0.05）,IL-1β + oe-GPR30 + si-Nrf2组较IL-1β + oe-GPR30+si-NC组升高（P <0.05）。IL-1β组TNF-α、IL-6水平较Control组升高（P <0.05）,IL-1β + oe-GPR30组较IL-1β + oe-NC组降低（P <0.05）,IL-1β + oe-GPR30 + si-Nrf2组较IL-1β + oe-GPR30 + si-NC组升高（P <0.05）。IL-1β组ROS、MDA水平较Control组升高（P <0.05）,SOD水平较Control组降低（P <0.05）,IL-1β + oe-GPR30组ROS、MDA水平较IL-1β + oe-NC组降低,SOD水平较IL-1β + oe-NC组升高（P <0.05）,IL-1β + oe-GPR30 + si-Nrf2组ROS、MDA水平较IL-1β + oe-GPR30 + si-NC组升高,SOD水平较IL-1β + oe-GPR30 + si-NC组降低（P <0.05）。结论 上调GPR30表达激活Nrf2/ARE信号通路,能抑制IL-1β诱导的髓核细胞凋亡、炎症和氧化应激反应。     

新生儿脐血细胞因子Elafin、IL-18、IFN-γ/IL-4与HBV宫内感染的相关性研究

目的 研究新生儿脐血细胞因子弹性蛋白酶特异性抑制物（Elafin）、白细胞介素18（IL-18）、γ-干扰素（IFN-γ）/白细胞介素4（IL-4）与乙型肝炎病毒（HBV）宫内感染的相关性。方法 选取2016年5月—2019年5月攀枝花市妇幼保健院收治的HBV携带产妇分娩的新生儿96例。其中,31例发生HBV宫内感染新生儿作为宫内感染组,65例未感染新生儿作为宫内未感染组。另选取同期该院非HBV携带且健康产妇分娩的新生儿90例作为对照组。比较3组脐血Elafin、IL-18、IFN-γ、IL-4水平及IFN-γ/IL-4,分析新生儿宫内感染影响因素、脐血因子之间关联性及与HBV-DNA载量相关性。结果 宫内感染组Elafin、IL-18、IFN-γ、IFN-γ/IL-4低于宫内未感染组、对照组,IL-4高于宫内未感染组、对照组（P <0.05）。宫内感染组与宫内未感染者组产妇HBV大三阳、羊水情况、阴道流血史的比较,差异有统计学意义（P <0.05）。产妇HBV大三阳［R=3.125（95% CI：2.379,4.105）,P<0.05］、产妇羊水浑浊［R=2.781（95% CI：2.041,3.790）,P <0.05］、产妇阴道流血史［R=2.389（95% CI：1.816,3.144）,P <0.05］、Elafin［R=0.574（95% CI：0.405,0.813）,P <0.05］、IL-18［R=0.529（95% CI：0.352,0.796）,P <0.05］、IFN-γ/IL-4［R=0.475（95% CI：0.440,0.512）,P <0.05］是新生儿HBV宫内感染的影响因素。Elafin与IL-18呈正相关（r =0.649,P <0.05）,IFN-γ/IL-4与Elafin、IL-18呈正相关（r =0.529和0.499,P <0.05）。HBV-DNA载量≥ 1.00×10⁴copies/ml患者Elafin、IL-18、IFN-γ/IL-4 水平较< 1.00×10⁴copies/ml患者低（P <0.05）。Elafin、IL-18、IFN-γ/IL-4与HBV-DNA载量呈负相关（r =-0.601、-0.556和-0.712,均P <0.05）。结论 Elafin、IL-18、IFN-γ/IL-4在新生儿宫内感染中呈异常表达,并与HBV-DNA载量密切相关。     

二肽基肽酶-4通过CXCR4/mTOR信号通路介导小鼠肺泡巨噬细胞MH-S自噬的机制研究

目的 探究二肽基肽酶-4（DPP-4）通过趋化因子受体4（CXCR4）/哺乳动物雷帕霉素靶蛋白（mTOR）信号通路介导小鼠肺泡巨噬细胞MH-S自噬的机制。方法 体外培养小鼠肺泡巨噬细胞MH-S并分组转染。分别设置PBS组（PBS培养MH-S细胞）、LPS组（100 ng/mL LPS诱导24 h）、DPP-4组（DPP-4表达病毒转染）、si-DPP-4组（si-DPP-4病毒载体转染）、DPP-4 + BafA1组（DPP-4表达病毒转染+自噬抑制剂BafA1干预）及si-DPP-4 + BafA1组（si-DPP-4病毒载体转染+自噬抑制剂BafA1干预）。绿色荧光蛋白（GFP）检测转染效率，稳定转染后，酶联免疫吸附试验检测MH-S细胞上清液炎症因子水平，腺病毒检测MH-S细胞自噬流变化，实时荧光定量聚合酶链反应检测细胞DPP-4、CXCR4、mTOR mRNA的表达，Western blottig检测CXCR4/mTOR通路蛋白的表达。结果 LPS组IL-1β、IL-6、TNF-α、GFP、RPF、Merge数量，CXCR4 mRNA、mTOR mRNA和CXCR4蛋白、p-mTOR/mTOR蛋白相对表达量高于PBS组（P <0.05）；DPP-4组与LPS组IL-1β、IL-6及TNF-α水平比较，差异无统计学意义（P >0.05）；DPP-4组GFP、RPF、Merge数量，DPP-4 mRNA相对表达量高于LPS组（P <0.05），CXCR4 mRNA、mTOR mRNA、CXCR4蛋白、p-mTOR/mTOR蛋白相对表达量低于LPS组（P <0.05）；si-DPP-4组IL-1β、IL-6、TNF-α水平高于LPS组（P <0.05），GFP、RPF及MergeMerge数量低于LPS组（P <0.05）；si-DPP-4组和DPP-4 + BafA1组IL-1β、IL-6、TNF-α水平、CXCR4蛋白、p-mTOR/mTOR蛋白相对表达量高于DPP-4组（P <0.05），GFP、RPF及Merge数量低于DPP-4组（P <0.05）；si-DPP-4组DPP-4 mRNA相对表达量低于DPP-4组（P <0.05），CXCR4 mRNA、mTOR mRNA相对表达量高于DPP-4组（P <0.05）；si-DPP-4 + BafA1组IL-1β、IL-6水平、CXCR4 mRNA、mTOR mRNA、CXCR4蛋白、p-mTOR/mTOR蛋白相对表达量高于si-DPP-4组（P <0.05），GFP、RPF、Merge数量低于si-DPP-4组（P <0.05）。结论 DPP-4能够调节小鼠肺巨噬细胞自噬作用，调控炎症反应，其作用机制可能与CXCR4/mTOR通路有关。     

针刺对乳腺癌化疗后癌因性疲乏模型小鼠肠-脑轴相关因子的影响

目的 观察针刺对乳腺癌化疗后癌因性疲乏（CRF）模型小鼠肠-脑轴相关因子的影响,探讨针刺改善乳腺癌CRF的可能机制。方法 将BALB/c小鼠随机分为空白组、模型组、针刺组和假针刺组,以荷瘤加化疗的方法复制乳腺癌化疗后CRF模型小鼠。针刺足三里、三阴交、百会、关元、气海穴位,1次/d,30 min/次,干预14 d。通过小鼠一般情况、强迫游泳实验、旷场实验评估小鼠体力和疲劳情况;Western blotting检测下丘脑和结肠组织中炎症因子白细胞介素-1β（IL-1β）、IL-6、肿瘤坏死因子-α（TNF-α）蛋白表达;酶联免疫吸附试验检测血清HPA轴相关因子皮质醇（CORT）、促肾上腺皮质激素（ACTH）表达。结果 模型组模型复制后强迫游泳不动时间长于空白组（P <0.05）。模型组干预后强迫游泳不动时间长于针刺组（P <0.05）,假手术组干预后长于针刺组（P <0.05）。模型组模型复制后水平运动得分、垂直运动得分低于对照组（P <0.05）。针刺组干预后水平运动得分、垂直运动得分高于模型组、假针刺组（P <0.05）。模型组、假针刺组小鼠下丘脑中IL-1β、IL-6、TNF-α蛋白相对表达量高于空白组（P <0.05）,针刺组低于模型组、假针刺组（P <0.05）。针刺组、模型组、假针刺组结肠组织中IL-1β、IL-6、TNF-α蛋白相对表达量高于空白组（P <0.05）,针刺组低于模型组、针刺组（P <0.05）。模型组、假针刺组ACTH蛋白水平高于空白组（P <0.05）,CORT蛋白水平低于空白组（P <0.05）;针刺组ACTH蛋白水平低于模型组（P <0.05）,CORT蛋白水平高于模型组（P <0.05）;针刺组ACTH蛋白水平低于假针刺组（P <0.05）,CORT蛋白水平高于假针刺组（P <0.05）。结论 针刺可能通过降低乳腺癌CRF模型小鼠中枢和结肠中促炎因子的表达水平,调节HPA轴功能紊乱状态,进而改善乳腺癌化疗后CRF的疲乏症状,这可能是针刺治疗CRF的作用机制之一。     

星状神经节阻滞术对大鼠急性心肌梗死后炎症反应的影响

目的 探讨星状神经节阻滞术（SGB）对大鼠急性心肌梗死（AMI）后心肌细胞炎症的保护作用。方法 选取8周龄雄性SPF级Wistar大鼠60只,体重200～250 g,随机分为假手术组、AMI组和SGB组,每组20只。假手术组只打开胸腔暴露心脏,不结扎冠状动脉;AMI组结扎冠状动脉左前降支复制AMI模型;SGB组在AMI模型复制成功后行SGB。模型复制成功后1周采集各组大鼠血清及心脏组织,qRT-PCR检测各组大鼠心肌组织中炎症因子（IL-6、IL-1β及TNF-α）mRNA;酶联免疫吸附试验检测各组大鼠血清中炎症因子（IL-6、IL-1β及TNF-α）,全自动生化分析仪检测各组大鼠血清中心肌酶（AST、LDH和CK-MB）。结果 各组大鼠心肌组织中炎症因子IL-6、IL-1β及TNF-α mRNA相对表达量比较,差异有统计学意义（P <0.05）,SGB组IL-6、IL-1β及TNF-α mRNA的相对表达量均较AMI组降低（P <0.05）。各组大鼠血清中炎症因子IL-6、IL-1β及TNF-α表达水平比较,差异有统计学意义（P <0.05）,AMI组、SGB组IL-6、IL-1β及TNF-α表达水平较假手术组升高（P <0.05）,SGB组IL-6、IL-1β及TNF-α表达水平较AMI组降低（P <0.05）。各组大鼠血清AST、LDH及CK-MB表达水平比较,差异有统计学意义（P <0.05）,AMI组、SGB组AST、LDH及CK-MB表达水平较假手术组升高（P <0.05）,SGB组AST、LDH和CK-MB表达水平较AMI组降低（P <0.05）。结论 SGB对大鼠AMI后心肌细胞炎症有一定的保护作用。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.