TGF—β1在肝纤维化大鼠肝组织中的表达及其生物学意义

目的：通过研究大鼠肝纤维化模型肝组织中转化生长因子β1(Transforming growth factor β1,TGF－β1)的表达和分布规律，初步探讨TGF－β1在肝纤维化发病机制中的作用。方法：雄性SD大鼠32只，体重250－300克，皮下注射CCl4制备大鼠肝纤维化模型，分别于注射CCl4后1，4，8周处理动物，采用免疫组织化学方法检测肝组织中TGF－β1的表达及分布。结果：TGF－β1主要表达于肝脏间质组织中。CCl4注射诱导后，大鼠肝组织中TGF－β1的表达较正常对照明显增强（P＜0．01）。且CCl4注射1、4、8周组肝组织中TGF－β1的表达强度呈明显的逐级递增的趋势（P＜0．01）。结论：TGF－β1的表达水平与大鼠肝纤维化严重程度呈显正相关，可能与肝纤维化的发生发展有关。     

HG颗粒对CCl4复合因素所致肝纤维化大鼠血清Hyp及TGFβ1含量的影响

目的：研究HG颗粒对肝纤维化（hepatic fibrosis）大鼠血清羟脯氨酸（Hyp）及转化生长因子β1（TGFβ1）含量的影响。方法：大鼠皮下注射CCl4，同时给予高脂饲料和20％乙醇喂养建立肝纤维化大鼠模型，分别予HG颗粒、复方鳖甲软肝片灌胃治疗。对照观察两药物对肝纤维化模型大鼠血清Hyp及TGFβ1含量的影响。结果：肝纤维化模型大鼠血清Hyp及TGFβ1含量均明显增高。HG颗粒治疗后有明显缓解，综合疗效优于阳性药物对照组。结论：HG颗粒对CCl4复合因素所致肝纤维化模型大鼠具有显著的治疗作用。     

银杏叶提取物对大鼠慢性肝损伤的保护作用

目的：观察银杏叶提取物对大鼠慢性肝损伤的保护作用。方法：随机分为正常组、模型组、银杏天宝组和秋水仙碱组，银杏天宝和秋水仙碱以灌胃的方式给药。对比观察银杏天宝和秋水仙碱对四氯化碳所致慢性肝损伤大鼠的肝功能、肝纤维化、肝病理组织学及肝组织氧化指标的影响。结果：银杏天宝组大鼠肝功能指标丙氨酸氨基转移酶（ALT）、天门冬氨酸转移酶（AST）、白蛋白（ALb)、碱性磷酸酶（AKP）较模型组明显改善（P＜0．05或P＜0．01）；肝纤维化血清学指标透明质酸（HA）、层粘连蛋白（LN）和肝组织羟脯氨酸（Hyp)含量明显低于模型组（P＜0．05或P＜0．01）；肝组织中丙二醛（MDA）含量较模型组降低，过氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH－Px)活性明显高于模型组（P＜0．05或P＜0．01）；HE染色示肝组织纤维化程度较模型组明显减轻（P＜0．05）；银杏天宝综合效果优于秋水仙碱。结论：银杏叶提取物对慢性肝损伤有良好的保护作用，抗氧化作用可能是其主要的作用机制之一。     

抗纤软肝方抑制二甲基亚硝胺诱导大鼠肝纤维化形成的研究

目的观察抗纤软肝方抑制二甲基亚硝胺诱导大鼠肝纤维化形成的作用效果并探讨其作用机制。方法采用二甲基亚硝胺诱导的大鼠肝纤维化模型，用高、中、低三种剂量（42．0g／kg，21．0g／kg，10．5g／kg）的抗纤软肝方水提液进行干预治疗，并与秋水仙碱进行对照，检测大鼠肝功能、肝组织羟脯胺酸（Hyp）、超氧化物歧化酶（SOD）、血清透明质酸（HA）含量及肝脏病理组织学改变。结果抗纤软肝方高、中、低剂量组血清谷丙转氨酶（ALT）、谷草转氨酶（AST）、碱性磷酸酶（ALP）水平均显著低于模型组和秋水仙碱组（P〈0．05）。抗纤软肝方各剂量组大鼠肝组织Hyp含量均明显低于模型组（P〈0．01），而肝组织SOD含量均明显高于模型组（P〈0．01）。抗纤软肝方高剂量组大鼠血清HA含量明显低于模型组，差异有显著性意义（P〈0．01）。抗纤软肝方高、中、低剂量组肝组织纤维化病变明显减轻，与模型组比较，差异均有显著性意义（P〈0．01）。结论抗纤软肝方对二甲基亚硝胺诱导的肝纤维化形成具有明显的抑制作用，其机制与抗脂质过氧化损伤、保护肝细胞和抑制胶原纤维合成有关。     

干扰素-α对肝纤维化大鼠肝星状细胞凋亡的诱导作用

目的：研究干扰素－α（IFN－α）对肝纤维化大鼠肝星状细胞（HSC）凋亡的影响。方法：用四氯化碳（CCl4)复制肝纤维化模型大鼠32只，随机分为A，B，C3组。A组：6只，造模结束即处死；B组14只，皮下注射－α10万／100g8周，C组12只，注射等量的生理盐水8周。治疗结束时用TUNEL法检测各组肝星状细胞凋亡情况；HE染色观察肝组织学变化；免疫组化染色检测中间丝蛋白（Desmin,),α-平滑肌肌动蛋白（α－SMA），I型胶原，转化生长因子1（TGF－β1）等指标。结果：B组较其他两组肝组织学明显改善，肝纤维化程度减轻，I型胶原，TGF－β1的显色指数降低；B组肝星状细胞明显减少，凋亡指数增加，与C组相比，差异有统计学意义。结论：IFN－α在体内可诱导HSC凋亡，这可能是IFN－α抗肝纤维化的作用机制之一。     

"益肝浓缩煎剂"对实验性大鼠肝纤维化防治作用的研究

目的 研究“益肝浓缩煎剂”对四氯化碳大鼠肝纤维化预防与治疗作用。方法 以CCl4诱导大鼠肝纤维化模型，注射CCl4前2周及造模结束后分别予“益肝浓缩煎剂”进行防治，各持续10周；测定肝组织羟脯氨酸（hydroxyproline,Hyp)含量，光镜、电镜观察肝脏病理形态变化。结果“益肝浓缩煎剂”预防、治疗组Hyp显著降低（P＜0．01），胶原沉积及脂肪变性明显减轻（P＜0．05），电镜显示“益肝浓缩煎剂”预防组肝细胞内脂滴明显减少，细胞器接近正常，狄氏间隙内仅见少量胶原纤维增生。结论“益肝浓缩煎剂”对大鼠肝纤维化具有明确防治作用。     

慢性乙肝患者血清细胞因子、乙肝病毒与肝纤维化的关系

目的：探讨慢性乙肝患血清细胞因子（TGF－β，TNF-α，IL-6，IL-8），乙肝病毒（HBV）对肝纤维化（HA，PCⅢ，C-Ⅳ，LN）的影响作用。方法：采用ELISA和RIA方法检测171例慢性乙肝患血清TGF－β，TNF-α，IL-6，IL-8，HLA，PCǚ，C-Ⅳ，LN的水平，HBV－DNA定量检测采用PCR方法。结果：慢性乙肝患血清TGF－β，TNF-α，IL-6，IL-8，HA，PCⅢ，C-Ⅳ，LN的含量均不同程度高于对照组，且随肝损害程度的加重而升高，与肝损害程度呈正相关关系（P＜0．05或P＜0．01）；须血清TGF－β1水平与血清HA，PCⅢ，C-Ⅳ，LN水平具有直线相关关系。HBV－DNA阳性组（Ⅱ组）均高于HBV－DNA阴性组（I组），且在慢性中，重度肝炎间差异显（P＜0．05）。结论：血清TGF－β，TNF-α，IL-6，IL-8参与慢性乙肝的发病机制及肝纤维化的形成，且与病毒复制的活跃程度相关。     

软肝宁煎剂对肝纤维化大鼠防治作用的实验研究

目的观察软肝宁煎剂防治肝纤维化的作用并探讨其作用机制。方法采用CCl4复合因素诱导Wistar大鼠建立肝纤维化模型,设正常对照组、肝纤维化模型组、软肝宁煎剂预防组和软肝宁煎剂治疗组。实验结束后分别测定各组大鼠的肝脏指数和肝功能：ALT、AST,肝纤维化指标,透明质酸（HA）,并作肝组织病理学检测及肝组织中转化生长因子（TGF—β1）免疫组化染色。结果1．软肝宁煎剂预防组、治疗组与模型组肝纤维化大鼠组织学比较有显著性差异（P〈0．05,P〈0．01）;2．在肝脏指数方面：预防组与模型组比较有显著性差异（P〈0．05）,而治疗组无明显差异;3．软肝宁煎剂能明显降低大鼠血清中ALT、AST和大鼠肝脏组织中HA的含量,与模型组比较有显著性差异（P〈0．01）;4．软肝宁煎剂预防组和治疗组与模型组比较,明显抑制了TGF—β1的表达。结论软肝宁煎剂可通过保护肝细胞,减轻肝细胞损伤,促进ECM的降解,减少细胞因子TGF—β1的产生及释放来防治大鼠肝纤维化的发生和发展。     

肝纤康防治肝纤维化的实验研究

目的：观察肝纤康对小鼠实验性肝纤维化的防治作用及其机制。方法：采用四氯化碳（CCl4）复制小鼠肝纤维化模型,同时予以肝纤康灌胃治疗,观察小鼠血清丙氨酸氨基转移酶（ALT）、天门冬酸氨基转移酶（AST）、白蛋白（Alb）、肝组织羟脯氨酸（Hyp）含量及肝组织病理改变。结果：模型组小鼠ALT、AST、Hyp显升高,Alb显降低,肝纤维化病变明显;给药组ALT、AST、Hyp明显降低,Alb明显升高,与模型且比较差异有显性（P＜0．01或P＜0．05）;并能明显减轻小鼠肝细胞损害和胶原纤维增生的程度。结论：肝纤康有较好的保护肝功能和防治肝纤维化作用。     

活血化瘀中药对大鼠纤维化肝间质胶原的抑制作用

目的：研究中药活血化瘀中药益肝康对CCl4和猪血清（PS）所致之两种肝纤维化模型的防治作用。方法：采用CCl4和PS10周法制作SD大鼠肝纤维化模型，含10％活血化瘀中药饲料14周结合方法。预防组在制模前4周即开始预防用药，于制模结束时停止用药；治疗组在制模结束前4周开始治疗用药，于制模结束后10周停止用药。设正常对照和模型自然恢复对照。Masson染色肝组织肝组织胶原，计算机图像分析系统分析纤维间隔数量，宽度和假小叶形成情况。结果：两种制模方法预防组和治疗组均较对照组假小叶和纤维间隔数目明显减少（P＜0．05／P＜0．01）并可使PS模型纤维间隔变薄（P＜0．05）。结论：益肝康对上述两种造模方法所致之肝纤维化均具有明显的防治作用。造模前4周即开始预防用药比造模结束前4周开始治疗用药更能有效地防止CCl4致大鼠肝纤维化的形成。     

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.