肝细胞生长因子对肝纤维化的保护作用及其机制研究

目的 观察肝细胞生长因子(HGF)对实验性肝纤维化大鼠的保护作用及其可能的作用机制.方法 采用CCl4复合因素造模,HE染色观察肝组织形态学变化,赖氏法检测ALT、AST,TUNEL标记法检测肝细胞凋亡百分率,免疫组化方法观察增殖细胞核抗原(PCNA)、bcl-2、bax、Cyt C、caspase-3表达.结果 造模5～8周时,模型组可见肝小叶结构紊乱,纤维组织明显增生,并向肝小叶内延伸分割肝小叶,造模8周可形成假小叶.与模型组比较,HGF治疗组肝细胞变性坏死、炎性细胞浸润及纤维组织增生较轻(P<0.01),ALT、AST水平下降(P<0.05),肝细胞凋亡明显减少(P<0.05),PCNA阳性表达明显增高(P<0.05),bcl-2表达明显增多(P<0.01),同时bax、Cyt C、caspase-3表达显著减少(P<0.05).结论 HGF通过调节线粒体途径抑制肝细胞凋亡、促进肝细胞增殖而发挥对实验性肝纤维化大鼠的保护作用.     

硒及中药抗肝纤维化实验研究

目的 探讨硒及中药的抗肝纤维化作用。方法 用CCl4等复合因素制备大鼠肝纤维化的动物模型，对病理形态学、常规生化指标ALT、A／G及血清肝纤维化指标HA、PC Ⅲ的变化进行观察。结果 模型组与预防组各组之间均有显著性差异，而中药＋硒预防组与中药预防组之间亦有显著性差异。病理结果显示，模型组正常肝小叶结构被破坏，有假小叶形成，肝细胞肿胀，呈水样变性，部分细胞脂肪变性可见肝细胞的点状坏死；而预防给药各组肝细胞的脂肪变性和水样变性明显减轻，未见明显的假小叶形成，其中以中药＋硒组肝细胞脂肪性和水样变性程度最轻。结论 硒及中药单独应用均可提高A／G值、降低血清ALT及HA、PCⅢ的水平，减轻肝组织纤维化的形态；如果在中药中适量加硒，则会进一步增强抗肝纤维化的作用。     

双虎清肝颗粒对四氯化碳诱发肝纤维化大鼠血液TNF-α和肝脏组织学的影响

目的：探讨双虎清肝颗粒对四氯化碳诱发肝纤维化大鼠血液TNF-α和肝脏组织学的影响。方法：清洁级Sprague-Dawley大鼠60只,随机分成6组,A组（正常对照组）、B组（模型组）、C1组（双虎清肝颗粒小剂量组）、C2组（双虎清肝颗粒中剂量组）、C3组（双虎清肝颗粒大剂量组）、D组（水飞蓟素对照组）。除正常对照组外,均经皮下注射400mL/L四氯化碳8周,后各治疗组给予不同剂量双虎清肝颗粒干预8周,阳性对照组给予水飞蓟素干预8周,ELISA法检测肿瘤坏死因子（TNF-α）,常规HE及Masson染色,光镜观察肝组织的脂肪变、炎症及纤维化程度。结果：各组大鼠肝脏病理表现：A组肝细胞排列整齐,未见脂质空泡形成,汇管区未见炎症,肝小叶结构清晰可见,未见肝纤维化及假小叶形成;B组可见大量脂质空泡形成,汇管区可见大量炎性细胞浸润,成纤维细胞大量增生,肝细胞广泛变性呈片状坏死。汇管区可见大量假小叶形成,肝小叶间隔明显增宽和大量胶原纤维沉积;C1、C2、C3、D组：C1组同B组相比,未见明显差异,可见大量脂质空泡形成,汇管区见大量炎性细胞浸润、成纤维细胞增生,肝细胞广泛变性及点状、片状坏死及较多假多小叶形成。C2组同模型组相比,脂质空泡有所减少,肝细胞坏死程度有所减轻,假小叶形成较少,仍明显可见、较多胶原纤维沉积。C3、D组同B组相比,脂质空泡明显减少,肝细胞坏死程度明显减轻,假小叶形成、胶原纤维沉积明显减少（见图1）。各组大鼠肝纤维化病变半定量结果：A组大鼠纤维化程度为0,B组大鼠纤维化程度为16.1±5.5,C1组大鼠纤维化程度为12.6±4.6^a,C2组大鼠纤维化程度为10.7±3.9^a,C2组大鼠纤维化程度为6.4±3.4^a,D组大鼠纤维化程度为6.5±3.3^a,以上数据为半定量计数结果,计算公式：P＋L＋2×（PN＋BN）;与B组比较,^aP〈0.05。各组大鼠肝脏TNF-α表达结果：A组大鼠8.01±3.45^b,B组大鼠19.15±4.86,C1组大鼠11.28±3.43^a,C2组大鼠9.93±5.31^a,C3组大鼠9.37±5.02^a,D组大鼠10.86±5.28^a。与B组比较,^aP〈0.05,与B组比较,^bP〈0.01。结论：双虎清肝颗粒能够显著改善四氯化碳所诱发的肝纤维化大鼠肝脏组织学变化及TNF-α的表达,并且量效关系明显。     

益生菌制剂治疗肝硬化的形态学研究

观察口服益生菌制剂对大鼠肝硬化模型的治疗效果,以寻求利用微生态疗法治疗肝病的新途径。用ｗｉｓｔａｒ 大鼠５０ 只,分四组做实验,并进行组织学观察,结果显示：治疗组肝细胞变性坏死程度减轻,假小叶形成延缓。提示,益生菌对肝硬化有一定治疗作用,可作为肝病患者的辅助治疗。     

枳椇子对实验性肝纤维化Ⅰ、Ⅲ型胶原的影响

目的研究枳楔子提取物对CCl4诱导的实验性肝纤维化的保护作用。方法用CCl4制备大鼠肝纤维化模型,免疫组化观察Ⅰ、Ⅲ型胶原蛋白的表达。结果模型组肝细胞大量坏死,汇管区炎性细胞浸润,假小叶形成。预防组能减轻纤维化时肝细胞的变性坏死及炎性细胞浸润,纤维组织增生较模型组明显减少,呈局限性,假小叶部分消失。预防组Ⅰ、Ⅲ型胶原免疫组化着色减少且浅,呈丝状,与模型组相比程度明显减少。结论枳棋子能促进肝纤维化时Ⅰ、Ⅲ型胶原的降解。其机理可能与抑制肝星状细胞(hepatic stellate cell,HSC)活化有关。     

维拉帕米和尼群地平对大鼠肝硬化作用的实验研究

目的：观察维拉帕米和尼群地平对大鼠肝硬化模型的治疗效果，并探讨其作用机制，以寻求用钙拮抗剂治疗肝病的新途径。方法：80只Wistar大鼠分为正常对照组、肝硬化模型组、维拉帕米组、尼群地平组、联合用药组。第4周、第8周测血清谷丙转氨酶（ALT）、总胆红素（TBIL）、透明质酸（HA）、Ⅳ型胶原（Ⅳ-C），肝组织切片分析。结果：维拉帕米和尼群地平有降低ALT和TBIL的作用，对肝硬化的指标HA和Ⅳ-C也有改善，且联合用药效果更佳。病理证明两种药物能减轻肝细胞变性坏死程度，延缓假小叶形成。结论：维拉帕米和尼群地平联合使用，可以有效地预防CCl4/乙醇对大鼠肝功能的损伤，降低肝硬化程度。     

绿甘安对大鼠肝硬化的缓解作用

目的探讨在绿甘安干预下，大鼠肝硬化形成时的肝脏功能和肝脏组织病理学改变是否有缓解作用。方法雄性SD大鼠50只随机分为3组,绿甘安组20只采用绿甘安尾静脉注射，皮下注射四氯化碳（CC14），饮用乙醇；肝硬化组20只皮下注射CCI4，饮用乙醇；对照组10只正常饮水摄食。10周后检测各组大鼠的肝脏功能，并观察肝脏组织的病理学变化。结果3组大鼠肝脏功能有差异（P〈0．05），在总胆红素（TBIL）、丙氨酸转氨酶（ALT）、总蛋白（TP）、白蛋白（ALB）、球蛋白（GLOB）指标上，绿甘安组介于肝硬化组和正常对照组之间（P〈0．05）。在肝脏组织病理学检查中，绿甘安组大鼠存在肝细胞变性、坏死、纤维组织增生，但是假小叶形成不明显；肝硬化组大鼠纤维增生明显，并形成大小不一的假小叶。结论绿甘安对大鼠肝硬化形成有一定的缓解作用。     

肝硬化大鼠肝缺血再灌注损伤肝细胞死亡方式

目的研究肝硬化大鼠肝缺血再灌注(I/R)损伤时肝细胞死亡的主要方式。方法采用四氯化碳复合法制作肝硬化大鼠模型,将肝硬化大鼠随机分为假手术(SO)组和I/R组,I/R组建立70%肝I/R模型,并于再灌注后0、1、6、24、48 h取材。比较各组的血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平,肝细胞钠钾ATP酶、钙ATP酶活性,流式细胞仪检测肝细胞胀亡和凋亡百分比,电镜观察肝细胞形态学改变。结果与SO组相比,I/R组再灌注后血清ALT、AST水平显著升高(P<0.05),6 h达高峰,后逐渐下降;肝细胞钠钾ATP酶、钙ATP酶活性显著下降(P<0.05),于再灌注1 h达低谷,后逐渐恢复;再灌注早期(6 h内)肝细胞死亡方式以胀亡为主,后期(24 h后)凋亡细胞逐渐增多;电镜下可见典型胀亡和凋亡改变。结论胀亡是肝硬化大鼠肝脏I/R损伤肝细胞死亡的主要方式,肝功能损伤与胀亡密切相关。     

同型半胱氨酸对人血管平滑肌细胞凋亡及bax、bcl-2表达的影响

目的　观察同型半胱氨酸 (Hcy) 对人血管平滑肌细胞 (VSMCs) 凋亡以及bax、bcl-2表达的影响。方法　采用组织贴块法体外培养人VSMCs; 采用流式细胞仪检测细胞凋亡率; 逆转录 -聚合酶链反应法检测Bax、bcl-2mRNA的表达。结果　体外培养的人VSMCs在终浓度为 0 (对照组)、100、200、500、1 000μmol/LHcy的培养液中孵育 24h后的细胞凋亡率分别为 ( 2. 68±0. 23 )%、 ( 2. 79±0 .12 )%、( 8. 45±2. 41 )%、 ( 13. 37±4 .71 )%、(23. 75±5 .56)%, 表明Hcy诱导人VSMCs细胞凋亡呈浓度依赖性; baxmRNA相对表达量分别为 0 .86±0. 01、0 .92±0 .03、1. 51±0 .02、1. 82±0 .03、1 .91±0 .02, bcl-2mRNA相对表达量分别为 1. 38±0 .04、1. 32±0 .03、1. 28±0 .03、1 .21±0. 02、1 .09±0. 02, 表明Hcy呈浓度依赖性诱导人VSMCsbax基因表达显著上调, bcl-2基因表达轻度下调, bax/bcl-2比值升高。结论　Hcy诱导人VSMCs凋亡可能是通过上调bax基因表达来实现的, 诱导人VSMCs凋亡可能是Hcy致动脉粥样硬化作用的机制之一。     

益舒软肝丸抗脂质过氧化的实验研究

目的:研究益舒软肝丸逆转肝硬化的作用机理。方法:以CCL4复合因素法建立肝硬化模型,首先制备出肝硬化的实验动物模型,造模结束后,连续灌胃给药3个月。检查ALT、AST,A/G、CHE;HA、LN、PⅢNP、Hyp;SOD、MDA。结果:与模型对照组大鼠比,用药组组织切片显示汇管区有少量纤维组织增生,但未见假小叶结构;肝功能指标ALT、AST减少,A/G、CHE增加,肝功能有显著好转;HA、LN、PⅢNP、Hyp水平显著降低,肝纤维化程度降低;MDA水平降低。结论:说明益舒软肝丸有明显的抗肝硬化的作用,作用机制可能与抗脂质过氧化,保护肝细胞有关。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.