y-氨基丁酸对炎性因子致胰岛细胞凋亡的保护作用

【目的】探讨1-氨基丁酸（gamma-aminobutyricacid,GABA）对炎性因子所诱导的胰岛细胞凋亡的保护作用,初步研究其作用机制。【方法】将胶原酶v：通过总胆管灌注到大鼠内,分离纯化大鼠胰岛细胞,并通过DTZ染色鉴定胰岛纯度。将新鲜分离的胰岛分为3组：正常对照组、通过白介素-1B（IL-1B）-y干扰素（IFN-7）建立胰岛细胞炎症模型（IL-1β＋IFN-1诱导组）、GABA干预组（GABA＋IL-1β＋IFN-1）。观察（IL-1β＋IFN-1）与GABA预孵育胰岛细胞的凋亡;二醋酸酯荧光素,碘化丙啶染色、流式细胞术及糖刺激实验检测胰岛细胞活性。凋亡率和功能,免疫荧光检测凋亡细胞Caspase-3蛋白表达。【结果】（IL-18＋IFN-7）组作用24h对胰岛细胞活性、凋亡率和糖刺激指数分别为20％、（32．7±5.3）％和（1．62±0．13）,对照组3项指标分别为90％、（5．5±2．8）％和（2．37±0．11）,两组比较差异显著（P〈0．01）;（GABA＋IL-1β＋IFN-y）组3项指标分别为70％、（18．0±6．3）％和（1．97±0．12）,与（IL-1β＋IFN-1）组比较,均有明显差异（P〈0．01）。（IL-1β＋IFN-1）组胰岛的Caspase-3蛋白表达明显增加,而（GABA＋IL-1β＋IFN-1）组胰岛的Caspase-3蛋白表达明显受到抑制。【结论】联合IL-1β及IFN-y明显诱导胰岛细胞凋亡,GABA显著抑制IL-1β及IFN-1诱导的胰岛细胞凋亡,其机制可能与降低Caspase-3蛋白的表达有关。     

氨基胍对胰岛β细胞保护作用的机理研究

目的探讨氨基胍（AG）对胰岛β细胞的保护作用及机理,为胰岛β细胞的保护治疗提供实验依据。方法培养胰岛β细胞株NIT细胞,分别与以下4组作用：①（IL-1β＋IFN-γ）组、②（IL-1β＋IFN-γ＋AG）组、③AG组、④对照组（DMEM）。硝酸还原酶法检测上清一氧化氮（NO）水平,比色法检测上清诱导型一氧化氮合酶（iNOS）水平,化学发光法检测上清胰岛素（Ins）水平。结果①AG＋IL-1β＋IFN-γ刺激的NIT-1细胞与IL-1β＋IFN-γ刺激组相比,分泌NO、iNOS水平下降（P〈0.05）。②AG＋IL-1β＋IFN-γ刺激的NIT-1细胞与IL-1β＋IFN-γ刺激组相比,Ins分泌增加（P〈0.05）。结论氨基胍可减轻IL-1β联合IFN-γ对NIT细胞的损伤作用,保护NIT细胞的胰岛素分泌功能。     

左旋精氨酸/一氧化氮通路对小鼠胰岛β细胞凋亡的影响

目的研究左旋精氨酸／一氧化氮通路对胰岛β细胞凋亡的影响，初步探讨一氧化氮（NO）诱导胰岛β细胞凋亡的作用。方法体外培养的NIT-1小鼠胰岛β细胞，用不同浓度的L-精氨酸（L-arg）处理，6h后采用Griess化学显色法检测细胞培养液内的NO水平，Annexin-V／PI双染流式细胞术检测细胞的凋亡。而后联合应用hemoglobin处理细胞，分为3组：对照组；L-arg组；L-arg＋hemoglobin组；6h后检测NO的水平和细胞的凋亡，并用Western Blot检测P53蛋白的表达。结果与对照组比较，L-arg 4mg／mL处理组的NO水平最高（P〈0．05），细胞凋亡最明显（P〈0．05）；hemoglobin干预后，NO水平和细胞凋亡率均较L-arg单独处理组明显降低（P〈0．05），与正常对照组之间差异没有显著性（P〉0．05）；Western Blot提示L—arg组的P53蛋白的表达水平明显高于对照组和hemoglobin处理组（P〈0．05）。结论L-arg／NO通路可诱导NIT-1小鼠胰岛β细胞凋亡，并呈现一定程度的剂量依赖性；NO可能通过P53的活化诱导NIT-1胰岛细胞凋亡。     

皮下注射胰岛素抑制胰岛β细胞凋亡预防NOD鼠糖尿病

目的：观察皮下注射胰岛素免疫干预对非肥胖糖尿病（non-obese diabetic,NOD）鼠胰岛炎、B细胞凋亡和糖尿病的影响,并探讨其诱导免疫耐受的机制。方法：60只NOD雌鼠随机分为胰岛素处理组（n=34）和磷酸盐缓冲液（phosphate buffered saline,PBS）对照组（n=28）,分别于4周、12周、20周、28周皮下注射中效胰岛素优泌林N（Humulin N）6U（60μL）＋不完全弗氏佐剂（incomplete Freund＇s adjuvant,IFA）60μL,对照组予PBS（60μL）＋IFA（60μL）。于12周龄观察胰岛炎和胰岛B细胞凋亡;检测胰岛Fas和FasL的表达;测定血清IL-4和IFN-γ浓度,以及胰岛内I-Aβ^x7,IL-1β,IFN-γ,Fas,IL-4 mRNA的表达水平。结果：NOD鼠皮下注射胰岛素加IFA组30周龄和52周龄时发病率仅为21．4％和28．6％,而皮下PBS加IFA组为71．4％和85．7％（P〈0．05）。胰岛素组胰岛炎积分比对照组低,但差异无统计学意义（P〉0．05）。胰岛素组胰岛Fas抗原表达和B细胞凋亡率均比PBS对照组低（均P〈0．05）。胰岛素组胰岛内I-Aβ^x7,IFN-γ,IL-1β,FasmRNA表达较PBS对照组低（均P〈0．05）,而IL-4mRNA表达较对照组高（P〈0．05）;胰岛素组血清IL-4比PBS组高,IFN-γ比PBS组低（均P〈0．05）。结论：皮下注射胰岛素能诱导NOD鼠的免疫耐受而预防糖尿病的发生,但不能阻断胰岛炎的进展。皮下注射胰岛素能诱导调节性T细胞产生,使全身和胰岛局部T细胞由,Th1向Th2转型,从而抑制Fas介导的B细胞凋亡而预防糖尿病。     

中药单体成分大黄素对胰岛β细胞NIT-1的影响

目的研究中药提取的单体成分大黄素对胰岛β细胞NIT-1增殖、凋亡及胰岛素分泌作用的影响。方法不同浓度的大黄素分别作用于NIT-1细胞不同时间。以MTT法检测细胞的增殖活性；收集细胞，以Annexin V／PI染色，经流式细胞术检测细胞凋亡发生率；收集细胞培养上清液测定基础和高糖刺激后胰岛素分泌量。结果2．5μg／mL大黄素作用于NIT-1细胞时对其增殖无明显影响，5．0μg／mL以上对NIT-1细胞增殖的影响呈时间和剂量依赖性降低（P〈0．01）；0～25．0μg／mL大黄素分别作用于NIT-1细胞24h后，细胞凋亡率呈浓度依赖性增加（P〈0．05）；0～5．0μg／mL大黄素分别作用于NIT-1细胞24h后，基础胰岛素分泌量呈浓度依赖性降低（P〈0．05）；高糖刺激后胰岛素分泌量在大黄素0和2.5μg／mL组间无差别，而在5．0μg／mL组则明显降低（P〈0．05）。结论大黄素可诱导胰岛细胞凋亡，并抑制胰岛素分泌。     

一氧化氮和Ca2+介导的细胞因子损伤大鼠胰岛细胞的研究

目的观察-氧化氮和Ca^2＋在白细胞介素-1β（IL-1β）、肿瘤坏死因子（TNF）和1-干扰素（IFN-1）诱导的胰岛细胞凋亡中的作用。方法应用体外单层培养的3-5d的Wistar大鼠胰岛细胞，分别检测IL-1β、TNF和IFN-1对胰岛细胞凋亡细胞百分率、[Ca^2＋]i含量以及培养液中基础和高糖刺激下胰岛素分泌量、NO含量及NOS活性以及DNA片段的影响。结果IL-1β、TNF和IFN-1联合可诱导胰岛细胞凋亡率明显增加及DNA片段化，基础和高糖刺激下胰岛素分泌量降低，同时胰岛细胞[Ca^2＋]i、NO含量和NOS活性亦明显升高（P〈0．01），且有时间和剂量依赖性。结论NO和Ca^2＋，可能是介导上述细胞因子引起胰岛细胞凋亡的重要途径。     

过氧化氢酶对高糖诱导NIT-1胰岛β细胞Pax6基因表达下降的影响

 【目的】探讨过氧化氢酶（eatalase）对高糖诱导的NIT-1胰岛B细胞成对同源异形盒转录因子6（Pax6）基因表达下降的影响。【方法】体外培养NIT-1胰岛B细胞24h，分4个处理组：低糖组（NG），低糖＋过氧化氢酶组（NG＋C），高糖组（FIG），高糖＋过氧化氢酶组（HG＋C），用2，7二氯氢化荧光素二酯（H2DCF-DA）染色检测活性氧簇（ROS）的水平，RT-PCR半定量检测Pax6 mRNA表达。【结果】HG组ROS水平（1．10±0．24）明显高于NG组（0．95±0．26），P〈0．05；FIG＋C组ROS水平（0．94±0．26）低于HG组，P〈0．05；HG组Pax6 mRNA表达（0．64±0．09）低于NG组（0．93±0．12），P〈0．05；HG±C组Pax6 mRNA表达（0．74±0．11）高于HG组，但差异无统计学意义，P〉0．05。【结论】高糖可使NIT-1胰岛β细胞内ROS产生增加，胰岛β细胞特异性转录因子Pax6基因表达下降，给予ROS的抗氧化剂过氧化氢酶后，Pax6基因表达有所恢复，但差异无统计学意义。     

毛细支气管炎患儿外周血T细胞亚群Th1/Th2及相关细胞因子的变化

目的探讨毛细支气管炎患儿外周血T细胞亚群与Th1／Th2免疫变化。方法流式细胞仪检测32例毛细支气管炎患儿、16例支气管哮喘患儿及20例健康儿童外周血T细胞亚群；ELISA法检测以上儿童血清IFN-γ（ng／L）、IL-4（ng／L）。结果毛细支气管炎组CD4^＋百分率略高于对照组，CD8^＋百分率略低于对照组，但两组间均无显著差异（P〉0．05）。而CD4^＋／CD8^＋比值则明显高于对照组（P〈0．05）。哮喘组CD4^＋百分率高于对照组，CD8^＋百分率低于对照组，两组间有显著差异（P〈0．05），且CD4^＋／CD8^＋比值明显高于对照组（P〈0．05）。毛细支气管炎组、哮喘组与对照组IFN-γ、IL-4、IFN-γ／IL-4水平变化差异显著（P〈0．05）。哮喘组IL-4水平略高于毛细支气管炎组（P〉0．05）。毛细支气管炎组IFN-γ水平低于哮喘组，有显著差异（P〈0．05）。结论毛细支气管炎和哮喘患儿均存在细胞免疫失调，以Th2型细胞占优势。     

高糖刺激INS-1细胞DNase Ⅰ表达升高对细胞凋亡的影响

目的：探讨脱氧核糖核酸酶Ⅰ（DNaseⅠ）在高糖引起的胰岛β细胞凋亡过程中的作用。方法：实验分3组。正常组、高糖组和高糖＋DNase Ⅰ siRNA组。其中正常组给予含有11．1mmol／L葡萄糖浓度的培养基外,其余2组均给予葡萄糖浓度为30mmol／L的培养基。通过转染外源性DNase Ⅰ siRNA,敲降高糖培养的ⅠNS-1细胞内DNase Ⅰ的表达。采用Westernblot检测DNaseⅠ、caspase-3蛋白表达,流式细胞仪观察细胞凋亡的变化。结果：与正常组相比,高糖可以显著增加INS-1细胞DNase Ⅰ和caspase-3的蛋白表达水平（P〈0．05）;与高糖组相比,高糖＋siRNA组DNaseⅠ敲降后显著降低高糖所引起的细胞内DNase Ⅰ蛋白表达水平（P〈0．05）．同时也显著降低高糖所引起的细胞内caspase-3的蛋白表达水平（P〈0．05）。流式细胞仪结果显示,高糖明显导致细胞凋亡率升高（16．7％）,而敲降DNase Ⅰ后则明显减少细胞凋亡的发生（9．9％）。结论：高糖可以诱导细胞内DNase Ⅰ的表达升高,从而介导胰岛β细胞的凋亡,该研究可能为胰岛β细胞凋亡的机制研究提供新的证据。     

卡介菌多糖核酸对尖锐湿疣患者外周血CD4+T细胞细胞因子表达的调节

目的研究卡介菌多糖核酸（BCG-PSN）对尖锐湿疣（CA）患者外周血CD4^＋T细胞IL-2、IL-4、IL-12，IFN-γ表达的调节作用。方法采用流式细胞仪检测了20例正常对照者和60例CA患者（BCG-PSN组40例，激光术后加用BCG-PSN；病例对照组20例，激光术后未加用BCG-PSN）治疗前后外周血CD4^＋T细胞IL-2、IL-4、IL-12、IFN-γ表达水平。结果治疗前CA患者外周血IL-2、IL-12和IFN-γ阳性CD4^＋T细胞百分率较正常对照组均显著下降（P〈0．01），且Th1／Th2平衡失调（P〈0．01）。治疗后BCG-PSN组患者外周血IL-2、IL-12和IFN-γ阳性CD4^＋T细胞百分率显著升高（P〈0．01），Th1／Th2恢复平衡。病例对照组IL-2、IL-12和IFN-γ阳性CD4^＋T细胞百分率于治疗前后差异均无显著性意义（P〉0．05）；临床观察证实BCG-PSN能够显著提高CA临床治愈率，降低CA的复发率。结论CA患者存在Th1／Th2失调；BCG-PSN通过上调外周血CD4^＋T细胞IL-2、IL-12、IFN-γ的表达，纠正机体细胞因子失调而改善患者的细胞免疫功能，以提高其临床疗效和控制复发。     

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.