吸入一氧化氮改善犬烟雾吸入性损伤的氧合功能

目的：评价吸入一氧化氮（ＮＯ）在犬烟雾吸入性损伤氧合功能改善的效果。方法：烟雾吸入伤后，１７只犬随机分为２组，对照组（ｎ＝８）单纯吸氧（ＦＩＯ２，０．４５）治疗组（ｎ＝９）吸氧（ＦＩＯ２，０．４５）＋０．００４５％（４５×１０＾－６）ＮＯ，连续监测１２ｈ血气及动脉血乳酸变化，数据行多个样本的均数间方差分析。结果：吸入ＮＯ治疗组ＰａＯ２动静脉氧含量差（Ｃａ－ｖＯ２）５０％ＳａＯ２时血氧分压（Ｐ５０Ｏ     

侧脑室微量注射NO供体对大鼠痛行为反应的影响

目的考察一氧化氮（ＮＯ）在前脑对大鼠痛行为的影响。方法采用辐射热作为伤害性刺激，以浅麻状态大鼠甩尾潜伏期（ＴＦＬ）为测痛指标，观察侧脑室和隔核分别微量注射硝普钠或亚甲基兰对痛阈的影响。结果侧脑室注射硝普钠使大鼠ＴＦＬ显著性减小（Ｐ＜０．０５），其最大值为３６．２％，持续时间为２０分钟；该作用可被ＮＯ的螯合剂血红蛋白阻断。隔核内注入硝普钠对ＴＦＬ的影响与上述结果相似。侧脑室注射亚甲基兰使大鼠ＴＦＬ显著性升高（Ｐ＜０．０５）。结论ＮＯ在大鼠前脑对痛行为反应具有易化作用；且部分是通过ＮＯ—ｃＧＭＰ通路实现的。     

P型Ca^2＋通道在高K^＋引起的大鼠小脑一氧化氮合酶激活中作用

目的：用大鼠小脑脑片研究Ｐ型Ｃａ＾２＋通道在高Ｋ＾＋引起的一氧化氮合酶激活中的作用。方法：通过测定Ｌ－「＾３Ｈ」精氨酸转变成Ｌ－「＾３Ｈ」瓜氨酸来判定一氧化氮合酶（ＮＯＳ）活性。结果：表明５０ｍｍｏｌ．Ｌ＾－１Ｋ＾＋可明显提高ＮＯＳ活性,特异性Ｐ型钙通道阻断剂蜂蛛毒素ＡＧＡ０．１ｎｍｍｏｌ．Ｌ＾－１和蜂蛛毒素ＦＴＸ１００ｎｍｍｏｌ．Ｌ＾－１可以明显阻断５０ｍｍｏｌ．Ｌ＾－１Ｋ＾＋引起ＮＯＳ活性增强作用,ＮＭＤＡ受体通道阻断剂ＭＫ－８０１１０ｎｍｍｏｌ．Ｌ＾－１不能阻断５０ｍｍｏｌ．Ｌ＾－１Ｋ＾＋引起ＮＯＳ活性增强作用。结论：说明高Ｋ＾＋引起ＮＯＳ活性增强主要是由于Ｃａ＾２＋通过Ｐ型钙通道进入细胞内引起的,谷氨酸受体不参与高Ｋ＾＋引起ＮＯＳ激活。     

一氧化氮对体外肾小管细胞增殖的影响

目的 探讨ＮＯ对肾小管细胞增殖的抑制效应。方法 应用体外培养的人集合管（Ｈ５）和负鼠近端小管（ＯＫ）细胞株,以Ｌ－精氨氨酸、硝普钠、内毒素γ－干扰素,肿瘤坏死因子－α,Ｎ－单甲基－Ｌ－精氨酸刺激或抑制合成,观察两种细胞＾３Ｈ－胸腺嘧啶摄 的变化。结果 ＮＯ引起Ｈ５和ＯＫ细胞＾３Ｈ－胸腺嘧啶摄入量浓度依赖性减少,结论ＮＯ可抑制这两种肾小管细胞增殖。     

亚甲蓝短暂部分逆转吸入NO降低缺氧性肺动脉高压的作用

目的：吸入一氧化氮（ＮＯ）可特异性降低肺动脉高压，但也有使血中高铁血红蛋白（ＭｅＨｂ）浓度增高的毒副作用。作者探讨用亚甲蓝（ＭＢ）还原ＭｅＨｂ同时，能否削弱吸入ＮＯ的治疗作用。方法：用缺氧性肺动脉高压模型，观察９条犬吸入体积分数为（９０±７）×１０＾－６的ＮＯ降低肺动脉压时，ｉｖ２ｍｇ·ｋｇ＾－１ＭＢ对上述作用的影响。结果：吸入ＮＯ可显著降低肺动脉高压（Ｐ〈０．０１），ｉｖＭＢ可逆转ＮＯ作用的５０     

生理溶液中硝普钠释放一氧化氮通路及其动力学研究

目的：探索一氧化氮供体硝普钠（ＳＮＰ）在任洛氏溶液（ＲＬＳ）中,一氧化氮（ＮＯ）释放通路及其动力学特征,为体外ＮＯ定量生物学研究提供科学依据。方法：在３７℃恒温避光条件下,对ＮＯ特异氧化产物ＮＯ２＾－Ｇｒｉｅｓｓ还原显色,采用分光光度法,比较两种活性巯基化合物半胱氨酸（ＣＹＳ）和谷胱甘肽（ＧＳＨ）存在的ＲＬＳ中,ＳＮＰ释放ＮＯ的情况（ｎ＝３）。结果：无活性巯基存在的ＲＬＳ中未测得ＮＯ;而当有２５ｍｍｏｌ／Ｌ ＣＹＳ存在时,ＳＮＰ释放ＮＯ呈一级动力学,速率常数κ＝０．１３９７ｍｉｎ＾－１（ｒ＝０．９３２１）,稳态浓度为０．８７ｍｍｏｌ／Ｌ,ＣＹＳ浓度的平方与ＳＮＰ释放ＮＯ呈线性关系;有２５ｍｍｏｌ／ＬＧＳＨ存在时,ＮＯ释放通路反应呈多相性,约在１０ｍｉｎ时,出现０．５２ｍｍｏｌ／Ｌ的峰值,后迅速下降,在３０ｍｉｎ     

吸入NO对肺源性心脏病急性加重期患者血气及肺通气功能的影响

目的　探讨吸入一氧化氮（ＮＯ） 对慢性肺心病急性加重期患者动脉血气和肺通气功能的影响。方法　２０ 例肺心病急性加重期患者,在鼻导管吸氧（２ Ｌ／ｍｉｎ） 不变的情况下,分别吸入４５ ×１０－６ ＮＯ或４５×１０－ ６ＮＯ和３５％ Ｏ２ 混合气各６０ ｍｉｎ,测定吸入前后患者的血气和肺通气功能［第１ 秒用力肺活量（ＦＥＶ１） 和用力肺活量（ＦＶＣ）］ 。结果　当患者单纯吸入４５×１０－６ ＮＯ后,ＰａＯ２ 由吸ＮＯ前的８－１３ ±０－７ ｋＰａ 降为７－３３ ±０－６ ｋＰａ,ＳａＯ２由（９１±３－２） ％ 降至（８７±２－３） ％ （ 两者Ｐ均＜０－０５） ,对ＰａＣＯ２ ,ＦＥＶ１ 和ＦＶＣ无明显影响。当吸入４５×１０－６ ＮＯ和３５％ 氧气混合气后,ＰａＯ２ 则由８－０７±０－９ ｋＰａ 升至９－４１±０－８２ ｋＰａ,ＳａＯ２ 由（９０ ±２－２）％ 升至（９３±２－５） ％ （Ｐ＜０－０５）。ＰａＣＯ２ ,ＦＥＶ１ 和ＦＶＣ无明显影响。结论　单纯吸入ＮＯ可令肺心病患者ＰａＯ２ 和ＳａＯ２ 下降,而吸入４５ ×１０－６ ＮＯ和３５ ％ 氧气混合气则可改善ＰａＯ２ 和ＳａＯ２ ,两者对ＰａＣＯ２ ,ＦＥＶ１ 和ＦＶＣ无明显影响。     

硝普钠阴茎海绵体注射治疗阳萎

目的 探讨ＮＯ供体－硝普钠对促使阴茎勃起的作用。方法 选择 ４２例阳萎患者,采用硝普钠进行阴茎海绵体内注射（ＩＣＩ）,并选择罂粟碱／酚妥拉胆进行对照。结果 硝普钠ＩＣＩ后：１．阴茎长度,周径等明显改变,增加值与对照相比无显著差异,２．Ｖｉｒａｇ硬度计点表明硝普钠与罂粟碱／酚妥拉明效果之间无显著差异。３．所有测试患者无１例出现低血压或局部不适等副反应,与罂粟碱／酚妥拉明相比各有优劣,但总体差异不大。     

左旋精氨酸对吸入一氧化氮降低肺动脉高压的延长作用

目的观察一氧化氮底物左旋精氨酸（Ｌ一ａｒｇ）延长吸入一氧化氮（ＮＯ）选择性降低肺动脉高压过程中的作用。方法８只猪麻醉后制成急性缺氧性肺动脉高压模型,在 Ｓｗａｎ－Ｇａｎｚ导管和动脉导管监测下吸入 ＮＯ（１２— １５ｐｐｍ）的过程中静脉注入 Ｌ－ ａｒｇ（共 １０ｇ）,观察停用 ＮＯ后体循环和肺循环血流动力学的变化情况。结果单纯吸入 ＮＯ能选择性降低急性缺氧性肺动脉高压,肺动脉压力从 ４ ２± ０ ４ｋＰａ降至 ２． ５± ０ ．５ｋＰａ（１ｋＰａ＝ ７．５ｍｍＨｇ, Ｐ＜ ０．０１）,肺血管阻力从 ５６±２５ｋＰａ·ｓ·Ｌ－１降至３１±１３ｋＰａ·ｓ·Ｌ－１（Ｐ＜０．０１）,但持续时间短;ＮＯ吸入加静脉注射Ｌ－ａｒｇ没有使肺动脉压进一步下降,但能显著延长吸入ＮＯ对肺动脉压的降压时间（２０倍）,对体循环血压则无影响。结论提供内源性ＮＯ的底物Ｌ－ａｒｇ能延长ＮＯ的降压作用,提示急性缺氧时ＮＯ的生成可能有相对不足。     

NO在外源性自由基损伤内皮细胞中的作用

目的：探讨ＮＯ在外源性自由基损伤内皮细胞（ＥＣ）中的作用。方法：培养的家兔主动脉ＥＣ随机分为四组：１．对照组（Ｃ,ｎ＝６）：２ｍｌＰＢＳ;２．自由基损伤组（Ｘ／ＸＯ,ｎ＝６）：２ｍｌＰＢＳ中加入终浓度为１μｍｏｌ／ｍｌＸ,０．１ＩＵ／ｍｌ的ＸＯ;３．Ｌ－Ａｒｇ组：含终浓度为１０＾－３Ｍ的Ｌ－Ａｒｇ,余同２;４．ＳＮＰ组：含终浓度为１０＾－５Ｍ的ＳＮＰ,余同２。在观察Ｌ－ＮＡＭＥ对自由基损伤的作用时     

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…     

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.     

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.     

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.