对自制全氟化碳乳剂静脉输注安全性的实验研究

目的探讨自制全氟化碳乳剂（PFE）静脉输注的安全性。方法35只雄性Wistar大鼠随机分为对照组（5只）和PFE组（30只）。腹腔麻醉后，对照组静脉注射生理盐水10mL／kg后2h处死，PFE组大鼠于静脉注射PFE后5min经眼眶静脉取血200止测定全氟化碳（PFC）浓度，然后分别于2h，4h，6h，24h，48h和10d随机处死5只。观察各组血液PFC浓度，PaO2水平，GPT、00rr、BUN、Cr浓度，肺脏、肝脏、肾脏常规病理变化。结果PFE组大鼠活动、反应正常，无一例死亡；肝脏、肾脏病理无明显异常；PFC颗粒广泛分布于肺泡及肺微血管。PFE组2h，4h，6h，24h时间点GPT及GOT均显著高于对照组（P均〈0．05）；第10d降至（92．5±6．4）U／mL和（163．9±1.3）U／mL，与对照组比较无明显差异。BUN、Cr水平与对照组比较无明显差异（P均〉0．05）。静脉注射PFE10mL／kg后5min，2h，4h，6h，24h，48h，10d血中PFC浓度分别为（20．0±1.8）mg／mL，（1．8±0．7）mg／mL，（1．5±0.6）mg／mL，（1．2±0．4）mg／mL，（0．5±0．2）mg／mL，（0．2±0．03）mg／mL，0mg／mL。PFE组2h时间点PaO2显著高于对照组[（119．2±8．6）mmHg比（99．6±4．7）mm Hg，P〈0．05]。结论静脉输注PFE对大鼠一般情况、肺脏、肝脏、肾脏脏器病理无明显影响，具有较好的安全性。静脉输注PFE后PFC颗粒可广泛分布于肺泡及肺微血管，并显著提高健康大鼠PaO2，可试用于急性肺损伤的防治研究。     

改变组织醛固酮及其受体表达对SHR大鼠肾脏纤维化的影响

 【目的】观察改变肾组织醛固酮及其受体水平对自发性高血压大鼠肾脏纤维化的影响。【方法】8周龄的雄性自发性高血压大鼠（SHR）24只及同源正常京都大鼠（WKY）8只，SHR分为贝那普利干预组[30ing／（kg·d）]、大剂量安体舒通干预组[100mg／（kg·d）]和高血压模型对照组，同时设同源的正常对照组，干预时间为8周，检测收缩压、尿蛋白、血白蛋白、尿素氮、肌酐、肾组织醛固酮受体、TGF-β1的mRNA和蛋白表达。【结果】贝那普利能下调组织醛固酮【（15．8±2．6）vs（22．2±0．6）pg／mg]及其受体水平【（15±4）vs（13±5）PU]并减轻肾脏纤维化[（17．0±1．8）vs（20．0±2．3）PU]，均为P〈0．05；大剂量安体舒通能上调组织醛固酮[（24．3±4．6）vs（22．2±0．6）pg／mg]及其受体水平[（16±6）vs（13±5）PU]并加重肾脏纤维化[（22．6±3．0）vs（20．0±2．3）PU]，均为P〈0．05。【结论】肾组织醛固酮及其受体水平的改变可能影响高血压肾脏纤维化的过程。     

贝那普利与奥美沙坦酯对糖尿病肾病的治疗效果研究

目的：剖析贝那普利+奥美沙坦酯用于糖尿病肾病中的疗效。方法：收集2015年1月至2016年5月该科纳入的64例糖尿病肾病患者为研究对象，采用数字抽签原理，将64例病例分成实验组与对照组，各组均32例。实验组联用贝那普利与奥美沙坦酯，对照组单用奥美沙坦酯。观察并比较两组相关生化指标与炎症因子的变化情况。结果：实验组 Scr、PRO 与 UAER 生化指标的改善情况明显优于对照组（P <0.05）。实验组用药后的 IL -6与 hs - CRP 水平分别是（14.14±3.22）ng/ L、（4.31±3.09）mg/ L，对照组是（22.53±2.56）ng/ L、（7.63±2.29）mg/ L。实验组明显比对照组低（P <0.05）。结论：糖尿病肾病联用贝那普利与奥美沙坦酯，患者病情恢复迅速，相关生化指标改善显著，值得临床借鉴。     

卵蛋白致敏哮喘豚鼠淋巴细胞白介素-2活性增强及其机制

建立了卵蛋白致敏哮喘豚鼠动物模型，并对其淋巴细胞白介素－2诱生能力和白介素－2mRNA的表达进行观察。结果显示致敏哮喘豚鼠腹腔灌洗细胞和支气管肺泡灌洗细胞主要是酸性粒细胞和淋巴细胞；致敏哮喘豚鼠支气管肺泡灌洗液（22．56±2．44ng／ml）和腹腔灌洗液（20．28±3．24ng／ml）的淋巴细胞白介素－2分泌水平均明显高于生理盐水对照组支气管肺泡灌洗液（14．23±4．71ng／ml，P＜0．05）和腹腔灌洗液（10．37±2．48ng／ml，P＜0．05）的淋巴细胞白介素－2分泌水平。哮喘豚鼠腹腔淋巴细胞与支气管肺泡淋巴细胞的白介素－2分泌水平呈正相关（r＝0．66，P＜0．05）。采用PT－PCR方法发现，哮喘豚鼠腹腔灌洗细胞白介素－2mRNA的表达（2799±678cpm）显著高于生理盐水对照组淋巴细胞（611±103cpm，P＜0．01）。本研究提示哮喘豚鼠白介素－2活性的增高是其淋巴细胞白介素－2mRNA表达增高的结果，增高的白介素－2可在酸性粒细胞募集中发挥作用。     

牛黄熄风胶囊对大鼠凝血功能的影响

目的观察牛黄熄风胶囊（ＮＨＸＦＣ）对凝血功能的影响。方法实验用Ｗｉｓｔａｒ大鼠３０只，随机分为实验组和对照组，实验组动物用ＮＨＸＦＣ每只０．２５ｇ／ｄ灌胃，对照组生理盐水每只５ｍｌ／ｄ灌胃，１０ｄ后测定凝血和纤溶功能指标。结果用药组凝血酶原时间，白陶土部分凝血活酶时间、凝血酶时间和出血时间分别为２０．５６±４．０７ｓ，３６．３１±３．２５ｓ，４８．１０±６．６４ｓ，１１．３９±１．８３ｓ，较对照组均明显延长（Ｐ＜０．０１）。结论ＮＨＸＦＣ有抗凝促纤溶的作用。     

恒磁场对小鼠血糖含量影响的实验研究

目的：探讨恒磁场对机体血糖含量的影响。方法：将６０只小鼠随机分为正常组（给水）、７天喂养组（给１５％葡萄糖）和１４天喂养组（给１５％葡萄糖），每组又分为对照组和实验组。用表面强度为０．３５Ｔ的磁片连续照射自然饲养条件下的小鼠正常组、７天喂养组和１４天喂养组（一周后加磁）７天，取眼眶血用ＰＡＰ法测其血糖含量。结果：一定强度的恒磁场对正常组小鼠血糖含量无明显影响（Ｐ＞０．０５），能明显抑制７天喂养组小鼠血糖上升，对照组为７．２５９±０．９５０ｍｍｏｌ／Ｌ，实验组为６．２６７±０．４５４ｍｍｏｌ／Ｌ（Ｐ＜０．０５）；使高血糖１４天喂养组小鼠的血糖含量显著下降，对照组为７．３５０±０．８７０ｍｍｏｌ／Ｌ，实验组为６．２２０±０．．４５２ｍｍｏｌ／Ｌ（Ｐ＜０．００５）。结论：一定强度的恒磁场作用一定时间对高血糖具有一定的降糖作用和抑制血糖升高的作用。     

基于雨课堂的形成性评价在临床技能学教学中的研究与应用

目的 探讨基于雨课堂的形成性评价在临床技能学教学中的应用效果。 方法 选取我校2016级临床本科专业2个班学生70名，对照组35名采用传统教学及评价方法，实验组35名实施雨课堂及形成性评价方法。比较两组学生的考核成绩；并对实验组学生进行问卷调查其对形成性评价的满意度。 结果 实验组临床技能考核总评成绩为（84.11±7.76）分，明显高于对照组的（74.37±12.58）分，差异有统计学意义（P＜0.05）；问卷调查实验组亦明显优于对照组（P<0.05）。 结论 形成性评价有利于提高临床技能学教学质量和学生综合能力，促进学生全面发展。     

HX—1号液保存狗肾48,72小时的实验研究

为观察ＨＸ－１号液保存狗肾脏效果，运用本地杂种狗２０只，用ＨＣ－ＷＣＵ液（对照组）和ＨＸ－１液（实验组）低温保存狗肾４８、７２小时后，行自体异位肾移植观察术后狗肾功能恢复及存活情况，结果显示：ＨＣ－ＷＣＵ液４８、７２小时组，术后血肌酐峰值为６４２．６０±１５８．６０μｍｌｏ／Ｌ及６８６．２０±１５４．０４μｍｏｌ／Ｌ，ＨＸ－１液４８、７２小时组术后血肌酐峰值为４４８．３２±３６．９μｍｌｏ／Ｌ及５     

霍乱毒素对成年金黄地鼠视网膜节细胞凋亡的影响

为探讨霍乱毒素对神经细胞凋亡的影响,手术切断成年金黄地鼠视神经,用荧光染色技术,研究玻璃体注射霍乱毒素对视网膜节细胞凋亡的影响。观察结果如下：（１）切断视神经７ｄ后,霍乱毒素实验组和对照组的凋亡细胞平均密度分别为４０±３．７２个／ｍｍ２,５３．４４±４．２３个／ｍｍ２;凋亡细胞与成活细胞的平均比率分别为（３．３６±０．３１）％,（６．３８±０．５１）％。与对照组相比,实验组的凋亡细胞密度及凋亡率均下降（Ｐ值均＜０．０１）;（２）切断视神经１４ｄ后,实验组与对照组数据分别为４５．３１±２．２８个／ｍｍ２、３０．９４±２．６３个／ｍｍ２及（１０．９７±０．５５）％、（１５．３９±１．３１）％。实验组凋亡细胞密度虽有增加,但其凋亡率仍下降（Ｐ值均＜０．０１）。以上结果提示,霍乱毒素能抑制视神经切断的成年金黄地鼠视网膜节细胞的凋亡。     

尿转铁蛋白和微量白蛋白测定在早期肾损诊断中的应用

为寻求早期发现肾脏损害的新方法,采用免疫透射比浊法检测尿转铁蛋白（TF）和微量白蛋白（mALB）,Jaffe速率法倒尿肌酐。结果正常对照组尿TF／Cr为096±07／mg／mmol．mALB／Cr为1.48±0．79mg／mmol。尿蛋白定性阴性的糖尿病、高血压、系统性红斑狼疮及尿略感染患者的TF／Cr、mALB／Cr值较正常对照组增高（P＜0．01）;尿蛋白定性阳性患者的TF／Cr、InALB／Cr值较阴性组显著增高（P＜0．o1）,两项联检可提高阳性检出率。提示TF、mALB检测是诊断肾脏早期损害灵敏、可靠的实验室指标。     

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.