赤芍总苷退黄降酶的作用及机制研究

目的 探讨赤芍总苷退黄降酶的作用及机制。方法 ICR小鼠随机分成正常对照组,模型对照组,赤芍总苷低、中、高剂量组和苯巴比妥钠组;灌胃α-萘异硫氰酸酯(ANIT)诱导小鼠黄疸模型,分别在实验第6天和第12天观察各组药物对小鼠总胆红素(TBIL)、直接胆红素(DBIL)、胆汁酸(TBA)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)等血清学指标及对小鼠胆汁分泌量和肝组织中尿苷二磷酸葡萄糖酸转移酶(UDPG-T)活性的影响,实验第6天观察各组药物对戊巴比妥钠睡眠时间的影响。结果 与模型对照组比较,除第6天赤芍总苷中剂量组ALT、第12天低剂量组AST无显著差异外,赤芍总苷3个剂量组血清学指标均明显下降(P<0.05或P<0.01);赤芍总苷中、高剂量组胆汁分泌量显著增加(P<0.01或P<0.05);3个剂量组和苯巴比妥钠组睡眠时间均明显缩短(P<0.01);赤芍总苷组肝组织UDPG-T活性明显提高(P<0.05)。结论 赤芍总苷具有退黄降酶作用,其作用机制可能与增加胆汁分泌量、提高肝药酶及UDPG-T活性有关。     

益气活血中药对心力衰竭大鼠MMP-1、TIMP-1影响的实验研究

[目的]观察益气活血复方对慢性心力衰竭大鼠心肌组织基质金属蛋白酶1(MMP-1)和基质金属蛋白酶组织抑制因子-1(TIMP-1)表达的影响。[方法]选用雄性SD大鼠,采用冠状动脉结扎术配合饥饿、游泳等方法造成慢性心力衰竭的动物模型。将造模成功的大鼠随机分为3组:模型组、中药组和西药对照组;中药干预6周后,将动物处死,取其心肌组织,利用实时定量荧光聚合酶链反应(PCR)技术和蛋白印迹分析法(Western blot)分别检测心肌组织中MMP-1、TIMP-1基因表达和蛋白表达。[结果]与对照组比较,大鼠模型组MMP-1的表达高于正常组(P<0.01),而TIMP-1的表达明显低于正常组(P<0.01);中药组和西药组MMP-1的表达均低于模型组(P<0.01),TIMP-1的表达明显高于模型组(P<0.01)。[结论]益气活血中药可以下调MMP-1的表达,增加TIMP-1的表达,从而阻止MMP-1对心肌细胞外基质结构的破坏作用,延缓心肌重塑,改善心脏功能,从而阻止CHF的发展。     

合成冰片对大鼠肝CYP450酶含量及CYP3A1 mRNA表达的影响

[目的]研究冰片对大鼠肝脏细胞色素氧化酶(cytochromeP450,CYP450)含量及其亚型CYP3A1m RNA表达的影响。[方法]istar大鼠合成冰片(设0.3gk/g和0.03gk/g剂量组,1次d/,连续7d)灌胃,以溶媒羧甲基纤维素纳(CM C-Na)和苯巴比妥钠为对照组,钙沉积法提取肝微粒体,紫外分光光度法测定CYP450含量,实时定量RT-PCR法检测肝脏CYP3A1m RNA的表达。[结果]0.3gk/g合成冰片口服可诱导大鼠肝脏CYP450酶含量增高(P<0.05),CYP3A1m RNA表达上调(P<0.05)。[结论]高剂量合成冰片口服可能影响肝脏药物代谢。     

母体血清ADAM12-S与总胆汁酸联合检测妊娠期肝内胆汁淤积患者的诊断价值

目的 探讨母体血清解整合素-金属蛋白酶12-S（ADAM12-S）、总胆汁酸（TBA）浓度检测对妊娠期肝内胆汁淤积（ICP）的诊断价值。方法 选取2017年1月—2019年1月威海市立第三医院收治的194例ICP患者（观察组）和同期200例正常妊娠孕妇（对照组）。检测两组血清ADAM12-S、TBA、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）,观察组间差异,绘制ROC曲线分析ADAM12-S、TBA、ADAM12-S+TBA联合诊断ICP的价值。结果 观察组患者血清ADAM12-S水平低于对照组（P <0.05）,TBA、ALT、AST水平高于对照组（P <0.05）;重度组患者血清ADAM12-S水平低于轻、中度组患者,血清ADAM12-S水平随着ICP病情程度的加重而降低（P <0.05）;重度组患者TBA、ALT、AST水平高于轻、中度组患者,TBA、ALT、AST水平随着ICP病情程度的加重而升高（P <0.05）。ADAM12-S与TBA（r =-0.351,P <0.05）、ALT（r =-0.309,P <0.05）、AST（r =-0.419,P <0.05）均呈负相关。ROC分析结果显示ADAM12-S、TBA及ADAM12-S+TBA联合诊断ICP的曲线下面积（AUC）为0.761、0.830及0.879。结论 ICP患者血清ADAM12-S水平降低,TBA水平升高,ADAM12-S和TBA水平与ICP病情密切相关,ADAM12-S+TBA联合检测对ICP具有较高诊断价值。     

淫羊藿苷对TGF-β1诱导的肾小管上皮细胞上皮间质转分化的作用及机制

[目的] 观察淫羊藿苷对转化生长因子-β1(TGF-β1)诱导的肾小管上皮-间质转化的作用以及对Smad信号通路的影响。[方法] 将肾小管上皮细胞(HK-2)分为空白对照组、TGF-β1组、TGF-β1+淫羊藿苷(10、20、40 μmol/L)组。采用CCK-8法检测10、20、40 μmol/L的淫羊藿苷干预10 μg/L TGF-β1诱导的肾小管上皮细胞的增殖影响; 使用实时定量聚合酶链式反应法检测检测上皮间质转化分管关键因子α-平滑肌肌动蛋白(α-SMA)、E-钙黏蛋白(E-cadherin)、波形蛋白(vimentin)mRNA的表达量; 采用Western blot检测α-SMA、E-cadherin、Smad2/3和p-Smad2/3蛋白表达量; 划痕实验和侵袭迁移小室法(Transwell小室)分别检测HK-2细胞的迁移和侵袭能力。[结果] 与空白对照组比较, TGF-β1组的HK-2细胞增殖、迁移和侵袭能力显著增高(P<0.05), α-SMA、vimentin蛋白和mRNA以及p-Smad2/3蛋白表达量显著增加(P<0.05), 而E-cadherin、Smad2/3蛋白和mRNA表达量显著降低(P<0.05)。与TGF-β1组比较, TGF-β1+淫羊藿苷(10、20、40 μmol/L)组的HK-2细胞增殖、迁移和侵袭能力显著降低(P<0.05), α-SMA、vimentin蛋白和mRNA以及p-Smad2/3蛋白表达量显著降低(P<0.05), 而E-cadherin、Smad2/3蛋白和mRNA表达量显著增加(P<0.05)。淫羊藿苷对TGF-β1诱导HK-2细胞抑制增殖、迁移和侵袭能力以及上皮间质转化无剂量依赖性。[结论] 淫羊藿苷可以抑制TGF-β1诱导的HK-2细胞的上皮-间质转化的分化, 可能与抑制Smad信号通路有关。     

慢性再生障碍性贫血辨证分型与Fas/FasL蛋白表达相关性研究

[目的]探讨慢性再生障碍性贫血中医辨证分型与Fas、FasL蛋白表达的相关性,解析慢性再生障碍性贫血辨证分型的物质基础。[方法]选择90例慢性再生障碍性贫血患者,其中脾肾阳虚、肾阴阳两虚、肝肾阴虚者各30例;另设15例健康志愿者为正常对照组。应用免疫印迹杂交技术检测慢性再生障碍性贫血患者和正常人骨髓Fas、FasL蛋白表达。[结果]慢性再生障碍性贫血患者Fas蛋白、FasL蛋白的表达高于正常对照组(P<0.05或P<0.01),而且脾肾阳虚组、肾阴阳两虚组与肝肾阴虚组组间Fas蛋白、FasL蛋白的表达存在明显差异(P<0.05或P<0.01),按脾肾阳虚组、肾阴阳两虚组与肝肾阴虚组次序依次升高。[结论]慢性再生障碍性贫血的辨证分型与Fas、FasL蛋白表达存在相关性,可作为慢性再生障碍性贫血辨证分型的物质基础。     

L-乳酸对创伤性颅脑损伤后缺氧诱导因子-1α和突触可塑性相关蛋白的影响

目的 探讨L-乳酸对创伤性颅脑损伤后缺氧诱导因子-1α（HIF-1α）和突触可塑性相关蛋白——突触后密度蛋白95（PSD-95）和生长相关蛋白43（GAP-43）表达的影响。方法 健康成年雄性SD大鼠27只，采用随机数字表法将其分为假手术组（Sham组）、创伤性颅脑损伤组（颅脑损伤组）和创伤性颅脑损伤+L-乳酸组（颅脑损伤+Lac组），每组9只。神经细胞株PC12细胞系分为对照组、细胞模型组（MSC组）和细胞模型+L-乳酸组（MSC+Lac组）。采用改良的Fenney’s自由落体打击模型复制中度创伤性脑损伤模型和机械划痕细胞模型。于颅脑损伤后7 d时检测改良神经功能评分（mNSS），采用Western blotting法检测大鼠损伤侧皮层、海马和PC12细胞HIF-1α、PSD-95和GAP-43蛋白的相对表达量，qRT-PCR检测大鼠损伤侧皮层HIF-1α mRNA相对表达量，免疫荧光染色法检测大鼠损伤侧皮质和海马PSD-95的表达。结果 3组大鼠mNSS评分比较，差异有统计学意义（P <0.05）；与Sham组比较，颅脑损伤组mNSS评分升高（P <0.01），与颅脑损伤组比较，颅脑损伤+Lac组mNSS评分降低（P <0.01）。与Sham组比较，颅脑损伤组的HIF-1α蛋白、mRNA相对表达量和PSD-95、GAP-43蛋白相对表达量降低（P <0.05）；与颅脑损伤组比较，颅脑损伤+Lac组HIF-1α蛋白、mRNA相对表达量和PSD-95、GAP-43蛋白相对表达量增加（P <0.05）。与Sham组比较，颅脑损伤组大鼠损伤侧皮层和海马PSD-95蛋白免疫荧光强度降低（P <0.05），与颅脑损伤组比较，颅脑损伤+Lac组大鼠损伤侧皮层和海马PSD-95蛋白免疫荧光强度增强（P <0.05）。与对照组比较，MSC组细胞的HIF-1α、PSD-95、GAP-43蛋白相对表达量降低（P <0.05）；与MSC组比较，MSC+Lac组细胞的HIF-1α、PSD-95、GAP-43蛋白相对表达量增加（P <0.05）。结论 L-乳酸可以减轻颅脑损伤大鼠的脑损伤程度，其机制可能与上调HIF-1α表达进而促进PSD-95和GAP-43表达有关。     

鱼腥草对糖尿病大鼠肾脏组织中BMP-7和TGF-β1表达的影响

[目的]探讨鱼腥草对糖尿病肾脏组织中转化生长因子β1(TGF-β1)和骨形成蛋白-7(BMP-7)表达的影响。[方法]建立链脲佐菌素(STZ)诱导的糖尿病模型,随机分为模型组、鱼腥草组和洛汀新组,另设正常组;观察8周后肾质量/体质量比值、肾小球面积及24h尿β₂微球蛋白、24h尿白蛋白和肌酐清除率,并应用免疫组化检测肾脏组织中TGF-β1、BMP-7的蛋白表达。[结果]鱼腥草给药可明显抑制糖尿病模型大鼠肾小球的肥大,降低24h尿β₂微球蛋白、24h尿白蛋白排泄率和肌酐清除率(P<0.05);免疫组化半定量显示,与模型组比较,鱼腥草组TGF-β1表达明显减少(P<0.05),BMP-7表达增多(P<0.05),而与洛汀新组比较无显著差异(P>0.05)。[结论]鱼腥草对糖尿病肾脏组织有明显的保护作用,其机制可能与其降低肾脏中TGF-β1表达,增加BMP-7的表达有关。     

CTRP9对远端缺血预处理心肌梗死模型大鼠心肌缺血再灌注致脑损伤的保护作用及其机制研究

目的 探讨CTRP9对远端缺血预处理心肌梗死模型大鼠心肌缺血再灌注致脑损伤的保护作用。方法 选取40只雄性SD大鼠，随机分为4组：假手术组（NS组）、心肌缺血再灌注组（NIR组）、缺血预处理组（NIPost组）及缺血预处理+ CTRP9抑制剂组（NIPostI组），每组10只。采用苏木精-伊红染色观察大鼠脑组织病理学变化，免疫组织化学法检测大鼠脑组织凋亡因子、炎症因子的表达，TUNEL法检测大鼠脑组织细胞凋亡，Western blotting检测大鼠心肌组织p-AMPK/t-AMPK、LC3Ⅰ/Ⅱ及P62蛋白的表达。结果 ①HE染色结果显示，NS组皮层的神经元胞浆十分丰富，核呈圆形，碱染后呈蓝色，分布均匀且排列整齐；NIR组神经元结构受损，分布不均匀，胞浆出现空泡，胞核固缩，碱染后出现了淡红色；NIPost组细胞结构大多恢复正常，大部分神经元包膜完整，胞核清晰可见；NIPostI组经CTRP9抑制剂干预后，预处理的保护效应消失。②NIR组、NIPost组及NIPostI组脑组织Bax、IL-6、IL-8表达水平高于NS组（P <0.05），Bcl-2、IL-10表达水平低于NS组（P <0.05）；NIPost组较NIR组Bax、IL-6、IL-8表达水平降低（P <0.05），Bcl-2、IL-10表达水平升高（P <0.05）；NIPostI组较NIPost组Bax IL-6、IL-8表达水平升高（P <0.05），Bcl-2、IL-10表达水平降低（P <0.05）。③NIR组、NIPost组和NIPostI组脑组织凋亡细胞多于NS组（P <0.05）；NIPost组和NIPostI组较NIR组凋亡细胞减少（P <0.05）。NIPost组和NIPostI组比较，差异无统计学意义（P >0.05）。④NIR组、NIPost组及NIPostI组心肌组织p-AMPK/t-AMPK蛋白相对表达量低于NS组（P <0.05），LC3Ⅰ/Ⅱ和P62蛋白相对表达量高于NS组（P <0.05）；NIPost组较NIR组p-AMPK/t-AMPK蛋白相对表达量升高（P <0.05），LC3Ⅰ/Ⅱ和P62蛋白相对表达量降低（P <0.05）；NIPostI组较NIPost组p-AMPK/t-AMPK蛋白相对表达量降低（P <0.05），LC3Ⅰ/Ⅱ和P62蛋白相对表达量升高（P <0.05）。结论 远端缺血预处理可缓解大鼠心肌缺血再灌注所致脑损伤。CTRP9可通过激活AMPK信号通路，参与远端缺血预处理对心肌缺血再灌注所致脑损伤的保护过程。CTRP9水平升高有益于防治心肌梗死。     

栀子酸调节胆汁淤积大鼠SHP-LRH-1信号通路的实验研究

目的：研究栀子酸(geniposidic acid,GPA)对α-萘异硫氰酸酯(α-naphthyl isothiocyanate,ANIT)诱导胆汁淤积 大鼠胆汁酸代谢小分子异源二聚体伴侣受体(small heterodimer partner,SHP)与肝受体同源物1(liver receptor homologue 1,LRH-1)信号通路的调节。方法：将50只SD大鼠随机分为5组,分别为空白组、ANIT组、ANIT+GPA 100 mg/kg组 (AG100组)、ANIT+GPA 50 mg/kg组(AG50组)、ANIT+GPA 25 mg/kg组(AG25组),每组10只,连续给药10 d,空白组和 ANIT组用生理盐水灌胃,ANIT+GPA各组给予GPA,给药的第8天,除空白组外,其余各组用ANIT(65 mg/kg)灌胃1 次造模,继续给药至第10天,测血清总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)和总胆汁酸(total bile acids,TBA)的含量;分离并培养大鼠原代肝细胞(rat primary hepatocytes,RPH),将RPH分为空白组、40 μmol/L ANIT 组、40 μmol/L ANIT+GPA 4.00,1.00,0.25 mmol/L组(A4G,A1G和A0.25G组),real-time RT-PCR检测RPH中SHP和胆汁 酸合成关键酶胆固醇7α羟化酶(cytochrome P450 family 7 subfamily A member 1,CYP7a1) mRNA转录水平,蛋白印迹法检 测SHP和CYP7a1蛋白表达;沉默实验中,将RPH分为空白对照组、阴性转染组、siRNA-LRH-1组(ZR组)、siRNA-LRH- 1+GPA 4.00,1.00,0.25 mmol/L组(ZR4G、ZR1G、ZR0.25G组),检测SHP,CYP7a1和LRH-1蛋白和基因的表达;过表 达实验中,将RPH又分为空白对照组、阴性转染组(空白转染siRNA-阴性组)、LRH-1过表达组(LRH-1过表达质粒,OE 组)、LRH-1过表达质粒+GPA 4.00,1.00,0.25 mmol/L组(OE4G,OE1G,OE0.25G组),检测SHP,CYP7a1和LRH-1蛋 白和基因的表达。结果：在体实验中,与空白对照组比较,ANIT组的TC和TBA均显著升高(均P<0.01)、TG无差别; 与ANIT组比较,AG100组和AG50组的TC和TBA均显著降低(均P<0.01)。RPH实验中,与空白对照组比较,ANIT组中 SHP的蛋白和基因水平均显著降低(均P<0.01),CYP7a1的蛋白和基因水平均显著升高(均P<0.01);与ANIT组比较, A4G和A1G组的SHP基因和蛋白水平均显著升高(均P<0.01),A0.25G组SHP基因和蛋白水平均升高(P<0.05),A4G和A1G 组的CYP7a1基因和蛋白水平均显著降低(均P<0.01)。LRH-1沉默实验中,与阴性转染组比较,ZR组中CYP7a1和LRH-1 蛋白和基因均显著抑制(均P<0.01),SHP无变化;与ZR组比较,ZR4G,ZR1G和ZR0.25G组SHP基因和蛋白水平均显 著升高(均P<0.01),LRH-1和CYP7a1无显著变化。LRH-1过表达实验中,与阴性转染组比较,OE组的CYP7a1和LRH-1 蛋白和基因均显著抑制(均P<0.01),SHP无变化;与OE组比较,OE4G和OE1G组SHP基因和蛋白水平均显著升高(均 P<0.01),OE0.25G组SHP基因显著升高(P<0.05),LRH-1和CYP7a1无显著变化。结论：RPH中LRH-1的过表达能上调 CYP7a1的活性,GPA可以改善ANIT诱导的胆汁淤积大鼠的生物化学水平和肝脏病理,其机制可能与GPA激活大鼠 RPH中SHP造成LRH-1的消耗来降低CYP7a1的表达有关。     

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.     

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.     

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…     

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.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.