扶正健肝方对免疫性肝纤维化大鼠胶原代谢的影响

目的观察扶正健肝方对白蛋白诱导的肝纤维化大鼠胶原代谢的影响。方法采用人血白蛋白(HSA)诱导大鼠肝纤维化,并随机分为扶正健肝方大、小剂量组(生药39.4、9.85g/kg)、秋水仙碱组(0.0001g/kg)、模型组、对照组等5组。放射免疫分析法测定层粘连蛋白(laminin,LN)、透明质酸(hyaluronic acid,HA)和Ⅳ型胶原(collagen type Ⅳ,Ⅳ-C)的含量,化学法测定肝脏羟脯氨酸(hydroxyproline,Hyp)的含量。采用HE染色及VonGieson胶原纤维特殊染色观察肝组织结构改变及肝纤维化程度。图像分析系统定量分析肝内胶原纤维含量。结果扶正健肝方能明显降低人血白蛋白诱导肝纤维化大鼠血清层粘连蛋白、透明质酸和Ⅳ型胶原的含量(P<0.05,P<0.01),同时可降低大鼠肝脏中羟脯氨酸的含量。病理学观察,扶正健肝方能使大鼠胶原纤维沉积明显减轻,假小叶结构明显减少。图像定量分析显示扶正健肝方能明显降低肝脏胶原纤维的含量。结论扶正健肝方能通过对肝脏胶原物质代谢的影响而抑制人血白蛋白诱导的大鼠肝纤维化形成和发展。     

抗肝纤方对大鼠肝纤维化防治作用的实验研究

目的：通过大鼠肝纤维化动物模型，研究抗肝纤方预防肝纤维化的作用，并探讨其作用机制。方法：采用二甲基亚硝胺(DMN)诱导大鼠制备肝纤维化模型，以秋水仙碱为阳性对照，采用光镜观察组织学改变并测定血清谷丙氨酸转移酶(ALT)、谷草氨酸转移酶(AST)、白蛋白(ALB)、球蛋白(GLB)、透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、和Ⅳ型胶原(Ⅳ—C)，以反映肝细胞损伤及肝纤维化的程度。结果：抗肝纤方能显著降低大鼠血清中ALT、AST、HA、LN、PCⅢ、Ⅳ—C的水平，升高ALB。病理组织学检查亦表明，抗肝纤方能明显减轻实验大鼠肝脏纤维化程度。结论：抗肝纤方对实验性肝纤维化有预防作用。     

益气活血解毒化痰方治疗慢性病毒性乙型肝炎肝纤维化临床研究

目的:观察益气活血解毒化痰方治疗慢性病毒性乙型肝炎肝纤维化的临床疗效。方法:86例慢性病毒性乙型肝炎肝纤维化患者随机平均分为中药组和常规组。对照组按照临床诊疗指南给予常规治疗,中药组在此基础上给予益气活血解毒化痰方治疗,3个月为1个疗程,两组均治疗2个疗程。比较两组患者中医证候积分、症状体征评分、血清肝纤维化指标、超声影像学指标和S指数(一种肝纤维化非创伤性诊断模型),以评价临床综合疗效。结果:治疗后,两组患者证候积分较治疗前有所改善(P<0.05),且中药组证候积分显著低于常规组(P<0.05);两组血清肝纤维化指标、S指数评分、门静脉直径、脾肿指数均较治疗前明显改善(P<0.05);中药组患者有效率明显高于常规组(P<0.05)。结论:益气活血解毒化痰方治疗慢性病毒性乙型肝炎肝纤维化临床疗效显著。     

龙胆草提取物对四氯化碳致肝纤维化大鼠TNF-α、HA及NO的影响

目的 观察龙胆草提取物对四氯化碳致肝纤维化大鼠TNF、HA及NO的影响.方法 50只雄性大鼠随机分为正常组、模型组、给药组和秋水仙碱组,并以灌胃的方式给药,观察龙胆草提取物四氯化碳所致肝纤维化大鼠肝病理组织学的影响.结果 龙胆草给药组肝纤维化指标透明质酸(HA)、肿瘤坏死因子(TNF-α)含量明显低于模型组(P＜0.05或P＜0.01);血清一氧化氨(NO)含量较模型组明显降低(P＜0.05或P＜0.01);HE染色显示肝纤维化程度较模型组明显减轻(P＜0.05).结论 龙胆草提取物对四氯化碳致肝纤维化大鼠一定的保护作用.     

草苁蓉及氧化苦参碱治疗肝纤维化的实验研究

目的:观察草苁蓉(BR)、氧化苦参碱(OM)治疗大鼠肝纤维化的疗效,为临床治疗提供理论依据.方法:二甲基亚硝胺(DMN)腹腔注射制作肝纤维化的大鼠模型,观察BR、OM治疗后大鼠血清ALT、PCⅢ和CⅣ的变化情况及肝组织的病理学改变.结果:BR、OM可明显提高肝纤维化模型大鼠血清ALT,降低模型大鼠血清PCⅢ和CⅣ(BR、OM组与模型组比较:P＜0.05);另外BR、OM组大鼠胶原纤维面密度和肝纤维化分级与模型组比明显减轻P＜0.05.结论:BR、OM对DMN造模的大鼠肝纤维化有治疗作用.     

加味四逆散对肝纤维化大鼠肝组织Ⅳ型胶原和转化生长因子β1影响的免疫组化研究

目的 :观察研究加味四逆散对肝纤维化大鼠肝组织Ⅳ型胶原和转化生长因子 β1(TGFβ1)的影响效果及不同剂量与疗效的关系 ,从而探讨该方抗肝纤维化的机理和合适用量。方法 :采用二甲基亚硝胺 (DMN)腹腔注射制备大鼠肝纤维化模型 ,加味四逆散大、中、小不同剂量灌胃给药 ,免疫组织化学方法 (SP法 )检测分析各组大鼠肝组织Ⅳ型胶原和转化生长因子 β1的含量。结果 :加味四逆散能明显降低肝纤维化大鼠肝组织Ⅳ型胶原和转化生长因子 β1的含量 ,与病理模型组比较有显著性差异 (P <0 0 5 ) ;加味四逆散中剂量影响效果好于小剂量和大剂量 ,三组之间的疗效呈中 >小 >大剂量的关系 ,中剂量与小、大剂量比较有显著性差异 (P >0 0 5 ) ,而小剂量与大剂量比较无显著性差异 (P >0 0 5 )。结论 :加味四逆散可有效的减少肝组织Ⅳ型胶原的沉积和拮抗转化生长因子 β1的生成 ,对肝纤维化有肯定的治疗作用 ,而且中剂量疗效较好。     

肝纤愈对免疫性肝纤维化大鼠肝功能及组织病理学改变的影响

目的:建立大鼠免疫损伤性肝纤维化的实验模型,研究中药复方肝纤愈(GXY)对肝纤维化模型动物肝功能指标及肝组织病理学的影响。方法:在以人血白蛋白(HSA)诱导的免疫损伤性肝纤维化大鼠模型基础上,GXY小剂量(6.1g/kg)、大剂量(12.2g/kg)灌胃给药,连续8周,以鳖甲软肝片和秋水仙碱为阳性对照药。测定大鼠血清中ALT、AST、TP、Alb含量;光镜、电镜观察肝组织病理学改变。结果:GXY(大)组可明显降低HSA诱导免疫性肝纤维化大鼠模型血清中ALT、AST的含量,升高Alb的含量,同时可改善实验大鼠生存质量,且可显著改善肝组织病理学。结论:GXY具有明显的抗肝纤维化作用。     

三参提取物抗大鼠肝纤维化作用的研究

目的：研究三参提取物灌胃给药对大鼠肝纤维化的预防和治疗作用。方法：采用皮下注射四氯化碳（CCl4）和腹腔注射二甲基亚硝胺（DMN）诱导的2种大鼠肝纤维化模型,观察三参提取物对大鼠肝纤维化的影响。结果：三参提取物对2种肝纤维化大鼠有升高血清和肝脏中白蛋白（ALB）含量,降低血清中Ⅳ型胶原、总胆红素（TBiL）和肝脏中Hyp、丙二醛（MDA）含量,改善肝细胞损伤程度及肝纤维化、降低肝门静脉血压等作用。结论：三参提取物具有抗COL和DMN大鼠肝纤维化的作用,提示临床上可用于防治肝纤维化。     

姜黄素对四氯化碳诱导大鼠肝纤维化的影响

目的:观察姜黄素(Cur)预防给药对四氯化碳(CCl4)诱导大鼠肝纤维化的影响,并探讨其相关的分子机制.方法:64只雄性SD大鼠随机分为正常对照组(10只),模型对照组(14只)和水飞蓟宾组(10只),Cur低、中、高剂量组(各10只).模型对照、水飞蓟宾和Cur组均采用皮下注射体积分数40%CCl4复制肝纤维化模型,水飞蓟宾组大鼠同时给予0.5 g/L水飞蓟宾,Cur低、中、高剂量组大鼠同时分别给予1、2、4 g/L的Cur灌胃7周.HE染色观察各组大鼠肝组织的病理形态,进行肝纤维化分级;血清生化学检测谷氨酸氨基转移酶(ALT)、谷草转氨酶(AST)及碱性磷酸酶(ALP)含量,计算白球蛋白比值(A/G);放射免疫法测定透明质酸(HA)、Ⅲ型前胶原氨基端肽(PⅢNP)、层粘连蛋白(LN)以及胶原Ⅳ(C-Ⅳ)的含量变化;免疫组织化学染色法检测肝组织过氧化物酶增殖体激活受体γ(PPAR-γ)和Collagen Ⅰ的含量.结果:Cur预防给药可明显降低ALT、AST的活性,升高A/G,同时降低血清HA、LN、PⅢNP、C-Ⅳ含量(F=11.535,19.927,4.831,16.415,17.596,19.692,21.535,P＜0.05);病理形态显示Cur对大鼠的肝纤维化进展有明显的抑制作用;Cur预防给药使受试动物肝组织PPAR-γ表达明显增加、Collagen Ⅰ的表达明显减少(F=6.519,7.541,P＜0.05).结论:Cur预防给药能明显抑制CCl4诱导的大鼠肝纤维化形成,可能与激活PPAR-γ,减少Collagen Ⅰ的产生,预防细胞外基质的过量沉积有关.     

Effect of exogenous hydrogen sulfide on liver fibrosis in rats

目的 探讨外源性硫化氢对四氯化碳(CCl4)诱导大鼠肝纤维化的预防作用.方法 将24只Wistar雄性大鼠随机分为3组,每组8只,即正常对照组、模型组、硫化氢(H2S)预防组.H2S预防组除腹腔注射40％ CCl4外,还给予NaHS腹腔注射,1次/d,至第8周,所有大鼠均被处死,收集大鼠血液,检测肝纤维化指标;取肝组织检测脂质过氧化指标及观察肝脏病理变化;应用RT-PCR和Western blot方法检测肝组织NF-κB的表达.结果 外源性H2S能降低血清HA、LN、PCⅢ及肝组织MDA含量(P＜0.01或P＜0.05),增加肝组织SOD、GSH-Px活性(P＜0.01),减轻肝纤维化程度(P＜0.05),而且能使NF-κB表达明显减少.结论 外源性硫化氢对CC14诱导的大鼠肝纤维化具有保护作用,其机制可能与硫化氢抑制NF-κB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.