改良线栓法大鼠大脑中动脉阻塞模型的建立

目的对大鼠大脑中动脉阻塞（MCAO）再灌注模型进行改良，通过比较再灌注24h时大鼠神经功能评分、梗死率、模型制作时间、成功率和死亡率等指标评价改良线栓法大鼠MCAO再灌注模型的有效性。方法12只SD大鼠随机分为对照和模型两组，对照组采用分离结扎翼腭动脉，从颈外动脉插入线栓至大脑中动脉。模型组采用不分离结扎翼腭动脉，从颈总动脉分叉处插入线栓至大脑中动脉。阻断大脑中动脉血供2h后将线栓拔出实现再灌注。于再灌注24h时观察脑组织组织病理学改变，计算比较两组大鼠神经功能评分、模型制作时间、模型成功率和死亡率以及鼠脑切片TTC染色测量脑梗死率。结果两组MCAO模型在再灌注24h后大鼠神经功能评分、梗死率、模型成功率和死亡率等方面没有显著差异；模型组的模型制作时间显著少于对照组（P〈0．05）。结论采用不分离结扎翼腭动脉，由颈总动脉插入线栓的改良线栓法是稳定和可靠的MCAO造模方法。     

大鼠线栓法局灶性脑缺血再灌注损伤模型改进的实验研究

目的提供一种比较简易的大鼠局灶性脑缺血再灌注损伤模型的制备方法。方法40只SD大鼠线栓法制作局灶性脑缺血再灌注损伤模型,选择距颈总动脉（CCA）分叉1cm处切口,不分离颈外动脉（ECA）和颈内动脉（ICA）,且不结扎颈外动脉的手术方法,通过调整进线角度使线栓从CCA顺行进入ICA,进而入颅堵塞大脑中动脉（MCA）。造模后缝合皮肤,再灌注时拔出一定长度栓线,使栓线回至CCA分叉处即可。通过神经功能检测、2,3,5-三苯基四氮唑（TTC）染色和病理学检查等方法评价该模型的可靠性。结果大鼠手术后神经功能缺损明显,神经功能评分集中,TTC染色稳定。结论该改良方法手术简单,创伤小,缺血效果可靠,可用于脑缺血再灌注损伤的研究。     

大鼠大脑中动脉闭塞局灶脑缺血再灌注改良模型的建立

目的 介绍一种简便可靠的插线法，可用于制作SD大鼠大脑中动脉(MCA)闭塞局灶脑缺血再灌注模型。方法 结扎并游离颈外动脉，用2-0丝线悬吊翼腭动脉，用插入端蘸不饱和聚酯的白色鱼线从颈外动脉切口处插入，经颈内动脉，可逆性阻断大鼠一侧大脑中动脉。随后进行神经病学评分、TTC染色、亚甲蓝染色以观察模型的可靠性，将此改良法与经典的Longa法进行对比研究。结果 大鼠MCA阻断2h后进行再灌注，模型成功则出现Horner’s征阳性、神经病学评分≥1分，TTC染色显示梗死范围，亚甲蓝染色提示MCA供血区神经元大量缺失。与经典的Longa法模型对比，改良模型的成功率高、死亡率低。结论 该改良模型简便可靠，稳定性好，是研究MCA局灶脑缺血再灌注较为理想的实验动物模型。     

大鼠大脑中动脉永久性缺血和缺血再灌注模型的比较

目的:比较大鼠大脑中动脉永久性阻塞模型和缺血再灌注模型的差异,寻找一种制作简单,成功率高的脑缺血模型。方法:将150只SD雄性大鼠随机分为:永久性大脑中动脉阻塞60只,线栓阻塞大脑中动脉4h、8h、24h后生理盐水灌注后取脑;大脑中动脉缺血再灌注60只,线栓阻塞大脑中动脉100min后,拔出线栓形成再灌注,分别在再灌注4h、8h、24h后灌注取脑;对照组30只。比较模型制作的成功率、术后存活率、神经功能缺失评分、脑梗死体积及模型稳定性。结果:脑缺血再灌注组模型成功率高于永久性脑缺血组,差异有统计学意义(P<0.05);永久性脑缺血模型组死亡率较脑缺血再灌注模型组死亡率有升高趋势,但无统计学意义;TTC染色:永久性大脑中动脉阻塞梗死灶随着缺血时间的延长逐渐扩大,大脑中动脉缺血再灌注梗死灶随再灌注时间的延长无明显变化;结论:大鼠大脑中动脉缺血再灌注模型手术方式简单、结果稳定、缺血时间可控,是一种较理想的模拟脑梗死的动物模型。     

改良法制作SD大鼠局灶性脑缺血/再灌注模型探讨

目的探讨线栓法制造大鼠局灶性脑缺血/再灌注模型的成功经验。方法采用改良线栓法制作Sprague-Dawley(SD)大鼠大脑中动脉阻塞(MCAO)局灶性脑缺血/再灌注动物模型。结果30只大鼠中,经神经功能评分、核磁共振血管成像及TTC染色验证,28只造模成功,成功率超过90%。结论改良线栓法MCAO制作大鼠局灶性脑缺血/再灌注模型值得推广。     

线栓法制作大鼠局灶性脑缺血/再灌注模型若干问题的探讨

目的 对线栓法制作大鼠局灶性脑缺血／再灌注模型进行改进，分析影响模型成功率的原因及解决方法。方法参照Zea Longa法，使用SD大鼠制作局灶脑缺血／再灌注模型，但术中不结扎翼腭动脉，栓线直接从颈总动脉进入大脑中动脉。根据神经功能缺损症状，结合TTC或HE染色判断模型制作是否成功。结果改进后的模型成功率80％，在制作过程中易出现蛛网膜下腔出血、脑实质出血、颈部血管破裂出血、脑缺血不完全和麻醉意外等问题。结论改进后的模型成功率高，选择体重合适的大鼠、制作良好的栓线和控制术中出血是模型制作成功的关键。     

珍龙醒脑胶囊对大鼠脑缺血再灌注损伤的保护作用

目的研究珍龙醒脑胶囊对电刺激颈总动脉大鼠血管阻塞及大脑中动脉缺血再灌注大鼠神经功能、血小板聚集、脑指数、脑梗死范围的影响。方法 50只Wistar大鼠随机分5组,空白组、珍龙醒脑胶囊(ZLXN)低、中、高剂量组和脑心通胶囊组(NXT组)。采用电刺激颈总动脉血栓形成造模,测试珍龙醒脑胶囊对血管阻塞时间的影响;48只Wistar大鼠随机分为6组,假手术组、模型组、ZLXN低、中、高剂量组和NXT组,线栓法制备大鼠大脑中动脉缺血再灌注模型,观察珍龙醒脑胶囊对大脑中动脉缺血再灌注大鼠神经功能、血小板聚集、脑指数、脑梗死范围的影响。结果珍龙醒脑胶囊能延长大鼠电刺激颈总动脉血管阻塞时间、降低脑缺血再灌注神经功能评分、降低血小板聚集率、降低脑指数、使脑梗死体积变小。结论珍龙醒脑胶囊对脑缺血再灌注损伤具有较好的保护作用。     

缺血后处理对大鼠脑缺血再灌注的神经保护作用

目的 探讨缺血后处理对大鼠脑缺血再灌注的神经保护作用.方法 30只Wistar雄性大鼠随机分为假手术组、缺血再灌注组(I/R组)和缺血后处理组(IP组).采用线栓法建立大鼠大脑中动脉缺血模型,脑缺血2h后IP组给予缺血后处理.于脑缺血再灌注后24 h行神经行为学评分进行神经功能测定,TTC染色观察脑梗死体积,应用透射电镜观察神经细胞及髓鞘的超微结构变化,行各组间比较.结果 IP组大鼠行为学结果优于I/R组,IP组脑梗死体积明显小于I/R组,IP组大脑皮层神经元、髓鞘损伤均轻于I/R组.结论 缺血后处理可改善大鼠脑缺血再灌注后神经功能,减小梗死体积,减轻神经细胞损伤,具有神经保护作用.     

一种基于血管内皮细胞损伤的大鼠局灶性脑梗死模型

目的：建立一种因血管内皮细胞损伤而诱导的大鼠局灶性脑梗死模型。方法：取S—D大鼠11只，分离左侧颈总动脉、颈外动脉和颈内动脉。结扎左颈外动脉远心端，夹闭左翼腭动脉和颈总动脉，经颈外动脉逆行插管并缓慢注入月桂酸钠至颈内动脉系统，造成大脑中动脉血管内皮细胞受损。结果：从模型动物的行为表现、梗死灶形态学和病理学进行考察，10只大鼠均产生一定程度的脑梗死表现，造模成功率为90．9％。结论：该模型的稳定性和重复性较好，能在大脑中动脉的供血区产生恒定的梗死灶，适合进行脑缺血损伤的有关实验研究。     

吗啡对大鼠大脑中动脉缺血再灌注后神经功能影响

目的观察吗啡预处理对大鼠大脑中动脉缺血再灌注损伤后大脑组织形态学改变、梗死面积及神经功能的影响。方法将雄性Wistar大鼠随机分为假手术组、模型组及吗啡组,每组12只。假手术组不阻断脑血流,模型组和吗啡组按LONGA方法阻断大脑中动脉2h后再开放灌注。模型组和吗啡组在脑缺血前60min分别腹腔注射生理盐水及1mg/kg吗啡2mL。再灌注24h时,测定大鼠神经功能缺损评分,苏木精-伊红染色观察缺血脑组织形态学改变,红四氮唑(TTC)染色计算脑梗死面积。结果假手术组大鼠神经功能及脑组织形态学正常,大脑组织无梗死。与模型组比较,吗啡组脑组织形态学病理改变较轻,脑梗死面积减少(t=11.22,P<0.05),神经功能缺损评分降低(t=5.86,P<0.05)。结论吗啡预处理能减轻大鼠局灶脑缺血再灌注损伤,改善神经功能。     

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.