体外扩增恒河猴自体内皮细胞人工血管移植研究

目的为自体内皮细胞移植的临床应用奠定理论基础。方法将恒河猴表浅静脉内皮细胞在体外培养１３．９±１．４天;扩增培养的自体细胞衬里于用纤维蛋白胶预衬的膨体聚四氟乙烯（ｅＰＴＦＥ）人工血管,继续培养９天。１５只恒河猴随机分为两组。实验组（１０只）用衬有自体静脉内皮细胞的人工血管置换骼总动脉;对照组（５只）用未衬里内皮细胞的人工血管置换。结果细胞数增加１４８±８９倍。所培养的细胞为二倍体细胞,纯度９９％。原代及传代细胞培养上清液中６－酮－前列腺素Ｆ１ａ（６－ｋｅｔｏ－ＰＧＦ１ａ）和ＶｏｎＷｉｌｅｂｒａｎｄ因子（ｖＷＦ）含量差异无显著意义。细胞种植后２小时和９天,人工血管腔面见一层均匀的基质,基质表面有一层连续的内皮细胞单层。内皮细胞紧密排列。呈梭状,形态饱满。实验组除１只于术后１２小时因近端吻合口破裂腹腔内出血死亡,１只人工血管于术后４周阻塞外,其余８只恒河猴人工血管术后４周均保持通畅,内膜下组织厚度为８０±１２μｍ;对照组５条人工血管全部阻塞。结论自体内皮细胞移植可有效地提高人工血管的通畅率。     

成人静脉内皮细胞单次传代大规模体外培养

用胶原酶消化成人静脉，总数：２５．９±６．７２×１０￣３个细胞。获取９．１２±４．３×１０￣３个细胞／ｃｍ￣２，活细胞率为９９％。以２．３９±０．４３×１０￣３个细胞／ｃｍ￣２的接种密度将其接种到一次性塑料培养皿中进行原代培养。待细胞进入增殖平台期后（生长时间为：７．２５±０．５ｄ），以１：２６比例将原代细胞进行传代培养。经８±０．８２ｄ培养后，细胞接触仰制形成。整个体外培养扩增时间为：１５±１．４ｄ，血管内皮细胞数增加了３３３±４０倍。经荧光标记第Ⅷ因子相关抗原单克隆抗体和透射电镜观察证实：１９９％以上的原代及传代细胞为血管内皮细胞。扩增后的血管内皮细胞染色体２ｎ＝４６条，未发现异倍体细胞。在原代和传代细胞的条件培养液内ｔ－ＰＡ和ＶＷＦ含量相差无统计学意义。     

麻疹患儿血清心肌肌钙蛋白I、肌酸磷酸激酶同工酶水平的检测及意义

笔者对２０００年１２月至２００１年７月我院收治的５６例麻疹患儿进行心肌肌钙蛋白Ⅰ（ＣＴｎＩ）、肌酸磷酸激酶同工酶（ＣＫ -ＭＢ）检测 ,以探讨麻疹患儿的心肌损害情况。现将结果报告如下。１．１对象麻疹组５６例均符合卫生部制定的麻疹诊断标准 ［１］。男性３６例 ,女性２０例；年龄２０ｄ～１０岁 ,平均 (２．７４±２．４９）岁。病程３～９ｄ ,平均 (５．０９±１．２５）ｄ。其中典型麻疹３１例 ,重型麻疹２５例 ;并发肺炎１５例 ,脑炎９例 ,心肌炎４例 ,心力衰竭６例 ,呼吸衰竭３例。血清抗麻疹病毒ＩｇＭ抗体阳性３６例。对…     

清解利咽汤治疗小儿疱疹性咽峡炎疗效观察

疱疹性咽峡炎是儿科的一种常见病,笔者于１９９７～１９９９年每年５～９月间采用自拟清解利咽汤治疗该病４２例,取得满意疗效,报告如下。１　资料与方法１．１　临床资料诊断标准参照儿科学全国教材［１］。全部病例来自我院儿科门诊与急诊共８２例,按就诊顺序随机分为两组。治疗组４２例,其中男２２例,女２０例;年龄２～７岁,平均（３．６３±１．５７）岁;病程１～２ｄ,平均（１．０５±０．３８）ｄ。对照组４０例,其中男１９例,女２１例;年龄２～６岁,平均（３．９７±１．６８）岁;病程１～２ｄ,平均（１．１２±０．…     

人脐静脉内皮细胞的培养

目的：建立人内皮细胞的培养及其生物学功能检测方法。方法：以脐带来源的脐静脉内皮细胞行原代及传代培养，以光镜、电镜及第Ⅷ因子相关抗原的Ｓ－Ｐ免疫细胞方法进行观察及鉴别。结果：培养细胞具有特征性的Ｗｅｉｂｅｌ－Ｐａｌａｄｅ小体，其上清液及细胞内测到血管紧张素转换酶（ＡＣＥ）和ＶｏｎＷｉｌｌｂｒａｎｄ因子（ＶＷＦ）分别为８４±９Ｕ，７０±８Ｕ；（１．０８±０．２６）×１０（－２）Ｕ／ｍｌ，（１．０１±０．１４）×１０（－２）Ｕ／ｍｌ。结论：形态学及免疫学证明，培养细胞是内皮细胞，并具有合成、释放ＡＣＥ和ＶＷＦ的生物学功能。     

不同分离方法对大鼠表皮屏障功能的影响

目的：研究不同表皮分离方法对大鼠表皮水渗透屏障功能的影响。方法：用胰蛋白酶法、Ｄｉｓｐａｓｅ法、加热法和一天培养－加热法四种不同方法从新生大鼠皮肤上分离得到大鼠表皮，在气－液面培养的不同阶段测定表皮的水渗透屏障系数并与新生大鼠皮肤的屏障功能相比较。结果：表皮水渗透系数（Ｋｐ）值在胰蛋白酶法为（２．１±０．９）ｃｍ·ｈ－１，Ｄｉｓｐａｓｅ法为（３．８±１．２）ｃｍ·ｈ－１，加热法为（４．３±１．４）ｃｍ·ｈ－１，一天培养－加热法为（２．２±０．７）ｃｍ·ｈ－１，而新生大鼠皮肤的Ｋｐ值为（１．９±０．９）ｃｍ·ｈ－１。Ｄｉｓｐａｓｅ法和加热法有可能损伤表皮的屏障结构导致表皮水渗透性增高。此种损伤经过约３ｄ的气－液面培养后即可得到部分的修复。在气－液面培养条件下，表皮正常的屏障功能可维持８～１０ｄ。结论：胰蛋白酶和一天培养－加热分离法对大鼠表皮屏障功能无明显损伤作用。在气－液面培养条件下，该表皮可维持正常的屏障功能     

短暂性脑缺血发作后海马区星形胶质细胞形态学研究

采用ＳＤ大鼠制成模拟短暂性脑缺血发作（ＴＩＡｓ）动物模型。应用免疫组织化学方法抗神经胶原纤维酸性蛋白（ＧＦＡＰ）标记星形胶质细胞，研究ＴＩＡｓ后海马结构不同区域星形胶质细胞反应的规律。结果显示：海马ＣＡ１区星形胶质细胞反应最为显著，再灌注７ｄ时星形胶质细胞密度、面积和染色灰度达最高峰，分别为１２．６８±１．５７、（１２３．９０±１９．３９）μｍ２、１１３．２０±１８．７６；齿状回次之，且随存活时程延长星形胶质细胞反应下降缓慢。再灌注３０ｄ时星形胶质细胞反应的各项指标与再灌注７ｄ时无差别（Ｐ＞０．０５）。而ＣＡ３区星形胶质细胞反应相对较弱，且星形胶质细胞反应随存活时程延长下降较快，再灌７ｄ时星形胶质细胞密度、面积和染色灰度分别为９．２４±０．８８、（１１３．６０±１８．８７）μｍ２、９６．６１±９．３６，与再灌注３０ｄ时相比具有显著性差别（Ｐ＜０．０１）。结果表明：ＣＡ１区星形胶质细胞反应呈持续性，而ＣＡ３区星形胶质细胞反应呈一过性。     

恒河猴静脉内皮细胞衬里ePTFE人工血管的实验研究

按原位获取法获取恒河猴表浅静脉内皮细胞，在体外培养扩增。制备成内皮细胞悬液（2×109／L）。用纤维蛋白胶和纤维连接蛋白联合预衬各ePTFE人工血管腔（长10cm，直径3mm），将内皮细胞灌入此人工血管。结果内皮细胞的贴壁率明显提高［（94．62±2．84）％］；内皮细胞高密度种植入工血管后2h，扫描电镜下见人工血管腔表面已形成完整的内皮细胞单层；孵育9d后，透射电镜见内皮细胞骨架已分化成熟，表明此时人工血管腔内皮细胞具有良好的抗切应能力。     

冠状动脉旁路移植术76例临床分析

目的 为评价冠状动脉硬化病（ＣＡＤ）病人行冠状动脉路移植术（ＣＡＢＧ）后的病死率及远期效果。方法 总结了从１９９４年９月至１９９７年５月为７６例ＣＡＤ病人行ＣＡＢＧ的临床资料及术后１个月至２年８个月的随访资料。结果 手术死亡２例，病死率为２．６％，术后心排血量（４．９６±１．５６）和心脏指数（２．７５±０．７６）较术前（分别为３．８８±１．７４和２．１７±１．０６）明显增加（Ｐ〈０．０１），余７４     

乳香提取物对急性非淋巴细胞白血病细胞诱导分化作用

探讨乳香提取物对急性非淋巴细胞白血病诱导分化作用，采用造血祖细胞体外培养技术研究乳香提取物对３６例急性非淋巴白血病细胞诱导分化成熟。结果：诱导分化率ＡＮＬＬＭ３（６７．９±７．９）％；ＡＮＬＬＭ２ａ（５７．９±１１．７）％。ＮＢＴ还原率ＡＮＬＬＭ３（６７．８±３．９）％、ＡＮＬＬＭ２ａ（５９．９±９．５）％。墨汁吞噬功能：ＡＮＬＬＭ３（５６±８．９）％，ＡＮＬＬＭ２ａ（５９．８±８．７）％。结论：乳香提取物对急性非淋巴白血病细胞有诱导分化作用，使之诱导分化成熟，并恢复其功能     

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.     

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.