1,6—二磷酸果糖抗失血性休克实验研究

本实验观察了ＦＤＰ抗失血性休克作用。３组失血性休克大鼠分别接受５％ＦＤＰ溶液（Ａ组）、５％葡萄糖溶液（Ｂ组）和生理盐水（Ｃ组）静注。给药６０ｍｉｎ后，Ａ组ＭＡＰ为１０．４±２．１ｋＰａ，与Ｂ、Ｃ组７．９±２．４和７．７±２．６ｋＰａ间均有差异（Ｐ＜０．０１）；Ａ组动物存活率７５％，而Ｂ、Ｃ组分别为２５％和１５％（Ｐ＜０．０１）；Ａ组动脉血ｐＨ和ＰａＯ２分别为７．２４±０．１４和１３．４６±１．２２ｋＰａ，与Ｂ、Ｃ组７．１４±０．１４和１０．２９±３．８４ｋＰａ与７．０２±０．１０和７．２５±２．１２ｋＰａ间有显著差异（Ｐ＜０．０１）；Ａ组回输血液再灌流后血浆ＳＯＤ和ＭＤＡ分别为１２００±１２６Ｕｍｌ－１和０．４７±０．２５ｎｍｏｌｍｌ－１，同Ｂ、Ｃ组１０８１±１１９Ｕｍｌ－１和０．９１±０．２９ｎｍｏｌ－１与８３５±９Ｕｍｌ－１和１．１３±０．１６ｎｍｏｌ－１间均有显著差异（Ｐ＜０．０１）。结果表明ＦＤＰ保护组织损伤而产生抗休克作用。     

长程吸入一氧化氮对大鼠缺氧性肺动脉高压的影响

目的探讨长程吸入一氧化氮（ＮＯ）对慢性缺氧性肺动脉高压的阻抑效应及其机制。方法将３２只雄性Ｗｉｓｔａｒ大鼠分为（１）正常对照组;（２）缺氧组;每天缺氧１２小时,共３周;（３）吸入ＮＯ组：缺氧同时每天吸入２０ｐｐｍＮＯ１２小时,共３周。观察肺动脉压力、右心室肥厚、血浆内皮素－１（ＥＴ－１）和环磷酸鸟苷（ｃＧＭＰ）变化以及肺组织病理学改变。结果（１）缺氧组大鼠肺动脉压力明显升高（４．３±０．９ｋＰａ）,右心室肥厚显著（Ｐ均＜０．００１）,吸入ＮＯ组肺动脉压力降低（３．０±０．４ｋＰａ）,右心室肥厚减轻;（２）缺氧组腺泡内肌型肺动脉增多,无肌肺动脉明显减少,与对照组相比,差异显著（Ｐ＜０．０１）,吸入ＮＯ组明显改善三型血管比例失调。（３）缺氧组血浆ＥＴ－１含量明显升高,（１９７±１５ｐｇ／ｍｌ）,ｃＧＭＰ水平显著降低。吸入ＮＯ组ＥＴ－１含量降低（１６３±１４ｐｇ／ｍｌ）;ｃＧＭＰ含量升高。结论长程吸入２０ｐｐｍＮＯ能阻抑慢性缺氧性肺动脉压力升高,且无明显毒副作用。     

小儿肾小球疾病时血清纤维结合蛋白的改变

用火箭电泳法测定了６３例肾小球疾病患儿血清纤维结合蛋白（ＦＮ）的含量。３１例急性肾炎患儿急性期血清ＦＮ平均为１１６．３±１０５．０ｍｇ／Ｌ，较对照组（１６７．１±４０．６ｍｇ／Ｌ）明显减低（Ｐ＜０．０５），但其波动范围较大。１３例激素敏感性肾病综合征患儿血清ＦＮ为３０４．４±９３．４ｍｇ／Ｌ，较对照组显著升高（Ｐ＜０．００１），６例激素耐药的肾病患儿，血清ＦＮ无明显改变。９例肾病患儿激素治疗前血清ＰＮ为２６８．８±７２．５ｍｇ／Ｌ，治疗后４～６周，ＦＮ升高到３６１．８±８８．３ｍｇ／Ｌ（Ｐ＜０．０５）。１３例紫癜性肾炎患儿，血清ＦＮ为７７．２±３９．９ｍｇ／Ｌ，较对照组显著减低（Ｐ＜０．０１）。     

慢性肾衰血透患者脂质过氧化损伤与NK细胞活性的临床相关分析

本文测定２３例慢性肾衰血透患者血浆ＬＰＯ、ＳＯＤ、ＲＢＣ－ＬＰＯ及ＮＫ细胞活性。结果表明透前血浆ＬＰＯ、ＳＯＤ、ＲＢＣ－ＬＰＯ及ＮＫ细胞活性分别为１０．８５±２．１１ｎｍｏｌ／ｍｌ、４０．２４±８．０ｕ／ｍｌ、２３．９１±５．４９ｎｍｏｌ／ｇＨｂ和２９．９２±６．０８％（正常对照分别为６．５３±０．６５ｎｍｏｌ／ｍｌ、７９．２５±７．６１ｕ／ｍｌ、１６．３３±３．６１ｎｍｏｌ／ｇＨｂ和５１．２１±８．３３％）。透后血浆ＬＰＯ、ＳＯＤ分别为９．３８±１．５４ｎｍｏｌ／ｍｌ和５１．０７＋９．１６ｕ／ｍｌ，结果均与正常对照有显著差异；且透前、透后血浆ＬＰＯ、ＳＯＤ也有显著差异（Ｐ＜０．０１）。它们之间的相关分析表明血浆ＬＰＯ与ＢＵＮ、Ｃｒ呈正相关（ｒ＝０．３２５１Ｐ＜０．０５、ｒ＝０．４１９１Ｐ＜０．０１），与ＳＯＤ呈负相关（ｒ＝－０．５１１９Ｐ＜０．０１）；血浆ＳＯＤ与ＢＵＮ、Ｃｒ呈负相关（ｒ＝－０．５３５３、ｒ＝－０．４７６１Ｐ＜０．０１），ＮＫ细胞活性与ＲＢＣ－ＬＰＯ呈负相关（ｒ＝－０．４１３２Ｐ＜０．０５），与血浆ＬＰＯ、ＳＯＤ、ＢＵＮ、Ｃｒ无相关。上述表明慢性肾衰血透患者有脂质过氧化损伤，ＳＯＤ酶活性下     

家兔急性DIC血清NO的变化及其与血管紧张素转换酶的关系

目的：观察急性实验性弥散性血管内凝血（ＤＩＣ）家兔血清ＮＯ水平和血管紧张素转换酶（ＡＣＥ）活性的变化及其关系。方法：用４％兔脑粉（组织凝血活酶）浸液（２ｍｌ／ｋｇ＋生理盐水稀释至３０ｍｌ）静脉注射复制家兔急性实验性ＤＩＣ动物模型，用硝酸还原酶比色法测定ＮＯ含量，紫外分光光度法测定ＡＣＥ活性。结果：家兔血清ＮＯ在注射浸液开始后１５ｍｉｎ下降，３０、６０ｍｉｎ升高，与注射前比较均无显著性差异（Ｐ＞０．０５）。１５、３０ｍｉｎ家兔血清ＡＣＥ活性变化无显著性（Ｐ＞０．０５），但６０ｍｉｎ明显下降（Ｐ＜０．０１）。ＤＩＣ组血清ＮＯ水平与血清ＡＣＥ活性呈显著负相关（γ＝－０．８４１，Ｐ＜０．０１）。结论：在组织凝血活酶所致的急性ＤＩＣ发病机制中，血液ＮＯ可能不起重要作用，其变化与血清ＡＣＥ活性有关     

血β_2－微球蛋白在慢性肺心病缓解期判定肾功能减退的价值

对３０例慢性肺心病缓解期患者及５０例正常人采用ＲＩＡ法测定了血清的β_２－微球蛋白（β_２－ＭＧ），结果显示：慢性肺心病缓解期患者血清β_２－ＭＧ值为３．５±０．５８ｍｇ／Ｌ，较正常人血清β_２－ＭＧ值３．２４±０．４５ｍｇ／Ｌ为高（ｔ检验，Ｐ＜０．０１），肺心病缓解期患者中有１４例（Ａ组）血清β_２－ＭＧ值为４．２９±０．３８ｍｇ／Ｌ，超过正常上限，且血ＢＵＮ６．８ｍｍｏｌ／Ｌ，Ｃｒ１３２μｍｏｌ／Ｌ，Ｃｃｒ６４ｍｌ／ｍｉｎ；另１６例（Ｂ组）血清β_２－ＭＧ值（３．１２±０．３４ｍｇ／Ｌ）正常，血ＢＵＮ５．４ｍｍｏｌ／Ｌ，Ｃｒ１１４μｍｏｌ／Ｌ，Ｃｃｒ１０２ｍｌ／ｍｉｎ，两组β_２－ＭＧ及Ｃｃｒ比较有显著差异（ｔ检验，Ｐ＜０．０１）。提示血清β_２－ＭＧ测定在慢性肺心病缓解期患者中较ＢＵＮ、Ｃｒ能更早地发现肾功能减退。     

反义寡脱氧核苷酸对人肝癌裸鼠模型生长及转移的影响

目的 观察反义Ｈ－ｒａｓ寡脱氧核苷酸（ＯＤＮ）对高表达蛋白ｐ２１Ｈ- ｒａｓ的人肝癌高转移裸鼠模型ＬＣＩ－Ｄ２０细胞生长、凋亡及转移潜能的影响。方法原代培养ＬＣＩ－Ｄ２０细胞，经１０μｍｏｌ／Ｌ浓度反义ＯＤＮ处理后，以１．５×１０细胞数分别接种于１４只裸鼠皮下缝制皮囊内：６只接种反义Ｈ－ｒａｓＯＤＮ处理细胞，４只接种Ｈ－ｒａｓ非特异性反义ＯＤＮ处理细胞，余４只接种未作处理的对照细胞。结果反义Ｈ－ｒａｓ对ＬＣＩ－Ｄ２０细胞增殖具有显著抑制作用（ｔ＝３１．５２９，Ｐ＜０．０１），反义ＯＤＮ处理细胞，Ｓ期比率（３６．０±１．４）显著低于对照组（５８．５±０．９，ｔ＝１３．５１９，Ｐ＜０．０１），而Ｇ１／Ｇ０期比率（５６．７％±１．１％）高于对照组（３７．４±０．７，ｔ＝１４．８０２，Ｐ＜０．０１）；反义Ｈ－ｒａｓＯＤＮ处理细胞的凋亡发生率（３４．０％±４．５％）显著高于对照组（２．５％±１．２％，ｔ＝１３．４３４，Ｐ＜０．０１）；反义Ｈ－ｒａｓ处理对ＬＣＩ－Ｄ２０细胞在接种动物体内的生长具有显著延迟抑制作用（ｔ＝３．５０９，ｔ＝３．４５２，Ｐ＜０．０１）；接种动物的肺转移率，反义Ｈ－ｒａｓＯＤＮ处理组显著低于对照组。     

左旋精氨酸对吸入一氧化氮降低肺动脉高压的延长作用

目的观察一氧化氮底物左旋精氨酸（Ｌ一ａｒｇ）延长吸入一氧化氮（ＮＯ）选择性降低肺动脉高压过程中的作用。方法８只猪麻醉后制成急性缺氧性肺动脉高压模型,在 Ｓｗａｎ－Ｇａｎｚ导管和动脉导管监测下吸入 ＮＯ（１２— １５ｐｐｍ）的过程中静脉注入 Ｌ－ ａｒｇ（共 １０ｇ）,观察停用 ＮＯ后体循环和肺循环血流动力学的变化情况。结果单纯吸入 ＮＯ能选择性降低急性缺氧性肺动脉高压,肺动脉压力从 ４ ２± ０ ４ｋＰａ降至 ２． ５± ０ ．５ｋＰａ（１ｋＰａ＝ ７．５ｍｍＨｇ, Ｐ＜ ０．０１）,肺血管阻力从 ５６±２５ｋＰａ·ｓ·Ｌ－１降至３１±１３ｋＰａ·ｓ·Ｌ－１（Ｐ＜０．０１）,但持续时间短;ＮＯ吸入加静脉注射Ｌ－ａｒｇ没有使肺动脉压进一步下降,但能显著延长吸入ＮＯ对肺动脉压的降压时间（２０倍）,对体循环血压则无影响。结论提供内源性ＮＯ的底物Ｌ－ａｒｇ能延长ＮＯ的降压作用,提示急性缺氧时ＮＯ的生成可能有相对不足。     

牛磺酸对糖尿病大鼠心肌组织肾素－血管紧张素系统的抑制作用

在链脲佐菌素所致糖尿病大鼠模型（链脲佐菌素７０ｍｇ／ｋｇ，ｉ．ｐ）中观察了大鼠心肌组织肾素－血管紧张素系统（ＲＡＳ）的变化以及牛磺酸的治疗作用（２％牛磺酸饮水给药４周）。结果表明：糖尿病大鼠较正常大鼠心肌组织ＲＡ，ＡＣＥ活性显著升高（Ｐ＜０．０１），ＡＴ－Ⅰ和ＡＴⅡ含量均明显增加（Ｐ＜０．０１），牛磺酸治疗组大鼠较未治疗组大鼠上述各项指标均有不同程度的降低，其中ＡＣＥ活性和ＡＴ－Ⅰ、ＡＴ－Ⅱ含量的改变差异显著（Ｐ＜０．０５，Ｐ＜０．０１），ＲＡ改变差异不显著（Ｐ＞０．０５）。提示：心肌组织ＲＡＳ功能亢进参与了糖尿病性心肌病发病过程。牛磺酸抑制心肌组织ＲＡＳ功能对减轻糖尿病心肌损害具有一定的临床治疗意义。     

L精氨酸对大鼠低氧性肺动脉高压的防治作用

观察Ｌ－精氨酸对大鼠常压低氧性肺动脉高压的预防和治疗作用。结果表明，Ｌ－精氨酸（２００ｍｇ／ｋｇ·ｄ）可明显预防低氧所致的肺动脉高压和右心室肥厚，Ｌ－精氨酸预防组平均肺动脉压（ｍＰＡＰ）（２．６１±０．０９ｋＰａ）明显低于低氧处理组（３．５８±０．０６ｋＰａ），两组间差异有显著性（Ｐ＜０．０５）；右心室／（左心室＋室间隔）重量比值（０．２６±０．０１）明显低于低氧组（０．３４±０．０１），两组间差异有显著性（Ｐ＜０．０５）。大鼠形成肺动脉高压后，经静脉灌注３００ｍｇ／ｋｇ的Ｌ－精氨酸可明显降低其ｍＰＡＰ，提示Ｌ－精氨酸对低氧性肺动脉高压可能具有一定的防治作用。     

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.