维持性血液透析患者高血压与TXA_2－PGI_2严衡失调的关系

观察了２７例维持血液透析患者血浆前列腺素（ＰＧｓ）的变化，结果显示：尿毒症组血浆血栓素Ｂ２（ＴＸＢ２）、６－酮－ＰＧＦ１α（６－ｋｅｔｏ－ＰＧＦ１α）水平降低，而ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值升高。其中有高血压者６－ｋｅｔｏ－ＰＧＦ１α较无高血压者为低（Ｐ＜０．０５）。ＴＸＢ２、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比却高于无高血压者（Ｐ＜０．０１）。透析间期体重增加＞３．０ｋｇ与＜３．０ｋｇ者的血浆ＴＸＢ２、６－ｋｅｔｏ－ＰＧＦ１α水平及ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值无显著性差异。血透或血滤后ＴＸＢ２、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值降低，而６－ｋｅｔｏ－ＰＧＦ１α升高。血压与血浆ＴＸＢ２、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值呈正相关（分别ｒ＝０．６４，ｒ＝０．７２），与６－ｋｅｔｏ－ＰＧＦ１α呈负相关（ｒ＝－０．５８）。以上结果表明，维持性血液透析患者高血压与ＴＸＡ－ＰＧＩ２平衡失调有关，血透及血滤均能降低ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值，使高血压减轻。     

光量子血疗对脑梗塞患者治疗前后血浆中TXB_2、6－keto－PGF_（1α）的改变

采用自血光量子血液疗法治疗动脉粥样硬化性脑梗塞患者８４例，其中４０例患者在治疗前后分别测定血浆中ＴＸＢ２、６－ｋｅｔｏ－ＰＧＦ１α的含量，结果显示：治疗后患者血浆中ＴＸＢ２明显降低（ｔ＝４．４７Ｐ＜０．００１），６－ｋｅｔｏ－ＰＧＦ１α明显升高（ｔ＝０．３０Ｐ＜０．００１）。提示：ＵＢＩ对脑梗塞患者有较好的临床疗效。     

梗阻性黄疸患者的尿前列腺素与肾功能

本文通过测定８例梗阻性黄疸患者术前、术后２４小时尿中ＰＧＩ２和ＴＸＡ２的稳定代谢产物６－ｋｅｔｏ－ＰＧＦ１α、ＴＸＢ２及２４小时尿量（Ｕｖ）、内生肌酐清除率（Ｃｃｒ），探讨前列腺素对肾功能的影响。结果显示：术前６－ｋｅｔｏ－ＰＧＦ１α明显高于对照组（Ｐ＜０．０５），ＴＸＢ２、Ｕｖ、Ｃｃｒ较对照无明显变化（Ｐ＞０．０５）。术后一周，ＴＸＢ２明显增高（Ｐ＜０．０５），ＰＧＩ２、Ｕｖ、Ｃｃｒ明显下降（Ｐ＜０．０５）。术后两周，ＴＸＢ２逐渐下降，６－ｋｅｔｏ－ＰＧＦ１α、Ｕｖ、Ｃｃｒ恢复术前水平，结果认为：前列腺素对维持肾血流及肾小球滤过率有重要作用。     

汉防己甲素对高血压病患者血内LPo、hSOD－1、6－keto－PGF＿（1α）及TXB＿2水平影响的探讨

本文用中药汉防己甲素（Ｔｅｔｒａｎｄｒｉｎｅ）治疗高血压病患者。并用放射免疫及生化检测技术测定高血压患者治疗前后血内脂质过氧化物（ＬＰｏ），超氧化物歧化酶（ｈＳＯＤ－１），血栓素（ＴＸＢ２），前列环素（６－ｋｅｔｏ－ＰＧＦ１α）的变化。结果显示：汉防己甲素有显著降压作用并能极显著降低高血压患者血内ＬＰｏ、ＴＸＢ２水平，极显著升高ｈＳＯＤ－１、６－ｋｅｔｏ－ＰＧＦ１α水平（Ｐ＜０．０１），降低ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值（Ｐ＜０．０１）。与硝苯吡啶治疗组对比无显著差异（Ｐ＞０．０５）。说明汉防己甲素降压机理是阻滞心肌和血管平滑肌电压依赖式钙通道及升高６－ｋｅｔｏ－ＰＧＦ１α水平所致。     

狼疮性肾炎患者尿血栓素—前列环素平衡变化及其临床意义

作者观察了２４例狼疮性肾炎患者、１２例正常对照者尿ＴｘＡ２、ＰＧＩ２代谢产物ＴＸＢ２、６－ｋｅｔｏ－ＰＧＦ１α含量。结果表明，与正常组相比较，各组狼疮性肾炎患者尿ＴＸＢ２含量均增高６－ｋｅｔｏ－ＰＧＦ１α比值与尿蛋白量呈正相关（ｒ＝０．７４）。表明狼疮性肾炎患者肾组织内存在严重的ＴＸＡ２－ＰＧＩ２平衡失调，前列腺素代谢异常可能与狼疮性肾炎的发生、发展有关。检测尿ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比     

肺心病患者血浆TXB2和6─keto─PGF1α含量的动态观察

为了解肺心病患者血栓烷Ａ２（ＴＸＡ２）及前列环素（ＰＧＩ２）的含量变化，分别对２８例肺心病缓解期患者、２９例急性发作期患者治疗前后及１０例健康人进行了ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α的含量测定。结果：健康人组血浆ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α的含量分别为１０９．７４±５６．１４ｎｇ／Ｌ及５４．７６±３５．６２ｎｇ／Ｌ，ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α＝２．００４。肺心病各期患者ＴＸＢ２含量均明显高于正常人（Ｐ＜０．０５～０．０１），其中以急性发作期最高（７０９．２２±３５４．４９ｎｇ／Ｌ），经中西医结合治疗后下降为４０８．２４±２８９．４１ｎｇ／Ｌ（Ｐ＜０．０５），与缓解期含量３３３．４±３２４．１４ｎｇ／Ｌ无显著差异（Ｐ＞０．０５）。但肺心病各期患者６－ｋｅｔｏ－ＰＧＦ１α与健康组相比均无显著差异。由于ＴＸＢ２增高，致ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α均明显高于健康组     

PGI_2、TXA_2和肾髓质PGE_2与高蛋白负荷时肾小球滤过率增高的关系

用放射免疫分析法测定了蛋白质食入量为（２．０９～２．７９）ｇ／１００ｇＢＷ（２４ｈ）的１５只大鼠（实验组）和正常蛋白质食入量的１０只大鼠（对照组）的腹主动脉血、肾静脉血、尿６－ｋｅｔｏ－ＰＧＦ１α的浓度、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１ａ比值以及肾髓质中的ＰＧＥ２浓度。实验组大鼠肾髓质中ＰＧＥ２浓度及尿中６－ｋｅｔａ－ＰＧＦ１ａ浓度明显高于对照组（Ｐ＜０．００１），实验组大鼠腹主动脉血、肾静脉血、尿中ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值明显低于对照组（Ｐ＜０．０１和Ｐ＜０．０００１）。以上结果提示高蛋白摄入时肾脏合成、释放的ＰＧＥ２增多以及ＴＸＡ２减少，ＰＧＩ２增多在肾小球滤过率增加的机制中具有重要作用。     

维持性血液透析患者高血压与TXA2—PGI2平衡失调的关系

观察了２７例维持血液透析患者血浆前列腺素（ＰＧｓ）的变化。结果显示：尿毒症组血浆血栓素Ｂ２（ＴＸＢ２）、６－酮－ＰＧＦ１α（６－ｋｅｔｏ－ＰＧＦ１α）水平降低，而ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值升高。其中有高血压者６－ｋｅｔｏ－ＰＧＦ１α较无高血压者为低（Ｐ＜０．０５）。ＴＸＢ２、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比却高于无高血压者（Ｐ＜０．０１）。透析间期体重增加＞３．０ｋｇ与＜３．０ｋｇ     

旋磁场对大鼠脑缺血再灌注时TXA2—PGI2和自由基代谢的影响

用四血管阻断法造成大鼠全脑缺血０．５ｈ后，再灌注０．５ｈ时，大鼠脑组织和血浆过氧化脂质（ＬＰＯ）、血栓素Ｂ２（ＴＸＢ２）含量及ＴＸＢ２／６－ｋｅｔｏ－前列腺素Ｆ１α（６－ｋｅｔｏ－ＰＧＦ１α）比值明显增高，而６－ｋｅｔｏ－ＰＧＦ１α含量却无明显变化。如在大鼠脑缺血０．５ｈ后开始再灌注时，用０．０８Ｔ、２５００ｒ／ｍｉｎ的旋磁场作用于双侧颈动脉区２０ｍｉｎ，大鼠脑组织和血浆ＬＰＯ含量、ＴＸＢ２／６－     

老年糖尿病肠病患者血小板功能、血栓素B_2及6－酮－前列腺素F_（1α）的变化

对１８例老年糖尿病肠病患者和２２例糖尿病无肠病者的血小板聚集、血栓素Ｂ２（ＴＸＢ２）和６－酮－前列腺素Ｆ１α（６－ｋｅｔｏ－ＰＧＦ１α）进行测定，并且与健康老年人比较。结果表明：肠病组血小板聚集率和肠病组、无肠病组血浆ＴＸＢ２、ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值均明显高于健康人组（Ｐ＜０．０１），而６－ｋｅｔｏ－ＰＧＦ１α则明显降低（Ｐ＜０．０１）。肠病组血小板聚集率、ＴＸＢ２及ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值变化较无肠病组更为明显（Ｐ＜０．０１）。这提示血小板功能亢进和血栓素Ａ２（ＴＸＡ２）与前列环素（ＰＧＩ２）间平衡失调可能在老年糖尿病肠病的发病过程中起着一定作用。     

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.     

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.