畸变产物耳声发射早期诊断药物性聋的实验观察

目的 比较DPOAE和ABR在早期诊断庆大霉素耳毒性中的作用。方法 选听力正常豚鼠,随机分3组,DPOAE组10只,ABR组10只,对照组6只。实验组每日肌注庆大霉素100mg/kg,对照组注射等生理盐水,所有动物在注药后每3天测1次DPOAE和ABR。一旦DPOAE振幅下降50%或ABRⅢ波反应阈移10dB以上时,分别停药观察。2周后处死作耳蜗铺片观察毛细胞形态变化。结果 DPOAE组注药第7天出现变化。信药2周后再测听力玩继续下降,而ABR组注药第10天才出现轻微变化,停药2周后再测ABR阈移进一步加大,毛细胞形态变化与功能变化基本一致。结论 DPOAE较ABR能更早发现庆大霉素耳毒性。     

庆大霉素耳蜗毒性早期诊断和治疗的实验研究

目的 比较畸变产物耳声发射(DPOAE)和听性脑干反应(ABR)对庆大霉素(GM)致聋早期诊断中的作用。一旦发现致聋后立即给予肌注谷胱苷肽(GSH),观察其听力能否改善。方法选听力正常豚鼠40只,随机分DPOAE组10只,ABR Ⅰ、Ⅱ组各12只(Ⅰ组为ABR出现变化后停药,Ⅱ组为停药后再注射GSH 5d),对照组6只。实验组每日肌注GM 100mg／kg,对照组注射等量盐水。用药前后采用DPOAE和ABR监测其振幅和IV波反应阈。停药2周后行耳蜗铺片,观察毛细胞形态学变化。结果DPOAE组在用GM后平均7d出现变化,而ABR组平均10d出现阈移。ABR Ⅰ组用GM 10d停药2周后复查阈移呈进一步增大(P<0．01),而ABRⅡ组(停药后用GSH)2周后复查阈移无明显增大(P>0．05)。毛细胞形态学与功能变化基本一致。结论DPOAE较ABR能更早地发现GM耳毒性,及时停药听力有望不受损害,而ABR出现变化后,即使停药听力损害仍将继续加重。GSH能阻止GM对耳蜗的继续损害。     

卡那霉素对昆明小鼠听脑干反应和畸变产物耳声发射的影响

目的 研究卡那霉素(KM)对昆明小鼠听脑干反应(ABR)和畸变产物耳声发射(DPOAE)的影响.探讨昆明小鼠对氨基糖甙类抗生素(AmAn)的耳毒易感性.方法 16只雄性昆明小鼠随机分为KM组和对照组,给于皮下注射uax4[2×750mg/(kg·d)]或者等量生理盐水,连续用药2周,分别记录用药前、后ABR阈值和DPOAE幅值;应用硝酸银染色观察耳蜗形态学变化.结果 KM组用药1周后,DPOAE幅值明显下降.而ABR阈移无显著变化;2用后ABK阈移显著增大且停药后进一步增大.对照组ABR阈移和DPOAE幅值在用药前后无明显改变;耳蜗硝酸银染色显示对照组外毛细胞排列整齐,结构完整,而KM组外毛细胞则发生大部分缺失.结论 昆明小鼠对AmAn易感,应用KM可以建立昆明小鼠AmAn耳毒性模型.在听功能检测上DPOAE可能比ABR更灵敏.     

D-甲硫氨酸对庆大霉素耳毒性保护作用的研究

目的探讨D-甲硫氨酸对庆大霉素耳毒性的保护作用.方法30只豚鼠分为生理盐水对照组、庆大霉素组及D-甲硫氨酸加庆大霉素联合用药组.采用听觉脑干诱发电位(ABR)及耳蜗铺片技术,观察研究耳毒性及D-甲硫氨酸的保护作用.结果联合用药组动物各频率阈移均比单独使用庆大霉素组显著降低,且耳蜗组织学检查显示其毛细胞缺失明显轻于庆大霉素组.结论使用庆大霉素的同时联合应用D-甲硫氨酸可有效减少庆大霉素的耳毒性.     

D-甲硫氨酸对庆大霉素耳毒性保护作用的研究

目的：探讨D－甲硫氨酸对庆大霉素耳毒性的保护作用。方法：30只豚鼠分为生理盐水对照组、庆大霉素组及D－甲硫氨酸加庆大霉素联合用药组。采用听觉脑干诱发电位（ABR）及耳蜗铺片技术，观察研究耳毒性及D－甲硫氨酸的保护作用。结果：联合用药组动物各频率阈移均比单独使用庆大霉素组显著降低,且耳蜗组织学检查显示其毛细胞缺失明显轻于庆大霉素组。结论：使用庆大霉素的同时联合应用D－甲硫氨酸可有效减少庆大霉素的耳毒性。     

自由基在实验性庆大霉素耳毒性中的作用(摘要)

为探讨自由基在庆大霉素(GM)耳毒性中的作用,本实验观察了豚鼠肌肉注射 GM(160mg/kg·日)、等量生理盐水(B 组)后正常组(不做任何处理,C 组)耳功能及其改变,耳蜗组织及肾组织中自由基的含量。A 组给药后豚鼠最早6天耳廓反射消失,最迟12天,平均9天,用药前后 ABR(脑干诱发电位)阈移为55±17(P<0.05)听力下降非常显著。B 组给生理盐水9天,ABR 阈移为1.6±4.5(P>0.05),听力基本上无改变。正常组听力为26±5。     

脑活素对豚鼠庆大霉素耳毒性保护作用的研究

目的：旨在观察脑活性能否拮抗庆大霉素素蜗毒性。方法：取听力正常豚鼠50只，随机分为脑活素组10只[肌注脑活素360mg/(kg.d),10ds]；大庆霉素组15只[肌注庆大霉素120mg/(kg.d)10d]；庆大霉素＋脑活素组15只（肌注等量庆大霉素＋脑活素10d)；生理盐水组10只（肌注等量生理盐水10d)。用药前及用药10d并饲养一周测试听性脑干反应（ABR），第17d处死，行左耳耳蜗铺片、右耳石蜡包埋切片，并在光镜下观察内耳病理形态变化，对损失毛细胞进行计数。结果：庆大霉素＋脑活素组ABR阈值明显低于庆大霉素组，耳蜗各回毛细胞平均失率明显低于庆大霉素组。结论：脑活素对庆大霉素所致毒性有明显保护作用。     

鼓阶开窗微孔技术注入胰岛素样生长因子-1对庆大霉素致聋豚鼠的治疗作用

目的 探讨通过鼓阶开窗,微孔技术注胰岛素样生长因子-1(IGF-1)入内耳鼓阶,研究IGF-1对感音神经性聋动物模型(庆大霉索致耳聋豚鼠)的治疗作用.方法 豚鼠20只,施用庆大霉素致耳聋后均分为IGF-1组和对照组,行鼓阶开窗术,微孔技术注入试剂(IGF-1组注入鼠重组IGF-1,对照组注入人工生理外淋巴液)10μl,分别在术前和术后7、14 d行ABR测试;测试完后每组3只断头取听泡,在扫描电镜下观察耳蜗毛细胞改变.结果 IGF-1组ABR反应阈(RT)术后7、14 d均比术前有显著降低;IGF-1组比对照组RT在术后14 d有显著降低.扫描电镜发现对照组较IGF-1组毛细胞受损严重;同时,IGF-1组受损毛细胞表面有指状微绒毛生长.结论 微孔技术注入IGF-1可以改善豚鼠受损听力,减轻庆大霉素耳毒性的继续损伤,其机制可能为减轻耳蜗毛细胞的损伤并修复部分毛细胞,同时保护传人神经.     

川芎嗪对顺铂耳毒性保护作用的实验研究

目的探讨活血化瘀中药川芎嗪是否对顺铂的耳毒性具有保护作用。方法将听力正常的30只豚鼠随机分为3组,每组10只。对照组：生理盐水3 ml/（kg.d）腹腔注射6天;顺铂组：顺铂3 mg/（kg.d）腹腔注射6天;顺铂加川芎嗪组：先腹腔注射川芎嗪140 mg/（kg.d）3天,从第4天起腹腔注射川芎嗪140 mg/（kg.d）后再注射顺铂3 mg/（kg.d）6天。给药前后通过听觉脑干诱发电位（ABR）检测豚鼠听功能的变化;然后在麻醉状态下断头取耳蜗,半数标本切片后用DNA末端转移酶介导的缺口末端标记法（TUNEL）检测耳蜗内细胞凋亡情况;半数标本进行耳蜗基底膜铺片观察毛细胞形态及酶学变化。结果顺铂组用药后ABR阈值升高,毛细胞受损,琥珀酸脱氢酶（SDH）活性减弱,有部分毛细胞凋亡,与对照组及川芎嗪组比较差异具有统计学意义（P〈0.05）。顺铂加川芎嗪组用药后ABR阈值升高,毛细胞受损较轻,凋亡细胞较少,与顺铂组比较差异有统计学意义（P〈0.05）。结论川芎嗪能降低顺铂的耳毒性。     

来比林对抗庆大霉素耳毒性的实验

目的 :观察来比林对抗庆大霉素耳毒性的作用 .方法 :将豚鼠随机分为庆大霉素 (gentamicin ,GM )组、来比林组 (lysisinaspirin ,LAP)、GM +LAP组及对照组 ,采用听性脑干反应 (ABR)、耳蜗铺片及透射电镜技术、观察用药前后听阈及耳蜗毛细胞形态学改变 ,并检测血清尿素氮、肌苷以及庆大霉素血药浓度 .结果 :GM组 8kHzABR 4wk平均阈移达 5 0dB ,GM +LAP组平均阈移为 30dB ,差异显著 (P <0 .0 5 ) .形态学改变与听力变化一致 .GM +LAP组血液中丙二醛较GM组明显减少 (P <0 .0 5 ) .GM +LAP组超氧化物歧化酶活性明显高于GM组 (P <0 .0 5 ) .LAP对庆大霉素血药浓度没有影响 .结论 :LAP能有效减轻GM的耳毒性作用 ,水杨酸盐连接有其他基团并不影响拮抗耳毒性的作用 .并且更加安全 ,有效 ,方便临床使用     

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.