模拟失重大鼠裸露心肌纤维的张力—pCa关系

目的：观察４周尾部悬吊法模拟失重是否影响大鼠心肌肌钙蛋白Ｃ对Ｃａ＾２＋的亲和力。方法：用１％ＴｒｉｔｏｎＸ－１００制备裸露心肌纤维，观察心肌肌原纤维的张力－ｐＣａ关系。结果：对照与４周模拟失重组大鼠心肌肌原纤维的张力－ｐＣａ关系保持不变，其ｐＣａ５０值分别为６．１５±０．０４与６．０６±０．０７，两组均值间无显差别（Ｐ〉０．０５）；Ｈｉｌｌ系数ｎ分别为２．４８±０．１７与２．８５±０．２４，两值     

3，4’，5－三羟基芪－3－β－单－D－葡萄糖甙对损伤动脉内膜血小板沉积量的影响

在离体动脉损伤模型上，应用￣（１２５）Ｉ标记血小板，观察了３，４，５－三羟基芪－３－β－单－Ｄ－葡萄糖甙（ＰＤ）对模拟血管成形术后血小板沉积量的影响。结果表明，对照组血小板沉积量为９．４２±２．０１×１０￣６／ｃｍ￣２和４０２．３７±７２．８５×１０￣６／ｇ（标本干重，下同）；ＰＤ组血小板沉积量为：５．９３±１．９５×１０￣６／ｃｍ￣２和２５３．４９±７６．３８×１０￣６／ｇ，两组间差异有统计学意义（Ｐ＜０．０５）。     

血清α－L－岩藻糖苷酶活力测定对原发性肝癌的诊断意义

测定了原发性肝癌７７例（ＰＨＣ组），肝硬化３５例（ＤＣ组），消化系统其他恶性肿瘤患者３３例（ＤＳＣ组）及健康人１００例（ＮＣ组）血清α－Ｌ－岩藻糖苷酶（ＡＦＵ）活力。结果表明：ＰＨＣ组ＡＦＵ（６６９．６±１９１．５ｎｍｏｌ·ｍｌ￣（－１）·ｈ￣（－１））显著高于ＮＣ组（３１４．３±６７．０ｎｍｏｌ·ｍｌ￣（－１）·ｈ￣（－１），Ｐ＜０．０１），ＤＳＣ组（３９０．６±１０２．３ｎｍｏｌ·ｍｌ￣（－１）·ｈ￣（－１），Ｐ＜０．０１）和ＤＣ组（４５８．３±１５０．１ｎｍｏｌ·ｍｌ￣（－１）·ｈ￣（－１），Ｐ＜０．０５）。其诊断敏感性和特异性分别为７１．４％和８９．３％，与ＡＦＰ联合检测时ＰＨＣ组总的阳性检出率达８８．２％。     

NIDDM患者血小板Ca_(2+)转运及其与聚集功能的关系

３２例ＮＩＤＤＭ患者，分血小板聚集功能亢进组（ｎ＝１７）和无亢进组（ｎ＝１５），探讨Ｃａ２＋转运影响血小板胞浆游离Ｃａ２＋（［Ｃａ２＋］ｉ）变化与最大聚集（ＭＡＲ）的关系。结果：亢进组血小板静息［Ｃａ２＋］ｉ高于对照组（１３４．４±２６．４对１０１．５±１３．３ｎｍｏｌ／Ｌ，Ｐ＜０．０１）。［Ｃａ２＋］ｉ与ＭＡＲ呈正相关（ｒ＝０．３２１９，Ｐ＜０．０５）以凝血酶刺激，有胞外Ｃａ２＋内流及胞内Ｃａ２＋释放时，亢进组［Ｃａ２＋］ｉ高于对照组（９１８．９±２０７．６对７９１．２±１１９．６ｎｍｏｌ／Ｌ，Ｐ＜０．０１），并与ＭＡＲ呈正相关（ｒ＝０．３３７１，Ｐ＜０．０１）；以ＴＭＢ８阻滞胞内Ｃａ２＋释放，组间差异仍然显著（Ｐ＜０．０５）；当缺乏胞外Ｃａ２＋内流时，则组间不呈显著差异（Ｐ＞０．０５）。以钙载体Ａ２３１８７刺激，在有或无胞外Ｃａ２＋时，亢进组［Ｃａ２＋］ｉ均高于对照组（Ｐ均＜０．０５）然而，无亢进组上述各指标与对照组间均未呈显著差异。提示ＮＩＤＤＭ患者血小板聚集功能亢进与［Ｃａ２＋］ｉ变化有关，可能涉及胞浆内Ｃａ２＋稳态异常，凝血酶刺激胞外Ｃａ２＋内流及Ａ２３１８７作用胞内Ｃａ２＋释放增强等环节     

准分子激光角膜切削术治疗近视散光

目的：评价准分子激光角膜切削术（ＰＲＫ）治疗近视散光的临床效果。方法：对２６０眼近视散光用ＶＩＳＸ２０／２０准许分子激光系统治疗并随访一年。结果：术前近视散光－０．２５￣－４．００Ｄ，平均－１．００±０．６２Ｄ；术后６月为－０．０７±０．４０Ｄ；术后１年为－０．０６±０．３９Ｄ。术后较术前散光度明显降低（ｐ〈０．０５）。术后１年较术后６月散光理低（ｐ〉０．０５）。无明显回退现象。结论：ＰＲＫＣＦ     

参麦注射液对缺血大鼠心肌内钙超载的影响

目的：观察参麦注射液对大鼠缺血心肌细胞内钙超载的影响及其心肌保护作用。方法：用异丙肾上腺素制备大鼠心肌缺血模型,Ｆｕｒａ－２ 法测定大鼠红细胞胞浆游离钙浓度（ＥｒｙＣａｉ）;生化法测定红细胞膜钙泵（Ｃａ－ｐｕｍ ｐ）、钠泵（Ｎａ－ｐｕｍ ｐ）活性,同步观察大鼠心肌组织病理变化。结果：参麦注射液治疗后ＥｒｙＣａｉ较缺血组显著降低（１．６８±０．１０ Ｆ３３５／Ｆ３８５ ｖｓ１．５６±０．１５ Ｆ３３５／Ｆ３８５ Ｐ＜ ０．０５）,但仍高于对照组（１．５６±０．１５ Ｆ３３５／Ｆ３８５ ｖｓ１．３６±０．１０Ｆ３３５／Ｆ３８５ Ｐ＜ ０．００１）;钙泵（１０５．１±２９．４ μｍ ｏｌＰｉ·ｇＨｂ－ １ ·２ｈ－ １ｖｓ １２６．８±３０．７ μｍ ｏｌＰｉ·ｇＨｂ－ １ ·２ｈ－ １ Ｐ＞ ０．０５）及钠泵（３５．１±１８．２ μｍ ｏｌＰｉ·ｇＨｂ－ １·２ｈ－ １ ｖｓ ４３．３±１０．２ μｍ ｏｌＰｉ·ｇＨｂ－ １·２ｈ－ １ Ｐ＞ ０．０５）活性较缺血组有所增高,但无统计学意义,且钙泵（１２６．８±３０．７ μｍ ｏｌＰｉ·ｇＨｂ－ １ ·２ｈ－ １ ｖｓ １６８．６±３９．６ μｍ ｏｌＰｉ·ｇＨｂ－ １ ·２ｈ－ １ Ｐ＜ ０．０１）及钠泵（４３     

大鼠局限性脑皮质损伤后海马CA－1区神经元损害及丹参的保护作用 

探讨海马神经元损害的机理及丹参的保护作用．方法：作者检测了大鼠局限性脑皮质损伤后海马ＣＡ－１区组织腺苷三磷酸（ＡＴＰ）酶活性，Ｎａ＋，Ｋ＋，Ｃａ＋离子含量，并观察了病理组织学的改变．结果：脑损伤后海马组织Ｎａ＋－Ｋ＋－ＡＴＰ酶、Ｃａ２＋－ＡＴＰ酶活性分别为０．４２５±０．０６６和０．４１９±０．０２０μｍｏｌＰｉ／（ｍｇ蛋白·ｈ），较正常对照组（Ｎａ＋－Ｋ＋－ＡＴＰ酶０．６３５±０．０４３，Ｃａ２＋－ＡＴＰ酶０．５２７±０．０１７）明显降低（Ｐ＜０．０１）；Ｎａ＋，Ｃａ２＋含量（Ｎａ＋２１５．７４±２４．３０，Ｃａ２＋４．５９±０．２５μｍｏｌ／ｇ干脑）较正常对照组（Ｎａ＋１４２．２５±１１．３９，Ｃａ２＋３．７３±０．３８）明显增高（Ｐ＜０．０１）．丹参治疗组大鼠海马组织ＡＴＰ酶活性抑制（Ｎａ＋－Ｋ＋－ＡＴＰ酶０．５９３±０．０２７，Ｃａ２＋－ＡＴＰ酶０．４６８±０．０４０）及Ｎａ＋，Ｃａ２＋聚积（Ｎａ＋１８１．７２±１９．６２，Ｃａ２＋４．０８±０．３８）程度较脑损伤组显著降低（Ｐ＜０．０１），电镜观察神经元损害也明显减轻．结论：提示丹参可能通过改善ＡＴＰ酶功能、抑制Ｎａ＋，Ｃａ２＋聚积而减轻脑损伤后海     

持续性不卧床腹膜透析腹膜炎治疗新方案

为了比较两种不同治疗方案对持续性不卧床腹膜透析（ＣＡＰＤ）腹膜炎的疗效，我们研究４１例ＣＡＰＤ腹膜炎，其中２０例（Ａ组）用新方案治疗，２１例（Ｂ组）用以往常规方案治疗。两组的疗效明显不同，表现为Ａ组治愈率较Ｂ组高（９４．０％比７８．６％，Ｐ＜０．０５）；腹膜炎持续时间较Ｂ组短（２．８±１．６天比４．０±２．０天，Ｐ＜０．０５）；腹膜炎复发率较Ｂ组低（１５９±９８．８天比９８±９９．６天，Ｐ＜０．０５）；治疗失败率较Ｂ组低（６．０％比２１．４％，Ｐ＜０．０５）。研究证明：新方案治疗ＣＡＰＤ腹膜炎疗效优于以往的常规治疗方案。     

吸入NO对肺源性心脏病急性加重期患者血气及肺通气功能的影响

目的　探讨吸入一氧化氮（ＮＯ） 对慢性肺心病急性加重期患者动脉血气和肺通气功能的影响。方法　２０ 例肺心病急性加重期患者,在鼻导管吸氧（２ Ｌ／ｍｉｎ） 不变的情况下,分别吸入４５ ×１０－６ ＮＯ或４５×１０－ ６ＮＯ和３５％ Ｏ２ 混合气各６０ ｍｉｎ,测定吸入前后患者的血气和肺通气功能［第１ 秒用力肺活量（ＦＥＶ１） 和用力肺活量（ＦＶＣ）］ 。结果　当患者单纯吸入４５×１０－６ ＮＯ后,ＰａＯ２ 由吸ＮＯ前的８－１３ ±０－７ ｋＰａ 降为７－３３ ±０－６ ｋＰａ,ＳａＯ２由（９１±３－２） ％ 降至（８７±２－３） ％ （ 两者Ｐ均＜０－０５） ,对ＰａＣＯ２ ,ＦＥＶ１ 和ＦＶＣ无明显影响。当吸入４５×１０－６ ＮＯ和３５％ 氧气混合气后,ＰａＯ２ 则由８－０７±０－９ ｋＰａ 升至９－４１±０－８２ ｋＰａ,ＳａＯ２ 由（９０ ±２－２）％ 升至（９３±２－５） ％ （Ｐ＜０－０５）。ＰａＣＯ２ ,ＦＥＶ１ 和ＦＶＣ无明显影响。结论　单纯吸入ＮＯ可令肺心病患者ＰａＯ２ 和ＳａＯ２ 下降,而吸入４５ ×１０－６ ＮＯ和３５ ％ 氧气混合气则可改善ＰａＯ２ 和ＳａＯ２ ,两者对ＰａＣＯ２ ,ＦＥＶ１ 和ＦＶＣ无明显影响。     

1,6—二磷酸果糖对心肌细胞胞质游离Ca^2＋和pH的影响

考察外源性的１，６－二磷酸果糖（ＦＤＰ）对心肌细胞内游离Ｃａ＾２＋浓度和ｐＨ值的影响，用荧光探针（Ｆｕｒａ－２，ＢＣＥＣＦ）技术同时测定成年大鼠心肌细胞内游离Ｃａ＾２＋浓度和ｐＨ值，并观察其在缺氧／复氧条件下的变化，结果：在缺氧／复氧过程中，胞质游离Ｃａ＾２＋胞质游离Ｃａ＾２＋浓度缓慢升高，从基础值１３０±２９．５ｎｍｏｌ／Ｌ上升至７４２±１５４ｎｍｏｌ／Ｌ，胞质ｐＨ值则从７．１２±０．０８降至６     

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.