大鼠孤束核中部轴突终末及实触形式观察──针刺针麻的形态学研究

对正常大鼠孤束核中部进行透射电镜观察，结果表明：此区域内孤束核（ＮＴＳ）的轴突终末多为含圆形清亮小泡的终末（Ｒ），其次为含多形性小泡的终末（ＰＬ）和含有大颗粒小泡的终末（ＬＧ），另外还可见少量含扁平小泡为主的终末（Ｆ）。其终末的突触形式绝大多数为轴树突触约占９５．５％，轴体突触占３．５％，轴轴突触占０．７％，树树突触占０．３％，还可见到少数突触小球样结构，并对其针刺镇痛的形态学基础进行了探讨。     

大鼠下丘脑室旁核向孤束核投射的电镜研究

用直流电电解损毁大鼠下丘脑一侧室旁核（Pa)后，电镜观察同侧孤束核内侧亚核（Sol M)中Pa投射纤维终末的超微结构及突触联系，结果：Sol M中有Pa下行投射纤维终末存在，构成的突触以轴－树突触为主，轴－棘，轴－轴突触为少量，无轴－体突触，Pa终末内的突触小泡以圆形清亮囊泡为主，突触的类型主要为Gray I型，Sol M 中有少量Pa终末参与构成突触球，Pa下行投射终末溃变以电子致密型为主，有少量水样溃变。     

延髓背角胶状质亚核内突触复合体的亚显微结构

透射电镜下观察了延髓背角胶状质亚核内突触形式，结果表明：在三叉神经尾侧脊束核胶状质亚核内存在着大量以树突为中心、少量以轴突为中心的突触复合体。前者依据参与构成复合体神经终末内含突触小泡的形态，可将复合体再分为圆形透明小泡、椭圆形和扁平状透明小泡及含大致密核心小泡（ＬＤＶ）三个亚型，后者仅分为扇贝型和普通型二型。本文详细描述了各型复合体的形态特征，并对其功能进行了讨论。     

大鼠下丘脑室旁核向孤束核投射的电镜研究

用直流电电解损毁大鼠下丘脑一侧室旁核(Pa)后,电镜观察同侧孤束核内侧亚核(Sol M)中Pa投射纤维终末的超微结构及突触联系。结果:Sol M 中有Pa 下行投射纤维终末存在,构成的突触以轴-权突触为主,轴-棘、轴-轴突触为少量,无轴-体突触。Pa 终末内的突触小泡以圆形清亮囊泡为主,突触的类型主要为Gray Ⅰ型。Sol M 中有少量Pa 终末参与构成突触小球。Pa 下行投射终末溃变以电子致密型为主,有少量水样溃变。     

下橄槛榄内侧副核中继的大脑-小脑通路─-HRP法电镜研究

目的：为了观察大鼠橄榄内侧副核（MAO）内皮质溃变终未与橄榄小脑投射神经元间的突触联系；。方法：用顺行演变结合HRP电镜技术，观察12只大民橄榄内侧副核；。结果：1．皮质溃变终末分布于双侧MAO的中、下段，以同侧多见；2．溃变终末以电子致密型溃变为主，也见少数神经微丝型和电子透亮型溃变；3．溃变终未与HRP标记的树突或胞体形成轴-树和轴-体突触，其特点是：①轴一树突触多见，多为含圆形清亮小泡终未形成的非对称型突触，少数为含扁平小泡终末形成的对称型突触；②轴-体突触少，多形成对称型突触；③正常终末与溃变终末共同与HRP标记树突形成以树突为中心的汇聚型突触复合体。讨论：结果表明，皮质-小脑通路在下橄榄内侧副核中存在着单突触联系。     

中缝大核下行抑痛作用在脊髓背角水平活动方式的形态学研究

用海人酸损毁家兔中缝大核,在透射电镜下观察其顺行溃变的投射纤维终末在颈髓背角内的分布,超微结构特征及突触联系。研究表明,家兔中缝大核—脊髓背角投射纤维终末分布于背角浅层和深层。投射纤维终末多呈圆顶形,直径多在1～2μm,含有大量圆形透明小泡和少量致密核心小泡或含有多形性透明小泡及少量致密核心小泡。投射纤维终末均作为突触前成分与背角神经元形成大量的轴—树突触和少量的轴—体、轴—棘突触,此外于背角浅层内还见到有溃变终末参与构成的汇聚型突触复合体。本文结果支持中缝大核—脊髓背角投射通路的下行抑痛效应是通过突触后抑制的作用方式实现的观点。     

大鼠中缝大核内M—ENK样树突和轴突终末的超微结构

本文用免疫细胞化学PAP 法,在电镜下观察中缝大核(NRM)内甲硫脑啡肽(M—ENK)样免疫反应树突和轴突终末的形态和突触关系。M—ENK 样免疫反应树突数量较多,直径粗细不等,接受一个或多个突触传入;根据标记情况,可分为浓染型和淡染型两种。M—ENK 样轴突包括有髓纤维和无髓纤维两类。M—ENK 样轴突终末含有清亮圆囊泡或相伴颗粒囊泡。所见突触型式有:(1)轴—树(M—ENK)突触,(2)轴—棘(M—ENK)突触,(3)轴—轴(M—ENK)突触,(4)轴(M—ENK)—树突触。上述结果提示NRM 内脑啡呔能缝—脊神经元接受多种信息传入,可能具有整合作用;脑啡肽能轴突终末参与核团内局部突触调节,并存在突触前调节机制。     

针刺中大单壁有衣小泡参与神经细胞膜再循环的形态学证实

在针刺条件下，延髓背角胶状质轴、树突终末内大单壁有衣小泡均活跃生成，但主要位于轴突终末内（９１．０％）。电镜下看到了ＬＳＷＣＶ处于形成中各阶段的影像及多个同时出现构成的有衣小泡簇，其外衣在高倍镜下呈现网格状，具备泡衣的典型形态特点，认为ＬＳＷＣＶ的形成是膜回收和转运的形态学依据。     

大鼠延髓背角内脑啡肽阳性结构的突触联系

目的 观察大鼠延髓背角（MDH）内脑啡肽（ENK）阳性结构的突触联系。方法 免疫电镜技术。结果 ENK阳性胞体较少，呈小型圆形和梭形，主要分布于MDH的Ⅱ层；ENK阳性终末主要见于Ⅰ层和Ⅱ层外侧部。ENK阳性结构主要形成四种联系；ENK阳性终末与阴性终末紧密接触，但未见突破联系；ENK阳性终末与Ⅰ层的阴性胞体形成对称性轴－体突触；阴性终末与Ⅱ层的ENK阳性树突形成非对称性轴－树突触；ENK阳性终末与Ⅱ层的ENK阳性树突形成对称性轴－树突触。上述阳性或阴性终末均主要含圆形小泡，有时可见少量扁平小泡、椭圆形小泡和大颗粒囊泡。结论 MDH内的ENK阳性终末与ENK阳性或阴性神经元的胞体和树突形成对称性和非对称性突触联系。     

大鼠中脑水管周围灰质腹外侧部神经毡的超微结构研究

应用电镜技术，观察了大鼠中脑水管周围灰质（ＰＡＧ）腹外侧部内侧区和外侧区神经毡的超微结构。结果显示，外侧区神经毡有髓纤维多为直径大于１．２μｍ的粗纤维、髓鞘厚度不等；树突直径多在１．２￣１．５μｍ之间；突触型式以轴－树突触占优势，易见多个轴突终扣与同一树突变形成突触或突触复合体，亦观察到轴一体突触、轴－轴突触和树－树突触。内侧区神毡内有髓纤维分布稀疏，多为０．６￣１．４μｍ的薄髓纤维；树突数量多，     

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.