恒河猴静脉内皮细胞衬里ePTFE人工血管的实验研究

按原位获取法恒河猴表浅静脉内皮细胞，在体外培养扩增，制备成内皮细胞悬液。用纤维蛋白胶和纤维连接蛋白联合预衬各ｅＰＴＦＥ人工血管腔，将内皮细胞灌入此人工血管，结果内皮细胞的贴壁率明显提高；内皮细胞高密度种植人工血管后２ｈ，扫描电下见人工血管腔表面已形成完整的内皮细胞单层；孵育９ｄ后，透射电镜见内皮细胞骨架已分化成熟，表明此时人工血管腔内皮细胞具有良好的抗切应能力。     

小口径内皮化人工血管的临床应用研究

目的探讨小口径内皮化人工血管的临床应用效果。方法将成人大隐静脉内皮细胞在体外培养（１２．５４±１．２８） ｄ;扩增培养的自体细胞衬里　于纤维蛋白胶和纤维连接蛋白联合预衬的国产 ｅＰＴＦＥ人工血管,继续培养 ９ ｄ。将此人工血管行股－　动脉旁路搭桥术。结果细胞数增加（１７８．２６±４４．９３）倍。细胞种植后 ２ ｈ和 ９ ｄ,人工血管腔面见一层均匀的基质,基质表面有一层连续的内皮细胞单层。内皮细胞排列紧密,呈梭形状,形态饱满。除１例术后２月出现人工血管血栓形成外,其余１０例患者经６～３６月的随访检查,人工血管通畅良好。结论双期法离休衬里技术可有效地提高小口径人工血管的通畅率。     

恒河猴自体静脉内皮细胞种植ePTFE人工血管后置换髂总动脉的实验研究

15只恒河猴随机分为2组：实验组10例，其人工血管均经自体静脉内皮细胞种植；对照组5例，其人工血管均未经任何处理。实验组、对照组手术方法相同，将长6cm、直径3mmePTFE(膨体聚四氟乙烯）人工血管近端与腹主动脉行端-侧吻合、远端与髂总动脉行端-端吻合，术后当日、1周及4周，所有恒河猴均行静脉法数字减影造影术，术后4周行彩色B型超声波检查，然后取出所有对照组及9例实验组恒河猴腹腔内之人工血管，标本送光镜、扫描电镜及透射电镜检查。结果表明，术后4周，对照组人工血管均不通畅，而实验组有8条人工血管通畅良好。B超见全部对照组及1例实验组人工血管腔内形成血栓，实验组8例通畅之人工血管均保持较高的血流量。扫描电镜见实验组全部人工血管腔内均有一层完整融合的内皮细胞单层，而对照组人工血管腔内未见有内皮细胞。     

体外扩增恒河猴自体内皮细胞人工血管移植研究

目的为自体内皮细胞移植的临床应用奠定理论基础。方法将恒河猴表浅静脉内皮细胞在体外培养１３．９±１．４天;扩增培养的自体细胞衬里于用纤维蛋白胶预衬的膨体聚四氟乙烯（ｅＰＴＦＥ）人工血管,继续培养９天。１５只恒河猴随机分为两组。实验组（１０只）用衬有自体静脉内皮细胞的人工血管置换骼总动脉;对照组（５只）用未衬里内皮细胞的人工血管置换。结果细胞数增加１４８±８９倍。所培养的细胞为二倍体细胞,纯度９９％。原代及传代细胞培养上清液中６－酮－前列腺素Ｆ１ａ（６－ｋｅｔｏ－ＰＧＦ１ａ）和ＶｏｎＷｉｌｅｂｒａｎｄ因子（ｖＷＦ）含量差异无显著意义。细胞种植后２小时和９天,人工血管腔面见一层均匀的基质,基质表面有一层连续的内皮细胞单层。内皮细胞紧密排列。呈梭状,形态饱满。实验组除１只于术后１２小时因近端吻合口破裂腹腔内出血死亡,１只人工血管于术后４周阻塞外,其余８只恒河猴人工血管术后４周均保持通畅,内膜下组织厚度为８０±１２μｍ;对照组５条人工血管全部阻塞。结论自体内皮细胞移植可有效地提高人工血管的通畅率。     

恒河猴自体静脉内皮细胞种植ePTFE人工血管后置换髂总动脉的实验研究

:15只恒河猴随机分为 2组 :实验组 10例 ,其人工血管均经自体静脉内皮细胞种植 ;对照组 5例 ,其人工血管均未经任何处理。实验组、对照组手术方法相同。将长 6cm、直径 3mmePTFE(膨体聚四氟乙烯 )人工血管近端与腹主动脉行端 -侧吻合、远端与髂总动脉行端 -端吻合。术后当日、1周及 4周 ,所有恒河猴均行静脉法数字减影造影术 ,术后 4周行彩色B型超声波检查 ,然后取出所有对照组及 9例实验组恒河猴腹腔内之人工血管 ,标本送光镜、扫描电镜及透射电镜检查。结果表明 ,术后 4周 ,对照组人工血管均不通畅 ,而实验组有 8条人工血管通畅良好。B超见全部对照组及 1例实验组人工血管腔内形成血栓 ,实验组 8条通畅之人工血管均保持较高的血流量。扫描电镜见实验组全部人工血管腔内均有一层完整融合的内皮细胞单层 ,而对照组人工血管腔内未见有内皮细胞。     

内皮细胞衬里静脉人工血管10例随访报告

本文报告用自体大网膜源内皮细胞衬里静脉人工血管的临床应用。10例病人均患“布加综合征”，其中6例行下腔静脉-步心房转流术（以下简称腔房转流）、2例行肠系膜上静脉-右心房转流术（以下称肠房转流）、肠系膜上静脉-右颈内静脉转流术（以下称肠颈转流）和肠腔转流术各1例。所用人工血管包括绦纶9根和带外支持环的PTFE1根，内径为16mm，长度为8～30cm。术中取自体大网膜约100g，经酶促降解和分离，提取内皮细胞高密度种植于人工血管住面．所有病人康复出院，已随访5～8年，有9例人工血管均保持通畅，其中2例女性病人结婚后，1人生子。     

豚鼠、兔气管壁淋巴管的分布

为观察豚鼠和兔气管淋巴管的分布特征及超微结构，本文应用淋巴管间接注射、光镜和电镜观察及计算机图像分析的方法进行了研究。结果表明，两种动物气管淋巴管结构、分布相似。粘膜层仅存在丰富的毛细淋巴管，粘膜下层、肌层、外膜层有毛细淋巴管和淋巴管分布。在320张组织切片中，淋巴管检出李豚鼠为36％；兔为23％（P＜0．01）。淋巴管的平均最大直径豚鼠为22．6±14．1μm（x±s）；兔为23．7±14．9μm（x±s）。体密度豚鼠为2．05±0．49μm3／μm3×10－3（x±Sx）；兔为1．29±0．40μm3／μm3×10－3（x±Sx）。截面密度豚鼠为5．89±1．20Ly／mm2（x±Sx）；兔为2．32±0．58Ly／mm2（x±Sx）。豚鼠气管淋巴管比兔的丰富。超微结构，毛细淋巴管的壁均由一层内皮细胞围成，基膜不完整或缺乏，无周细胞和孔窗。内皮细胞间连接形式可分为端端、重叠和嵌合连接。内皮细胞胞质内有大量囊泡。     

大鼠微血栓形成对内皮细胞功能的影响

静脉注射高分子右旋糖酐复制大鼠微循环障碍动物模型。观察肠系膜微循环，计数循环内皮细胞（CEC），测定血浆内皮素（ET），内皮源性舒血管内子（EDRF）水平，对心内膜，主动脉，肠系膜微血管进行病理学检查，发现肠系膜微血管内血流缓慢，血细胞聚集成团，有微血栓形成，微血栓K值（22．95±3．3）明显低于对照组（3．04±0．81）；心，血管内膜缺损；CEC计数，血浆ET，EDRP水平分别为13．70±7．82（个／0．9μl),160．42±10．70（ng/L)和3．48±0．34（μmol/L)，与对照组5．33±2．34（P＜0．01），123．10±11．74（P＜0．0001）和4．08±0．44（P＜0．05）比较有显著性差异。提示；微血栓形成不仅导致微循环障碍，还导致内皮细胞损伤，功能障碍，促进血小板粘附，聚集和血栓形成，可能是伴有微血栓形成的冠心病病人心肌梗塞发生率高的重要因素。     

盆腔术后硬膜外腔注入氯胺酮镇痛剂量探讨

硬膜外腔注入氯胺酮用于术后镇痛已多见报道，但对剂量各家报道不一［１～３］。我科１９９８年间采用双盲法探讨盆腔术后硬膜外注入氯胺酮镇痛的最佳剂量，现报告如下。１　资料与方法１．１　资料　选择ＡＳＡⅠ～Ⅱ级择期妇科手术患者９０例，年龄１８～５５岁，随机分为３组，每组３０例，各组患者在年龄、体重、手术时间、麻醉初量、术中镇静、镇痛药剂量均无明显差异，见表１。表１　３组患者的一般资料（ｘ±ｓ）组别年龄（岁）体重（ｍ／ｋｇ）麻醉初量（Ｖ／ｍｌ）手术时间（ｔ／ｍｉｎ）Ⅰ３５．６±８．４４４．３±５．５１１…     

不同细胞密度对小鼠心肌微血管内皮细胞小管生成的影响

目的 探讨小鼠心肌微血管内皮细胞的体外小管生成实验的最佳细胞浓度，从而为心脏微血管的研究提供体外实验模型。方法 组织块贴壁法培养小鼠心肌微血管内皮细胞，将小鼠心肌微血管内皮细胞分成5×103个/孔、1×104个/孔、2×104个/孔、3×104个/孔4组，并接种至Matrigel胶包被的48孔板中，细胞接种后24 h在倒置显微镜下观察拍照，并用Image J软件对形成的管腔数量、分支数量进行统计，统计结果用（x-〗±s)表示，数据采用SPSS 17.0软件分析。结果 组织块贴壁法可成功培养小鼠心肌微血管内皮细胞，分离培养的小鼠心肌微血管内皮细胞vWF相关抗原阳性表达。细胞密度为5×103个/孔时无管腔样结构生成，当细胞浓度为1×104个/孔、2×104个/孔、3×104个/孔时可有管腔样结构生成。细胞浓度为2×104个/孔时形成的管腔数量及分支数量高于1×104个/孔、3×104个/孔（P＜0.05）。 结论 分离培养的小鼠心肌微血管内皮细胞具有血管形成能力。在一定的细胞接种浓度范围内，接种的细胞密度越大，体外血管形成能力增强，但细胞浓度超过血管形成的最佳浓度后，随着接种细胞浓度的增大，小鼠心肌微血管内皮细胞的体外血管形成能力减弱。     

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…     

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.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…