胰岛素抵抗大鼠肝脏丝氨酸/酪氨酸磷酸化IRS-1表达异常与脂联素相关的研究

目的 探讨胰岛素抵抗大鼠丝氨酸/酪氨酸磷酸化异常与脂联素(APN)的关系.方法 高脂饲料喂养10周建立胰岛素抵抗大鼠模型,并用正常血糖-高血浆胰岛素钳夹技术评估.应用ELISA法检测大鼠血清APN含量,Western blot法检测肝脏组织中胰岛素受体底物1(IRS-1)磷酸化丝氨酸(IRS-1Ser636)及磷酸化酪氨酸(IRS-1Tyr465)表达.结果 高脂组大鼠葡萄糖榆注率(GIR60～120)明显低于基础饲料组(1.56±0.43vs5.15±0.66 mg·kgM-1·min-1,P<0.01);与基础饲料组相比,高脂饲料组大鼠血清APN水平显著降低(0.70±0.07vs 0.85±0.12 pg/ml,P<0.01),IRS-1Tyr465蛳表达显著降低(111.68±13.41vs127.77±13.17,P<0.05),IRS-1Ser636水平显著升高(109.47±13.75vs94.23±15.05,P<0.05).血清APN水平与IRS-1Tyr465正相关(r=0.68,P<0.01),与IRS-1Ser636负相关(r=-0.70,P<0.0).结论 胰岛素抵抗大鼠APN水平与IRS-1Tyr465正相关,与IRS-1Ser626负相关,提示APN改善胰岛素抵抗机制可能与纠正IRS-1磷酸化异常有关.     

炎症因子对胰岛素抵抗动物模型血管内皮细胞功能影响的研究

目的 探讨炎症因子在胰岛素抵抗状态下血管内皮细胞功能异常中的作用及可能的机理.方法 SD大鼠随机分为正常对照组(NC组)、肥胖组(OB组)和肥胖+阿司匹林干预组(OB-AS组).NC组给予普通饲料喂养;OB组给予高脂饲料喂养;OB-AS组在给予高脂饲料喂养4周后,在高脂饲养的基础上每天给予200 mg/kg体质量的阿司匹林灌胃4周.应用正常葡萄糖高胰岛素钳夹试验评价外周胰岛素敏感程度;测定不同浓度乙酰胆碱(Ach)及硝普钠作用下股动脉血流速度的改变以评价血管内皮细胞依赖性舒张功能及非内皮细胞依赖性血管舒张功能;测定循环中肿瘤坏死因子-α(TNF-α)和C-反应蛋白(CRP)的水平;检测血管组织中核转录因子κB抑制蛋白激酶β-核因子-κB(IKKβ-NF-κB)分子通路的激活情况.结果 OB组血中TNF-α和CRP的水平较NC组升高 (P<0.05),Ach刺激的血管舒张反应降低(P<0.05);血管舒张时血中一氧化氮(NO)水平低下(P<0.05).血管组织NF-κBp65和IKKβ的染色强度明显增强, 血管组织NF-κBp65的表达是NC组的1.7倍(P<0.05).与OB组比较,OB-AS组其炎症因子水平下降(P<0.05),给予Ach后血中NO水平增加(P<0.05),血管舒张强度增加(P<0.05).OB-AS组血管组织NF-κBp65和IKKβ的染色强度、内皮细胞NF-κBp65的表达水平较OB组下降(P<0.05).结论 胰岛素抵抗状态下循环中增多的炎症因子通过激活经典的IKKβ-NF-κB分子通路导致内皮源性NO产生减少,可能是胰岛素抵抗状态下血管内皮细胞功能异常的分子机理之一.     

胰岛素抵抗大鼠血清脂联素与超敏C反应蛋白的关系

目的探讨胰岛素抵抗大鼠血清脂联素(APN)与超敏C反应蛋白(hs-CRP)水平的关系。方法采用高脂饲料喂养建立胰岛素抵抗大鼠模型,并用正常血糖-高血浆胰岛素钳夹技术评估。应用ELISA方法检测大鼠血清脂联素(APN)和超敏C反应蛋白(hs-CRP)水平。结果高脂饲料喂养组(HF组)大鼠的葡萄糖输注率明显低于基础饲料喂养组(NF组)[GIR60～120,(0.76±0.28)vs(4.26±0.70)mg·kg-1·min-1,P<0.01]。与NF组相比,HF组大鼠血清APN水平明显降低[(11.32±0.52)vs(14.03±0.46)ng/ml,P<0.01],血清hs-CRP水平明显升高[(6.02±1.12)vs(2.60±0.54)ng/ml,P<0.01],胰岛素敏感性指数(ISI)明显降低[LnISI,-(2.19±0.22)vs-(1.54±0.38),P<0.01]。胰岛素抵抗大鼠血清hs-CRP与APN水平呈负相关(r=-0.85,P=0.000)。结论胰岛素抵抗大鼠血清APN水平降低,血清hs-CRP水平升高,二者之间存在负相关。     

短期胰岛素治疗对糖尿病大鼠内脏脂肪抵抗素mRNA表达的影响

目的观察短期胰岛素治疗后糖尿病(DM)大鼠内脏脂肪组织抵抗素(resistin)mRNA表达及血清抵抗素水平的变化。方法采用小剂量链脲佐菌素(STZ)注射联合高糖高脂饲料喂养制备糖尿病大鼠模型,予胰岛素控制部分糖尿病大鼠血糖,设立空白对照组、血糖未控制组、血糖控制组。分别检测3组大鼠血清抵抗素水平及内脏脂肪组织抵抗素mRNA的表达;观察3组大鼠血清抵抗素、游离脂肪酸(FFA)、三酰甘油(TG)、总胆固醇(TC)水平及内脏脂肪抵抗素mRNA表达的变化。结果与空白对照组比较,血糖未控制组大鼠血清抵抗素及内脏脂肪组织抵抗素mRNA的表达显著增高[(696.23±187.77)vs(538.31±142.14);(62.26±25.79)vs(10.15±12.13),P<0.05];与血糖控制组大鼠比较,血糖未控制组大鼠内脏脂肪组织抵抗素mRNA的表达亦显著增高[(62.26±25.79)vs(10.45±2.99),P<0.05]。血糖控制组大鼠FFA较血糖未控制组大鼠FFA水平显著降低[(0.53±0.16)vs(0.73±0.19),P<0.05],而TC水平显著增高[(1.92±0.16)vs(1.22±0.38),P<0.05]。结论短期的胰岛素治疗能降低糖尿病大鼠内脏脂肪组织抵抗素mRNA的表达,可能与血糖控制后胰岛素抵抗改善及胰岛素负调节抵抗素mRNA表达有关。     

苦酸通调方对自发性糖尿病大鼠腹部脂肪组织中NF-κB及IKKβ蛋白表达的影响

目的观察苦酸通调方对自发性糖尿病大鼠腹部脂肪组织中NF-κB及IKKβ蛋白表达的影响。方法将高脂饲料喂养的雄性SPF级ZDF大鼠30只,随机分为模型组、苦酸通调组、吡格列酮组3组,普通饲料喂养的雄性SPF级ZL大鼠为正常对照组,每组各10只。苦酸通调方组按照3.29 g/(kg·d)灌胃,吡格列酮组按照1.07 mg/(kg·d)灌胃。模型组和正常对照组灌服等体积蒸馏水,每天1次,连续12周。经Western blot法检测各组大鼠腹部脂肪组织中NF-κB、IKKβ蛋白的表达水平。结果在治疗第12周末,模型组、吡格列酮组、苦酸通调组大鼠腹腔脂肪组织中NF-κB、IKKβ蛋白表达明显高于正常对照组(P0.01)。与模型组相比,苦酸通调组和吡格列酮组NF-κB、IKKβ蛋白的表达均明显降低(P0.01,P0.05),且苦酸通调组优于吡格列酮组(P0.05)。结论苦酸通调方组在一定程度上能抑制糖尿病大鼠腹部脂肪组织中NF-κB、IKKβ蛋白的表达,可能是苦酸通调方抑制炎症信号通路的传导而发挥其改善胰岛素抵抗治疗糖尿病的机制之一。     

黄连素对肥胖胰岛素抵抗大鼠骨骼肌胰岛素抵抗的干预研究

目的 探讨黄连素改善肥胖胰岛素抵抗大鼠骨骼肌胰岛素抵抗的可能机制。 方法 40只Wistar大鼠分为高脂组（HF组,30只）和正常对照组(NC组,10只)。成模后处理NC组10只及HF组10只大鼠。检测血浆中内毒素（ET）水平,RT-PCR检测骨骼肌中 Toll样受体4（TLR4） mRNA ,Western blot检测骨骼肌TLR4、IκB激酶（IKKβ）、IKKβ 181位丝氨酸磷酸化（p-IKKβSer181、核因子κB（NF-κB） 、肿瘤坏死因子-α（TNF-α）蛋白表达,胰岛素受体(IR)与胰岛素受体底物(IRS)-1总蛋白及磷酸化水平。余20只肥胖大鼠分为黄连素干预组（ FB组,10只）及肥胖模型对照组（ FC组,10只）,继续高脂饮食喂养,FB 组予200 mg/(kg·d)每日1次黄连素灌胃,FC 组予等量蒸馏水灌胃,持续8周后检测以上指标。 结果 肥胖大鼠血浆中ET水平升高,且骨骼肌TLR4/IKKβ/NF-κB内毒素信号通路激活,炎症因子TNF-α蛋白表达增加,黄连素干预使肥胖胰岛素抵抗大鼠血浆中ET水平降低,且骨骼肌组织TLR4/IKKβ/NF-κB内毒素信号通路各蛋白及TNF-α蛋白表达均下调, IR及IRS-1酪氨酸磷酸化水平均升高（ P<0.05）。结论 黄连素可改善肥胖胰岛素抵抗大鼠骨骼肌胰岛素抵抗,其机制可能是通过下调骨骼肌 TLR4/IKKβ/NF-κB内毒素信号通路减少炎症因子TNF-α产生所致。     

黄连素改善妊娠期糖尿病大鼠胰岛素抵抗及其机制研究

目的 观察黄连素对高脂饲料喂养联合小剂量链脲佐菌素(STZ)诱导的妊娠期糖尿病(GDM)大鼠的作用及其可能机制。 方法 采用高脂饲料喂养雌性SD大鼠5周,交配受孕后第1天腹腔注射STZ(25 mg/kg)建立GDM大鼠模型,妊娠第1~19天黄连素溶液[200 mg/(kg·d)]灌胃干预。监测各组大鼠孕期空腹血糖和胰岛素抵抗指数的变化。于妊娠第20天剖宫取胎,测量各组胎鼠和胎盘重量,通过实时荧光定量PCR法和ELISA法检测各组肝脏组织CRP、TNF-α基因和蛋白水平,通过Western blotting法检测肝脏细胞IKKβ和NF-κB蛋白的表达。 结果 与正常妊娠组相比,模型组孕鼠空腹血糖和胰岛素抵抗指数明显升高(均P＜0.05),胎鼠和胎盘的重量明显增加(均P＜0.05),肝脏组织CRP、TNF-α基因和蛋白表达增多(均P＜0.05),肝细胞IKKβ蛋白和核NF-κB蛋白的表达增多(均P＜0.05)。经黄连素干预后GDM孕鼠肝脏细胞浆IKKβ蛋白和核NF-κB蛋白表达减少(均P＜0.05),CRP、TNF-α基因和蛋白表达减少(均P＜0.05),胰岛素抵抗指数和空腹血糖降低(均P＜0.05)。 结论 黄连素可以通过IKK/NF-κB信号通路,抑制NF-κB核转位,降低GDM模型大鼠肝脏组织中的炎症反应,从而改善胰岛素抵抗,降低血糖水平。      

高脂饮食诱导的胰岛素抵抗大鼠内脂素的表达水平

目的:研究高脂饮食诱导的胰岛素抵抗(IR)对大鼠脂肪内脏脂肪素(visfatin)表达水平的影响。方法:将24只雄性SD大鼠随机分为正常对照组和高脂饮食组。适应性饲养后,测定空腹血糖(FBG)和空腹血清胰岛素(FINS),分别喂以正常饲料和高脂饲料。12周后,检测两组大鼠体重、FBG和FINS,用HOMA模型评价胰岛素抵抗指数,处死,分离附睾、肠系膜、折返腹膜脂肪以及肾脏脂肪垫,称重,计为内脏脂肪重量。利用逆转录-多聚酶链反应(RT-PCR)分别检测两组大鼠内脏脂肪中visfatin表达的差异,并分析HOMA-IR值、内脏脂肪量分别与visfa-tin/β-actin光密度比值之间的相关关系。结果:高脂饮食成功诱导了胰岛素抵抗,高脂喂养组大鼠的内脏脂肪明显增多,其FBG轻度升高(P>0.05)、FINS明显升高、HOMA-IR明显升高(P<0.05)。高脂饮食组大鼠的内脏脂肪中visfatin表达显著高于对照组(P<0.05)。HOMA-IR值、内脏脂肪量分别与visfatin/β-actin光密度比值呈正相关(均为P<0.01)。结论:高脂饮食诱导的胰岛素抵抗大鼠内脏脂肪组织中visfatin mRNA表达明显增加,且其表达与HOMA-IR和内脏脂肪量之间呈正相关,提示visfatin在胰岛素抵抗的发生和发展过程中起有一定的作用。     

葡萄糖调节蛋白78 mRNA在高脂喂养大鼠肝脏中的表达和意义

目的 检测高脂饲料喂养大鼠的肝脏葡萄糖调节蛋白7S(GILP78)mR2qA的表达情况,探讨内质网应激与胰岛素抵抗之间的关系及GKP78在胰岛素抵抗发生机制中的作用.方法 采用高脂饲料喂养建立胰岛素抵抗大鼠模型,30只雄性Wistar大鼠被随机分为基础饮食喂养组(NC,n=15)和高脂饮食喂养组(HF,n=15),分别喂养10用后,用正常血糖-高血浆胰岛素钳夹技术进行评估.应用Real Time PCR方法检测大鼠肝脏中GRP78 mRNA的表达.结果 ①高脂饲料组大鼠的葡萄糖输注率明显低于基础饲料组[GIR60-120(0.90±0.15)vs(4.97±0.68)mg/(ks·min),P<0.01].②高脂饲料组肝脏GRP78 mRNA的表达明显高于基础饲料组[(1.13±0.50)vs(0.43±0.10,P<0.01].③肝脏GRP78 mRNA表达与内脏脂肪占体质量的百分比(r=0.52,P=0.019)、总胆固醇(TC)(r=0.51,P=0.022)成正相关.结论 高脂诱导的胰岛素抵抗大鼠肝脏中GILP78mRNA表达增加,表明大鼠肝脏发生内质网应激和未折叠蛋白反应.     

白藜芦醇对急性心肌梗死大鼠核因子-κB信号通路表达的影响

目的探讨白藜芦醇对急性心肌梗死(AMI)大鼠核因子-κB(NF-κB)信号通路表达的干预作用。方法将30只雄性Sprague-Dawley大鼠随机分为假手术组、AMI组和白藜芦醇组,每组10只;AMI和白藜芦醇组大鼠采用结扎大鼠左冠状动脉前降支法制备AMI模型,假手术组大鼠不结扎左冠状动脉前降支;术后第1天白藜芦醇组大鼠开始腹腔注射白藜芦醇10 mg·kg~(-1)·d~(-1),假手术组及AMI组大鼠分别注射等剂量生理盐水;每日1次,持续用药至术后4周。然后处死各组大鼠,取梗死区域的心肌组织,采用实时荧光定量聚合酶链反应和Western blot法检测大鼠心肌组织中NF-κB、NF-κB抑制蛋白α(IκBα)、IκB激酶α(IKKα)蛋白及其mRNA的表达。结果 AMI组大鼠心肌组织中NF-κB、IκBα和IKKαmRNA表达显著高于假手术组(P<0.05),白藜芦醇组大鼠心肌组织中NF-κB、IκBα和IKKαmRNA表达显著低于AMI组(P<0.05),白藜芦醇组与假手术组大鼠心肌组织中NF-κB、IκBα和IKKαmRNA表达比较差异均无统计学意义(P>0.05)。AMI组大鼠心肌组织中NF-κB、IκBα和IKKα蛋白表达显著高于假手术组(P<0.05),白藜芦醇组大鼠心肌组织中NF-κB、IκBα和IKKα蛋白表达显著低于AMI组(P<0.05);白藜芦醇组大鼠心肌组织中NF-κB、IκBα蛋白表达显著高于假手术组(P<0.05),但2组大鼠心肌组织中IKKα蛋白表达比较差异无统计学意义(P>0.05)。结论白藜芦醇可以抑制AMI大鼠NF-κB信号通路表达情况,具有心脏保护效应。     

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.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

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.