高原低氧条件下45h睡眠剥夺对自我监控的元认知能力的影响

目的探讨海拔2 850m的高原低氧条件下45h完全睡眠剥夺(sleep deprivation,SD)期间,脑力疲劳对个体外显操作自我监控的元认知能力的影响.方法 7名20～22岁的健康男性青年,在完全睡眠剥夺条件下,每隔6h进行1次元认知能力测验,具体内容为一组难度水平不同的系列加法任务.结果①通过总体分析,被试完成各难度水平任务的正确率与其主观评判等级之间的相关为0.63(P ＜0.01),表明这二者具有较度的一致性;②对SD过程中各次测验的三项校验指标,即确信等级与正确率二者之间的相关系数、校验曲线的斜率和最高确信等级的正确率,进行分析,结果表明,这三项指标在各次测验之间均无显著性差异(P >0.05),其F值分别为F7, 43≈0.455、F7, 43≈0.646和F7,43≈1.001.结论个体自我监控的元认知能力作为人体一种相对独立的能力,在海拔不超过2 850m,SD不超过45h的时间内,其基本保持完好,可采用主观报告的方法对脑力疲劳程度进行量化.     

24h睡眠剥夺前后平衡能力变化的初探

目的 本研究的目的 是探索静态姿势图在24h睡眠剥夺后的变化趋势.方法 观察8名健康男性(18～22岁)的24h睡眠剥夺前后部分立位平衡能力的变化特点.结果研究表明,静态平衡的各项数据在脑力疲劳前后发生了变化.结论 立位平衡测验可能是测定脑力疲劳的一种方法.     

24小时睡眠剥夺对主观疲劳程度和心理运动能力的影响

目的了解24h睡眠剥夺对主观疲劳程度和心理运动能力的影响，探讨自拟的疲劳评价问卷评估主观疲劳程度的可行性。方法对医科大学12名男学员进行24h睡眠剥夺，以微机化神经行为进行视简单反应时和光标追踪测试，以自认疲劳分级（RPE）和自拟的疲劳调查问卷进行主观疲劳程度自评。结果受试者睡眠剥夺后视简单反应时显著延长，光标追踪偏差有所增加，疲劳评价问卷的总评分和各因子分非常显著地高于剥夺前;睡眠剥夺前后疲劳评价问卷总分与RPE评分的相关系数为r＝0.76（P＜0.01）。结论24h睡眠剥夺能引起心理运动能力的下降;疲劳评价问卷的信度和效度得到了初步验证，具有应用前景。     

高原低氧条件下45h睡眠剥夺对工作记忆的影响

目的探究高原(海拔约2 850m)和平原(海拔约400m)环境下完全睡眠剥夺(sleep deprivation,SD)对工作记忆能力的影响.方法完全SD条件下,分别在高原和平原对15名被试(高原7名,平原8名)进行间隔为6h的8次工作记忆测验.此测验的任务包括两种:一为字母内容匹配任务,一为字母位置匹配任务.结果①两种工作记忆任务上,高原与平原相比,各时间点的测量值差异均未达到显著性水平;②高原和平原环境下,SD各时间点的工作记忆测量值同基础值相比,除时间点2(第1天下午)、时间点3(第1天晚上)以外,其余差异均达显著性水平;③在高原环境下,时间点5(第2天早上)两项工作记忆任务测验成绩同时间点4(第1天夜间)相比均未呈现升高趋势,字母内容匹配任务测验成绩表现尤为明显,与平原不一.结论中等海拔高度(2 100～3 050m)的高原,在只进行轻体力劳动的情况下,45h完全SD对机体工作记忆能力的影响与平原大致相似.SD超过20h,工作记忆能力显著低于基础值.     

重复口服小剂量咖啡因对完全睡眠剥夺条件下视知觉检索能力的影响

目的　研究睡眠剥夺 (SD)与咖啡因在 SD条件下对视知觉检索 (VCS)能力的影响 .方法　采取随机三盲 2× 1 0析因设计 ,1 2名健康男性 (1 8～ 2 0岁 )为被试 ,进行 6 0 h完全睡眠剥夺 (TSD) ,用 VCS测验研究 SD条件下重复口服小剂量咖啡因的保护作用 .结果　 1 SD使 VCS的正确反应减少 ,错误反应增加 ,同时明显延长反应时 ;2咖啡因在 SD条件下可使 VCS的正确反应明显增加 ,错误反应明显减少 ,但对反应时没有明显影响 .结论　重复口服小剂量咖啡因在 6 0h TSD条件下对 VCS能力有明显保护作用 .     

莫达非尼对睡眠剥夺应激条件下计算能力和知觉加工的影响

目的:观察在睡眠剥夺应激条件下莫达非尼对计算能力和知觉加工能力的改善作用,为此药在我军的应用策略提供实验依据.方法:18名健康男性志愿者,在2次睡眠剥夺实验中交叉服用莫达非尼和安慰剂,睡眠剥夺时间从第1日 07:00到第3日07:00,并于第2日0:00,12:00和第3日0:00分别服用莫达非尼100 mg或安慰剂.采用随机双盲设计给药,并在第1日07:00,第2日02:00和14:00及第3日02:00和07:00安排连续相加测验和Stroop测验.结果:连续相加测验中,两组的正确率没有统计学差异(P＞0.05),而完成时间上安慰剂组的时间延长(P＜0.05).Stroop测验中,测验反应时的莫达非尼组快于安慰剂组(P＜0.05),而正确率没有组间差异(P＞0.05).结论:莫达非尼对睡眠剥夺应激条件下人的计算能力和知觉加工有改善作用,是一种较理想的睡眠剥夺对抗措施.     

中链甘油三酯对72h睡眠剥夺大鼠的认知能力和抗氧化能力的影响

目的 研究中链甘油三酯对72h连续睡眠剥夺大鼠的认知能力和抗氧化能力的影响.方法 将30只雄性SD大鼠随机分为正常睡眠组(NC组)、睡眠剥夺组(SD组)、低剂量MCT组(LD组)、中剂量MCT组(MD组)和高剂量MCT组(HD组),用不含MCT的饲料喂养NC组和SD组,用含低、中、高剂量中链甘油三酯的饲料喂养LD组、MD组、HD组.4周后,利用睡眠剥夺箱对大鼠进行睡眠剥夺连续72h后,使用Y型电迷宫来检测大鼠的认知能力,并检测大鼠肝脏中丙二醛(MDA)含量以及超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)的活性.结果 72h连续睡眠剥夺后,SD组大鼠的迷宫反应正确率显著低于其余各组,SD组与NC组相比,MDA含量增加(P＜0.05),GSH-Px和SOD活力下降(P ＜0.05,P＜0.01);LD组和MD组的MDA均显著低于SD组(P ＜0.05,P＜0.01),MD组的GSH-Px活性显著高于SD组(P＜0.05).MCT对SOD的活性没有显著作用.结论 72h睡眠剥夺使大鼠的认知能力和抗氧化能力明显下降,而中链甘油三酯能改善睡眠剥夺大鼠的认知能力和抗氧化能力.     

高原低氧条件下45h睡眠剥夺对工作记忆的影响

目的 探究高原(海拔约2 850m)和平原(海拔约400m)环境下完全睡眠剥夺(sleep depriva-tion,SD)对工作记忆能力的影响。方法 完全SD条件下,分别在高原和平原对15名被试(高原7名,平原8名)进行间隔为6h的8次工作记忆测验。此测验的任务包括两种:一为字母内容匹配任务,一为字母位置匹配任务。结果①两种工作记忆任务上,高原与平原相比,各时间点的测量值差异均未达到显著性水平;②高原和平原环境下,SD各时间点的工作记忆测量值同基础值相比,除时间点2(第1天下午)、时间点3(第1天晚上)以外,其余差异均达显著性水平;③在高原环境下,时间点5(第2天早上)两项工作记忆任务测验成绩同时间点4(第1天夜间)相比均未呈现升高趋势,字母内容匹配任务测验成绩表现尤为明显。与平原不一。结论中等海拔高度(2 100-3 050m)的高原,在只进行轻体力劳动的情况下,45h完全SD对机体工作记忆能力的影响与平原大致相似。SD超过20h,工作记忆能力显著低于基础值。     

睡眠剥夺对工作记忆的影响

目的: 探讨不同时间睡眠剥夺对工作记忆的影响. 方法: 32名青年男性随机分为4组: 对照组,SD21 h,SD45 h和SD69 h组,每组8名. 采用数字记忆广度、词汇记忆广度、连续减法和随机数字生成测验对4组被试进行测试. 结果: 睡眠剥夺后,记忆广度成绩下降,69 h有显著差异,其中倒背45 h就有显著差异;连续减法测验成绩下降,69 h时反应总数有显著差异,45 h时正确数/反应总数之比就有显著差异;随机数字生成测验敏感于其他测验,SD21 h就出现随机数字生成总数和随机性有显著差异,偏离理想数字序列的程度(R)和相邻数字对在所有数字中所占比例(A)在SD45 h时有显著差异. 结论: SD后对于工作记忆影响较大,对于工作记忆要求高的测验受影响更大,并且这种影响在SD45 h以后更为显著.     

一种疲劳自评问卷的信度和效度初探

目的 :探讨以量表形式自我评价主观疲劳程度的可行性。方法 :建立一种简便、实用的主观疲劳程度自评问卷 ,对其信度和效度进行初步检验。结果 :该问卷总分和各因子分两次测试评分的相关系数分别为 0 .95、0 .80、0 .89、0 .6 0 (P <0 .0 1) ;总分和各因子分相互之间高度相关 ,且与自认疲劳分级 (RPE)、睡眠质量问卷、症状自评量表 (SCL - 90 )总分具有高度相关性。健康男性医学生 2 4h睡眠剥夺后疲劳问卷总分和各因子分比平时显著增高 (P <0 .0 1)。舰员经 2个多月海上航行后疲劳问卷总分和各因子分显著高于医学生平时 (P <0 .0 1) ,但低于医学生 2 4h睡眠剥夺后 (P <0 .0 1)。结论 :该问卷具有较高的信度和效度。对问卷内容进行修订 ,并作进一步标准化后 ,可望用于对健康人群主观疲劳程度的评价。     

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.