关附庚素对缺O_2、高K~ 及酸中毒豚鼠乳头肌和兔窦房结动作电位的影响

关附庚素（ＧＦＧ）０．８６μｍｏｌ／Ｌ使缺Ｏ２、高Ｋ＋和酸中毒的豚鼠乳头肌动作电位零相最大上升速率（Ｖｍａｘ）进一步降低，动作电位时程（ＡＰＤ）和有效不应期（ＥＲＰ）进一步缩短，而ＥＲＰ／ＡＰＤ９０明显增大。ＧＦＧ８，１６，１２μｍｏｌ／Ｌ使兔窦房结动作电位Ｖｍａｘ、舒张期去极化速率（ＲＤＤ）、自发活动频率（ＳＦＦ）和平均复极化速率（ＭＲＲ）显著降低，ＡＰＤ和舒张间隔（ＤＩ）明显延长，并呈现浓度依赖性     

奎尼丁与二氢奎尼丁对豚鼠乳头肌动作电位影响的对比研究

应用经典玻璃微电极方法对比研究不同浓度奎尼丁（Ｑ）与二氢奎尼丁（ＤＨＱ）对豚鼠乳头肌动作电位的影响，随药物浓度递增，两药均使动作电位时程（ＡＰＤ９０）逐渐延长，Ｏ相最大除极速度（Ｖｍａｘ）逐渐降低，但Ｑ作用的高峰浓度在２０μｍｏｌ／Ｌ，而ＤＨＱ在１０μｍｏｌ／Ｌ，ＤＨＱ≤１０μｍｏｌ／Ｌ时对Ｖｍａｘ的作用大于Ｑ。提示，ＤＨＱ对心肌细胞动作电位的影响大于Ｑ。     

氨氯地平对豚鼠心房肌动作电位及早期后除极的影响

用标准玻璃微电极技术观察氨氯地平对豚鼠左房肌快反应动作电位和异丙肾上腺素诱发的早期后除极作用。结果发现氨氯地平５μｍｏｌ／Ｌ对动作电位无影响；１０μｍｏｌ／Ｌ可明显缩短动作电位时程（ＡＰＤ），但对动作电位幅度（ＡＰＡ）、０相上升速率（Ｖｍａｘ）、有铲不应期（ＥＲＰ）和三相时程（ＤＰ３）无影响；２５μｍｏｌ／Ｌ氨 平可显著抑制异丙蛹地腺素诱发的早期后除极活动。提示：（１）Ｌ型钙电流在异丙肾上腺素诱发     

甲苯喹哌对豚鼠右心室乳头肌动作电位的作用

通过研究新抗心律失常药甲苯喹哌（ｔｏｑｕｉｐｉｄｉｎｅ，Ｔｏｑ）抗心律失常作用的心肌电生理学机制。利用微电极技术观察甲苯喹哌对豚鼠右心室乳头肌动作电位的作用，并与利多卡因进行比较。结果：Ｔｏｑ在１和１０μｍｏｌ／Ｌ时对动作电位各参数无明显影响，但在５０及１００μｍｏｌ／Ｌ时，可明显降低动作电位的Ｖｍａｘ，ＡＰＡ，缩短ＡＰＤ２０，ＡＰＤ５０和ＡＰＤ９０，并明显延长或提高动作电位的ＥＲＰ，ＥＲＰ／ＡＰＤ９０和ＥＲＰ－ＡＰＤ９０利多卡因１μｍｏｌ／Ｌ对动作电位各参数无明显影响。１０和５０μｍｏｌ／Ｌ利多卡因可剂量依赖性降低Ｖｍａｘ，ＡＰＡ，缩短ＡＰＤ２０，ＡＰＤ５０和ＡＰＤ９０。并明显延长ＥＲＰ，ＥＲＰ／ＰＤ９０和ＥＲＰ－ＡＰＤ９０结论：Ｔｏｑ有与利多卡因类似的心肌电生理作用，但其效价强度低于利多卡因。     

甲苯喹哌对豚鼠右心室乳头肌动作电位的作用

通过研究新抗心律常药甲苯喹哌（ｔｏｑｕｉｐｉｄｉｎｅ，Ｔｏｑ）抗心律失常作用的心肌电生理学机制，利用微电极技术观察甲苯喹哌对豚鼠右心室乳头肌动作电位的作用，并与利多卡因进行比较。结果，Ｔｏｑ在１和１０μｍｏｌ／Ｌ时对动作电位各参数无明显影响，但在５０及１００μｍｏｌ／Ｌ时，可明显降低动作电位的Ｖｍａｘ，ＡＰＡ，缩短ＡＰＤ２０，ＡＰＤ５０和ＡＰＤ９０，并明显延长或提高地动作电位的ＥＲＰ，ＥＲＰ／ＡＰ     

雌二醇对兔窦房结起搏细胞动作电位的影响

目的： 观察雌二醇（１７βｅｓｔｒａｄｉｏｌ，简称 Ｅ）对兔窦房结细胞动作电位的影响。方法：采用常规微电极技术记录兔窦房结细胞在不同 Ｅ浓度和作用时间的动作电位。结果：（１） Ｅ浓度依赖和时间依赖性显著延长窦房结细胞动作电位时程（ Ａ Ｐ Ｄ５０ 和 Ａ Ｐ Ｄ９０）及３ 期复极时间。（２） Ｅ浓度依赖和时间依赖性降低窦房结细胞动作电位０ 期最大除极速率（ Ｖｍ ａｘ）、动作电位幅度（ Ａ Ｐ Ａ）和延长０ 期除极时间，且 Ｅ１×１０５ｍ ｏｌ／ Ｌ组观察到８０～１００ ｍ ｉｎ 时，有３例动作电位完全消失。结论： Ｅ对窦房结细胞 Ｋ＋ 通道和 Ｃａ２＋ 通道都有阻断作用。     

川芎嗪对豚鼠心室乳头状肌慢反应动作电位的双重作用

目的：观察川芎嗪对豚鼠心室乳头状肌慢反应动作电位和收缩力的影响。方法：常规电生理方法，标准玻璃微电极技术。结果：①低浓度川芎嗪（３０～３０μｍｏｌ／Ｌ）对豚鼠乳头状肌慢反应动作电位的幅度（ＡＰＡ）、时程（ＡＰＤ）、最大去极速度（Ｖｍａｘ）和收缩力（ＦＣ）均呈剂量依赖性抑制；②较高浓度的川芎嗪（０１～３０ｍｍｏｌ／Ｌ）则可使豚鼠乳头状肌慢反应动作电位的ＡＰＡ、ＡＰＤ、Ｖｍａｘ和ＦＣ均呈现剂量依赖性增强；③川芎嗪对豚鼠乳头状肌慢反应动作电位的增强作用可被钙通道阻断剂维拉帕米所拮抗。结论：川芎嗪对心肌慢内向电流具有双重作用，即低浓度抑制，高浓度则增强     

维拉帕米联用阿霉素,长春新碱,足叶己甙体外净化白血病细胞

采用体外克隆形成培养技术研究维拉帕米（ＶＰＬ）联用阿霉素（ＡＤＭ），长春新碱（ＶＣＲ）和足叶己甙（ＶＰ－１６）体外净化白血病细胞，结果显示，ＶＰＬ２．２μｍｏｌ／Ｌ能明显增加单一应用的不同浓度ＡＤＭ，ＶＣＲ或ＶＰ－１６对白血病细胞克隆形成单位（Ｌ－ＣＦＵ）的抑制作用，而不增加其对正常粒巨系克隆形成单位（ＧＭ－ＣＦＵ）的毒性，０．９２μｍｏｌ／ＬＡＤＭ，０．０２５０μｍｏｌ／ＬＶＣＲ及１．７０μｍｏ     

pH值对川芎嗪在豚鼠心肌电生理-机械特性的影响中的作用

目的：观察调节ｐＨ至７．４的川芎嗪与不调节ｐＨ的川芎嗪对豚鼠心室乳头状肌电生理－机械特性的影响。方法：常规电生理方法,标准玻璃微电极技术。结果：①调节 ｐＨ至 ７．４与不调节 ｐＨ的低浓度川芎嗪（３．０～ ３０μｍｏｌ）均使豚鼠乳头状肌慢反应电位（ＳＡＰ）的动作电位幅值（ＡＰＡ）,动作电位时程（ＡＰＤ）,最大除极速度Ｖｍａｘ及收缩力（ＦＣ）呈剂量依赖性抑制;②调节ｐＨ至７．４的高浓度川芎嗪（０．１～３．０ ｍｍｏｌ／Ｌ）使豚鼠乳头状肌 ＳＡＰ的 ＡＰＡ、ＡＰＤ、Ｖｍａｘ及ＦＣ呈剂量依赖性增强;而不调节ｐＨ的高浓度川芎嗪（０．１～３．０ ｍｍｏｌ／Ｌ）使豚鼠乳头状肌ＳＡＰ的ＡＰＡ、ＡＰＤ、Ｖｍａｘ及ＦＣ呈抑制效应。结论：①川芎嗪对豚鼠心肌电生理－机械特性有双重影响作用,即低浓度抑制,高浓度增强。②川芎嗪本身的酸性影响川芎嗪对豚鼠心肌电生理－机械特性的正性作用。     

两面针碱对钙调蛋白依赖环核苷酸磷酸二酯酶的抑制作用

以钙调蛋白依赖环核苷酸磷酸二酯酶（ＣａＭ－ＰＤＥ）为分子模型，应用正文试验证实两面针碱（Ｎｉ－ｔｉｄｉｎｅ，Ｎｉｔ）是一种新的ＣａＭ拮抗剂。实验结果表明：①：Ｎｉｔ抑制ＣａＭ－ＰＤＥ活性ＩＣ５０为８６μｍｏｌ／Ｌ。②７５μｍｏｌ／ＬＮｉｔ对０～８０ｎｇ／ｍｌＣａＭ存在下，ＣａＭ－ＰＤＥＶｍａｘ基本不变，半激活浓度（ＡＣ５０）增大，抑制常数（Ｋｉ）为６６μｍｏｌ／Ｌ。提示Ｎｉｔ以竞争方式拮抗ＣａＭ对其靶酶（ＰＤＥ）的活化。③７５μｍｏｌ／ＬＮｉｔ对ＣａＭ－ＰＤＥ抑制动力学研究：改变底物（ｃＡＭＦ）浓度，ＣａＭ－ＰＤＥ的Ｖｍａｘ减少，米氏常数（Ｋｍ）值增大，Ｋｉ为６４μｍｏｌ／Ｌ，α＞１。提示Ｎｉｔ对ＣａＭ－ＰＤＥ的抑制作用是非竞争一竞争性混合型抑制。由此推测Ｎｉｔ可能通过与ＣａＭ竞争酶分子上的ＣａＭ结合位点从而抑制ＣａＭ－ＰＤＥ的激活活性。     

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.