三维球体间充质干细胞移植对大鼠缺血再灌注损伤脑组织TNF-α及凋亡相关蛋白表达的影响

目的 观察三维(3-D)球体间充质干细胞(MSCs)移植对脑缺血再灌注损伤大鼠脑组织肿瘤坏死因子α(TNF-α)及凋亡相关蛋白表达的影响,探讨3-D球体MSCs的神经保护作用及可能机制。 方法 实验大鼠随机分为假手术组、溶剂对照组、3-D球体MSCs治疗组(n=36),假手术组常规分离大脑中动脉(MCA)但不结扎,MSCs治疗组采用线栓法建立大脑中动脉缺血(MCAO)模型后给予MSCs移植,溶剂对照组模型建立成功后给予等体积溶剂对照。各组大鼠分别于移植治疗后1、3、7 d进行神经功能评分;采用ELISA和RT-PCR方法检测大鼠脑组织中的TNF-α表达;采用免疫组化SABC法染色,观察损伤侧大鼠脑组织Caspase-3和Caspase-8蛋白的表达。 结果 与假手术组、溶剂对照组相比,MSCs治疗组大鼠神经运动功能评分降低(P <0.05);与假手术组相比,溶剂对照组大鼠脑组织TNF-α、Caspase-3和Caspase-8表达增加(P <0.01);与溶剂对照组相比,MSCs治疗组脑组织TNF-α、Caspase-3、Caspase-8表达下降(P <0.05,P <0.01)。 结论 3-D球体MSCs移植可能通过下调脑组织中炎性因子TNF-α含量及减少凋亡相关蛋白的表达,改善大鼠脑缺血再灌注损伤后神经运动功能。     

羊栖菜多糖对TGF-β1诱导的大鼠肺成纤维细胞的影响

目的 研究羊栖菜多糖对TGF-β1诱导的大鼠肺成纤维细胞的影响,探讨其抗肺纤维化作用及机制。方法 将实验分成对照组、TGF-β1组、TGF-β1+不同剂量羊栖菜多糖组（25、50、100μg/ml）,采用MTT法检测细胞增殖,RT-PCR法检测Smad 3、Smad 7、α-SMA、Ⅰ型胶原mRNA的表达,ELISA法检测Ⅰ型胶原蛋白的表达, Western blot法检测α-SMA的表达。结果 TGF-β1能诱导肺成纤维细胞增殖及表达Smad3 mRNA、Smad7 mRNA、Ⅰ型胶原、α-SMA（P < 0.05）。羊栖菜多糖可以不同程度抑制TGF-β1诱导的肺成纤维细胞的增殖以及Smad3mRNA、Ⅰ型胶原和α-SMA的表达,且呈剂量依赖性（P < 0.05）,能促进TGF-β1诱导的肺成纤维细胞表达Smad7 mRNA, 呈剂量依赖性（P < 0.05）。结论 在离体细胞,羊栖菜多糖能抑制TGF-β1诱导的肺成纤维细胞增殖、分化与表达,其机制可能与其下调Smad3,促进Smad 7表达从而抑制TGF-β/Smads信号通路有关。     

补阳还五汤对缺氧心脏成纤维细胞旁分泌MMP-2/9、TIMP-1、TNF-α的影响

[目的] 探讨补阳还五汤对缺氧诱导心脏成纤维细胞旁分泌基质金属蛋白酶2(MMP-2)、基质金属蛋白酶9(MMP-9)、基质金属蛋白酶组织抑制因子1(TIMP-1)及肿瘤坏死因子-α(TNF-α)的影响,并从基因和蛋白水平探讨其保护心肌细胞、预防心肌纤维化的机制。[方法] 培养小鼠乳鼠心脏成纤维细胞,将其分为对照组、模型组、补阳还五汤组。采用逆转录聚合酶链式反应(RT-PCR)法和酶联免疫吸附测定(ELISA)法分别检测各组成纤维细胞和细胞培养上清液中MMP-2、MMP-9、TIMP-1及TNF-α mRNA表达和蛋白分泌。[结果] 与对照组比较,模型组MMP-2、MMP-9及TNF-α mRNA表达上调,蛋白旁分泌增加,TIMP-1表达下调(P<0.05);与模型组比较,补阳还五汤组MMP-2、MMP-9 mRNA表达下调,蛋白旁分泌减少,TIMP-1则上调(P<0.05),而TNF-α仅有下调趋势,无统计学差异(P>0.05)。[结论] 补阳还五汤可保护缺氧心肌,预防心肌纤维化。其机制可能与抑制缺氧成纤维细胞的旁分泌,调节MMP-2、MMP-9、TIMP-1的表达平衡有关。     

益气活血中药对心力衰竭大鼠MMP-1、TIMP-1影响的实验研究

[目的]观察益气活血复方对慢性心力衰竭大鼠心肌组织基质金属蛋白酶1(MMP-1)和基质金属蛋白酶组织抑制因子-1(TIMP-1)表达的影响。[方法]选用雄性SD大鼠,采用冠状动脉结扎术配合饥饿、游泳等方法造成慢性心力衰竭的动物模型。将造模成功的大鼠随机分为3组:模型组、中药组和西药对照组;中药干预6周后,将动物处死,取其心肌组织,利用实时定量荧光聚合酶链反应(PCR)技术和蛋白印迹分析法(Western blot)分别检测心肌组织中MMP-1、TIMP-1基因表达和蛋白表达。[结果]与对照组比较,大鼠模型组MMP-1的表达高于正常组(P<0.01),而TIMP-1的表达明显低于正常组(P<0.01);中药组和西药组MMP-1的表达均低于模型组(P<0.01),TIMP-1的表达明显高于模型组(P<0.01)。[结论]益气活血中药可以下调MMP-1的表达,增加TIMP-1的表达,从而阻止MMP-1对心肌细胞外基质结构的破坏作用,延缓心肌重塑,改善心脏功能,从而阻止CHF的发展。     

人脐带间充质干细胞对糖尿病肾病大鼠肾脏HIF-1α表达的影响

目的 观察人脐带间充质干细胞（HUMSC）对糖尿病肾病大鼠肾脏缺氧诱导因子（HIF-1α）表达的影响。方法 50只健康清洁级8周龄雄性SD大鼠,随机选取20只为健康对照组,其余30只采用链脲菌素复制糖尿病肾病大鼠模型（模型组）,两组大鼠饲养12周。第12周,随机选取两组大鼠各3只分别尾静脉注射DiR-HUMSCs,代谢12～16 h后在小动物活体光学3D成像系统下观察DiR-HUMSCs在大鼠体内的分布。随机选取9只模型组大鼠进行HUMSCs移植（HUMSCs移植组）。HUMSCs移植采用尾静脉注射方式移植浓度为1×10⁶个/mL HUMSCs 500 μL至大鼠体内,每周1次,连续4周,共28 d。检测3组大鼠的24 h尿蛋白定量（24 h UPro）、血清肌酐（Scr）、血尿素氮（BUN）、尿肌酐（Ucr）、尿白蛋白与肌酐比值（UACR）水平;酶联免疫吸附试验（ELISA）检测3组大鼠血清HIF-1α水平;采用PAS和Masson染色进行肾脏组织病理检测;免疫荧光法检测3组大鼠肾组织HIF-1α、Slc12A3和Aquaporin1蛋白的表达。结果 移植HUMSCs治疗4周后,与健康对照组比较,模型组和HUMSCs移植组大鼠Ucr水平降低（P <0.05）,Scr、24 h UPro、BUN、UCAR均升高（P <0.05）;与模型组比较,HUMSCs移植组大鼠Ucr水平差异无统计学意义（P >0.05）,Scr、24 h UPro、BUN、UCAR均降低（P <0.05）。糖尿病肾病大鼠病理损伤缓解,系膜增生和基底膜增厚改善,小管空泡变性减少,间质纤维化减轻。模型组大鼠血清HIF-1α水平较健康对照组升高（P <0.05）,HUMSCs移植组血清HIF-1α水平较模型组下降（P <0.05）。与健康对照组比较,模型组大鼠肾脏远端小管中HIF-1α蛋白水平增加（P <0.05）;HUMSCs移植组的HIF-1α蛋白水平较模型组降低（P <0.05）。模型组远端小管标记蛋白Slc12A3水平低于健康对照组（P <0.05）,HUMSCs移植组Slc12A3水平较模型组升高（P <0.05）。HUMSCs移植组的Aquaporin1蛋白水平较模型组和健康对照组均降低（P <0.05）。糖尿病肾病大鼠近端小管中无HIF-1α表达。结论 HIF-1α主要在糖尿病肾病大鼠肾脏远端小管表达,且HUMSCs可通过抑制HIF-1α的表达修复肾小管的损伤。     

JNK信号通路在白介素-1β介导人胚肺成纤维细胞活化中的作用

目的 探讨c-Jun氨基末端激酶（JNK）信号转导通路在白细胞介素-1β（IL-1β）介导的人胚肺成纤维细胞（FB）活化中的作用。方法 体外培养人胚肺FB,用IL-1β、JNK抑制剂（SP600125）作用于细胞,采用免疫蛋白印迹法（Western blot）检测细胞JNK/SAPK磷酸化水平和α-平滑肌激动蛋白（α-SMA）的表达,RT-PCR方法检测纤溶酶原激活物抑制剂（PAI-1）、纤维连接蛋白（FN）、神经生长因子（NGF）和α-SMA mRNA的相对表达量,ELISA法检测培养上清液中NGF及白细胞介素-6（IL-6）水平。结果 在IL-1β刺激下,人胚肺FB中α-SMA及磷酸化JNK蛋白表达显著高于对照组,同时PAI-1、FN、NGF和α-SMA mRNA的表达及培养上清液中NGF、IL-6水平均明显高于对照组（P<0.05）;SP600125显著抑制IL-1β诱导的上述指标表达增加（P<0.05）。结论 IL-1β促进人胚肺FB活化及细胞外基质聚集,JNK信号转导通路参与这一过程。     

BrdU标记法探讨糖尿病大鼠H2S与细胞外基质积聚的关系

目的 探讨硫化氢（hydrogen sulfide,H₂S）与糖尿病肾病（diabetic nephropathy,DN）大鼠肾细胞外基质过度积聚的关系。方法 21只SD大鼠随机分成正常对照组（对照组）、糖尿病肾病组（DN组）、硫化氢干预组（DN+H₂S组）。链脲佐菌素（STZ）法建立糖尿病大鼠模型,DN+H₂S组给予NaHS治疗8周,其他组给予同等剂量的0.9%生理盐水治疗。观察3组大鼠肾脏病理改变、BrdU阳性细胞和α平滑肌肌动蛋白（α-smooth muscle actin,α-SMA）分布差异。结果 与对照组比较,DN组大鼠尿蛋白量、相对肾重均明显增多,病理呈典型的DN改变,BrdU阳性细胞比值、肾小球α-SMA表达和分布显著增多（P<0.01）;应用NaHS治疗后,大鼠肾脏DN改变明显减轻（P<0.01）,BrdU阳性细胞比值、肾小球α-SMA表达和分布与正常对照组比较,差异无统计学意义（P>0.05）。结论 H₂S可以抑制DN大鼠肌性成纤维细胞增殖,减少α-SMA表达和分布,减缓DN大鼠的肾小球细胞外基质积聚。     

柴胡皂苷D对人肾小管上皮细胞转分化的影响及机制

目的探讨柴胡皂苷D(SSD)对人肾小管上皮细胞转分化的影响及其作用机制。 方法将人肾小管上皮细胞HK-2细胞分为对照组、空白溶剂对照组、肾间质纤维化(RIF)组(5 μg/L TGF-β1)、阳性对照组(5 μg/L TGF-β1+10 μmol/L贝那普利)、SSD组(5 μg/L TGF-β1+10.00 μmol/L SSD)、SSD+DKK-1组(5 μg/L TGF-β1+10.00 μmol/L SSD+100 μg/L DKK-1)。光学显微镜观察各组细胞形态变化,免疫荧光检测细胞E-钙黏素(E-cadherin)、α-平滑肌肌动蛋白(α-SMA)表达,Western blotting检测细胞基质金属蛋白酶(MMP)-7、Snail、E-cadherin、α-SMA、β-catenin蛋白表达,qRT-PCR检测细胞胶原蛋白Ⅰ(Collagen Ⅰ)相对表达量。 结果对照组、空白溶剂对照组细胞有序、紧密排列,RIF组细胞呈现出长梭形且细胞排列分散；阳性对照组、SSD组和SSD+DKK-1组中长梭形细胞较RIF组减少且细胞分散程度降低。RIF组E-cadherin荧光斑低于对照组(P＜0.05),α-SMA荧光斑和MMP-7、Snail、E-cadherin、α-SMA、β-catenin蛋白表达、Collagen Ⅰ基因相对表达量高于对照组(P＜0.05)。阳性对照组、SSD组E-cadherin荧光斑和蛋白表达高于RIF组(P＜0.05),α-SMA荧光斑和MMP-7、Snail、α-SMA、β-catenin蛋白表达、Collagen Ⅰ基因相对表达量低于RIF组(P＜0.05)。SSD+DKK-1组E-cadherin荧光斑和蛋白表达高于SSD组(P＜0.05),α-SMA荧光斑和MMP-7、Snail、α-SMA、β-catenin蛋白表达、Collagen Ⅰ基因相对表达量低于SSD组(P＜0.05)。 结论SSD可抑制人肾小管上皮细胞转分化,可能与抑制Wnt/β-catenin途径活化有关。     

蝎毒提取物对Lewis细胞及DU-145细胞转移的抑制作用

目的 观察蝎毒提取物对Lewis肺癌细胞肺转移和前列腺癌细胞株DU-145骨转移的抑制作用。方法 C57BL/6小鼠尾iv Lewis肺癌细胞（实验分模型组和给药组）,裸鼠尾iv CM-DiI标记DU-145细胞（实验分模型组、对照组和给药组）,给药组均每天ig给予蝎毒提取物300 mg/kg 1次,C57BL/6小鼠给药12 d,裸鼠给药24 d,模型组和对照组给予等量生理盐水,肉眼及镜检观察肺转移灶Lewis肺癌细胞肺转移情况,活体成像系统观察DU-145细胞骨转移的情况。在体外实验,免疫组化法检测Lewis细胞基质金属蛋白酶-9（MMP-9）的表达,免疫组化法和Western blotting检测DU-145细胞MMP-9、NF-κB、基质金属蛋白酶抑制因子1（TIMP-1）、IκB-α蛋白表达。结果 接种Lewis肺癌细胞后,蝎毒提取物组平均癌细胞肺转移灶数为3.2±1.2,而模型组为13.5±5.3,差异显著（P＜0.01）。活体成像检测显示,接种DU-145细胞30 d后,对照组未见荧光团,模型组8只裸鼠中有6只肩胛骨、骨盆、肋骨及胫骨显示有大量荧光团存在,蝎毒提取物组仅有3只裸鼠出现明显荧光团。免疫组化法和Western blotting检测显示,与对照组相比,蝎毒提取物给药后DU-145细胞MMP-9、NF-κB蛋白表达下调（P＜0.01）,TIMP-1表达上调（P＜0.01）,免疫组化检测亦显示IκB-α蛋白表达上调（P＜0.05）。结论 蝎毒提取物抑制Lewis肺癌细胞肺转移和DU-145细胞骨转移,其作用是通过NF-κB和TIMP-1途径抑制MMP-9表达实现的。     

肿瘤相关成纤维细胞通过IL-6/STAT3通路介导胰腺癌中髓源性抑制细胞的分化

目的 探讨胰腺导管腺癌（PDAC）中肿瘤相关成纤维细胞（CAF）介导髓源性抑制细胞（MDSC）分化相关作用机制及生物学意义,为揭示CAF和MDSC通过重塑胰腺癌微环境促进胰腺癌进展提供理论基础和实验依据。方法 分离纯化PDAC肿瘤组织中原代CAF,以人包皮成纤维细胞（HFF）作为对照,通过实时荧光定量PCR、酶联免疫吸附试验检测筛选CAF中表达上调的细胞因子。分别使用CAF和HFF培养上清培养人外周血单个核细胞（PBMC）,观察PBMC的分化情况,研究上述细胞因子参与调节MDSC分化、发挥募集作用的具体机制。结果 分离的原代CAF表达活化标志物α-平滑肌肌动蛋白（α-SMA）和成纤维细胞激活蛋白a（FAPa）,对照细胞HFF不表达α-SMA和FAPa。CAF培养上清中白细胞介素6（IL-6）、基质细胞衍生因子1（SDF-1）、单核细胞趋化蛋白1（MCP-1）的表达量均高于HFF培养上清（P均<0.01）,而且IL-6、SDF-1、MCP-1的表达量随培养时间的延长而增加（P均<0.01）。与HFF培养上清相比,CAF培养上清能够促进更多的PBMC分化成CD13高表达的中性粒细胞样MDSC（CD13^hi-nMDSC;P<0.01）。在培养体系中单独加入人重组IL-6蛋白可以诱导PBMC向CD13^hi-nMDSC分化（P<0.01）,单独加入人重组SDF-1或MCP-1蛋白不能诱导CD13^hi-nMDSC亚群的增加;加入IL-6中和抗体或信号转导与转录激活因子3（STAT3）抑制剂FLLL32后能够明显减少由CAF培养上清诱导的分化（P<0.05）。结论 CAF可通过IL-6/STAT3通路促进PBMC分化为CD13^hi-nMDSC。     

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.