胆囊结石易患人群筛选方法的研究

作者研究了５１例胆囊结石患者和９例非胆石患者的血清脂质和胆汁胆固醇饱和指数。结果表明：（１）结石组与非结石组之间ＣＳＩ的差异无显著意义。（２）用逐步判别法对两组血清脂质指标进行分析，提示由ａｐｏＡ－１，ＨＤＬ－Ｃｈ和ＬＤＬ－Ｃｈ所构成的判别函数（Ｐ＜０．０５），对胆石与非胆石人群有良好的区分作用，其内部检验符合率和外推检验符合率分别为８４％和７０％。     

威灵仙预防胆结石的实验研究

金黄地鼠服用致石膳食可形成胆石模型，作者用该模型观察中药威灵仙对胆石的预防作用。结果显示：威灵仙水煎剂具有明显的预防胆石形成作用，给药组成石率为７．７％，与对照组（５３．３％）比较有显著差异（Ｐ＜０．０５），其效果与服用熊去氧胆酸相似。此外，威灵仙大剂量组可降低血清胆固醇的水平。     

威灵仙预防胆结石的实验研究

金黄地鼠服用致石膳食可形成胆石模型，作者用该模型观察中药威灵仙对胆石的预防作用，结果显示：威灵仙水煎剂具有明显的预防胆石形成作用，给药组成石率为７．７％，与对照组（５３．３％）比较有显著差异（Ｐ〈０．０５），其效果与服用熊去氧胆酸相似，此外，威灵仙大剂量组可降低血清胆固醇的水平。     

高脂饮食与大鼠在体动脉内皮素合成关系的研究

采用动脉内皮铺片方法，以免疫组化技术检测动脉内皮内皮素（ＥＴ）阳性细胞率，观察高胆固醇饮食动物与在体动脉内皮细胞胞浆ＥＴ阳性率的关系。结果显示，高脂饮食动物动脉内皮ＥＴ阳性细胞率显著高于对照组（Ｐ＜０．０１），高脂饮食持续时间愈长，其动脉内皮ＥＴ阳性细胞率愈高。开始高胆固醇饮食前及之后４、８、１２周ＥＴ阳性细胞率分别为（０．６９±０．３８）％、（１．４２±０．４０）％、（５．２２±０．９８）％、（１０．６６±１．４４）％。     

细菌L型与胆囊结石的成因研究

探讨细菌Ｌ型在胆囊结石、胆囊炎发病中的意义。方法：应用高渗培养抚育地胆囊结石、胆囊炎病例１３０份的胆囊胆汁标本进行了普通菌及Ｌ型菌联合培养。另外对其中胆囊切除标本行革兰染色，于光镜油镜下观察。结果：胆囊疾病组细菌Ｌ型总检出率为５９．２３％，对照组为５．０％；各种类型胆囊结石胆汁中以胆色素类结石检出率最高，为８８．８９％，其次为混合性胆石（８０．０％），胆固醇类胆石（５４．８４％）和黑色结石（５０．     

铝对大鼠海马CA＿3区突触传递的长时程增强的阻抑作用

为探讨铝对学习记忆功能的影响及机制，３０只大鼠分别用基础饲料和添加铝的饲料喂养１２个月后，记录给予高频刺激前后诱发的大鼠海马ＣＡ３区群体峰电位（Ｐｓ）幅度变化。结果：基础饲料组在高频刺激后ＰＳ幅度加大，即引起了突触传递的长时程增强（ＬＴＰ）；低铝组和高铝组高频刺激前ＰＳ幅度分别为基础饲料组［（４４９．６±９２．５）μＶ］的５１．４％和２５．２％（均为Ｐ＜０．０５），但高频刺激仍可使低铝组产生ＬＴＰ，而高铝组未出现ＬＴＰ。ＣＡ３区微量注射ＮＯ清除剂血红蛋白（Ｈｂ）后基础组和低铝组ＰＳ幅度分别减至注射Ｈｂ前的（３４．７±１０．９）％和（２６．１±１２．９）％，高铝组无明显改变。结果提示铝可降低ＣＡ３区ＰＳ幅度和阻止ＬＴＰ形成，此作用与铝剂量有关，ＮＯ途径也可能参与铝的作用。     

饮食对仓鼠胆石形成及溶解的实验研究

本实验采用高精制糖和高动物脂肪饲料诱使幼年仓鼠形成胆固醇石(Ch S),低蛋白饲料诱使成年仓鼠形成胆色素石(P S)。4周后两组成石率分别为81.56%和89.77%。恢复正常饲料8周后,两组动物所形成的胆石均明显减少,部分动物中胆石完全消失。成石期Ch S组动物胆汁呈胆固醇过饱和,P S组胆汁中未结合胆红素显著增加;两组胆汁诸胆汁酸普遍减少。溶石期末两组仓鼠胆汁成分又趋正常。结果提示,饮食与胆石形成及其类型和所形成胆石的重新溶解有密切关系。     

深圳地区50份胆石分析

目的了解深圳地区胆石的特点,指导临床治疗。方法对1998年1月至2006年10月在深圳盐田区人民医院行外科手术取得的50份胆石进行胆石成份、微量元素及实验室检查等方面的研究。结果50份胆石中,19份（38%）属胆固醇类结石（CS）,31份（62%）属胆红素类结石（PS）,CS：PS=1：1.68,按性别分类,男：女=1：1.5。其中16份来自胆囊结石,女性占75%,男性占25%。按成分分类CS占52.5%,而PS占37.5%。胆红素类结石患者的胆汁培养阳性率比胆固醇类结石患者显著高。提示胆红素类结石的形成与胆道系统感染有关。我们通过对30份胆石的微量元素（Ca、Fe、Mg、Cu、Mn、Zn）等的测定,发现无显著性差异。结论深圳地区胆石以胆红素类结石为主,PS：CS为1.68：1,女性患者居多,男女比为1：1.5;女性患者好发胆囊结石,且以胆固醇类结石为主;胆红素类结石患者的胆汁培养阳性率比胆固醇类结石患者高;胆红素类结石其Ca、Fe、Mg、Cu等金属离子的含量比胆固醇类结石高,而Mn、Zn的含量则无明显差异。不同部位的胆石其微量元素含量无显著差异。     

胆汁蛋白质的氨基酸分析

为了在Ｂ超引导下胆囊穿刺灌注溶石药前，估计结石成份，选择适当药物，作者对胆固醇结石患者（７例）及正常对照组（７例）胆囊胆汁中的蛋白质进行了其主要氨基酸的测定。结果表明：胆固醇结石患者的酸性氨基酸含量（１２．２６±５．５３％）较对照组（７．０９±４．５１％）增高（Ｐ＜０．１），结石患者胆汁蛋白质总含量较对照组显著增高（Ｐ＜０．０１）。     

人体胆石中的自由基信号初探

目的；探讨自由基对胆色素结石形成的影响。方法；用电子顺磁共振谱（ＥＰＲ）分析胆石，用ＦＴ－ＩＲ测定胆红素钙含量。结果；胆固醇结石的ＥＰＲ信号很弱或检测不出，胆色素结石则可同时具有自由基和过渡金属离子的ＥＰＲ特征，其中心谱线（ｇ＝２．００４０，线宽＝９．５Ｇ）由自由基引起，且强度与胆石中胆红素钙的含量正相关（ｒ＝＋０．９９５，Ｐ〈０．００１）。结论；胆色素结石中存在源于胆红素类化合物的自由基。自由基     

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.