参附注射液对大鼠肠缺血再灌注时肠上皮细胞Caspase-3、Bcl-2基因表达的影响

目的 :研究参附注射液对大鼠肠缺血再灌注期间粘膜上皮细胞凋亡的影响 ,并探讨其可能机制。方法 :采用大鼠肠缺血再灌注模型。 2 4只大鼠随机分为对照组 (C组 )、缺血再灌注组 (I/R组 )和参附治疗组 (SF组 ) ,SF组于阻断前 30min静注SF液 2ml·(1 0 0 g) -1 。再灌注 2h检测回肠粘膜上皮细胞casapse 3、Bcl 2蛋白的表达及细胞凋亡 ;同时观察小肠粘膜病理形态学改变。结果 :①凋亡细胞检测显示 :I/R组凋亡细胞显著增多 ,SF组凋亡细胞数较I/R组显著减少而多于C组 (均P <0 .0 5 )。②casapse 3、Bcl 2蛋白的表达 :caspase 3表达I/R组显著多于SF组和C组 (P <0 .0 1 ) ,SF组与C组无明显差异 ;Bcl 2表达SF组显著高于I/R组 (P <0 .0 5 ) ,后者显著低于C组 (P <0 .0 5 )。③SF组小肠粘膜病理损伤程度明显减轻I/R组 (P <0 .0 1 )。结论 :参附注射液通过抑制caspase 3表达和促进Bcl 2基因表达减少缺血再灌注期间肠粘膜上皮细胞的凋亡 ,从而减轻肠粘膜缺血再灌注损伤     

吡那地尔对大鼠心肌缺血/再灌注时细胞凋亡及fas基因表达的影响

目的　探讨 ATP敏感性钾通道 (KATP)开放剂吡那地尔对大鼠心肌缺血 /再灌注时心肌细胞凋亡及 fas基因蛋白表达的调节作用 .方法　 4 0只大鼠随机分成 4组 :1假手术组 (仅穿线而不结扎 ,观察 6 .5 h) ;2缺血 /再灌注组(缺血 30 min,再灌注 6 h) ;3吡那地尔组 (缺血前 10 m in静推吡那地尔 0 .2 mg· kg- 1 ,然后缺血 30 min/再灌注 6 h) ;4吡那地尔 +优降糖组 (缺血前 10 min静推吡那地尔 0 .2 m g·kg- 1 +优降糖 3mg·kg- 1 ,然后缺血 30 min/再灌注 6 h) .称质量法计算心肌梗死范围 ,以缺口末端标记法 (TUNEL)检测凋亡细胞 ,以 SABC免疫组化法检测 fas蛋白的表达 .结果　缺血 /再灌注组出现显著的心肌细胞凋亡 ,伴有 fas蛋白表达指数升高 (P<0 .0 1vs假手术组 ) ;吡那地尔可抑制心肌细胞凋亡 ,并显著下调 fas蛋白的表达 (P<0 .0 5 ) ,而优降糖可取消吡那地尔的作用 .结论　细胞凋亡及 fas基因表达改变参与了心肌缺血 /再灌注损伤过程 ,KATP开放剂 (吡那地尔 )可抑制心肌细胞凋亡、下调 fas基因的蛋白表达 .     

小剂量FK506预处理对大鼠小肠移植缺血再灌注损伤中细胞凋亡的影响

目的 :研究小剂量FK5 0 6预处理对大鼠小肠移植缺血再灌注 (ischemia/reperfusion ,I/R)损伤中细胞凋亡的影响 .方法 :建立大鼠小肠移植I/R损伤模型 ,FK5 0 6预处理方式为大鼠浅麻醉后按 0 .3mg·kg-1 剂量通过尾静脉注射 ,自然环境恢复 6h后行异位节段性小肠移植术 ;免疫荧光细胞化学方法检测移植肠凋亡细胞 ;免疫组化方法测定移植肠中热休克蛋白 70 (HSP70 )表达 .结果 :小肠移植I/R损伤造成小肠粘膜细胞凋亡增加 ,小剂量FK5 0 6预处理可有效减少I/R损伤引起的细胞凋亡 ,荧光强度定量分析表明 ,同虚假手术组相比 ,I/R组各时相点荧光强度明显增强 (0 .5 ,6 .0 ,2 4 .0h ,P<0 .0 1 ) ;FK5 0 6预处理组各时相点荧光强度与I/R组相比明显减少 (0 .5h ,P <0 .0 5 ;6 .0h ,P <0 .0 5 ;2 4 .0h ,P <0 .0 1 ) ;虚假手术组无HSP70表达 ,I/R组再灌注后 0 .5和 6 .0h未见HSP70表达 ,2 4 .0h可见有少量HSP70表达 ,FK5 0 6预处理组再灌注后 0 .5h即可见有少量HSP70表达 ,6 .0h时表达增多 ,再灌注后 2 4 .0h ,HSP70表达至高峰 .结论 :小剂量FK5 0 6预处理可有效减少I/R引起的细胞凋亡 ,减轻大鼠移植肠的缺血再灌注损害 ;这种保护作用与热休克蛋白的合成有关     

高氧液对兔全脑缺血再灌注损伤生化指标的影响

目的　探讨高氧液对兔全脑缺血再灌注损伤的保护作用 .方法　 18只家兔随机分 3组 (n=6 ) .用夹闭双侧颈总动脉加降压法建立全脑缺血模型 .A组再灌注时用平衡液 2 0m L· kg- 1 静脉推注 (对照组 ) ;在再灌注时用高氧液 2 0 m L·kg- 1 静脉推注 (治疗组 ) ;C组于实验前 3d用高氧液 2 0 m L·kg- 1静脉推注每日 1次 (预处理组 ) .各组在缺血前、缺血 2 0min和再灌注 4 5 min抽取颈内静脉血测定血浆一氧化氮(NO) ,超氧化物歧化酶 (SOD)和丙二醛 (MDA) .结果　再灌注后 B组和 C组 MDA含量明显低于 A组 (P<0 .0 1或 P<0 .0 5 ) ,B组和 C组血浆 SOD活性高于 A组 (P<0 .0 5 ) .B组和 C组血清 NO含量明显低于 A组 (P<0 .0 1或 P<0 .0 5 ) .结论　高氧液对神经元缺血损伤具有保护作用 .     

超速起搏预适应对缺血再灌注心室肌有效不应期及其离散度的影响

目的　观察超速起搏预适应对缺血再灌注 (I/ R)心室肌有效不应期 (ERP)及不应期离散度的影响。　方法　 4 8只健康家兔分为对照组 (C组 )、缺血再灌注组 (IR组 )、起搏预适应早期保护作用组 (EP组 )和延迟保护作用组 (DP组 )。观察 3个试验组 I/ R心肌超微结构、心室肌 ERP及 ERP离散度变化。　结果　 (1 )电镜下 EP组和 DP组心肌细胞超微结构损伤较 IR组明显减轻。 (2 ) EP及 DP组 ERP缺血早期 (I5min)较缺血前 (I前)延长 ,缺血晚期 (I30 min)和再灌注早期 (R5 min,R1 5 min)较缺血前明显缩短。与 IR组相比 ,EP及 DP组 I5 min和 I1 5 min的心室肌 ERP明显缩短 ,I30 min明显延长 (P<0 .0 5 )。(3)缺血期各时点和 R5min的心室肌 ERP离散度较 IR组明显减少 (P<0 .0 5 )。　结论　超速起搏预适应可明显减轻兔 I/ R时心肌细胞超微结构损伤 ,其抗 I/ R心律失常的重要机制可能是明显减轻缺血期和再灌注早期心室肌 ERP离散度     

缺血预处理对大鼠缺血再灌注小肠能量代谢、Bcl-2和Bax表达的影响

目的:探讨缺血预处理对小肠细胞能量代谢和凋亡基因bcl-2,bax表达的影响及它们与肠细胞凋亡的内在联系. 方法:健康SD大鼠36只,雌雄不限,随机分为3组,空白对照组(C组)、缺血预处理组(IPC-I/R组)和缺血再灌注组(I/R组),每组12只. 按Murry法制备缺血预处理模型,I/R组用血管钳夹闭肠系膜前动脉1 h,再灌注2 h, IP-I/R组用血管钳夹闭肠系膜前动脉10 min松开10 min,反复4次,余同I/R组. 高效液相色谱法测定ATP,ADP含量;免疫组化检测Bcl-2及Bax蛋白的表达,每组选24个视野分别测量A值. TUNEL法检测凋亡的小肠细胞并计算凋亡指数. 结果:C和IPC-I/R组ATP含量高于I/R组(P<0.05);IPC-I/R组Bcl-2 A值高于C组和I/R组(P<0.01),I/R组Bcl-2 A值低于C组(P<0.05);I/R组Bax A值明显高于C组和IPC-I/R组(P<0.01),且IPC-I/R组高于C组(P<0.05);与C组比较,I/R组和IPC-I/R组凋亡指数较高(P<0.01, P<0.05);与I/R组相比,IPC-I/R组凋亡指数较低(P<0.01). 结论:缺血预处理能在一定程度上延缓ATP降解并调控Bcl-2及Bax蛋白的表达、抑制缺血再灌注介导的小肠细胞凋亡.     

醒脑静注射液对脑缺血-再灌注损伤家兔血清白介素-8的影响

目的 :观察醒脑静注射液 (XNJI)对脑缺血 再灌注损伤 (CIRI)家兔血清白介素 8(IL 8)水平的影响 ,并探讨其脑保护机制。方法 :2 8只家兔随机分为假手术对照组 (C组 )、缺血再灌注组 (I R组 )和醒脑静注射液组 (XNJI组 ) ,分别在缺血前、缺血 3 0min、再灌注 3 0min、60min、12 0min时取静脉血 ,测定血清IL 8浓度 ,实验结束后取脑组织观察脑超微结构的变化。结果 :脑缺血 再灌注期间 ,I R组不同时点血清IL 8水平明显高于XNJI组 ,缺血 3 0min为 (0 .62± 0 .18)ng·L-1及 (0 .43± 0 .0 8)ng·L-1,P <0 .0 5 ;再灌注 3 0min ,为血清IL 8水平 (0 .73± 0 .19)ng·L-1及 (0 .45± 0 .0 9)ng·L-1;再灌注 60min ,血清IL 8水平为 (0 .87± 0 .2 9)ng·L-1及 (0 .47± 0 .0 6)ng·L-1;再灌注 12 0min血清IL 8水平为 (1.0 3± 0 .43 )ng·L-1及 (0 .44± 0 .0 7)ng·L-1,再灌注各时点组均P <0 .0 1,超微结构发生异常改变 ;XNJI组不同时点血清IL 8浓度显著低于I R组 (XNJI组缺血 3 0min为(0 .48± 0 .0 7)ng·L-1,P <0 .0 5 ;再灌注 3 0min为 (0 .5 0± 0 .0 8)ng·L-1;再灌注 60min为 (0 .5 5± 0 .14)ng·L-1;再灌注 12 0min为 (0 .5 9± 0 .17)ng·L-1,再灌注各时点组P <0 .0 1) ,其超微结构异常改变较I R组     

芬太尼对家兔缺血再灌注期心肌组织及血清IL-6、TNF-α的影响

目的 :观察芬太尼对家兔缺血再灌注期心肌组织及血清白介素 6 (IL 6 )、肿瘤坏死因子 (TNF α)的影响。方法 :2 4只家兔随机分为 3组。假手术组 (C组 )、缺血再灌注组 (IR组 )和芬太尼组 (F组 ) ,每组 8只。IR组行冠状动脉左前降支阻断 30min ,再灌注 3h ,于缺血前 5min(I0 )、缺血 30min(I1 )、再灌注 1h(R1 )和 3h(R2 )取颈内静脉血并于实验结束取心肌组织 ,分别测定IL 6和TNF α浓度 ,光镜下观察心肌病理结构变化。F组缺血前 2 0min缓慢静注芬太尼 5 0 μg kg后 ,以 4 0 0 μg (kg·h)速度维持 ;C组仅分离血管 ,不阻断血流 ,采样时点和检测指标均同IR组。结果 :IR组血清IL 6在R1 和R2 时持续升高 (P <0 .0 1) ,TNF α在I1 时显著升高 (P <0 .0 1) ,TNF α和IL 6水平同F组和C组差别有显著性 (P <0 .0 1) ;心肌组织中IL 6和TNF α含量明显增加 ,同F组和C组比差异有高度显著性 (P<0 .0 1)。F组血清IL 6在R2 时升高 ,为I0 的 1.33倍 (P <0 .0 5 ) ,TNF α在I1 及R1 时升高 (P <0 .0 5 ) ,R2 时降低 (P>0 .0 5 ) ;心肌组织IL 6、TNF α虽较C组有升高 ,但明显低于IR组 (P <0 .0 1)。光镜下F组心肌水肿较轻 ,白细胞浸润较少 ;IR组水肿严重 ,白细胞明显浸润。结论 :芬太尼抑制缺血再灌注心肌组织和血清IL 6?     

缬沙坦对缺血再灌注损伤大鼠心肌能量代谢的影响

目的 研究缬沙坦对大鼠心肌缺血再灌注能量代谢方面的作用及其作用机制。 方法 将50只雄性SD大鼠随机等分为5组：假手术组(0.9%氯化钠溶液2ml/d)、I/R组(0.9%氯化钠溶液2ml/d)、缬沙坦组(缬沙坦30mg·kg-1·d-1)、缬沙坦+L-NAME组(缬沙坦30mg·kg-1·d-1、L-NAME15mg/kg)、L-NAME组（L-NAME15mg/kg）。每日清晨灌喂,2周后制作大鼠在体心肌缺血再灌注模型。L-NAME于缺血前15min尾静脉注射。再灌注结束后测定大鼠心肌组织中NOS含量、ATP含量及ATP酶活性,并在电镜下检测大鼠心肌组织超微结构的变化。结果 缬沙坦组与I/R组比较,NOS含量、ATP含量及ATP酶活性差异有显著统计学意义（P<0.01）,心肌超微结构异常改变显著减轻;缬沙坦+L-NAME组与缬沙坦组比较,NOS含量、ATP含量及ATP酶活性差异有显著统计学意义（P<0.01）;与I/R组比较,差异无统计学意义（P>0.05）;单独应用L-NAME组对NOS含量、ATP含量及ATP酶活性基本无影响（P>0.05）。结论 缬沙坦可以明显改善大鼠缺血再灌注损伤心肌的能量代谢,其与清除氧自由基,减轻钙超载等途径有关,一氧化氮合酶(NOS)-NO途径可能是其途径之一。     

缺血预处理对再灌注心肌肿瘤坏死因子-α、白介素-6的影响

目的观察缺血预处理对家兔心肌缺血再灌注期(MIR)血清及心肌组织中肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)的影响,并探讨其心肌保护机制。方法24只家兔随机分为3组,每组8只:空白组(C组)、缺血再灌注组(IR组)和缺血预处理组(IP组)。IP组阻断冠状动脉左前降支(LAD)5min,恢复血流10min后,再行缺血30min,再灌3h;IR组仅单纯缺血30min,再灌3h;C组仅分离血管,不阻断血流。各组分别于缺血前5min(I0)、缺血30min(I1)、再灌注1h(R1)和3h(R2)取颈内静脉血,IP组于缺血5min,再灌注10min时(IP)加抽一次血样,3组实验结束取心肌组织,批量测定血清及心肌组织中TNF-α、IL-6浓度,光镜下观察心肌病理结构变化。结果IP组血清TNF-α于IP时点迅速增高(P<0.01),I1~R2恢复至基值;IR组I1~R2增高,分别是I0的1.61、1.50倍。IP组血清IL-6在I1时有增高趋势,但无统计学意义(P>0.05),R1、R2与I0比无变化;IR组于R1迅速增高,R1、R2分别是I0的1.56、1.74倍。IP组心肌TNF-α、IL-6高于C组(P<0.01),显著低于IR组(P<0.01)。光镜下IP组心肌水肿与白细胞浸润程度较IR组明显减轻。结论IP对TNF-α、IL-6合成分泌的调控可能是IP保护再灌注心肌的又一个机制。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.     

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.