中药复方制剂治疗变应性鼻炎临床与实验研究

目的 :中药复方制剂 (鼻炎清胶囊 )治疗变应性鼻炎临床疗效观察及实验研究。方法 :门诊患者随机设立治疗组与对照组 (鼻炎康 )进行疗效对比观察 ;制做动物模型。①观察半小时过敏性鼻炎表现 ;②大鼠被动皮肤过敏实验 ;③鼻粘膜光镜检查。结果 :治疗组总有效率 96 .8%,对照组 (鼻炎康 )总有效率 77.4%,统计学处理差异有显著性 (P <0 .0 5 ) ,治疗组疗效优于对照组。实验研究表明 ,治疗大剂量组动物症状明显较轻 ;大剂量组在两个抗血清稀释度上均能明显抑制兰斑生成 ;光镜组织学观察 ,治疗大剂量组抑制粘膜内嗜酸性细胞及嗜中性细胞浸润 ,其程度显著优于模型对照组 (P <0 .0 1) ;结论 :“鼻炎清胶囊”大剂量能明显抑制大鼠被动皮肤过敏反应 ,减少嗜酸性白细胞及炎细胞渗出 ,显示对Ⅰ型变态反应有抑制作用。     

鼻炎清颗粒对大鼠变应性鼻炎IL-4、IFN-r水平的调节作用

目的：观察鼻炎清颗粒治疗大鼠变应性鼻炎（AR）后鼻粘膜组织形态学变化和细胞因子水平，探讨该药治疗AR的部分免疫学机制。方珐：用卵清白蛋白、氢氧化铝、百白破疫苗联合致敏大鼠制成变应性鼻炎动物模型，将鼻炎清颗粒灌胃给药2周后，观察鼻粘膜组织学变化，用ELISA法检测血清中细胞因子IL-4、IFN-r水平。结果：鼻炎清颗粒治疗组中大剂量组和中剂量组血清IL-4水平明显低于模型组，差异有统计学意义（P〈0．01～0．05）；IFN-r水平明显高于模型组，差异有统计学意义（P〈0．01）；光镜观察发现，模型组鼻粘膜上皮细胞脱落、水肿、血管扩张、腺体增生，固有层内可见大量嗜酸性粒细胞、肥大细胞浸润．用药组中大剂量组和中剂量组及阴性对照组则无上述改变。结论：鼻炎清颗粒通过调节Th1和Th2细胞因子的表达．纠正失衡的Th1／Th2的细胞因子网络并抑制炎症细胞在鼻粘膜的汇集，防止其脱颗粒。对变应性鼻炎产生治疗作用。     

鼻炎敏滴鼻剂治疗变应性鼻炎的实验研究

目的　观察鼻炎敏治疗变态反应性鼻炎大鼠细胞因子及鼻粘膜组织形态学变化。方法　用卵清蛋白致敏大鼠制成变应性鼻炎动物模型 ,将鼻炎敏灌胃给药 ,用放射免疫法测定血清中细胞因子IL 2 ,IL 4浓度 ;观察鼻粘膜组织形态学变化。结果　药物治疗组血清IL 2含量明显高于模型组 ,其差异有显著性意义 (P <0 .0 5 ) ;药物治疗组血清中IL 4含量明显低于模型组 ,差异有高度显著性 (P <0 .0 5 ) ;光镜和电镜观察发现 ,模型组鼻粘膜有大量嗜酸粒细胞、肥大细胞浸润 ,并伴肥大细胞脱颗粒 ;用药组及空白对照组则无上述改变。结论　鼻炎敏滴鼻剂可使变应性鼻炎大鼠血清IL 2 ,IL 4浓度指标逆转 ,并抑制炎症细胞在鼻粘膜的汇聚 ,防止其脱颗粒     

鼻炎清颗粒对大鼠变应性鼻炎IgE、ECP水平的调节作用

目的:观察鼻炎清颗粒治疗大鼠变应性鼻炎(AR)后鼻粘膜组织形态学变化和血清特异性IgE和嗜酸粒细胞阳离子蛋白(ECP)水平,探讨该药治疗AR的部分免疫学机制。方法:用卵清蛋白、氢氧化铝、百白破疫苗联合致敏大鼠制成变应性鼻炎动物模型,将鼻炎清颗粒灌胃给药2周后,观察鼻粘膜组织学变化,用ELISA法检测血清中IgE和ECP水平。结果:鼻炎清颗粒治疗组中大、中和小剂量组的血清IgE水平分别为(26.46±6.12)、(49.11±4.48)(、70.68±7.59)ng/ml,与阳性模型组(81.03±7.54)ng/ml比较差异有统计学意义。鼻炎清颗粒治疗组中大、中和小剂量组血清ECP水平分别为(1.48±0.25)(、2.30±0.56)、(3.05±1.27)ng/ml,与阳性模型组(4.23±1.20)ng/ml比较差异有统计学意义,与小剂量组差异无统计学意义。光镜观察发现,模型组鼻粘膜上皮细胞脱落、水肿,血管扩张,腺体增生,固有层内可见大量嗜酸性粒细胞、肥大细胞浸润,用药组中大剂量组和中剂量组及阴性对照组则无上述改变。结论:鼻炎清颗粒通过降低血清特异性IgE和ECP水平并抑制炎症细胞在鼻粘膜的汇集,防止其脱颗粒,在变应性鼻炎的治疗中发挥着免疫调节作用。     

鼻炎喷剂对变应性鼻炎大鼠鼻黏膜形态及组胺含量的影响

目的：观察鼻炎喷剂对变应性鼻炎（AR）大鼠鼻黏膜形态及组胺含量的影响。方法：选用雄性SD大鼠60只,随机分为6组：正常对照组、模型组、鼻炎喷剂低剂量组、鼻炎喷剂中剂量组、鼻炎喷剂高剂量组、西药对照组。采用卵清蛋白喷雾致敏造成大鼠AR模型,各治疗组采用相应药物滴鼻给药。治疗15 d后,光镜下观察各组大鼠鼻黏膜形态改变,并用荧光分光光度计测定鼻黏膜组胺含量。结果：模型组大鼠可见鼻黏膜水肿、充血,炎症细胞及嗜酸性粒细胞浸润;各治疗组鼻黏膜病变明显改善。模型组鼻黏膜组胺含量升高,各治疗组组胺含量显著降低（P〈0.01）。结论：鼻炎喷剂可减轻鼻黏膜病变、降低鼻黏膜组胺含量达到治疗AR的目的。     

稀土硝酸铈治疗变应性鼻炎的实验研究

目的：研究硝酸铈治疗实验性变应性鼻炎的治疗效果。方法：健康豚鼠39只随机分成正常对照组,变应性鼻炎组：用2,4-二异氰酸甲苯酯（2,4-Toluene—Dissocya—nate,TDU作致敏原,经鼻腔滴入建立变应性鼻炎模型。治疗期间变应性鼻炎组动物随机分成阳性对照组、药物治疗对照组、硝酸铈治疗组3组,正常对照组设为阴性对照组,治疗15d。观察症状体征、鼻分泌物涂片、鼻粘膜组胺含量和光镜和电镜下鼻粘膜组织形态学的变化。结果：阳性对照组出现鼻痒、喷嚏、流清涕,鼻分泌物嗜酸性粒细胞增多,鼻粘膜组胺含量增多,嗜酸性粒细胞浸润,鼻粘膜细胞超微结构改变。与阳性对照组相比,硝酸铈治疗组上述变化明显减轻。结论：硝酸铈治疗变应性鼻炎有效。     

变应性鼻炎豚鼠鼻粘膜组胺含量对血流量的影响

目的：探讨变应性鼻炎豚鼠不同病程中鼻粘膜组胺含量对血流量的影响。方法：６０只豚鼠随机分成正常组和致敏组（ｎ＝３０），分别检测致敏后激发前和激发后即刻，２４，４８，７２ｈ豚鼠鼻粘膜中的组胺含量，每组动物处死前均用激光多谱勒探测仪测定其鼻粘膜血流量，用直线相关与回归分析比较不同时相点豚鼠鼻粘膜中的组胺含量与鼻粘膜血流量的关系。结果：致敏原激发前致敏组动物鼻粘膜中组胺含量和鼻粘膜血流量均明显高于正常对照     

蛔虫变应原致过敏性鼻炎豚鼠模型建立

为了建立蛔虫变应原致过敏性鼻炎的实验动物模型,将健康豚鼠３０只,随机分为致敏组（ｎ＝２０）和对照组（ｎ＝１０）。致敏组经腹腔、四肢皮下注射蛔虫变应原免疫４周后,鼻腔雾化吸入蛔虫变应原;对照组以生理盐水代替变应原。结果致敏组１８只出现鼻痒、喷嚏、流清涕等过敏性鼻炎的临床症状（评分〉５分）,鼻腔分泌物涂片见大量嗜酸性粒细胞,以及鼻粘膜水肿、粘膜嗜酸性粒细胞和肥大细胞浸润等组织学变化,而对照组无上述变化     

豚鼠和新西兰兔变应性鼻炎模型建立及比较

目的:旨在比较不同动物在不同剂量致敏原诱导下形成变应性鼻炎模型的特点.方法:采用甲苯-2,4-二异氰酸酯(Toluene-2,4-diisocyanate,TDI)致敏豚鼠和新西兰兔制作变应性鼻炎动物模型,在豚鼠和新西兰兔组中又各自使用高低两种TDI剂量.记录建模过程中动物症状体征评分,典型表现;末次激发后行鼻黏膜组织病理学检查及组胺含量测定;记录动物死亡率和建模成功率;对死亡动物行呼吸道解剖和组织病理学检查,探索死亡原因.结果:豚鼠和新西兰兔均能在TDI诱导下形成变应性鼻炎典型症状体征,模型组动物鼻黏膜见大量以嗜酸性粒细胞为主炎症细胞浸润且组胺含量明显增高(与空白对照组比较P<0.01).但不同动物之间,以及相同动物在不同给药剂量下,其症状体征出现的时间、典型表现、鼻黏膜嗜酸性粒细胞浸润程度、鼻黏膜组胺含量高低、建模死亡率、成功率等均有较大差异.动物死亡原因与药物剂量和变态反应均有一定关系.结论:豚鼠和新西兰兔在不同药物剂量下均可成功建模,但成模特点差异较大,应根据研究目的不同选取所需模型.     

克鼻敏对过敏性鼻炎豚鼠鼻粘膜和血组胺的影响

２，４－二异氰酸甲苯酯致敏豚鼠符合鼻变态反应，出现典型的鼻痒、喷嚏、流涕症状。实验表明：克鼻敏可减少鼻局部症状的积分值（Ｐ〈０．００１），并优于立复汀对照组。结果还显示克鼻敏对致敏豚鼠鼻粘膜肥大的高含量有明显的抑制作用（Ｐ〈０．００５）。同时亦降低血中含量，说明其作用是通过降低变压原对肥大细胞的刺激，减少组胺释放，从而有效地控制变应性鼻炎发生的。     

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.