丙泊酚对睡眠剥夺大鼠甲状腺PI3K/Akt通路及细胞凋亡的影响

目的 探讨丙泊酚对睡眠剥夺(SD)大鼠甲状腺磷脂酰肌醇3激酶(PI3K)/蛋白激酶B(Akt)通路及细胞凋亡的影响.方法 Sprague Dawley大鼠50只分为正常组(Normal组)、SD模型组(SD组)、丙泊酚低剂量组(10mg/kg)、丙泊酚中剂量组(25mg/kg)、丙泊酚高剂量组(50mg/kg),每组10只.除Normal组模拟正常睡眠外,其余各组大鼠均建立SD模型,造模成功后丙泊酚各组腹腔注射相应剂量药物,Normal组和SD组腹腔注射等量生理盐水.观察各组大鼠毛色、行为等一般行为状况,称取大鼠体重,检测血清游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平;取甲状腺组织称重,HE染色观察甲状腺病理变化;TUNEL染色观察甲状腺组织细胞凋亡;Western blot检测甲状腺组织PI3K、p-Akt、半胱氨酸天冬氨酸蛋白酶3(caspase-3)、B细胞白血病2(Bcl-2)蛋白表达水平.结果 与Normal组相比,SD组大鼠出现甲状腺组织滤泡腔减小、高度增生等病理损伤,体重及甲状腺重量、血清FT4水平、甲状腺组织PI3K、p-Akt、Bcl-2蛋白表达水平降低(P＜0.05),血清FT3、TSH水平、甲状腺细胞凋亡率、caspase-3蛋白表达水平升高(P＜0.05);与SD组相比,丙泊酚低、中、高剂量组大鼠甲状腺病理损伤减轻,体重、甲状腺重量、血清FT4水平及甲状腺组织PI3K、p-Akt、Bcl-2蛋白表达水平升高(P＜0.05),血清FT3、TSH水平、甲状腺细胞凋亡率、caspase-3蛋白表达水平降低(P＜0.05),且丙泊酚各剂量组上述指标呈剂量依赖性.结论 丙泊酚可激活SD大鼠甲状腺组织PI3K/Akt通路的蛋白表达,抑制甲状腺细胞凋亡和损伤,改善机体甲状腺激素分泌紊乱.     

血硫化氢与肠缺血-再灌注损伤大鼠凝血功能的相关性研究 斯伟宏 卢根林 黄惊鸿 吴爱兵

【】 目的 ： 观察硫化氢与肠缺血-再灌注损伤大鼠凝血功能的相关性。方法： 雄性Wistar大鼠24只,分为S(假手术)组、I（缺血-再灌注）组,N（缺血-再灌注 NaHS）组,每组8只。S组仅行剖腹及游离肠系膜上动脉（SMA）,I 和N组剖腹、游离及钳夹肠SMA 60min和再灌注120min,建立大鼠肠缺血-再灌注损伤模型。N组于再灌注前10min静脉注射NaHS 100μmol/kg后,按1mg(kg/ h)持续静脉注射直到再灌注2h,S和I组静脉注射相同体积的生理盐水,作用时间和持续时间均同N组。留取血测定H2S、凝血功能指标。结果: N组凝血酶原时间（prothrombin time,PT）、活化部分凝血酶时间（activated partial thromboplastin time,APTT)、凝血酶时间（thrombin time ,TT）、D-二聚体均低于I组、高于S组（p＜0.01）,N组H2S、纤维蛋白原（fibrinogen,FIB）FIB低于S组、高于I组（p＜0.01）。H2S与FIB呈正相关（r= 0.758, p＜0.01）,与PT 、APTT、TT、D-二聚体呈负相关（r= -0.715、-0.721、-0.689、-0.748, p＜0.01）。结论 H2S能有效纠正肠缺血-再灌注损伤大鼠凝血功能障碍。     

新生儿凝血功能检查及临床意义初探

目的：探讨新生儿早期的凝血状态及临床意义。方法以贵州省人民医院出生的新生儿为研究对象,其中早产组为153例早产儿（27～36＋6周）,肺炎组为63例新生儿肺炎,窒息组为65例轻度窒息新生儿,吸入组为61例新生儿胎粪吸入综合征,呼吸组为31例呼吸窘迫综合征,对照组为健康足月新生儿28例。使用sysmexCA7000自动血凝分析仪检测受检者血液样本凝血四项（APTT、PT、FIB、TT）,分析各组指标显著差异性。结果新生儿早产组APTT、PT、TT均明显高于对照组, FIB、PLT低于对照组,结果差异均有显著性（P＜0.05）;肺炎组APTT、PT均明显高于对照组,FIB低于对照组,具有显著差异（P＜0.05）,PLT、TT差异无统计学意义（P＞0.05）;窒息组FIB、PLT低于对照组,PT、TT高于对照组,差异均有显著性（P＜0.05）, APTT无统计学差异（P＞0.05）;吸入组FIB低于对照组,TT、PT高于对照组,差异有统计学意义（P＜0.05）,APTT、PLT无统计学差异（P＞0.05）;呼吸组APTT、PT、TT高于对照组,FIB低于对照组,差异有显著性（P＜0.05）,PLT结果无统计学差异（P＞0.05）。结论新生儿在不同情况下,凝血四项均表现出差异性,及时检测凝血指标,对新生儿凝血功能紊乱作出诊断并预防具有重要的意义。     

白芨多糖对大鼠血小板聚集、疑血功能及TXB2、6-keto-PGF1α表达的影响

目的：观察白芨多糖对大鼠血小板聚集、凝血功能及血浆血栓素B2（TXB2）、6-酮-前列腺素F1α（6-keto-PGF1α）水平的影响,探讨白芨多糖的止血机制.方法：健康SD大鼠60只,随机分为正常对照组（生理盐水）、白芨多糖高剂量组（12 g/kg）、白芨多糖中剂量组（6 g/kg）、白芨多糖低剂量组（3 g/kg）、云南白药组（0.4g/kg）,连续给药14 d;股动脉采血,测定各组大鼠血小板聚集率、凝血酶原时间（PT）、凝血酶时间（TT）、部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、TXB2和6-keto-PGF1α水平.结果：与空白对照组比较,白芨多糖中、高剂量能增加大鼠血小板聚集率,缩短PT、APTT和TT,显著增加FIB、TXB2含量和降低6-keto-PGF1α含量（P＜0.05或P＜0.01）.结论：白芨多糖可能通过激活内源性,外源性凝血系统,促进血小板聚集和调节TXB2、6-ke-to-PGF1α的水平,发挥止血功能.     

1，25（OH）2D3对人系膜细胞增殖及PI3K/Akt信号通路的影响

目的 观察1,25-二羟维生素D3〔1,25（OH）2D3〕对人系膜细胞（HMC）增殖及Akt、mTOR表达的影响,探讨PI3K/Akt信号通路在1,25（OH）2D3对HMC增殖调控中的作用。方法 体外培养HMC,取传代培养至第3～7代细胞分为4组：正常对照组（N组）、1,25（OH）2D3组（10-8 mol/L,VD组）、PI3K抑制剂干预组（LY294002 2 μg/ml,LY组）,LY294002（2 μg/ml）联合1,25（OH）2D3组（10-8 mol/L）组（LY+VD组）,干预48 h,倒置相差显微镜观察各组细胞生长,CCK-8法检测各组细胞增殖,流式细胞术检测各组细胞周期时相分布,Western blotting检测各组Akt、p-Akt、mTOR、p-mTOR表达的情况。结果 各实验组吸光度值（A值）比较,差异有统计学意义（F=281.641,P＜0.01）,其中VD组、LY组和LY+VD组A值均低于N组,LY+VD组A值均分别低于VD组和LY组,差异均有统计学意义（P＜0.01）。各实验组G2/M期比较,差异无统计学意义（P＞0.05）。各实验组G1期、S期和PI比较,差异均有统计学意义（P＜0.05）;其中VD组、LY组和LY+VD组G1期均高于N组,S期和PI均低于N组,LY+VD组G1期均高于VD组,S期和PI均低于VD组,差异均有统计学意义（P＜0.05）。各实验组Akt/β-actin、mTOR/β-actin灰度值比较,差异无统计学意义（P＞0.05）。各实验组p-Akt/Akt、p-mTOR/mTOR灰度值比较,差异有统计学意义（P＜0.05）;其中VD组、LY组和LY+VD组p-Akt/Akt、p-nmTOR/mTOR灰度值均低于N组,LY+VD组p-Akt/Akt、p-nmTOR/mTOR灰度值均低于VD组和LY组,差异有统计学意义（P＜0.05）。结论 1,25-（OH）2D3可通过PI3K/Akt信号通路抑制体外培养HMC的增殖。     

常规凝血指标和血小板计数与血栓弹力图判断危重型蝮蛇咬伤患者严重程度的临床价值

目的 探讨危重型蝮蛇咬伤患者常规凝血指标、血小板计数（PLT）和血栓弹力图（TEG）对病情严重程度的评估价值。方法 选取2010年1月-2014年1月中国人民解放军总医院第一附属医院急救部治疗的危重型蝮蛇咬伤患者68例为研究对象。按局部伤口、神经毒症状、血循毒症状的第2高分,将患者依次分为非危重组（20例）、危重组（27例）和极危重组（21例）。检测常规凝血功能指标〔活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、凝血酶原时间（PT）、纤维蛋白原（FIB）、D-二聚体（DD）〕和PLT,描绘TEG,记录血凝时间（R）、血块成型时间（K）、α角和血块强度（MA）。结果 3组APTT、TT比较,差异无统计学意义（P＞0.05）。3组PT、FIB、DD和PLT比较,差异有统计学意义（P＜0.05）;其中,极危重组PT、DD高于非危重组和危重组,极危重组FIB、PLT低于非危重组和危重组,差异有统计学意义（P＜0.05）。3组R、K、α角和MA比较,差异均有统计学意义（P＜0.05）;其中,极危重组R、K较非危重组和危重组延长,极危重组α角、MA小于非危重组和危重组,差异有统计学意义（P＜0.05）。APTT、TT、PT和PLT与R呈正相关（r=0.379、0.571、0.061、0.645,P＜0.05）;TT、PT、DD与K呈正相关（r=0.637、0.611、0.521,P＜0.05）,FIB、PLT与K呈负相关（r=-0.371、-0.723,P＜0.05）;TT、PT与α角呈负相关（r=-0.687、-0.702,P＜0.05）,FIB、PLT与α角呈正相关（r=0.335、0.728,P＜0.05）;APTT、TT、PT与MA呈负相关（r=-0.567、-0.787、-0.679,P＜0.05）,FIB、PLT与MA呈正相关（r=0.329、0.639,P＜0.05）。结论 常规凝血功能指标、PLT及TEG对判断危重型蝮蛇咬伤患者病情严重程度有重要参考价值,其可以较好地评估患者凝血功能状态,有助于提供精确治疗。     

溶血对coatron1800血凝分析仪测定结果的影响分析

目的：探讨溶血标本对coatron1800血凝分析仪测定结果的影响。方法：随机收集本院临床溶血标本40例进行血浆血凝测定。以血红蛋白每下降10 g/L为标准,分为轻度、中度、重度溶血3个等级,同时测定3次凝血酶原时间（ PT）、活化部分凝血活酶时间（ APTT）、凝血酶时间（ TT）和血浆纤维蛋白原（ FIB）;对溶血的干扰因素进行统计学分析。结果：非溶血组与轻度溶血组比较,TT、FIB检测结果差异显著（P＜0．05）;与中度溶血组比较,PT、TT、FIB差异具有统计学意义（P＜0．05）;与重度溶血组比较,PT、TT、FIB差异具有统计学意义（P＜0．05）。结论：临床检测中溶血标本对APTT检测结果影响较小;而对于PT、TT、FIB干扰较大,医务人员应规范抽血,避免由于抽血不当而引起的溶血现象。     

肝病患者出凝血四项和D-D的检测分析

目的研究凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、血浆纤维蛋白原（FIB）、血浆凝血酶时间（TT）及D-二聚体（D-D）对各型肝脏疾病的诊断价值。方法检测30例健康体检者和87例临床已确诊为肝病患者的PT、APTT、FIB、TT和D-D。前四项采用自动血凝仪检测,后一项采用乳胶凝集法检测。结果不同的肝病患者PT、APTT、FIB、TT和D-D与健康组对比,具有不同程度的差异。肝硬化、肝癌患者PT、APTT、TT时间延长（P〈0.01）,FIB含量降低（P〈0.01）,D-D水平较高,分别为72.2%和60.0%。急性肝炎组PT时间延长（P〈0.01）、APTT时间也延长（P〈0.01）、TT和FIB差异无统计学意义（P〉0.05）、D-D平为18.8%,慢性肝炎组PT、APTT、TT时间延长（P〈0.01）,FIB含量无统计学意义（P〉0.05）,D-D水平为7.4%。各型肝脏疾病PT、APTT、TT的值和D-D水平呈现肝硬化组〉肝癌组〉慢性肝炎组〉急性肝炎组,而FIB则相反。结论 PT、APTT、FIB、TT和D-D可客观地评价肝病患者的凝血功能状况,并且与肝病的严重程度相一致。这可以为临床肝脏疾病的诊断、治疗、动态观察以及判断预后提供重要依据,具有重要的临床价值。     

肝素早期抗凝对内毒素致急性肺损伤大鼠凝血功能的影响

目的观察内毒素致急性肺损伤大鼠的凝血功能变化及肝素早期抗凝治疗的效果。方法健康雄性SD清洁级大鼠50只,随机分为5组。A1-A3及B组均尾静脉注射大肠杆菌脂多糖（LPS）5mg/kg,A1-A3组分别在给予LPS后1min静注肝素100U/100g、50U/100g、25U/100g,C组给予等容量的生理盐水。B组在LPS注射前和注射后1min、4h,A1-A3组和C组4h经右股静脉取静脉血检测血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、血浆纤维蛋白原水平（FIB）。结果LPS注射1min后B组PT、TT缩短,FIB减少。LPS注射4h后,与C组比较,B组PT、APTT延长,FIB减少（P〈0.05）;与B组比较,A1-A3组FIB显著增加（P〈0.01）;A1组和A2组TT显著延长（P〈0.01）;A1组APTT显著延长（P〈0.01）。结论肝素早期抗凝治疗对内毒素性急性肺损伤大鼠凝血紊乱有改善作用,小剂量治疗较适宜。     

独一味水提物对大鼠血液凝集参数的影响

目的研究藏药独一味对凝血作用和血液凝集参数的影响。方法以云南白药（0.09 g/kg）为阳性对照组,蒸馏水为空白对照组,独一味水提物为试验组,试验组分高（0.3 g/kg）、中（0.15 g/kg）、低（0.075 g/kg）三个剂量组,给大鼠灌胃给药14 d后,颈总动脉采血测定其凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）以及纤维蛋白原含量（FIB）。结果与空白对照组比较,独一味水提物的高、中、低剂量组及云南白药组的TT值分别缩短了25.77%、12.42%、8.60%和24.91%;FIB值分别增加了26.80%、6.38%、20.72%和9.44%;PT、APTT值无明显变化。结论独一味水提物能增加大鼠纤维蛋白原的含量并能缩短大鼠凝血酶时间。     

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.