PGI_2与TXA_2在冲击伤、破片伤及冲击伤复合破片伤中的改变和意义

本实验观察了狗中度冲击伤、肢体破片伤及两者复合伤后24h内肺动脉平均压(PAP)、动脉血浆及肺组织中前列环素(6-keto-PGF_1α)与血栓素(TXB_2)的变化。结果表明,冲击伤、破片伤及复合伤后PAP、动脉血浆及肺组织中TXB_2均有升高,PAP以复合伤后升高最为明显。TXB_2在破片伤及复合伤后的变化幅度高于冲击伤后。6-keto-PGF_1α在冲击伤、破片伤后血浆及肺组织中均有升高,但在复合伤后血浆中有所下降,肺组织中则无明显变化。本文讨论了这些变化的意义。     

Na[~(125)I]标记6-酮-PGF_(1α)和血栓素B_2

前列环素(FGI_2,其稳定代谢产物6-keto-PGF_1α)和血栓素A_2(TXA_2,其稳定代谢产物TXB_2)为花生四烯酸代谢途径的两个重要产物,它们的生理活性恰巧相反,前者抑制血小板聚集和扩张血管,后者诱导血小板聚集和收缩血管。二者平衡如果失调,可能导致某些疾病的发生。为了推广敏感的、特异的测定6-keto-PGF_1α和TXB_2放射免疫法,我们用Na[~(125)I]成功地标记了6-keto-PGF1α和TXB_2。     

动脉粥样硬化的实验研究Ⅱ.中药8501在防治家兔实验性动脉粥样硬化中对血栓素A_2、前列环素平衡的影响

系统地观察实验性动脉粥样硬化(以下简称AS)形成过程中血栓素A_2(TXA_2)/前列环素(PGI_2)平衡与血小板膜流动性的变化,探讨8501对前列腺素代谢及血小板膜流动性的影响及其在AS防治中的作用。结果发现,高脂组家兔在血清胆固醇含量明显升高的同时,血浆6-keto-PGF_(1α)水平显著降低,TXB_2水平显著升高,且前者降低先于后者增高,血小板膜流动性亦有所增加。8501除明显降低血脂外,还具有显著防止血浆6-keto-PGF_(1α)降低和TXB_2升高的作用,提示8501可能通过抑制TXA_2合成酶或激活PGI_2合成酶而发挥作用。     

阻塞性黄疸大白鼠肾脏前列环素与血栓素的改变

本实验用放免方法测定雄性Sprague-Dewley大白鼠分别在结扎胆管1、2、3和4周后肾皮质与髓质组织中6-keto-PGF_(1α)及TXB_2含量来了解肾皮质与髓质中前列环素和血栓素A_2的变化。结合表明,肾皮质与髓质中6-Keto-PGF_(1α)在胆管结扎早期(1～2周)显著升高,而后期(3—4周)无继续升高。肾皮质与髓质中的TXB_2在结扎胆管后期显著升高,引起6-keto-PGF_(1α)/TXB_2比值在胆管结扎后期显著降低。提示胆管梗阻时间越长,肾组织中TXA_2合成增加越明显,导致肾脏易于出现血管痉挛,血小板聚集,肾循环功能障碍。     

实验性失血性休克时血小板功能的变化

本实验从粘附、聚集和释放三方面系统观察了家免失血性休克早期血小板功能的变化、结果表明:休克早期血小板功能显著增强。粘附率、聚集率、血5-羟色胺(5-HT)和血栓素B_2(TXB_2)水平显著升高。随休克时间延长,粘附和聚集逐渐抑制,而5-HT和TXB_2水平进行性升高、提示血小板释放的5-HT和TXA_2是参与失血性休克发展的重要体液因素。     

冠心病不同临床类型患者血浆、血小板脂质过氧化损伤与TXA_2/PGI_2平衡的研究

作者观察98例正常人和109例不同临床类型冠心病人血浆、血小板LPO、SOD,SeGSHP_x,RBC—SOD及血浆TXB_2、6-keto-PGF_(1α)的变化,发现各型冠心病组均有LPO、PL—LPO、TxB_2、TxB_2/6-keto-PGF_(1α)比值明显升高,6-keto-PGF_(1α),SOD、PLSOD、RBC-SOD,SOD/LPO及SeGSHPX/LPO比值明显降低。但各型程度不同,以急性心肌梗塞和不稳定性心绞痛改变突出。血浆LPO与6-keto-PGF_(1α)呈显著负相关。提示脂质过氧化损伤与TXA_2/PGI_2平衡密切相关。认为SOD/LPO、SeGSHPx/LPO,TXB_2/6-keto-PGF_(1α)比值在冠心病诊断中是重要有意义的指标,血小板SOD/LPO比值能更敏感地反映冠心病人氧化与抗氧化能力的平衡状态。     

前列环素,血栓素在缺血性肾损害中的作用

采用兔肾缺血模型,用放免方法测定血浆及组织内6-keto-PGF_(1α)和TXB_2的变化。结果提示肾缺血再灌流早期内、外髓质6-keto-PGF_(1α)及全肾组织TXB_2显著增加,6-keto-PGF_(1α)/TXB_2比值则显著下降。6-keto-PGF_(1α),TXB_2的异常代谢可能是缺血再灌流早期肾血流量减少和血流再分布的重要原因。     

犬出血性、组胺性休克时血浆血栓素B_2和6-酮-前列腺素F_(1α)的变化

本文观察了出血性休克和应用回输血治疗及组胺性休克应用肾上腺素治疗时,犬血浆血栓素B_2(TXB_2)和6-酮-前列腺素F_1α(6-Keto-PGF_1α)的变化。在这两种休克模型中,血浆中FXB_2和6-Keto-PGF_1α均明显升高.血浆中TXB_2升高可能成为导致微循环恶化的重要因素,6-Keto-PGF_1α升高可介导血压下降.这两种物质增多均可能促进休克的持续发展.     

海水性肺损伤血浆过氧化脂质与前列腺素的变化分析

作者在海水性肺损伤的动物模型中,测定分析了绵羊动脉血浆过氧化脂质(LPO)、血栓素 B_2(TXB_2)和6—酮—前列腺素 F_(1α)6—Keto—PGF_(1α))的变化规律。结果表明,LPO、TXB_2和6—Keto—PGF_(1α)均随 P_aO_2降低而升高。TXB_2/PGF_(1α)(T/P)的比值呈进行性下降趋势,与 P_aO_2呈一致性下降关系。作者认为,海水溺水后缺氧是引起血浆 LPO、TXB_2和6—Keto—PGF_(1α)升高的主要原因,而高浓度的 LPO 和 TXB_2又进一步加重海水性肺损伤的发生和发展,形成恶性循环。T/P 比值平衡紊乱也被认为是加重海水性肺损伤的重要因素之一。     

小剂量阿斯匹林间歇疗法对急性心梗PGI_2-TXA_2失衡的改善

将42例急性心肌梗塞(AMI)患者随机分入阿斯匹林(ASA)每日疗法组(300 mg/d)、ASA间歇疗法组(300 mg/3d)和非ASA组,另设一正常对照组,动态观测患者组住院3周内血浆前列环素(PGI_2)和血栓素A_2(TXA_2)的稳定代谢产物6-酮前列腺素F_(12)(6-keto-PGF_(12))、血栓素B_2(TXB_2)浓度及6-keto-PGF_(12)/TXB_2(K/T比值)的变化。结论:1.小     

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.