三七总苷对重症急性胰腺炎大鼠氧自由基的影响

目的探讨三七总苷对重症急性胰腺炎（SAP）大鼠氧自由基的影响。方法SD大鼠135只，随机分为假手术组、SAP组和三七总苷治疗组，每组45只，通过十二指肠胆胰管逆行加压注射5％牛磺胆酸钠溶液的方法制备大鼠SAP模型，每组造模后又按6、12和24h分为3个时间点。分别在3个组的不同时间点抽血，测定大鼠血清丙二醛（MDA）、超氧化物歧化酶（SOD）、淀粉酶。胰腺病理改变等指标的变化。结果SAP组各个时段血清淀粉酶和MDA水平升高,SOD水平降低，与对照组各个时段比较有统计学差异（P〈0.01）；三七总苷治疗组在6、112和24h3个时间点与SAP组相比，血清淀粉酶和MDA的水平均降低（P〈0.01或P〈0．05），SOD水平升高（P〈0．01）。结论三七总苷通过降低损害因子MDA、升高保护因子SOD，对SAP有治疗作用。     

N-乙酰半胱氨酸对重症急性胰腺炎肠屏障作用的实验研究

目的:探讨N-乙酰半胱氨酸(NAC)对重症急性胰腺炎(SAP)肠屏障的作用及机制。方法:54只清洁健康雄性SD大鼠,随机分成假手术(Sham)组、SAP组和NAC+SAP3组,每组18只。建模后6、12、24h分批处死,采集腹主动脉血测定二胺氧化酶(DAO)及淀粉酶(AMY)含量;取胰腺和末端回肠标本进行组织病理诊断;小肠组织匀浆测定丙二醛(MDA)、还原型谷胱甘肽(GSH)和超氧化物歧化酶(SOD)水平。结果:与Sham组比较,SAP组血AMY和DAO水平均明显增高(P<0.05),小肠组织中SOD和GSH水平明显降低(P<0.05),MDA水平明显增高(P<0.05)。与SAP组比较,NAC+SAP组其6 h时间点血清AMY、DAO水平与SAP组同时间点无明显变化(P>0.05),而12、24 h时间点较SAP组同时间点显著降低(P<0.05);其小肠组织中MDA、SOD和GSH水平在6 h时间点与SAP组同时间点无明显差异(P>0.05),12、24 h时间点SOD和GSH水平明显增高(P<0.05),MDA水平明显降低(P<0.05)。结论:NAC通过增强肠组织抗氧化能力、维护肠组织内氧化还原平衡,可以保护肠黏膜结构和功能的完整性,对预防SAP大鼠肠屏障损害具有重要意义。     

还原型谷胱甘肽对重症急性胰腺炎大鼠肺损伤的保护作用

目的 研究还原型谷胱甘肽对重症急性胰腺炎（SAP）大鼠肺损伤的保护作用;探讨SAP肺损伤的发病机制.方法 54只SD大鼠随机分为对照组、模型组和治疗组.采用十二指肠乳头逆行插管胰胆管注射5%的牛磺胆酸钠的方法复制大鼠SAP模型,各组大鼠分别于建模后3h、6 h、12h剖杀,检测血清淀粉酶、肺含水量、肺组织中TNF-α、LIF基因的表达水平.结果 治疗组各时间点血清淀粉酶均低于模型组（P〈0.05）,但仍高于对照组（P〈0.05）;治疗组较模型组肺含水量减少（P〈0.05）,明显较对照组高（P〈0.05）;对照组肺组织中未见明显的LIF基因表达,建摸后3h、6 h、12h治疗组TNF-α、LIF基因的表达水平均低于模型组（P〈0.05）,模型组及治疗组大鼠肺组织中TNF-α基因的表达水平均高于对照组（P〈0.05）.结论 还原型谷胱甘肽对SAP大鼠肺损伤具有保护作用.     

谷氨酰胺对重症胰腺炎大鼠血清细胞因子水平的影响

目的探讨谷氨酰胺对重症急性胰腺炎大鼠TNF—a、IL-6、IL-10水平的影响。方法54只大鼠分3组：谷氨酰胺（Gln）治疗组,重症胰腺炎（SAP）组,对照（NC）组,每组18只。顺行穿刺注射4％牛磺胆酸钠制作SAP模型。Gin组自阴茎背静脉注射Gin,SAP组与NC组注射生理盐水。比较3组3、6、12h腹水量,血清淀粉酶水平,细胞因子水平及组织病理学评分。结果SAP组腹水、血清淀粉酶、病理学评分、TNF—a,IL-6与NC组各时段比较均升高,差异有统计学意义;IL-10水平在3h较NC组升高,差异有统计学意义（P〈0．05）。Gln组腹水、血清淀粉酶、病理学评分3h和6h时段均较SAP组降低,差异有统计学意义（P〈0．05）;TNF—a,IL-6水平较SAP组各时段均降低,差异有统计学意义（P〈0．05）;IL-10水平3h低于SAP组,差异有统计学意义（P〈0．05）,6h和12h无显著变化。结论谷氨酰胺可调节细胞因子水平,减轻胰腺组织的病理学损害,对SAP有治疗作用。     

银杏叶提取物防治急性重症胰腺炎大鼠内毒素血症的实验研究

目的 :观察银杏叶提取物 (GinkoBilobaExtract;EGb)对急性重症胰腺炎 (AcuteSeverePancreatitis ;ASP)内毒素血症的防治作用。方法 :78只SD大鼠随机分为 3组 :假手术 (SO)组、ASP组和EGb治疗组。治疗组大鼠在ASP诱发后经腹腔内注射EGb 2 0mg kg ;假手术组和ASP组大鼠腹腔注射等量生理盐水。结果 :治疗组与ASP组比较 ,血清淀粉酶明显下降 (术后 6、12h ,P <0 .0 5 ) ;血中血小板活化因子 (Platelet activatingFactor ;PAF)、内毒素含量明显下降 (P均 <0 .0 1) ,血清过氧化物歧化酶 (SOD)含量明显下降 (P均 <0 .0 5 ) ;治疗组胰腺组织的病理损害较ASP组明显减轻。结论 :EGb对ASP大鼠胰腺与内毒素血症有良好的保护作用。     

利多卡因、胞二磷胆碱治疗急性胰腺炎的实验研究

目的　探讨利多卡因、胞二磷胆碱对急性胰腺炎 (AP)的治疗作用。方法　在 2 4只wistar大鼠胰管内逆行注入牛胆汁酸钠 ,造成AP模型后 ,随机分成治疗组和对照组 ,治疗组大鼠以利多卡因 (2mg/kg)和胞二磷胆碱 (2mg/kg)于尾静脉缓慢静注 ,3h后再重复 1次 ,直至实验结束 ;对照组以同样方法及间隔时间给予生理盐水 (50ml/kg)动态观察各组指标的变化。 结果　对照组大鼠血清超氧化物歧化酶 (SOD)含量明显低于治疗组 (P <0 .0 5) ;血清淀粉酶明显高于治疗组 (P <0 .0 1 ) ;2 4h病死率和存活时间明显短于治疗组 (P<0 .0 5)。结论　利多卡因 ,胞二磷胆碱对大鼠急性胰腺炎有治疗作用     

糖皮质激素受体在大鼠重症胰腺炎中的表达变化及甲强龙冲击治疗后的影响

目的了解糖皮质激素受体在大鼠重症胰腺炎中的表达变化情况,观察早期大剂量甲基强的松龙冲击治疗后对大鼠重症胰腺炎的治疗作用。方法72只SD大鼠[（300±50）g]随机分成生理盐水组（NS组）、重症胰腺炎组（SAP组）、重症胰腺炎甲强龙治疗组（MES组）,每组24只,三组再各分为6h、12h、24h三个时间点,每个时间点8只,通过腹腔内注射L-精氨酸（320mg／100g）制作大鼠重症胰腺炎模型,观察各时间点血清淀粉酶、胰腺湿＼干值、胰腺病理变化及糖皮质激素受体变化。结果SAP组较NS组在6h、12h、24h三个时间点的血清淀粉酶、胰腺湿干比率、胰腺病理评分均显著升高（P〈0．01）,糖皮质激素受体水平明显下降（P〈0．01）;而MES组较SAP组在6h、12h、24h三个时间点的血清淀粉酶、胰腺湿干比率、胰腺病理评分均显著降低,糖皮质激素受体水平明显升高。结论重症胰腺炎早期糖皮质激素受体水平下降,早期大剂量的使用甲强龙能有效的减轻炎症反应,改善病理损伤,有效的提高糖皮质激素受体水平。     

围胰腺区域性微创治疗大鼠重症急性胰腺炎的实验研究

目的 观察围胰腺区域性微创治疗方案对重症急性胰腺炎(SAP)大鼠的影响.方法 72只SD大鼠随机分为自然病程组(SAP组)、常规治疗组(R组)、DDFA治疗组(DDFA组)、微创治疗组(W组),各组分配18只.每组分6、12、24 h三个时间点,每时间点分配6只.采用5%牛黄胆酸钠逆行胰管注射法建立大鼠SAP模型.建模后按时间点分批采血并测血白细胞、血淀粉酶,提取血清测IL-6、TNF-α、PL-A2,吸取腹腔液测淀粉酶,取胰腺组织制作病理切片.结果 各组各时间点间腹腔液淀粉酶含量及血淀粉酶含量、白细胞计数、血清IL-6、TNF-α、PL-A2含量、病理评分比较均有显著性差异.结论 围胰腺区域性微创治疗方案能显著降低大鼠血白细胞、淀粉酶、IL-6、TNF-α、PL-A2、腹水淀粉酶、胰腺组织病理评分,是阻止SAP进展的有效方法.     

七叶皂甙钠治疗重症急性胰腺炎的实验研究

目的　探讨中药提取物七叶皂甙钠对重症急性胰腺炎 (SAP)的作用。方法　雄性SD大鼠分为模型组、七叶皂甙钠治疗组 ,经胆胰管逆行推注牛磺胆酸钠法制模型 ,治疗组大鼠分别在模型制成后 3 0min经股静脉注射七叶皂甙钠 2 0mg/kg,对照组注射等量生理盐水 ,两组在制模后 6h和 1 2h分批抽取下腔静脉血 ,检测肿瘤坏死因子α( (TNFα) ,淀粉酶 ,并行胰腺坏死程度评分。结果　治疗组 6h和 1 2h腹腔渗液淀粉酶、血清淀粉酶及TNFα与对照组比较差异有显著性意义 (P <0 .0 1 ) ,两组胰腺坏死程度评分差异有显著性意义 (P <0 .0 1 )。结论　七叶皂甙钠治疗重症急性胰腺炎 ,可以阻断不良炎性介质的作用 ,对胰腺具有保护作用     

HMGB1、TLR4在重症急性胰腺炎大鼠胰腺组织中的表达及乌司他丁的干预效应

目的：探讨 HMGB1、TLR4在重症急性胰腺炎大鼠胰腺组织中的作用机制以及乌司他丁的干预效应。方法将54只SD大鼠分为对照组、SAP组和乌司他丁治疗组,3组又分为6、12 h和24 h 3个小组（每小组n＝6）。对照组开腹后仅翻动胰腺组织,SAP组用5％的牛磺胆酸钠制备SAP模型,治疗组在SAP造模成功后经尾静脉注射乌司他丁。观察3组大鼠胰腺组织的病理学改变;EPS‐G7法检测血清中的淀粉酶;ELISA法检测血清及胰腺组织中的HMGB1;Envision两步免疫法检测胰腺组织中的HMGB1、TLR4的表达水平。结果 SAP组、治疗组各时间点的淀粉酶与对照组比较明显升高,病理学改变明显,差异均有统计学意义（P＜0．05）,示SAP造模成功;SAP组在胰腺组织及血清中的 HMGB1表达在6 h开始升高,于12 h快速上升,至24 h保持上升趋势,与对照组大鼠相同时间点比较明显升高,差异有统计学意义（P＜0．05）,治疗组与SAP组相同时间点的 HMGB1比较明显降低,差异有统计学意义（P＜0．05）;SAP组胰腺组织中的 TLR4表达在6 h开始升高,12 h达高峰,24 h开始下降,与对照组大鼠相同时间点比较明显升高,差异有统计学意义（P＜0．05）。治疗组与SAP组相同时间点的TLR4比较明显降低,差异有统计学意义（P＜0．05）。结论 HMGB1在SAP大鼠胰腺中的致炎作用可能是部分结合其受体 TLR4并通过MyD88依赖性途径而实现的,而乌司他丁可能是通过中断SAP大鼠胰腺组织中的 HMGB1、TLR4信号通路发挥保护作用。     

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.