益心舒胶囊与氟伐他汀对动脉粥样硬化内皮功能的影响

目的观察益心舒胶囊与氟伐他汀对兔动脉粥样硬化内皮功能的影响。方法 32只新西兰大白兔随机分为正常对照组、高脂组、益心舒胶囊组、氟伐他汀组各8只,喂养4个月后耳缘静脉取血,采用酶学方法测定各组动物的血脂水平;处死动物后取胸主动脉,做内皮依赖性舒张功能检测,HE染色观察病理形态变化。结果高脂组TC、LDL明显高于正常对照组(P<0.05),益心舒组及氟伐他汀组的TC及LDL水平均明显低于高脂组(P<0.05),益心舒组低于氟伐他汀组(P<0.05)。益心舒组及氟伐他汀组舒张最大值高于高脂组(P<0.05),但两者均低于正常对照组(P<0.05)。益心舒组及氟伐他汀组血管病理改变均较高脂组减轻。结论益心舒及氟伐他汀治疗能改善血管内皮依赖性舒张功能,明显减轻实验性动脉硬化兔的动脉硬化程度。     

辛伐他汀和氟伐他汀对高胆固醇喂养兔的血管内皮功能的影响

目的:观察辛伐他汀和氟伐他汀对高胆固醇喂养兔的血管内皮功能的影响。方法:共28只纯种日本大耳白兔,随机分为4组(每组7只):A组、B组和C组均先喂以1.5%(质量分数)的高胆固醇饲料4周,之后A组继续喂以1.5%(质量分数)的高胆固醇饲料4周,B组喂以1.5%(质量分数)的高胆固醇饲料加辛伐他汀5mg·kg-1·d-14周,C组喂以1.5%(质量分数)的高胆固醇饲料加氟伐他汀20mg·kg-1·d-14周,D组喂以普通饲料共8周。8周后取血测定总胆固醇、甘油三酯、低密度脂蛋白胆固醇及高密度脂蛋白胆固醇。麻醉后分离胸主动脉去除脂肪和结缔组织,切成4mm长的血管环置浴槽中做离体灌流实验,分别观察对乙酰胆碱、硝酸甘油和去甲肾上腺素的浓度反应曲线。结果:A组血清胆固醇水平明显升高,B组和C组则明显下降。A组血管对乙酰胆碱的内皮依赖性舒张功能明显减弱,且对去甲肾上腺素的收缩功能增强。而B组和C组这些功能接近正常对照的D组,B组和C组之间无显著性差异。4组血管对非内皮依赖性舒张剂硝酸甘油的反应相似。结论:辛伐他汀和氟伐他汀均可预防高胆固醇喂养兔的血管内皮功能失调,二者之间无显著性差异。     

氟伐他汀调脂治疗对血管内皮功能的影响

目的: 探讨高脂血症患者血管内皮细胞功能的变化及氟伐他汀对其的影响.方法: 选高脂血症患者44例为治疗组,血脂正常者20例为对照组,检测氟伐他汀治疗前后血浆内皮素-1浓度(ET-1)和血脂,观察肱动脉血管超声检测血管内皮依赖性舒张功能的变化.结果: 高脂血症组ET-1的水平明显高于对照组(P＜0.01),血管内皮依赖性舒张显著低于对照组(P＜0.01);氟伐他汀治疗后1周血脂水平较治疗前有下降趋势,但无统计学意义(P＞0.05 ),而ET-1明显下降、反应性充血引起的肱动脉内径扩张显著增强(P＜0.05);治疗后8周TC、TG、 LDL-C均有明显降低(P＜0.05～0.01),且 ET-1进一步降低,反应性充血引起的肱动脉内径扩张进一步增强(P＜0.01).结论: 高脂血症患者内皮功能受损,氟伐他汀调脂治疗的同时具有改善内皮功能的作用.     

动脉硬化兔血管壁组织中LOX-1的表达

目的 研究动脉硬化兔血管壁组织中血凝素样氧化低密度脂蛋白受体-1(LOX-1)的表达情况,探讨氟伐他汀干预对其表达的影响.方法 24只新西兰大白兔随机分为正常饮食组、高脂饮食组及高脂饮食加氟伐他汀干预组(n=8).应用RT-PCR法和免疫组化法分别检测各组动物胸主动脉血管壁组织中LOX-1 mRNA和蛋白的表达,并进行统计学分析.结果 高脂饮食组及高脂饮食加氟伐他汀干预组兔胸主动脉血管壁组织中均有LOX-1 mRNA及蛋白表达,而正常饮食组无表达;高脂饮食加氟伐他汀干预组LOX-l mRNA及蛋白表达水平均明显低于高脂饮食组(P＜0.05).结论 动脉硬化兔胸主动脉血管壁组织中LOX-1表达明显升高,而氟伐他汀干预能够显著下调其表达水平.     

卡维地洛改善动脉粥样硬化兔血管内皮舒张功能

目的 观察β-受体阻滞剂卡维地洛对动脉粥样硬化家兔血管内皮舒张功能的影响.方法 18只雄兔随机分为3组:高脂对照组、卡维地洛组和正常对照组.高脂对照组给予每只兔胆固醇1 g/d;卡维地洛组在高脂基础上给予卡维地洛10 mg·kg -1·d -1.两组给予相应处理1周后,行腹主动脉球囊损伤术,并继续相应处理10周.正常对照组给予假手术及正常饮食.干预结束时,测定血脂、脂质过氧化物及一氧化氮(NO)水平,取动脉组织检测血管原位超氧化物生成、内皮细胞NO合酶活性和内皮依赖血管舒张功能.结果 与正常对照组相比,高脂对照组血清总胆固醇、甘油三酯、脂质过氧化物、NO水平和血管内原位超氧化物生成均明显增加,而内皮细胞NO合酶活性明显降低(均P＜0.01).卡维地洛明显降低血清脂质过氧化物和内皮细胞NO合酶活性,并显著抑制血管原位超氧化物的生成(P＜0.05).与正常对照组相比,高脂对照组兔血管内皮依赖舒张功能明显减弱(P＜0.01);卡维地洛明显改善高脂兔内皮依赖舒张功能(P＜0.05).结论 卡维地洛能改善NO介导的血管内皮依赖舒张功能,其机制可能在于卡维地洛除β-受体阻断作用外,还具有抗氧化和增强内皮源性NO活性的作用.     

动脉硬化兔血管壁组织中LOX-1的表达

目的研究动脉硬化兔血管壁组织中血凝素样氧化低密度脂蛋白受体-1(LOX-1)的表达情况,探讨氟伐他汀干预对其表达的影响。方法24只新西兰大白兔随机分为正常饮食组、高脂饮食组及高脂饮食加氟伐他汀干预组(n=8)。应用RT-PCR法和免疫组化法分别检测各组动物胸主动脉血管壁组织中LOX-1 mRNA和蛋白的表达,并进行统计学分析。结果高脂饮食组及高脂饮食加氟伐他汀干预组兔胸主动脉血管壁组织中均有LOX-1 mRNA及蛋白表达,而正常饮食组无表达;高脂饮食加氟伐他汀干预组LOX-1 mRNA及蛋白表达水平均明显低于高脂饮食组(P<0.05)。结论动脉硬化兔胸主动脉血管壁组织中LOX-1表达明显升高,而氟伐他汀干预能够显著下调其表达水平。     

调脂胶囊对动脉粥样硬化患者血脂、炎症反应以及氧化损伤的影响

目的 观察复方中药调脂胶囊对具有动脉粥样硬化证据的高血脂患者血清超敏C反应蛋白(hsCRP)、白细胞介素-6(IL-6)及超氧化物歧化酶(SOD)的影响,探讨其在调理血脂作用之外,改善动脉粥样硬化内皮功能的作用机制.方法 选择高脂血症并经颈动脉超声显示有确切动脉粥样硬化证据患者100例,随机分为调脂胶囊组和氟伐他汀组,每组50例.调脂胶囊组每日口服调脂胶囊2次,每次4粒;氟伐他汀组每日口服氟伐他汀20mg,每晚1次口服,两组均治疗24周.检测两组患者用药前后血脂和血清hsCRP、IL-6及SOD水平变化,同时检测两组用药前后的肝肾功能水平.结果 调脂胶囊组和氟伐他汀组治疗前后检测各项指标差异有显著性(P＜0.01),调脂胶囊组与氟伐他汀组比较,治疗后血脂差异无显著性(P＞0.05),但血清SOD水平较高,差异有显著性(P＜0.01),血清hsCRP和IL-6较低,差异有显著性(P＜0.05),同时,未发现调脂胶囊有肝肾损伤等不良反应.结论 调脂胶囊具有明确的调理血脂作用,并具有抗炎以及较强的抗氧化作用.     

阿托伐他汀对不稳定型心绞痛患者C-反应蛋白的影响及临床意义

目的 观察阿托伐他汀对不稳定型心绞痛(UAP)患者C-反应蛋白(CRP)的影响及其临床意义.方法 选择UAP患者78例,随机分为观察组42例和对照组36例,观察组给予阿托伐他汀10mg每晚顿服,对照组饮食控制,于治疗前及治疗后4周测定血脂及CRP的变化,分析6个月内心血管事件的发生率.结果 观察组CRP治疗后显著低于治疗前(P＜0.05),对照组治疗前后无显著性差异(P＞0.05),观察组6个月内心血管事件发生率显著低于对照组(P＜0.01).结论 阿托伐他汀在调脂的同时还可减轻炎症反应,提示阿托伐他汀可改善血管内皮功能,有利于动脉粥样硬化斑块的稳定,对UAP的发生、发展及预后起重要作用.     

益肾活血解毒汤对家兔颈动脉粥样硬化斑块及炎性因子的影响

[目的]研究益肾活血解毒汤及其与阿托伐他汀联用对颈动脉粥样硬化(CAS)斑块、炎性因子的影响.[方法]将50只新西兰兔随机分为空白组(BCG)9只,模型组41只,用高脂饲料喂养和球囊损伤术制备CAS兔模型,共8周;造模成功后,将模型组40只兔随机分为中药组(TCMG),西药组(WMG),中西药结合组(ZXG),模型对照组(MG),各组10只,于第9周开始分别灌胃给药,共6周.分别于第9、15周结束时取血检测各组家兔血清炎症标志物的含量,观察颈动脉病理形态学变化.[结果]治疗前,与BCG比较,MG、TCMG、WMG及ZXG IL-18、hs-CRP、IL-10值均有显著性差异(P＜0.01).治疗前后组内比较及疗后组间比较,三个治疗组IL-18、hs-CRP指标均有降低(P＜0.05或P＜0.01),IL-10升高(P＜0.05或P＜0.01);ZXG疗效明显优于TCMG或WMG( P＜0.01);光镜下观察结果显示,各给药组颈动脉病变程度均明显减低.[结论]益肾活血解毒汤联合阿托伐他汀治疗可显著调节CAS兔1L-18,hs-CRP,IL-10三种炎性因子水平.     

阿托伐他汀对高血压合并高脂血症患者内皮功能的影响

目的:探讨高血压合并高脂血症患者应用阿托伐他汀治疗后对血管内皮舒张功能的影响。方法:168例高血压患者随机分成阿托伐他汀治疗组(观察组)84例及常规治疗组(对照组)82例,比较治疗12周前后应用超声检测肱动脉流量介导性扩张的血管内皮舒张功能及血脂、C反应蛋白(CRP)的变化。结果:观察组和对照组治疗前与治疗12周后比较,血管内皮舒张功能均有显著改善(P<0.01和P<0.05);治疗后两组间比较,血脂、血管内皮舒张功能及CRP水平有显著差异(P<0.05)。结论:高血压合并高脂血症患者应用阿托伐他汀治疗12周后除改善血脂情况外,可进一步改善内皮依赖性血管舒张功能及减轻炎症反应。     

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.