关附甲素对心肌慢反应动作电位的影响

关附甲素（ＧＰＡ）８．６μｍｏｌ／Ｌ使缺Ｏ＿２、高Ｋ￣＋和酸中毒的豚鼠乳头肌动作电位幅值（ＡＰＡ）和最大除极速率（Ｖ＿（ｍａｘ））下降，ＡＰＤ＿９０显著缩短，ＥＲＰ／ＡＰＤ＿９０比值增大，ＧＦＡ２６μｍｏｌ／Ｌ可使高Ｋ￣＋除极所致的慢反应ＡＰＡ和Ｖ＿（ｍａｘ）降低，ＧＦＡ５０μｍｏｌ／Ｌ时使兔窦房结动作电位０相去极化速率（ＭＲＤ）、舒张期去极化速率（ＲＤＰ）和平均复极化速率（ＭＲＲ）降低，自发活动频率（ＳＦＦ）减慢，并使舒张期去极化时间（ＤＤＴ）及动作电位时程（ＡＰＤ）延长。     

关附庚素对缺O_2、高K~ 及酸中毒豚鼠乳头肌和兔窦房结动作电位的影响

关附庚素（ＧＦＧ）０．８６μｍｏｌ／Ｌ使缺Ｏ２、高Ｋ＋和酸中毒的豚鼠乳头肌动作电位零相最大上升速率（Ｖｍａｘ）进一步降低，动作电位时程（ＡＰＤ）和有效不应期（ＥＲＰ）进一步缩短，而ＥＲＰ／ＡＰＤ９０明显增大。ＧＦＧ８，１６，１２μｍｏｌ／Ｌ使兔窦房结动作电位Ｖｍａｘ、舒张期去极化速率（ＲＤＤ）、自发活动频率（ＳＦＦ）和平均复极化速率（ＭＲＲ）显著降低，ＡＰＤ和舒张间隔（ＤＩ）明显延长，并呈现浓度依赖性     

碘杂环化合物IHC－72对心肌慢反应动作电位影响的浓度和时间依赖性

采用常规玻璃微电极技术研究３，６－二甲氨基－二苯骈碘杂环依地酸盐（ＩＨＣ－７２）对豚鼠右室乳头肌慢反应动作电位（ＳＡＰ）的影响。２．５４μｍｏｌ／ＬＩＨＣ－７２对ＳＡＰ各参数均无影响。２５．４，１０１．６μｍｏｌ／Ｌ　ＩＨＣ－７２对ＳＡＰ幅值（ＡＰＡ）的抑制率分别为７．４％、１９．３％，对０相最大上升速率（Ｖｍａｘ）的抑制率分别为２．５％、３９．１％（Ｐ均＜０．０５或０．０１）。１０１．６μｍｏｌ／ＬＩＨＣ－７２灌流５，１０，２０ｍｉｎ对ＡＰＡ的抑制率分别为３．３％、１０％和２１％，对Ｖｍａｘ的抑制率分别为１５．２％、２２．９％和３８．３％（Ｐ均＜０．０１），故ＩＨＣ－７２对ＡＰＡ、Ｖｍａｘ的抑制具有浓度和时间依赖性。ＩＨＣ－７２还能缩短ＳＡＰ复极５０％、１００％的时程（ＡＰＤ５０、ＡＰＤ１００），相对延长其有效不应期（ＥＲＰ）；而对静息膜电位（ＲＭＰ）无明显影响。１０１．６μｍｏｌ／ＬＩＨＣ－７２对ＳＡＰ的抑制与５μｍｏｌ／ＬＶｅｒａｐａｍｉｌ效应相当。结果揭示ＩＨＣ－７２具有钙拮抗作用。     

甲苯喹哌对豚鼠右心室乳头肌动作电位的作用

通过研究新抗心律失常药甲苯喹哌（ｔｏｑｕｉｐｉｄｉｎｅ，Ｔｏｑ）抗心律失常作用的心肌电生理学机制。利用微电极技术观察甲苯喹哌对豚鼠右心室乳头肌动作电位的作用，并与利多卡因进行比较。结果：Ｔｏｑ在１和１０μｍｏｌ／Ｌ时对动作电位各参数无明显影响，但在５０及１００μｍｏｌ／Ｌ时，可明显降低动作电位的Ｖｍａｘ，ＡＰＡ，缩短ＡＰＤ２０，ＡＰＤ５０和ＡＰＤ９０，并明显延长或提高动作电位的ＥＲＰ，ＥＲＰ／ＡＰＤ９０和ＥＲＰ－ＡＰＤ９０利多卡因１μｍｏｌ／Ｌ对动作电位各参数无明显影响。１０和５０μｍｏｌ／Ｌ利多卡因可剂量依赖性降低Ｖｍａｘ，ＡＰＡ，缩短ＡＰＤ２０，ＡＰＤ５０和ＡＰＤ９０。并明显延长ＥＲＰ，ＥＲＰ／ＰＤ９０和ＥＲＰ－ＡＰＤ９０结论：Ｔｏｑ有与利多卡因类似的心肌电生理作用，但其效价强度低于利多卡因。     

甲苯喹哌对豚鼠右心室乳头肌动作电位的作用

通过研究新抗心律常药甲苯喹哌（ｔｏｑｕｉｐｉｄｉｎｅ，Ｔｏｑ）抗心律失常作用的心肌电生理学机制，利用微电极技术观察甲苯喹哌对豚鼠右心室乳头肌动作电位的作用，并与利多卡因进行比较。结果，Ｔｏｑ在１和１０μｍｏｌ／Ｌ时对动作电位各参数无明显影响，但在５０及１００μｍｏｌ／Ｌ时，可明显降低动作电位的Ｖｍａｘ，ＡＰＡ，缩短ＡＰＤ２０，ＡＰＤ５０和ＡＰＤ９０，并明显延长或提高地动作电位的ＥＲＰ，ＥＲＰ／ＡＰ     

卡托普利对豚鼠心室肌细胞跨膜电位及L-型钙电流影响的初步观察

我们采用蛋白酶（０．２ｍｇ／ｍｌ）循环消化的方法获取了７０％～８０％耐钙豚鼠心肌细胞，并用膜片钳全细胞式记录方法，初步观察了卡托普利（Ｃａｐｔ）对心室肌细胞跨膜电位及Ｌ型钙电流的影响。实验表明，Ｃａｐｔ１０μｍｏｌ／Ｌ显著缩短豚鼠心肌单细胞的动作电位时程（ＡＰＤ），药物作用１０分钟后，ＡＰＤ５０缩短３７．２２％，ＡＰＤ９０缩短３５．３３％（ｎ＝３，Ｐ＜０．０５）；但对静息电位（ＲＰ）、超射（ＯＳ）和动作电位幅度（ＡＰＡ）无显著影响。当心肌细胞的保持电压为－４０ｍＶ，除极到０ｍＶ，刺激电压时程为２５０ｍｓ，频率为０．５Ｈｚ时，Ｃａｐｔ１０μｍｏｌ／Ｌ可使Ｌ型钙内向峰电流减少４２．６８％，正常对照组在同一时间内仅下降４．１％（ｎ＝３，Ｐ＜０．０５）。可见，卡托普利具有类似维拉帕米样Ｌ－型钙通道阻断剂作用。     

pH值对川芎嗪在豚鼠心肌电生理-机械特性的影响中的作用

目的：观察调节ｐＨ至７．４的川芎嗪与不调节ｐＨ的川芎嗪对豚鼠心室乳头状肌电生理－机械特性的影响。方法：常规电生理方法,标准玻璃微电极技术。结果：①调节 ｐＨ至 ７．４与不调节 ｐＨ的低浓度川芎嗪（３．０～ ３０μｍｏｌ）均使豚鼠乳头状肌慢反应电位（ＳＡＰ）的动作电位幅值（ＡＰＡ）,动作电位时程（ＡＰＤ）,最大除极速度Ｖｍａｘ及收缩力（ＦＣ）呈剂量依赖性抑制;②调节ｐＨ至７．４的高浓度川芎嗪（０．１～３．０ ｍｍｏｌ／Ｌ）使豚鼠乳头状肌 ＳＡＰ的 ＡＰＡ、ＡＰＤ、Ｖｍａｘ及ＦＣ呈剂量依赖性增强;而不调节ｐＨ的高浓度川芎嗪（０．１～３．０ ｍｍｏｌ／Ｌ）使豚鼠乳头状肌ＳＡＰ的ＡＰＡ、ＡＰＤ、Ｖｍａｘ及ＦＣ呈抑制效应。结论：①川芎嗪对豚鼠心肌电生理－机械特性有双重影响作用,即低浓度抑制,高浓度增强。②川芎嗪本身的酸性影响川芎嗪对豚鼠心肌电生理－机械特性的正性作用。     

常咯啉对离体豚鼠心肌的电生理作用

用豚鼠离体乳头肌观察了常咯啉（ＣＲＬ）对心肌收缩性、自律性、兴奋性和不应期的影响；用微电极技术进一步研究ＣＲＬ对动作电位及Ｖｍａｘ特性的影响，结果表明，ＣＲＬ具有负性肌力作用；可降低乳头肌自律性；延长功能性不应期；降低兴奋性；降低ＡＰＡ，缩短ＡＰＤ５０和ＡＰＤ９０；使ＥＲＰ／ＡＰＤ９０比值增大；对Ｖｍａｘ的抑制呈现浓度、频率和使用依赖性。当刺激频率为３Ｈｚ时，ＣＲＬ的起效速率为０．０４１±０．００７ＡＰ－１；恢复时间常数为１３６±２５ｓ。提示ＣＲＬ为慢动力型，属ＩＣ类抗心律失常药。     

卵巢功能早衰患者抗卵巢抗体及细胞免疫功能的测定

目的：探讨卵巢功能早衰（ＰＯＦ）患者细胞免疫功能的变化及其与抗卵巢抗体（ＡＯＡｂ）之间的关系。方法：检测３０例正常妇女（对照组）和３０例ＰＯＦ患者（ＰＯＦ组）的血清ＡＯＡｂ、外周血Ｔ淋巴细胞亚群及对卵巢抗原的白细胞促凝血活性（ＬＰＣＡ）。结果：对照组血清ＡＯＡｂ水平为１．３９±０．７２ｋＵ／Ｌ，ＰＯＦ组血清ＡＯＡｂ水平为６．８０±１．９１ｋＵ／Ｌ，两者比较，差异有极显著性（Ｐ＜０．０１）。与对照组比较，ＰＯＦ组ＣＤ３＋、ＣＤ４＋细胞百分率（分别为６５．４２±５．３１％和４４．７９±５．９０％）明显升高，ＣＤ８＋细胞百分率（２５．６３±４．２６％）明显降低，ＣＤ４＋／ＣＤ８＋比值（１．６６±０．２７）增加（Ｐ＜０．０１）。ＣＤ４＋／ＣＤ８＋比值升高者的ＡＯＡｂ阳性率（８５．７％，１８／２１），明显高于ＣＤ４＋／ＣＤ８＋比值正常者（３／９，Ｐ＜０．０１）。ＡＯＢｂ阳性的ＰＯＦ患者ＬＰＣＡ水平上升，且与ＡＯＡｂ之间有非常显著的相关性（χ２＝８．３７８，Ｐ＜０．０１）。结论：ＰＯＦ患者对卵巢抗原同时产生细胞免疫和体液免疫反应，ＰＯＦ的发病可能与免疫因素有关     

山莨菪碱对缺血心肌电生理的影响

通过结扎免冠状动脉左前降支，分析缺血心肌单相动作电位（ＭＡＰ）和心电图ＳＴ段变化的方法，观察了山莨菪碱对缺血心肌电生理的影响。结果心肌缺血５ｍｉｎ时，单相动作电位幅度（ＡＭＡＰ）、动作电位时程（ＭＡＰ９０和ＭＡＰ５０）分别降低１５．　６±３．６ｍＶ，２８．７±１２．４ｍｓ和４０．１±１３．４ｍｓ；给予莨菪碱静脉注射后，缺血５ｍｉｎ时上述各项指标的变化分别为９．３±３．４ｍＶ，２２．０±５．１ｍｓ和２３．１±７．５ｍｓ，两组之间差异明显（Ｐ＜０．０１）。缺血５ｍｉｎ时，单纯缺血组和加用山莨菪碱组的ＳＴ段偏移分别为０．３７±０．１７ｍＶ和０．２４±０．１０ｍＶ（Ｐ＜０．０１）。结果说明山莨菪碱可增加心肌对缺血的耐受力。     

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.