狭窄冠脉致犬心肌缺血模型在清醒与麻醉状态下的比较

目的：比较狭窄冠状动脉导致心肌缺血模型犬在麻醉和清醒状态下的差异,及药物治疗的差异。方法：在无菌条件下给犬心外膜安置心电电极、血压导管、信号发射器并分离冠状动脉前降支,放置动脉压迫环。手术恢复期后,动物按正交设计给予处置：分别在清醒与麻醉状态下狭窄冠状动脉,进行模型组和硝酸甘油治疗组的观察。主要监测心外膜心电图ST段、血压、心率、体温。结果与结论：麻醉犬心率明显高于清醒犬,冠脉狭窄后麻醉及清醒犬心电图ST段均明显升高;硝酸甘油治疗的效果,清醒犬较麻醉犬起效快,维持时间长。     

稳定型与变异型心绞痛患者心电图及冠状动脉造影特点分析

目的 探讨稳定型与变异型心绞痛患者心电图及冠状动脉造影的特点。方法 选取2014年8月—2018月6月十堰市人民医院诊治的心绞痛患者78例，所有患者都给予12导联动态心电图与冠状动脉造影检查，记录影像学特征，判断12导联动态心电图的诊断价值。结果 78例患者中，冠状动脉造影诊断为稳定型心绞痛58例（稳定组），变异型心绞痛20例（变异组），两组患者的性别、年龄、合并疾病、体重指数、心功能分级、狭窄分级等比较，差异无统计学意义（P >0.05）。变异组的ST-T压低、T波倒置、ST-T压低合并T波倒置等心电图特征与稳定组比较，差异有统计学意义（P <0.05）。变异组的QRS波持续时间高于稳定组（P <0.05）。心电图诊断变异型心绞痛的敏感性与特异性为95.0%和93.1%。Logistic回归分析显示QRS波持续时间、T波倒置、ST-T压低合并T波倒置是冠心病患者易发变异型心绞痛的影响因素（P <0.05）。结论 动态心电图鉴别诊断稳定型心绞痛与变异型心绞痛患者具有很好的敏感性与特异性，心电图可作为冠状动脉造影的补充检查手段。     

调肾保心法治疗冠心病心绞痛60例临床疗效观察

[目的] 观察调肾保心法治疗冠心病心绞痛临床疗效。[方法] 将120 例冠心病心绞痛患者随机分为观察组60 例和对照组60 例,两组均给予常规西药治疗,观察组在西药治疗基础上加用调肾保心法汤药(孙兰军经验方),两组疗程均为4 周,评价两组治疗前后心绞痛分级及发作次数、心电图变化、硝酸甘油用量及停减率、中医证候改善情况。[结果] 心电图改善情况:观察组总有效率为81.67%,优于对照组53.33%(P<0.05);心绞痛疗效:观察组治疗后发作次数及硝酸甘油停减均优于对照组(P<0.05);心绞痛分级变化观察组较对照组有优势;中医证候疗效观察组总有效率为91.7%,优于对照组78.3%(孕约园援园缘)。[结论] 调肾保心法对冠心病心绞痛临床疗效显著,值得推广应用。     

复方丹参滴丸对豚鼠离体心脏心电图的影响

目的 观察复方丹参滴丸及其组成药物丹参、三七对豚鼠离体心脏心电图的影响,研究其心脏毒性作用。方法 应用Langendorff离体豚鼠心脏灌流装置,将复方丹参滴丸浸膏和丹参浸膏（给药质量浓度均以丹参素计）、三七浸膏（给药质量浓度以人参皂苷Rg₁计）均按3、0.3、0.1、0.03 μg/mL灌注,观察离体豚鼠心脏心电图的变化。结果 复方丹参滴丸浸膏和丹参浸膏对豚鼠离体心脏心电图无明显影响,三七浸膏在低质量浓度（0.3、0.1、0.03 μg/mL）对豚鼠离体心脏心电图没有影响,但在3 μg/mL时可轻微延长PR、RR间期,减慢心率,与对照相比差异显著（P＜0.05）。3种药物对校正后的QT间期（QT_c）及T波峰到T波结束间期（T_p-e）均无显著影响。结论 复方丹参滴丸及其组成药物丹参、三七在实验质量浓度范围内不诱发心室肌细胞复极化延长及严重心律失常。     

聚乙二醇化葛根素对大鼠心肌缺血再灌注损伤的保护作用

目的 探讨聚乙二醇（PEG）化葛根素对大鼠心肌缺血再灌注损伤（MIRI）的保护作用。方法 将SD大鼠随机分为6组（每组10只）： 假手术组,MIRI模型组,葛根素注射剂（20 mg/kg）对照组,PEG化葛根素低、中、高剂量（244、488、976 mg/kg）组。阻断大鼠升主动脉造成心肌缺血30 min,再灌注120 min,造成大鼠MIRI模型,在结扎后5 min各给药组尾iv给药。心电图监测心律失常情况,再灌注结束后腹主动脉采血,测定血清肌酸激酶（CK）、乳酸脱氢酶（LDH）、天冬氨酸转氨酶（AST）和丙二醛（MDA）水平,并测量心肌梗死面积。结果 葛根素注射剂和PEG化葛根素均具有抗心律失常,降低血清中CK、LDH、AST和MDA水平的作用,减少心肌梗死面积;其中PEG化葛根素中、高剂量组的药效明显强于葛根素注射剂组。结论 PEG化葛根素对大鼠MIRI引起的损伤具有保护作用。     

RP-HPLC法测定左卡尼汀片中左卡尼汀杂质A

目的 探讨聚乙二醇（PEG）化葛根素对大鼠心肌缺血再灌注损伤（MIRI）的保护作用。方法 将SD大鼠随机分为6组（每组10只）： 假手术组,MIRI模型组,葛根素注射剂（20 mg/kg）对照组,PEG化葛根素低、中、高剂量（244、488、976 mg/kg）组。阻断大鼠升主动脉造成心肌缺血30 min,再灌注120 min,造成大鼠MIRI模型,在结扎后5 min各给药组尾iv给药。心电图监测心律失常情况,再灌注结束后腹主动脉采血,测定血清肌酸激酶（CK）、乳酸脱氢酶（LDH）、天冬氨酸转氨酶（AST）和丙二醛（MDA）水平,并测量心肌梗死面积。结果 葛根素注射剂和PEG化葛根素均具有抗心律失常,降低血清中CK、LDH、AST和MDA水平的作用,减少心肌梗死面积;其中PEG化葛根素中、高剂量组的药效明显强于葛根素注射剂组。结论 PEG化葛根素对大鼠MIRI引起的损伤具有保护作用。     

瑞香素不同给药途径在大鼠体内药动学研究

目的 建立大鼠血浆中瑞香素的测定方法,观察瑞香素在大鼠体内的药动学行为。方法 将大鼠随机分组,分别 ig 瑞香素溶液 250、312.5、375 mg/kg,尾 iv 瑞香素溶液 50、62.5、75 mg/kg,HPLC 测定不同时间间隔的血药浓度,运用 DAS 1.0 药动学程序计算药动学参数。结果 大鼠 ig 给药后符合单室开放模型;iv 后也符合单室开放模型。结论 瑞香素在大鼠体内能快速分布并消除,两种给药途径瑞香素的体内药动学过程不同,静注和口服给药各有优势。     

委陵菜黄酮在大鼠体内的药动学研究

目的：建立测定血浆中委陵菜黄酮的分析方法,初步对该化合物在大鼠体内的经时过程进行考察。方法：建立委陵菜黄酮的HPLC测定方法,考察大鼠iv委陵菜黄酮（10、20、40 mg/kg）后血药浓度-时间曲线。结果：大鼠尾iv 3 个剂量委陵菜黄酮后,血浆药时曲线符合三室模型,药时曲线下面积AUC_0-180分别为346.05、455.74和1 655.14 μg/（mL·min）,分布相半衰期t_1/2α分别为103.90、15.59和9.49 min,消除相半衰期t_1/2β分别为30 580.98、2 045.70和894.84 min。结论：iv给药后,委陵菜黄酮血浆药时曲线符合三室模型,在大鼠体内迅速分布,但消除速率较慢。     

杠柳毒苷在大鼠体内的药动学研究

目的 考察杠柳毒苷iv给药在大鼠体内的药动学过程。方法 大鼠iv给予低、中、高剂量（0.37、0.74、1.48 mg/kg）杠柳毒苷后于不同时间点采血,血浆样品经甲醇沉淀蛋白-C₁₈固相萃取处理,HPLC-UV法测定不同时间点大鼠血浆中杠柳毒苷药物浓度。用DAS药动学数据软件计算药动学参数。结果 低、中、高剂量组杠柳毒苷的分布相半衰期t_1/2α分别为1.49、2.32、3.48 min,消除相半衰期t_1/2β分别为14.00、12.37、15.44 min,无显著性差异。AUC_0-60分别为8.581、19.782、50.615 mg/L?min,与剂量呈线性相关。结论 杠柳毒苷iv给药在大鼠体内分布及消除迅速,其体内过程符合二房室模型,在0.37～1.48 mg/kg符合线性动力学过程。     

“心痛膏”穴位敷贴治疗胸阳痹阻型冠心病心绞痛120例疗效观察

[目的] 观察“心痛膏”穴位敷贴治疗胸阳痹阻型冠心病心绞痛短期疗效。[方法] 202例患者随机分为两组,治疗组120例,对照组82例。治疗组在中西医治疗基础上给予“心痛膏”穴位敷贴治疗,每次6贴分贴于特定穴位,每次4 h,每日1次。对照组单纯为中西医基础治疗,无中药外敷。待1个疗程即两周后,记录对比治疗前后患者的临床症状（包括心电图变化等）、硝酸甘油用量,观察心绞痛发作频率和持续时间。[结果] 结合“心痛膏”穴位敷贴治疗可有效缓解胸阳痹阻型冠心病心绞痛患者不适症状,改善心电图、减少硝酸甘油用量,心绞痛程度减轻、发作频率下降、发作时间缩短,从而疗效优于对照组治疗。[结论] 结合“心痛膏”穴位敷贴短期治疗胸阳痹阻型冠心病心绞痛效果较好,有一定的临床推广价值。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.