银杏叶提取物对糖尿病大鼠血液、睾丸组织中内皮素和一氧化氮水平的影响

目的:探讨银杏叶提取物(EGb)对糖尿病大鼠血液、睾丸组织中内皮素(ET)和一氧化氮(NO)水平的影响.方法:将SD大鼠分为三组:正常对照组、糖尿病组、EGb治疗组.EGb治疗5 w后,分别测定三组大鼠血液中葡萄糖、胰岛素、ET和NO水平以及睾丸组织中ET、NO水平和一氧化氮合酶(NOS)活性.结果:EGb治疗组与糖尿病组大鼠比较血糖明显降低(P＜0.01),血清胰岛素水平轻度升高(P＞0.05).各组大鼠血浆中ET水平无明显差异(P＞0.05),血浆NO水平糖尿病组显著高于对照组,而EGb治疗组明显低于糖尿病组(P＜0.05).睾丸组织中ET水平糖尿病组显著高于对照组(P＜0.05),EGb治疗组低于糖尿病组(P＞0.05);EGb治疗组大鼠睾丸组织中N0水平、NOS和iNOS活性显著低于糖尿病组(P＜0.01和P＜0.05).结论:EGb可通过降低糖尿病大鼠血液中葡萄糖和NO水平及睾丸组织中ET、N0水平和NOS活性,从而减轻糖尿病对睾丸组织所造成的损害.     

SS-GAG对高糖状态下血管内皮细胞NO释放及ET-1分泌的影响

目的观察高糖状态下扇贝裙边糖胺聚糖(scallop skirt glycosaminogly can, SS-GAG)对体外培养的血管内皮细胞(ECV-304)一氧化氮(NO)释放及内皮素-1(ET-1)分泌的影响。方法在体外培养生长良好的ECV-304分别加入不同浓度葡萄糖,建立高糖损伤细胞模型,选择葡萄糖终浓度为55.5mmoL/L的培养液作为高糖环境,加入不同浓度SS-GAG继续培养至12、24、36、48h,倒置显微镜下观察细胞生长状态,特异性硝酸还原酶法检测细胞内NO,放射免疫法测定ET-1。结果① 高糖能抑制ECV-304细胞生长,细胞形态发生改变。 SS-GAG减轻高糖对ECV-304损伤,SS-GAG保护组细胞形态基本完好;② 高浓度葡萄糖促进ET-1的分泌,与正常对照比较差异有统计学意义（P＜0．01)。而NO含量则随作用时间的延长表现出先升高后下降的动态变化过程,与正常对照比较差异有统计学意义（P＜0．01)。SS-GAG对高糖状态下ECV-304细胞分泌ET 1、NO具有调节作用,使其趋于正常,与正常对照比较差异无统计学意义（P＞0．05),与高糖比较差异有统计学意义（P＜0．01)。结论高浓度葡萄糖对ECV-304具有明显的损伤作用,可直接导致ECV-304形态和功能异常,引起ET-1分泌增多以及损伤内皮NO系统使NO分泌失调。SS-GAG可减轻高糖对ECV-304细胞的损伤,通过调节 ET和NO平衡,起到保护ECV-304作用。     

先天性心脏病伴肺动脉高压患者血清一氧化氮及血浆内皮素水平的变化研究

目的探讨一氧化氮（NO）和血浆内皮素1（ET－1）在先天性心脏病（COHD）合并肺动脉高压中的作用及其临床意义。方法75例左向右分流型COHD患儿分为三组：其中无肺动脉高压组25例;轻度肺动脉高压组25例和中重度肺动脉高压组25例,正常对照组25例。采用放射免疫法和硝酸盐还原酶法测定血液中NO和ET－1含量,计算NO／ET—1比值。结果CHD组血浆ET－1水平（46．18±2．541pg／ml）高于对照组（25．75±3．87pg／ml）,P〈0．005;血清NO浓度（23．82±6．46μg／ml）低于对照组（37．27±2．47μg／ml）,P〈0．001;NO／ET—1的比值（0．68±0．39）明显低于对照组（1．18±2．80）,P〈0．001。CHD伴中重度肺动脉高压组的NO浓度低于轻度肺动脉高压组和无肺动脉高压组（P〈0．001）,肺动脉压力的程度和NO／ET—1的浓度呈负相关（r=-0．813,P〈0．001）。结论COHD患者血浆ET—1浓度的升高和NO浓度的降低及NO／ET-1比值降低,在肺动脉高压形成和发展中起到了重要的作用。     

乙酸性胃溃疡大鼠溃疡愈合不同时期一氧化氮及内皮素的变化

目的探讨雷尼替丁干预不同时期中一氧化氮(NO)、内皮素(ET)在大鼠乙酸性胃溃疡的变化及其相互关系。方法采用乙酸性胃溃疡模型,测定不同干预时期大鼠血清中NO、ET水平并分析其相互关系,观察溃疡的病理变化。结果大鼠在造模形成溃疡后,模型组NO水平较健康对照组降低,而ET-1水平较健康对照组升高(P<0.01);经雷尼替丁治疗2周后,NO水平无明显回升,ET-1水平无明显降低(P>0.05),大鼠胃溃疡未愈合;治疗4周后,大鼠NO水平明显回升,而ET-1水平明显降低(P<0.01或P<0.05),溃疡趋向愈合;治疗6周后,大鼠NO水平回升至正常,而ET-1水平下降至正常,与健康对照组比较,差异无统计学意义(P>0.05),溃疡愈合。经相关分析表明NO水平改变与ET-1水平变化呈负相关(P<0.01)。结论大鼠乙酸性胃溃疡时,NO/ET失衡,雷尼替丁可诱导、促进NO合成,反馈性抑制ET生成,使NO/ET平衡重建,溃疡愈合。     

高血压孕妇血浆一氧化氮、内皮素-1和尿一氯化氮及cGMP水平

目的：比较先兆子痫和血压正常孕妇血清一氧化氮（NO）和内皮素-1（ET-1）、尿NO和尿环磷鸟苷（cGMP）水平差异。方法：孕〉32周的91例先兆子痫患者（轻度48例，重度43例）和40例血压正常的健康孕妇纳入研究。采用化学发光法测量血清和尿NO水平，采用放射免疫法测定血清ET-1和尿cGMP水平。结果：先兆子痫孕妇血清和尿NO及尿cGMP水平显著低于对照组（分别为P〈0．001，P〈0．001及P〈0．01）。先兆子痫孕妇血清ET—1水平显著高于对照组（P〈0．001）。在所有分组中．血浆ET—1、NO与尿NO及cGMP均旱显著负相关，而血浆NO、尿NO和尿cGMP呈正相关。结论：NO和ET-1的失衡在先兆子痫病生理机制上起重要作用。     

内皮素、一氧化氮水平与老年糖尿病肾病的关系探讨

目的 :探讨老年糖尿病肾病 (DN)与血清内皮素 (ET)及一氧化氮 (NO)的关系。方法 :选择糖尿病 (DM)患者 5 6例 ,分为DN组及非糖尿病肾病组 (NDN) ,分别测定各组的血清 ET及 NO水平 ,并将 ET及 NO进行相关分析。结果 :DM组血 ET及NO水平明显升高 (P <0 .0 5 ) ,ET/ NO无明显变化 (P >0 .0 5 ) ,DN组与 NDN组比较 ,DN组 ET及 ET/ NO明显高于 NDN组 (P <0 .0 1) ,NO明显低于 NDN组 (P <0 .0 1) ,ET与 NO呈负相关 (P <0 .0 1)。结论 :DN组与 NDN组相比 ,血 ET明显升高 ,NO明显降低 ,ET、NO水平与糖尿病肾病的发生发展密切相关。     

丹参对心肌缺血—再灌注损伤大鼠心功能及血清一氧化氮和血浆内皮素的影响

目的 观察丹参对心肌缺血－再灌注损伤大鼠心功能及血清一氧化氮和血浆内皮素的影响。方法 建立在体大鼠心肌缺血－再灌注损伤模型，用心功能分析系统测定左室心功能，分别用酶法和放免法测定血清NO和血浆ET水平。实验分假手术组、心肌缺血－再灌注损伤组和丹参治疗组。结果 在缺血期和再灌注期，缺血－再灌注损伤组与假手术组相比，左心LVSP、＋dp/dtmax、－dp/dtmax、＋dp/dtmax/IP明显下降（P＜0．001），血清NO水平明显降低，血浆ET值显著升高（P＜0．001）；而丹参则使LVSP、＋dp/dtmax、-dp/dtmax、＋dp/dtmax／IP明显升高（与缺血－再灌注损伤相比，P＜0．001），提高血清NO水平，降低血浆ET值，恢复NO／ET平衡（P＜0．001）。结论 丹参能改善心肌缺血－再灌注损伤大鼠左心舒缩功能，提高血清NO和降低血浆ET水平，恢复NO／ET平衡。     

实验性糖尿病肾病大鼠肾皮质NO和ET-1测定

目的 :测定实验性糖尿病肾病大鼠肾皮质中NO和内皮素 1(ET 1)的含量 ,探讨NO和ET 1含量变化在糖尿病肾病发生发展中的作用。方法 :应用链脲佐菌素 (STZ)诱导糖尿病大鼠 ,分别在成模后 2周、12周时处死 ,应用硝酸还原酶法测定其肾皮质匀浆中NO2 -/NO3 -含量 ,应用放免法测定肾皮质匀浆中ET 1含量。结果 :糖尿病大鼠 2周、12周时 ,血糖、内生肌酐清除率、2 4h尿蛋白量、肾重 /体重比均明显高于同时期正常组大鼠 (P <0 .0 1)。糖尿病大鼠 2周时肾皮质匀浆中NO2 -/NO3 -含量明显高于 2周正常组大鼠 (P <0 .0 1) ,并与内生肌酐清除率呈正相关 (r=0 .75 ,P <0 .0 5 ) ,而肾皮质匀浆中ET 1含量则低于正常组 (P <0 .0 1) ;12周时糖尿病大鼠肾皮质匀浆中NO2 -/NO3 -含量明显下降 ,并低于 12周正常组大鼠 (P <0 .0 1) ,而肾皮质匀浆中ET 1含量则高于正常组 (P <0 .0 1)。结论 :糖尿病早期 ,肾皮质组织内NO含量升高 ,ET 1含量下降 ,参与早期肾小球高滤过机制 ;糖尿病晚期 ,肾皮质组织内NO水平下降 ,ET 1水平升高 ,可能参与肾小球硬化机制     

内皮素-1、一氧化氮、诱导型一氧化氮合酶在新生儿缺氧性肺动脉高压中的研究

目的：探讨血清内皮素-1（ET—1）、一氧化氮（NO）、诱导型一氧化氮合酶（iNOS）在新生儿缺氧性肺动脉高压（HPH）的作用。方法：本研究对35例HPH新生儿、22例正常新生儿,分别于生后3天内、第7天采血,用ELISA法检测血清NO、iNOS、ET-1含量,并采用彩色多普勒超声心动图同步测定肺动脉收缩压（PASP）、检测血气分析。结果：1．HPH组与对照组PaO2、PaO2／FiO2、PASP值的比较：两组间三者的数值在发病3天内,差异有统计学意义（P〈0．05,P〈0．01）,第7天升高,与对照组相比差异无统计学意义（P〉0．05）。2．HPH组与对照组血清NO、iNOS、ET-1水平的比较：发病3天内HPH组血清iNOS、ET-1水平较对照组明显增高,NO水平较对照组明显减低,差异均有统计学意义（P〈0．05）。第7天,ET-1水平有所下降、但仍持续在较高水平,与对照组相比差异仍有统计学意义（P〈0．05）;iNOS水平较前明显降低,与对照组相比差异无统计学意义（P〉0．05）;而NO水平在第7天较前升高,与对照组相比较略低、差异无统计学意义（P〉0．05）。3．血清N0、iNOS、ET-1水平与PASP的关系：发病3天内,血清iNOS、ET-1水平与PASP呈正相关（P〈0．01,P〈0．05）,NO水平与PASP呈负相关（P〈0．01）;第7天,仅血清ET-1与PASP仍呈正相关（P〈0．05）,NO、iNOS水平与PASP均无相关性。结论：在新生儿HPH急性缺氧早期,ET-1合成增多,NO减少,使肺动脉平滑肌痉挛、收缩,促进了HPH的发生、发展,而随着肺血管内皮细胞功能的改善,在iNOS的持续刺激下,NO水平逐渐增高,调节HPH病情的恢复。血清NO、iNOS、ET-1可能参与了新生儿HPH的发生、发展。     

创伤性休克患者血浆内皮素和血清一氧化氮的变化及意义

目的：探讨一氧化氮（NO）与内皮素（ET）在创伤性休克患者中的变化及临床意义。方法：将56例创伤性休克患者分成轻度、中度、重度3组。另选取35例健康人作为正常对照组，各组均采用放射免疫法检测血浆ET和血清NO水平，同时进行对比分析。结果：创伤性休克患者轻度组血浆ET和血清NO的含量仅轻度升高．与正常对照组比较差异无统计学意义（P〉0．05）；中度、重度组患者血浆ET和血清NO较正常对照组明显升高（P〈0.05）．中度组患者血浆ET和血清NO水平较轻度组为高（P〈0．05），重度组患者又较中度组高（P〈0．05）。创伤性休克患者血清NO与血浆ET水平呈正相关（r=0．61）。结论：ET和NO可能协同参与了创伤性休克患者的发病过程。血浆ET和血清NO升高越明显，创伤性休克患者病情越重。血浆ET和血清NO的检测可作为判断病情轻重的一个重要临床指标。     

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.