腹膜透析液对小鼠腹膜间皮超微结构的影响

目的应用美国Ｂａｘｔｅｒ腹膜透析液和国产乳酸盐、醋酸盐腹膜透析液进行持续性不卧床腹膜透析动物实验,以观察和比较不同类型透析液对正常小鼠腹膜间皮的损伤作用。方法分别将３种透析液注入各组小鼠腹膜腔内,在透析第１０天、第２１天和停药后第１０天取膈腹膜,作电镜观察。结果注入透析液后第１０天,乳酸盐组和醋酸盐组腹膜间皮发生病理变化并随着透析时间延长而进行性加重,出现微绒毛脱落和粘连、间皮细胞皱缩和纤维蛋白性粘连。Ｂａｘｔｅｒ组间皮细胞的病理变化表现轻微。注入透析液后第２１天,乳酸盐组和醋酸盐组的腹膜淋巴孔直径分别为（６．９６±２．４６）和（６．９８±２．１６）μｍ,明显大于对照组（１．４７±０．８８）μｍ（Ｐ＜０．０１）;淋巴孔的分布密度与对照组比较差异亦有显著性（Ｐ＜０．０１）,而Ｂａｘｔｅｒ组的淋巴孔直径及分布密度均无明显变化。停止注射透析液后第１０天,Ｂａｘｔｅｒ组间皮细胞恢复正常;乳酸盐组和醋酸盐组均有不同程度恢复,但淋巴孔仍呈病理改变。结论乳酸盐和醋酸盐腹膜透析液易引起腹膜间皮细胞纤维化,导致硬化性腹膜炎的发生。     

腹膜孔与腹水转归机理的研究

应用扫描电镜、透射电镜和ODO冷冻断裂技术,对16例人体样本的腹膜孔进行研究;并为证实腹膜孔作为腹水吸收的主要通路,作了动物实验。结果表明:人体腹膜孔位于膈腹膜立方形间皮细胞之间,由相邻细胞的胞质突起围成。构成腹膜孔的立方形间皮细胞和腹膜孔无基底膜。在立方形间皮细胞的胞质内有成束的微丝。在腹膜下小管内,有由间皮细胞的胞质突起和结缔组织形成的纤维网格,并构成腹膜孔的底和淋巴陷窝的顶。在动物实验中,腹水小鼠的腹膜孔数量增多。口径变大;注入小鼠腹膜腔内的红细胞和碳颗粒被腹膜孔所吸收。本实验结果提示,立方形间皮细胞胞质内的微丝、腹膜下小管内的间皮细胞胞质突起和纤维网格,对腹膜孔的吸收起调节作用,腹膜孔是腹水转归的主要通道。     

膈腹膜吸收间皮扫描电镜图像处理系统定量研究

应用扫描电镜、电镜与计算机联机数字图像处理系统对小鼠膈腹膜进行观察、图像复原、图像数据化处理和统计分析，并根据腹膜间皮形态和功能提出吸收间皮概念。同时，还以测定吸收间皮分布面积揭示腹膜对物质的转归作用。实验结果表明，全膈腹膜吸收间皮以板块状正偏态分布，最大板块面积１１５３μｍ＾３，最小６６μｍ＾２，其中左膈和右膈腹膜吸收间皮均以正态分布。全膈、左膈和右膈腹膜吸收间皮板块平均面积分别为４３２．６μｍ     

改良的经腹腹膜外剖腹产术的临床观察

对１５０例有剖宫产指征，存在宫内感染因素的产妇分别采用改良经腹腹膜外，腹膜外和子宫下段三种不同术式剖宫产。结果表明：三术式切皮至胎头娩出平均时间依次为１９．５，２２．６和１９．９ｍｉｎ（ｐ〈０．０５）；手术总平均时间依次为５８．０，６８．２和７２．０ｍｉｎ（ｐ〈０．０１）；术后胃肠功能恢复平均时间依次为２６．６，２６．０和４７．９ｈ（ｐ〈０．０１）；术后产褥病率依次为１０．０％，１２．０％和２４．     

多虑平贴膏抗过敏作用实验研究

实验用０．２％和０．０５％多虑平贴膏溶液抗２，４一二硝基氯苯所致小鼠皮肤过敏反应。降低小鼠耳肿胀重量分别为１１．４±１．３和１１．６±１１．２ｍｇ，生理盐水（ＮＳ）为１５．９±２．２ｍｇ（Ｐ＜０．０１）；抗组胺所致大鼠皮肤血管扩张面积分别为０．０４±０．０６和０．４０±０．５４ｃｍ￣２，ＮＳ为１．４２±０．７１ｃｍ￣２（Ｐ＜０．０１）；提高组胺对豚鼠的致痒阈分别为６３５．５±９９和１５８±４３ｍｇ，ＮＳ为３０±２９．４μｇ（Ｐ＜０．０１）；抗炎性刺激所致毛细血管通透性吸光度分别为０．１７±０．０５和０．２０±０．１３，ＮＳ为０．３９±０．０６（Ｐ＜０．０１）。结果表明多虑平贴膏有很强的抗过敏作用，是一种新型抗过敏制剂。     

阿奇霉素分散片人体生物利用度及生物等效性对比研究

以藤黄八迭球菌为指示菌,采用微生物法测定 １０ 名志愿者阿奇霉素分散片（实验制剂）和胶囊（参比制剂）经时血药浓度。最低检测限度 ０００５μｇ／ｍ ｌ,线性范围 ００１～０４μｇ／ｍ ｌ。实验采用双交叉单剂口服给药设计,数据经 ３ Ｐ９７ 药代动力学程序处理,阿奇霉素实验制剂和参比制剂主要药物动力学参数 ｋａ为０７２１９±０．０７５５ｈ－ １ 和 ０．７５５２±０．０５９３ｈ－ １,ｔ１／２（α）为 ２．３１８８±０．２４３８ｈ 和 ２．３５１８±０．３８１１ｈ,ｔ１／２ （β）为４１．５８１０ ±２． ２２８５ｈ 和 ４４．１２８３±９．８６４３ｈ, Ｃｍ ａｘ 为 ０．２４５８ ±０．００５８μｇ／ｍ ｌ 和 ０．２３８３±０．００６１μｇ／ｍ ｌ, Ａ Ｕ Ｃ０～１２０为 ０．４１７０±０．０８７４μｇ／（ｍ ｌ·ｈ ）和 ０．３８７７±０．０９６２μｇ／（ｍ ｌ·ｈ ）,实验制剂相对生物利用度为１０７．０５６６％ 。经双单侧ｔ检验和（１２α）置信区间法分析,两种制剂主要药代动力学参数剂型间、阶段间和个体间差异均无显著性（ Ｐ＞ ０．０５）,证实二者具有生物等效性。     

改良的经腹腹膜外剖腹产术的临床观察

对１５０例有剖宫产指征，存在宫内感染因素的产妇分别采用改良经腹腹膜外，腹膜外和子宫下段三种不同术式剖宫产。结果表明：三术式切皮至胎头娩出平均时间依次为１９．５，２２．６和１９．９ｍｉｎ（Ｐ＜０．０５）；手术总平均时间依次为５８．０，６８．２和７２．０ｍｉｎ（Ｐ＜０．０１）；术后胃肠功能恢复平均时间依次为２６．６，２６．０和４７．９ｈ（Ｐ＜０．０１）；术后产褥病率依次为１０．０％，１２．０％和２４．０％（Ｐ＜０．０１）；术后并发症依次为０％，２６．０％和６．０％（Ｐ＜０．０１）。新生儿Ａｐｇａｒ１ｍｉｎ评分，术中出血量三种不同术式组无明显差异。改良经腹腹膜外剖宫产是一种简便、安全、实用的术式，尤适用于子宫下段形成不良、存在宫内感染因素的产妇。     

冻疮搽剂药效学实验研究

含生药量分别为２５％和１２．５％的冻疮搽剂降低小鼠炎症性耳肿胀分别为８．７±３．３和９．９±４．２μｇ，对照组为１３．８±２．８ｍｇ（Ｐ＜０．０５或０．０１）；提高豚鼠对组胺的致痒阈分别为２７０．５±２９．４和９４．０±４１．６μｇ，对照组为３０．０±２９．４μｇ（Ｐ＜０．０１）；拮抗炎性刺激所致毛细血管通透性吸光度分别为０．１１±０．０３和０．１３±０．０３，对照组为０．２２±０．０３（Ｐ＜０．０１）；消除大鼠蛋清所致脚趾肿胀，６ｈ末分别为０．１１±０．０８和０．１３±０．１３ｃｍ￣３，与对照组０．３５±０．１２ｃｍ￣３均有显著差异（Ｐ＜０．０１）．结果表明冻疮搽剂具有广泛的药理作用，是治疗冻疮的有效制剂。     

掺硅对铁黄合成过程及铁黄形态的影响 Ⅰ.掺硅时间和掺硅量的影响

研究了掺硅时间和掺硅量对铁黄形态及结构的影响规律，制得了分布均匀、无枝叉的超细铁黄，其平均长轴为０．２～０．２５μｍ，轴比＞９。发现反应开始时硅酸钠的添加量越大，铁黄粒子越小，分布也越均匀，最终铁黄的结构变化也越大。当反应初期合成体系中硅原子与铁原子的摩尔比大于０．０１５时，反应过程会生成Ｆｅ３Ｏ４。铁黄合成后期掺硅对铁黄大小和轴比影响不大，但可以有效防止铁黄粒子凝并。     

高温下身着防毒服作业时全身汗中营养成分流失的初步研究

本研究观察了１３名男性青年身着全身式防毒服，在热室（干球温度３４．２℃）内以５．４ｋｍ的时速行走，至自觉不能忍受再坚持２００ｍ时为止，其汗液中主要营养成分的流失情况。结果行走时间为５８．２±２．９ｍｉｎ，平均体温３７．８±０．１℃，心率１５１．３±８．０ｂｐｍ，出汗量仅７８０．５±７５．２ｇ。全身汗液中Ｋ、Ｎａ、Ｃａ，Ｍｇ、Ｆｅ、Ｃｕ、Ｚｎ浓度分别为１２．３±１．８、１１３．０±７．０、０．８±０．１３、０．９±０．２０、０．０２７±０．００４、０．００５±０．００１、０．０３５±０．００２ｍｍｏｌ／Ｌ，血清Ｋ、Ｚｎ浓度降低，且Ｚｎ低于正常水平。每升汗液中氨基酸总量为１０８５５±６７９μｍｏｌ／Ｌ；必需氨基酸占２１．２％，其中以赖氨酸最高，为１０３８．５±９０．７μｍｏｌ／Ｌ，蛋氨酸最低，为４９．８±４．０μｍｏｌ／Ｌ；非必需氨基酸以丝氨酸、甘氨酸最高，分别为２７７４．３±１７９．０和１５７２．１±８３．９μｍｏｌ／Ｌ；胱氨酸最低，为４．８±０．９μｍｏｌ／Ｌ。汗液中维生素Ｂ１、Ｂ２、Ｃ仅分别为４５２±２２０、３１２±１７４和３３３０±１２００μｇ／Ｌ。     

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.