饮红茶对大鼠慢性缺氧性肺动脉高压的影响

慢性缺氧过程中，饮红茶的大鼠（HT组）平均肺动脉压（Ppa）为2.50±0.20kPa，肺血管阻力（PVR）为2824.80±658.69kPa·s~(-1)／L，均显著低于缺氧对照组（Ppa为2.97±0.25kPa，PVR为3763.46±529.62kPa·s~(-1)／L），而HT组肺血管对急性缺氧的反应性（22.50±6.16％）则显著强于缺氧对照组（10.65±3.80％）。结果表明，长期饮红茶可防止大鼠慢性缺氧性肺动脉高压的形成。     

低体温对肺循环的影响

本文观察了低体温时实验动物肺循环的变化,并初步探讨了气道动力学对其影响。结果发现:低体温时动物平均肺动脉压及肺血管阻力均显著上升,分别从基础值1.41±0.04kPa和36.00±2.31kPa·s/L上升到1.83±0.12 kPa和106.92±11.91kPa·s/L,低体温前后肺动脉嵌压无明显变化,心输出量减少。低体温时动物肺通气量显著减小,从对照值7.63±0.79 L/min降至4.53±0.59L/min,但动脉血气值无显著变化,肺动态顺应性变化不明显,肺组织形态结构无显著变化。提示:低体温时肺动脉收缩,导致肺血管阻力加大是肺高压形成的原因。低体温时肺血管的收缩反应与肺低通气无关。     

消炎痛及乙胺嗪对动物急性缺氧性肺、脑血管反应的影响

研究消炎痛及乙胺嗪对家兔肺、脑血管和大鼠脑微动脉缺氧反应的影响。发现吸入10％氧使家兔肺血管阻力(PVR)增加,脑血管阻力(CVR)降低,大鼠脑微动脉扩张。用消炎痛明显增强家兔缺氧性肺、脑血管反应。△PVR％由用药前26.6±16.7％增至44.2±7.7％;△CVR％则由一12.9±4.5％减至-30.7±4.7％;大鼠微动脉直径增大率(△D％)由用药前28.2±2.0％增至41.3±5.8％;用乙胺嗪则使缺氧时△PVR％由 84.6±18.1％降至 23.8±8.5％;△CVR％由-16.7±4.5％变为 6.9±2.8％;△D％由 29.7±5.8％减至 25.6±5.0％。结果表明前列腺素在缺氧性肺血管收缩反应及脑血管扩张反应中起调节作用,而白三烯则在缺氧性肺血管收缩反应中起介导作用。     

大鼠过敏性肺泡炎时肺血管反应性的变化

本实验采用普通高温放线菌(Therm oactinomyces vulgaxis)孢子混悬液给SD大鼠气管内缓慢注入,以复制过敏性肺饱炎,测定其血流动力学指标,并与对照组和注盐水组动物比较,观察大鼠肺血管反应性的变化。结果表明,肺泡炎大鼠的血流动力学指标与对照组和盐水组比较差异无显著意义;但对缺氧的肺血管收缩反应(△PVR),肺炎组(729.4±152.3kPa·s/L)明显低于盐水组(1434.8±295.1kPa·s/L)和对照组(1838.9±620.3kPa·s/L)。     

洗涤红细胞保护液肺动脉灌注对体外循环术后肺损伤的影响

目的观察心内直视手术中采用低温洗涤红细胞保护液肺动脉灌注对肺损伤的影响。方法选择风湿性二尖瓣病变伴中重度肺动脉高压(PH)的患者30例,分为肺动脉灌注组和对照组(各15例)。灌注组在升主动脉阻断后,经主肺动脉间断灌注低温洗涤红细胞保护液,测定并记录两组患者围术期的肺血管阻力(PVR)、静脉血与动脉血白细胞计数比值(V/A)、肺循环血浆丙二醛(MDA)含量及氧合指数(OI)、机械辅助通气时间。结果(1)PVR:转流结束即刻、术后12、24h灌注组(46·4kPa·s·L-1±8·1kPa·s·L-1、48·5kPa·s·L-1±7·0kPa·s·L-1、36·1kPa·s·L-1±6·3kPa·s·L-1)明显低于对照组(65·7kPa·s·L-1±5·3kPa·s·L-1、79·8kPa·s·L-1±8·7kPa·s·L-1、47·9kPa·s·L-1±7·1kPa·s·L-1,均P<0·05)。(2)MDA含量:转流结束即刻、术后12、24h灌注组(分别为14·3mmol/L±0·8mmol/L、16·1mmol/L±0·7mmol/L、13·3mmol/L±0·5mmol/L)明显低于对照组(18·9mmol/L±0·9mmol/L、21·6mmol/L±0·4mmol/L、22·5mmol/L±0·7mmol/L,均P<0·05)。(3)V/A比值:转流结束即刻、术后12h灌注组(1·16±0·05、1·20±0·05)明显低于对照组(1·53±0·07、1·68±0·25,均P<0·01)。(4)OI:转流结束即刻、术后12、24h灌注组(370±33、388±41、414±40)明显高于对照组(217±30、210±36、222±33,均P<0·05)。(5)机械辅助通气时间:灌注组(13h±4h)显著低于对照组(27h±6h,P<0·01)。结论洗涤红细胞保护液肺动脉灌注可以减轻体外循环术后肺损伤。     

川芎嗪与尼群地平配伍对慢性阻塞性肺病患者血流动力学的影响

对15例慢性阻塞性肺病(COPD)患者应用右心漂浮导管检测技术,观察了川芎嚎与尼群地平配伍对血流动力学的影响。同时,用放射免疫法测定了治疗前后肺动脉混合静脉血浆内皮素-1(ET-1)、血栓素B_2(TXB_2)、6-酮-前列腺素F_(1a)(6-Keto-PGF_(1a))浓度。结果发现:用药即刻和15、30、60min时肺动脉平均压(mPAP)分别下降了1.4％、17.0％、20.0％、18.0％;肺循环阻力(PVR)分别下降了15.2％、36.2％、43.0％、34.6％,体循环阻力(SVR)分别下降了7.9％、19.2％、17.9％、20.8％;心输出量(CO)上升15.8％、22.6％、22.2％、33.8％,体循环血压(mSAP)及心率(HR)的变化无统计学意义。血浆ET-1水平从(78.47±20.27)ng/L降至(61.37±25.20)ng/L(P<0.05);TKB_2从(397.92±190.25)ng/L降至(179.28±88.87)ng/L(P<0.05);6-Keto-PGF_(1a)无变化;TXB_2/6-Keto-PGF_(1a)比值从8.40±2.28降至5.48±2.19(P<0.05)。结果表明:二药配伍能有效降低肺血管阻力及肺动脉压,且对肺循环有一定的选择性。其作用可能是通过降低血浆ET-1水平及调节TXB_2/6-Keto-PGF_(1a)比值来实现的。     

1,6-二磷酸果糖对组胺升高豚鼠气道阻力的抑制作用

为了探讨1，6－二磷酸果糖（FDP）的平喘作用，我们比较研究了FDP对组胺致敏豚鼠呼吸力学的影响。结果表明，给豚鼠静注组胺s8μg／kg30s后，肺阻力从（0．032±0.004）kPa·ml－1·s－1升至（0．088±0．014）kpa·ml-1.s-1。而静注FDP400mg/kg15min后再次静往同等剂量组胺，在30s后肺阻力仅从（0．032±0.006）KPa·ml-1.s-1升至（O．040±O．008）kpa.ml-1.s-1，两次升高幅度具有明显差异（P＜O．01）。提示FDP能明显抑制组胺诱发的豚鼠支气管收缩作用。     

肺心病患者血清α—羟丁酸脱氢酶测定的临床意义

48例肺心病患者血清中。-羟丁酸脱氢酶(HBD)的含量为2.85±1.12pmol·s~(-1)/L,明显高于正常值和正常对照组(2.29±0.34pmol·s~(-1)/L):急性发作期(3.14±1.18pmol/s~(-1)/L)明显高于缓解期(2.36±0.92pmol·s~(-1)/L):48例中有右心衰竭、右室肥厚者HBD也均升高。似可以将HBD值升高作为心肌损伤的判定指标之一。     

钾对狗缺氧性脑、肺血管舒缩反应的影响

本文探讨低浓度、低剂量KCl静脉滴注对狗急性缺氧性脑、肺血管舒缩反应的影响。结果显示:给狗静滴KCl3.5mg/kg/h后2小时,缺氧所致的肺血管阻力变化百分率由给KCl前的41％±5％降至10％±4％,第3小时降至7％±3％(P均<0.001),停输KCl后2小时肺血管反应仍低。输KC后第2、3小时,缺氧所致的脑血流量增加的百分率由输KCl前的11％±6％分别降至8％±3％、6％±2％(P<0.01,P<0.05);缺氧性脑血管舒张反应在输KCl后有一定程度的减弱,但不具统计学意义。     

硝苯吡啶对缺氧性肺动脉高压的血液动力学作用观察

14例高原慢性肺心病患者舌下含服硝苯吡啶20mg 2h后,平均肺动脉压自6.5±0.6下降至4.5±0.5 kPa,心输出量自5.65±0.78增加至7.06±0.88L/min、肺小动脉阻力则自581.8±112.7降至266.1±58.4 dyn·s·cm~(-5)。结果表明,硝苯毗啶能显著地减轻肺血管缺氧性痉挛、降低肺动脉高压、增加心排出量。     

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.