MiR-182模拟物提高1型糖尿病小鼠的心脏功能

目的 探讨miR-182模拟物对1型糖尿病小鼠心脏功能的影响及可能作用机制。方法 40只8周龄雄性C57小鼠随机分为正常对照组（n=5）,miR-182模拟物对照组（n=5）,1型糖尿病组（n=15）,1型糖尿病+miR-182模拟物治疗组（n=15）。腹腔注射链脲佐菌素（STZ）建立1型糖尿病动物模型。实验于8周末结束,采用小动物用高分辨超声仪测量小鼠心脏功能;运用透射电镜观察心肌组织超微结构改变;利用real-time PCR技术检测心肌组织β-肌球蛋白重链（β-MHC）,α-肌球蛋白重链（α-MHC）,心房钠尿肽（ANP）,Ⅰ型（Col Ⅰ）和Ⅲ型胶原（Col Ⅲ） mRNA及miR-182 mRNA的表达含量。结果 ①miR-182模拟物可改善1型糖尿病小鼠的心脏功能,增加心脏射血分数及左室短轴缩短率（P<0.01）;②miR-182模拟物可降低糖尿病小鼠心肌组织ANP、Col I、Col Ⅲ的表达及β/a-MHC比值（P<0.01）;③miR182模拟物可改善1型糖尿病小鼠心肌超微结构变化,减轻自噬。结论 MiR-182模拟物能改善1型糖尿病小鼠的心脏功能,其机制可能与减轻心肌肥大和心肌纤维化,减轻线粒体结构损伤及减轻自噬有关。     

血管紧张素Ⅱ1型受体自身抗体在甲亢大鼠心肌肥大中的作用及其与PI3K/Akt信号通路的关系

目的 观察甲亢心肌肥大大鼠血清血管紧张素Ⅱ1型受体自身抗体（AT₁-AA）与心肌组织磷脂酰肌醇-3-激酶（PI3K）、蛋白激酶B（Akt）的表达,探讨AT₁-AA在甲亢大鼠心肌肥大中的作用及其与PI3K/Akt信号通路的关系。方法 将54只SD大鼠随机分为3组：甲亢组、甲亢+奥美沙坦组及对照组,每组18只,前2组灌服左甲状腺素钠制备甲亢大鼠模型,甲亢+奥美沙坦组同时给予奥美沙坦。以心脏质量指数（HWI）和心钠肽（ANP）mRNA作为心肌肥大指标,采用酶联免疫吸附法（ELISA）检测大鼠血清AT₁-AA,并通过蛋白质印迹法检测各组大鼠血管紧张素Ⅱ1型受体（AT₁R）和PI3K/p-Akt的表达水平;根据AT₁-AA检测结果,将甲亢组和甲亢+奥美沙坦组大鼠分为AT₁-AA阳性组和阴性组,比较AT₁-AA阳性组和阴性组AT₁R及PI3K/p-Akt的表达情况。结果 （1）与对照组比较,甲亢组、甲亢+奥美沙坦组大鼠HWI增加,ANP mRNA相对表达量升高（P均<0.05）;甲亢组大鼠HWI及ANP mRNA相对表达量亦高于甲亢+奥美沙坦组大鼠（P<0.05）。（2）甲亢组、甲亢+奥美沙坦组大鼠AT₁-AA 阳性率及光密度（D）值（61.11%,72.22%和0.44±0.12,0.49±0.08）高于对照组（16.67%和0.28±0.05,P均<0.01）。（3）甲亢组、甲亢+奥美沙坦组大鼠AT₁R和PI3K/p-Akt的表达较对照组升高（P<0.05,P<0.01）;与甲亢组相比,甲亢+奥美沙坦组大鼠心肌组织PI3K、p-Akt表达水平均降低（P<0.01,P<0.05）。（4）甲亢组大鼠中,AT₁-AA阳性组PI3K/p-Akt的表达明显高于AT₁-AA阴性组（P<0.01）;甲亢+奥美沙坦组大鼠中,AT₁-AA阳性组PI3K/p-Akt的表达较AT₁-AA阴性组降低（P<0.05）。结论 AT₁-AA可能通过AT₁R激活PI3K/Akt信号通路参与甲亢心肌肥大病理生理过程。     

高表达ANG基因的自体骨髓基质细胞移植治疗猪缺血性心脏病

目的 将高表达血管生长素（ANG）的自体骨髓基质细胞移植于慢性心肌缺血猪模型,观察移植后血管新生程度及对心功能的影响。 方法 建立猪慢性缺血性心脏病动物模型,随机分为3组：转染ANG重组腺病毒载体（Ad-ANG）的自体骨髓基质细胞移植组（组Ⅰ,n=11）,单纯自体骨髓基质细胞移植组（组Ⅱ,n=10）,注射无血清DMEM培养液的对照组（组Ⅲ,n=10）。体外培养自体骨髓基质细胞,利用Ad-ANG转染培养细胞,用CM-DiI标记细胞,移植于模型猪心脏的缺血区域。观察指标包括：冠状动脉（冠脉）造影Rentrop分数及心脏射血分数、梗死区百分数、荧光显微镜下标记细胞、血管数量及ANG的表达和分泌。 结果 与组Ⅱ及组Ⅲ相比,组Ⅰ冠脉造影Rentrop分数、心脏射血分数增高;缺血心肌区新生血管计数增高,可见大量CM-DiI标记的移植成活细胞,梗死区面积较小,ANG蛋白表达增高,差异有统计学意义（P<0.05或P<0.01）。 结论 高表达ANG的自体骨髓基质细胞移植于慢性缺血心肌,移植细胞成活率高,能明显改善缺血心肌局部血运,改善心功能。     

益肾保真方对肾性贫血大鼠血清促红细胞生成素表达的影响

目的 探讨益肾保真方对慢性肾衰竭大鼠贫血的干预作用及疗效机制。 方法 采用二步5/6肾切除的方法复制慢性肾衰竭大鼠贫血模型,将造模成功的43只大鼠随机分为正常组（n=9）、模型组（n=8）、益肾保真方高剂量组[n=9,46.5 g/（kg·d）]、益肾保真方低剂量组[n=9,15.6 g/（kg·d）]及尿毒清组[n=8,2.5 g/（kg·d）]。灌胃给药,每日1次,连续6周,测定各组大鼠血肌酐（SCr）、尿素氮（BUN）、血红蛋白（Hb）、红细胞计数（RBC）、平均红细胞容积（MCV）及血清促红细胞生成素（EPO）含量。 结果 益肾保真方高、低剂量组Hb、RBC及EPO水平均较模型组和尿毒清组升高（P<0.05）,MCV在组间的差异无统计学意义;与模型组比较,益肾保真方高、低剂量组BUN、SCr水平均降低（P<0.01）,但与尿毒清组比较差异无统计学意义。 结论 益肾保真方对肾性贫血有干预作用,其机制可能与降低氮质潴留、减轻毒素对造血的抑制、提高红细胞刺激因子EPO水平有关。     

阿霉素性心肌病大鼠左心室肌纤维化程度与缝隙连接蛋白的变化

目的 探讨阿霉素性心肌病大鼠发生心律失常的发病机制。方法 健康wistar雄性大鼠20只,体重200g,适应周围环境1周后,随机将20只wistar雄性大鼠分为对照组（n=10）和阿霉素（ADR）组（n=10）。ADR组的大鼠在1周内进行3次腹腔注射ADR 2mg/kg;同时对照组则进行3次腹腔注射0.9%NaCl （2ml/kg）,停药后让两组大鼠自由饮食4周。7周后对两组大鼠行心脏彩超检测,左心室舒张末径（LVEDd）与左心室收缩末期内径（LVESd）及左心室射血分数（LVEF）,行VG染色观察各组大鼠心肌纤维化情况;扫描电镜染色观察左心室心肌细胞闰盘病理学变化;两组大鼠心肌结缔组织生长因子（CTGF）、转化生长因子β1（TGF-β1）、N型钙黏蛋白（N-cad）、桥粒芯糖蛋白（DSG2）表达应用ELISA法检测;采用Western blot法检测两组大鼠的心肌细胞Cx40 、Cx43、p-Cx43蛋白表达。结果 与对照组相比,阿霉素组大鼠明显出现心室重构,并易出现心律失常;电镜下观察ADR组大鼠心肌细胞闰盘破损严重,间隙增宽,VG染色显示ADR组大鼠病理积分明显高于对照组（P<0.05）;ADR组大鼠相较于对照组大鼠心室肌中CTGF、TGF-β1的表达升高显著,N-cad、DSG2、Cx40、Cx43及p-Cx43的表达明显减低（P<0.05）。结论 ADR组大鼠可能由于心室肌细胞纤维化、闰盘结构受损、缝隙连接重构等原因导致心律失常。     

血管紧张素转化酶2过表达对大鼠心肌梗死后心室重构的影响

目的 观察血管紧张素转化酶2(ACE2)过表达对大鼠急性心肌梗死(AMI)后心室重构的影响,并探讨其可能的分子机制。方法 75只SD大鼠随机分为假手术组(Sham组)、AMI组、生理盐水组(AMI+NS组)、报告基因组(AMI+AdEGFP组)和重组腺病毒AdACE2组(AMI+AdACE2组),每组15只。结扎大鼠冠状动脉左前降支建立AMI模型,AMI+NS、AMI+AdEGFP、AMI+AdACE2组于心肌梗死周边区各选取5个点分别注射生理盐水、AdEGFP和AdACE2,Sham组与AMI组不予注射。建模4周后测量血流动力学指标和心室质量;用组织学方法评价心肌组织结构变化与胶原沉积;用免疫组化染色检测心肌组织血管紧张素(Ang)Ⅱ(AngⅡ)、Ang-(1-7)及α-平滑肌肌动蛋白(α-SMA)表达,蛋白质印迹法检测心肌组织ACE2、Src同源结构域2蛋白酪氨酸磷酸酶１(SHP-1)、ERK1/2、p-ERK1/2、p38、p-p38、α-SMA及转化生长因子β₁(TGF-β₁)蛋白的表达。 结果 (1)与其他4组相比,AMI+AdACE2组ACE2表达水平升高(P<0.05),同时Ang-(1-7)表达也升高(P<0.05)。(2)与Sham组相比,AMI、AMI+NS及AMI+AdEGFP组左室舒张末压,心室质量/体质量比值,胶原沉积,梗死周边区AngⅡ、Ang-(1-7)、SHP-1、p-ERK1/2/ERK1/2、p-p38/p38、α-SMA、TGF-β₁表达均升高(P<0.05)。(3)与AMI、AMI+NS及AMI+AdEGFP组相比,AMI+AdACE2组Ang-(1-7)、SHP-1表达升高(P0.05),p-ERK1/2/ERK1/2、p-p38/p38、α-SMA及TGF-β₁表达降低(P<0.05)。 结论 过表达ACE2可明显改善大鼠心肌纤维化进程,缓解心室重构,其机制可能与ACE2激活酪氨酸磷酸酶SHP-1,负性调节肾素-血管紧张素系统(RAS)下游丝裂原活化蛋白激酶(MAKPs)活性有关。     

异丙酚或七氟醚联合瑞芬太尼靶控输注对脑组织氧代谢影响的对比研究

目的 比较择期颅脑肿瘤患者麻醉过程中,异丙酚与七氟醚分别复合瑞芬太尼对脑组织氧代谢的影响,为临床用药提供参考。 方法 采用随机、双盲对照研究,纳入拟开展择期颅内肿瘤手术患者为研究对象,分为异丙酚+瑞芬太尼静脉靶控输注组（PR组,n=30）和七氟醚+瑞芬太尼静吸复合组（SR组,n=30）。观察指标包括：麻醉期间不同时间点患者的血流动力学指标、手术麻醉时间、颈静脉球血氧饱和度（SjvO₂）及脑动静脉血氧含量差（Da-jvO₂）等。 结果 两组患者血流动力学、麻醉手术时间差异无统计学意义;与PR组相比,SR组SjvO₂较高,而Da-jvO₂则较低（P<0.01）。 结论 异丙酚或七氟醚复合瑞芬太尼麻醉均可安全用于颅脑肿瘤患者手术,前者利于维持稳定的脑氧供需平衡,且术后苏醒迅速,后者可改善脑组织氧合状况。     

氟西汀对抑郁大鼠心脏电生理的影响

目的 研究抑郁刺激对大鼠心脏电生理影响,以及氟西汀的干预作用。方法 将60只雄性SD大鼠随机分为3组,即对照组（CTL,n=20）、抑郁组（CUMS组,n=20）和氟西汀组FLX组（n=20）。氟西汀给药方式为灌胃;慢性温和不可预见刺激建立抑郁模型,行为学评价包括糖水消耗实验和强迫游泳进行评估抑郁模型;利用Langendorff装置维持体外心脏循环进行心脏电生理研究,记录心房和心室组织ERP、APD₉₀,并用Burst程序刺激心房和心室,诱发心律失常。结果 1与正常对照组比较,糖水偏好百分比降低、强迫游泳静止时间延长;氟西汀组行为学评价分数有所改善。差异均有统计学意义（P<0.05）;2抑郁组的心房和心室ERP小于正常组与氟西汀组,而APD₉₀大于其余两组,差异有统计学意义（P<0.05）;3抑郁组房颤诱发率（100%）明显高于对照组（0）、氟西汀组（40%）,心室颤动诱发率在对照组、抑郁组和氟西汀组分别为：0、80%和40%,抑郁组心房颤动诱发率高于心室。结论 抑郁刺激诱发心脏心房和心室组织发生电生理改变,采用抗抑郁药物进行干预,有改善作用,证明抑郁与心血管疾病之间存在密切关系。     

TGF-β_1/Smads通路在心肌梗死后心室重构中的作用

目的研究TGF-β1/Smads通路在心肌梗死后心室重构中的作用及辛伐他汀（simvastatin,Sim）干预的影响。方法清洁级Wistar大鼠40只随机分为4组：结扎大鼠冠状动脉建立心肌梗死模型组（MI,n=10）,假手术组（Sham,n=10）为对照组,辛伐他汀干预组（MI＋Sim,n=10）,辛伐他汀自身对照组（Sim,n=10）。8周后测量各组大鼠血液动力学,心室重量/体重,非梗死区胶原含量,荧光定量RT-PCR检测梗死区和非梗死区转化生长因子（TGF）β1mRNA、Smad3 mRNA、Smad7 mRNA的表达。结果与假手术组和辛伐他汀干预组相比,MI组左室舒张末压,心室重量/体重,非梗死区胶原含量均增加,梗死区和非梗死区TGF-β1mRNA、Smad3 mRNA表达增加,而Smad7 mRNA表达降低（P〈0.05）。结论 TGF-β1/Smads传导通路参与心肌梗死后的心室重构过程,Smad3对心室重构有促进作用,而Smad 7对心室重构有抑制作用。辛伐他汀可能通过抑制Smad3表达,促进Smad7表达从而有效改善心肌梗死后心室重构。     

TGF-β_1/Smads通路与心肌梗死后心室重构的关系及辛伐他汀干预的影响

目的研究TGF-β1/Smads通路与心肌梗死后心室重构的关系及辛伐他汀（simvastatin,Sim）干预的影响。方法清洁级Wistar大鼠40只随机分为4组,结扎大鼠冠状动脉建立心肌梗死模型组（MI,n=10）、假手术组（Sham,n=10）为对照组、辛伐他汀干预组（MI＋Sim,n=10）和辛伐他汀自身对照组（Sim,n=10）。8周后测量各组大鼠血液动力学、心室重量/体重、非梗死区胶原含量、荧光定量RT-PCR检测梗死区和非梗死区转化生长因子（TGF）β1mRNA、Smad3 mRNA、Smad7 mRNA的表达。结果与假手术组和辛伐他汀干预组相比,MI组左室舒张末压、心室重量/体重、非梗死区胶原含量均增加,梗死区和非梗死区TGF-β1mRNA、Smad3 mRNA表达增加,而Smad7 mRNA表达降低（P〈0.05）。结论 TGF-β1/Smads传导通路参与心肌梗死后的心室重构过程,Smad3对心室重构有促进作用,而Smad 7对心室重构有抑制作用。辛伐他汀可能通过抑制Smad3表达,促进Smad7表达,从而有效改善心肌梗死后心室重构。     

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.