苓桂术甘汤对充血性心衰竭大鼠心脏指数与血流动力学的影响

目的：观察苓桂术甘汤对慢性心衰竭（chronic heart failure,CHF）大鼠心脏指数和血流动力学的影响。方法：采用冠状动脉结扎法复制CHF大鼠模型,于模型复制后第7周开始灌胃给药,连续给药4周后,测定大鼠血流动力学参数、心脏指数。结果：苓桂术甘汤小（4．29g／kg）、中（21．45g／kg）、大（42.90g／kg）剂量能明显提高CHF大鼠左心室收缩压（left ventricular systolic pressure,LVSP）,左心室内压最大上升速率（maximal rate of left ventricular pressure of development,＋dp／dtmax）和左心室内压最大下降速率（maximal rate of left ventricular pressure of dedine,-dp／dtmax）（P〈10．05,或P〈0．01）,降低左心室缩张末压（left ventricular end diastolic pressure,LVEDP）（P〈0．01）,并能明显降低CHF大鼠心脏质量指数（heart mass index,HMI）和左心室质量指数（left ventricular massindex,LVMI）（P〈0．05,或P〈0．01）,其中苓桂术甘汤中剂量组LVEDP和LVMI降低最为显著,优于卡托普利组（P〈0．05）。结论：苓桂术甘汤对CHF大鼠心脏舒缩性能具有显著的改善作用,其作用与其阻押大鼠心室重构密切相关。     

The Effects of Benidipine on Left Ventricular Remodeling in Essential Hypertension

Objective To investigate the effects of benidipine on arterial hypertension and left ventricular remodeling in essential hypertension. Methods 24 outpatients suffered from essential hypertension with left ventricular hypertrophy detected by echocardiography were candidated. Blood pressure, interventricular septum（IVS）, left ventricular posterior wall（LVPW）, left ventricular internal diameter（LVDd）, peak velocity of early fiow（E）, peak velocity of late fiow（A） , ratio of early to late peak velocity（E/A）, systolic fractional of left ventricular minor（FS）, Left ventricular mass （LVM ） and left ventricular mass index （LVMI） were measured by 219 echocardiograms before and after treatment. Results 24 patients＇ arterial pressure decreased significantly after 2 weeks＇ and 3 weeks＇ treatment than before test（P〈0.05）. The thickness of interventricular septum（IVS）, left ventricular posterior walI（LVPW） were decreased （P〈0.01）. LVM（Left ventricular mass） and LVMI（（left ventricular mass index） were significantly reversed（P〈0.01）. Simultaneously, Cardiac performance was improved. Conclusion Benidipine, 2-4mg once daily, could significantly drcrease artrial pressure and reverse left ventricular remodeling in essential hypertension.     

天麻钩藤饮对肾血管性高血压大鼠醛固酮和血管紧张素Ⅱ的影响

目的：观察天麻钩藤饮对肾血管性高血压大鼠醛固酮（aldosterone,ALDO）和血管紧张素Ⅱ（angiotension Ⅱ,AngⅡ）的影响。方法：将48只雄性SD大鼠随机分为假手术组、模型组、卡托普利组和天麻钩藤饮组,每组12只。模型复制后第5周开始给药,连续治疗8周。然后观察各组大鼠左室质量（left ventricular mass,LVM）、左室质量指数（lef tventrieular mass index,LVI）和心肌组织胶原（colloid,Coll）浓度,同时检测各组大鼠血浆和心肌组织中AngⅡ和ALDO水平。结果：12周后模型组大鼠的LVM、LVI和Coll均明显高于假手术组（P〈0．05,P〈0．01）;卡托普利组和天麻钩藤饮组大鼠的上述指标均有显著降低（P〈0．01）,而两药之间没有显著性差异（P〉0．05）。模型复制12周后,模型组大鼠血浆和心肌ALD0和AngⅡ水平显著高于假手术组（P〈0．01）;卡托普利显著降低血浆和心肌AngⅡ水平（P〈0．05）,而对血浆和心肌ALD0水平则无显著性影响（P〉0．05）;天麻钩藤饮则同时降低了血浆和心肌ALD0和AngⅡ水平（P〈0．05,P〈0．01）。结论：天麻钩藤饮能够缓解和逆转左室肥厚和心肌纤维化,其作用可能与降低血浆和心肌局部ALDO、AngⅡ水平有关。     

新风胶囊对佐剂性关节炎大鼠心功能及血清和心肌脑利钠肽的影响

目的观察新风胶囊（Xinfeng Capsules,XFC）对佐剂性关节炎（adjuvant arthritis,AA）大鼠心功能及血清、心肌脑利钠肽（brain natriuretic peptide,BNP）影响。方法将60只大鼠随机分为正常对照组、模型对照组、甲氨喋呤（methopterin,MTX）组、雷公藤多苷片（Tripterygium glucosides Tablet,TGT）组和XFC组,每组12只,除正常对照组外,分别对其余各组大鼠右后足跖皮内注射弗氏完全佐剂致炎,致炎后第19天开始给药。正常对照组及模型对照组均给予生理盐水,其余3组分别给予MTX、TGT、XFC。观察各组大鼠足跖肿胀度、关节炎指数（arthritis index,AI）、心功能、血清BNP水平及心肌BNP mRNA表达的变化。结果①与正常对照组比较,模型对照组心率（heart rate,HR）、心脏指数（heart index,HI）、左室收缩期压（left ventricular systolic pressure,LVSP）、左室舒张期末压（left ventricular end-diastolic pressure,LVEDP）显著升高（P〈0.05）,左室内压上升下降最大速率（maximum rate of ventricular pressure of devel-opment or decline,±dp/dtmax）显著下降（P〈0.05）。与模型对照组比较,XFC组HI、LVSP和LVEDP显著降低（P〈0.05,或P〈0.01）,±dp/dtmax显著升高（P〈0.05,或P〈0.01）。与MTX组比较,XFC组LVSP、LVEDP显著降低（P〈0.05）,＋dp/dtmax显著升高（P〈0.05）。②与正常对照组比较,模型对照组血清BNP及心肌BNP mRNA表达水平显著升高（P〈0.05,或P〈0.01）。与模型对照组比较,各治疗组血清BNP显著降低（P〈0.05）,仅TGT组BNP mRNA表达水平降低（P〈0.05）。结论 AA大鼠存在不同程度的心功能下降。XFC在改善AA大鼠足跖肿胀度和AI的同时,也能提高其心功能,其机制可能与XFC下调血清BNP水平,抑制心肌BNP mRNA表达,从而保护心肌细胞有关。     

益心解毒方对心力衰竭气虚血瘀证大鼠血流动力学影响的实验研究

目的：研究益心解毒方对心肌梗死后心力衰竭大鼠血流动力学与B型钠尿肽（B-type natriuretic peptide,BNP）的影响及在改善相关证候指标方面的优势。方法：利用左冠状动脉结扎术复制心肌梗死后心力衰竭大鼠模型,术后将模型大鼠随机分为模型组、益心解毒方组以及阳性药（福辛普利钠片）组,另外设假手术组对照。术后第2天,益心解毒方组给予益心解毒方中药水溶液（9.33g/kg）,阳性药对照组给予福辛普利钠片剂水溶液（1.2mg/kg）,模型组和假手术组分别给予等体积生理盐水,采用灌胃途径连续给药28d。观察各组动物的宏观表征变化,并记录呼吸频率,评价各组动物的血流动力学指标,并通过酶联免疫吸附法测定各组大鼠血浆中的BNP含量。结果：术后28d,益心解毒方组大鼠毛发及活动状态均优于模型组,尤其表现在大鼠足底皮肤紫暗和呼吸频率得到改善。在动脉血流动力学方面,与假手术组相比,模型组大鼠的收缩压（systolic blood pressure,SBP）、舒张压（diastolic blood pressure,DBP）以及平均动脉压（mean arterial pressure,MAP）明显下降（P〈0.05）,而益心解毒方和阳性药福辛普利钠均能很好地改善SBP和DBP,并有效地提升MAP（P〈0.05）。在心室血流动力学方面,模型组大鼠的左心室收缩压（left ventricular systolic pressure,LVSP）、左室收缩压最大上升速率（maximal rate of left ventricular systolic pressure,LV＋dP/dtmax）和左室舒张压最大上升速率（maximal rate of left ventricular diastolic pressure,LV-dP/dtmax）明显低于假手术组（P〈0.05）,益心解毒方和福辛普利钠均能上调心力衰竭大鼠的LVSP、LV＋dP/dtmax和LV-dP/dtmax,进而改善心力衰竭大鼠的心室血流动力学指标（P〈0.05）。酶联免疫吸附测定结果显示,模型组大鼠的血浆BNP水平明显高于假手术组（P〈0.05）,益心解毒方和福辛普利钠使得心力衰竭大鼠血浆BNP水平显著下降（P〈0.05）。结论：益心解毒方能通过增加心力衰竭大鼠左室心肌的收缩力而上调LVSP、LV＋dP/dtmax和LV-dP/dtmax,提高主动脉的SBP、DBP以及MAP,改善心肌梗死后心力衰竭大鼠血流动力学各项指标,降低心力衰竭大鼠血浆中BNP水平,说明其能够改善心力衰竭时心肌室壁压力的变化。同时,该药能够缓解心力衰竭大鼠足底皮肤的血瘀情况,提高安静状态下呼吸频率等,改善气虚血瘀证的相关表征。     

川芎嗪对左室肥厚大鼠血流动力学的影响

目的观察川芎嗪（ugustrazine）对压力超负荷所致左室肥厚大鼠血流动力学指标的影响。方法采用腹主动脉缩窄（abdominal aorti ccoarctation，AAC）法建立大鼠心肌肥厚模型，观察各组大鼠心肌肥厚参数及血流动力学指标改变。结果制模后大鼠平均体重增长明显减慢；左室肥厚参数明显增高（P〈0．05），川芎嗪（100，50me/kg）可明显增加左室肥厚大鼠平均体重增长值，而降低左室肥厚参数（P〈0．05），造模各组间血压及左室内压无显著差异，但均高于假手术组，但与模型组比较，川芎嗪可显著降低左心室舒张期末压。结论川芎嗪对AAC术导致的左心室心肌肥厚有明显保护作用，且显著改善肥厚心肌的血流动力学指标。     

自发高血压大鼠心肌肥厚与心室颤动阈值的关系

【目的】探讨自发高血压大鼠心肌肥厚与心室颤动阈值的关系。【方法】20只雄性自发高血压大鼠，随机分成10周龄组（n=10）和18周龄组（n=10）；10只10周龄雄性Wistar大鼠为对照组。分别测定3组大鼠的动脉收缩压、心脏质量指数、心室有效不应期和心室颤动阈值。【结果】①自发高血压大鼠的动脉收缩压和心脏质量指数明显高于Wistar大鼠（P〈0．001），心室颤动阈值明显低于Wistar大鼠（P〈0．001）；②自发高血压大鼠中，18周龄自发高血压大鼠的动脉收缩压和心脏质量指数明显大于10周龄自发高血压大鼠（P〈0．001），心室颤动阈值明显低于10周龄自发高血压大鼠（P〈0．001）；③不同周龄自发高血压大鼠和Wistar大鼠之间，心室有效不应期没有明显差异（P〉0．05）；④Wistar大鼠中心脏质量指数与动脉收缩压及心室颤动阈值均无明显相关关系，不同周龄自发高血压大鼠中，心脏质量指数与动脉收缩压及心室颤动阈值均呈明显相关关系；动脉收缩压和心脏质量指数与心室颤动阈值呈负相关（P〈0．001）；⑤心脏质量指数、动物周龄和种类是影响心室颤动阈值的主要因素（P〈0．001）。【结论】肥厚心肌的心室颤动阈值降低；动脉收缩压愈高，心肌肥厚程度愈明显，心室颤动阈值愈低。     

温阳贴贴敷涌泉穴治疗慢性心力衰竭阳虚证的临床疗效观察

目的 观察温阳贴贴敷涌泉穴对慢性心力衰竭（chronic heart failure, CHF）阳虚证患者心功能和心肌重构的影响。方法将141例患者随机分为对照组（71例）和观察组（70例）。对照组给予西医综合治疗,观察组在对照组基础给予温阳贴贴敷涌泉穴,于晚上睡前贴敷,次日清晨取下,隔2日贴敷1次,连续24周。比较治疗前后心肌重构和心功能参数[左室射血分数（left ventricular ejection fraction, LVEF）、心脏指数（cardiac index, CI）、心肌能量消耗值（myocardial energy expenditure, MEE）、左室舒张末期内径（left ventricular end-diastolic diameter, LVEDd）、左室质量指数（left ventricular mass index, LVMI）、左室重构指数（left ventricular remodeling index, LVRI）];比较治疗前后6 min步行试验(6-min walk test, 6MWT)、Lee氏心衰评分、阳虚证评分和明尼苏达心衰生...     

自发高血压大鼠心肌肥厚与心室颤动阈值的关系

 【目的】探讨自发高血压大鼠心肌肥厚与心室颤动阈值的关系。【方法】20只雄性自发高血压大鼠，随机分成10周龄组（n=10）和18周龄组（n=10）；10只10周龄雄性Wistar大鼠为对照组。分别测定3组大鼠的动脉收缩压、心脏质量指数、心室有效不应期和心室颤动阈值。【结果】①自发高血压大鼠的动脉收缩压和心脏质量指数明显高于Wistar大鼠（P〈0．001），心室颤动阈值明显低于Wistar大鼠（P〈0．001）；②自发高血压大鼠中，18周龄自发高血压大鼠的动脉收缩压和心脏质量指数明显大于10周龄自发高血压大鼠（P〈0．001），心室颤动阈值明显低于10周龄自发高血压大鼠（P〈0．001）；③不同周龄自发高血压大鼠和Wistar大鼠之间，心室有效不应期没有明显差异（P〉0．05）；④Wistar大鼠中心脏质量指数与动脉收缩压及心室颤动阈值均无明显相关关系，不同周龄自发高血压大鼠中，心脏质量指数与动脉收缩压及心室颤动阈值均呈明显相关关系；动脉收缩压和心脏质量指数与心室颤动阈值呈负相关（P〈0．001）；⑤心脏质量指数、动物周龄和种类是影响心室颤动阈值的主要因素（P〈0．001）。【结论】肥厚心肌的心室颤动阈值降低；动脉收缩压愈高，心肌肥厚程度愈明显，心室颤动阈值愈低。     

主动脉弓狭窄致大鼠慢性心力衰竭模型的建立及病理过程观察

目的观察主动脉弓狭窄致大鼠心力衰竭的病理过程变化。方法沿胸骨剪断大鼠左侧第二根肋骨开胸,于头臂干和左颈总动脉之间行主动脉弓缩窄术(transverse aortic constriction,TAC)建立慢性心力衰竭模型24只,另取大鼠8只行假手术。假手术组于术后12周,模型组分别在TAC术后4周、8周、12周时进行超声心动、血流动力学检测和N端前脑钠素(N-terminal pro-brain natriuretic peptide,NT-pro BNP)测定,并进行心肌组织病理学观察。结果模型组在TAC术后4周时NT-pro BNP显著增加、8周达到峰值(P0.05)、12周时呈下降趋势;超声心动图结果显示,模型组TAC术后4周时射血分数(ejection fraction,EF)、短轴率(fraction shortening,FS)显著升高、左心室收缩末期容积(left ventricular end systolic volume,LVESV)显著减小(P0.05),8周时EF显著升高(P0.05),12周时EF显著降低、左心室舒张末期容积(left ventricular end diastolic volume,LVEDV)、LVESV显著增加(P0.05);血流动力学检测显示,模型组在TAC术后左室最大收缩速率(left ventricular pressure maximal rate of rise,dp/dtmax)降低、左室最大舒张速率(left ventricular pressure maximal rate of fall,﹣dp/dtmax)升高(P0.05);病理学观察显示,模型组TAC术后4周时心肌细胞肥大、排列紊乱,8周时心肌间结缔组织增生、炎症细胞浸润,12周时心肌细胞凋亡、胶原纤维沉积。结论主动脉弓狭窄致大鼠心力衰竭模型在TAC术后4周时心肌出现代偿性肥厚,8周时心肌出现失代偿的初期反应,12周时出现心肌纤维化,形成不可逆的心力衰竭。     

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.