添加丙氨酰谷氨酰胺胃肠外营养对烫伤大鼠的作用

目的探讨添加丙氨酰谷氨酰胺（Ala-Gln）全胃肠外营养（TPN）对烫伤大鼠的空肠黏膜、蛋白质代谢及创面肉芽组织的影响。方法33只SD大鼠,随机分为非烫伤正常参照组（正常组）、传统TPN组（传统组）和添加Ala-Gln的TPN组（二肽组）,每组各11只。正常组自由饮食,另2组大鼠在颈外静脉插管后行30%体表面积Ⅲ度烫伤,并接受等热量（780 kJ.kg-1.d-1）等氮量（1.8 g氮量.kg-1.d-1）TPN 7天,留取24 h尿测每日氮平衡和累积氮平衡;7天后取血测定总蛋白（TP）、白蛋白（ALB）、前白蛋白（PAB）、转铁蛋白（TRF）,高效液相法检测肌肉中谷氨酰胺（Gln）的含量;取一段空肠作黏膜形态学观察;光镜下观察烫伤创面肉芽组织的情况。结果二肽组的血清PAB、TRF及肌肉中Gln含量明显高于传统组（P〈0.01）,空肠黏膜绒毛高度、隐窝深度、黏膜厚度、绒毛表面积明显高于传统组（P〈0.01）,创面肉芽组织中的毛细血管和成纤维细胞密度明显高于传统组（P〈0.01）。结论烫伤大鼠应用添加Ala-Gln的胃肠外营养能改善机体氮平衡,促进机体蛋白质合成,减少肌肉中Gln含量的下降,减轻空肠黏膜的萎缩,...     

添加丙氨酰谷氨酰胺胃肠外营养对烫伤大鼠蛋白质代谢的作用

目的　探讨添加丙氨酰谷氨酰胺 (Ala Gln)全胃肠外营养 (TPN)对烫伤大鼠蛋白质代谢的影响。方法　将3 3只SD大鼠随机分为非烫伤正常参照组 (正常组 )、传统TPN组 (传统组 )和添加二肽TPN组 (二肽组 ) ,每组各 11例。正常组自由饮食 ,另两组大鼠在颈外静脉插管后行 3 0 %体表面积Ⅲ度烫伤 ,并接受等热量 ( 780kJ·kg-1·d-1)等氮量( 1.8g·kg-1·d-1,二肽组 48%的氮量由Ala Gln提供 )TPN 7d ,留取 2 4h尿测每日氮平衡和累积氮平衡 ;7d后取血测定总蛋白 (TP)、白蛋白 (ALB)、前白蛋白 (PAB)、转铁蛋白 (TRF) ,高效液相法检测肌肉中谷氨酰胺 (Gln)的含量。结果　二肽组血清PAB、TRF及肌肉中Gln含量明显高于传统组 (P <0 .0 1)。结论　烫伤大鼠应用添加Ala Gln的胃肠外营养能改善机体氮平衡 ,促进机体蛋白质合成 ,减少肌肉中Gln含量的下降     

肝移植后营养支持对蛋白质代谢及营养状况影响的探讨

目的:探讨全肠外营养(TPN)、传统TPN及添加丙氨酰谷氨酰胺(Ala-Gln)的TPN对肝移植后机体蛋白质代谢及营养状况影响。方法:将35例肝移植患者随机分3组:术后未经TPN(饮食组)、不添加Ala-Gln的TPN组(传统组)、添加Ala-Gln的TPN组(二肽组)。TPN于术后第2天予以等热量(每千克体重104.6kJ)、等氮量(每千克体重0.16g)共7天。对术后第2天、术后第9天营养预后指数(PNI)、总蛋白(TP)、白蛋白(Alb)、前白蛋白(PAB)、转铁蛋白(TF)监测。结果:术后第9天比较于术后第2天,增高差异有显著性的有:所有组的Alb(P<0.05),传统组的PAB、TF及二肽组的PNI、PAB、TF(P<0.01);增高幅度大且差异有显著性的有:二肽组较饮食组及传统组的PNI(P<0.05),二肽组较饮食组的Alb(P<0.05),二肽组较饮食组及传统组的PAB(P<0.01),二肽组及传统组较饮食组的TF(P<0.01)。结论:肝移植术后TPN是必要的,而TPN中添加Ala-Gln能更好地改善蛋白质代谢和营养状况。     

肝移植术后营养支持对移植肝功能影响

目的:探讨非全肠外营养(TPN)、传统TPN及添加丙氨酰谷氨酰胺(Ala-Gln)的TPN对肝移植后移植肝功能的影响。方法:将35例肝移植患者随机分3组:术后未经TPN(饮食组)、不添加Ala-Gln的TPN组(传统组),添加Ala-Gln的TPN组(二肽组)。TPN于术后第2天予以等热量(每千克体重104.6kJ)、等氮量(每千克体重0.16g)共7天。监测术后第2、9天肝功能指标。结果:移植后第9天,二肽组的胆碱酯酶(CHE)与饮食组和传统组比较有更显著的升高(P<0.01);传统组、二肽组的载脂蛋白B(APOB)与饮食组比较有更显著的升高(P<0.01);二肽组的天门冬氨酸氨基转移酶(AST)与饮食组和传统组比较有更显著的下降(P<0.01、P<0.05)。结论:肝移植术后进行TPN治疗,有利于移植肝合成功能的改善和缺血再灌注损伤的修复;而添加Ala-Gln的TPN治疗则更为有利。     

全肠外营养加谷氨酰胺二肽对生长期大鼠氮平衡的影响

目的 :观察添加谷氨酰胺 (Gln)二肽的全肠外营养 (TPN)对生长期大鼠氮平衡的影响。　方法 :30只Wistar大鼠 (体重 1 4 0～ 1 80g) ,根据TPN配液采用的复方氨基酸品种不同 ,随机分成三组 :Glamin组 (G组 )、Vamin组 (V组 )和Novamin组 (N组 ) ,每组 1 0只大鼠。其中复方氨基酸Glamin内含有Gln二肽。经颈内静脉置管于上腔静脉。所有动物均给予TPN支持 7天 ,其中非蛋白热量为 6 2 7.6kJ/ (kg·d) ;氮量为 1 .0g/ (kg·d) ;糖∶脂比例为 6∶4。　结果 :TPN支持结束时 ,三组动物体重分别略有下降 ,但组间对比显示 ,三组之间差异无显著性意义。G组在氮潴留率、净氮利用率和累积氮平衡方面明显优于V组和N组 (P <0 .0 5 )。　结论 :TPN中添加Gln二肽能明显改善生长期大鼠的蛋白质合成代谢     

丙氨酰谷氨酰胺双肽全肠外营养在胃肠道肿瘤患者术后的应用

目的 探讨丙氨酰谷氨酰胺(Gla-Gln)双肽全肠外营养(total parenteral nutrition,TPN)在胃肠道肿瘤患者术后的应用.方法 64 例胃肠道肿瘤患者术后分为常规TPN 组(对照组) 32 例和TPN Gla-Gln 组(实验组) 32 例,所有患者术后第1～7 天等热量(96.0 kJ·kg-1·d-1)、等氮(0.25 g·kg-1·d-1)的肠外营养治疗,实验组另外添加0.5 g·kg-1·d-1 的Gla-Gln双肽.观察血清白蛋白、血清前蛋白、氮平衡变化,并检测手术前后外周血IgG、IgM、IgA、C3 、C4 的变化.结果 ①两组患者血清白蛋白、前白蛋白在术后第1天均有下降,与术前相比差异非常显著(P＜0.01),术后第8天时两组均有回升,但对照组回升较慢,两组比较有显著性差异(P＜0.05).②两组患者术后第4天IgG、IgA、IgM值均低于术前,与术前相比两组均有非常显著的差异(P＜0.01),实验组术后第8天IgG、IgA、IgM明显回升并高于术前,与对照组比较有显著性差异(P＜0.05).实验组术后第8天C3、C4值与对照组比较有显著性差异(P＜0.05).③实验组术后第8天氮平衡明显优于对照组(P＜0.01).结论 丙氨酰谷氨酰胺双肽全肠外营养在胃肠道肿瘤手术患者中使用安全,有助于改善患者术后的营养状况,提高患者的免疫功能.     

丙氨酰谷氨酰胺对消化道肿瘤术后化疗患者蛋白质代谢的影响

目的 :研究丙氨酰谷氨酰胺 (Ala- Gln)添加全胃肠外营养 (TPN)对消化道肿瘤术后化疗患者蛋白质代谢的影响。方法 :30例消化道癌肿患者随机分为两组 :传统组和二肽组 ,术后给予等热量 (每千克体重 10 4k J)、等氮量 (每千克体重 0 .16 g)、TPN同时化疗 5天。手术前后对人体测量、血浆蛋白、淋巴细胞计数等指标进行监测 ;术后留 2 4h尿测氮平衡和累积氮平衡。结果 :二肽组转铁蛋白 (TF)、淋巴细胞数术后第 6天能维持术前水平 (P>0 .0 5 ) ,传统组则明显低于术前 (P<0 .0 5 ) ;两组间人体测量、血浆蛋白、淋巴细胞数差异无显著性。术后第 6天传统组累积氮平衡为 (- 32 .17± 10 .16 ) g,二肽组为 (- 13.5 6± 5 .6 1) g,两组间每日氮平衡和累积氮平衡差异显著 (P<0 .0 1)。结论 :Ala- Gln在肠外营养中的使用是安全有效的 ,能减轻肿瘤患者术后的分解代谢 ,有效地改善氮平衡 ,维持血循环中淋巴细胞的数目 ,增强对手术及化疗的耐受性     

谷氨酰胺对胃肠道肿瘤患者术后免疫功能的影响

目的:观察谷氨酰胺(Gln)对胃肠道肿瘤患者术后免疫功能的影响.方法:胃肠道肿瘤患者40例,分为研究组(n=20)和对照组(n=20),两组由术后第1天开始连续给予肠外营养7 d.两组肠外营养能量按104 kJ·kg-1·d-1供给,氮入量为0.2 g·kg-1·d-1.研究组由20%L-丙氨酰-L-谷氨酰胺双肽注射液0.5 g·kg-1·d-1,余氮量由8.5%乐凡命供给.对照组仅用8.5%乐凡命为氮源,分别抽取术前、术后第1天、术后第8天的静脉血,测定比较血清Gln、白蛋白、NK细胞、IL-6、TNF-α水平.结果:研究组Gln、白蛋白、NK细胞水平在术后第8天明显高于对照组,而IL-6、TNF-α水平明显低于对照组.结论:补充Gln能提高胃肠道肿瘤患者的细胞免疫功能,维持细胞因子之间的相对平衡,增强NK细胞活性,对胃肠道肿瘤患者的术后康复具有重要意义.     

丙氨酰-谷氨酰胺对神经危重症患者肠屏障与免疫功能的影响研究

目的：探讨丙氨酰-谷氨酰胺(Aln-Gln)双肽对神经危重症患者肠屏障功能及免疫功能的影响。方法：40例神经危重症患者随机分为治疗组和对照组,每各20例,治疗组给予基础治疗+静脉供给Aln-Gln双肽;对照组仅给予基础治疗。于治疗前、治疗后7天检测两组患者的血浆Gln浓度、APACHEⅡ评分、血清白蛋白（ALB）、前白蛋白（PAB）、转铁蛋白（TRF）及免疫球蛋白IgA、IgG、IgM的浓度水平。结果：治疗组患者治疗7天后,血浆Gln浓度、ALB、PAB、TRF及IgA、IgG、IgM的浓度均显著高于治疗前,与对照组相比明显增高(P＜0.05);治疗7天后,治疗组患者的APACHEⅡ评分显著低于治疗前,与对照组相比,APACHEⅡ评分也偏低(P＜0.05)。结论：神经危重症患者极易引起肠功能障碍及免疫功能降低,肠外供给Aln-Gln能提高血浆Gln浓度,营养指标及免疫球蛋白的浓度水平,改善肠道黏膜屏障功能和患者机体的免疫功能。     

基于Wnt/β-catenin信号通路探讨黄芪多糖对脾虚湿困大鼠小肠黏膜损伤修复作用机制

目的 探讨黄芪多糖通过Wnt/β-catenin信号通路修复脾虚湿困大鼠小肠黏膜损伤的机制.方法 60只Wistar大鼠随机分为对照组、模型组、黄芪多糖高剂量组(900 mg·kg-1·d-1)、黄芪多糖中剂量组(600 mg·kg-1·d-1)、黄芪多糖低剂量组(300 mg·kg-1·d-1)、参苓白术散组(2.5...     

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.