脑膜淋巴管转运功能障碍加重脂多糖诱导的小鼠中枢炎症

目的：探讨脑膜淋巴管（meningeal lymphatic vessel,mLV）转运功能障碍对脂多糖（lipopolysaccharide,LPS）诱导的小鼠中枢神经系统炎症的影响。方法：①16只C57BL/6雄性小鼠随机分为4组,Control组腹腔注射生理盐水,LPS组分别腹腔注射LPS（2 mg/kg）12、24、72 h,而后观察小鼠mLV转运功能、海马区小胶质细胞（microglial,MG）活化、白介素（interleukin,IL）-6 和IL-1β水平。②将8只小鼠随机分为2组,分别为Control组和VEGFR3抑制剂MAZ51组,观察MAZ51对mLV转运功能的影响。③将24只小鼠分为4组,分别为Control组、MAZ51组、LPS组、LPS+MAZ51组,对MAZ51组和LPS+MAZ51组预先腹腔注射 MAZ51（10 mg/kg）,每周5 d,共30 d,6周后对LPS组和LPS+MAZ51组注射LPS,1 d后行为学实验评估小鼠的逃避恐惧能力;免疫组化检测MG 活化情况;ELISA 法检测IL-6、IL-1β的表达量。结果：小鼠腹腔注射LPS 24 h后脑膜LYVE-1面积和颈深淋巴结内OVA-647面积明显减少（P < 0.01）,72 h内均低于基础水平（P < 0.01）,24 h后海马MG活化、IL-6和IL-1β均明显增加 （P < 0.01）。与Control组相比,MAZ51组OVA-647荧光面积显著减少（P < 0.01）。LPS组小鼠海马区MG活化和IL-6、IL-1β的表达相对Control组均明显增加（P < 0.01）且小鼠僵直时间明显降低（P < 0.01）;与LPS组相比,LPS+MAZ51组小鼠海马区MG 活化和炎症因子的表达均增加（P < 0.01）且僵直时间明显减少（P < 0.01）。结论：mLV转运障碍通过增加炎性介质聚积,活化 MG,加重LPS诱导的小鼠中枢炎症和认知功能障碍。     

白三烯B4受体1拮抗剂U75302对脓毒症小鼠细胞免疫与炎症反应的影响

目的 观察白三烯B4受体1（leukotriene B4 receptor 1,LTB4-BLT1）拮抗剂U75302对脓毒症小鼠免疫功能的影响,探讨阻断白三烯B4受体1在脓毒症治疗中的意义。方法 采用盲肠结扎穿孔术（cecal ligation and puncture,CLP）致脓毒症小鼠模型,将18只雄性C57BL/6小鼠随机分为假手术组（n=6）、 CLP组（n=6）、CLP+腹腔注射U75302组（n=6）。手术后24 h检测3组小鼠外周血中肿瘤坏死因子α（tumor necrosis factor-α,TNF-α）及白介素10（interleukin-10,IL-10）的水平,利用流式细胞术检测3组小鼠腹腔灌洗液中Gr-1⁺细胞的计数以及胸腺T淋巴细胞的凋亡情况。结果 与CLP组相比,CLP+腹腔注射U75302组小鼠外周血中的TNF-α水平降低约43%（P<0.05）,IL-10水平升高约88%（P<0.05）,腹腔Gr-1⁺细胞计数降低（P<0.05）,胸腺T淋巴细胞凋亡比例减少（P<0.01）。结论 LTB4-BLT1拮抗剂U75302可降低外周血TNF-α水平、提高IL-10水平、改善细胞免疫,可能干预脓毒症的炎症反应。     

白三烯B4受体1拮抗剂U75302对脓毒症小鼠细胞免疫与炎症反应的影响

目的 观察白三烯B4受体1（leukotriene B4 receptor 1,LTB4-BLT1）拮抗剂U75302对脓毒症小鼠免疫功能的影响,探讨阻断白三烯B4受体1在脓毒症治疗中的意义。方法 采用盲肠结扎穿孔术（cecal ligation and puncture,CLP）致脓毒症小鼠模型,将18只雄性C57BL/6小鼠随机分为假手术组（n=6）、 CLP组（n=6）、CLP+腹腔注射U75302组（n=6）。手术后24 h检测3组小鼠外周血中肿瘤坏死因子α（tumor necrosis factor-α,TNF-α）及白介素10（interleukin-10,IL-10）的水平,利用流式细胞术检测3组小鼠腹腔灌洗液中Gr-1⁺细胞的计数以及胸腺T淋巴细胞的凋亡情况。结果 与CLP组相比,CLP+腹腔注射U75302组小鼠外周血中的TNF-α水平降低约43%（P<0.05）,IL-10水平升高约88%（P<0.05）,腹腔Gr-1⁺细胞计数降低（P<0.05）,胸腺T淋巴细胞凋亡比例减少（P<0.01）。结论 LTB4-BLT1拮抗剂U75302可降低外周血TNF-α水平、提高IL-10水平、改善细胞免疫,可能干预脓毒症的炎症反应。     

紫草素对脂多糖诱导的小鼠肺损伤的保护作用

目的 研究紫草素在小鼠ALI中的作用与机制,为ALI的药物治疗提供新的思路。方法 将BALB/c小鼠分成空白对照组、紫草素组、LPS组和LPS+紫草素组,小鼠气管内滴入LPS （5mg/kg）之前1h,预先通过灌胃法给予小鼠50mg/kg剂量的紫草素或其溶剂。LPS给药6h后采集肺泡灌洗液（BALF）及肺组织,用ELISA法检测BALF中TNF-α和IL-1β的浓度,BCA法测定BALF中蛋白浓度;肺组织行病理组织切片检查,测定肺湿干重比,比色法检测组织匀浆液中MPO活性及NO浓度,Western blot法检测肺组织中诱生型一氧化氮合成酶（iNOS）的表达水平。对上述结果进行分析,研究紫草素在ALI小鼠体内的抗炎作用与机制。结果 检测BALF中TNF-α和IL-1β的浓度以及BALF中的蛋白含量发现,紫草素+LPS组的浓度较LPS组显著降低,差异有统计学意义（P<0.05）。比色法测定肺组织中MPO活性和NO浓度发现,紫草素+LPS组也明显低于LPS组,差异有统计学意义（P<0.05）。紫草素预处理组的肺湿干重比也较LPS组明显降低,差异有统计学意义（P<0.05）。此外,紫草素预处理组的肺组织病理学改变也较LPS组有所减轻,尤其体现在肺组织炎性细胞的浸润明显减少。Western blot法检测显示,紫草素+LPS组的iNOS表达量较LPS组明显下降,差异有统计学意义（P<0.05）。结论 紫草素可在病理学改变、减轻肺水肿、减少炎性因子的释放和中性粒细胞的浸润等多方面缓解ALI。这种保护作用的潜在机制可能与紫草素抑制iNOS有关。     

二肽基肽酶-4通过CXCR4/mTOR信号通路介导小鼠肺泡巨噬细胞MH-S自噬的机制研究

目的 探究二肽基肽酶-4（DPP-4）通过趋化因子受体4（CXCR4）/哺乳动物雷帕霉素靶蛋白（mTOR）信号通路介导小鼠肺泡巨噬细胞MH-S自噬的机制。方法 体外培养小鼠肺泡巨噬细胞MH-S并分组转染。分别设置PBS组（PBS培养MH-S细胞）、LPS组（100 ng/mL LPS诱导24 h）、DPP-4组（DPP-4表达病毒转染）、si-DPP-4组（si-DPP-4病毒载体转染）、DPP-4 + BafA1组（DPP-4表达病毒转染+自噬抑制剂BafA1干预）及si-DPP-4 + BafA1组（si-DPP-4病毒载体转染+自噬抑制剂BafA1干预）。绿色荧光蛋白（GFP）检测转染效率，稳定转染后，酶联免疫吸附试验检测MH-S细胞上清液炎症因子水平，腺病毒检测MH-S细胞自噬流变化，实时荧光定量聚合酶链反应检测细胞DPP-4、CXCR4、mTOR mRNA的表达，Western blottig检测CXCR4/mTOR通路蛋白的表达。结果 LPS组IL-1β、IL-6、TNF-α、GFP、RPF、Merge数量，CXCR4 mRNA、mTOR mRNA和CXCR4蛋白、p-mTOR/mTOR蛋白相对表达量高于PBS组（P <0.05）；DPP-4组与LPS组IL-1β、IL-6及TNF-α水平比较，差异无统计学意义（P >0.05）；DPP-4组GFP、RPF、Merge数量，DPP-4 mRNA相对表达量高于LPS组（P <0.05），CXCR4 mRNA、mTOR mRNA、CXCR4蛋白、p-mTOR/mTOR蛋白相对表达量低于LPS组（P <0.05）；si-DPP-4组IL-1β、IL-6、TNF-α水平高于LPS组（P <0.05），GFP、RPF及MergeMerge数量低于LPS组（P <0.05）；si-DPP-4组和DPP-4 + BafA1组IL-1β、IL-6、TNF-α水平、CXCR4蛋白、p-mTOR/mTOR蛋白相对表达量高于DPP-4组（P <0.05），GFP、RPF及Merge数量低于DPP-4组（P <0.05）；si-DPP-4组DPP-4 mRNA相对表达量低于DPP-4组（P <0.05），CXCR4 mRNA、mTOR mRNA相对表达量高于DPP-4组（P <0.05）；si-DPP-4 + BafA1组IL-1β、IL-6水平、CXCR4 mRNA、mTOR mRNA、CXCR4蛋白、p-mTOR/mTOR蛋白相对表达量高于si-DPP-4组（P <0.05），GFP、RPF、Merge数量低于si-DPP-4组（P <0.05）。结论 DPP-4能够调节小鼠肺巨噬细胞自噬作用，调控炎症反应，其作用机制可能与CXCR4/mTOR通路有关。     

芒柄花素磺酸钠通过MAPKS信号通路缓解OVA诱导哮喘小鼠肺部炎症

[目的] 观察芒柄花素磺酸钠对卵清蛋白（OVA）诱导哮喘小鼠的保护作用及其机制。[方法] 购买SPF级C57BL/6小鼠60只,并随机分6组,每组10只,具体组别如下：空白对照组（CON组）、模型组（OVA组）、芒柄花素磺酸钠低剂量（MBHS-L组）、芒柄花素磺酸钠中剂量（MBHS-M组）、芒柄花素磺酸钠高剂量（MBHS-H组）和地塞米松组（DEX组）,使用OVA诱导建立小鼠哮喘模型。实验主要评价小鼠哮喘症状并进行评分、计量支气管肺泡灌洗液（BALF）中炎症细胞数量（Diff-Quick染色法）、镜下观察肺组织的病理学变化[苏木精-伊红（HE）染色法]、分析BALF中超氧化物歧化酶（SOD）活性和肿瘤坏死因子α（TNF-α）、白细胞介素1β（IL-1β）、白细胞介素6（IL-6）和丙二醛（MDA）水平（ELISA法和化学发光法）、分析肺组织p-ERK1/2,p-JNK和p-p38MAPK蛋白表达水平（免疫荧光法和Western blot法）。[结果] 与OVA组比较,哮喘症状评分、BALF炎症细胞数量、TNF-α、IL-1β和MDA水平以及p-ERK1/2,p-JNK和p-p38MAPK蛋白表达水平在MBHS组和DEX组均明显降低（P＜0.05）,而SOD的活性明显升高（P＜0.05）,肺组织病理学变化明显改善。[结论] 芒柄花素磺酸钠可能通过MAPKS信号通路缓解OVA诱导哮喘小鼠的肺部炎症。     

β1受体阻滞剂上调肠道上皮细胞HO-1对脓毒症大鼠肠道功能的保护作用

目的 探讨β₁受体阻滞剂艾司洛尔（Esmolol）能否上调血红素氧合酶-1（heme oxygenase-1,HO-1）起到对脓毒症大鼠肠道功能的保护作用。方法 本实验于哈尔滨医科大学附属第一医院外科中心实验室完成。40只雄性Wistar大鼠按随机数字表法分为4组：假手术组（sham组,n=10）、脓毒症组（CLP组,n=10）、艾司洛尔干预组（Esmolol+CLP组,n=10）、HO-1抑制剂组（Esmolol+ZnPP+CLP组,n=10）。采用盲肠结扎穿孔术（CLP）制备脓毒症大鼠模型,Esmolol组通过静脉输注艾司洛尔注射液,速度为15mg/（kg·h）,Esmolol+ZnPP+CLP组术前1h腹腔内注射ZnPP溶液（40μmol/kg）,术后同速静脉输注艾司洛尔注射液。其余各组大鼠腹腔注射等体积生理盐水,并且静脉输注等渗盐水,速度2ml/（kg·h）。术后12h处死大鼠,ELISA法检测各组血清肿瘤坏死因子（TNF-α）和白细胞介素（IL-1β）水平,采用蛋白印迹法及免疫组化法检测大鼠肠组织HO-1表达水平,光学显微镜观察大鼠肠组织病理变化情况。结果 与Sham组相比,CLP组大鼠血清TNF-α、IL-1β水平均明显升高（43.71±6.24pg/ml vs 2742.69±221.71pg/ml,52.69±14.15pg/ml vs 482.73±125.49pg/ml,P<0.05）;肠组织中HO-1水平表达升高（P<0.05）;肠组织病理损伤明显。与CLP组相比,Esmolol+CLP组血清TNF-α、IL-1β水平均明显下降（2742.69±221.71pg/ml vs 968.81±99.46pg/ml,482.73±125.49pg/ml vs 156.15±38.29pg/ml,P<0.05）;肠组织HO-1水平表达明显升高（P<0.05）;肠组织病理损伤程度减轻。与CLP组相比,Esmolol+ZnPP+CLP组大鼠血清TNF-α、IL-1β水平无明显差异（2742.69±221.71pg/ml vs 2545.18±173.74pg/ml,482.73±125.49pg/ml vs 474.43±113.98pg/ml,P>0.05）;肠组织病理损伤程度无明显差异。结论 Esmolol能改善脓毒症诱发的肠道损伤,其可能是通过上调HO-1通路来减轻肠组织炎性反应,继而减轻肠道损伤。     

右美托咪定对博莱霉素诱导的肺纤维化小鼠TLR4/MyD88信号通路的影响

目的：　探究右美托咪定（dexmedetomidine,DEX）对博莱霉素（bleomycin,BLM）诱导的肺纤维化小鼠的保护作用以及对Toll样受体4/髓样分化因子（toll-like receptor 4/myeloid differentiation factor88,TLR4/MyD88）信号通路的影响。方法：　通过注射BLM诱导实验性小鼠肺纤维化。将小鼠分为生理盐水（Sham）组、BLM组、BLM+DEX组、BLM+PFD组和BLM+DEX+LPS组。苏木素-伊红（hematoxylin and eosin,HE）染色和Masson染色分析肺组织病理学变化;免疫组织化学检测纤连蛋白（fibronectin,Fn）、α-平滑肌肌动蛋白（α-smooth muscle actin,α-SMA）和Ⅰ型胶原蛋白（collagenⅠ）表达情况;原位缺口末端标记法（TdT mediated dUTP nick end labeling,TUNEL）检测肺组织中细胞凋亡;检测支气管肺泡灌洗液（bronchoalveolar lavage fluid,BALF）中总细胞数量及蛋白质含量;Western blot检测肺组织中TLR4/MyD88信号通路和细胞凋亡相关蛋白水平。结果：　与Sham组相比,BLM刺激后肺组织中肺泡炎评分[（2.56±0.24）分vs.（0.15±0.02）分]和Ashcroft评分[（5.68±0.52）分vs.（0.09±0.01）分]明显增高,Fn[（63.63±5.48）% vs.（25.12±2.16）%]、α-SMA[（58.63±5.03）% vs.（17.56±1.25）%]和collagen Ⅰ[（55.32±5.16）% vs.（12.03±1.20）%]表达升高（P<0.05）,肺部炎症程度和纤维化程度增加;同时TUNEL阳性细胞率增高,细胞中bcl-2相关X蛋白（bcl-2 associated X protein,Bax）水平增高,B淋巴细胞瘤-2蛋白（B-cell lymphoma-2 protein,Bcl-2）水平降低（P<0.05）;BALF中总细胞数量[（3.54±0.06）×10⁵个/mL vs.（0.98±0.07）×10⁵个/mL]和蛋白质含量[（2.85±0.20）mg/mL vs.（0.29±0.03）mg/mL]升高（P<0.05）;肺组织中TLR4和MyD88蛋白水平升高（P<0.05）。DEX治疗可减轻BLM诱导的小鼠肺纤维化和炎症,降低TUNEL阳性细胞率,并逆转Fn、α-SMA、collagen Ⅰ、Bax和Bcl-2表达（P<0.05）;同时DEX也降低BLM诱导的小鼠BALF中总细胞数量和蛋白质含量（P<0.05）。此外,DEX降低BLM诱导的小鼠肺组织中TLR4和MyD88蛋白水平（P<0.05）。吡非尼酮（pirfenidone,PFD）与DEX具有相似的作用效果。脂肪酶（lipase,LPS）可以部分逆转DEX对BLM诱导的肺纤维化小鼠保护作用（P<0.05）。结论：　DEX可能通过抑制TLR4/MyD88信号通路改善BLM诱导的小鼠肺纤维化。     

重症肺炎患者BALF中细胞因子及α-SMA水平与疾病严重程度的研究

目的 探讨重症肺炎患者支气管肺泡灌洗液（BALF）中细胞因子水平及α-SMA水平反映疾病严重程度及肺纤维化程度的意义。方法 将笔者医院重症监护室收治的45例重症肺炎患者分为非ALI/ARDS组、ALI组及ARDS组,检测3组患者入科后支气管肺泡灌洗液的HGF、KGF及其他炎性因子水平,评价上述指标反映重症肺炎患者病情严重程度的意义,同时检测3组患者肺泡灌洗液中α-SMA水平,评价3组患者肺纤维化的程度。结果 3组患者BALF中的细胞因子HGF、KGF、IL-6、IL-8及MCP-1水平呈现ARDS组 > ALI组 > 非ALI/ARDS组（P<0.05）;3组患者BALF中α-SMA水平呈现ARDS组 > ALI组 > 非ALI/ARDS（P<0.05）。结论 对于初入科的重症肺炎患者,细胞因子HGF、KGF、IL-6、IL-8及MCP-1水平越高,其病情相对越重,灌洗液中α-SMA水平可以反映肺纤维化程度,其水平越高,肺组织修复能力越差,对患者的预后有一定提示作用。     

基于TWEAK/Fn14信号通路探讨大黄酚对OVA诱导哮喘小鼠的保护作用

[目的] 观察大黄酚对卵清蛋白（OVA）诱导哮喘小鼠模型的保护作用,并探讨肿瘤坏死因子样凋亡弱诱导因子（TWEAK）/成纤维细胞生长诱导因子14（Fn14）信号通路与其保护作用的关系。[方法] 60只C57BL/6小鼠按体质量随机分为正常对照组（CON组）、模型组（OVA组）、地塞米松阳性对照组（DEX组）、大黄酚低剂量组（RHU-L组）、大黄酚中剂量组（RHU-M组）和大黄酚高剂量组（RHU-H组）,每组10只。实验结束后,对各组小鼠的哮喘症状进行评分;Diff-Quick染色法计量各组小鼠支气管肺泡灌洗液（BALF）中炎症细胞数。苏木精-伊红（HE）染色法观察肺组织病理学变化;酶联免疫吸附法检测各组小鼠BALF中白细胞介素-4（IL-4）、白细胞介素-5（IL-5）、肿瘤坏死因子-α（TNF-α）和白细胞介素-1β（IL-1β）的含量;免疫组化法检测各组小鼠肺组织中TWEAK蛋白的表达水平。蛋白免疫印迹法检测各组小鼠肺组织TWEAK/Fn14信号通路蛋白TWEAK和Fn14的表达水平。[结果] 大黄酚可明显降低哮喘症状评分（P<0.05）,减少哮喘小鼠BALF中总细胞、嗜酸性粒细胞、中性粒细胞和淋巴细胞的数量（P<0.05）,改善肺组织的病理学变化,降低BALF中IL-4、IL-5、TNF-α和IL-1β炎症因子的水平（P<0.05）,减少肺组织中TWEAK和Fn14蛋白表达（P<0.05）。[结论] 大黄酚对OVA致哮喘小鼠模型具有较好的保护作用,其可能与调节TWEAK/Fn14信号通路有关。     

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.