清开灵对内毒素性发热家兔血管内皮细胞分泌功能的影响

目的探讨清开灵注射液对内毒素性发热家兔血管内皮细胞分泌功能的作用.方法复制内毒素(ET)性发热家兔模型,观察清开灵对体温的影响,并用放免法测定内皮素以及血栓素B2(TXB2)、6-酮-前列腺素F1α(6-keto-PGF1α)的含量,用发色底物法测定血浆组织纤溶酶原激活物(t-PA)及其组织纤溶酶原激活物抑制剂(PAI)的活性.结果清开灵对ET性发热家兔有显著性的解热效应(P＜0.01),清开灵 ET组内皮素、TXB2的含量(P＜0.01)以及PAI的活性(P＜0.05)明显低于ET组;而6-keto-PGF1α的含量(P＜0.05)和t-PA的活性(P＜0.01)明显高于ET组.结论清开灵可能通过改善内毒素性发热家兔血管内皮细胞的分泌功能,起到扩张微血管,加快体表散热,从而对发热家兔的解热效应起到一定的整合作用.     

清开灵注射液对内毒素性发热家兔清热化瘀作用的研究

目的 观察清开灵注射液(清开灵)对内毒素性发热家兔清热化瘀的作用.方法 采用大肠杆菌内毒素诱导家兔热瘀证病理模型,用数字温度计观察清开灵对发热家兔体温的影响;用放免法测定血清肿瘤坏死因子(TNFα)的含量;用发色底物法检测血浆组织纤溶酶原激活物(t-PA)和组织纤溶酶原激活物抑制剂(PAI)的活性;并观察肺、肾、肝的形态改变.结果 清开灵治疗组的最大体温上升度(ΔT)[(0.66±0.08)℃]、体温反应指数(TRI2)(4.67±0.66)、血清TNFα[(3.54±0.78)μg/L] 的含量和血浆PAI[(0.84±0.02)AU/mL]的活性明显低于内毒素组的ΔT[(1.31±0.13)℃]、TRI2(8.44±0.98)、TNFα[(6.10±3.25)μg/L] 的含量和PAI[(0.86±0.01)AU/mL] 的活性,两者相比有显著性差异(P＜0.05～0.01);而血浆t-PA[(0.26±0.01)IU /mL]的活性则明显高于内毒素组[(0.21±0.02)IU/mL],两者比较差异亦有显著性(P＜0.01);光镜显示,清开灵可减轻发热家兔肺、肾、肝组织血管扩张充血、淤血形态的改变.结论 清开灵可能通过抑制发热家兔致热性细胞因子的释放和调节血液中纤溶和促凝物质的活性达到清热化瘀作用的.     

COPD和慢性肺心病患者急性感染期血浆纤溶活性的改变及其临床意义

分别检测24例慢性阻塞性肺病(COPD)患者及20例慢性肺心病患者的血浆组织型纤溶酶原激活物(t-PA),纤溶酶原激活物抑制物(PAI)活性及D二聚体(D-D)含量等纤溶指标,并与正常对照组进行比较,发现两观察组的t-PA活性明显降低(P<0.01),PAI活性明显上升(P<0.01),D-D含量也显著升高(P<0.01),但两观察组间各指标平均值相差不显著(P均>0.05)。提示纤溶系统功能改变在COPD阶段已经开始,此点对临床防治有重要意义。     

中风系列方对大鼠脑缺血再灌注损伤的研究

目的:探讨中风系列方活血汤、化痰汤、清热化痰汤、养阴汤、益气汤对脑缺血再灌注损伤的保护作用.方法:制作SD大鼠脑缺血与再灌注损伤模型,随机分假手术对照组,脑缺血再灌注损伤组,活血汤、化痰汤、清热化痰汤、养阴汤及益气汤各治疗组,维脑路通对照治疗组.观察各组脑组织前列环素(PGI2)和血栓素B2(TXB2)含量,血浆组织型纤溶酶原激活物(t-PA)活性及组织型纤溶酶原激活物抑制剂(PAI)活性.结果:益气汤及养阴汤能显著提高脑缺血再灌注损伤大鼠脑皮质6-酮-前列腺素F1α的含量;活血汤、清热化痰汤、养阴汤、益气汤能显著降低脑缺血再灌注损伤大鼠脑皮质TXB2的含量;活血汤、养阴汤、益气汤具有调节血浆t-PA与PAI活性的作用.结论:活血汤、清热化痰汤、养阴汤及益气汤具有抗凝和溶栓的作用,对脑缺血再灌注损伤具有保护作用.     

糖尿病患者t—PA、PAI变化及临床意义

目的 阐明糖尿病患血浆组织纤溶酶原激活物（t-PA)、纤溶酶原激活物抑制物（PAI）的变化及临床意义。方法 采用发色底物法测定73例糖尿病患和71例非糖尿病患t-PA、PAI并进行对照分析。结果 糖尿病组t-PA较对照组增高，差异有显性（P＜0.05)；PAI较对照组增高，差异有高度显性（P＜0.01)，PAI占优势。结论 糖尿病患纤溶活性相对降低，较易患血栓性疾病。     

肝硬化患者纤溶活性增高与组织纤溶酶原激活物及其抑制剂的关系

目的 探讨肝硬化患者纤溶性增高与组织纤溶酶原激活物(t-PA),组织纤溶酶原激活物抑制剂(PAI)的关系.方法 根据Child-Pugh分级把明确诊断为肝硬化的35例患者分为三组,A级10例,B级13例,C级12例.对每例样本检测组织纤溶酶原激活物(t-PA)抗原,组织纤溶酶原激活物抑制剂(PAI),纤维蛋白(原)降解产物(FDP)和D-二聚体(D-dimer).结果 22例具有正常纤溶活性(FDP＜5μg/ml;D-dimer＜0.5μg/ml)的病例中,其中A级12例,B级6例,C级4例,tPA抗原随病情严重程度而显著性升高,差异有显著性意义(P＜0.05),而PAI活性在三组结果近似(P＞0.05).另外,通过比较高纤溶活性和正常纤溶活性(B级和C级)t-PA/PAI变化.我们注意到t-PA在纤溶活性高的患者略高于正常纤溶患者,但差异没有显著意义(P＞0.05).PAI在两组间结果近似,差异没有显著性意义(P＞0.05).结论 t-PA随病情加重而显著性升高,PAI随病情加重变化不大;t-PA/PAI失衡不是肝硬化患者纤溶升高的主要因素.     

无症状性脑梗死患者血清脂蛋白(α)水平与纤溶活性检测

目的:探讨无症状性脑梗死(SCI)患者血清脂蛋白(α)[Lp(α)]水平与纤溶活性的关系.方法:采用Olimpus-AU 5400全自动生化分析仪测定53例SCI患者和55例健康者(对照组)血清Lp(α)水平,用发色底物法检测血浆组织型纤溶酶原激活物(t-PA)和纤溶酶原激活物抑制剂(PAI)活性,并对SCI患者的血清Lp(α)水平与血浆t-PA和PAI活性进行相关分析.结果:SCI组血清Lp(α)水平[(238.48±48.76)mg/L]高于对照组[(198.36±38.42)mg/L,t=4.759,P＜0.05];SCI组t-PA活性[(0.11±0.01)IU/mL]低于对照组[(0.49±0.12)IU/mL,t=-22.973,P＜0.05],而PAI活性[(0.86±0.22)AU/mL]高于对照组[(0.48±0.10)AU/mL,t=11.626,P＜0.05].SCI组血清Lp(α)水平与t-PA活性呈负相关(r=-0.676,P＜0.05),与PAI活性呈正相关(r=0.813,P＜0.05).结论:血清Lp(α)水平升高是SCI重要的危险因素;其可能通过降低t-PA的活性和(或)增强PAI的活性,干扰纤溶系统的平衡,参与SCI的形成.     

2型糖尿病患者血栓通治疗前后血栓状态变化

目的观察血栓通治疗2型糖尿病患者血栓状态的变化.方法将86例2型糖尿病患者随机分成两组,A组:血栓通组,B组:对照组,采用酶免法及显色法测定血小板α颗粒膜糖蛋白质-140(GMP-140)、组织纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物(PAI)、血管性假血友病因子(vWF)四项标志物变化.结果血栓通组患者治疗后GMP-140、PAI、vWF明显降低,而t-PA活性升高,与治疗前对比差异有显著意义(P＜0.01);B组治疗前后无差异(P＞0.05);A组治疗后各标志物变化与B组对比有显著差异(P＜0.01).结论血栓通能显著降低GMP-140、PAI、vWF,而且还能升高t-PA活性,具有调节纤溶系统功能及抗凝作用.     

糖尿病患者血小板功能及纤溶活性的改变

目的 :探讨糖尿病患者血小板功能及纤溶活性的改变。方法 :用玻珠柱法测定血小板的粘附性 ,用发色底物显示法测定t-PA、PAI活性。结果 :糖尿病患者的血小板粘附功能和组织纤溶酶原激活物抑制物 (PAI) ,活性明显高于对照组 ,并存在显著差异 (P <0 .0 5 )。组织型纤溶酶原激活物 (t-PA)活性明显低于对照组 ,并存在非常显著差异 (P <0 .0 1)。结论 :糖尿病患者血小板粘附性增高 ,PAI活性增高 ,t-PA活性降低。这一研究结果对糖尿病合并发生血栓性疾病的发病机理及指导临床用药以缓解或延迟糖尿病并发症的发生具有重要意义     

肝硬化患者纤溶活性变化与临床指征关系的探讨

目的:探讨肝硬化患者纤溶活性增高与组织纤溶酶原激活物(t-PA),组织纤溶酶原激活物抑制剂(PAI)的关系。方法:根据Ch ild-Pugh分级把明确诊断为肝硬化的86例患者分为三级,A级26例,B级30例,C级30例。对每例样本检测组织纤溶酶原激活物(t-PA)抗原,组织纤溶液酶原激活物抑制剂(PAI),纤维蛋白(原)降解产物(FDP)和D-二聚体(D-d im er)。结果:46例具有正常纤溶活性(FDP<5 mg/l;D-d im er<0.5 mg/l)的病例,其中A级26例,B级12例,C级8例,t-PA抗原随病情严重程度而显著性升高(P<0.05),而PAI活性在三组结果近似(P>0.05)。t-PA在纤溶活性高的患者略高于正常纤溶患者,但差异没有显著性意义(P>0.05);PAI在两组间结果近似,差异没有显著性意义(P>0.05)。结论:t-PA随病情加重而显著性升高,PAI随病情加重变化不大。     

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.