益气养阴活血利水中药复方对兔视网膜脱离后视网膜组织中ATP含量的影响

目的：研究益气养阴活血利水中药复方（复明片）对兔实验性视网膜脱离后视网膜组织中ATP含量的影响。方法将48只有色家兔随机分为正常对照组（A组）、模型对照组（B组）、西药对照组（C组）、复明片组（D组），每组12只。 B、C、D组制作视网膜脱离模型。造模后第1天给药，A组、B组予温开水灌胃；C组予西药混合溶液灌胃，以上均1次/d；D组予复明片混悬液灌胃，1次/d。并于造模后7、21 d分别观察各组视网膜复位情况，取材后观察视网膜组织中ATP含量。结果模型对照组视网膜组织ATP含量与正常对照组比较明显减少（P<0.01），与模型对照组比较，西药对照组和复明片治疗组ATP含量明显升高（P<0.01）。至术后第3周，复明片治疗组ATP含量已与正常对照组无明显差异(P>0.05)。结论益气养阴活血利水中药复方（复明片）能改善视网膜脱离后视网膜组织的能量代谢，有助于视功能的恢复。     

益气养阴活血利水法对兔视网膜脱离后ERG及视网膜组织超微结构的影响

目的研究益气养阴活血利水之复明片对免实验性视网膜脱离后视网膜电图及视网膜组织超微结构的影响。方法将72只有色家免随机分为正常对照纽（A组）、模型组（B组）、VitB1混合液对照组（C组）、复明片组（D组）,每组18只。B、C、D组制作视网膜脱离模型。造模后第1天下午开始给药,A组与B组均予温开水,C组予VitB1混合溶液,D组予复明片混悬液灌胃,体积为5mL／kg,1次,d。并于造模前1d及造模后的1、6、13、20d,行暗适应ERG、最大混合反应ERG、明适应ERG检查;于造模后7、14、21d分别观察各组视网膜复位情况,取材后电镜下观察超微结构改变。结果益气养阴活血利水之复明片能提高RD后免眼暗适应ERG、暗适应最大反应、明适应ERG的a波和b波振幅,缩短其潜时,与模型组及对照组比较,差异均有统计学意义（P〈0．05）;能促进脱离视网膜复住。减轻脱离及复住视网膜组织及细胞的形态学损伤,改善视功能。结论益气养阴活血利水之复明片通过抑制兔视网膜脱离后的细胞增殖、抑制炎症反应以及抑制基质的降解而起到保护视网膜组织结构、促进视网膜脱离后视功能恢复的作用。     

益气养阴活血利水法对兔视网膜脱离后视网膜组织中IL-1β表达的影响

目的 研究益气养阴活血利水之复明片时兔实验性视网膜脱离后视网膜组织中IL-1β表达的影响.方法 将72只兔随机分为正常对照组(A组)、模型组(B组)、西药组(C组)、复明片组(D组),每组18只.B、C、D组制作视网膜脱离模型.造模后第1天下午开始给药,A组与B组均予温开水灌胃,C组予西药混合溶液灌胃,D组予复明片混悬泣灌胃,5 mL/kg,1次/d.并于造模后7、14、21 d采用S-P免疫组化法检测视网膜组织白介素-1β(Intedeukin-1β,IL-1β)的袁达.结果 IL-1β在模型组和西药组的神经上皮层阳性表这,在复明片组的神经上皮层弱阳性表达,差异具有统计学意义(P<0.05,P<0.01).结论 益气养阴活血利水之复明片能抑制视网膜组织中IL-1β的表达.     

复明片对兔视网膜脱离后视网膜色素上皮细胞增殖的影响

目的研究复明片对兔实验性视网膜脱离后视网膜色素上皮细胞(retinal pigment epithelium,RPE)增殖的影响。方法用有色家兔96只设正常对照组(A组),制作视网膜脱离模型后分模型组(B组)、西药对照组(C组)、复明片组(D组)。并于造模后7、14、21 d分别取视网膜组织制备细胞悬液,流式细胞仪检测各兔增殖细胞核抗原(PCNA)在视网膜神经上皮层的表达。结果脱离后视网膜神经上皮层PCNA阳性细胞表达均呈上升趋势,7d后开始下降,且复明片组相较其余各组比较均有统计学意义(P<0.05)。结论复明片通过恢复视网膜色素上皮与神经上皮之间的接触,阻止RPE的增殖即PCNA的表达。     

复脉饮对缺血大鼠视网膜形态学及其血清SOD、NO的影响

目的 :研究复脉饮对实验性缺血大鼠视网膜的形态结构及其血清超氧化物歧化酶 (SOD)和一氧化氮 (NO)水平的影响。方法 :6 0只Wister大鼠分为复脉饮治疗组、复明片对照治疗组和生理盐水对照组 ,每组2 0只。采用高眼压法形成大鼠视网膜缺血模型。建模后分别喂饲复脉饮、复明片和生理盐水 3周。制备电镜半薄切片 ,在光镜下观察各组大鼠视网膜的显微结构 ;制备电镜超薄切片 ,在电镜下观察其超微结构 ;检测各组血清SOD和NO水平。结果 :复脉饮治疗后 ,缺血大鼠视网膜的分层、厚度、显微和亚显微结构等明显优于空白对照组 ,也优于复明片对照组 ;其血清SOD水平升高而NO水平降低 ,与生理盐水对照组有显著差异(P <0 .0 5 )。结论 :复脉饮可能参与了抗氧化 ,参与了视神经细胞间信号传导通路的修复以及神经递质和调质的平衡 ,能有效治疗大鼠视网膜缺血性损害     

自拟护网明目散对实验性玻璃体积血患者视网膜的保护作用观察

目的:观察自拟护网明目散对实验性玻璃体积血的视网膜组织的影响。方法:将新西兰白兔实验性玻璃体积血模型分成正常组,模型对照组,中药(护网明目散)治疗组,西药治疗对照组。分别于第4周、第8周随机处死各组之中的6只,取视网膜组织,送光镜检查。结果:护网明目散治疗组病理改变较模型对照组、西药治疗对照组视网膜各层组织损伤轻微。结论:护网明目散能够明显的减轻和防止积血对视网膜组织造成的损害。     

大鼠实验性视网膜脱离复位模型的建立及其形态学观察

目的 建立视网膜脱离复位模型并进行组织学观察.方法 30只健康SD大鼠(60眼),分3组,每组各10只.左眼为模型眼,采用视网膜下注射透明质酸钠的方法建立视网膜脱离模型,右眼为正常对照,不做任何处理,分别于术后1d,1周,3周取眼球,光镜下观察其组织学形态.结果 29只模型眼成功建立视网膜脱离模型,1周内全部复位.光镜下观察,视网膜脱离早期视网膜各层水肿,结构紊乱,光感受器外节丢失变薄.视网膜复位1周,视网膜水肿减轻,各层间有空泡样变,光感受器细胞排列紊乱、变薄.外核层细胞数目减少,排列紊乱.视网膜复位3周,视网膜各层排列整齐,外核层细胞少,神经节细胞有变性.结论 本实验成功建立视网膜脱离及短期复位的动物模型,组织学观察复位后视网膜细胞存在不可逆性受损.     

复明片治疗糖尿病视网膜病变视网膜光凝术后临床观察

目的 比较糖尿病视网膜病变患者行视网膜激光光凝术后予以复明片与单纯西药治疗的疗效.方法 将63例(121眼)糖尿病视网膜病变患者随机分为治疗组36例(69眼)和对照组27例(52眼),两组均采用降血糖联合视网膜激光光凝术治疗,治疗组在此基础上口服复明片.30 d为1个疗程,共治疗1~3个疗程.观察两组治疗后视力、眼底的变化.结果 治疗组患者视力提高优于单纯西药对照组(P<0.05),眼底出血、视网膜水肿及渗出的吸收程度均优于单纯西药对照组(P<0.05).结论 复明片治疗糖尿病视网膜病变视网膜光凝术后效果优于单纯西药治疗.     

实验性网脱复位后未脱离区域视网膜组织形态学观察

目的:研究视网膜脱离(RD)复位后未发生脱离区域的视网膜组织形态改变。方法:将20只健康成年新西兰灰兔随机分为空白对照组2只和实验组18只,实验组在显微镜下行视网膜下注射透明质酸钠建立视网膜脱离自动复位动物模型,分别于术后10d、20d、30d处死实验兔并摘除眼球进行组织学观察。结果:未发生脱离区域的视网膜在复位早期表现为色素上皮层基本正常,感光细胞层、双极细胞层排列紊乱,感光细胞、双极细胞、神经节细胞均有变性。结论:RD复位后视网膜上光感受器的不完全再生,双极细胞和神经节细胞的不可逆变化,均可影响视功能的提高。     

二十碳五烯酸对增殖性糖尿病性视网膜病变动物模型视网膜组织的超微结构改变的影响

目的 探讨二十碳五烯酸(eicosapentaenoic acid,EPA)对增殖性糖尿病性视网膜病变(proliferative diabetic retinopathy,PDR)动物模型视网膜组织超微结构的影响.方法 应用链脲佐菌素腹腔注射造成的糖尿病Sprague-Dawley大鼠模型,1个月后行血管内皮生长因子(vascular endothelial growth factor,VEGF)玻璃体腔注射造成PDR动物模型36只,在VEGF注射同时,注射后2、4周分别玻璃体注射EPA,并根据前期研究结果分为背景期(D组)12只、增殖前期(E组)8只、增殖期给药组(F组)4只,并与仅仅玻璃体腔注射VEGF的PDR模型组(C组)12只比较,应用透射电镜观察视网膜神经细胞的损害情况.结果 电镜结果显示增殖前期给药组EPA注射后6周、背景期给药组EPA注射后4周视网膜神经细胞损害明显减轻.结论 EPA不仅可通过封闭flk-1受体抑制糖尿病性视网膜病变的发展,还对视网膜神经细胞具有保护作用,具体机制尚待进一步研究阐明.     

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.