新生期长爪沙鼠铅中毒动物模型的建立

为建立新生期长爪沙鼠铅中毒动物模型,选用6-7日龄长爪沙鼠11窝,随机分成正常对 照组、低铅组和高铅组,分别给予腹腔注射乙酸铅溶液0.1 ml(剂量分别为0、12、36 mg／kg), 隔日注射1次,共9次。每6天称其体重,末次注射后次日取全血,测定血铅含量和血红蛋白,并 取脑称脑重,取肾脏和脑组织作病理学观察。结果表明,高、低铅组沙鼠的体重、脑重和血红蛋白 均明显低于正常对照组(P<0.05,P<0.01);血铅含量明显高于正常对照组(P<0.01),体重、脑重 和血红蛋白与血铅呈负相关(r=-0.669,P<0.05;r=-0.7403,P<0.01;r=-0.919,P<0.01); 病理学观察显示,染铅沙鼠的肾组织病变主要以肾小管上皮细胞变性为特点,脑组织病变以锥体细 胞变性,齿状颗粒细胞树状结构紊乱为特点,损伤程度与染铅剂量呈正相关。结果提示,新生期 长爪沙鼠腹腔注射乙酸铅溶液建立铅中毒模型是一种简便、稳定和易于控制剂量的方法,该模型 可成为研究早期铅中毒致神经系统和血液系统等损伤的理想模型。     

妊娠期低水平铅暴露对新生儿钙磷代谢及造血系统的影响

目的 :研究妊娠期低水平铅暴露对新生儿钙磷代谢及造血系统的影响。 方法 :分别测定 79例汉族及5 9例维吾尔族 (维族 )母亲及新生儿脐血铅、钙、磷、碱性磷酸酶、血红蛋白、红细胞游离原卟啉的含量 ,分析脐血铅对新生儿钙、磷、碱性磷酸酶及血红蛋白、红细胞游离原卟啉的影响。 结果 :(1)汉族产妇血铅 6 3 87μg/L ,新生儿脐血铅 4 7.71μg/L ,维族产妇血铅 87 92 μg/L ,新生儿脐血铅 6 1.5 7μg/L ,维族产妇及新生儿脐血铅均高于汉族产妇及新生儿脐血铅含量 (P <0 .0 5 ～ 0 .0 1) 。 (2 )以脐血铅 10 0 μg/L为界将新生儿分为高铅组和低铅组 ,两组血钙相比差异有统计学意义 (P <0 .0 1) ,而两组血红蛋白及红细胞游离原卟啉相比差异均无统计学意义 (P >0 .0 5 )。 结论 :妊娠期低水平铅暴露可致新生儿血钙下降 ,但对新生儿血红蛋白及红细胞游离原卟啉则无影响     

长爪沙鼠近交系培育中血液生理生化指标的变化

目的探讨脑缺血模型长爪沙鼠近交系培育过程中血液生理生化指标动态变化。方法应用Beckman全自动生化分析仪(CX5)和日本光电全自动血细胞分析仪(MEK-7222K)对近交第11至20代(F11到F20)近交系长爪沙鼠17项血液生化和22项血常规指标进行检测。结果 F11~20长爪沙鼠的尿酸(URIC)、乳酸脱氢酶(LD)、肌酸激酶(CK)、丙氨酸氨基转移酶(ALT)、高密度脂蛋白胆固醇(HDLD)、镁(MG)、红细胞(RBC)、白细胞(WBC)、嗜酸性粒细胞(EOS)、中性粒细胞(NEUT)、单核细胞(MON)、嗜碱性粒细胞(BAS)、血小板(PLT)、血小板压积(PCT)、血小板体积分布宽度(PDW)、血红蛋白(HGB)、平均红细胞血红蛋白量(MCH)、红细胞体积分布宽度(RDW)呈现上升趋势,淋巴细胞(LYM)、肌酐(CRE)、尿素氮(BUN)、碱性磷酸酶(ALP)、葡萄糖(GLU)呈现下降趋势;红细胞压积(HCT)、红细胞平均体积(MCV)、平均红细胞血红蛋白浓度(MCHC)、血小板平均体积(MPV)趋势平稳,多数指标F17后趋于平稳。结论长爪沙鼠近交培育对其多数血液生理生化指标具有一定的影响。     

急性脑梗死患者血液流变学及血细胞参数的变化

目的　探讨急性脑梗死患者血液流变学及全血细胞 2 5项参数的变化。方法　对12 7例脑梗死患者和 5 3例建康人的血液流变学及全血细胞参数进行比较。结果　 (1)除红细胞分布宽度和平均红细胞血红蛋白含量外 ,观察组急性期其它指标与对照组比较均有显著差异 (P <0 .0 5～ 0 .0 1) ;(2 )观察组恢复期全血低切粘度、全血低切还原粘度、全血高切相对指数、全血低切相对指数、血浆粘度、红细胞压积、红细胞聚集指数、白细胞计数、平均红细胞血红蛋白含量恢复到对照组水平 (P >0 .0 5 ) ;(3)观察组治疗前后红细胞计数和平均血小板体积有显著差异 (P <0 .0 5 )。结论　血液流变学及血细胞参数异常可能与脑梗死的发生有关     

驱铅益智口服液对血液系统铅毒性的拮抗作用

目的 探讨驱铅益智口服液对血液系统安全性和铅染毒大鼠贫血的治疗作用.方法 依据<食品安全性毒理学评价程序和方法>(GB 15193.1-2003)的要求,采用小鼠骨髓嗜多染红细胞微核实验评价驱铅益智口服液对血液系统安全性.以2%醋酸铅溶液灌胃3周,建立铅染毒大鼠模型,观察低、中、高剂量驱铅益智口服液(染毒后分别给于1 250、2 500和5 000 mg/kg体质量)治疗前后大鼠血铅含量、外周血血红蛋白浓度和血清铁蛋白的变化.结果 低、中、高剂量驱铅益智口服液组雌雄小鼠的骨髓嗜多染红细胞微核率与阴性对照组相比差异均无统计学意义(P>0.05).与模型对照组相比,3种剂量驱铅益智口服液均可显著下调铅染毒大鼠血铅水平(P<0.01),升高血红蛋白浓度(P<0.05或P<0.01),减低血清铁蛋白水平(P<0.01).其效果优于或相当于乙二胺四乙酸的排铅作用.结论 驱铅益智口服液对骨髓红系造血系统无明显致畸作用;并可显著减低血铅水平,上调铁储备,改善铅中毒大鼠贫血状态,拮抗铅对血液系统的毒性作用.     

稳心颗粒对急性加重期肺心病血液流变学和高凝状态的影响

目的　观察稳心颗粒治疗肺心病急性加重期疗效及对血液流变学和高凝状态的影响。方法　选择慢性肺心病急性加重期患者 10 0例 ,随机分为治疗组 5 2例 ,对照组 4 8例。对照组按照常规治疗办法 :吸氧、抗感染、镇咳、祛痰、强心、利尿等 ;治疗组在常规治疗基础上 ,给予稳心颗粒 1袋口服 ,每日 3次。 2组疗程均为 4周 ,治疗前及疗程结束后检测血液流变学、血浆D 二聚体、血红蛋白、红细胞压积 ,治疗中观察记录疗效和副反应。结果　治疗组总有效率 92 .3% ,对照组为 6 8.8% ,2组比较有非常显著性差异 (P <0 .0 1)。治疗后 2组血液流变学均有所改善 ,而治疗组较对照组改善更显著 (P <0 .0 5 )。治疗组血浆D 二聚体、血红蛋白和红细胞压积 ,比治疗前明显下降 (P <0 .0 5或P <0 .0 1) ,比对照组治疗后明显下降 (P <0 .0 5 )。治疗组并发症和病死率明显低于对照组 (P <0 .0 5 ) ,不良反应轻微。结论　稳心颗粒治疗肺心病急性加重期疗效显著 ,明显改善患者血液流变学 ,明显降低D 二聚体、血红蛋白、红细胞压积和纤维蛋白原 ,明显降低心律失常、肺性脑病、休克发生率和病死率 ,改善患者预后     

80例职业铅接触者外周血红细胞参数分析

目的了解职业性铅接触对人体红细胞相关参数的影响。方法将铅作业者按血铅浓度分为铅接触组和铅吸收组,并与上岗前健康体检工人外周血红细胞参数中的红细胞计数(RBC)、血红蛋白(Hb)、红细胞压积(HCT)、红细胞平均容积(MCV)、红细胞平均血红蛋白量(MCH)、红细胞平均血红蛋白浓度(MCHC)、红细胞平均分布宽度(RDW)及在显微镜下阅片观察点彩红细胞结果进行统计学分析。结果铅吸收组RBC、Hb、HCT水平明显低于对照组(P<0.01);铅接触组血RBC、HCT、MCH水平低于对照组(P<0.05),RDW均数高于对照组(P<0.001),不论是铅接触组还是铅吸收组RBC、Hb、HCT的异常率高于对照组(P<0.01)。结论长期接触铅可引起红细胞相关参数的改变。     

铅对生长发育期小鼠脑组织一氧化氮含量的影响

目的　研究铅对生长发育期小鼠脑组织一氧化氮 (Nitricoxide ,NO)含量的影响。方法　将 6 2只Babl/C近交系小鼠随机分成四组 :高铅组 (0 .0 75 %醋酸铅 )、中铅组 (0 .0 5 %醋酸铅 )、低铅组 (0 .0 2 5 %醋酸铅 )、对照组(蒸馏水 ) ,每组小鼠用相应浓度的醋酸铅溶液经饮水染毒 8周后 ,测定小鼠脑组织NO含量。结果　各铅染毒组与对照组相比体重增长减缓 ,其中 0 .0 75 %组体重增长减缓显著 (P <0 .0 5 )。与对照组相比 ,铅染毒小鼠脑内NO含量下降 ,其中 0 .0 75 %组与对照组比较下降明显 (P <0 .0 1)。结论　铅染毒使生长发育期小鼠体重增长减缓 ,且抑制小鼠脑内NO的合成。     

糖尿病血液流变学指标检测与糖化血红蛋白的相关性研究

对 6 8例Ⅱ型糖尿病进行血液流变学指标和糖化血红蛋白检测 ,并与健康对照组比较 ,结果 ,　两组血检指数Q值、纤维蛋白原和血浆粘度、红细胞压积、全血粘度 (2 30s- 1 切变率 )和血小板聚集度差异有显著性 (P <0 0 5 )。其中糖化血红蛋白升高者 38例 ,与糖化血红蛋白正常者 30例相比较 ,前者纤维蛋白原明显升高 (P <0 .0 5 )。结果表明 ,糖尿病患者血液处于浓、粘、聚、缓状态 ;血糖控制越差 ,糖化血给蛋白增高 ,纤维蛋白原增高越明显 ,血液高凝倾向越重 ;在降糖治疗的同时 ,降低血粘度 ,降低纤维蛋白原和抗血小板聚集等综合治疗十分重要     

铅作业工人血锌原卟啉、血铅和24小时尿铅浓度检测结果分析

目的比较铅作业工人和非铅作业工人血常规、血锌原卟啉、血铅和24h尿铅浓度的差异,探讨铅作业工人血锌原卟啉、血铅及24h尿铅浓度的相关性。方法74例铅作业工人作为观察组,72例非铅作业工人作为对照组,测定血常规、血锌原卟啉、血铅和24h尿铅浓度,并对结果资料进行统计学处理。结果观察组血红蛋白含量和血小板低于对照组,白细胞和红细胞则无差异;观察组血锌原卟啉、血铅及24h尿铅浓度均显著高于对照组;血锌原卟啉和血铅浓度间有良好的相关性(r=0．795)。结论血锌原卟啉是反映铅作业工人血铅浓度的指标,可作为铅作业工人健康监护和铅中毒现场筛查指标。     

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.