烧伤败血症发病规律探讨

６６９例烧伤败血症患者的临床资料分析以探讨该病的发病规律。结果：本组共检出细菌１２４６株,其中Ｇ＋球菌４０．０％,Ｇ－杆菌占５７．７％,主要优势菌为金黄色葡萄球菌和绿脓杆菌。烧伤败血症发生率：小儿及老年组（１３．１％和１０．３％）明显高于中青年组（Ｐ＜０     

新补益汤对记忆获得与血小板聚集的作用

新补益汤是一补肝肾的复方，经药理实验证明：给小鼠灌服新补益汤２０ｇ／ｋｇ，１次／ｄ，５ｄ。结果发现，在跳台实验中该方能对抗东莨菪碱所致小鼠学习记忆获得障碍，延长错误潜伏期１１７．５±７１．８ｓ，对照组为１３．４±１４．９ｓ（Ｐ＜０．０１），减少错误次数０．８±０．７次，对照组为２．５±１．４次（Ｐ＜０．０１）。该方还能对抗二磷酸腺苷（ＡＤＰ）诱导的大鼠血小板（Ｐｔ）聚集，Ｐｔ聚集率为４１．３５±１．７％，对照组为４９．４７±３．８％（Ｐ＜０．０１）。另外还发现，杞菊地黄丸也能对ＡＤＰ诱导的大鼠Ｐｔ聚集有明显的抑制作用，Ｐｔ聚集率为３５．８６±３．１％，对照组为４９．４７±３．８％（Ｐ＜０．０１）。     

1,6—二磷酸果糖抗失血性休克实验研究

本实验观察了ＦＤＰ抗失血性休克作用。３组失血性休克大鼠分别接受５％ＦＤＰ溶液（Ａ组）、５％葡萄糖溶液（Ｂ组）和生理盐水（Ｃ组）静注。给药６０ｍｉｎ后，Ａ组ＭＡＰ为１０．４±２．１ｋＰａ，与Ｂ、Ｃ组７．９±２．４和７．７±２．６ｋＰａ间均有差异（Ｐ＜０．０１）；Ａ组动物存活率７５％，而Ｂ、Ｃ组分别为２５％和１５％（Ｐ＜０．０１）；Ａ组动脉血ｐＨ和ＰａＯ２分别为７．２４±０．１４和１３．４６±１．２２ｋＰａ，与Ｂ、Ｃ组７．１４±０．１４和１０．２９±３．８４ｋＰａ与７．０２±０．１０和７．２５±２．１２ｋＰａ间有显著差异（Ｐ＜０．０１）；Ａ组回输血液再灌流后血浆ＳＯＤ和ＭＤＡ分别为１２００±１２６Ｕｍｌ－１和０．４７±０．２５ｎｍｏｌｍｌ－１，同Ｂ、Ｃ组１０８１±１１９Ｕｍｌ－１和０．９１±０．２９ｎｍｏｌ－１与８３５±９Ｕｍｌ－１和１．１３±０．１６ｎｍｏｌ－１间均有显著差异（Ｐ＜０．０１）。结果表明ＦＤＰ保护组织损伤而产生抗休克作用。     

镁抗大鼠再灌注心律失常作用与心肌代谢的相互关系

根据３种不同Ｍｇ￣（２＋）浓度的灌流液将３６只大鼠随机均分为３组。采用Ｌａｎｇｅｎｄｏｒｆｆ装置灌注离体心脏模型，研究不同浓度Ｍｇ￣（２＋）灌流时，再灌注心律失常（ＲＡ）发生的情况，同时检测再灌注前、后冠脉流出液中环磷酸腺苷（ｃＡＭＰ）、血栓素Ｂ_２（ＴＸＢ_２）和６－酮－前列腺素Ｆ_（１α）（６－Ｋ－ＰＧＦ_（１α））浓度变化，并探讨其相互关系。结果显示，镁可有效地降低ＲＡ发生率，同时减少再灌注时ｃＡＭＰ、ＴＸＢ_２和６－Ｋ－ＰＧＦ_（１α）的合成及释放。当镁分别为０．４、１．２或４．８ｍｍｏｌ／Ｌ时，再灌注心室颤动分别为１００％、３３．４％和１６．７％（均为Ｐ＜０．０１）。而且再灌注后３种代谢产物增加百分率也显著下降，其中ｃＡＭＰ分别为１１８％、６７％和３２％（均为Ｐ＜０．０１）；ＴＸＢ_２为１６１％、１０６％（Ｐ＜０．０５）和２８％（Ｐ＜０．０１）；６－Ｋ－ＰＧＦ_（１α）为５７％、４４％（Ｐ＜０．０５）和１９％（Ｐ＜０．０１）。结果提示，镁可以显著降低再灌注心肌细胞合成及释放ｃＡＭＰ、ＴＸＡ_２和ＰＧＩ_２，因而降低ＲＡ发生率。     

他巴唑与强的松合用对Graves病甲状腺功能及自身抗体的影响

目的：探讨他巴唑与强的松合用对Ｇｒａｖｅｓ病（ＧＤ）甲状腺功能及自身抗体的影响。方法：选择初诊的ＧＤ６７例,随机分成两组。治疗组给予他巴唑和强的松各 １５ ｍｇ／ｄ,对照组他巴唑 １５ ｍｇ／ｄ,均于上午８时顿服。结果：治疗４周及８周后Ｔ３、Ｔ４同时正常者：治疗组分别为２７例和３５例（７７．１４％、１００％）;对照组分别为１５例和２４例（４７％、７５％）,差异显著（Ｘ２＝６．５４７,Ｐ＜０．０２５; Ｘ２＝９．９３６,Ｐ＜０．００５）。Ｔ３、Ｔ４恢复正常所需时间治疗组为４．９１±１．７０周;对照组为７．０１±３．３２周,两组比较差异显著（Ｐ＜０．００５）。治疗３个月及１２个月后,ＴＧＡｂ、ＴＭＡｂ及ＴＲＡｂ抑制率明显高于对照组（ Ｐ均＜ ０． ０５）。结论：他巴唑与强的松联合应用疗效优于单用他巴唑。     

新生儿窒息后糖代谢紊乱时4种激素水平的动态观察

连续３ｄ监测４２例窒息足月新生儿４种主要调节主糖浓度的激素：皮质醇（Ｆ）、胰高血糖素（ＧＣ）、生长激素（ＧＨ）和胰岛素（Ｉ）。以探讨其在血糖紊乱中的调节机制。结果发现，生后第１ｄ血糖和Ｆ浓度最高。经方差分析，血糖第１ｄ与第２、３ｄ差异有显著意义（均为Ｐ〈０．０１）；Ｆ第１ｄ与第２ｄ比较无显著性差异（Ｐ〉０．０５）。但与第３ｄ比较，差异有显著意义（Ｐ〈０．０１）。连续３ｄ血糖与生后日龄、Ｆ、ＧＣ、Ｇ     

古方地黄饮子抗衰老作用的研究

实验观察了古方地黄饮子的抗衰老作用。结果表明地黄饮子（２％和４％）能延长果蝇平均寿命（Ｐ＜０．０５）和最高寿命；能降低３月龄小鼠血浆过氧化脂质（ＬＰＯ），升高红细胞谷胱甘肽（ＧＳＨ）（２０ｇ·ｋｇ－１·ｄ－１·２８ｄ，ｉｇ，Ｐ＜０．０５或Ｐ＜０．０１）；能显著减低９月龄小鼠随增龄增加的血浆ＬＰＯ（１．０ｇ＆２．５ｇ·ｋｇ－１·ｄ＼｛－１＼｝·１６ｗ，ｉｇ，Ｐ＜０．０５）；能抑制体外大鼠肝、脑匀浆ＬＰＯ生成（Ｐ＜０．０１），抑制率与剂量呈良好相关；延长小鼠游泳和常压下耐缺氧时间（２０ｇ＆１２ｇ·ｋｇ－１·ｄ＼＋－１·８ｄ，ｉｇ，Ｐ＜０．０５）。结果提示地黄饮子有延寿抗衰作用。     

ω_3多不饱和脂肪酸、牛磺酸促智作用的实验研究——对大鼠脑神经发育的影响

探讨ω３多不饱和脂肪酸及牛碘酸，对大鼠脑神经发育是否存在协同的促进作用。方法将断乳仔鼠随机分成４组，每组１０只，（１）正常对照组（ＮＧ），（２）ω３多不饱和脂肪酸组（ω３Ｇ），（３）牛磺酸组（ＴＧ），（４）牛磺酸＋ω３多不饱和脂肪酸组（Ｔω３）。其中（１）ＮＧ组喂饲普通饲料并灌胃生理盐水，（２）ω３Ｇ组喂饲普通饲料并灌胃ω３多不饱和脂肪酸（３）ＴＧ组喂饲添加０．６％牛磺酸饲料（在普通料基础上）并灌胃生理盐水（４）Ｔω３组亦喂饲添加０．６％牛磺酸饲料并灌胃ω３多不饱和和脂肪酸。以上各组灌胃剂量皆为０．２ｍｌ／１０ｇｗｔ，共持结１个月。以大鼠学习行为、脑干听觉诱发电位（ＢＡＥＰ）及突触定量分析３个方面作为检测脑神经发育的指标。结果（１）Ｔω３组大鼠主动回避反应习得率（ＡＡＲＲ）（６４％）明显高于ω３Ｇ组（４５％）及ＴＧ组（＄÷％）（Ｐ＜０．０１）；三者均高于ＮＧ组（２５％）（Ｐ＜０．０１）。其中ω３ＧＶＳＮＧＰ＜０．０５）。（２）Ｔω３组大鼠脑干听觉诱发电位（ＢＡＥＰ）Ⅰ～Ⅴ波峰间期（ＩＰＬ）与ω３Ｇ组及ＴＧ组相比无统计学意义（Ｐ＞０．０５），但呈缩短趋势。三者Ⅰ～Ⅴ波ＩＰＬ均短于ＮＧ组（Ｐ＜０．０１）。（３）     

膀胱癌PCNA的表达及意义

用免疫组化方法检测６０例膀胱移行细胞癌增殖细胞核抗原（ＰＣＮＡ）,在肿瘤Ｇ１．Ｇ２,Ｇ３级细胞中的指数分别为：２． ４±３． ９％;９． ５±１３． ０％;５４． ８±２９． ３％。 Ｇ３级显著高于 Ｇ１与 Ｇ３级（ Ｐ＜０． ０１）。浸润性肿瘤（Ｔ２—Ｔ４）５２． １±３５．１％显著高于表浅性肿瘤（Ｔａ—Ｔ１）１８±２３．４％（Ｐ＜０．０１）。将所有肿瘤平均指数３０．４±３２．３％分为ＰＣＮＡ＜３０．４和＞ ３０． ４两组,通过生存分析表明： ＰＣＮＡ指数较高组与较低组相比有不良的预后,提示 ＰＣＮＡ指数为 ＴＣＣ侵袭性生物学行为和预后提供了量化的参数。     

卡托普利治疗高血压病伴糖尿病及糖尿病肾病的临床观察

选择２６例原发性高血压（ＥＨ）伴Ⅱ型糖尿病（ＮＩＤＤＭ），其中糖尿病肾病（ＤＮ）１２例，加用卡托普利３７．５～１１２．５ｍｇ／日口服治疗，共４周．结果：收缩压（ＳＢＰ）／舒张庄（ＤＢＰ）由２１．９±２．３／１３．５±０．５ｋｐ＿ａ降为１９．３±１．５／１２．２±０．８Ｋｐ＿ａ（Ｐ＜０．０１），空腹血糖／餐后２小时血糖由１０．７±４．５／１３．７±３．９ｍｍｏｌ／Ｌ减为６．５±１．６／１０．２±２．７ｍｍｏｌ／Ｌ（Ｐ＜０．０１）；２４小时尿蛋白由１．９±０．３ｇ减为０．６±０．３ｇ（Ｐ＜０．０１）．表明该药在降压的同时确有改善糖代谢、降低尿蛋白排泄的作用。     

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.