大鼠肺动脉高压模型中肺组织肥大细胞及巨噬细胞数量的变化

目的观察肥大细胞、巨噬细胞在大鼠肺动脉高压（pulmonary hypertension,PH）模型,及辛伐他汀干预肺组织中的变化。方法对大鼠行腹主动脉-下腔静脉分流术,术后第8d野百合碱腹腔注射制备PH模型,并应用辛伐他汀进行干预,35d后观察各组肺动脉压及心室重量变化。同时采用免疫组化方法半定量检测各组肺组织内肥大细胞及巨噬细胞数量的变化。结果平均肺动脉压（mPAP）模型组动物较对照组升高（P〈0．05）,干预组较模型组降低（P〈0．05）;右心室／（左心室＋室间隔）（RV／LV＋S）模型组较对照组增加（P〈0．05）,而干预组较模型组RV／LV＋S降低（P〈0．05）。模型组动物肺部肥大细胞及巨噬细胞数量较对照组均增高（P〈0．05）,干预组肥大细胞数量较模型组下降（P〈0．05）,巨噬细胞数量与模型组相比差异无统计学意义（P〉0．05）。结论肥大细胞及巨噬细胞参与了肺动脉高压的形成或／和肺动脉高压造成的损伤促进了肥大细胞及巨噬细胞的聚集与活化。辛伐他汀对肺动脉高压有改善作用,减少肥大细胞的聚集与活化可能是其机制之一。     

卡托普利对大鼠左向右分流模型肺小动脉重构的影响

目的观察血管紧张素转换酶抑制剂（ACEI）对肺循环容量负荷过重导致的肺血管重构的影响。方法采用腹主动脉一下腔静脉瘘制造大鼠容量负荷性肺动脉高压（PH）模型,并应用卡托普利进行干预,6周后观察各组肺动脉收缩压（PASP）、舒张压（PADP）、右室收缩压（RVSP）变化;心室重量变化;采用免疫组化染色比较肺血管平滑肌细胞（VSMC）α-平滑肌肌动蛋白（α-actin）及增殖细胞核抗原（PCNA）的阳性表达,比较15-50μm无肌性动脉肌性化程度以及肺小动脉50～100μm和101150μm血管厚度与血管外径之比（％WT）。结果手术组动物RVSP、PASP、PADP较对照组显著升高（P〈0．05）,手术＋卡托普利组RVSP、PASP、PADP均低于手术组（P〈0．05）;手术组RV／（LV＋S）、RV／BW、（LV＋S）／BW较对照组显著增加（P〈0．001）,而手术＋卡托普利组则较手术组明显降低（p〈0．01）,同对照组比较,手术组α-actin染色IOD值显著降低（P〈0．01）,而手术＋卡托普利组IOD值则高于手术组（P〈0．05）,手术组细胞PCNA阳性率显著升高（P〈0．01）,而手术＋卡托普利组低于手术组（P〈0．05）;手术组同其他两组比较,50～100μm、101～150μm血管％WT及15～50μm血管肌性化百分比显著增加（P〈0．01,）。结论卡托普利能有效地抑制肺动脉VSMC由收缩表型向合成表型转化,抑制VSMC的增生和肥厚,防止无肌性肺小动脉的肌性化,减缓PH肺血管重构进程,提示ACEI对左向右分流型先心病肺动脉高压有治疗前景。     

辛伐他汀对大鼠冠脉微栓塞后微小血管再生影响的实验研究

目的 探讨辛伐他汀干预对冠脉微栓塞（CME）后心肌微小血管保护与微小血管再生的影响及可能机制. 方法 自心尖部注入大鼠自体血栓微粒造成心肌内微小血管栓塞,建立冠脉微栓塞模型.40只大鼠随机分成5组：对照组（C组）、假手术组（sham组）、冠脉微栓塞模型组（M组）、辛伐他汀干预组（ST组）及辛伐他汀＋N-硝酸-L-精氨酸甲酯（L-NAME）干预组（STN组）.28 d后使用Ⅷ因子染色评定单位面积心肌微小血管的密度,免疫荧光检测单位面积心肌微小血管的数量.采用硝酸还原比色法测定心肌组织中NO含量. 结果 术后28 d,辛伐他汀组与微栓塞组比较,微小血管密度及微小血管数量均显著增加（均P＜0.01）;辛伐他汀＋L-NAME组与辛伐他汀组比较,微小血管密度及微小血管数量均显著减少（P＜0.01）.微栓塞组与sham组比较,NO含量显著下降（P＜0.05）;辛伐他汀组与微栓塞组比较,NO含量显著性增加（P＜0.01）;辛伐他汀＋L-NAME组与辛伐他汀组比较,NO含量显著下降（P＜0.01）. 结论 辛伐他汀可增加冠脉微栓塞后心肌内微小血管密度和新生微小血管数量,而这种作用可能是通过一氧化氮（NO）介导的.     

辛伐他汀对野百合碱致肺动脉高压大鼠肺血管病变的影响

目的 探讨辛伐他汀早期干预对野百合碱致肺动脉高压(PH)大鼠肺血管病变的作用及其机制.方法 32只Sprague-Dawley大鼠随机分为正常对照组、辛伐他汀对照组、PH模型组和辛伐他汀干预PH组,每组8只.PH模型组和辛伐他汀干预PH组大鼠皮下注射野百合碱80μg/g;2个对照组大鼠皮下注射等体积生理盐水.辛伐他汀干预PH组和辛伐他汀对照组大鼠自注射野百合碱或生理盐水当日开始以辛伐他汀2μg/g每日1次灌胃,连续21 d.实验第21天测定各组大鼠肺动脉平均压(mPAP);取肺组织观察肺小动脉周围炎症细胞浸润程度,记录炎性评分,采用病理图像分析系统测定肺小动脉壁面积/管面积比值和管壁厚/管外径比值,评价肺血管重构的严重程度;酶联免疫吸附试验测定肺组织匀桨自细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)和单核细胞趋化蛋白1(MCP-1)水平.结果 PH模型组、辛伐他汀干预PH组和正常对照组大鼠mPAP分别为(34±9)、(23 ±7)、(20 ±4)mm as(1mm Hg=0.133 kPa);肺小动脉周围炎性评分为(3.40±0.65)、(2.19±0.81)、(0.82 ±0.01)分;肺小动脉壁面积管面积比值为(0.560 ±0.086)、(0.442 ±0.061)、(0.408 ±0.049),管壁厚/管外径比值为(0.368±0.055)、(0.325 ±0.045)、(0.302 ±01035);肺组织匀浆中IL-6为(765±179)、(264±127)、(59±26)pg/ml,TNF-α为(447 ±86)、(179±91)、(38±11)pg/ml,MCP-1为(4428±757)、(697±211)、(32 ±7)pg/ml.辛伐他汀干预PH组各项指标均明显低于PH模型组(P<0.05或P<0.01).结论 辛伐他汀可延缓野百合碱诱导的大鼠PH形成和肺血管重构,其作用机制可能与辛伐他汀抑制肺小动脉周围炎症和肺组织前炎性因子IL-6、TNF-α及MCP-1有关.     

不同细胞生长因子组合对内皮祖细胞培养过程的影响

目的 观察不同细胞生长因子组合对体外培养过程中内皮祖细胞（EPC）数量和功能的影响。方法采用密度梯度离心法分离人脐血单个核细胞，接种至包被有人纤维连接蛋白的培养皿，按照处理方式不同分为4组：对照组（不添加细胞因子）、VEGF组[加入血管内皮生长因子（VEGF）】、VEGF＋ECGS组[加入VEGF及内皮细胞生长添加剂（ECGS）]、多因子组（加入多种细胞生长因子），6d后倒置显微镜下观察各组细胞集落形成情况，测定黏附能力及收获的EPC数量。结果VEGF组及ECGS＋VEGF组细胞集落形成能力（11.53±1.72、1310±2．09）均显著强于对照组（587±0．55）（均P〈0.01】；ECGS＋VEGF组细胞黏附能力（55．53±18.32）显著强于VEGF组（24.92±4．31）（均P〈0．01）；多因子组细胞集落形成及粘附能力（33．83±5．10、65.22±10、98）均明显强于其余各组（P〈0．05或0．01）。VEGF组及VEGF＋ECGS组收获的EPC数量分别为对照组的185、284倍，均显著增加（均P〈0.01）；多因子组EPC数量虽多于VEGF＋ECGS组，但差异并无统计学意义（P〉0．05）。结论EPC体外培养时，添加VEGF及ECGS是一种经济有效的方法，可显著改善EPC的集落形成及黏附能力，增加EPC的收获数量。     

抑制糖原合酶激酶活性对老龄大鼠内皮祖细胞增殖的作用机制

【摘要】 目的 探讨抑制糖原合酶激酶3β（GSK3β）活性对老龄大鼠内皮祖细胞（EPC）增殖的作用机制。 方法 密度梯度离心法分离培养老龄大鼠骨髓源性EPC，取对数生长期的EPC，分别加入表达催化GSK3β失活的GSK3β KM基因的重组缺陷型腺病毒pMSCV GSK3β KM（基因转染组）或空病毒pMSCV GFP（对照组）。采用镜下计数法及四氮唑溴盐比色法（MTT）测定EPC增殖能力，荧光激活细胞分离仪（FACS）分析各组EPC细胞周期变化。采用蛋白印迹法测定Wnt信号通路中磷酸化糖原合酶激酶3β（pGSK 3β）、β 连环蛋白（β catenin）及细胞周期蛋白D1(cyclinD1)的蛋白表达。 结果 与对照组比较，基因转染组EPC数量显著增加(P＜001）；MTT法检测基因转染组EPC在490 nm 吸光度值与对照组比较差异有统计学意义（P＜001）；FACS分析显示基因转染组细胞周期S期比例较对照组显著增加（P＜001）；蛋白印迹法测定显示，与对照组比较，基因转染组pGSK 3β、β catenin及cyclinD1的蛋白表达显著增加（P＜001）。 结论 抑制EPC的GSK 3β活性可通过激活Wnt信号通路促进老龄大鼠EPC的增殖能力。     

辛伐他汀早期与后期干预野百合碱诱导肺动脉高压大鼠的研究

目的观察不同时期应用辛伐他汀对野百合碱(MCT)诱导大鼠肺动脉高压(PAH)的改善作用,初步评价早期应用辛伐他汀对PAH的预防效果。方法将24只SD大鼠随机分成4组,每组6只。对照组:d_0腹腔注射生理盐水1次;PAH模型组:d_0腹腔注射MCT(50 mg/kg)1次;早期干预组:腹腔注射MCT(50 mg/kg)d–7~d~(–1)辛伐他汀(20 mg·kg~(–1)·d~(–1))灌胃,d_0腹腔注射MCT(50 mg/kg)1次,d1~14辛伐他汀灌胃;后期干预组:d0腹腔注射MCT(50 mg/kg),d15~35辛伐他汀(20 mg·kg~(–1)·d~(–1))灌胃。d_(36)通过右心导管测大鼠右心室收缩压(RVSP)和平均肺动脉压(m PAP),处死大鼠后分离心肺,测定右心室肥厚指数(RVHI)和肺小动脉中膜厚度百分比(WT%),进行肺小动脉周围炎症评分。结果与PAH组比较,早期干预组及后期干预组RVSP、m PAP、RVHI、WT%得到显著改善(P0.01),肺小动脉周围炎症评分降低(P0.05);与后期干预组比较,早期干预组m PAP、RVSP改善更明显(P0.05),WT%下降更显著(P0.01),而RVHI、肺小动脉周围炎症评分无显著差异(P0.05)。结论辛伐他汀早期及后期干预均可改善MCT诱导PAH大鼠RVSP、m PAP及WT%的恶化,早期干预较后期干预效果更显著。     

辛伐他汀对野百合碱诱导肺动脉高压大鼠血红素加氧酶1表达的影响

目的观察辛伐他汀对野百合碱致肺动脉高压大鼠的肺循环血流动力学和肺小动脉重构的作用,以及对肺组织血红素加氧酶1（HO-1）表达的影响。方法 52只SD大鼠随机分为五组：正常对照组、辛伐他汀对照组、肺动脉高压模型组、辛伐他汀治疗组和血红素加氧酶抑制剂（ZnPP）组。右心导管测定肺动脉平均压（mPAP）、右心室收缩压（RVSP）。以右心室/（左心室＋室间隔）的质量比（RVHI）作为评价右心室肥厚的指标。病理图像分析系统测定并计算动脉管壁面积百分比和动脉管壁直径百分比以评价肺血管重构严重程度。免疫组化方法观察HO-1在大鼠肺组织中表达部位,通过免疫印迹法半定量测定肺组织HO-1蛋白表达水平。结果与模型组比较,辛伐他汀治疗组mPAP、RVHI显著降低[（35.63±5.10）mm Hg比（65.78±15.51）mm Hg,0.33±0.05比0.53±0.06,P〈0.05]。辛伐他汀治疗减轻了肺血管重构,动脉管壁面积百分比和动脉管壁直径百分比分别为（50.78±9.03）%和（43.75±4.23）%,较模型组明显降低[（65.92±7.19）%,（52.00±5.35）%]。免疫组化显示在肺动脉高压模型组,HO-1主要在肺泡巨噬细胞中呈阳性表达。在辛伐他汀治疗组,HO-1表达明显增高,尤其在血管平滑肌细胞和肺泡巨噬细胞呈强阳性表达。HO-1的抑制剂ZnPP部分抑制辛伐他汀对PH大鼠的作用,其mPAP为（52.88±17.45）mm Hg,动脉管壁面积%为（50.78±9.03）%,动脉管壁直径百分比为（52.00±5.35）百分比。结论辛伐他汀减轻野百合碱诱导大鼠的肺动脉高压,抑制肺血管重构改变,其作用机制与增加HO-1表达有关。     

辛伐他汀对2型糖尿病合并冠心病患者血管内皮功能的影响

目的：研究辛伐他汀对2型糖尿病合并冠心病患者血管内皮功能的影响。方法：分析检测64例2型糖尿病合并冠心病患者给予辛伐他汀治疗前后血糖、血脂、血浆一氧化氮（NO）与内皮素（ET）水平，用高分辨血管外彩色多普勒测定肱动脉内皮依赖性舒张功能均有显著性改善（P＜0．01），血脂正常组治疗前后比较血脂无显著性变化（P＞0．05），肱动脉内皮依赖性舒张功能显著改善（P＜0．05），治疗前后ET水平明显降低（P＜0．05，P＜0．01），NO水平明显升高（P＜0．05，P＜0．01），血脂异常组肱动脉内皮依赖性舒张功能改善的程度与患者血TC和LDL降低的程度呈正相关关系（相关系数分别为0．532和0．503，均P＜0．001）；与血ET降低程度呈正相关关系（相关系数为0．58，P＜0．01），与患者血NO升高程度呈正相关关系（相关系数为0．79，P＜0．01），结论：辛伐他汀通过降脂和平衡NO／ET的比值等途径保护内皮功能，对治疗糖尿病合并冠心病病人（高血脂或血脂正常）有一定的应用价值。     

姜黄素对高脂血症大鼠血脂和血管内皮生长因子水平的影响

目的观察姜黄素对高脂血症大鼠血脂及血管内皮生长因子（VEGF）水平的影响。方法将健康4周龄雄性sD大鼠50只随机分为正常对照组、模型对照组、低剂量姜黄素组、高剂量姜黄素组和辛伐他汀组,正常对照组给予普通饲料喂养,余各组给予高脂饲料喂养。低剂量姜黄素组、高剂量姜黄素组和辛伐他汀组于每13上午同一时间分别给予姜黄素50、100mg·kg-1、辛伐他汀20mg·kg-1灌胃。12周后颈动脉取血测定各组大鼠血清血脂、VEGF水平。结果模型对照组较正常对照组大鼠血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）水平均显著升高,高密度脂蛋白（HDL）、VEGF水平均显著降低（P〈0．01）;各给药组较模型对照组大鼠TC、TG、LDL水平均显著降低,HDL、VEGF水平均显著升高（P〈0．01）;高剂量姜黄素组较低剂量姜黄素组大鼠血清TC、TG、LDL水平显著降低（P〈0．01）,HDL、VEGF水平显著升高（P〈0．01）;辛伐他汀组较高剂量姜黄素组大鼠血清TC、LDL水平显著降低,TG水平显著升高（P〈0．01）,血清HDL、VEGF水平比较差异均无统计学意义（P〉0．05）。结论姜黄素能有效降低高脂血症大鼠血清TC、TG、LDL水平,同时升高血清HDL、VEGF水平,且作用强度与剂量有关。姜黄素具有调节血脂、促进受损血管内皮修复的作用。     

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.     

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.