益舒软肝丸对肝硬化大鼠TGF-β1及TIMP-1表达的影响

目的 研究益舒软肝丸抗肝硬化的作用机理.方法 以CCl4复合因素法建立肝硬化模型,首先制备出肝硬化的实验动物模型,造模结束后,连续灌胃给药3个月.检查ALT、AST,A/G、CHE;HA、LN、PⅢNP、Hyp;TGF-β1和TIMP-1.结果 与模型对照组大鼠比,用药组组织切片显示汇管区有少量纤维组织增生,但未见假小叶结构;肝功能指标ALT、AST减少,A/G、CHE增加,肝功能有显著好转; HA、LN、PⅢNP、Hyp水平显著降低,肝纤维化程度降低;TGF-β1和TIMP-1阳性表达减少.结论 益舒软肝丸有明显的抗肝硬化的作用,其作用机制可能与下调大鼠组织TGF-β1和TIMP-1的表达,抑制细胞外基质的合成和胶原增生、沉积有关.     

益舒软肝丸（YS）逆转大鼠肝硬化的实验研究

目的:观察YS逆转肝硬化的作用。方法:以CCl4复合因素法建立肝硬化模型,首先制备出肝硬化的实验动物模型,造模结束后,连续灌胃给药3个月。检查ALT、AST,A/G、CHE;HA、LN、PⅢNP、Hyp。结果:与模型对照组大鼠比,用药组组织切片显示汇管区有少量纤维组织增生,但未见假小叶结构;肝功能指标ALT、AST减少,A/G、CHE增加,肝功能有显著好转;HA、LN、PⅢNP、Hyp水平显著降低,肝纤维化程度降低。结论:说明YS有明显的抗肝硬化的作用。     

肝硬化患者肝纤维化血清标志物与肝功能指标分析

目的:探讨血清肝纤维化与肝功能指标联合检测在肝硬化患者中应用的价值。方法:随机抽取46例肝硬化患者,其中23例为肝硬化静止期,23例为肝硬化活动期。采用化学发光法检测肝纤维化血清标志物透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原N端肽(PⅢNP)和Ⅳ型胶原(CⅣ),同时检测丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)。结果:肝硬化活动期患者血清HA和LN均明显高于肝硬化静止期患者(P0.01),血清PⅢNP和CⅣ在2组间差异均无统计学意义(P0.05);血清HA、LN、PⅢNP及CⅣ与ALT、AST均呈正相关关系(P0.05～P0.01)。结论:血清HA、LN、PⅢNP及CⅣ可以作为反映肝纤维化程度的指标之一,动态监测其变化很重要。血清肝纤维化指标在肝硬化静止期较活动期明显下降。肝纤维化指标联合肝功能检测有利于临床对疾病演变的监测和治疗。     

吴茱萸总生物碱对大鼠肝纤维化的防治作用

目的研究吴茱萸总生物碱（totalalkaloidsofEvodiarutaecarpa,TAE）对四氯化碳（carbontetrachloride,CCl。）致大鼠实验性肝纤维化的防治作用,探索其作用机制。方法采用40％CCl。皮下注射12周复制大鼠肝纤维化模型,检测各组大鼠血清丙氨酸转氨酶（alaninetransaminase,ALT）、天冬氨酸转氨酶（aspartatetransaminase,AST）,层黏连蛋白（1aminin,LN）、透明质酸（hyalurnicacid,HA）、Ⅲ型前胶原（precollagentype1ii,PCⅢ）、丙二醛（malonaldehyde,MDA）、超氧化物歧化酶（superoxidedismutase,SOD）和肝组织中羟脯氨酸（hydroxyproline,Hyp）水平,并对肝脏进行病理学检查。结果模型组大鼠肝脏有明显胶原沉积、脂肪变性和肝纤维化,部分大鼠形成完整的假小叶;血清ALT、AST、MDA、SOD、LN、HA、PCⅢ和肝组织中Hyp含量明显高于正常组（P〈0．05,或P〈0．01）。给药10周末,TAE50,1.0mg／kg组肝小叶结构明显改善,脂肪变性减轻,胶原纤维间隔减少,ALT、AST、MDA、LN、HA、PCⅢ及肝组织中Hyp水平明显下降。结论TAE50,100mg／kg灌胃给药对CCl4致大鼠实验性肝纤维化有保护作用,其作用机制与抗脂质过氧化有关。     

抗纤维化治疗对肝纤维化和肝功能指标的改善作用

目的探讨抗肝纤维化治疗对肝维化和肝功能指标的改善作用.方法实验组口服安络化纤丸,对照组常规治疗,观察两组治疗前后的临床症状、体征、肝功能(ALT、A/G)和肝纤维化指标(HA、LN、PCⅢ和CⅣ)的变化.结果实验组治疗前后症状、体征改善比较明显(P＜0.01),肝功能和肝纤维化指标ALT、A/G、HA、CⅣ明显降低(P＜0.01～P＜0.05).两组治疗后的肝纤维化指标比较无显著差异(P＞0.05).结论安络化纤丸对肝纤维化和肝功能指标有明显的改善作用.     

安络化纤丸联合胸腺肽a1治疗HBV-DNA阴性慢性乙型肝炎肝纤维化临床观察

目的 探讨延缓HBV-DNA阴性慢性乙型肝炎从肝纤维化向肝硬化发展的治疗方法.方法 治疗组口服安络化纤丸,皮下注射胸腺肽a 1,对照组常规护肝治疗,观察治疗前后的肝功能(ALT、AST、ALB、TBil)、血清肝纤维化指标(HA、IVC、PⅢ NP、LN)、肝脏纤维化超声半定量积分和随访1年内HBV-DNA阳转、肝功能反弹情况及肝硬化发生情况.结果 治疗组治疗后与治疗前比较肝功能指标改善明显,肝纤维化指标HA、IVC明显降低(P<0.01),肝纤维化超声半定量积分明显下降(P<0.01),1年内肝功能反弹明显减少,HBV-DNA阳转及肝硬化发生较少.结论 安络化纤丸联合胸腺肽a 1治疗HBV-DNA阴性慢性乙型肝炎具有一定的抗肝纤维化作用,并可抑制HBV-DNA阳转延缓向肝硬化发展.     

益舒软肝丸对肝硬化逆转作用的临床疗效观察

目的：观察益舒软肝丸对肝硬化的治疗效果。方法：观察35例肝硬化患者治疗前后的临床症状、肝功能、B超变化。结果：35例患者ALT、TBiL均较治疗前明显下降（P〈0．05），A、A／G比值较治疗前均显著性升高（P〈0．01）；B超总评分较治疗前有显著性改善（P〈0．01）。并可使6例治疗前肝功能指标异常、肝脏缩小、实质回声增粗、脾大，门静脉增粗的患者治疗后肝脾大小及回声完全恢复正常，有使肝硬化形态逆转的表现。结论：益舒软肝丸治疗肝硬化作用明显且有逆转作用。     

乙型肝炎肝硬化抗病毒抗肝纤维化治疗的临床疗效

目的：探讨抗病毒、抗肝纤维化治疗乙型肝炎肝硬化的可行性及效果。方法将该院收治的86例乙型肝炎肝硬化患者给予抗病毒抗纤维化药物治疗,随访观察患者治疗前及治疗后1年乙肝病毒肝纤维化指标（HA、PCⅢ、LN）、肝功能指标（ALT、AST、TBiL、ALB）变化。结果治疗后除ALB指标水平上升外,TBiL、ALT、AST等肝功能指标及HA、PCIII、LN等肝纤维化指标较治疗前明显下降（P＜0.05）。结论乙型肝炎肝硬化抗病毒抗肝纤维化治疗可显著提高患者肝功能,延缓肝纤维化进展,临床疗效较为满意,保障其生活质量及生命安全。     

复方鳖甲软肝片治疗早期肝硬化临床疗效观察

应用复方鳖甲软肝片(鳖甲、红花、郁金、黄芪、人参、虫草菌丝、灵芝、栀子等)治疗早期肝硬化40例,观察治疗前后症状体征、肝功能(ALT、AST、TBiL、ALB、A/G)、肝纤维化四项(HA、LN、PC-Ⅲ、IV-C)及肝脾B超变化,经统计学处理,治疗后与治疗前比较有显著性差异(P<0.05或P<0.01)。提示复方鳖甲软肝片对临床早期肝硬化有一定的治疗作用。     

安络化纤丸治疗肝纤维化临床疗效评价

目的：评价安络化纤丸治疗肝纤维化的临床疗效。方法：治疗组口服安络化纤丸,对照组常规治疗,观察比较两组治疗前后的临床症状、体征、肝功能（ALT、A/G）和肝纤维化指标（HA、LN、PC-Ⅲ、Ⅳ-C）的改善情况。结果：治疗组治疗后与治疗前症状、体征、肝功能指标改善比较明显,肝纤维化指标HA、PC-ⅢI、V-C明显降低（P均〈0.05）,有统计学意义。治疗组与对照组治疗后的肝纤维化指标LN比较无统计学意义（P〉0.05）。结论：安络化纤丸具有很好的抗肝纤维化的作用。     

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.