透明晶状体和老年性白内障晶状体上皮细胞水通道蛋白1的表达

目的　探讨透明晶状体和老年性白内障患者晶状体上皮细胞水通道蛋白 1(aquaporin 1,AQP1)的表达水平。方法　收集 5例透明晶状体和 4 0例老年性白内障患者的前囊膜。应用免疫组织化学方法和计算机图像分析技术对前囊膜下晶状体上皮细胞AQP1进行检测。结果　AQP1阳性表达在透明晶状体和老年性白内障患者前囊膜下晶状体上皮细胞的细胞膜。图像分析透明晶状体和老年性白内障患者晶状体上皮细胞AQP1平均吸光度值差异有显著性意义 (P <0 0 5 )。老年性白内障患者晶状体上皮细胞AQP1平均吸光度值低于透明晶状体上皮细胞AQP1平均吸光度值。结论　透明晶状体和老年性白内障患者晶状体上皮细胞的细胞膜表达AQP1,AQP1可能在老年性白内障发生发展中起一定作用。     

基质金属蛋白酶-2,9及其抑制因子-1,2在老年性白内障晶状体上皮细胞的表达

目的　研究基质金属蛋白酶- 2, 9 (MMP -2、MMP- 9) 及其抑制因子- 1, 2 (TIMP 1、TIMP- 2) 在老年性白内障晶状体上皮细胞的表达, 探讨其在老年性白内障发病中的作用。方法　对40 例老年性白内障患者(排除代谢性和继发性白内障) 和8例晶状体脱位(晶状体透明) 患者晶状体前囊膜, 用免疫组化方法(SP法) 和免疫荧光技术检测MMP- 2、MMP- 9、TIMP- 1、TIMP -2的表达。结果　MMP- 2、MMP- 9、TIMP- 1、TIMP- 2在老年性白内障晶状体上皮细胞表达均为阳性, 而在透明晶状体上皮细胞仅1例表达阳性, 其余为阴性。MMP- 2在老年性白内障组和透明晶状体组平均吸光度(A值) 分别为(0 .447 9±0 .093 7)、(0 .145 8±0. 053 6); TIMP -2 为(0. 573 4±0. 109 4)、(0 .135 7±0. 023 1); MMP -9为(0 .177 9±0 065 5)、(0. 039 2±0 .009 3); TIMP -1为(0 .279 0±0. 062 6)、(0 .092 2±0. 028 2)。结论　基质金属蛋白酶及其抑制因子在老年性白内障发病机制中可能发挥重要作用。     

超声乳化白内障吸除术治疗白内障合并继发性闭角型青光眼

【目的】初步评价单纯超声乳化白内障吸除加后房型折叠式人工晶体植入术治疗合并有白内障的继发性闭角型青光眼的疗效。【方法】回顾分析 1997年 5月至 2 0 0 0年 3月收住本院青光眼病区资料完整的 2 7例 (2 7眼 )继发性闭角型青光眼病例 ,19例为继发性急性闭角型青光眼 ,8例为继发慢性闭角型青光眼 ,患者均有不同程度的晶状体混浊。患者入院后均行透明角膜切口超声乳化白内障吸除加后房型折叠式人工晶状体植入术。随访 3个月～ 4年 ,平均 (19± 11)个月。【结果】所有患者术中、术后没有出现严重的并发症。术后最佳矫正视力 0 35± 0 19,明显好于术前 0 11± 0 0 7(配对秩和检验 ,P<0 0 5 ) ;眼压 (2 0 3± 0 72 )kPa及联合使用不同类抗青光眼药物的种数 (0 87± 0 4 2 )种 ,较手术前的 (4 0 9± 1 6 1)kPa和(2 6 7± 0 2 4 )种药物减少 (配对秩和检验 ,P <0 0 5 ) ;前房深度也由术前的 (1 2 5± 0 5 6 )mm加深到术后的 (2 4 3± 0 6 7)mm(配对t检验 ,P <0 0 5 ) ,原来狭窄的房角增宽 ,关闭的房角部分开放。【结论】单纯白内障超声乳化摘除联合人工晶体植入术是治疗合并有白内障的继发性闭角型青光眼的一种新的有效的选择     

老年核性及皮质性白内障晶状体上皮细胞中TGF-β2的表达

目的 :比较老年核性及皮质性白内障晶状体上皮细胞中转化生长因子 β2 (TGF β2 )mRNA的表达有无差异 ,结合两种类型白内障晶状体上皮细胞的增殖状态 ,探讨其发病机理。方法 :将老年核性与皮质性白内障的患者分为两组 ,每组 4 0例 (男、女比例 1∶1) ,于白内障超声乳化术中截取其前囊膜 (含晶状体上皮细胞 ) ,用RT PCR的方法检测出每组晶状体上皮细胞中TGF β2 mRNA的水平 ,两组间u检验作统计学分析。结果 :老年核性白内障组晶状体上皮细胞中TGF β2 mRNA的水平低于老年皮质性白内障组 (P <0 .0 1)。结论 :TGF β2 通过调节晶状体上皮细胞增殖状态 ,从而在白内障发生过程中起重要作用。老年核性白内障的发生与晶状体上皮细胞增殖有关 ,而皮质性白内障的发生与晶状体上皮细胞的退行性变有关。     

Ⅰ型胶原基因的克隆及其在正常及年龄相关性白内障晶状体上皮细胞的表达

目的: 克隆Ⅰ型胶原基因并研究其在正常晶状体和年龄相关性白内障晶状体上皮细胞的表达,并比较二者表达的差异.方法: 用改良的消减杂交法克隆Ⅰ型胶原基因,地高辛标记Ⅰ型胶原cDNA片段制作探针,用原位杂交法研究其在晶状体前囊膜切片上的表达,并作统计学处理. 结果: 克隆到了Ⅰ型胶原基因的cDNA片段,长约600 bp,Ⅰ型胶原在正常晶状体和年龄相关性白内障晶状体上皮细胞中均有表达;阳性细胞百分率分别为(73.0±14.9)%和(75.0±16.3)%,阳性表达的积分指数分别为(0.60±0.15)和(0.73±0.16),经统计分析,P>0.05,其在年龄相关性白内障晶体上皮细胞的表达与在正常晶体上皮细胞的表达未见明显差异. 结论: Ⅰ型胶原在正常晶状体和年龄相关性白内障晶状体上皮细胞中均有表达;在年龄相关性白内障晶状体上皮细胞中,其Ⅰ型胶原的表达较正常晶状体未见减少,提示其可能在白内障的发生及白内障术后的后囊混浊中起重要作用.     

老年核性与皮质性白内障晶体上皮细胞密度及增殖细胞核抗原表达

目的 :检测老年核性白内障和皮质性白内障晶体上皮细胞密度和增殖细胞核抗原 (proliferatingcellnucle arantigen ,PCNA)表达 ,了解这两种白内障晶体上皮细胞增殖状态。方法 :用SP免疫组化染色方法染色两组病例中央区晶体上皮铺片。用计算机图像分析系统计算上皮铺片的细胞密度。结果 :核性白内障晶体上皮细胞密度为(5 0 38± 2 6 2 .0 3)个 /mm2 ,30张铺片中PCNA阳性 2 5张。皮质性白内障晶体上皮细胞密度为 (4 2 5 0 .6 3± 2 75 .0 5 )个 /mm2 。PCNA阳性 4例。结论 :老年核性白内障晶体上皮细胞密度高于皮质性白内障。PCNA阳性率高。提示老年核性白内障晶体上皮细胞增殖状态较为活跃 ,而皮质性白内障晶体上皮细胞退行性改变明显。     

氯通道蛋白-3在透明晶状体和老年性白内障患者晶状体上皮细胞中的表达

目的研究透明晶状体和老年性白内障患者晶状体上皮细胞氯通道蛋白-3（chloride channel protein 3，CLC-3）的表达。方法随机收集40例老年性白内障手术患者和5例透明晶状体（来自晶状体脱位患者）的晶状体前囊膜，采用免疫组织化学染色和免疫荧光技术检测晶状体上皮细胞CLC-3的表达。结果CLC-3阳性表达于晶状体上皮细胞的细胞膜。老年白内障组40张切片中，CLC-3表达均为阳性。而透明晶状体组5张切片中，4张阴性，1张可疑阳性。计算机图像分析结果，透明晶状体组平均吸光度（A）值明显低于老年白内障组，差异有统计学意义（P〈0．05）。结论老年性白内障患者晶状体上皮细胞CLC-3表达阳性。CLC-3可能参与老年性白内障的形成。     

老年核性及皮质性白内障晶状体上皮细胞中TGF-β2的表达

目的比较老年核性及皮质性白内障晶状体上皮细胞中转化生长因子β2(TGF-β2)mRNA的表达有无差异,结合两种类型白内障晶状体上皮细胞的增殖状态,探讨其发病机理.方法将老年核性与皮质性白内障的患者分为两组,每组40例(男、女比例1∶1),于白内障超声乳化术中截取其前囊膜(含晶状体上皮细胞),用RT-PCR的方法检测出每组晶状体上皮细胞中TGF-β2 mRNA的水平,两组间u检验作统计学分析.结果老年核性白内障组晶状体上皮细胞中TGF-β2mRNA的水平低于老年皮质性白内障组(P<0.01).结论TGF-β2通过调节晶状体上皮细胞增殖状态,从而在白内障发生过程中起重要作用.老年核性白内障的发生与晶状体上皮细胞增殖有关,而皮质性白内障的发生与晶状体上皮细胞的退行性变有关.     

Caspase-3及Bax在人晶状体上皮细胞中的表达

目的 :观察Caspase 3及Bax在人晶状体上皮细胞中的表达 .方法 :收集 30只白内障晶状体前囊膜以及胚胎晶状体 (6只 )和成人透明晶状体 (4只 )的前囊膜 ,采用免疫组织化学的方法观察Caspase 3及Bax的表达情况及染色强度 .结果 :Caspase 3及Bax在各型白内障中均有很好的表达 ,在年龄相关性白内障中Caspase 3及Bax的表达为 11/ 12 ,10 / 12 ,在高度近视性白内障中Caspase 3及Bax的表达为 7/ 8,6 / 8,在外伤性白内障中Caspase 3及Bax的表达为 5 / 6 ,5 / 6 ,在并发性白内障中Caspase 3及Bax的表达为 3/ 4 ,4 / 4 ;在各型白内障中Caspase 3及Bax的表达没有显著性差异 (P >0 .0 5 ) .结论 :在白内障的发生中存在晶体上皮细胞的凋亡     

年龄相关性白内障晶状体囊膜中P33ING1的表达

目的:探讨年龄相关性白内障的发生与晶状体前囊膜中P33ING1表达之间的相关性.方法:收集30例年龄相关性白内障及10例透明晶状体前囊膜,采用免疫组织化学法,分别观察透明晶体组和白内障组晶状体上皮细胞中P33ING1阳性表达水平.结果:白内障患者晶状体囊膜中P33ING1含量较正常人明显增高.结论:P33ING1在年龄相关性白内障的形成过程中起重要作用.     

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.