血定安对重症非控制性失血性休克再灌注期脂质过氧化反应的影响

目的 :研究血定安 (gelofusion)对重症非控制性失血性休克低压复苏期间脂质过氧化反应的影响。方法 :12只犬随机等分为平衡盐液 (LR)组 (组Ⅰ )和血定安 (GF)组 (组Ⅱ )。采用非控制性失血性休克模型 ,当MAP降到 2 0mmHg时 ,两组分别输注LR或GF并调节输液速度使MAP维持在 35～ 40mmHg。于放血前 (T1)、休克至MAP 40mmHg (T2 )、2 0mmHg (T3 )及复苏后 30min (T4 )、6 0min (T5)、12 0min (T6)时测血SOD和MDA ,记录HR、MAP、CO、CI,复苏 12 0min时计腹腔失血量。结果 :组Ⅰ输液量及腹腔失血量均显著大于组Ⅱ (P <0 .0 1,和P <0 .0 5 )。再灌注后组Ⅰ血SDO活性进行性下降 ,血MDA迅速上升 ,于T5时显著高于组Ⅱ ,而组Ⅱ再灌注期MDA与缺血期 (T3 )比较差异无显著性 ,且SOD呈上升趋势 ,其中T6SOD值显著高于组Ⅰ (P <0 .0 5 )。再灌注期间组ⅡMAP较组Ⅰ稳定。 12 0min组Ⅰ存活率低于组Ⅱ (P <0 .0 5 )。结论 :与LR比较 ,GF低压复苏重症非控制性失血性休克能显著降低再灌注期脂质过氧化反应程度 ,维持较稳定的血流动力学 ,降低动物死亡率。     

左心室舒张功能不全在卧位型心绞痛发病中的作用

目的　探讨左心室舒张功能不全在卧位型心绞痛 (AD)发病中的作用。方法　对 31例左心室射血分数 (LVEF) >5 0 %的AD患者和 2 0例具有同质可比性的冠心病非AD患者和 2 0例正常对照者的左心室造影 (LVG)资料进行了分析。结果　 (1)AD组左心室舒张期前 1/3充盈分数为 0 .30± 0 .12 ,明显低于冠心病非AD组 (0 .41± 0 .12 ,P <0 .0 0 1)和对照组 (0 .46± 0 .0 7,P <0 .0 0 1) ,而左心室舒张期后 1/3充盈分数为 0 .36± 0 .0 9,明显高于冠心病对照组 (0 .31± 0 .0 8,P <0 .0 5 )和正常对照组 (0 2 9± 0 .0 6 ,P <0 .0 5 )。 (2 )左心室造影前和造影后的左心室舒张末压 (LVEDP)在AD组为 16mmHg± 5mmHg和 2 0mmHg± 5mmHg,冠心病对照组 (为 14mmHg± 5mmHg和 16mmHg± 5mmHg) ,均明显高于正常对照组 (10mmHg± 4mmHg和 12mmHg± 4mmHg)。左心房收缩使LVEDP升高差值 (LACD)在AD组亦显著高于正常对照组 (6 .4mmHg± 2 6mmHg与 4.1mmHg± 2 .2mmHg,P <0 .0 1)。然而左心室造影前与造影后自身比较 ,仅AD组LVEDP和LACD造影后明显升高。结论　左心室舒张功能不全是AD发病的主要病理因素。     

血小板活性因子及其拮抗剂对大鼠肝硬化门脉高压的影响

目的探讨肝硬化时肝脏和血循环中血小板活性因子(PAF)的变化以及其对门脉高压的影响。方法CCl4腹腔注射8周(0·15ml/kg,2次/周)诱导大鼠肝硬化,快速3H-PAF液闪检测肝及循环中PAF水平;受体饱和结合实验分析肝组织PAF结合能力;监测外源性PAF及其拮抗剂BN52021对门脉压和系统动脉压的影响。结果与对照组相比,肝硬化时肝内PAF、肝脏输出PAF及肝内生PAF水平明显升高,分别4·0ng/g±0·4ng/gvs2·7ng/g±0·5ng/g(P<0·01)、6·3ng/ml±0·6ng/mlvs3·4ng/ml±0·6ng/ml(P<0·01)、1·0ng/ml±0·6ng/mlvs-0·3ng/ml±0·5ng/ml(P<0·01);肝组织PAF结合能力Bmax明显升高(2·8±0·21)fmol/μg膜蛋白vs(0·9±0·06)fmol/μg膜蛋白,P<0·01,而受体亲和力Kd差异无统计学意义(8·0nmol/L±1·3nmol/Lvs5·8nmol/L±1·0nmol/L,P>0·05)。肝硬化组基础门脉压升高(12·2mmHg±0·7mmHgvs5·3mmHg±0·6mmHg,P<0·01),系统动脉压降低(82mmHg±10mmHgvs114mmHg±9mmHg,P<0·01)。门脉注入PAF(1μg/kg)后,肝硬化组门脉压提高了32%(12·1mmHg±0·6mmHgvs16·0mmHg±0·7mmHg,P<0·01),升高幅度约为对照组的227%(4·1mmHg±1·0mmHgvs1·8mmHg±0·3mmHg,P<0·01),而系统动脉压在两组均下降(肝硬化组由82mmHg±10mmHg降至48mmHg±4mmHg,P<0·01;对照组由114mmHg±9mmHg降至52mmHg±4mmHg,P<0·01)。门脉注入BN52021(5mg/kg),肝硬化组门脉压降低了16%(14·6mmHg±1·6mmHgvs12·3mmHg±0·8mmHg,P<0·05),而系统动脉压在肝硬化组和对照组均无明显变化(P>0·05)。结论肝硬化时肝脏合成PAF明显增加是循环血PAF升高的重要来源,并上调节肝的血流动力学影响门脉高压形成,其作用可被其拮抗剂BN52021部分逆转。     

低压复苏治疗未控制性出血性休克的作用

目的:通过检测血内皮素和乳酸的动态变化,探讨低压复苏治疗未控制性出血性休克的作用.方法: 建立未控制性出血性休克模型,分为低压复苏组和传统复苏组;假休克组作对照组.于休克初期、休克末期、充分复苏结束后和观察期末测定血乳酸和内皮素浓度.结果:(1)低压复苏组和传统复苏组乳酸和内皮素水平较假休克组各时间点明显增高,差异有统计学意义(P＜0.05),休克末达到最高水平.(2)休克初期传统复苏组和低压复苏组乳酸和内皮素差异无统计学意义(P＞0.05),其他时间段传统复苏组比低压复苏组均明显增高,差异有统计学意义(P0＜.05);低压复苏组乳酸和内皮素复苏后下降趋势更明显.结论:低压复苏比传统复苏有更低血乳酸和内皮素水平,而且复苏后下降趋势更明显.提示低压复苏的方法能改善微循环和减轻酸中毒,复苏的效果和预后更好.     

低温扩容对大鼠失血性休克的治疗效果

目的　探讨失血性休克期间给予低温 ,以及在复苏期间应用扩血管药物增加血容量对大鼠失血性休克的治疗效果。方法　将 35只Wistar雄性大鼠随机分为 4组 :低温扩容组 (SNP ,10只 ) ,休克期直肠温 32 .0℃± 0 .5℃ ,复苏期回输血液后 ,输注 1倍失血量的乳酸林格液 ;低温组 (OT ,10只 ) ,休克期直肠温 32 .0℃± 0 .5℃ ,复苏期只回输血液 ;常温组 (NT ,10只 ) ,休克期直肠温 38.0℃± 0 .5℃ ;对照组 (Con ,5只 ) ,不放血也不给予低温和复苏。实验中持续监测平均动脉压 (MAP) ,在 0min、失血末、休克末和复苏末测血气和乳酸值 ,记录大鼠生存时间和 72h生存率。结果　休克期OT组及SNP组MAP显著高于NT组 (P <0 .0 5 )而低于Con组 (P <0 .0 5 ) ,复苏期SNP组和Con组MAP显著低于OT组 (P <0 .0 5 )。失血末 ,与Con组比其余各组乳酸值均显著升高 (P <0 .0 5 ) ,BE值显著降低 (P<0 .0 5 ) ,各组间pH值无差异 ;休克末 ,两低温组乳酸值与Con组比无显著差异 (P >0 .0 5 ) ,而BE仍低于Con组 (P<0 .0 5 ) ,常温组乳酸值和BE显著低于其余 3组 (P <0 .0 5 ) ,两低温组和常温组pH值显著低于Con组 (P <0 .0 5 ) ,而常温组pH值又显著低于两低温组 (P <0 .0 5 ) ;复苏末 ,两低温组乳酸值、BE及pH值与Con组比无显著差异 (P >     

精氨酸血管加压素对非控制性出血性休克大鼠彻底止血后的复苏效果

目的 观察精氨酸血管加压素(arginine vasopressin,AVP)对非控制性出血性休克大鼠彻底止血后复苏效果.方法 采用大鼠脾实质切除及脾动脉切断方法复制非控制性出血性休克模型,在止血前采用低压复苏(50 mmHg,1 h)后结扎血管彻底止血,观察乳酸林格氏液(Lactated Ringer's,LR)、AVP(0.4 U/kg和0.04 U/kg)对大鼠血流动力学指标、血气指标、存活时间和存活率的影响.LR组在彻底止血后输注2倍失血量LR;AVP 0.1 U/kg组和0.4 U/kg组在2倍量的LR中分别加入AVP0.4 U/kg和0.04 U/kg输注.结果 非控制性出血性休克大鼠在休克后以及低压复苏后血流动力学指标包括左心室收缩压(left intraventricular systolic pressure,LVSP)、左心室压力上升或下降的最大速率(the maximal change rate of left intraventricular pressure,±dp/dtmax)明显低于休克前(P<0.05),血气也发生了明显改变;2倍失血量的LR输注不能较好地恢复平均动脉血压(mean artery pressure,MAP)和血流动力学指标,AVP 0.4 U/kg和0.04 U/kg输注,明显增加MAP和改善休克大鼠血流动力学指标,延长休克动物存活时间并提高存活率,与LR组相比明显升高(P<0.05).结论 AVP对非控制性出血性休克大鼠彻底止血后有较好的复苏效果.     

复苏压力对大鼠未控制出血性休克早期复苏效果的影响

目的比较不同的复苏压力对大鼠未控制出血性休克（uncontrolled hemorrhagic shock,UHS）早期复苏效果的影响。方法采用脾脏损伤的未控制出血性休克模型。48只SD大鼠根据早期复苏压力的不同分为6组：不复苏组（对照）和40、50、60、70、80mmHg复苏组,每组8只。伤后平均动脉压（mean arterial pressure,MAP）降至40mmHg时开始低压复苏,用乳酸林格液加羟乙基淀粉（2：1比例）复苏,使MAP维持在各组设定的水平,持续1h,对照组此期不输注任何液体,然后结扎脾动脉止血,各组均行充分复苏2h。记录各组血流动力学、失血量、血细胞比容、血气、肝功及存活时间。结果60、70、80mmHg复苏组的出血量显著高于另3组（P〈0．05）,50mmHg复苏组的存活时间显著长于对照组和80mmHg复苏组（P〈0．05）。40mmHg复苏组和80mmHg复苏组的血流动力学指标显著低于50、60、70mmHg复苏组（P〈0．05）。70、80mmHg复苏组的酸中毒显著轻于40mmHg复苏组（P〈0．05）。40～60mmHg复苏组的血细胞比容显著高于80mmHg复苏组（P〈0．05）。40mmHg复苏组的肝功指标显著高于50、60、70mmHg复苏组（P〈0．05）。结论未控制出血性休克的早期复苏中,血压过高会增加出血量,缩短存活时问;血压过低则抑制心功能,加重肝功能损害。血压在50～60mmHg较为合适。     

RNA干扰血管紧张素Ⅱ1a型受体对肾血管性高血压大鼠血压及心肌肥厚的影响

目的用RNA干扰技术下调血管紧张素Ⅱ1a型受体(AT1a)表达,观察其对肾血管性高血压及其心肌肥厚重构的影响。方法构建两肾一夹(two-kidney,one-clip:2K1C)高血压大鼠模型,用携带U6启动子和AT1a特异短发夹RNA(shRNA)编码序列的质粒pAT1a-shRNA1,pAT1a-shRNA2单次尾静脉注射给药,以含非特异性shRNA编码序列的无关质粒pGenesil-Con(pCon)、选择性AT1受体拮抗剂缬沙坦每日灌胃给药干预3周,无干预为对照,检测尾动脉压变化和颈动脉压水平、左心室重量与体重之比(LV/BW),并用Western-blot分析组织AT1受体表达情况。结果尾动脉压(与干预前比较):Blank组及pCon组继续升高25mmHg左右,pAT1a-shRNA1、pAT1a-shRNA2组下降15~16mmHg,缬沙坦组下降约30mmHg;颈动脉压和左室/体重之比:pAT1a-shRNA1(194mmHg±5mmHg;2·27±0·37)、pAT1a-shRNA2(200mmHg±5mmHg;2·31±0·26)、缬沙坦组(164mmHg±5mmHg;2·26±0·39)显著低于对照组(234mmHg±10mmHg;3·24±0·38)及pCon组(232mmHg±7mmHg;2·94±0·06);与对照组相比,pAT1a-shRNA1、pAT1a-shRNA2组左心室(分别下降53·3%和47·8%)和主动脉(分别下降58·7%和49·3%)组织内AT1受体表达显著减少。结论RNA干扰AT1a受体有效地抑制了肾血管性高血压进展及其心肌肥厚重构。RNA干扰技术可能成为高血压病基因治疗的一种新策略。     

大鼠出血性休克再灌注肾损伤的一种新模型

目的 :探讨一种新的出血性休克再灌注肾损伤 (HS RRI)的大鼠模型。方法 :30只SD大鼠完全随机分为S3 0 、S40 、S50 、S60 、S3 组共 5组 ,其中前 4组模型依据文献建立 ,S3 组是新模型 ,选用失血量、平均动脉压 (MAP)、休克末尿素氮(BUN)及肌酐 (Cr)、再灌注 2 4h肾组织病理损伤等指标。结果 :S3 组复苏成功率 83.33%。各组在复苏 30min时的MAP与其休克前相比差异均显著 (P <0 .0 1)。S3 组和S40 组的失血量、BUN、Cr、肾组织病理损伤积分与其他 4组的差异均显著 (P <0 .0 5 ) ,其中S3 组肾损伤最明显 ,S40 组最轻。结论 :S3 组的大鼠模型 (MAP 4 0mmHg ,休克 3h)是再灌注肾损伤较严重的模型。     

降脂治疗对老年单纯性收缩期高血压的动脉弹性及脉压的影响

目的观察降脂治疗对老年单纯性收缩期高血压(ISH)动脉弹性及脉压的影响。方法选择70例血脂轻度增高的老年ISH患者,随机分成2组,每组35例。一组接受降压治疗(单纯降压组),另一组在相同降压治疗的基础上联合他汀类药物(阿托伐他汀)10 mg/d降脂治疗(联合治疗组),治疗时间均为3个月。使用动脉弹性测定仪分别测定2组治疗前、治疗后的大动脉弹性指数C1、小动脉弹性指数C2及脉压。进行组内治疗前、后的C1、C2及脉压比较,及组间治疗后C1、C2及脉压比较。结果2组治疗后的C1(9.0±2.7,11.1±2.8)mL/mmHg×10、C2(3.8±3.0,5.2±2.0)mL/mmHg×100均较治疗前C1(7.3±2.1,6.9±2.0)mL/mmHg×10、C2(2.6±2.2,2.7±2.3)mL/mmHg×100提高(P<0.05);而联合治疗组治疗后C1(11.1±2.8)mL/mmHg×10、C2(5.2±2.0)mL/mmHg×100较单纯降压组C1(9.0±2.7)mL/mmHg×10、C2(3.8±2.0)mL/mmHg×100进一步提高(P<0.05);单纯降压组治疗后脉压(80±6)mmHg较治疗前(70±5)mmHg升高(P<0.05);而联合治疗组治疗后脉压(62±7)mmHg较治疗前(71±4)mmHg降低(P<0.05);联合治疗组治疗后脉压(62±7)mmHg较单纯降压组(80±6)mmHg降低(P<0.05)。结论联合降脂治疗较单纯降压治疗可进一步改善老年ISH的动脉弹性功能,且可缩小脉压。     

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.