通心络胶囊对冠心病稳定型心绞痛患者血管内皮功能的影响

目的观察通心络胶囊对冠心病稳定型心绞痛患者血管内皮功能的影响。方法将80例冠心病稳定型心绞痛随机分为通心络组和对照组各40例,对照组予冠心病常规治疗,通心络组在常规治疗的基础上加服通心络胶囊,4粒/次,3次/d,治疗8周。测定治疗前后一氧化氮（NO）、内皮素-1（ET-1）、6-酮-前列腺素F1a（6-Keto-PGF1a）及血栓素B2（TXB2）的水平。结果治疗后通心络组NO和6-Keto-PGF1a分别为（86.20±15.20）μmol/L和（113.78±34.5）8μg/L,较同组治疗前及对照组治疗后均显著升高（P〈0.05）;治疗后通心络组ET-1和TXB2分别为（64.04±20.24）μg/L和（70.90±11.34）μg/L,较同组治疗前及对照组治疗后均显著降低（P〈0.05）。结论通心络胶囊可有效改善冠心病稳定型心绞痛患者的血管内皮功能,其机制可能与纠正ET/NO、TXA2/PGI2的失衡有关。     

辛伐他汀对急性心肌梗死患者炎症水平和内皮功能的影响简

目的 探讨辛伐他汀对急性心肌梗死（AMI）患者炎症水平和内皮功能的影响.方法 将我院2010年6月到2012年6月收治的95例AMI患者分为对照组和观察组,对照组给予常规治疗,观察组在对照组治疗基础上给予口服辛伐他汀治疗,分别对对照组和观察组1个月后炎症因子（IL-6、TNF-α、sCD40L、MMP-9、CRP）和内皮功能（vWF、NO、ET-1）进行分析.结果 对照组和观察组治疗后IL-6、TNF-α、sCD40L、MMP-9、CRP水平较治疗前明显下降,差异具有统计学意义（P＜0.05）.治疗后观察组L-6、TNF-α、sCD40L、MMP-9、CRP水平较对照组明显下降,差异有统计学意义（P＜0.05）.对照组治疗前后vWF、NO、ET-1无统计学意义（P＞0.05）.观察组治疗后vWF、NO、ET-1水平较治疗前明显降低,差异具有统计学意义（P＜0.05）.结论 辛伐他汀治可显著改善AMI患者炎症和血管内皮功能.     

冠心病患者血清血栓素B2、6-酮-前列腺素F1α和前列腺素E2的测定及其意义

目的探讨冠心病(CHD)患者血清血栓素B2(TXB2)、6-酮-前列腺素F1α(6-Keto-PGF1α)和前列腺素E2(PGE2)水平的变化及其临床意义.方法采用放射免疫法测定了88例CHD患者和30例非冠心病患者的血清TXB2、6-Keto-PGF1α和PGE2水平,进行对照分析.结果CHD组血清TXB2和PGE2水平高于对照组(P＜0.01),6-keto-PGF1α水平低于对照组(P＜0.01).合并急性心肌梗死(AMI)组血清TXB2和PGE2水平高于无合并组(P＜0.01),6-keto-PGF1α水平低于无合并组(P＞0.01).出现心力衰竭(CHF)组血清TxB2水平高于无CHF组(P＜0.01),6-keto-PGF1α水平低于无CHF组(P＜0.01),PGE2与无CHF组差异无显著性意义(P＞0.05).住院死亡组血清TxB2水平高于好转出院组(P＜0.01),6-keto-PGF1α水平低于好转出院组(P＜0.01),PGE2差异无显著性意义(P＞0.05).结论测定血清TXB2、6-keto-PGF1α和PGE2的变化,有助于研究CHD患者的病理机制、病情进展和预后.     

参归益智方联合丁苯酞对阿尔茨海默病患者血管内皮功能影响的临床研究

目的观察参归益智方联合丁苯酞软胶囊对阿尔茨海默病（AD）患者血管内皮生长因子（VEGF）、一氧化氮（NO）、内皮素（ET-1）、肿瘤坏死因子（TNF-α）、白介素-1（IL-1）水平的影响，探讨其对AD患者的治疗作用和机制。方法100例AD患者随机分为对照组50例，给予丁苯酞软胶囊口服；研究组50例，给予参归益智方和丁苯酞软胶囊口服。治疗前、治疗3月、6月后，比较2组患者血浆VEGF、NO、ET-1、TNF-α、IL-1表达水平差异，及简易精神状态量表（MMSE）评分变化。结果治疗前，2组患者血浆VEGF、NO、ET-1、TNF-α、IL-1水平及MMSE量表评分比较，差异无统计学意义（P＞0.05）。治疗3月、6月后与对照组比较，研究组血浆VEGF、NO表达水平明显升高（P＜0.05），血浆ET-1、TNF-α、IL-1表达水平明显下降（P＜0.05）；研究组MMSE量表评分明显升高（P＜0.05），MMSE评分改善率明显高于对照组（P＜0.05）。结论参归益智方联合丁苯酞能明显提高AD患者血管内皮功能，明显提高认知记忆能力。     

富硒灵芝对动脉粥样硬化大鼠血脂代谢及内皮细胞损伤的影响

目的：通过观察富硒灵芝对动脉粥样硬化大鼠血中血脂、一氧化氮（NO）、内皮素-1（ET-1）、血栓素B2（TXB2）和6-酮-前列腺素F1α（6-keto-PGF1α）活性的影响,探讨其抗动脉粥样硬化的作用机制。方法：采用腹腔注射VitD3及喂养高脂饲料方法复制动脉粥样硬化大鼠模型。将50只大鼠随机分为正常对照组、模型对照组、富硒灵芝高剂量组、富硒灵芝低剂量组、血脂康阳性药对照组。测定各组大鼠血中血脂、NO、ET-1、TXB2、6-keto-PGF1α含量。结果：与模型对照组比较,富硒灵芝可显著降低动脉粥样硬化大鼠TC、TG、LDL-C、ET-1、TXB2水平,升高HDL-C、NO、6-keto-PGF1α水平。结论：富硒灵芝能调节动脉粥样硬化大鼠脂质代谢异常,并对内皮细胞损伤有一定的保护作用。     

盐酸法舒地尔对PCI术后慢血流冠心病患者内皮细胞损伤的作用及其机制研究*

目的 探讨采用盐酸法舒地尔治疗对减轻经皮冠脉介入术（PCI）后慢血流冠状动脉粥样硬化性心脏病（以下简称冠心病）患者血管内皮细胞损伤的临床价值。方法 选取2015年5月—2016年8月华北石油管理局总医院实施PCI治疗慢血流冠心病患者120例作为研究对象。按入院顺序随机分为治疗组和对照组,每组 60例。两组患者术后均采用常规治疗,治疗组术后同时给予盐酸法舒地尔治疗,疗程2周。对比两组的血管内皮损伤、内皮舒张及炎症指标。治疗后随访3个月,记录两组患者发生的心血管不良事件。结果 治疗前两组患者外周血内皮细胞微粒（EMPs）、血管性假血友病因子（vWF）、内皮素-1（ET-1）、一氧化氮NO、一氧化氮合酶（eNOS）、血管舒张功能（FMD）、血管内皮舒张功能（NMD）、白细胞介素-6（IL-6）、C反应蛋白（CRP）及肿瘤细胞坏死因子-α（TNF-α）比较,差异无统计学意义（P?>0.05）;治疗后两组患者上述指标比较,差异 有统计学意义（P?<0.05）,治疗组EMPs、vWF、ET-1、IL-6、CRP和TNF-α降低,NO、eNOS、FMD及NMD 升高;治疗前后两组比较,治疗后患者外周血EMPs、vWF、ET-1、IL-6、CRP及TNF-α较治疗前降低（P?<0.05）,NO、eNOS、FMD及NMD较治疗前升高（P?<0.05）;与对照组比较,治疗组治疗后的心血管不良事件发生降低 （P?<0.05）。结论 冠心病PCI术后采用盐酸法舒地尔治疗能减轻慢血流冠心病患者的炎症反应程度及血管内皮细胞损伤。     

灯盏花素治疗重症急性胰腺炎临床研究

目的：观察灯盏花素治疗重症急性胰腺炎（Severe acute pancreatitis,SAP）的作用。方法：将40例SAP患者随机分为A组（20例）和B组（20例）,同时以健康志愿者20例作为正常对照组。A组采用常规治疗,B组采用常规治疗＋灯盏花素注射液治疗,以放射免疫法测定血浆ET、TXB2、6-keto-PGF1α浓度及TXB2/6-keto-PGF1α比值,测定A、B两组APACHEⅡ评分及胰腺Balthazar CT分级评分。结果：（1）血浆6-keto-PGF1α、ET、TXB2及TXB2/6-keto-PGF1α比值：SAP患者血浆6-keto-PGF1α浓度显著低于正常对照组,而血浆ET、TXB2浓度及TXB2/6-keto-PGF1α比值显著高于正常对照组（P〈0.01）;B组入院后8天与B组入院时及A组入院后8天比较,血浆6-keto-PGF1α浓度显著上升,而血浆ET、TXB2浓度及TXB2/6-keto-PGF1α比值,均显著下降（P〈0.01～0.05）。（2）APACHE II评分和胰腺Balthazar CT分级评分：A、B两组入院后8天与入院时比较,两评分均显著下降（P〈0.01～0.05）;B组入院后8天与A组入院后8天比较,两评分均显著降低（P〈0.01～0.05）。结论：灯盏花素可能通过改善SAP患者的微循环障碍,从而对SAP起治疗作用。     

老年心血管疾病患者血浆PAF、TXB_2和6-K-PGF_(1α)水平的应用价值探讨

采用生物学方法、放射免疫方法测定30例老年健康对照者,27例老年冠心病患者和29例老年高血压患者血浆血小板活化因子（PAF）、血栓烷B2（TXB2）、和6-酮-前列素F1α（6-K-PGF1α）水平。并对14例冠心病患者、15例高血压患者和25例健康对照者作应激前后血浆的PAF、TXB2、6-K-PGF1α水平进行测定。结果表明：冠心病患者血浆PAF、TXB2水平较对照组显著增高（P＜0.01）．高血压患者血浆TXB2较对照组显著增高（P＜0．01）。老年冠心病患者应激后PAF、TXB2增加显著（P＜0．01）。这些结果表明：血浆PAF、TXB2、6-k-PGF1α检测时老年心血管患者在疾病的诊断,治疗和预后诊断有一定的临床价值。     

穴位敷贴联合疏络通脉方对老年冠心病稳定型心绞痛患者内皮功能及心电图的影响

目的 观察穴位敷贴联合疏络通脉方对老年冠心病稳定型心绞痛（气滞血瘀型）患者内皮功能及心电图的影响。方法 将我院86例老年冠心病稳定型心绞痛患者随机分为观察组与对照组各43例。对照组采用疏络通脉方治疗，观察组在对照组治疗基础上联合穴位敷贴治疗。比较两组患者临床疗效及心电图疗效情况；两组治疗前后胸闷、胸痛、气短等中医症候积分变化及血管扩张功能（FMD）、内皮素1(ET-1)、一氧化氮（NO）内皮功能指标变化情况；比较两组患者治疗期间不良反应发生情况。结果 治疗后，观察组临床总有效率高于对照组（ P<0.05）；观察组心电图疗效总有效率高于对照组（ P<0.05）；两组胸闷、胸痛、气短积分较治疗前降低，且观察组均低于对照组（ P<0.05）；两组FMD、NO水平较治疗前升高，ET-1降低，且观察组FMD、NO水平高于对照组，ET-1低于对照组（ P<0.05）；两组不良反应发生率比较无显著差异（ P>0.05）。结论 穴位敷贴联合疏络通脉方治疗老年冠心病稳定型心绞痛患者疗效较好，可提高患者治疗效果，改善患者心电图指标和内皮功能。     

丹红注射液联合麝香保心丸治疗心血瘀阻型冠心病心绞痛的临床效果及对患者血管内皮功能和炎症因子的影响

目的探讨丹红注射液联合麝香保心丸治疗心血瘀阻型冠心病心绞痛的临床效果及对患者血管内皮功能和炎症因子的影响。方法采用随机数字表法将128例心血瘀阻型冠心病心绞痛患者分为对照组(64例)和治疗组(64例)。所有患者均给予低盐低脂饮食、抗凝、降血脂等基础治疗,对照组静脉注射丹红注射液,治疗组在对照组基础上加服麝香保心丸。治疗1个月后,评价两组患者的临床疗效,检测治疗前后两组患者脂联素(APN)、一氧化氮(NO)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、内皮素(ET)、血栓素B2(TXB2)及血液流变学水平,以及治疗过程中的不良反应情况。结果治疗1个月后,治疗组总有效率为92.19%,显著高于对照组的81.25%(P0.05);两组患者APN、NO水平较治疗前均明显升高(P0.05),且治疗组较对照组升高更明显(P0.05);两组患者TNF-α、hs-CRP、ET、TXB2及血浆黏度、全血黏度、血细胞比容、纤维蛋白原水平较治疗前均明显降低(P0.05),且治疗组较对照组降低更明显(P0.05);两组治疗过程中均无恶心、呕吐、乏力、腹泻、头痛等不良反应发生。结论丹红注射液联合麝香保心丸能有效降低心血瘀阻型冠心病心绞痛患者TNF-α、hs-CRP、ET、TXB2水平,升高APN、NO水平,发挥抗炎和改善血管内皮功能,安全有效,值得临床推广应用。     

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.