中枢神经元烟碱受体在异氟醚抑制大鼠海马突触长时程增强效应中的作用

目的 观察海马内中枢神经元烟碱受体在异氟醚抑制大鼠海马突触长时程增强(LTP)中的作用.方法 雄性SD大鼠,断头后取出海马组织,制备厚400 μm的海马脑片.取77张脑片,随机分为11组(n=7):LIP组、异氟醚0.125、0.25、0.5组、烟碱0.1、1.0、10.0组、烟碱1.0+异氟醚0.25组、烟碱10.0+异氟醚0.25组、美加明组、美加明+异氟醚0.125组.各组脑片分别灌流人工脑脊液(ACSF)、异氟醚0.125、0.25、0.5 mmol/L、烟碱0.1、1.0、10.0 μmol/L、烟碱1.0 μmol/L+异氟醚0.25 mmol/L、烟碱10.0 μmol/L+异氟醚0.25 mmol/L、美加明3 μmol/L、美加明3 μmol/L+异氟醚0.125 mmol/L.采用细胞外微电极记录技术,记录海马脑片CA1区细胞外群体峰电位(PS)的变化,然后施以100 Hz的高频强直刺激(HFS),诱发LTP,观察各组脑片HFS后PS幅值的变化.结果 LTP组HFS后PS幅值增高,较HFS前增加了(52±12)%(P<0.01).与LTP组比较,异氟醚0.125、0.25、0.5组HFS后PS幅值降低(P<0.01),烟碱0.1组HFS后PS幅值差异无统计学意义(P>0.05),烟碱1.0、10.0组HFS后PS幅值增高(P<0.01).与异氟醚0.25组比较,烟碱1.0+异氟醚0.25组和烟碱10.0+异氟醚0.25组HFS后PS幅值增高(P<0.01).与异氟醚0.125组比较,美加明组HFS后Ps幅值差异无统计学意义(P>0.05),美加明+异氟醚0.125组HFS后PS幅值降低(P<0.05).结论 吸入麻醉药异氟醚能够抑制海马LTP的形成而影响记忆功能,其作用机制与抑制大鼠海马烟碱型乙酰胆碱受体有关.     

异氟醚对老年大鼠海马突触长时程增强效应的影响

目的：观察异氟醚对老年大鼠海马突触长时程增强(LTP)效应的影响,并探讨其影响老年大鼠认知功能的机制。方法：70只雄性老年SD大鼠,断头后取出海马组织,制备厚400 μm的海马脑片。取35张脑片,随机分为5组(n=7)：对照组、异氟醚0.062 5、0.125 0、0.250 0和0.500 0 mmol/L组。各组脑片分别灌流人工脑脊液(ACSF)、异氟醚0.062 5、0.125
0、0.250 0、0.500 0 mmol/L。采用细胞外微电极记录技术,记录海马脑片CA1区细胞外群体峰电位(PS)的变化。另取35张脑片,随机分为5组(n=7)：LTP组、异氟醚LTP 0.062 5、0.125 0、0.250 0和0.500 0 mmol/L组。各组脑片分别灌流ACSF、异氟醚0.062 5、0.125 0、0.250 0和0.500 0 mmol/L。海马脑片记录PS 30 min后,施以100 Hz的高频强直刺激(HFS),诱发LTP,观察各组脑片HFS后PS幅值的变化。结果：与对照组比较,异氟醚0.062 5 mmol/L组给药后PS幅值无明显改变(P>0.05),异氟醚0.125 0、0.250 0和0.500 0 mmol/L组给药后PS幅值明显降低(P<0.01)。LTP组HFS后PS幅值增高,较刺激前增加了(34±11)% (P<0.01)。与LTP组比较,异氟醚LTP 0.062 5、0.125 0、0.250 0和0.500 0 mmol/L组HFS后其PS幅值均明显降低(P<0.01)。结论：异氟醚能够抑制海马LTP的形成而影响老年大鼠的认知功能。     

瑞芬太尼复合N2O、异氟醚麻醉临床观察

目的 对瑞芬太尼复合N2O、异氟醚与单纯吸入N2O和异氟醚麻醉对比观察临床效果.选择ASAⅠ～Ⅱ级病人106例,随机分为两组,A组给予TCI泵入瑞芬太尼,吸入N2O、异氟醚,B组吸入N2O、异氟醚.结果 苏醒时间A组(5±2)min明显短于B组(8±3)min(P＜0.05),A组异氟醚用量明显少于B组用量(P＜0.05),有显著性差异.结论 瑞芬太尼复合N2O、异氟醚麻醉可以减少吸入麻醉药用量,术中血流动力学稳定,苏醒快.     

异氟醚对维库溴铵肌松效应的影响

目的 观察异氟醚对维库溴铵肌松效应的影响.方法 60例择期手术患者随机分成二组,分别为静脉麻醉组(对照组)和静脉麻醉复合吸入1MAC异氟醚组(异氟醚组),采用累积剂量反应的方法测定两组维库溴铵的剂量反应曲线.结果 吸入异氟醚使维库溴铵剂量反应曲线左移,异氟醚组的ED50和ED95分别为(19.6±4.8)μg/kg和(36.8±9.6)μg/kg,与对照组的(29.0±8.8)μg/kg和(55.9±10.4)μg/kg相比,分别减少32.4%和34.2%(P＜0.01).结论 1MAC异氟醚可以明显增强维库溴铵的肌松效应.     

异氟醚对大鼠认知功能及海马高级糖基化终末产物受体表达的影响

目的 观察异氟醚对大鼠海马高级糖基化终末产物受体(receptor for advanced glycation end products,RAGE)表达及认知功能的影响.方法 SD雄性老年大鼠(24月龄)45只,SD雄性成年大鼠(4月龄)45只,随机数字表法分为6组(n=15),老年对照组(C1组),成年对照组(C2组):吸入30%氧气的空氧混合气体对照;老年异氟醚单次吸入组(S1组),成年异氟醚单次吸入组(S2组):1.5%异氟醚单次吸入2h;老年异氟醚多次吸入组(R1组),成年异氟醚多次吸入组(R2组):1.5%异氟醚吸入3次,1次/d,2h/次.各组大鼠吸入处理后1d取8只行Morris水迷宫进行认知功能测试,其余大鼠处死取海马,RT-PCR方法测定RAGE mRNA水平,免疫组织化学方法测定RAGE蛋白表达.结果 各组大鼠吸入处理过程中生命体征平稳,血氧饱和度及心率均在正常范围.C1组穿越平台次数为(7.30±2.40)次,探索时间为(49.90±6.22)s,S1、R1组与C1组相比穿越平台的次数减少[穿越平台次数分别为S1(3.90±2.42),R1(3.44±2.40),F=7.448,P<0.01],探索时间缩短[探索时间分别为S1(43.33±7.08)s,R1(39.09±4.56)s,F=7.63,P<0.05],而逃避潜伏期延长(P<0.05).R2组较C2组逃逸潜伏期延长[逃逸潜伏期分别为R2(14.65±3.83)s,C2(7.84±2.51)s,F=12.773,P<0.01],探索时间缩短(均P<0.01),穿越平台次数减少(P<0.01).S2组与C2组比较,空间探索时间与穿越平台次数均未见显著统计学差异(P>0.05);RAGE表达:与C1组比较S1、R1组mRNA表达水平增高[mRNA表达分别为c1(0.11±0.02),S1(0.56±0.09),R1(0.73±0.14)F=169.447,P<0.01],免疫组化阳性细胞颗粒数增多(P<0.01),S1组与R1组比较蛋白表达差异无统计学意义(P>0.05);与C2组比较,S2组mRNA水平及蛋白表达未见明显差异(P>0.05),但R2组mRNA及免疫组化阳性细胞表达增高,与C2组比较差异有显著意义(均P<0.01).结论 异氟醚导致不同月龄大鼠认知功能改变,尤其对老年大鼠影响显著,可能与海马RAGE表达上调有关.     

异氟醚对东莨菪碱致空间认知障碍大鼠胆碱能毒蕈碱受体活性的影响

目的观察异氟醚对东莨菪碱致空间认知障碍大鼠脑皮层和海马组织中胆碱能毒蕈碱受体(M-R)活性的影响.方法雄性SD大鼠56只随机分为8组:对照/1d组,异氟醚/1d组,东莨菪碱/1d组,异氟醚 东莨菪碱/1d组;对照/7d组,异氟醚/7d组,东莨菪碱/7d组,异氟醚 东莨菪碱/7d组.异氟醚组、异氟醚 东莨菪碱组大鼠每天吸入1MAC(1.5%)异氟醚2h,连续4d.在末次给药后1d,对东莨菪碱/1d组、异氟醚 东莨菪碱/1d组大鼠腹腔注射东莨菪碱0.8mg/kg,连续3d;在末次给药后7d,对东莨菪碱/7d组、异氟醚 东莨菪碱/7d组大鼠给予相同处理.给药完毕后急性断头处死大鼠,分离脑皮层和海马,放射配体结合分析法测定M-R的活性.结果与对照/1d组和异氟醚/1d组相比,东莨菪碱/1d组、异氟醚 东莨菪碱/1d组海马M-R活性降低(P＜0.01).与对照/1d组相比,异氟醚/1d组海马M-R活性增高(P＜0.05).与东莨菪碱/1d组相比,异氟醚 东莨菪碱/1d组海马M-R活性增高(P＜0.01).与对照/7d组和异氟醚/7d组相比,东莨菪碱/7d组、异氟醚 东莨菪碱/7d组海马M-R活性降低(P＜0.05).结论大鼠持续吸入1.5%异氟醚4d(每天2h)可增加海马M-R的活性.     

JNK信号通路在异氟醚诱导新生大鼠海马神经细胞凋亡的作用

目的 探讨c-Jun氨基末端激酶(the c-Jun N-terminal kinase,JNK)信号通路对异氟醚诱导新生大鼠海马神经细胞凋亡以及对磷酸化JNK、Bcl-2和Bax蛋白表达的影响.方法 48只出生后7d(Py7)的新生大鼠按照随机数的方法随机均分为DMSO对照组(D组)、JNK抑制剂SP600125对照组(SP30组)、异氟醚+DMSO组(Iso+D组)和异氟醚+SP600125组(Iso+ SP30组).对照组吸入空气,异氟醚组吸入1.1％异氟醚4h.麻醉前20 min,幼鼠根据分组分别侧脑室注射SP600125 30 μg或者12％ DMS0 5μl.麻醉结束后6h,部分幼鼠灌注取脑,TUNEL荧光染色检测脑海马CA1区神经细胞凋亡(n=6);部分幼鼠取新鲜脑皮质,Western blotting法检测磷酸化JNK、Bcl-2和Bax蛋白表达的变化(n=6).组间资料的比较采用单因素方差分析.结果 幼鼠海马CA1区的TUNEL阳性细胞数比较,Iso+D组[(135.72±21.26)个/mm2]比D组[(24.07±1.35)个/mm2]增加5倍(P＜0.01);与Iso+D组相比,Iso+ SP30组[(42.49±5.56)个/mm2] CA1区的TUNEL阳性细胞数降低了84％ (P＜0.05).Iso+D组磷酸化JNK P46表达比D组增加44.1％ (P＜0.01),而Iso+ SP30组显著降低了磷酸化JNK P54 (p＜ 0.05)和P46(P＜ 0.01)的表达.Iso+D组Bax表达比D组增加1.5倍(P＜0.05),Bcl-2蛋白表达比D组下降42.2％ (P＜0.05);而Iso+ SP30组Bax表达下降(P＜0.05),Bcl-2蛋白表达上调(P＜0.01).D组与SP30组TUNEL阳性细胞数,磷酸化JNK,Bcl-2和Bax蛋白表达差异均无统计学意义.结论 JNK信号通路激活促进了异氟醚诱导发育期大鼠海马神经细胞凋亡,SP600125通过维持Bcl-2,降低Bax表达产生抑制凋亡作用.     

反复吸入七氟醚对大鼠海马神经元p-cofilin及cofilin表达和远期认知功能的影响

目的 探讨反复吸入七氟醚对大鼠海马神经元磷酸化丝切蛋白（p cofilin）及丝切蛋白（cofilin）表达和远期认知功能的影响。 方法 将20只雄性SD大鼠随机分为七氟醚组（n=10）和对照组（n=10）,七氟醚组大鼠吸入2.4% 七氟醚,每日2 h,连续7 d,对照组不吸入七氟醚。通过Morris水迷宫定位航行实验及空间探索实验检测两组大鼠认知功能,采用TUNEL实验检测海马神经元凋亡情况,Western Blot检测海马内Bax、Bcl 2、p cofilin和cofilin表达情况。 结果 定位航行实验的第3、4、5d,七氟醚组逃避潜伏期长于对照组,差异有统计学意义（P＜0.05）;两组大鼠空间探索实验结果发现,七氟醚组大鼠穿越平台次数明显少于对照组,平台象限停留时间明显短于对照组（均P＜0.05）;两组游泳速度无明显差异（P＞0.05）;与对照组比较,七氟醚组大鼠海马组织凋亡细胞数目明显增加（P＜0.05）;七氟醚组Bax表达明显高于对照组,而Bcl 2表达明显低于对照组（P＜0.05）;七氟醚组p cofilin表达明显低于对照组,而cofilin表达明显高于对照组（P＜0.05）。 结论 反复吸入七氟醚可降低大鼠认知功能,其机制可能与上调cofilin表达诱导的细胞凋亡有关。     

异氟醚复合麻醉对老年腹部手术患者术后认知功能和白细胞介素-6的影响

目的 探讨异氟醚静吸复合麻醉对老年腹部手术患者术后认知功能和白细胞介素-6(interleukin-6,IL-6)水平的影响,为降低术后认知功能障碍(post operative cognitive dysfunction,POCD)提供参考.方法 行腹部手术的老年患者60例分为异氟醚组和丙泊酚组,异氟醚组采用异氟醚静吸复合麻醉,丙泊酚组采用泵注丙泊酚麻醉.分别于手术前术后1、2d对2组患者进行简易智能精神状态量表(mini mental status examination,MMSE)评分并计算术后POCD发生率;分别于入室前(T0)、切皮后5min(T1)、术后1h(T2)、术后12h(T3)、术后24h(T4)测定患者血清IL-6的含量.结果 丙泊酚组术后1 、2d MMSE评分与术前比较显著下降(P＜0.05);而异氟醚组术后1d MMSE评分与术前比较显著下降(P＜0.05),但术后2d与术前比较差异无统计学意义(P＞0.05);异氟醚组术后POCD发生率为6.7%,显著低于丙泊酚组(20.0 %),差异有统计学意义(P＜0.05).异氟醚组IL-6水平从T1时间点开始逐渐下降,T1~T4时间点分别与T0时间点和丙泊酚组比较差异均有统计学意义(P＜0.05).结论 异氟醚麻醉静吸复全麻醉能减少老年腹部手术患者术后促炎性细胞因子的释放,抑制炎症反应,并能降低患者术后POCD的发生.     

银杏叶提取物对慢性酒精中毒大鼠学习记忆的影响

目的 探讨银杏叶提取物( EGb761)对慢性酒精中毒模型大鼠学习记忆的改善作用和机制.方法 将72只SD大鼠采用随机数字表法平均分为4组:对照组、慢性酒精中毒模型组、EGb761低剂量组和高剂量组,用水迷宫实验对大鼠认知能力进行评价,用电生理学方法来检测海马CA3区长时程增强( long-term potentiation,LTP)的变化.结果 (1)与对照组相比,模型组大鼠寻找平台的潜伏期明显延长,高频刺激后在CA3区诱导的场兴奋性突触后电位(field excitatory postsynaptic potential,fEPSP)的平均斜率明显下降(P＜0.05,P＜0.01).(2)与模型组相比,EGb761低剂量组和高剂量组大鼠寻找平台的潜伏期显著缩短;EGb761低剂量组[(126.16±5.84)％]和高剂量组[(141.31±5.75)％]高频刺激后诱导的fEPSP的平均斜率均明显高于模型组[(93.31±14.21)％,P=0.034,P=0.009].结论 EGb761通过促进大鼠海马突触可塑性的恢复来改善慢性酒精中毒导致的大鼠学习记忆能力障碍.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.     

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.