肝宁颗粒剂的药理学研究

目的:观察肝宁颗粒剂对四氯化碳所致大鼠急性肝损伤的保护作用和对α-萘异硫氰酸酯(ANIT)所致大鼠急性黄疸模型的退黄降酶作用.方法:将Wistar大鼠随机分组,每组10只.各治疗组连续灌胃给药几天后,分别用CCL4、ANIT造模,摘眼球取血,分离血清,以血清肝功能指标、SOD的活力及MDA含量以及肝脏组织病理学的改变为观察指标.结果:与模型组比较,除肝宁颗粒剂的低剂量组外的其余各组的ALT、AST、 TBIL、ALP、GGT、MDA均显著下降(P＜0.01或P＜0.05),使SOD显著升高(P＜0.01或P＜0.05);肝脏病理组织学检查表明,肝宁颗粒剂能明显减轻肝细胞变性、坏死、肝小胆管增生以及炎细胞浸润.与联苯双酯组比较,肝宁颗粒剂各项测定指标的疗效均较差.与茵栀黄注射液比较,肝宁颗粒剂高剂量组的ALT、GGT无差异(P＞0.05).结论:肝宁颗粒剂对四氯化碳所致大鼠急性肝损伤有明显的降酶保肝作用,但疗效低于联苯双酯滴丸.同时对α-萘异硫氰酸酯(ANIT)所致大鼠急性黄疸模型具有退黄降酶作用,疗效略低于茵栀黄注射液.含大黄的醇提制剂依然具有退黄、降酶、保肝作用.     

黄疸草对小鼠实验性肝损伤的保护作用

目的 :研究黄疸草对小鼠急性肝损伤的保护作用。方法 :分别采用四氯化碳 (CCl4 )、α -萘异硫氰酸酯 (ANIT)致小鼠急性肝损伤及黄疸模型 ,测定小鼠血清谷丙转氨酶 (ALT)、总胆红素(TBil)含量及血清、肝组织中丙二醛 (MDA)、超氧化物歧化酶 (SOD)水平和观察肝组织病理变化。结果 :黄疸草能明显降低CCl4 中毒性小鼠血清ALT、血清及肝组织中MDA的含量 (P <0 .0 0 1 ) ,使SOD水平显著增高 (P <0 .0 0 1 ) ;能明显降低ANIT中毒性小鼠血清TBil的含量 (P <0 .0 0 1 ) ;肝脏病理组织学检查表明黄疸草能明显减轻肝细胞变性和坏死。结论 :黄疸草对CCl4 和ANIT所致的急性肝损伤具有明显的保护作用     

白藜芦醇退黄保肝作用及其与胆汁酸排泄的相关性研究

目的:研究白藜芦醇的退黄保肝作用及其与胆汁酸代谢转运的相关性?方法:采用α-萘异硫氰酸酯(ANIT)致大鼠胆汁淤积性肝损伤模型,观察白藜芦醇退黄保肝的作用;原代大鼠三明治肝细胞模型上,观察白藜芦醇对ANIT损伤的肝细胞胆汁排泄,肝细胞内总胆固醇?总胆汁酸和总胆红素,以及对胆汁酸排泄相关代谢酶?转运体基因表达的影响?结果:白藜芦醇能显著降低ANIT所致胆汁淤积性肝损伤大鼠模型中血清丙氨酸氨基转移酶(ALT)?天门冬氨酸氨基转移酶(AST)活性及总胆红素(TBIL)?直接胆红素(DBIL)和间接胆红素(IBIL)的含量?在原代大鼠三明治肝细胞模型上白藜芦醇可恢复ANIT所致原代肝细胞胆管外排指数(BEI)的降低;显著降低ANIT所致的肝细胞内总胆汁酸和总胆红素的升高,恢复ANIT所致的总胆固醇水平的降低?白藜芦醇可显著改善ANIT所致的胆汁外排转运体Bsep?Mrp2?胆汁酸摄取转运体Ntcp及胆汁酸代谢相关酶Cyp7a1?Cyp8b1 mRNA表达的降低?结论:白藜芦醇具有退黄保肝?改善胆汁淤积的作用,其机制与调节肝细胞上胆汁酸排泄相关代谢酶和转运体相关?     

小叶金钱草对小鼠急性肝损伤的防护作用

目的:观察小叶金钱草对小鼠急性肝损伤的防护作用.方法:采用一次性灌胃CCl4中毒诱导小鼠急性肝损伤模型,α-萘异硫氰酸脂(ANIT)中毒诱导小鼠实验性黄疸模型;观察血清ALT活性及肝组织病理变化,血清及肝组织MDA、血清TBil的含量.结果:小叶金钱草能使CCl4中毒性小鼠血清ATL活性明显降低,肝脏病理变化显示肝细胞坏死减轻、空泡变性、嗜酸性变、炎性细胞浸润明显减少,血清及肝组织MDA含量明显降低,使ANIT中毒性小鼠血清TBil含量显著降低.结论:小叶金钱草对化学性肝损伤均有多种环节的防护作用.     

芝麻素对大鼠慢性肝损伤的保护作用

目的：探讨芝麻素对大鼠慢性肝损伤的保护作用及可能机制。方法：采用大鼠四氯化碳（CCl4）慢性肝损伤模型,观察芝麻素对慢性肝损伤大鼠血清ALT、AST水平以及肝组织匀浆SOD、MDA水平的影响,并观察肝组织病理学改变。结果：芝麻素能显著降低CCl4所致大鼠慢性肝损血清中ALT、AST含量;能升高CCl4所致大鼠慢性肝损肝组织中SOD,并能降低MDA的含量;病理结果显示达芝麻素能减轻慢性肝损伤的程度。结论：芝麻素对慢性肝损伤有明显的保护作用,其机制可能与抗脂质过氧化有关。     

鲨肝刺激物质类似物对CCl_4致小鼠急性肝损伤的保护作用

目的:探讨重组鲨肝刺激物质类似物(r-sHSA)对CCl4致小鼠急性肝损伤的保护作用及其作用机制。方法:利用腹腔注射CCl4制备小鼠急性肝损伤动物模型,以血清转氨酶活性以及组织病理变化为指标判断r-sHSA对化学性肝损伤的保护作用,并通过定量RT-PCR方法测定肝组织中相关细胞因子表达量的变化。结果:8~200μg/kg r-sHSA均可显著降低损伤小鼠血清转氨酶的活性,明显减轻肝细胞肿胀,减少中性粒细胞浸润,具有显著的肝保护作用,其机制可能与r-sHSA诱导TNF-α和肝细胞生长因子(HGF)表达,并下调TGF-β1的表达有关。结论:r-sHSA对CCl4致小鼠急性肝损伤具有明显的保护作用,其机制可能与细胞因子的表达调控有关。     

藤茶总黄酮对四氯化碳致急性肝损伤小鼠的保护作用

目的 观察藤茶总黄酮(Tengcha flavonoids，TCF)对四氯化碳(CCl4)诱导的小鼠急性肝损伤的影响。方法 用腹腔注射CCl4致小鼠急性肝损伤模型，测定不同剂量的TCF对肝损伤血清丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)活性、肝中超氧化物歧化酶(SOD)活性、肝中丙二醛(MDA)的影响，同时对肝组织进行病理学检查。结果 TCF具有剂量依赖性地降低CCl4致小鼠肝损伤血清ALT、AST值升高，降低肝组织匀浆中MDA的含量，增强SOD的活性，减轻CCl4对肝脏细胞的病理损伤。结论 TCF对CCl4致小鼠急性肝损伤具有一定的保护作用。     

绿豆癀对四氯化碳所致小鼠急性肝损伤的保护作用

目的：研究绿豆癀对四氯化碳（CCl4）所致小鼠急性肝损伤的保护作用。方法：用CCl4制作小鼠急性肝损伤模型,绿豆癀和绿豆粉干预,测定血清AST及ALT含量,并作肝组织病理学检测。结果：绿豆癀和绿豆粉能降低小鼠血清AST和ALT的含量（P〈0.01或P〈0.05）;减轻肝细胞变性、坏死程度,缓解肝组织的病理改变,绿豆癀比绿豆粉效果好（P〈0.05）。结论：绿豆癀对CCl4所致小鼠急性肝损伤有保护作用。     

田基黄中三个黄酮类化合物保肝退黄作用的实验研究

 【目的】研究田基黄中槲皮苷(Quercetin-3-β-D-rhamnose)、异槲皮苷(Quercetin-3-β-D-glucoside)、田基黄苷(Quercetin-7-β-D-rhamnose)3个黄酮类化合物的保肝退黄作用。【方法】选用四氯化碳(CCl4)和D-氨基半乳糖胺(D-Gal)致大鼠急性肝损伤模型,观察3个黄酮类化合物对血清丙氨酸转氨酶(ALT)、门冬氨酸转氨酶(AST)的影响;用α-萘异硫氰酸酯(ANIT)致小鼠黄疸性肝损伤模型,观察3个黄酮类化合物对血清总胆红素(T.BIL)的影响。【结果】异槲皮苷、槲皮苷、田基黄苷均能显著抑制CCl4和D-Gal所致的大鼠血清ALT和AST升高,对ANIT所致的小鼠血清总胆红素升高有明显的降低作用。【结论】田基黄中3个黄酮类化合物异槲皮苷、槲皮苷、田基黄苷均有保肝退黄作用。     

甘草酸、甘草次酸及苦参碱等对实验性胆汁淤积大鼠作用的比较

目的:观察甘草酸(GL)、甘草次酸(GA)、苦参碱(MT)、氧化苦参碱(OMT)、丹参酚酸B(SAB)、水飞蓟素(SI)和地塞米松(DEX)对异硫氰酸-1-萘酯(ANIT)致急性肝内胆汁淤积的作用。方法:应用灌胃ANIT(50 mg/kg)建立大鼠急性肝内胆汁淤积病理模型,观察上述药物对大鼠肝功能各项生化指标、肝组织病理改变、2 h胆汁流量和酮洛酚葡萄糖醛酸结合物(KPG)的累计胆排泄率的影响。结果:GL、GA和MT均能明显减轻ANIT导致的胆管损伤、胆汁淤积和肝细胞损伤。DEX减轻胆管损伤,对肝细胞损伤无保护作用。OMT、SAB和SI不能减轻ANIT的肝脏毒性。结论:GL、GA、MT和DEX对ANIT诱导的急性肝内胆汁淤积型肝炎有明显的保护作用,而且GL、GA和MT的保护作用优于DEX。     

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.