前列地尔对冠心病患者血脂及微循环——血液流变学的影响

目的：观察前列地尔（凯时）对冠心病的血脂及微循环，血液流变学变化，探讨其作用机理，方法，观察65例冠心病患列地尔治疗前后血脂及血液流变学，微循环检测结果并对作比分析。结果：前列地尔对冠心病血脂指标，血液流变学指标，微循环定量评分有明显影响，治疗前后比较有显性差异（P＜0．05或P＜0．01）。结论：前列地尔能有效降低冠心病血脂水平，同时改善血液流变性异常及微循环障碍，改善心肌缺血，是治疗冠心病的有效药物。     

高血压病微循环及血液流变学的变化特点

目的：探讨高血压病微循环及血液流变学的变化，方法：对248例高血压病患和210例血压正常进行进行甲襞微循环检查和血液流变学检查。结果：高血压病组甲臂微循环改变较对照组有明显差异（P＜0．01），高血压病组血液流变学改变较对照组有明显差异（P＜0．05），且微循环和血液流变学指标的变化程度与高血压病的病情发展有较好的相关性和平和性，结论：检测高血压病患甲臂微循环和血液流的变化，可作为高血压病情监测的一个重要手段。     

低能量He-Ne激光血管内照射对高粘血症患者血液流变学和甲襞微循环的影响

目的探讨低能量He－Ne激光血管内照射（ILIB）对高粘血症患者血液流变学和甲襞微循环（NFM）的影响。方法治疗组46例，在行常规疗法的同时加用ILIB治疗；对照组30例，采用常规疗法，即复方丹参片3片加藻酸双脂钠0.1g，3次/d口服。受试者均于治疗前后测定全血病切粘度和低切粘度、血浆粘度、红细胞压积、纤维蛋白原和血小板聚集率，并用XDM-300B型微循环动态图像仪检测NFM。结果治疗组治疗前、后血液流变学指标均具有显著性差异（P＜0．05或P＜0．01），NFM各项积分亦具有显著性差异（P＜0．05或P＜0．01）。对照组治疗前、后的血液流变学指标比较，除红细胞压积和血小板聚集率变化明显外（P＜0．05），其余指标及NFM各项积分均无显著性变化（P＞0．05）。结论ILIB能明显降低血粘度，改善微循环。     

金纳多注射液对早期糖尿病肾病血液流变学和肾功能的影响

目的：探讨金纳多注射液对早期糖尿病肾病（EDN）血液流变学和肾功能的影响。方法：将56例早期糖尿病肾病患者随机分为治疗组28例和对照组28例，两组均采用饮食控制和糖尿病常规治疗，治疗组加用金纳多注射液治疗，疗程4周。结果：治疗组血液流变学各项指标较治疗前显著下降（P＜0．05或P＜0．01）；尿白蛋白排泄率（UAER）、血肌酐（SCR）、尿素氯（BUN）和血脂明显下降（P＜0．01或P＜0．05），且明显优于对照组（P＜0.01或P＜0．05）。结论：金纳多注射液能改善EDN患者的血液流变学、血脂和微循环、减少尿白蛋白的排出，减轻肾损害，改善肾功能。     

奥扎格雷纳治疗冠心病的临床研究

目的：观察奥扎格雷纳（丹奥）治疗冠心病的临床疗效及对甲襞微循环和血液流变学变化的影响。方法：选择符合WHO冠心病诊断标准的患者192例确定为研究对象，随机分为丹奥治疗组（A组）112例和对照组（B组）80例。两组患者分别以治疗前后观察症状改善情况、心电图变化、甲襞微循环和血液流变学变化。结果：治疗组用药后临床疗效总有效率达88．48％、心电图变化总有效率达83．93％，与对照组比较（P〈0．01）。甲襞微循环各项指标和血液流变学变化均优于对照组（P〈0．01）。结论：丹奥治疗冠心病疗效显著，临床症状明显改善，心电图缺血变化好转，甲襞微循环和血液流变学指标明显改善。     

益气活血祛痰法对老年性左心室肥厚的逆转作用

目的：观察益气活血祛痰方药对老年性左心室肥厚的逆转作用。方法：将95例老年性左心室肥厚（LVH）患者随机分为益气活血祛痰方药组（以下简称治疗组）65例和美多心安对照组（以下简称对照组）30例。在治疗前后对心脏B超、心功能、血液流变学、动脉硬化指标以及甲皱微循环等进行观察。结果：治疗组室间隔厚度、左室后壁厚度及左室肌重量均显著降低（P＜0．05或P＜0．01）。益气活血祛痰方药对老年性LVH的病因具有缓解和消除作用,如改善 心功能和微循环，降低全血粘度载脂蛋白A1（apoA1)和心肌耗氧量，升高超氧化物歧化酶（SOD）活力等（P＜0．01），与对照组相比均具有显著性差异（P＜0．05或P＜0．01）。结论：益气活血祛痰方药对老年性LVH具有一定的逆转作用。     

金纳多对2型糖尿病患者血液流变学及超氧化物岐化酶的影响

目的：探讨银杏提取物（金纳多）对2型糖尿病患者（T2MD）血液流变学及超氧化物岐化酶（SOD）的影响。方法：应用金纳多15ml加入0．9％氯化钠注射液250ml中静脉滴注，治疗30例2型糖尿病人，治疗前后测定其血液流变学及SOD活性。结果：金纳多治疗后低切率全血比粘度降低（P＜0．01），血浆粘度、全血还原粘度、血小板粘附率均下降（P＜0．05），体外血栓长度下降（P＜0．05），湿重、干重均下降（P＜0．05）。SOD活性增加（P＜0．05）。结论：金纳多可降低血液粘度，改善SOD活性，防治糖尿病微循环障碍，减少血栓的形成。     

舒降之对高脂血症患者血液流变学的影响

目的观察舒降之（辛伐他汀）对高脂血症患者血液流变学的影响。方法选择60例高脂血症患者，给予舒降之（辛伐他汀）进行降脂治疗8周，观察治疗前后患者血液流变学和血脂指标的变化。结果经8周的降脂治疗后与治疗前比较，其血液流变学指标包括全血高切粘度、全血低切粘度、血浆粘度和红细胞压积均明显下降（P〈0．01，P〈0．05）；血清总胆固醇和低密度脂蛋白含量亦明显下降（p〈0．01，P〈0．05）。结论应用舒降之（辛伐他汀）进行降脂治疗在降低患者血脂水平的同时，能够显著改善其血液流变学指标，改善微循环，提高组织再灌注，从而降低了心脑肾相关疾病的发病率。     

芪棱片对血栓形成和缺血性脑水肿的作用研究

用血小板聚集实验（exvivo）、大鼠颈动脉血栓形成和急性脑水肿动物模型对芪棱片的药理作用进行观察。结果表明：芪棱片可明显抑制ADP诱导的大鼠血小板聚集（P＜0．001），对电刺激大鼠颈动脉血栓形成有显著的延缓作用（P＜0．01），本品不影响脑水肿时的Na 含量升高，而对水肿引起的K 含量降低有改善（P＜0．01），对脑水肿有明显缓解作用。本实验结果为芪棱片在临床上用于预防缺血性中风提供了实验依据。     

针刺对骨折家兔血液流变学的影响

目的：观察针刺对骨折家兔血液流变学的影响。方法：将健康雄性家兔36只手术造成骨折模型，随机分为针刺组和对照组，用血液流变学方法分期观察针刺的作用。结果：针刺在骨折的不同阶段均能改善家兔血液流变性，其中以第1周最为明显（P＜0．01），结论：针刺活血化瘀，改善微循环，促进骨折愈合。     

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.