七氟烷诱导大鼠海马HO-1基因表达机制的研究

目的:研究七氟烷诱导神经元血红素氧合酶-1(HO-1)基因表达的信号转导通路,探讨七氟烷脑保护机制.方法:40只Wis'ar大鼠[年龄(3～4)个月,体重120g～220g]随机分为对照组(C组)、脑缺血-再灌注组(D组)、0.3MAC七氟烷+脑缺血-再灌注组(S1组)、0.6MAC七氟烷+脑缺血-再灌注组(S2纽)和0.6MAC七氟烷+U-0126+脑缺血一再灌注组(U组).测定大鼠海马组织中HO-1-mRNA和ERK1/2、Nri2、AP-1、HO-1蛋白的表达水平,电镜下观察海马线粒体的变化.结果:D组大鼠海马组织中HO-1基因表达增加,ERK1/2、Nrl2和AP-1蛋白表达增加(P均<0.05),海马神经细胞线粒体变性率升高(P<0.01).S1组和s2组HO-1基殿表达增加,ERK1/2和Nrf2蛋白表达增加,线粒体变性率降低(P<0.01),AP-1蛋白表达变化不明旺(P>0.05).u组HO-1基因表达降低,ERK1/2和Nrf2蛋白表达降低,线粒体变性率升高(P<0.01),AP-1蛋白表达表达变化不明显(P>0.05).结论:七氟烷通过ERK1/2/Nrf2信号通路诱导大鼠海马神经细胞HO-1基因表达,保护了海马神经细胞.     

外源性一氧化碳对脑缺血-再灌注损伤大鼠海马气体信号分子的影响

目的研究外源性一氧化碳（CO）对脑缺血-再灌注损伤大鼠海马气体信号分子的影响,探讨脑保护策略.方法 24只Wister大鼠随机分为四组（n=6）：对照组（Ⅰ组）、脑缺血-再灌注组（Ⅱ组）、脑缺血-再灌注＋低浓度CO组（Ⅲ组）、脑缺血-再灌注＋高浓度CO组（Ⅳ组）.采用四血管阻断方法制作大鼠全脑缺血-再灌注模型,Ⅰ组行假手术,Ⅲ组和Ⅳ组夹闭两侧颈总动脉前30 min腹腔分别注射CO20 mL/kg或40mL/kg,Ⅰ组和Ⅱ组腹腔注射等量生理盐水.缺血20 min再灌注6 h后处死大鼠取海马,检测大鼠海马组织中H2S、NO和CO的量和CBS、HO和iNOS酶活性变化,以及CBS-mRNA、iNOS-mRNA和HO-1-mRNA表达水平.结果Ⅱ组与Ⅰ组相比大鼠海马中H2S、NO和CO的量增高,CBS、HO和iNOS酶活性增加,CBS-mRNA、iNOS-mRNA和HO-1-mRNA表达增高（P〈0.05或P〈0.01）;Ⅲ组与Ⅱ组比大鼠海马中H2S和CO的量增高,NO的量降低,CBS酶活性增加,iNOS和HO酶活性降低,CBS-mRNA表达增加,iNOS-mRNA和HO-1-mRNA表达降低（P〈0.05或P〈0.01）;Ⅳ组与Ⅱ组相比大鼠海马中H2S和CO的量显著增高,NO的量降低,CBS酶活性增加,iNOS和HO酶活性降低,CBS-mRNA表达增加,iNOS-mRNA和HO-1-mRNA表达降低（P〈0.05或P〈0.01）.结论外源性CO能够诱导脑缺血-再灌注后大鼠海马CBS-mRNA的表达,激活CBS,抑制iNOS-mRNA和HO-1-mRNA的表达,抑制iNOS和HO,对HO-1/CO、CBS/H2S和iNOS/NO系统产生调节作用.     

七氟烷后处理对海马HO-1表达的影响及其抗炎作用

目的 探讨七氟烷后处理对大鼠脑缺血再灌注损伤的保护作用及血红素氧合酶-1(HO-1)的抗炎作用.方法 清洁级雄性SD大鼠40只,体重230～270g,随机分为5组,假手术组(C组)、缺血再灌注组(IR组)、七氟烷组(S组)、抑制剂组(S+Z组)和溶剂对照组(S+D组).采用双侧颈总动脉夹闭合并低血压方法 制备脑缺血再灌注损伤模型.将所有大鼠再灌注24h后处死,取海马.光镜下观察各组海马病理学变化,检测海马肿瘤坏死因子α(TNFα)、白细胞介素1β(IL-1β)和HO-1表达.结果 七氟烷组HO-1(0.466±0.041)较缺血再灌注组(0.338±0.023)显著升高(P<0.05),TNF-α和IL-1β较缺血再灌注组显著降低(P<0.05);抑制剂组HO-1较七氟烷组显著降低(P<0.05),TNF-α和IL-1β较缺血再灌注组显著升高(P<0.05);七氟烷组海马病理学损伤较缺血再灌注组和抑制剂组减轻.结论 七氟烷后处理对大鼠脑缺血再灌注损伤有保护作用,其作用机制可能与七氟烷上调脑组织中HO-1表达,从而抑制炎症反应有关.     

地氟烷预处理对大鼠全脑缺血再灌注损伤的保护作用

目的 探讨地氟烷预处理对大鼠全脑缺血再灌注损伤的保护作用及其作用机制。方法 96只Wistar雄性大鼠随机分为4组：假手术组（S组）、缺血再灌注组（I/R组）、地氟烷组（D组）、5-羟葵酸组（5-HD组），每组24只。采用双侧颈总动脉夹闭＋全身低血压（MAP控制在35～45mmHg）法制备全脑缺血再灌注损伤模型，实验过程中监测MAP、血气各项指标。全脑缺血10min恢复灌注。D组脑缺血前吸入5．9％（1．0MAC）地氟烷1h，5-HD组在吸地氟烷前即刻静脉注射5-羟葵酸5mg／kg。分别于再灌注6、24和48h进行神经行为学评价，神经行为学评价后各处死8只大鼠，光镜下观察海马CA1区组织病理学改变，并计数该区神经细胞存活数目。结果缺血再灌注导致大鼠出现行为学缺陷，D组再灌注各时点、5-HD组再灌注6h神经行为学好于I／R组，I／R组再灌注各时点海马CA1区存活神经细胞数目减少，D组再灌注各时点、5-HD组再灌注6h海马CA1区存活神经细胞数目增加（P〈0．05）。结论1．0MAC地氟烷预处理对大鼠全脑缺血再灌注损伤有一定的保护作用，可能与ATP敏感性钾离子通道的激活有关。     

七氟烷诱导HO-1基因表达抑制氧糖剥夺神经元凋亡机制的研究

目的：探讨七氟烷诱导HO—1基因表达抑制氧糖剥夺神经元凋亡的机制。方法：将96孔和6孔培养板上培养7d的海马神经元随机分为5组（n=10）：正常培养组（C组）、氧糖剥夺组（D组）、氧糖剥夺组＋2％七氟烷组（s1组）、糖剥夺组十4％七氟烷组（S2组）、糖剥夺组＋4％七氟烷＋Znpp组（Z组）。C组神经元按正常培养方法培养。S1组在神经元缺糖缺氧的同时接受2％七氟烷麻醉。S2组在神经元缺糖缺氧的同时接受4％七氟烷麻醉。Z组在神经元进行缺糖同时加入Znpp使其终浓度分别为10μmol／L后同s2组处理。96孔培养板的神经元进行细胞存活率的检测。6孔培养板的神经元进行神经元纯度鉴定、神经元凋亡率、HO-1-mRNA和Fas蛋白表达的检测。结果：与D组比较S1组海马神经元HO-1—mRNA的表达增加，Fas蛋白表达减少，神经元存活率增加、凋亡率降低（P〈0．05）。与S1组比较S2组海马神经元HO-1-mRNA的表达增加，Fas蛋白表达减少，神经元存活率增加、凋亡率降低（P〈0．05）。与S2组比较Z组海马神经元HO-1-mRNA的表达减少，Fas蛋白表达增加，神经元存活率降低、凋亡率增加（P〈0．05）。结论：七氟烷通过诱导神经元HO-1-mRNA的表达而抑制了凋亡因子Fas，最终抑制了氧糖剥夺神经元的凋亡。     

内源性H2S和NO在大鼠脑缺血-再灌注损伤中的相互作用

目的研究胱硫醚β-合酶（cystathionine beta synthase,CBS）/硫化氢（H2S）体系和诱导型一氧化氮合酶（inducible nitric oxide synthasea,iNOS）/一氧化氮（NO）体系在大鼠脑缺血/再灌注损伤中的相互作用,探讨脑保护策略.方法 24只Wister大鼠随机分为4组（n=6）：对照组（C）、脑缺血/再灌注组（I/R）、脑缺血-再灌注＋氨基胍（iNOS抑制剂）组（I/R＋A）、脑缺血-再灌注＋羟氨（CBS抑制剂）组（I/R＋H）.采用4血管阻断方法制作大鼠全脑缺血-再灌注模型.对照组行假手术,脑缺血/再灌注＋氨基胍组夹闭两侧颈总动脉前30 min腹腔注射氨基胍500 mg/kg,脑缺血-再灌注＋羟氨组夹闭两侧颈总动脉前30 min腹腔注射羟氨5 mmol/L,对照组和脑缺血/再灌注组腹腔注射等量生理盐水.缺血20 min再灌注6 h后处死大鼠取海马,检测大鼠海马组织中H2S、NO、GSH、SOD、MDA量的变化及CBS-mRNA和iNOS-mRNA表达水平;电镜观察海马线粒体的变化.结果脑缺血/再灌注组与对照组相比大鼠海马中H2S、NO的量增高,GSH、SOD的量降低,MDA的量增高,CBS-mRNA和iNOS-mRNA表达增高（P〈0.01）,电镜观察海马线粒体受损;脑缺血-再灌注＋氨基胍组与脑缺血/再灌注组相比大鼠海马中NO、MDA的量降低,H2S、GSH和SOD的量增高,CBS-mRNA的表达增高,iNOS-mRNA表达降低（P〈0.05或P〈0.01）,电镜观察线粒体损伤减轻;脑缺血-再灌注＋羟氨组与脑缺血-再灌注组相比大鼠海马中H2S、GSH和SOD的量降低,NO、MDA的量增高,CBS-mRNA的表达降低,iNOS-mRNA表达增高（P〈0.05或P〈0.01）,电镜观察线粒体损伤加重.结论脑缺血/再灌注损伤过程中,iNOS/NO体系参与了神经细胞的损伤,而CBS/H2S体系具有抗损伤的作用,两体系间存在相互的调节;iNOS抑制剂在脑缺血-再灌注损伤过程中对神经细胞有保护作用.     

地氟烷对全脑缺血再灌注损伤大鼠海马神经细胞超微结构及凋亡相关基因表达的影响

目的探讨临床浓度地氟烷预处理对大鼠全脑缺血再灌注损伤后行为学、海马神经细胞超微结构及对凋亡相关基因bcl-2、bax表达的影响。方法72只Wistar雄性大鼠随机分为3组（n=24）,各组动物在不同时间点（再灌注后6h、24h和48h）观察各项指标。对照组为假手术组;缺血组采用双侧颈总动脉夹闭＋全身低血压法（MAP=40mmHg&#177;5mmHg）制成脑缺血模型;地氟烷组在脑缺血前吸入1．0MAC地氟烷1h。实验过程中监测血压、心率、血气各项指标。各组动物手术后重置笼中自由饮食。分别在6h、24h和48h进行动物行为学评分;之后10％多聚甲醛心脏灌洗,断头取脑,透射电镜观察海马区神经细胞超微结构的改变,免疫组织化学法观察凋亡相关基因bcl-2、bax在海马CA1区表达的动态变化。结果神经行为学评价显示,地氟烷组动物在缺血再灌注后各时间点的行为学表现优于缺血组（P〈0．05）;透射电镜结果显示地氟烷预处理可以改善神经细胞超微结构的改变;免疫组织化学结果显示,地氟烷组动物在各时间点促凋亡基因bax的表达低于缺血组（P〈0．05）;抗凋亡基因bcl-2的表达高于缺血组（P〈0．05）。结论1．0MAC地氟烷预处理对大鼠全脑缺血再灌注损伤有一定程度的保护作用,其机制与调控凋亡相关基因bcl-2、bax的表达有关。     

七氟烷后处理对大鼠脑缺血再灌注损伤PI3K/Akt通道的影响

目的探讨七氟烷后处理对大鼠脑缺血再灌注损伤PI3K/Akt通道的影响。方法 SD雄性大鼠40只随机分为5组（n=8）：假手术对照组（C组）、缺血再灌注损伤组（IR组）、2.5%七氟烷后处理组（S组）、2.5%七氟烷＋磷脂酰肌醇-3激酶/蛋白激酶B抑制剂LY294002组（S＋LY组）和溶剂对照组（DMSO组）。采用双侧颈总动脉阻断联合低血压法制备脑缺血再灌注模型。于再灌注结束后处死大鼠取海马,光镜下观察海马病理学变化,采用免疫组化法检测Caspase-3及p-Akt的表达,TUNEL法检测细胞凋亡。结果与C组相比,其余4组AI、Caspase-3及p-Akt表达均增加（P〈0.05）。与IR组相比,S组AI及Caspase-3表达显著降低（P〈0.05）,p-Akt表达明显增加（P〈0.05）,S＋LY组及DMSO组各指标表达无明显差异（P〉0.05）。结论七氟烷后处理可能通过激活PI3K/Akt通道,抑制Caspase-3表达,减少大鼠脑缺血再灌注损伤时神经元细胞凋亡,发挥脑保护作用。     

促红细胞生成素对全脑缺血再灌注损伤大鼠血红素加氧酶-1表达的影响

目的探讨促红细胞生成素（EPO）对大鼠脑缺血再灌注后血红素加氧酶1（HO-1）表达的影响。方法随机将雄性SD大鼠分为缺血再灌注组、治疗组、假手术组。治疗组按照缺血再灌注后不同时间点给予EPO腹腔注射，假手术组不手术，于各时间点断头取脑，用逆转录-聚合酶链反应技术检测大鼠皮层HO-1 mRNA的表达。结果① 全脑缺血再灌注后HO-1 mRNA的表达发生动态变化，缺血后6h开始明显升高，24h达高峰，此后缓慢下降；② EPO能够显著上调全脑缺血后皮层HO-1 mRNA的表达,缺血再灌注后即注射EPO组与缺血再灌注组各时间点HO-1和β-actin吸光度的比值差异有统计学意义（P＜0.05 ）。结论EPO的神经保护作用可能部分通过上调HO-1的表达来实现。     

新生鼠脑缺血预处理后海马CA1区GAP-43的表达

目的:观察新生Wistar鼠脑缺血再灌注后海马CA1区生长相关蛋白43(GAP-43)的表达和意义. 方法:通过阻断7日龄新生Wistar大鼠右侧颈总动脉45 min制备脑缺血模型,设置假手术组、缺血再灌注组和预缺血-缺血再灌注组. 采用免疫组化方法和计算机图像分析技术检测三组新生鼠不同时点海马CA1区脑组织GAP-43的动态变化及三组光镜下脑组织病理改变. 结果: ①脑组织病理改变:假手术组大鼠无异常病理改变,缺血再灌注组神经细胞变性、坏死,预缺血组-病理损伤较缺血再灌注组轻. ②GAP-43表达:缺血再灌注组海马GAP-43表达在再灌注后24 h时开始增高,7 d达高峰,至14 d与假手术组比较差异有统计学意义(P＜0.05);预缺血-缺血再灌注组GAP-43表达较缺血再灌注组增加更明显,与假手术组和缺血再灌注组比较均差异有统计学意义(P＜0.05). 结论: 新生鼠脑缺血预处理可减轻再次严重脑缺血对神经细胞的损伤,脑缺血预处理后海马CA1区GAP-43表达和合成增加,GAP-43表达增加可能与神经元再生和轴突重塑有关,是脑缺血后神经细胞内源性代偿机制之一.     

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.