基于GC-MS方法的肾虚证代谢组学研究

目的 应用GC-MS结合主成分分析(PCA)方法研究氢化可的松诱导的肾虚证大鼠和空白对照大鼠的尿液成分谱差异.方法 使用氢化可的松诱导大鼠建立肾虚证模型,GC-HS方法分析对照组和模型组大鼠的尿液,使用PCA方法进行模式识别,寻找标记物并做出相关代谢途径的可能解释.结果 PCA方法处理肾虚证和空白对照大鼠尿液数据显示,两组大鼠的数据可以在得分图实现分类,与对照组比较肾虚组大鼠由于氢化可的松诱导,大鼠机体进入一个过消耗后衰弱的状态,相关代谢发生显著变化.结论 GC-HS方法结合PCA模式识别的代谢组学方法具有研究复杂条件下机体病理生理变化的优势,本研究为理解中医的肾虚证和为该类疾病临床诊治的研究提供了证据.     

高血压病肝阳上亢证患者尿液样品的核磁共振谱代谢组学研究

[目的]寻找高血压病肝阳上亢证患者可能的生物标记物,揭示其证候本质。[方法]对2008年7月至2009年10月间山东省中医医院神经内科收治的9例高血压病肝阳上亢证患者与7例健康志愿者,用~1HNMR分析尿液成分,使用PCA方法进行模式识别,寻找标记物并做出相关代谢途径解释。[结果]两组~1HNMR谱数据可以在得分图实现分类;与健康志愿者作比较,高血压病肝阳上亢患者机体相关代谢发生显著变化,体内氨基酸、葡萄糖代谢明显异于健康志愿者。[结论]~1HNMR结合PCA模式识别的代谢组学方法具有研究复杂条件下机体病理生理变化的优势,为理解高血压病肝阳上亢证的证候本质和诊断提供了科学依据。     

高血压病肝阳上亢证患者尿液代谢指纹图谱研究

目的:探讨高血压病肝阳上亢证患者的尿液代谢谱特征。方法:采用高效液相色谱质谱联用技术结合主成分分析(PCA)方法分析、比较10例高血压病肝阳上亢证患者和10例健康志愿者的尿液成分谱差异。结果:与健康志愿者相比,高血压病肝阳上亢证患者机体相关代谢发生显著变化,两组的高效液相色谱数据在得分图中实现了较准确的分类。结论:高效液相色谱质谱联用结合PCA模式识别的代谢组学方法具有研究复杂条件下机体病理生理变化的优势,可以为高血压病肝阳上亢证的诊断提供一定的客观依据。     

基于核磁共振技术的小青龙汤证的证本质研究

目的通过分析各组大鼠尿液代谢物图谱,发现小青龙汤证的生物标志物,为临床诊断和治疗提供客观依据。方法对正常组和模型组大鼠的尿液进行核磁共振氢谱检测,图谱经Me-stRec预处理和积分后,所得数据用SIMCA-P+进行主成分分析(PCA),得到相应的散点图和载荷图,进行比较后找出差异性代谢物。结果与正常组比较,模型组中肌酸酐、胍基乙酸、三甲胺、牛磺酸、尿囊素等代谢物含量升高(P<0.05),琥珀酸、α-酮戊二酸、乳酸、甘氨酸、甲基烟碱等代谢物含量降低(P<0.05)。结论模型组大鼠尿液中与能量代谢有关的小分子化合物与正常组有明显差别,提示基于核磁共振技术和模式识别的代谢组学方法可以揭示小青龙汤证的证本质。     

糖尿病肾阴虚证模型大鼠尿液的代谢组学研究

目的:研究糖尿病肾阴虚证大鼠模型尿液的代谢表型变化,探讨代谢组学在糖尿病肾阴虚证研究中的应用.方法:将大鼠分为正常组、模型组,模型组采用甲状腺素和链脲佐茵素分别皮下和腹腔注射的方法来制作糖尿病阴虚证大鼠模型;收集造模组大鼠的尿液,进行GC-MS检测.结果:模型组大鼠血糖增高,尿糖、尿蛋白均增高.与正常组比较,模型组大鼠的尿液中包含的甘氨酸、琥珀酸含量显著升高(P<0.05),十六烷酸、胆固醇含量显著下降(P<0.05).结论:大鼠的尿液代谢谱与糖尿病肾阴虚证密切相关,代谢组学在中医糖尿病研究中有广泛前景.     

腺嘌呤与氢化可的松大鼠肾阳虚模型造模方法比较

目的比较腺嘌呤诱导与氢化可的松诱导的SD大鼠肾阳虚模型的优劣，从而得到临床症状、生化指标更符合中医“肾阳虚”型的动物模型，以供科研、教学使用。方法雄性SD大鼠100只，随机分成正常组、腺嘌呤造模组及氢化可的松低剂量组、中剂量组、高剂量组各20只，造模成功后检测血肌酐（Scr）、尿素氮（BUN）、尿液中17-羟皮质类固醇（17-OH）和血浆中甲状腺激素（13、T4）、睾丸酮（T）、雌二醇（E2）及模型大鼠骨密度。结果无论从症状主证方面，还是客观指标方面（除骨密度外），腺嘌呤诱导的SD大鼠肾阳虚型动物模型在生化指标研究方面均优于氢化可的松诱导组。结论腺嘌呤诱导的肾阳虚证SD大鼠模型在症状主证方面及其相关的生化研究方面优于氢化可的松组。     

基于1H核磁共振谱分析的自发性高血压大鼠尿液代谢特征

目的 采用¹H核磁共振谱分析结合偏最小二乘分析（PLS-DA）方法研究自发性高血压大鼠和Wistar大鼠尿液的成分谱差异,寻找可能的生物标记物。方法 选取自发性高血压大鼠和Wistar大鼠,连续4周收集尿液,以¹H-NMR分析两组大鼠的尿液成分,使用PLS-DA方法进行模式识别,通过OPLS-DA的相关系数寻找差异标记物。结果 PLS-DA方法处理高血压大鼠和Wistar大鼠的¹H-NMR谱数据显示,两组¹HNMR谱数据可以在得分图中明显区分,且代谢趋势在连续4周测定均非常稳定,说明自发性高血压大鼠有着特定的代谢模式,通过OPLS相关系数分析出体内部分氨基酸代谢产物和葡萄糖等能量代谢物质明显异于正常大鼠。结论 ¹H-NMR结合PLS-DA模式识别的代谢组学方法具有研究复杂条件下机体病理生理变化的优势,为了解高血压大鼠的代谢特征提供了科学依据.     

几种模式识别方法在大鼠高脂血症代谢组学研究中的应用

目的： 探讨不同的模式识别方法在分析大鼠高脂血症代谢组学实验数据中的应用。方法： 采用高脂饲料喂养的方法,建立大鼠高脂血症模型。同时,以GC/MS为技术基础的代谢组学研究大鼠高脂血症的发病过程,并对图谱进行分析,将分离得到内源性代谢物,分别应用主成分分析(PCA)、软独立建模分类法(SIMCA)、非线性映射(NLM)3种模式识别方法对数据进行分析。结果： SIMCA和NLM在样本分类的效果上优于PCA,且NLM可表现出样本的经时变化规律;而PCA和SIMCA能更好地解释与疾病相关的内源性代谢物的信息,3种方法所得的结果可以互相印证和补充。结论： 在代谢组学研究中,可以运用多种模式识别方法对数据进行分析处理,以得到更可靠和全面的信息。     

基于不同模式识别方法的大鼠尿液核磁共振氢谱分析

目的采用核磁共振波谱技术测试不同性别大鼠尿液代谢物,探讨不同模式识别方法对结果的影响。方法利用主成分分析（principal component analysis,PCA）、偏最小二乘法判别分析（partial least squares discriminant analysis,PLS-DA）、正交偏最小二乘法判别分析（orthogonal to partial least squares discri minant analysis,OPLS-DA）等方法分析不同性别大鼠尿液中的差异性代谢物。结果数据进行中心化处理后进行PCA和PLS-DA分析可以判别两组尿液中具有差异性的缬氨酸、乙酸、尿囊素、鸟氨酸、肌酸酐、二甲胺、丙氨酸、柠檬酸等代谢物,而进行OPLS-DA分析除了判别出以上具有差异性的代谢物外还确定了氨基马尿酸、甲胺、延胡索酸等两组中有显著差异的代谢物。结论 OPLS-DA分析是代谢组学研究中比较灵明的数据分析方法。     

抗结核药物利福平肝毒性时效关系的代谢组学

目的研究利福平(RFP)灌胃后不同时段大鼠尿液的代谢表型改变及其与组织病理学和血液生化指标的相关性。方法将36只雄性Wistar大鼠随机分为对照组、50和100mg/kgRFP3组,每组12只。每日灌胃给药1次,分别于给药第3、7、14天次日每组处死4只大鼠,采集血液标本和肝标本,进行血液生化指标测定和肝脏组织病理学检查。收集给药前24h及给药期间每天24小时的尿液,测定质子核磁共振(1H-NMR)谱,并运用主成分分析方法进行模式识别。结果在给药7d后,100mg/kgRFP组的血清总胆红素水平显著高于对照组(P<0.05)。肝脏组织病理显示RFP仅在较高剂量(100mg/kg)、较长给药时间(14d)时表现出轻度的肝毒性。各组大鼠尿液的代谢谱各不相同,随着给药时间的推移,大鼠尿液1HNMR谱发生一定改变。与对照组比较,给药组尿样1HNMR谱葡萄糖和牛磺酸显著增加,2-酮戊二酸和柠檬酸显著降低。结论尿液代谢谱的改变与常规毒性评价指标的改变相符合且更灵敏。大鼠尿液1H-NMR代谢轨迹与RFP作用时间密切相关,RFP引起的肝毒性与三羧酸循环中能量代谢异常及葡萄糖代谢紊乱有关。     

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.