原发性肾病综合征血浆血小板α颗粒膜蛋白水平的测定

目的：探讨血浆血小板α颗粒膜蛋白（Ｇμｐ－１４０）水平的变化在原发性肾病综合征（ＰＮＳ）中的意义。方法：用放免法测定了２４例ＰＮＳ病人和２０例正常的血浆ＧＭＰ－１４０水平,同时测定末梢血小板（ＰＬＴ）计数、血浆凝血酶原时间（ＰＴ）、血浆纤维蛋白原（Ｆｉｂ）定量、血及尿中纤维蛋白（原）降解产物（ＦＤＰ）。结果：ＰＮＳ病人血浆ＧＭＰ－１４０水平高于正常对照组（Ｐ＜０．０５）,同时ＰＬＴ、血浆Ｆｉｂ、尿ＦＤＰ水平明显升高（Ｐ＜０．０１）。ＰＮＳ病人血浆ＧＭＰ－１４０水平与２４ｈ尿蛋白定量呈正相关（γ＝０．５６,Ｐ＜０．０１）。结果：血浆ＧＭＰ－１４０水平是反映血小板活化的良好指标,血小板活化与肾小球滤过屏障损伤有关。     

糖尿病并发缺血性脑血管病病人血浆D-二聚体和GMP-140含量的测定

①目的探讨糖尿病病人并发脑血管病的发病机理。②方法采用ＥＬＩＳＡ双抗体夹心法和放射免疫测定法对非胰岛素依赖型糖尿病（ＮＩＤＤＭ）伴缺血性脑血管病病人血浆Ｄ－二聚体、ＧＭＰ－１４０和血小板表面ＧＭＰ－１４０的含量进行了测定。⑤结果ＮＩＤＤＭ伴脑动脉硬化、ＮＩＤＤＭ并发脑血栓形成和单纯脑血栓形成病人血浆Ｄ－二聚体、ＧＭＰ－１４０和血小板表面ＧＭＰ－１４０含量明显高于正常对照组，差异有极显著性（ｔ＝５．２５－２０．０４，Ｐ均＜０．００１）。单纯脑动脉硬化病人上述指标则无明显变化；动态观察单纯脑血栓形成病人，随着病情好转至恢复期，其上述指标较急性期明显下降（ｔ＝５．２２－７．０５，Ｐ均＜０．００１）；而ＮＩＤＤＭ并发脑血栓形成病人恢复期上述指标持续增右，与急性期相比差异不显著（ｔ＝１．４２－１．９９，Ｐ均＞０．０５）。④结论糖尿病病人血液处于高凝状态和血小板过度活化，这种异常变化可能是糖尿病并发缺血性脑血管病的危险因素之一。     

冠心病人血小板膜结合GMP－140单克隆抗体分子数与血小板计数

采用１２５Ⅰ标记抗人血小板α－颗粒膜蛋白（Ｇｒａｎｕｌｅｍｅｍｂｒａｎｅｐｒｏｔｅｉｎ，Ｍｒ＝１４０ｋｄ，简称ＧＭＰ－１４０）单克隆抗体ＳＺ－５１测定了３９例冠心病人和２０例正常人血小板ＧＭＰ－１４０结合量，并进行了血小板计数。结果显示冠心病人血小板膜ＧＭＰ－１４０特异抗体ＳＺ－５１的结合量为１９６４±９６３／血小板，显著高于正常人的结合量９４３±３４１／血小板（Ｐ＜０．０１），冠心病人的血小板计数为２．５９×１０５±０．６６×１０５／ｍｍ３，亦显著高于正常人的２．１５×１０５±０．４２×１０５／ｍｍ３（Ｐ＜０．０１）。说明冠心病人血小板膜ＧＭＰ－１４０的表达明显增高，即血中激活的血小板百分比和绝对数量均显著高于正常人，可能与血栓形成及其导致的血栓性并发症的发生有密切关系。     

肾移植病人血浆粘附分子GMP－140测定的意义

采用ＥＬＩＳＡ方法检测６０例肾移植患者血浆ＧＭＰ－１４０水平，探讨肾移植病人血浆ＧＭＰ－１４０水平变化和意义。结果显示：环孢霉素肾中毒组血浆ＧＭＯ－１４０水平为２９２±９９ｎｇ／ｍｌ，急性排斥组血浆ＧＭＰ－１４０水平为５１５±１８７ｎｇ／ｍｌ，移植肾功能稳定组血浆ＧＭＰ－１４０水平为１１４±３０ｎｇ／ｍｌ，三组比较有显著性差异（Ｐ＜０．０１）。在研究肾功能稳定并发感染者发现，此组病人血浆ＧＭＰ－１４０水平也显著升高为５７５±１７２ｎｇ／ｍｌ，与急性排斥组比较无显著性差异（Ｐ＞０．０５）。提示监测肾移植病人血浆ＧＭＰ－１４０水平有助于诊断急性排斥和鉴别环孢毒素肾中毒。     

急性脑梗死患者脑脊液及血浆中GMP-140、vWF含量的研究

目的：研究脑梗死急性期患者脑脊液（ＣＳＦ）和血浆中血小板颗粒膜蛋白－１４０（ＧＭＰ－１４０）和血管性假血友病因子（ｖＷＦ）含量的变化及临床意义。方法：应用双抗夹心酶联免疫吸附试验（ＥＬＩＳＡ）法测定了３４例脑梗死急性期病人ＣＳＦ和血浆中ＧＭＰ－１４０、ｖＷＦ的含量。结果：病人组ＣＳＦ和血浆中ＧＭＰ－１４０、ｖＷＦ含量较正常对照组显著升高（Ｐ＜００１）。结论：脑梗死患者急性期存在高凝状态和血小板活化功能亢进以及脑血管内皮的损伤;检测ＣＳＦ中ＧＭＰ－１４０和ｖＷＦ含量的变化对进一步了解急性脑梗死的发病机理和治疗提供了理论依据,对于观察病情演变、判断预后均有重要的临床意义。     

脑血栓形成患者急性期和恢复期血小板α颗粒膜蛋白-140的变化

目的研究血小板α颗粒膜蛋白－１４０（ＧＭＰ－１４０）在脑血栓形成患者急性期和恢复期的变化。方法测定５０例 （其中３０例急性期患者,２０例恢复期患者）脑血栓形成患者血浆ＧＭＰ－１４０的含量,并分别与２６名健康人作比较。结果 脑血栓形成患者急性期ＧＭＰ－１４０浓度明显高于恢复期和正常对照组（Ｐ＜０．０１）,恢复期与正常对照组间比较差异无显 著性（Ｐ＞０．０５）。结论脑血栓形成患者急性期血浆ＧＭＰ－１４０含量处于较高水平。     

急性脑梗死患者血浆纤溶活性和GMP-140含量的变化及临床意义

目的：探讨急性脑梗死患者血液纤溶状态及血小板活化状态在血栓形成中的重要意义。方法：对４２例急性脑梗死患者用发色底物法测定血浆ｔ－ＰＡ：Ａ、ＰＡＩ：Ａ和用酶联免疫吸附双抗体夹心法测定ＧＭＰ－１４０含量。结果：显示急性脑梗死患者在急性期ＰＡＩ：Ａ及ＧＭＰ－１４０含量明显高于正常对照组（Ｐ〈０．０１）,而ｔ－ＰＡ：Ａ含量则明显低于正常对照组（Ｐ〈０．０１）。结论：血浆ｔ－ＰＡ：Ａ、ＰＡＩ：Ａ及ＧＭＰ－１     

老年人糖尿病肾病患者血小板功能和α颗粒膜蛋白－140的变化

测定了老年人糖尿病肾病与无肾病者血小板最大聚集率（ＭＡＲ）、电泳率（ＥＰＭ）及α颗粒膜蛋白－１４０（ＧＭＰ－１４０），并与健康人对照。结果表明：与健康人组比较，肾病组和无肾病组ＭＡＲ升高及ＥＰＭ水平降低（Ｐ＜０．０１），肾病组ＧＭＰ－１４０水平升高（Ｐ＜０．０１）。肾病组的ＭＡＲ、ＧＭＰ－１４０的升高和ＥＰＭ水平的下降较无肾病组明显（Ｐ＜０．０１）。提示老年人糖尿病肾病病人血小板活化增强，有助于血栓形成和微血管损伤，这一变化可能在糖尿病肾病发生发展过程中起着一定作用。     

抗人活化血小板单克隆抗体在脑血检诊断中的应用研究

利用抗人活化血小板α－颗粒膜蛋白（α－ｇｒａｎｕｌｅ　ｍｅｍｂｖｒａｎｅ　ｐｒｏｔｅｉｎ，ＧＭＰ－１４０）单抗ＳＺ－５１，经放免法评估２２例急性脑血栓患者体内血小板的活化程度．结果血浆内ＯＭＰ－１４０的含量在脑血栓急性期显著增高（Ｐ＜０．０１），缓解期恢复正常，血小板表面ＧＭＰ－１４０分子数未见显著改变。提示血浆内ＧＭＰ—１４０的浓度可作为脑血栓急性期体外诊断新的参考指标。当兔颈动脉植入人血栓并用１２５Ｉ—ＳＺ—５１作为示踪剂，４ｈ后离体血栓与血液的放射活性比值（Ｔｈｒｏｍｂｕｓ／Ｂｌｏｏｄ，Ｔ／Ｂ）高达６．８：１，而用１２５Ｉ－ＩｇＧ时，Ｔ／Ｂ值仅为１．４：１。提示单抗ＳＺ－５１在体内能与血栓结合，为脑血栓的新的体内定位诊断方法提供了一定的理论依据。     

小剂量阿斯匹林对冠心病人血小板活化观察

选择４０例冠心病患者，随机分组，２０例为治疗组，在常规治疗基础上加用小剂量阿斯匹林（ＡＳＡ）１００ｍｇ／ｄ，并与常规治疗对照组２０例，观察治疗前后的血小板膜表面α－颗粒膜蛋白（ＧＭＰ－１４０）分子数、血浆血栓素Ｂ２（ＴＸＢ２）浓度变化。结果提示：治疗组ＧＭＰ－１４０分子数、ＴＸＢ２浓度治疗后较治疗前有显著性差异（Ｐ〈０．０１），而对照组无显著性差异（Ｐ〉０．０５）。说明小剂量阿斯匹林对血小板活化有     

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.