番石榴叶对2型糖尿病大鼠血糖的影响

目的：研究天然植物番石榴叶（guava leaves）水煎剂对2型糖尿病大鼠空腹血糖（fasting blood glucose,FBG）、空腹胰岛素（fasting insulin,FINS）和胰岛素敏感指数（insulin sensitivity index,ISI）的影响．方法：80只Wistar大鼠随机抽取10只作为正常对照组,其余大鼠用高热量饲料加小剂量链脲佐菌素（Streptozotocin,STZ）的方法建立实验性2型糖尿病大鼠模型,造模动物筛选后,随机分为二甲双胍对照组、模型对照组、番石榴叶大刺量组、番石榴叶中剂量组、番石榴叶小剂量组,每组10只,用番石榴叶水煎剂治疗8周,测定FBG,FINS,计算出ISI。结果：模型组FBG、FINS水平升高,ISI降低,与正常对照组比较,差异有显著性意义（P〈0．01）;番石榴叶各组大鼠FBG水平降低,血清FINS水平下降,ISI升高,与模型组比较差异有显著性意义。结论：番石榴叶能降低2型糖尿病大鼠的FBG和胰岛素抵抗。     

辛伐他汀对链脲佐菌素诱导2型糖尿病大鼠血糖的影响

[目的]探讨辛伐他汀对链脲佐菌素(STZ)诱导2型糖尿病大鼠血糖的影响.[方法]选取100只Wistar雄性大鼠适应性喂养1周后随机分为4组,每组各25只.A组(正常对照组)普通饲料喂养4周后腹腔注射柠檬酸钠缓冲液;B组(糖尿病模型组)、C组(他汀早期诱导组)和D组(他汀晚期诱导组)高脂饲料喂养4周后一次腹腔注射STZ 35 mg/kg溶液建立2型糖尿病大鼠模型,C组在高脂饲料喂养的同时给予辛伐他汀10 mg/kg·d-1的剂量灌胃,D组在糖尿病模型建立后给予相同剂量辛伐他汀灌胃,B组在糖尿病模型建立后给予等量蒸馏水,成模后均连续观察4周.测定各组0、4和8周大鼠体质量、空腹血糖和血脂水平,并于第8周末行OGTT试验.[结果]在第4周末和第8周末,2型糖尿病大鼠与正常对照组大鼠相比,空腹血糖(FPG)水平均显著升高(P＜0.05)、血清胰岛素(Ins)水平显著降低(P＜0.05),差异有统计学意义;与糖尿病大鼠相比,第4周末他汀晚期诱导组轻微升高FPG和降低Ins (P＞ 0.05)、他汀早期诱导组显著升高FPG和降低Ins (P＜0.001)以及更容易诱导糖尿病大鼠模型的建立;第8周末他汀晚期诱导组FPG显著高于糖尿病模型组(P＜0.05).[结论]对高脂饲料喂养的大鼠进行辛伐他汀(10 mg/kg· d-1)早期诱导更容易引起胰岛β细胞功能的减退从而升高FPG和诱发糖尿病模型的建立;在糖尿病模型建立之后,对糖尿病大鼠进行他汀治疗可以引起FPG升高.     

丝胶对2型糖尿病大鼠胰岛素水平的影响

目的:观察丝胶对2型糖尿病模型大鼠血清胰岛素水平的影响.方法:48只雄性SD大鼠随机分为正常对照组、2型糖尿病模型组、丝胶治疗组和二甲双胍阳性对照组4组,每组12只大鼠.采用高脂高糖饲料喂养联合链脲佐菌素(35mg/kg,2次)连续腹腔注射的方法制作2型糖尿病大鼠模型,以空腹血糖≥11.1mmol/L作为成模标准.待模型成功建立后,丝胶组和阳性对照组大鼠分别给予丝胶(2.4g/kg/d)和二甲双胍(55.33mg/kg/d)灌胃35天.分别采用葡萄糖氧化酶法和ELISA法检测各组大鼠的血糖和血清胰岛素水平.结果:模型组大鼠的血糖明显高于正常组大鼠、血清胰岛素水平明显低于正常组大鼠(P＜0.05);丝胶治疗组、阳性对照组大鼠的血糖明显低于模型组大鼠,血清胰岛素水平明显高于模型组大鼠(P＜0.05).结论:丝胶可提高2型糖尿病大鼠血清胰岛素水平,这可能是丝胶降血糖作用的机制之一.     

糖尿病大鼠肾组织RANTES表达的研究

目的探讨链脲佐菌素（saz）诱导的糖尿病大鼠肾组织RANTES的表达及与24小时尿白蛋白、血糖的关系。方法sD大鼠随机分为正常对照组和糖尿病组,每组15只。于实验第4周、8周、12周末,两组随机选出5只大鼠检测24小时尿白蛋白和血糖,通过RT—PCR、ELISA法检测肾皮质RANTES表达。结果通过RT—PCR及ELISA检测,RANTES表达在第12周糖尿病组较正常对照组显著增加（P〈O．01）;24小时尿白蛋白在第8周、第12周糖尿病组显著高于正常对照组（P〈0．05或P〈0．01）。结论糖尿病大鼠肾组织RANTES表达增加,并且与24小时尿白蛋白存在正相关。     

罗格列酮对糖尿病大鼠肾脏病理的影响及其机制探讨

目的探讨过氧化物酶体增殖物激活受体PPARγ激动剂罗格列酮对2型糖尿病大鼠肾脏病理影响及其机制。方法正常饮食的大鼠10只作为正常对照组,35只高脂高糖饮食加腹腔注射小剂量链脲佐菌素35mg/kg制备2型糖尿病大鼠模型,将成型的大鼠随机分为罗格列酮干预组10只,糖尿病非干预组9只。罗格列酮(3mg/kg灌胃)干预12周后处死大鼠,取血、尿、肾脏标本,检测空腹血糖、空腹胰岛素、血脂及胰岛素敏感指数。光学显微镜观察肾小球形态及测定肾小球截面积、肾小球基质面积、系膜增生评分。结果与正常组比较,罗格列酮干预组血糖、血脂、肾小球截面积、肾小球基质面积、胰岛素敏感性差异无统计学意义;糖尿病非干预组血糖、血脂、肾小球截面积、肾小球基质面积明显增高(P<0.05),胰岛素敏感性明显降低(P<0.05)。结论罗格列酮干预能改善2型糖尿病大鼠肾脏病理变化。     

2型糖尿病大鼠模型的建立与评价

目的建立类似人类2型糖尿病大鼠模型。方法♂大鼠90只,随机取20只为对照组,70只为高脂组。在脂肪乳灌胃5个月后行高胰岛素-正常血糖钳夹实验,测体重、收缩期血压、空腹血糖、空腹胰岛素、甘油三酯。高脂组(62只)大鼠腹腔注射小剂量链脲佐菌素和弗氏完全佐剂每周一次至造模成功。结果①5个月后,高脂组体重、收缩压、血清甘油三酯较对照组显著升高(P<0.05),空腹胰岛素明显升高,胰岛素敏感指数明显下降,差异有显著性(P<0.05)。②高脂组葡萄糖灌流速度较对照组下降,差异有显著性(P<0.05)。结论长期高脂饮食结合腹腔注射小剂量链脲佐菌素和弗氏完全佐剂成功复制出实验性2型糖尿病大鼠模型。     

柴芪汤对代谢综合征大鼠糖脂代谢及胰岛素抵抗的影响

目的：观察不同剂量柴芪汤对代谢综合征模型大鼠糖脂代谢及胰岛素抵抗（ IR）的影响。方法56只大鼠分为正常组16只,模型组16只,柴芪汤低、中、高剂量组各8只。采用高脂高糖高盐饲料持续喂养方式复制大鼠代谢综合征模型。柴芪汤各组从第9周开始分别灌胃给予不同剂量：低剂量组为1．90 g／（kg· d）,中剂量组5．71 g／（kg· d）,高剂量组17．13 g／（kg· d）。实验第8周末,模型组与正常组随机选取8只大鼠采血,实验第12周末,各组大鼠均行腹主动脉采血。用生化法检测血脂（ TG、TC、HDL-C、LDL-C）、空腹血糖（ FBG）,放免法检测空腹胰岛素（ FINS）,公式计算胰岛素抵抗指数（ IRI）。结果治疗4周后,与模型组比较,柴芪汤低剂量组FINS、TG明显下降（P＜0．05）,HDL-C明显升高（P＜0．05）;高、中剂量组FINS、TG、TC、IRI明显下降（P＜0.05）, HDL-C明显升高（P＜0．05）。结论柴芪汤可改善代谢综合征大鼠糖脂代谢,并能减轻IR,以中、高剂量效果明显。     

盐酸小檗碱对2型糖尿病大鼠血清炎症因子及胰腺β细胞形态的影响

目的观察盐酸小檗碱对2型糖尿病大鼠血清炎症因子水平的干预,以及对血糖、血清胰岛素、胰岛素敏感指数（insulin sensitive index,ISI）及胰腺β细胞形态学的影响,探讨盐酸小檗碱对改善糖尿病大鼠胰岛素抵抗的作用机理。方法健康雄性SD大鼠60只随机分为正常对照组、模型对照组、盐酸小檗碱组和二甲双胍组,每组15只,后三组在高脂饲料喂养30 d后,予以链脲佐菌素（streptozotocin,STZ）40 mg/kg制备2型糖尿病大鼠模型。成模后,盐酸小檗碱组予以盐酸小檗碱180 mg/（kg·d）灌胃30 d,二甲双胍组予以二甲双胍180 mg/（kg·d）灌胃30 d,检测实验大鼠的血清炎症因子水平、血糖、空腹胰岛素（fasting insulin,FINS）及ISI,并在光学显微镜和电子显微镜下观察各组胰腺β细胞的病理改变。结果模型对照组大鼠较正常对照组大鼠空腹血糖及空腹胰岛素水平均明显增高（P〈0.05）,血清炎症因子C反应蛋白（C-reactive protein,CRP）、IL-6,TNF-α亦明显增高（P〈0.05）。而二甲双胍组和盐酸小檗碱组的各项指标均较模型对照组明显下降（P〈0．05）,但两药物治疗组之间无显著性差异（P〉0．05）。光学显微镜下HE染色,免疫组化染色及电子显微镜下观察胰腺β细胞形态,显示用药组较模型对照组均有不同程度的改善。结论盐酸小檗碱可通过降低2型糖尿病大鼠血清炎症因子水平而起到降低血糖、改善胰岛素抵抗的作用。     

2型糖尿病大鼠模型制备实验研究

目的 探究建立2型糖尿病大鼠模型的主要影响因素,为制备2型糖尿病大鼠动物模型提供方法 参考.方法根据不同的高糖高脂饲料(HDF)配方、喂养周期及STZ注射剂量(35 mg/kg和40 mg/kg),将90只雄性SD大鼠随机分为正常对照组(NC组)及8个模型组(A-H组),每组各10只.STZ注射5 d后检测各组大鼠空腹血糖(FBG),首次空腹血糖测定后各组大鼠眼眶采血测定血清中总三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及空腹血清胰岛素(FINS)水平.第8周处死大鼠取肝脏、肾脏、脾脏、胰腺,称质量并计算脏器系数.结果 与正常对照组比较,各模型组的血糖值显著升高(P<0.01),TG、TC及LDL-C水平和肝、肾、胰腺等脏器系数都有不同程度升高且胰岛素敏感指数显著降低(P<0.05,P<0.01),成功建立2型糖尿病大鼠模型;大鼠注射STZ 35 mg/kg较40 mg/kg存活率大、存活时间长,血糖值差异无统计学意义(P>0.05);喂养周期为8周后注射STZ的大鼠较4周大鼠死亡率高.结论 HDF喂养4周后注射35 mg/kg STZ是建立2型糖尿病大鼠模型的较合适方法.     

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.