双侧颈总动脉结扎对大鼠学习记忆相关脑区血流量的影响

目的为建立双侧颈总动脉结扎致大鼠血管性痴呆模型，观察了大鼠双侧颈总动脉结扎后不同脑区脑血流量的影响。方法采用激光多普勒血流仪，测定麻醉大鼠双侧颈总动脉结扎后１０ｍｉｎ内不同脑区脑血流量变化。结果大鼠双侧颈总动脉结扎后，平均脑血流量减少额区６７８３％、顶区５６８２％、枕区１６１６％、Ｍｙｎｅｒｔ基底核５１２１％、尾壳核４１１８％，海马ＣＡ１５１８３和海马ＣＡ２４１２１。结论大鼠双侧颈总动脉结扎后与学习记忆有关的脑区脑血流量均显著下降     

不同动物的不同脑供血动脉结扎后存活率比较

目的：选择合适动物建立脑缺血模型。方法：结扎左侧或右侧颈总动脉；结扎双侧颈总动脉；结扎双侧椎动脉和双侧颈总动脉。结果：（1）结扎兔和SD大鼠左侧或右侧颈总动脉，不影响其存活；（2）结扎双侧颈总动脉后的SD大鼠，其中2／3以上动物在术后1－7d内死亡，虽然有2只大鼠存活10d，但体质消瘦；（3）结扎沙土鼠左侧颈总动脉后，有1／2的动物在5－12h内死亡；结扎双侧颈总动脉的沙土鼠，术后2－5h内全部死亡；（4）结扎SD大鼠4动脉（双侧椎动脉和双侧颈总动脉）后，其中约1／3在术后2－5h内死亡，约2／3在术后12h内死亡，另有2只在24h后死亡。结论：因大鼠的脑血管配置与人类近似，最好选用大鼠做脑缺血模型。     

血流动力学改变诱导的兔基底动脉顶端动脉瘤模型

目的 尝试采用结扎新西兰大白兔双侧颈总动脉诱导基底动脉顶端动脉瘤生成。方法 新西兰大白兔26只,分别游离双侧颈总动脉,不行结扎（假手术组,n=6）或结扎（实验组,n=20）双侧颈总动脉。分别于结扎前（0 d）、术后1 d、1周、4周经颅多普勒超声测量基底动脉血流速度;术后4周行脑血管造影了解基底动脉变化;术后1周、4周取基底动脉观察动脉形态变化并对分叉部行组织学检查。结果 假手术组动物全部成活,实验组术后存活率为80%（16/20）。实验组术后1 d,基底动脉血流速度直线升高,高于术前226%;术后1周仍在持续升高;术后4周血流速度处于稳定状态。实验组术后1周,基底动脉增粗,明显迂曲;而假手术组无明显变化。实验组基底动脉分叉部中膜厚度变薄;内弹力层部分消失、断裂或变薄。结论 双侧颈总动脉结扎所致血流动力学改变可诱导兔基底动脉顶端出现新生动脉瘤样改变。     

结扎双侧颈总动脉对实验动物脑膜血流量的影响（论著摘要）

一般认为沙土鼠（mongoliangerbils）脑底动脉环后交通枝缺损，没有联系颈内动脉和椎基底动脉系统的后交通动脉，不能构成完整的WilliS动脉环。结扎沙土鼠的颈总动脉，很易造成脑梗死病变。为了解结扎颈总动脉后脑血流量究竟下降多少，本实验用JI-200激光Doppler微循环动态分析仪，对动物大脑皮质运动区（LI，AP--;）软脑膜进行直接探测。结果结扎小鼠（昆明种，雄性，本院实验动物研究所）双侧颈总动脉后脑膜血流量下降（70.5士16.2）％（体重20.85士1.04g，n—24），体重为33.8士3.2g的小鼠脑血流量下降（70.8士16.2）％（。一10），…     

实验性血管痉挛模型造影方法的改进

脑血管造影是目前临床上普遍采用的检测、评价脑血管痉挛的方法。具有准确、直观等特点。故脑血管造影在研究中也被广泛用于检测CVS的有无、观察、评价治疗效果等 ,是研究血管痉挛的主要方法之一。但也有报告称在兔、猫、鼠等小动物模型上脑血管造影死亡率较高。我们在实验研究中也发现家兔在造影后经常死亡 ,或出现昏迷、偏瘫、血尿等并发症 ,对实验结果存在一定的影响。为此 ,我们改进了以往经颈总动脉或股动脉插管至主动脉搏弓的造影方法 ,参照临床应用的经肱动脉穿刺逆行椎基底动脉造影方法 ,采用 2号套管针穿刺动脉法行基底动脉造影…     

椎基底动脉供血不足脑血管造影34例分析

目的:观察以眩晕为唯一或主要症状的患者的脑血管造影的结果,从而对眩晕的血管原因进行分析,为临床治疗提供参考。方法:34例患者均经临床诊断为椎基底动脉供血不足,按改良的Seldinger技术进行全脑血管造影,并进行综合分析。结果:34老年患者中共有例22(64.7%)患者存在颈及颅内血管结构异常,其中单纯前循环病变3例(8.8%),单纯后循环病变12例(35.3%),前后循环同时受累的复合病变7例(20.6);其余12例(35.3%)造影未见血管结构异常。结论:后循环血管结构异常是导致椎基底动脉供血不足的重要病因,前循环狭窄亦是病因之一。数字减影血管造影是椎基底动脉供血不足安全准确的检查手段,有助于临床诊断和治疗选择。     

64层螺旋CT脑血管造影诊断烟雾病

目的探讨64层螺旋CT脑血管造影诊断烟雾病的价值。方法回顾分析64层螺旋CT脑血管造影诊断烟雾病26例病人CTA影像学资料。结果26例患者大脑基底部均见密集的细小毛细血管扩张网形成,显示率100％,受累血管清晰显示狭窄及闭塞,病变累及双佣血管者23例,单侧血管3例,受累血管均为颈内动脉末段、大脑前中动脉近段,3例基底动脉及双侧大脑后动脉迂曲增粗参与建立倜支循环。结论64层MSCT脑血管造影可清晰显示烟雾病的影像学特征,作为一种无创经济安全准确的检查方法在临床得到迅速推广及普及,是确诊烟雾病的一种重要检查方法。     

脑动静脉畸形血液动力学研究

目的 建立脑动静脉畸形（ＡＶＭ）的是生理学模型，检测血液动力学改变。方法 将大鼠左侧颈外静脉与颈总动脉行端侧吻合，结扎吻合口近尾端的颈总动脉，测定吻合前后及模型动物饲养１６周后的局部脑血流量、右侧颈外静脉压力、颈总动脉压力、颈总动脉的血流速度。结果 大鼠静脉动脉的端侧吻合形成动静脉分流，左侧局部脑血流量显著降低，右侧颈外静脉压增加、颈总动脉压降低、颈总动脉血流速度增快。１６周后，局部脑血流量较动静     

经颅多普勒超声与脑血管造影诊断脑动脉闭塞的对比分析

目的探讨经颅多普勒超声(transcranial doppler,TCD)与数字减影脑血管造影(digital subtraction an-giography,DSA)对脑动脉闭塞的诊断价值。方法对83例颅内外动脉闭塞患者均行脑血管TCD与DSA检测,进行对比分析。结果 TCD检测发现38支闭塞脑动脉与DSA检测符合,其中1支TCD诊断闭塞的基底动脉DSA检测正常。TCD检测发现74支狭窄脑动脉,其中DSA检测发现43支相对应的脑动脉闭塞,31支TCD诊断狭窄的脑动脉DSA检测正常。DSA检测发现另外18支闭塞脑动脉TCD检测正常。以DSA检测结果作为诊断标准,计算出TCD诊断动脉闭塞或狭窄的敏感性为81.81%,特异性为96.49%。结论 TCD对脑动脉闭塞的诊断具有较高的敏感性和特异性,TCD可以作为脑动脉闭塞的筛选手段。     

颈总动脉结扎的探讨

目的探讨通过颈内动脉回流压的测定,预测大脑侧支循环的代偿能力.方法对6例行颈总动脉结扎或切除的病人术中测量颈内动脉回流压.结果颈内动脉回流压在64mHg(8.8kPa)～85mmHg(11.33kPa)之间,6例术中、术后均无大脑并发症.结论颈内动脉回流压在一定水平,结扎或切除颈总动脉是可行的.     

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.