脑缺血后垂体前叶促性腺激素细胞免疫组织化学和超微结构变…

应用蒙古沙土鼠制作的急性脑缺血动物模型，在５和１０脑缺血后，再灌注４小时－１４天，用免疫组化和电镜技术观察了不同实验组动物垂体前叶内两种促性腺激素阳性细胞的密度染色反应和其超微结构的动态变化。结果表明：５急性脑血及再灌注过程中出现的细胞密度、染色强度和超微结构的发迹是暂时的、可逆的，在缺血后１周－２周内可基本恢复正常。但当脑缺血１０分钟再灌注后，垂有叶促性腺激素细胞呈现较严重的缺血性损伤，部分细胞     

急性脑缺血后脑隔——视前区内性功能调节相关神经元的变化

目的探讨急性脑缺血后出现性功能障碍的机理。方法应用蒙古沙土鼠急性脑缺血再灌注模型，对脑隔—视前区内性功能调节相关神经元光镜和电镜下的病理组织学和超微结构改变进行了观察。结果缺血５分钟再灌注造成的神经元密度和亚细胞水平的结构变化是暂时的，可在２周内恢复，１０分钟脑缺血再灌注后神经元的损害加重，且在２周后尚未恢复，损害主要为膜结构如线粒体、内质网等破坏。结论神经元损伤程度与缺血时间及再灌注时间长短密切相关，脑隔—视前区内神经元的病理损害是引起性功能障碍的重要形态学依据。     

二仙汤及其拆方对去势大鼠垂体促性腺激素细胞的影响

本以组织学特殊染色方法显示垂体前叶的细胞，观察了二仙汤及其拆方对去势的大鼠垂体促性腺激素细胞(GTH细胞)，形态及数量的影响．结果表明：去势后大鼠的GTH细胞明显肥大，PAS阳性反应增强呈分泌亢进状态，并出现大量因分泌过度而形成的“印环细胞”，而二仙汤及其拆方能通过改善GTH细胞的结构而调节促性腺激素的分谢水平．以维持机体内分泌的相对平衡。     

复方甲地孕酮微囊注射液对大鼠垂体前叶超微结构的影响

用不同剂量的复方甲地孕酮微囊注射液注射大鼠,观察垂体前叶催乳激素细胞和促性腺激素细胞的超微结构变化,结果在一定剂量下,对催乳激素细胞有促进作用,促性腺激素细胞在0.2ml和0.4ml组出现抑制性改变。各实验组催乳激素细胞的内质网呈现同心圆排列,同心圆数目与对照组相比,差异有高度显著性(P<0.005)。随着剂量增加,出现髓样变结构的细胞增多,其0.4ml组与对照组相比,差异有高度显著性(P<0.005)。     

褪黑素抑制促甲状腺释放激素刺激乳鼠垂体前叶细胞催乳素基因的表达

褪黑素（melatonin，MEL）主要由松果腺分泌，它是一种吲哚类激素，其功能之一能抑制下丘脑的促性腺释放激素和垂体前叶的促性腺激素。本工作利用原位杂交方法，观察了MEL对促甲状腺释放激素（thyrotropinreleasinghormone，TRH）兴奋垂体前叶激素-催乳素（prolactin，PRL）表达的影响。结果表明，在一定浓度范围内，MEL不但可抑制TRH刺激PRL基因表达的效应，还可直接抑制垂体前叶细胞PRL基因的表达。这为进一步探讨在体条件下MEL对PRL合成与分泌的调节，提供了实验依据。     

腺垂体细胞分类染色法改进的体会

采用组织化学技术,显示垂体的腺垂体前叶各类细胞,其结果表明腺垂体前叶有五种类型的细胞：（1）生长激素细胞桔黄色;（2）催乳激素细胞桔红色;（3）促甲状腺激素细胞深蓝色;（4）促性腺激素细胞紫红色;（5）促肾上腺皮质激素细胞浅蓝色或灰蓝色。各类细胞染色鲜艳,结构清晰,便于观察。对于教学、科研和临床诊断方面有十分重要的实际意义。     

脑垂体腺瘤156例免疫组化及超微结构研究

应用免疫组织化学染色方法及电镜超微结构观察，对１５６例垂体腺瘤进行分类研究，并结合临床资料分析。结果显示：来源于分泌催乳素和（或）生长激素细胞的腺瘤占４６．２％，Ｎｕｌｌ细胞腺瘤占２５．６％，促性激素细胞腺瘤占８．３％，促肾上腺皮质激素细胞腺瘤占４．５％，促甲状腺素细胞腺瘤仅１例占０．６％，而多种激素分泌细胞腺瘤比例偏高占１４．８％。讨论上述分类的临床意义及部分垂体腺瘤的免疫组化染色和超微结构特征     

脑垂体腺瘤156例免疫组化及超微结构研究

应用免疫组织化学染色方法及电镜超微结构观察，对１５６例垂体腺瘤进行分类研究，并结合临床资料分析。结果显示：来源于分泌催乳素和（或）生长激素细胞的脉瘤占４６．２％，Ｎｕｌｌ细胞腺瘤占２５．６％，促性激素细胞腺癌占８．３％，促肾上腺皮质激素细胞腺瘤占４．５％，促甲状腺素细胞腺瘤仅１例占０．６％，而多种激素分泌细胞腺癌比例偏高占１４．８％。讨论了上述分类的临床意义及部分垂体腺癌的免疫组化染色和超微结构特征，为临床诊断治疗脑垂体腺瘤提供了依据。     

垂体前叶功能减退危象

<正> 垂体是十分重要的内分泌器官,垂体前叶合成和分泌生长激素、泌乳素、促脂激素、黑素细胞刺激素、促性腺激素(黄体生成激素和促卵泡素)、促甲状腺激素和促肾上腺皮质激素,对机体的生长、发育、代谢和生殖起着非常重要的调节作用.垂体前叶功能减退的常见原因是产后出血引起的垂体缺血坏死、垂体肿瘤和垂体手术,当垂体前叶组织的50%遭到破坏,即可引起前叶功能减退.临床上以促性腺激素、促甲状腺激素和促肾上腺皮质激素缺乏为突出表现,主要为性器官萎缩、阴毛脱落、性欲减退、阳萎或闭经;面色苍白、面容衰老和代谢率降低以及乏力、     

产后大出血患者血清促性腺激素催乳素促甲状腺激素测定结果分析

<正> 产后大出血可引起垂体前叶功能减退即席汉氏综合征。西氏内科学提到垂体前叶受损达90％才出现完全的垂体前叶功能低下。本文对大出血产妇垂体前叶分泌激素是否有改变这个问题作了探讨,并对我院从1992年～1996年期间收住的32例产后大出血患者血清促性腺激素催乳素促甲状腺激素的测定结果进行了分析。现报告如下。     

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.