角膜穿孔伤对环丙沙星在兔眼内渗透性的影响

目的 研究角膜穿孔伤兔眼血-眼屏障的改变以及静脉注射环丙沙星后药物在眼内的渗透性。方法 15兔各右眼为实验组,左眼为对照组。右眼行角膜穿孔伤后1 h静脉注射环丙沙星,用药后0.5 h,取房水及玻璃体,用反向高效液相色谱法测定环丙沙星浓度,用双缩脲法测定房水蛋白含量。结果 实验组房水蛋白含量（12.641 ±6.786）g/L高于对照组的（2.739±1.111）g/L（P﹤0.01）;实验组房水环丙沙星浓度（1.365±0.588）ug /ml高于对照组的（0.669±0.329）ug/ml（P﹤0.01）;房水蛋白的含量与房水环丙沙星的浓度呈正相关,相关系数r=0.677（P﹤0.01）。实验组和对照组玻璃体中环丙沙星浓度均很低,两组之间的差异无显著性（P﹥0.05）。结论 角膜穿孔伤可以影响血-房水屏障,使其通透性明显增加;房水中环丙沙星的水平也明显提高,其浓度显著高于大部分眼内致病菌90%菌株最小抑菌浓度(MIC90s),为环丙沙星作为角膜穿孔伤和白内障手术后性眼内炎静脉预防性用药提供实验依据。     

不同手术方式对老年性白内障患者眼血-房水屏障功能的影响研究

目的比较不同手术方式对老年性白内障患者眼血-房水屏障功能的影响。方法将2010年2月至2011年5月馆陶县人民医院收治的老年性白内障患者82例按照手术方式不同分为A、B两组,A组40例采用现代囊外摘除术,B组42例采用超声乳化吸出术,比较分析两组患者的疗效及眼血-房水屏障功能情况。结果 A组总有效率为95.0%,B组为97.6%,两组比较差异无统计学意义(P>0.05);A组术后房水蛋白浓度明显高于B组,两组间差异有统计学意义(P<0.05);A组并发症发生率为7.5%,B组为4.8%,两组比较差异无统计学意义(P>0.05)。结论现代囊外摘出术和超声乳化吸出术治疗老年性白内障均可获得良好的临床效果与安全性,前者对患者眼血-房水屏障功能损伤较大,在应用时要综合考虑。     

眼挫伤早期继发性青光眼血-房水屏障功能的动态观察

【目的】 探讨眼挫伤早期继发性青光眼患者药物治疗后血-房水屏障(BAB)功能的动态变化及其与眼压的关系? 【方法】 收集受伤时间在7 d内的闭合性眼挫伤患者61例61眼,分为高眼压组(39例39眼)和正常眼压组(22例22眼)?所有患者均予糖皮质激素和非甾体类药物治疗,眼压升高者予降眼压药物治疗?在治疗后不同时间点行激光蛋白细胞检测仪检测,对比高眼压组和正常眼压组不同时间点房水闪辉值与细胞数,分析房水闪辉值?细胞数与眼压的相关关系? 【结果】 挫伤患者眼压与房水闪辉值和房水细胞数呈正相关,相关系数分别为r = 0.529和0.590(P < 0.001)? 高眼压组初诊时房水闪辉(pc/ms)?每0.5 mm3房水细胞数,均显著高于正常眼压组(78 ± 60 vs 20 ± 16,205 ± 88 vs 50 ± 16,P < 0.001)?高眼压组初诊时眼压为(39 ± 10)mmHg,治疗后末次眼压为(19 ± 11)mmHg,较治疗前显著下降(P < 0.001);眼压恢复至正常范围者31例(79.5%),仍高于21 mmHg者8例(20.5%)?两组患者LFCM值随治疗时间延长呈下降趋势;正常眼压组治疗后约30 d房水闪辉值(5 ± 2)pc/ms和0.5 mm3细胞数(1 ± 1)恢复至正常范围;而高眼压组治疗后120 d房水闪辉值(9 ± 1)pc/ms和0.5 mm3细胞数(5 ± 3)仍高于正常人(P < 0.001)?【结论】 眼挫伤早期继发青光眼患者的血-房水屏障功能的损害较正常眼压者严重,且与损伤早期眼压升高密切相关?抗青光眼药物治疗眼压控制的有效率为79.5%?合理应用糖皮质激素和非甾体抗炎药可以促进BAB功能恢复?     

血-房水屏障破坏与PcIOL前纤维蛋白膜形成的关系

目的探讨有青光眼和葡萄膜炎病史眼的血-房水屏障状态及其血-房水屏障破坏与后房型人工晶体(posterior chamber intraocularlens,PcIOL)前纤维蛋白膜形成之间的关系.方法测定31例白内障患者(病例组20只眼;对照组11只眼)白内障摘除联合PcIOL植入术前房水前列腺素E2(prostaglandin E2,PGE2)和蛋白含量,随访PcIOL植入眼术后前纤维蛋白膜形成的情况.分析房水PGE2和蛋白含量与前膜生成之间的关系.结果23只PcIOL植入眼中,病例组术后有5只眼出现前膜(5/13),对照组无1例出现前膜(0/10).前膜发生眼术前房水PGE2及蛋白含量显著高于无膜生成眼.病例组术前PGE2和蛋白含量均分别高于对照组和无膜生成眼.结论有青光眼和葡萄膜炎病史眼术前存在的血-房水屏障破坏与PcIOL前纤维蛋白膜生成有关.手术前后给予适量的抗前列腺素药物或皮质类固醇,将有利于防止前膜的生成或降低前膜生成率.     

黄芩苷在兔眼房水中的药代动力学研究

目的测定黄芩苷粉其标志成份黄芩苷能否通过白兔血-房水屏障,到达房水内及不同时间点房水中的质量浓度变化,计算其药代动力学参数,研究药代动力学特点。方法52只日本长耳白兔随机分为13组。除对照组外,其他12组为实验组。每组4只8眼。实验组每只白兔均灌服黄芩苷粉80 mg/kg,于给药后0.083 h、0.167 h、0.25 h、0.50 h0、.75 h、1 h1、.5 h2、h3、h5、h、8 h1、2 h给予前房穿刺取房水,采用高效液相色谱法(HPLC)进行测定,3P87软件拟合药代动力学参数。结果黄芩苷能透过兔眼血-房水屏障进入房水,但不同时间点黄芩苷在房水中的质量浓度均很微量,45 min达高峰,浓度为(0.221±0.030)mg/L。药代动力学参数,Tmax:0.75 h,T1/2a:1.174 h,AUC:0.063 9 mg/L,CL:0.002 63 mL/h。结论本方法灵敏、特异、准确,可用于房水中黄芩苷质量浓度的测定;灌服黄芩苷能透过兔眼血-房水屏障进入房水,这一结果为黄芩苷全身用药治疗眼前部疾病提供了实验依据。     

老年性白内障房水和泪液一氧化氮含量的研究

目的:探讨一氧化氮(Nitric oxide,NO)与老年性白内障发病之间的相关性。方法:应用NO酶法测定老年性白内障(32例)房水及泪液中NO的含量,以及裂隙灯检查无白内障的正常体检者(31例)泪液和角膜或角膜巩膜穿通伤患者(31例)房水中NO的含量。结果:裂隙灯检查无白内障的正常体检者泪液中NO平均含量为(24.39±8.32)mmol/L,角膜或角膜巩膜穿通伤患者房水中NO含量(86.12±23.28)mmol/L,老年性白内障组房水及泪液中NO含量较对照组明显升高(P<0.01)。结论:NO含量的增高与老年性白内障的发病有关。     

原发性开角型青光眼房水蛋白含量的检测及其与中医证型关系的研究

目的：探讨原发性开角型青光眼患者眼房水蛋白含量的改变及其与中医辨证分型之间的关系。方法采用溴甲酚绿比色法对128例128只眼原发性开角型青光眼和64例64只眼老年性白内障患者的房水蛋白进行了测定。结果开角型青光眼疾病分类各组及中医证型(肝郁气滞证、痰湿犯目证、肝肾阴虚证)各组均表现为房水白蛋白和总蛋白含量增高,与老年性白内障组相比,各组均有非常显著性差异(P＜0.01)。开角型青光眼疾病分类组间比较及中医证型组间比较,房水白蛋白和总蛋白含量亦均有显著性差异(P＜0.05)或非常显著性差异(P＜0.01)。结论原发性开角型青光眼患者的血-房水屏障功能遭到破坏,房水的粘度增加,房水淤积于眼内。     

实验性前部PVR血-房水屏障的改变

目的 通过房水蛋白浓度的测定,探讨实验性前部增生性玻璃体视网膜病变（anterior proliferative vitreoretinopathy,aPVR）病理状态下血－房水屏障的变化。方法 将培养的同种兔皮肤成纤维细胞10^5注入行睫状体平部穿通伤及晶状体切除后的兔眼睫状前区，制作前部PVR的动物模型，以行睫状体平部穿通伤及晶状体切除后的兔眼作为对照组，以不做手术的兔眼为正常组。于术后14、28、56d分别测定实验组和对照组房水蛋白的含量。结果 术后2周，实验组和对照组房水蛋白含量无明显差别，但均明显高于正常组；术后4周、8周实验组房水蛋白含量明显于对照组。结论 在aPVR病理状态下，血－房水屏障受到破坏，是引起低眼压的原因之一。     

正常眼组织各部及老年性白内障房水、晶体、血清微量元素测定

6个尸眼各部组织(正常眼球),老年性白内障晶体86个、房水34份,血清34份及正常晶体43个,正常房水14份,正常血清14份用高频等离子体发射光谱法(ICP-AES),催化极谱法(CP)测定,用原子吸收光谱法(AAS)进行对照测定,结果如下: 1.6个尸眼的Zn、Mg、Ca、Cu、Se含量以葡萄膜及视网膜最高,Zn含量以房水、视神经及晶体最低。 2.老年性白内障病人,晶体Zn较正常低,房水Cu、Ca较正常高,血清Zn较正常低,而Cu、Ca较正常高。 3.老年性白内障病人血清和晶体Cu的含量成正相关(r=0.373,P<0.05)。本研究对老年性白内障原因的探讨有意义。     

口服熊胆粉到达房水能力的实验研究

目的　探讨口服中药熊胆粉后,其标志成份牛磺熊脱氧胆酸(TUDCA)能否通过血-房水屏障到达房水内。方法　将5 6只家兔随机分成2组,对照组8只,给药组4 8只。给药组4 8只,随机分成6组,每组8只。空腹12h后给予熊胆粉10 0mg/mL灌胃,分别在灌胃后0 5、1,2、4、6、8h取其双眼房水。应用高效液相色谱仪(HPLC)法测定玻璃体内熊胆粉标记物熊脱氧胆酸(TUDCA)的质量浓度。结果　家兔灌胃后0 5、1、2、4、6、8h ,房水中TUDCA的分别为(2 3 70±1 4 1) μg/mL ,(35 16±3 6 3) μg/mL ,(41 5 1±2 83) μg/mL ,(47 78±4 6 9) μg/mL ,(32 38±5 2 4 ) μg/mL ,(44 72±7 4 8) μg/mL ,对照组几乎测不到TUDCA ,各时间点玻璃体内TUDCA浓度与对照组相比较差异具有显著性(P均<0 0 1) ,4h达高峰。结论　利用高效液相色谱仪法(HPLC)可准确测得房水中TUDCA的质量浓度;中药熊胆粉中主要成份TUD CA可透过血-房水屏障到达房水内。     

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.