—低氧对大鼠肺血管重建及血浆内皮素—1影响的实验研究

目的：探讨低氧对肺动脉压、肺血管重建及对内皮素－１（ＥＴ－１）的影响。方法：将３０只雄性Ｗｉｓｔａｒ大鼠随机两组：①对照组；②低氧组，每天８ｈ，共４周，４周后观察平均肺动脉压力（ｍＰＡＰ），右心室游离壁（ＲＶ）／左心室＋室间隔（ＬＶ＋Ｓ）。通过图像分析仪测量肺小动脉管壁厚度占外径百分比（ＭＴ％）、管理面积占血管总面积的百分比（ＭＡ％）及血浆中ＥＴ－１的水平。结果：①低氧组大鼠较正常对照组ｍＰＡＰ明     

L-精氨酸干预低氧性肺血管结构重构机制的研究

探讨Ｌ－精氨酸干预低氧性肺血管结构重构的机制。方法将１８只Ｗｉｓｔａｒ大鼠采用区组随机法分为对照组、低氧组和低氧＋Ｌ－Ａｒｇ组。以右心导管法测定肺动脉压力,并对大示本进行显微结构观测和超微结构观察,同时分光光度法间接测定血浆一氧化氮（ＮＯ）含量,并对肺组织以内皮素－１（ＥＴ－１）ｃＲＮＡ探针进行原位杂交,研究肺动脉内皮细胞ＥＴ－１ｍＲＮＡ的表达。结果低氧组大鼠肺动脉平均压（ｍＰＡＰ）为２．７１ＫＰ     

血管内皮细胞生长因子与高原肺水肿发病的关系

目的 探讨血管内皮细胞生长因子（ＶＥＧＦ）表达变化在高原肺水肿发病、高原习服－适应中的意义。方法 培养大鼠肺动脉血管内皮细胞,采用ＲＴ－ＰＣＲ方法和酶联免疫吸附（ＥＬＩＳＡ）方法分别观察低氧（体积分数为１％的Ｏ２）细胞及培养液中ＶＥＧＦ表达变化;将大鼠分为５组,分别模拟不同海拔高度、不同时间进行间断低氧习服,每天４ｈ,间断低氧习服后的大鼠再进行急性低氧（８０００ｍ,４ｈ）。用免疫组织化学及ＲＮＡ狭缝杂交方法测定急性低氧和低氧习服不同时间、不同海拔高度大鼠肺组织ＶＥＧＦ变化,并对肺组织切片进行初步病理分析;采用ＥＬＬＳＡ方法测定大鼠、高原移居者及高原肺水肿患者治疗前后血浆中ＶＥＧＦ水平。结果 低氧时大鼠肺动脉血管内皮细胞ＶＥＧＦ表达水平明显升高（Ｐ〉０．０１）;低氧大鼠（包括急性低氧组及间断低氧习服组）血头及肺组     

慢性低氧性肺动脉高压大鼠肺内血管内皮生长因子表达的变化

为了解低氧对肺内血管内皮生长因子（ＶＥＧＦ）基因表达的影响及ＶＥＧＦ在肺动脉高压发生中的作用，以常压低氧建立大鼠肺动脉高压模型，采用Ｅｌｉｓａ法检测大鼠肺动脉血血清ＶＥＧＦ的含量改变，以体外转录并用ＤＩＧ－ＵＴＰ标记的ＶＥＧＦｃＲＮＡ探针进行肺组织原位杂交，检测大鼠肺内ＶＥＧＦｍＲＮＡ表达的变化。结果发现：低氧３周后，大鼠形成明显的肺动脉高压；大鼠肺动脉血血清中ＶＥＧＦ含量在低氧３周组为４２０．３±７３．１ｐｇ／ｍｌ，明显高于对照组的３２２．２±５８．１ｐｇ／ｍｌ（Ｐ＜０．０１）；原位杂交显示，低氧大鼠肺小动脉管壁出现明显的ＶＥＧＦｍＲＮＡ表达，说明低氧在引起肺动脉高压的同时可刺激肺小动脉管壁，使ＶＥＧＦｍＲＮＡ表达增强，导致ＶＥＧＦ的合成和分泌增加，后者可能在低氧性肺动脉高压发生过程中起一定的作用。     

血管内皮生长因子在低氧性肺动脉高压大鼠肺内的分布和水平变化

为了解低氧性肺动脉高压时肺内血管内皮生长因子（ＶＥＧＦ）的改变及其意义，以常压低氧建立大鼠肺动脉高压模型，采用免疫组织化学染色法和Ｅｌｉｓａ法检测模型大鼠肺内ＶＥＧＦ的分布和含量变化。结果显示：低氧３周后大鼠形成明显的肺动脉高压；大鼠肺匀浆内ＶＥＧＦ含量在低氧３周组为４６６．９±７５．５ｐｇ／ｇ，明显高于对照组（３７６．２±４７．１ｐｇ／ｇ）；肺小动脉内膜的ＶＥＧＦ免疫组化染色阳性在低氧大鼠组明显增强。提示低氧在引起肺动脉高压的同时，可强烈刺激ＶＥＧＦ的合成和分泌，后者可能在低氧性肺血管重建过程中发挥重要的作用。     

川芎嗪对缺氧肺动脉高压大鼠血浆内皮素、降钙素基因相关肽水平的影响

用酶免疫检测法测定缺氧３周大鼠血浆内皮素－１（ＥＴ－１）、降钙素基因相关肽（ＣＧＲＰ）含量，研究缺氧肺动脉高压（ＨＰＨ）大鼠血浆ＥＴ－１、ＣＧＲＰ水平及川芎嗪对其影响。结果表明，缺氧可使血浆ＥＴ－１水平升高，血浆ＣＧＲＰ水平降低，ＥＴ－１和ＣＧＲＰ与ＨＰＨ形成密切相关，ＣＧＲＰ／ＥＴ－１比值失衡可能是ＨＰＨ发生发展的重要因素之一；川芎嗪对ＨＰＨ的形成有预防作用，此预防作用可能与纠正失衡的ＣＧＲＰ／ＥＴ－１比值有关。     

川芎嗪对缺氧肺动脉高压大鼠血浆内皮素,降钙素基因相？…

用酶免疫检测法测定缺氧３周大鼠血浆内皮素－１（ＥＴ－１）。降钙素基因相关肽（ＣＧＲＰ）含量，研究缺氧肺动脉高压（ＨＰＨ）大鼠血浆ＥＴ－１、ＣＧＲＰ水平及川芎嗪对其影响。结果表明，缺氧可使血浆ＥＴ－１水平升高，血浆ＣＧＲＰ水平降低，ＥＴ－１和ＣＧＲＰ与ＨＰＨ形成密切相关，ＣＧＲＰ／ＥＴ－１比值失衡可能是ＨＰＨ发生发展的重要因素之一；川芎嗪对ＨＰＨ的形成有预防作用，此预防作用可能与纠正失衡的ＣＧＲＰ／     

一氧化氮合成抑制剂对犬体内外内皮素－1分泌的影响

研究了一氧化氮在整体动物及培养的内皮细胞对内皮素－１分泌的影响。用药前缺氧时麻醉犬的肺动脉平均压（ｍＰＡＰ）、肺血管阻力（ＰＶＲ）及股动脉血浆内皮素－１（ＥＴ一１）分别为３．３±０．４ｋＰａ（１ｍｍＨｇ＝０．１３３ｋＰａ）、６８．７±１０．２ｋＰａ·ｓ／Ｌ、４７．２±１７．４ｎｇ／Ｌ。用一氧化氮合成酶抑制剂ＮＧ－硝基－Ｌ－精氨酸甲酯（Ｌ－ＮＡＭＥ）可使急性缺氧时的ｍＰＡＰ和ＰＶＲ增加到４．９±０．６ｋＰａ和１６０．９±３４．６ｋＰａ·ｓ／Ｌ（Ｐ均＜０．０１），其作用维持３小时，用药后６０、１２０、１８０分钟缺氧时的ＥＴ一１分别升高到６８．２±２０．６、７２．８±２０．９、７５．８±２２．７ｎｇ／Ｌ，Ｐ均＜０．０５。对人脐静脉内皮细胞的研究结果显示，１０－１１ｍｏｌ／Ｌ及１０－７ｍｏｌ／ＬＬ－ＮＡＭＥ均可显著增加培养基中的Ｅｒ－１浓度（Ｐ＜０．０５）。结果提示一氧化氮可抑制缺氧性肺血管收缩及ＥＴ－１的分泌。     

长程吸入一氧化氮对大鼠缺氧性肺动脉高压的影响

目的探讨长程吸入一氧化氮（ＮＯ）对慢性缺氧性肺动脉高压的阻抑效应及其机制。方法将３２只雄性Ｗｉｓｔａｒ大鼠分为（１）正常对照组;（２）缺氧组;每天缺氧１２小时,共３周;（３）吸入ＮＯ组：缺氧同时每天吸入２０ｐｐｍＮＯ１２小时,共３周。观察肺动脉压力、右心室肥厚、血浆内皮素－１（ＥＴ－１）和环磷酸鸟苷（ｃＧＭＰ）变化以及肺组织病理学改变。结果（１）缺氧组大鼠肺动脉压力明显升高（４．３±０．９ｋＰａ）,右心室肥厚显著（Ｐ均＜０．００１）,吸入ＮＯ组肺动脉压力降低（３．０±０．４ｋＰａ）,右心室肥厚减轻;（２）缺氧组腺泡内肌型肺动脉增多,无肌肺动脉明显减少,与对照组相比,差异显著（Ｐ＜０．０１）,吸入ＮＯ组明显改善三型血管比例失调。（３）缺氧组血浆ＥＴ－１含量明显升高,（１９７±１５ｐｇ／ｍｌ）,ｃＧＭＰ水平显著降低。吸入ＮＯ组ＥＴ－１含量降低（１６３±１４ｐｇ／ｍｌ）;ｃＧＭＰ含量升高。结论长程吸入２０ｐｐｍＮＯ能阻抑慢性缺氧性肺动脉压力升高,且无明显毒副作用。     

内皮素受体拮抗剂对低氧性肺动脉高压的影响

为了探讨内皮素（ＥＴ）在低氧性肺动脉高压发病中的作用和评价ＥＴＡ受体拮抗剂的预防效应,将３０只Ｗｉｓｔａｒ大鼠分为对照组,低氧组和低氧＋ＢＱ－１２３组,以常压低氧复制大鼠动脉高压模型,采用微导管法测定肺动脉平均压、放射免疫法检测血浆ＥＴ－１含量对肺组织切片进行图象分析。结果发现：低氧３周后,大鼠形成明显的肺动脉高压,肺小动脉管壁增厚和右心室肥厚,ＷＴ％和ＷＡ％均明显升高,低氧大鼠血浆ＥＴ－１含量为     

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.