乳癖安消胶囊对实验乳腺增生大鼠性激素及其受体的影响

目的观察乳癖安消胶囊对实验性乳腺增生大鼠的雌激素、孕激素及其相应受体的影响,为乳癖安消胶囊的临床运用提供依据。方法SD大鼠90只,随机分为6组:正常组、模型组、三苯氧胺组和乳癖安消胶囊大、中、小剂量组,每组15只。以肌注外源性苯甲酸雌二醇及黄体酮的方法复制大鼠乳腺增生模型,用放射免疫方法测定各组实验性大鼠模型血浆中雌二醇(E2)、孕酮(P)的含量,免疫组化方法观察乳腺组织中雌激素受体(ER)和孕激素受体(PR)的变化。结果乳癖安消胶囊能降低实验性乳腺增生大鼠的血清E2水平;也能降低乳腺组织ER、PR含量,使乳腺组织对雌激素的敏感性下降。结论乳癖安消胶囊通过降低实验大鼠血清E2水平和乳腺组织ER、PR含量而起到抑制乳腺增生的作用。     

乳癖舒对乳腺增生病大鼠的治疗作用

目的 通过观察乳癖舒对乳腺增生大鼠性激素和乳腺组织的影响,从而了解乳癖舒对乳腺增生大鼠的治疗作用.方法 采用苯甲酸雌二醇和黄体酮肌注造模30 d后,分别用三苯氧胺、逍遥散和乳癖舒治疗30 d,同时继续肌注雌二醇.采用放射免疫法测定血清中雌二醇(E2)和孕酮(P)含量.取乳房组织行HE染色,光镜观察病理变化.结果 乳癖舒、三苯氧胺、逍遥散可减少乳腺增生病大鼠乳腺小叶腺泡数,缩小腺泡腔和小叶导管直径;并使血清E2水平和雌二醇/孕酮比例(E2/P)降低.结论 乳癖舒可通过调节乳腺增生大鼠的性激素水平,改善增生乳腺的形态学变化而有效对抗雌激素引起的大鼠乳腺增生.     

三苯氧胺与乳癖散结在乳腺增生中的临床应用

目的 观察三苯氧胺和乳癖散结在乳腺增生中的药物效果和不良反应.方法 将766例乳腺增生按轻、重度分类,轻度随机分为A、B两组,分别单用乳癖散结和三苯氧胺;重度随机分为C、D、E、F四组,C组口服乳癖散结,D、E两组服用不同剂量三苯氧胺,F组联合应用乳癖散结和三苯氧胺.结果 轻度组疗效差异无统计学意义,不良反应A组最少(P<0.05),重度E、F组疗效相当均优于C、D组,F组和C、D组不良反应相比差异均无统计学意义,但均少于E组(P<0.05).结论 轻度乳腺增生单服乳癖散结即可,建议不用三苯氧胺;重度组联合应用乳癖散结和三苯氧胺效果好,不良反应少,临床可以考虑应用.     

消瘀通络散对乳腺增生大鼠乳头的动态变化、血清雌二醇、雌激素受体表达水平及病理组织形态的影响

[目的]观察自拟消瘀通络散对乳腺增生大鼠乳头高度、直径的动态变化、血清E2、ER蛋白表达水平及病理组织形态的影响,探讨其治疗乳腺增生的作用机制。[方法]将40只Wistar大鼠随机分为正常组、模型组、中药组和西药组4组。采用己烯雌酚联合黄体酮肌注的方法进行造模。中药组予自拟消瘀通络散50mg/d,西药组予三苯氧胺1.8mg.kg-1,均灌胃治疗,1次/d,共30d。用精密游标卡尺于造模前后、治疗前、治疗10、20、30d分别测量大鼠第2对乳头高度和直径,测定血清E2水平及ER蛋白表达水平,取大鼠第2对乳房常规HE染色,光镜下观察组织形态表现。[结果]治疗前及治疗10、20、30d4组大鼠第2对乳头直径、高度的比较:造模成功后,中药组、西药组、模型组均高于正常组(P0.05);治疗10、20、30d后,模型组明显高于正常组(P0.05);中药组和西药组均低于模型组(P0.05);中药组低于西药组(P0.05);中药组与正常组相比无显著性差异(P0.05)。E2含量比较:中药组和西药组均低于模型组(P0.05),中药组和西药组比较无显著性差异(P0.05)。ER蛋白表达水平比较:中药组和西药组均低于模型组(P0.05);中药组低于西药组(P0.05)。病理学比较:中药组和西药组大鼠乳腺组织的病理表现相似,与模型组比较改善明显,与正常组相近。[结论]自拟消瘀通络散具有缩小模型大鼠乳头直径、高度,降低血清中E2、ER蛋白表达水平和改善乳腺组织病理形态的作用。     

解毒胶囊对乳腺增生大鼠PCNA和BcL-2表达影响

目的:探究解毒胶囊对乳腺增生大鼠乳腺组织中PCNA和Bcl-2表达的影响。方法:选取50只SD雌性未孕大鼠,将其随机分为正常组、模型组、乳癖消组、三苯氧胺组和方药组,每组10只。4周后用western-blotting和QPCR法检测各组大鼠乳腺组织PCNA和Bcl-2表达情况。结果:与正常组比较,模型组PCNA和Bcl-2表达量均增高(P0.01);治疗组较模型组PCNA和Bcl-2表达量均减弱(P0.01,P0.05),相较于乳癖消组,方药组与三苯氧胺组减弱更为明显(P0.01,P0.05),其比较结果均有统计学差异;三苯氧胺组与方药组差异无统计学意义(P0.05)。结论:解毒胶囊可能通过影响乳腺增生大鼠乳腺组织PCNA和Bcl-2的表达来实现治疗乳腺增生症的目的。     

疏肝通络方干预乳腺增生大鼠的实验研究

目的 观察疏肝通络方对乳腺增生大鼠的作用及其作用机制.方法 未孕雌性Wistar大鼠84只,随机分为空白对照组、模型组、三苯氧胺对照组、乳癖消对照组和疏肝通络方大、中、小剂量组,每组12只.苯甲酸雌二醇和黄体酮肌注复制乳腺增生模型,给药30 d.观察大鼠乳腺组织形态,乳腺小叶及腺泡数目和直径;血清激素雌二醇(E_2)、孕酮(P)、泌乳素(PRL)、黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T);乳腺组织雌激素受体(ER)、孕激素受体(PR);子宫和卵巢组织形态.结果 疏肝通络方各组均能明显减少乳腺小叶数量和乳腺腺泡数量及直径,与模型组比较有显著性差异(P＜0.01);能降低乳腺增生大鼠血清E_2的含量,与模型组比较有显著性差异(P＜0.01);大、中剂量组能提高P的含量,与模型组比较有显著性差异(P＜0.05);大剂量组能降低PRL含量,与模型组比较有显著性差异(P＜0.05);对FSH、LH、T的影响不明显,与模型组比较无显著性差异(P＞0.05).疏肝通络方大、中剂量组均能下调乳腺增生大鼠ER、PR的表达,分值与模型组比较有显著性差异(P＜0.05,P＜0.01),与三苯氧胺组比较无显著性差异(P＞0.05);疏肝通络方对乳腺增生模型大鼠的子宫、卵巢组织异常增生有改善作用.结论 中药疏肝通络方对乳腺增生大鼠有明显的改善作用,其作用机制与调节内分泌激素紊乱、抑制乳腺组织雌、孕激素受体的高表达等有关.     

疏肝健脾方对乳腺增生病大鼠血清性激素及ER、PR表达的影响

目的 通过观察中药疏肝健脾方对乳腺增生病大鼠乳腺组织形态和血清性激素及其受体的影响,探讨疏肝健脾方防治乳腺增生病的机制.方法 选用SPF级雌性Wistar大鼠60只,随机分为空白对照组、疾病模型组、三苯氧胺组、小剂量药物组、大剂量药物组,采用苯甲酸雌二醇和黄体酮建立乳腺增生动物模型,分别灌服三苯氧胺、大小剂量疏肝健脾方煎液,观察大鼠乳腺组织形态和血清性激素及其受体的变化.结果 疏肝健脾方能够可使乳腺小叶腺泡数明显减少、腺泡腔缩小及腺导管扩张程度减轻,降低乳腺增生大鼠血清雌二醇(E2)、垂体促乳素(PRL)含量,升高孕激素(P)、睾酮(T)含量,部分升高FSH和LH的含量.明显抑制ER、PR的阳性表达强度.结论 疏肝健脾方可通过调节乳腺增生大鼠的性激素水平,降低实验大鼠乳腺组织中ER、PR含量,使其对雌激素的敏感性下降,对大鼠乳腺增生有明显的抑制作用.     

消癖汤治疗60例乳腺增生病临床观察

目的：观察自拟消癖汤治疗乳腺增生病的临床疗效。方法：对60例乳腺增生病患者运用自拟方消癖汤加减治疗，并与三苯氧胺治疗60例对比观察。结果：治疗组治愈33例，治愈率54．15％，总有效率93．16％；对照组治愈17例，治愈率为28．33％，总有效率为83．33％，2组治愈率比较，差异有显著性意义（P〈0．05）。在症状改善方面，中药治疗组也优于西药治疗组，并无明显不良反应。结论：消癖汤对治疗本病有较好疗效。     

消瘀通络散对乳腺增生大鼠乳头高度、直径、E2、ER蛋白表达水平及病理组织形态的影响

目的：观察自拟消瘀通络散对乳腺增生大鼠乳头高度、直径、血清雌二醇（E2）、ER蛋白表达水平及病理组织形态的影响,探讨其治疗乳腺增生的作用机制。方法：将40只Wistar大鼠随机分为正常组、模型组、中药组和西药组4组。采用乙烯雌酚联合黄体酮肌注的方法进行造模。中药组予自拟消瘀通络散50mg／d,西药组予三苯氧胺1．8ms／ks,均灌胃治疗,1次／d,共30d。于治疗前后测量各组大鼠第2对乳头直径、高度,于治疗后测定血清E2水平,取大鼠第2对乳房常规HE染色,光镜下观察组织形态表现及ER蛋白表达水平。结果：治疗后乳头直径、高度比较：中药组和西药组均低于模型组（P〈0．05）;两组之间比较,中药组低于西药组（P〈0．05）。E2含量比较：中药组和西药组均低于模型组（P〈0．05）,中药组和西药组比较差异无显著性（P〉0．05）。ER蛋白表达水平比较：中药组和西药组均低于模型组（P〈0．05）;中药组低于西药组（P〈0．05）。病理学比较：中药组和西药组大鼠乳腺组织的病理表现相似,较模型组改善明显,与正常组相近。结论：自拟消瘀通络散具有缩小模型大鼠乳头直径、高度,降低血清中E2和改善ER蛋白表达水平、乳腺组织病理形态的作用。     

乳癖消联合三苯氧胺治疗乳腺囊性增生病96例疗效评价

目的研究乳癖消联合三苯氧胺治疗乳腺囊性增生病的疗效。方法病例来源:2013年4月-2015年5月在我院接受治疗的96例乳腺囊性增生病女性患者。患者分组方法:分层随机化法。96例患者分为a组和b组两个组别。a组单用三苯氧胺进行治疗;b组采用乳癖消联合三苯氧胺进行治疗。观察指标:(1)总有效率;(2)治疗前和治疗后患者肿块大小、激素LH、E2、P水平的差异。结果 (1)b组相比于a组总有效率更高,?2统计处理有显著差异,P0.05;(2)治疗前两组肿块大小、激素LH、E2、P水平相似,t统计处理无显著差异,P0.05;治疗后b组相比于a组肿块大小、激素LH、E2、P水平改善更显著,t统计处理有显著差异,P0.05。结论乳癖消联合三苯氧胺治疗乳腺囊性增生病效果确切,可有效缩小肿块,改善患者激素水平,值得推广。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.