HBDH/LDH比值变化与针刺对大鼠心肌损伤保护作用关系的研究

目的:观察HBDH/LDH比值及LDH、HBDH活性变化与针刺心包经穴对心肌缺血-再灌注损伤保护作用间的关系。方法:50只大鼠随机分为假手术组、缺血-再灌注模型组、针刺内关治疗组、针刺郄门治疗组、针刺合谷对照组5组,每组10只。假手术组只穿线不结扎冠状动脉,其余各组制备缺血-再灌注动物模型,其中3个针刺穴位组分别于电针刺大鼠内关穴、郄门穴或合谷穴20 min后,结扎冠状动脉左前降支40 min,心电图监测,再次电针刺上述穴位20 min,松扎,恢复冠脉灌流。假手术组于穿线后100 min、模型组和各针刺穴位组于再灌注后60 min,抽取静脉血,分离血清,观察HBDH/LDH比值及LDH、HBDH活性变化。结果:与假手术组比较,HBDH、LDH活性及HBDH/LDH比值在缺血-再灌注模型组均显著升高;针刺心包经穴(内关、郄门)组HBDH、LDH活性及HBDH/LDH比值明显降低,与缺血-再灌注模型组比较差异均具有统计学意义。结论:针刺能有效降低大鼠心肌缺血-再灌注心肌细胞的损伤程度。     

经皮穴位电刺激在乳腺手术麻醉中的应用

[目的]观察不同穴位组合下经皮穴位电刺激(TEAS)在乳腺肿物切除术静脉麻醉中的临床效果。[方法]将60例择期行单侧乳腺肿物切除术的女性患者,随机分为A、B两组(n=30):A组,静脉全麻+TEAS患侧内关穴、合谷穴;B组,静脉全麻+TEAS患侧内关透外关穴、合谷透劳宫穴、双侧肩井穴。用韩氏穴位电刺激仪进行穴位刺激后行静脉全麻,TEAS持续至术毕,观察并记录TEAS前、TEAS 30 min、麻醉后5 min、麻醉后10 min、手术切皮后5 min、手术结束、苏醒各时间点(分别表示为T1、T2、T3、T4、T5、T6、T7)的脑电双频谱指数(bispectral index,BIS)、心率(heart rate,HR)、平均血压(mean blood pressure,MBP)、Sp O2的变化及切皮时体动反应、苏醒质量,并对有关指标进行统计学分析。[结果](1)TEAS后30 min(T2),B组较A组的BIS值、HR、MBP明显降低,差异有统计学意义(P0.05);在苏醒时(T7),B组较A组BIS值高,差异有统计学意义(P0.05)。(2)麻醉全过程丙泊酚及芬太尼的总用量,B组明显低于A组,差异有统计学意义(P0.05)。[结论]经皮穴位电刺激有强化、协同镇静效应,能显著减少丙泊酚和芬太尼的用量,在全麻乳腺肿物切除术静脉麻醉中有辅助作用。而TEAS患侧内关透外关穴、合谷透劳宫穴及双侧肩井穴的临床效果优于常规穴位刺激,值得临床推广应用。     

针刺公孙穴对健康青年人大脑前动脉血流动力学安全性影响的研究

目的:通过经颅多谱勒超声仪(TCD)观测针刺公孙穴对健康青年人大脑前动脉(ACA)血流动力学各参数的影响变化,探讨针刺左侧公孙穴对ACA血流动力学的影响及其时效关系,奠定临床基础。方法:随机选取ACA血流量正常的健康青年志愿者16名,针刺左侧公孙穴,在针刺前10min、针刺得气时、留针行针后15min、出针时、出针后10min 5个时间点采用TCD检测左右侧ACA收缩期最大血流速度(Vs)、舒张期最大血流速度(Vd)、平均血流速度(Vm)、搏动指数(PI)及阻抗指数(RI)的变化,记录并进行统计学处理。结果:在不同时间点针刺公孙穴,ACA血流速度均无显著变化;PI、RI的变化亦无统计学意义(P>0.05)。结论:针刺左侧公孙穴对ACA血流动力学影响不显著,提示该穴具有安全性,但临床上不作为治疗ACA脑供血不全的首选穴位。     

针刺"醒神益智"组穴对脑静息态功能的影响

目的 应用功能磁共振成像(fMRI)技术研究针刺穴位、非穴位对大脑静息态功能网络的影响,从而为进一步阐释针刺的神经机制提供科学依据.方法 选取健康大学生20名,随机分为穴位组和非穴位组,穴位组针刺百会、双侧风池、双侧内关,非穴位组针刺上述各穴位旁开1.5~2.0 cm非穴位处.针刺30 min后,受试者即刻接受磁共振扫...     

红外激光针灸对垂体后叶素致家兔心动过缓的影响

目的观察红外激光照射内关穴对垂体后叶素致家兔心动过缓的影响。方法将自制复合激光治疗仪输出的10.6μmCO2红外激光和650nm半导体红色激光及二者聚合后的复合激光分别照射动物内关穴,分析红外激光与红色激光的效应差异及二者聚合照射的效应变化。结果10.6μmCO2红外激光内关组心率在垂体后叶素注射后30min和40min时与正常对照组比较,差异无统计学意义(P>0.05),而650nm半导体激光内关组心率在垂体后叶素注射后各时间点与正常对照组比较,差异有统计学意义(P<0.05)。复合激光内关组心率在垂体后叶素注射后30min与模型组比较,差异有统计学意义(P<0.05),与正常对照组比较,差异无统计学意义(P>0.05),而复合激光非穴组心率与模型组比较,差异无统计学意义(P>0.05),与正常对照组比较,差异有统计学意义(P<0.05)。结论10.6μmCO2红外激光照射内关穴对垂体后叶素致心动过缓有明显改善作用,而650nm半导体激光无明显效应,但二者有协同作用,CO2红外激光照射穴位产生的热效应可能有利于半导体红色激光的穿透及其生化反应的进行。内关穴激光照射对心率的改善作用具有相对特异性。     

针灸联合穴位注射预防化疗呕吐临床研究

目的:观察胃复安足三里穴位注射配合针刺内关穴防治化疗呕吐的临床疗效。方法:将56例化疗患者随机分为对照组和观察组,对照组肌肉注射胃复安治疗,观察组采用胃复安双侧足三里穴位注射配合针刺内关穴治疗。结果:对照组显效15例,有效8例,无效4例,有效率为85.19%;观察组显效18例,有效9例,无效2例,有效率为93.09%。观察组有效率高于对照组(P<0.05)。结论:胃复安足三里穴位注射配合针刺内关能显著的预防癌症化疗患者呕吐的作用。     

针刺内关、太冲得气对原发性高血压患者胰岛素抵抗、血脂及血清TNF-α水平影响

目的:观察针刺内关、太冲得气对原发性高血压患者胰岛素抵抗、血脂及血清TNF-α水平的影响,探讨针刺得气与疗效的关系。方法:按照诊断纳入标准收治180例原发性高血压患者为研究对象,采用随机数字表法随机分为3组,每组60例。针刺得气组取受试者右侧内关穴、太冲穴施以真实的针刺,假针刺对照组在相同穴位施以假针刺,药物对照组口服苯磺酸左旋氨氯地平片,疗程均为14 d。比较治疗前后3组患者的胰岛素抵抗、血脂及血清TNF-α水平,并评价3种方法的临床治疗效果。结果:(1)针刺得气组、药物对照组、假针刺对照组总有效率分别为75.44%、85.00%、8.93%,针刺得气组与药物对照组差异无统计学意义,均显著高于假针刺对照组。(2)治疗前3组患者ISI、TNF-α比较无明显差异;治疗后针刺得气组、药物对照组ISI水平显著上升,TNF-α水平显著下降,但两组间比较无显著差异;假针刺对照组治疗前后相关指标无显著变化。(3)治疗前3组患者TG、TC、LDL、HDL水平无显著差异,治疗后针刺得气组、药物对照组TG、TC、LDL水平均显著下降,但两组间比较无显著差异,HDL水平均显著上升,且后者显著优于前者;假针刺对照组治疗前后相关指标无显著变化。结论:针刺内关、太冲得气可以改善原发性高血压患者胰岛素抵抗状态,降低血脂及血清TNF-α水平,效果与药物治疗相当,但假针刺相同穴位对上述指标无显著影响。     

不同经穴针刺对自发性高血压大鼠降压效应的观察

【目的】探讨不同经穴针刺对自发性高血压大鼠(SHR)的降压效应及累积效应。【方法】将105只SHR随机分为模型组、非穴组、内关组、太冲组、光明组、太溪组、蠡沟组,每组15只。各针刺组以毫针刺入相应穴位后,留针30 min,每日1次,共15次;模型组不予针刺。各组大鼠分别在针刺l、3、7、15 d时进行血压测量。【结果】非穴针刺无明显降压作用。针刺3、7、15 d时,太冲组、内关组、光明组SHR收缩压(SBP)、舒张压(DBP)、平均动脉压(MBP)下降幅度均显著大于模型组,差异有统计学意义(P0.05);针刺15 d时,太冲组SBP降幅显著优于内关组、蠡沟组、太溪组、光明组,差异有统计学意义(P0.05);太冲组DBP、MBP降幅显著高于太溪组、光明组(P0.05),与内关组、蠡沟组大鼠DBP比较差异无统计学意义(P0.05)。与治疗前比较,针刺1、3、7、15 d时,太冲组SBP、DBP、MBP显著下降,差异均有统计学意义(P0.05),其中针刺15 d时SBP降幅优于针刺1 d、3 d、7 d,DBP、MBP降幅优于针刺1、3 d,差异均有统计学意义(P0.05)。【结论】针刺太冲穴对SHR血压的调节作用优于针刺内关、太冲、光明、太溪、蠡沟等单穴和"非穴",且针刺降压作用具有一定的时间累积效应。     

针刺干预心肌缺血-再灌注损伤大鼠过程后离体心肌细胞凋亡的变化分析

目的 观察分析针刺在缺血-再灌注损伤过程后对大鼠离体心肌细胞凋亡的变化。方法 随机将24只清洁级Wistar大鼠分为假手术组、模型组、针刺Ⅰ组(内关组)、针刺Ⅱ组(郄门组)、针刺Ⅲ组(合谷组),针刺Ⅳ组(抑制剂组),每组各4只。假手术组单纯打开大鼠胸腔,冠状动脉左前降支不行结扎术,只做穿线。模型组按照动物模型建立方法进行造模,不进行干预,全程监测心电图。内关组、郄门组和合谷组在结扎冠状动脉前分别电针大鼠内关、郄门和合谷穴各20 min,然后结扎40 min,并记录心电图变化,40 min后各组再次电针上述穴位20 min,恢复冠状动脉血流,灌流60 min。抑制剂组麻醉成功后,尾静脉注射磷脂酰肌醇3-激酶抑制剂LY294002(0.3 mg/kg),余法同内关组。假手术组在试验开始100 min、模型组与内关组、郄门组、合谷组、抑制剂组于恢复灌流后60 min,在体实验结束,保存处理心脏标本,分离培养心肌细胞,采用流式细胞术分析心肌细胞凋亡率。结果 内关组和郄门组同模型组、合谷组相比较,离体心肌细胞凋亡率明显降低,差异有统计学意义(P<0.01);抑制剂组心肌细胞凋亡率高于内关组...     

针刺内关对失血性休克家兔血压和心泵功能的影响

本文研究分析了35只家兔在失血性休克后针刺内关和非穴对照点对血压、心泵功能的影响。结果表明:针刺内关可升高血压,MAP由休克时的5.41±0.27上升到9.96±0.27kPa(P<0.001)。SV由休克时的0.39±0.12增加到0.64±0.19ml,SI、CI等比休克时明显增大(P<0.001)。在内关组与非穴位对照组之间抗休克效应有相对特异性。本文认为针刺内关穴通过改善心泵功能、升高血压,有抗休克作用,这在针刺防止休克发展的过程中具有重要意义。     

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.