人参二醇皂甙对沙土鼠急性脑缺血再灌注损伤的保护作用

用结扎蒙古沙土鼠双侧颈总动脉制成的急性脑缺血－再灌注损伤模型研究人参二醇皂甙（ＰＤＳ）对损伤的保护作用。实验观察了脑缺血４０ｍｉｎ再灌注１ｈ后脑内的丙二醛（ＭＤＡ）含量、超氧化物歧化酶（ＳＯＤ）、谷胱甘肽过氧化物酶（ＧＳＨ－Ｐｘ）、乳酸脱氢酶（ＬＤＨ）活性及脑水含量的变化。结果发现ＰＤＳ２００ｍｇ／ｋｇ缺血前３０ｍｉｎｉｐ能明显保护脑组织ＳＯＤ、ＧＳＨ－Ｐｘ及ＬＤＨ活性（Ｐ）值分别为Ｐ＜０．００１，Ｐ＜０．０１，Ｐ＜０．０１，Ｐ＜０．０１），抑制ＭＤＡ生成（Ｐ＜０．００１），减轻脑水肿（Ｐ＜０．０５）。结果表明ＰＤＳ对急性脑缺血－再灌注损伤具有保护作用，其作用机理可能与抑制自由基及脂质过氧化作用有关。     

血清CPK,LDH,GOT和LAP活性地急性颅脑损伤的诊断价值

对８０例急性颅脑损伤患者血清ＣＰＫ、ＬＤＨ、ＧＯＴ和ＬＡＰ活性进行了测定，结果显示，急性颅脑损伤后血清ＣＰＫ和ＬＤＨ活性显著升高（Ｐ〈０．０５），而血清ＧＯＴ和ＬＡＰ活性升高不明显（Ｐ〉０．０５），至于血清酶活性判断急性颅脑损伤的脑损伤程度和患者预后的价值有继续探讨。     

自身免疫病血瘀证患者自由基损伤的研究

本文检测了３８例自身免疫病患者红细胞超氧化物歧化酶活性（Ｅｒｙ－ＳＯＤＡ），全血谷脱甘肽过氧化物醇（ＧＳＨ－Ｐｘ）活性及血浆丙二醛（ＭＤＡ）含量。结果表明；与正常对照组比较，自身免疫病组Ｅｒｙ－ＳＯＤＡ显著下降，ＧＳＨ－Ｐｘ活性和ＭＤＡ含量明显升高。血瘀证组与非血瘀证组比较，ＧＳＨ－Ｐｘ活性升高具有显著意义，（Ｐ＜０．０１），而Ｅｒｙ－ＳＯＤＡ降低和ＭＤＡ升高经统计学处理无显著意义（Ｐ＞０．０５）。提示自身免疫病的发生、发展与自由基损伤有密切关系，并且血瘀证患者自由基损伤程度更加严重。     

心肌缺血再灌注损伤时乳酸脱氢酶活性的改变和川芎嗪的保护作用

观察了２０只家兔心肌缺血再灌注损伤时乳酸脱氢酶（ＬＤＨ）活性的变化及川芎嗪对它们的影响。结果显示，非保护组血清ＬＤＨ活性进行性升高（Ｐ＜０．０１），心肌组织ＬＤＨ活性明显下降（Ｐ＜０．０５）；川芎嗪保护组变化不明显，心肌组织ＬＤＨ活性明显高于非保护组（Ｐ＜０．０５）。表明川芎嗪有保护作用。同时探讨了其可能机理。     

Change of Hydroxyl Radical Content in Isolated Rat Heart Perfused with Adriamycin and the Influence of Cordyceps Sinensis Alc

本实验采用Ｌａｎｇｅｎｄｏｒｆ大鼠离体心脏灌流模型，以水杨酸为捕捉剂，利用其与阿霉素灌流时产生的ＯＨ·反应生成的羟苯甲酸（ＤＨＢＡ）为指标，用高效液相色谱法（ＨＰＬＣ）检测了阿霉素损伤时冠脉流出液和心肌组织中ＤＨＢＡ含量，初步探讨了阿霉素性心肌损伤和ＯＨ·的关系。同时用生化方法测定了冠脉流出液中乳酸脱氢酶（ＬＤＨ）含量，作为心肌损伤的参考指标。并且观察了冬虫夏草醇提取物（ＣＳＡＥ）预灌注时对ＯＨ·生成量和ＬＤＨ漏出量的影响。结果表明：１５ｍｇ／Ｌ阿霉素灌注时，冠脉流出液和心肌组织中ＯＨ·含量显著增加，损伤加重；而使用０．４ｇ／ＬＣＳＡＥ预灌时，ＯＨ·含量明显下降，损伤减轻（Ｐ均＜０．０１）。ＬＤＨ与冠脉流出液及心肌组织中ＯＨ·含量均呈正相关（γ分别为０．９２２和０．９４９）。提示：①阿霉素性心肌损伤和ＯＨ·的产生增多有关。②ＣＳＡＥ能拮抗ＯＨ·的产生或清除已产生的ＯＨ·，具有保护作用。     

心肌缺因再灌注损伤时乳酸脱氢酶活性的改变和川芎嗪的保护作用

观察了２０只家兔心因再灌注损伤时乳酸氢酶（ＬＤＨ）活性的变化及川芎嗪对它们的影响，结果显示，非保护组血清ＬＤＨ活性进行性升高（Ｐ〈０．０１），心肌组织ＬＤＨ省城与明显下降Ｐ〈０．０５；川芎嗪保护组变化不明显，心肌组织ＬＤＨ活性明显高于非保护组（Ｐ〈０．０５）。表明川芎嗪有保护作用，同时探讨了其可能机理。     

绝经前后妇女性激素水平与血脂和免疫的关系

测定９６例绝经前后无冠心病（ＣＨＤ）妇女的性激素、血脂和免疫蛋白水平，并对１８例绝经后妇女进行尼尔雌醇干预治疗。结果显示：绝经后妇女的Ｅ２，Ｅ２／Ｔ，ＨＤＬ及ＡｐｏＡＩ降低，Ｔ，ＴＧ，ＴＣ，ＬＤＬ－Ｃ，ＡｐｏＢ，Ｌｐ（ａ），ＩｇＧ及ＡｃＡＩｇＧ升高；Ｅ２与ＨＤＬ－Ｃ呈正相关，与ＴＣ，ＡｐｏＢ，Ｌｐ（ａ），ＬＤＬ－Ｃ，ＩｇＧ，ＡｃＡＩｇＧ呈负相关；Ｔ与ＬＤＬ－Ｃ，ＩｇＧ，ＡＣＡＩｇＧ呈正相关，与ＨＤＬ－Ｃ呈负相关；尼尔雌醇治疗后ＴＧ，ＴＣ，ＬＤＬ－Ｃ，ＩｇＧ，ＡＣＡＩｇＧ下降，ＨＤＬ－Ｃ上升。提示Ｅ２是ＣＨＤ保护性因子。绝经后Ｅ／Ｔ比例失调，使ＣＨＤ发病危险性增加，而尼尔雌醇是绝经后妇女防治ＣＨＤ有效的雌激素替代剂     

内源性高甘油三酯血症患者血浆高密度脂蛋白亚类分析

内源性高甘油三酯血症（ＨＴＧ）常伴血浆ＨＤＬ－Ｃ含量下降及ＨＤＬ组成异常。为了研究ＨＴＧ患者血浆ＨＤＬ亚类的改变,作者建立了密度梯度聚丙烯酰胺梯度凝胶电泳法（ＧＧＥ）,对２５例ＨＴＧ患者（血浆ＴＧ＞２．２６ｍｍｏｌ／Ｌ,ＴＣ＜６．７２ｍｍｏｌ／Ｌ）及２５例年龄、性别匹配的血脂正常者（血浆ＴＧ＜１．６９ｍｍｏｌ／Ｌ,ＴＣ＜５．１７ｍｍｏｌ／Ｌ）的ＨＤＬ亚类——ＨＤＬ２ａ、ＨＤＬ２ｂ、ＨＤＬ３ａ、ＨＤＬ３ｂ和ＨＤＬ３ｃ进行了分析,同时对血浆及ＨＤＬ中脂质及载脂蛋白（ａｐｏ）ＡⅠ、ＡⅡ、Ｂ１００、ＣⅡ、ＣⅢ及Ｅ进行了测定。结果发现,ＨＴＧ患者空腹血浆ＴＧ、ａｐｏＢ１００、ａｐｏＣⅡ、ａｐｃＣⅢ及ａｐｏＥ显著增加（Ｐ＜０．００１）,ＨＤＬ－Ｃ及ａｐｏＡⅠ显著降低（Ｐ＜０．００１及Ｐ＜０．０５）;患者血浆ＨＤＬ组成异常,ＨＤＬ中ＴＧ含量显著增加（Ｐ＜０．００１）,ＴＣ、ａｐｏＡⅠ、ａｐｏＣⅡ、ａｐｏＣⅢ及ａｐｏＥ含量下降（Ｐ＜０．０１）;患者血浆ＨＤＬ亚类含量改变,ＨＤＬ２ｂ显著降低（Ｐ＜０．０２）,ＨＤＬ２ａ及ＨＤＬ３ａ增加（Ｐ＜０．０５）,且随血浆ＴＧ含量的升高而升高,ＨＤＬ３ｂ及ＨＤＬ３ｃ则未见改变     

大鼠睾丸乳酸脱氢酶同工酶－C_4的分离纯化研究

采用加热、硫酸铵分段盐析和ＤＥＡＥ－ＳｅｐｈａｄｅｘＡ－５０柱层析，从大鼠睾丸中分离纯化了ＬＤＨ－Ｃ４。比活性提高７８４倍，活性回收率为１２．３％，纯化的ＬＤＨ－Ｃ４经聚丙烯酰胺凝胶电泳（ＰＡＧＥ）鉴定均为一条酶带，位于ＬＤＨ３和ＬＤＨ４之间。     

血清谷氨酸脱氢酶对肝病诊断的临床评价

谷氨酸脱氢酶（ＧＬＤＨ）主要分布在肝细胞，正常血清ＧＬＤＨ活性很低，但在肝脏疾病尤其涉及肝细胞线粒体损害时活性显著升高，是肝实质损害的敏感指标。本文测定了各种肝病患者及健康献血员ＧＬＤＨ的活性，并与常规肝功能指标比较，以评价其临床意义。其结果显示：肝病组高于正常组（Ｐ＜０．０５），急性肝炎、重症肝炎、慢性活动性肝炎其活性升高，随病情好转而下降，测定ＧＬＤＨ对肝病早期诊断，掌握病情，判定预后有临床意义。     

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.     

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.