加味补阳还五汤对易卒中自发性高血压大鼠靶器官的保护作用

目的观察加味补阳还五汤对易卒中自发性高血压大鼠（SHR／SP）靶器官的保护作用。方法将20只6周龄雄性易卒中自发性高血压大鼠（SHR／SP）分成2组（每组10只）,其中一组喂含补阳还五汤的饲料为用药组,另一组常规饲养,作为对照组。同时用同龄10只WKY大鼠作为正常血压组。实验周期为3个月,观察指标为：大鼠血压,血浆NO、ET—1含量,大鼠心、脑、肾的损坏程度。结果用药纽的动物血压、靶器官（心、脑、肾）的损坏程度、血浆ET．1含量明显低于对照组,用药组大鼠血浆NO含量显著高于对照组（P〈0．01）。结论加味补阳还五汤能降低SHR／SP血压,减轻SHR／SP靶器官（心、脑、肾）的损坏程度。     

加减补阳还五汤对SHR/SP大鼠血压和学习记忆的影响

目的观察使用加减补阳还五汤对易卒中自发性高血压大鼠(SHR/SP)血压和学习记忆能力的影响.方法20只5周龄雄性易卒中自发性高血压大鼠(SHR/SP)随机分为二组(n=10只),喂含补阳还五汤的饲料为用药组,常规饲养为空白对照组;同时10只同龄WKY大鼠作为正常血压组.观察大鼠的体重、血压、行为学、记忆力和大脑病理变化.结果用药组和对照组的血压、体重与正常组比较,均有极显著性差异(P<0.001),用药组血压比对照组明显降低(P<0.05);用药组的学习记忆能力比对照组显著改善(P<0.001),但明显差于正常组(P<0.001).结论加减补阳还五汤对SHR/SP鼠具有一定的降压作用,能显著改善其学习记忆能力.     

加味补阳还五汤对易卒中自发性高血压大鼠血清微量元素的影响

目的观察加味补阳还五汤对易卒中自发性高血压大鼠(SHR／SP)血清微量元素锌、铜、铁、硒、锰的影响,进一步证实加味补阳还五汤对SHR／SP的智力改善具有一定的功能性作用。方法将20只8周龄雄性SHR／SP均分为对照组和用药组,对照组常规饲养,用药组喂含补阳还五汤的饲料。同时以同龄10只WKY大鼠作为空白组。实验周期为3个月,观察大鼠血清微量元素锌、铜、铁、硒、锰含量。结果空白组锌、锰、硒含量明显高于用药组(p值均<0．01),用药组又明显高于对照组(p值均<0．01)。空白组铜含量明显低于用药组(P<0．05),用药组又明显低于对照组(P<0．05)。3组血清铁含量的差异均无统计学意义(P值均>0．05)。结论加味补阳还五汤对SHR／SP血清锌、铜、硒、锰具有一定的调控作用,这些微量元素在一定程度上影响了学习记忆行为能力。     

加减补阳还五汤对易卒中自发性高血压大鼠海马区一氧化氮的影响

目的通过对易卒中自发性高血压大鼠(SHR/SP)饲喂加味补阳还五汤,观察其对SHR/SP大脑海马区一氧化氮(NO)含量的影响,从而证实加味补阳还五汤能降低SHR/SP大脑海马区本NO含量。方法将20只4周龄雄性易卒中自发性高血压大鼠(SHR/SP)分成2组(每组10只),其中一组喂含补阳还五汤的饲料为用药组,另一组常规饲养,作为对照组。同时用同龄10只WKY大鼠作为空白组。实验周期为3个月,观察大鼠海马区NO含量变化。结果空白组的海马区NO含量(4.56±0.57)μmol/L明显低于用药组(8.78±1.34)μmol/L(P<0.01),而用药组(8.78±1.34)μmol/L的海马区NO含量又明显低于对照组(10.10±1.09)μmol/L(P<0.01)。结论补阳还五汤可降低SHR/SP大鼠海马区的NO水平。     

加味补阳还五汤对自发性高血压大鼠记忆及行为能力的影响

自发性高血压大鼠（SHR／SP）具有认知功能障碍已经被证实。本实验是笔在清朝王清任的补阳还五汤的基础增加补肾填精、化痰通络等药物，组成加味补阳还五汤，观察其对SHR／SP大鼠学习记忆及行为能力的的影响。     

补阳还五汤促进大鼠慢性难愈性创面修复愈合的作用及机制

目的：探讨补阳还五汤促进大鼠慢性难愈性创面修复愈合的作用及机制。方法：在54只雄性SD大鼠背部制造全层皮肤缺损开放性创面,除正常对照组外,大鼠肌肉注射醋酸氢化可的松建立难愈性创面模型,并随机分为模型组、补阳还五汤组。观察各组大鼠创面愈合率,愈合时间;并通过免疫组织化学和图像分析等技术,观察各组大鼠创面肉芽组织中血管内皮生长因子（vascular endothelial growth factor,VEGF）表达情况和微血管数（microvessel count,MVC）。结果：模型组与正常对照组比较,创面愈合率低（P〈0．01,P〈0．05）,愈合时间明显延长（P〈0．01）;补阳还五汤组与模型组比较,创面愈合率显著提高（P〈0．01）,愈合时间明显缩短（P〈0．01）。模型组VEGF表达和MVC明显低于正常对照组（P〈0．01）;补阳还五汤组与模型组比较,VEGF表达和MVC均显著升高（P〈0．01）。结论：补阳还五汤能明显促进大鼠慢性难愈性创面的愈合,其作用机制可能与上调VEGF表达,诱导血管新生有关。     

不同黄芪剂量补阳还五汤促进大鼠慢性难愈性创面修复愈合的实验研究

目的：观察不同黄芪剂量补阳还五汤治疗大鼠慢性难愈性创面的疗效,探讨黄芪剂量对补阳还五汤疗效的影响。方法：在53只雄性sD大鼠背部制造全层皮肤缺损开放性创面,除正常对照组外,大鼠肌肉注射醋酸氢化可的松建立难愈性创面模型,随机分为模型组,黄芪15g、30g、60g、120g补阳还五汤组（以下简称黄芪15g、30g、60g、120g组）,观察各组大鼠创面愈合率、愈合时间。结果：模型组与正常对照组比较,创面愈合率低,愈合时间延长（P〈0．01,P〈0．05）;不同黄芪剂量补阳还五汤各组与模型组比较,创面愈合率显著提高,愈合时间明显缩短（P〈0．01,P〈0．05）,与正常对照组比较,差异无统计学意义（P〉0．05）;黄芪120g组创面愈合率高于黄芪15g组（P〈0．01,P〈0．05）,愈合时间短于后者（P〈0．05）,与黄芪30g、60g组比较差异无统计学意义（P〉0．05）。结论：不同黄芪剂量补阳还五汤均可明显促进慢性难愈性创面的修复愈合,以黄芪30、60、120g的补阳还五汤的疗效更佳。     

自发性高血压大鼠肾组织醛固酮及其受体与肾脏纤维化

目的观察组织醛固酮及其受体在自发性高血压大鼠肾脏纤维化中的作用。方法8周龄雄性自发性高血压大鼠（SHR）8只及同源正常组京都大鼠（WKY）8只，观察8周，检测收缩压、尿蛋白、血白蛋白、尿素氮和肌酐，大鼠肾组织的醛固酮受体和TGF-β，的mRNA和蛋白的表达。结果SHR．组出现明显的蛋白尿（P〈0．05）和低蛋白血症（P〈0．05），肾间质损伤的评分和肾小球内的胶原形成明显高于正常对照组（P〈0．05），肾组织TGF-β，mRNA和蛋白的表达亦明显高于正常对照组（P〈0．05），同时，SHR．组肾组织的醛固酮及其受体mRNA和蛋白的表达水平亦明显高于正常对照组（P〈0．05）。结论肾组织醛固酮及其受体水平升高可以使醛固酮的致纤维化作用加强，可能是高血压肾脏纤维化的部分原因。     

阿折地平对自发性高血压火鼠心肌细胞凋亡的影响

目的探讨阿折地平对自发性高血压大鼠心肌细胞凋亡的影响。方法将自发性高血压大鼠随机分为治疗组[阿折地平3mg／（kg·d）溶于生理盐水中灌胃]、SHR组,另选WKY大鼠为正常对照组,每组10只。分别每周测大鼠血压,10周后处死测其左心室肥厚指数,计数细胞凋亡数,ELISA法检测心肌细胞TNF-α的表达。结果SHR组与WKY组血压无明显改变,治疗前后比较亦无明显差异（P〉0．05）,治疗组的血压较治疗前显著降低（P〈0．01）,与WKY组比较无明显差异,治疗组左心室肥厚指数、细胞凋亡指数及TNF—α的表达显著小于SHR组（P〈0．01）,治疗组与WKY组比较无显著性差异（P〉0．05）。结论阿折地平能有效的控制血压,能有效的抑制高血压所致的左心室肥厚、细胞凋亡及心肌TNF-α的表达。     

阿托伐他汀的降血压作用及其机制实验研究

目的观察阿托伐他汀对自发性高血压大鼠（SHR）血压的影响,并通过其对血管紧张素Ⅱ1型（AT1）受体表达的影响探讨其调节血压的机制。方法将24只16周雄性sHR随机分为4组：SHR对照组,阿托伐他汀50mg剂量组[50mg／（kg·d）],阿托伐他汀10mg剂量组[10mg／（kg·d）],缬沙坦组[20mg／（kg·d）],灌胃给药共6周。在给药前和给药后,每2周采用尾袖法测量大鼠尾动脉收缩压（SBP）,化学比色法检测大鼠主动脉活性氧（Ros）浓度;免疫组织化学法和原位杂交法检测AT．受体蛋白和mRNA表达。结果实验前SHR各组SBP无差异,但显著高于WKY组（P〈0．01）;给药后4。6周,50mg剂量组SBP明显下降（P〈0．01）,10mg剂量组SBP无明显变化;自给药后2周缬沙坦组SBP逐渐下降（P〈0．01）。SHR对照组血清ROS水平显著高于WKY组（P〈0．01）;用药6周后,50mg剂量组血清ROS水平明显降低（P〈0．05）。SHR对照组心肌AT1受体蛋白阳性表达明显高于WKY组（P〈0．01）,50mg剂量组AT．受体蛋白阳性表达明显减少,平均光密度值显著降低（P〈0．01）。SHR对照组AT1受体mRNA表达明显高于wKY组（P〈0．01）,50mg剂量组AT．受体mRNA表达下调,平均光密度值显著降低（P〈0．01）：结论阿托伐他汀可降低SHR的血压,下调SHR心肌细胞AT1受体表达,减少ROS生成,改善血管内皮功能而发挥降低血压的作用。     

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.