间α胰蛋白酶抑制物在大鼠肾草酸钙结石模型中的表达

目的　研究间α胰蛋白酶抑制物(IαI) 在实验性肾草酸钙结石大鼠肾组织中的表达及意义。方法　采用乙二醇和氯化铵诱导形成大鼠肾草酸钙结石模型, 检测各组大鼠肾功能、肾组织Ca2 含量和草酸钙晶体沉积、尿生化,并用免疫组化和计算机图像分析技术观察IαI在肾组织的表达情况。结果　模型组大鼠的血清Cr、BUN、肾Ca2 含量、24 h尿Ca2 和草酸分泌量均明显高于正常组(P<0. 05)。正常肾组织IαI分布仅在近曲小管, 而在结石组肾组织的近曲小管、上皮细胞、皮髓质交界处等的表达显著增加。结论　高草酸尿和草酸钙结晶的沉积能使肾脏通过合成更多的IαI来抑制草酸钙晶体的形成。     

泽泻不同溶剂提取物对大鼠尿草酸钙结石形成的影响

目的　研究泽泻不同溶剂提取物对大鼠尿草酸钙结石形成的影响 ,并确定其抑制尿草酸钙结石形成的有效部位。方法　通过 ig不同剂量的泽泻不同溶剂提取物对乙二醇和氯化铵诱导的大鼠肾草酸钙结石模型进行试验研究。结果　泽泻乙酸乙酯浸膏高剂量组大鼠的血清 Cr,BU N,肾 Ca2 +含量 ,2 4 h尿 Ca2 +分泌量 ,肾组织的草酸钙晶体沉积均明显低于成石组 (P<0 .0 5 )。结论　泽泻乙酸乙酯浸膏能抑制实验性高草酸尿症大鼠尿草酸钙晶体的形成 ,是泽泻抑制尿草酸钙结石形成的有效部位。     

枸杞对大鼠肾草酸钙结石生成的干预效果及其机制

目的 研究枸杞对大鼠肾草酸钙结石生成的干预效果及可能机制。方法 Wistar大鼠根据诱石方式（吸烟或饮用乙二醇或两者联合）、枸杞浸泡剂干预与否以及干预浓度（10%或25%）进行分组,设立空白对照组,每组10只。分组处理40 d后,收集24 h尿液并采集肾组织样本。检测尿液中钙、草酸及枸橼酸浓度;观察各组大鼠肾小管草酸钙结晶沉积情况并进行等级评分;检测肾组织脂质过氧化物丙二醛（MDA）含量及总超氧化物歧化酶（T SOD）活性;TUNEL染色观察肾小管细胞凋亡并计算凋亡指数。结果 吸烟联合乙二醇诱石组尿钙浓度明显高于空白对照组（P<0.01）;单纯饮用乙二醇和吸烟联合乙二醇诱石组大鼠肾小管草酸钙结晶评分、肾组织MDA含量及肾小管上皮细胞凋亡指数均高于空白对照组,而尿液中枸橼酸浓度和肾组织T-SOD活性均低于空白对照组。10%和25%枸杞浸泡剂干预可显著降低吸烟联合乙二醇诱石组大鼠尿钙浓度（P<0.01）;同时使单纯饮用乙二醇和吸烟联合乙二醇诱石组大鼠肾小管草酸钙结晶评分、肾组织MDA含量及肾小管上皮细胞凋亡指数下降,而尿液中枸橼酸浓度和肾组织T-SOD活性升高。枸杞浸泡剂两种浓度间未见明显量效关系。结论 枸杞能有效抑制吸烟和（或）乙二醇诱导的大鼠肾草酸钙结石的生成,其机制可能与降低肾组织内自由基水平,抑制肾小管上皮细胞凋亡,以及减少尿液中促石成分而增加抑石成分有关。     

夏枯草提取物对大鼠尿草酸钙结石形成的影响

目的探讨夏枯草不同提取物对大鼠尿草酸钙结石形成的影响。方法40只Wistar大鼠随机分为5组（每组8只），采用乙二醇和氯化铵诱导的大鼠肾草酸钙结石模型进行试验研究。对照组（A组）、成石组（B组）、夏枯草水溶性提取物组（c组）、50％甲醇提取物组（D组）、100％甲醇提取物组（E组），分别通过灌胃方式予一定剂量的夏枯草不同提取物。饲养4周后，检测各组大鼠血BUN、Cr，24h尿草酸（Ox）、Ca^2＋分泌量和肾组织Ca^2＋含量。镜下观察肾组织切片中草酸钙结晶及肾小管扩张情况。结果A组大鼠血BUN、Cr明显低于其他各组，差别有显著性（P〈0.05），各组间血Ca^2＋、P浓度则无明显差异；24h尿Ox、Ca^2＋分泌量各夏枯草实验组与B组差异无显著性（P〉0．05）；C、D组肾组织Ca^2＋含量明显低于B组，差异有显著性（P〈0．05）。A组肾小管正常，B组肾小管腔可见大量成片草酸钙结晶存在，管腔明显扩张；C组肾小管腔可见散在草酸钙结晶存在，少数呈片状，管腔轻度扩张；D组肾小管腔仅见少许散在草酸钙结晶存在，管腔未见明显扩张；EL、EH组基本同B组。结论夏枯草水提取物和50％甲醇提取物能有效防止大鼠尿草酸钙结石形成。     

实验性大鼠肾草酸钙结石模型的筛选研究

目的筛选简捷且成石效果好的实验性大鼠肾草酸钙结石造模法。方法采用两类10种诱导法制作大鼠肾草酸钙结石模型,比较各组大鼠24h尿草酸排泄量和肾组织草酸钙结晶情况,综合评价10种造模法。结果10种造模法组的24h尿草酸排泄量及草酸钙结晶评分均显著高于空白对照组(P<0.05),其中1%乙二醇 1%氯化胺饮水1周建模效果好,且耗时最短。结论1%乙二醇 1%氯化铵饮水1周为首选造模法。     

实验性大鼠肾草酸钙结石模型的筛选研究

目的 筛选简捷且成石效果好的实验性大鼠肾草酸钙结石造模法.方法 采用两类10种诱导法制作大鼠肾草酸钙结石模型,比较各组大鼠24 h尿草酸排泄量和肾组织草酸钙结晶情况,综合评价10种造模法.结果 10种造模法组的24 h尿草酸排泄量及草酸钙结晶评分均显著高于空白对照组(P<0.05),其中1%乙二醇 + 1%氯化胺饮水1周建模效果好,且耗时最短.结论 1%乙二醇 + 1%氯化铵饮水1周为首选造模法.     

枸橼酸钾对大鼠肾草酸钙结石骨桥蛋白表达的影响

目的 探讨枸橼酸钾对大鼠肾草酸钙结石骨桥蛋白(osteopontn,OPN)表达的影响.方法 32只8周龄雄性Wistar大鼠随机分为正常对照组、枸橼酸钾组、结石组(乙二醇和氯化氨)、结石+枸橼酸钾组,每组8只.采用乙二醇和氯化铵诱导大鼠肾草酸钙结石模型进行试验研究.连续给药4周后处死大鼠取肾组织,采用HE染色和免疫组化法检测各组肾结石形成及OPN表达情况.结果 结石+枸橼酸钾组大鼠肾结石形成比结石组明显减少(P<0.05);结石+枸橼酸钾组大鼠的OPN表达比结石组明显降低(P<0.05);枸橼酸钾组OPN表达与对照组相比无明显变化(P>0.05).结论 枸橼酸钾可能通过减少草酸钙结晶的形成而减轻对肾小管上皮细胞的损伤,降低肾OPN的表达.     

加味乌茹汤治疗尿石症的实验研究

目的 探讨加味乌茹汤（茜草根、乌贼骨、北芪、肉桂、金钱草、海金砂等组成）对乙二醇和活性维生索D，诱导SD大鼠草酸钙尿路结石形成的相关物质代谢的影响。方法在70只SD雄性大鼠中，对60只进行草酸钙尿路结石模型的建立。然后分组给予加味乌茹汤、排石颗粒、生理盐水。测定了大鼠24h尿量、尿PH、Cr、尿中钙、草酸、磷、镁排泄量及其在血中钙、草酸、磷、镁的浓度，并在解剖显微镜下观察肾、输尿管、膀胱结石形成情况。结果与模型组相比，加味乌茹汤组尿钙、尿草酸排泄量明显减少（P〈0.05），血钙浓度降低，镁、磷离子增加。结论加味乌茹汤具有抑制内源性高草酸尿和吸收性高钙尿症的作用，从而降低肾钙含量，减少肾小管内草酸钙结晶形成，达到预防及治疗尿石症的目的。     

夏枯草提取物对肾草酸钙结石模型大鼠肾组织骨桥蛋白表达的影响

目的研究夏枯草50％甲醇提取物对大鼠肾组织骨桥蛋白（osteopontin，OPN）表达的影响。方法采用乙二醇和氯化铵诱导建立大鼠肾草酸钙结石模型，将24只Wistar大鼠随机分成3组：对照组（A）、结石组（B）、夏枯草组（C）。C组则通过灌胃方式予一定剂量的夏枯草50％甲醇提取物。饲养4周后，检测各组大鼠肾组织病理学改变和草酸钙结晶沉积情况。采用原位杂交RT—PCR观察各组大鼠肾组织中OPN mRNA表达，免疫组织化学和Westem blot检测各组大鼠肾组织OPN蛋白的表达水平。结果A组肾小管正常，B组肾小管腔可见大量成片草酸钙结晶存在，管腔明显扩张；C组肾小管腔可见少许散在草酸钙结晶存在，管腔轻度扩张。原位杂交显示A组大鼠肾组织中仅肾脏髓质小部分亨利氏袢中检测到OPN mRNA的表达，与此相反在B组和C组大鼠肾组织中则明显检测到OPN mRNA的表达，只是C组中OPN mRNA的表达强度相对弱于成石对照组。RT-PCR检测结果与原位杂交一致。免疫组化显示A组中仅能检测到OPN蛋白的微弱表达，B组大鼠肾组织中OPN表达则明显增强，C组大鼠肾组织中OPN表达强度低于B组。Western blotting检测显示A组轻度表达OPN，而B组则显著表达，C组表达强度低于B组。结论夏枯草50％甲醇提取物能有效抑制大鼠肾组织OPN的表达，减少肾组织草酸钙结晶的沉积，从而能有效抑制大鼠肾草酸钙结石的形成。     

枸杞对大鼠肾草酸钙结石生成的干预效果及其机制

目的 研究枸杞对大鼠肾草酸钙结石生成的干预效果及可能机制.方法 Wistar大鼠根据诱石方式(吸烟或饮用乙二醇或两者联合)、枸杞浸泡剂干预与否以及干预浓度(10%或25%)进行分组,设立空白对照组,每组10只.分组处理40 d后,收集24 h尿液并采集肾组织样本.检测尿液中钙、草酸及枸橼酸浓度;观察各组大鼠肾小管草酸钙结晶沉积情况并进行等级评分;检测肾组织脂质过氧化物丙二醛(MDA)含量及总超氧化物歧化酶(T-SOD)活性;TUNEL染色观察肾小管细胞凋亡并计算凋亡指数.结果 吸烟联合乙二醇诱石组尿钙浓度明显高于空白对照组(P<0.01);单纯饮用乙二醇和吸烟联合乙二醇诱石组大鼠肾小管草酸钙结晶评分、肾组织MDA含量及肾小管上皮细胞凋亡指数均高于空白对照组,而尿液中枸橼酸浓度和肾组织T-SOD活性均低于空白对照组.10%和25%枸杞浸泡剂干预可显著降低吸烟联合乙二醇诱石组大鼠尿钙浓度(P<0.01);同时使单纯饮用乙二醇和吸烟联合乙二醇诱石组大鼠肾小管草酸钙结晶评分、肾组织MDA含量及肾小管上皮细胞凋亡指数下降,而尿液中枸橼酸浓度和肾组织T-SOD活性升高.枸杞浸泡剂两种浓度间未见明显量效关系.结论 枸杞能有效抑制吸烟和(或)乙二醇诱导的大鼠肾草酸钙结石的生成,其机制可能与降低肾组织内自由基水平,抑制肾小管上皮细胞凋亡,以及减少尿液中促石成分而增加抑石成分有关.     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.