七氟醚对单肺通气致肺损伤保护作用研究

目的探讨七氟醚对单肺通气(one-lung ventilation,OLV)所致兔急性肺损伤后的保护作用及机制。方法采用36只白兔随机分为3组,分别为假手术组、单肺通气组、单肺通气+七氟醚组。其中单肺通气+七氟醚组按七氟醚浓度不同分为几个亚组。采用ELISA法检测兔肺组织中花生四烯酸(arachidonic acid,AA)含量,同时测定肺W/D值,通过HE染色观察肺组织形态学变化;采用RT-qPCR法检测肺组织中Clara细胞分泌蛋白(CCSP)和胞质型磷脂酶A2(C-PLA2) mRNA表达水平;采用Western blot法检测肺组织中CCSP和C-PLA2蛋白表达。结果单肺通气组肺组织中花生四烯酸含量、肺损伤程度及C-PLA2蛋白和mRNA表达水平均较假手术组明显增加(P0.05),而CCSP蛋白和mRNA表达水平明显降低(P0.05);单肺通气+七氟醚组兔肺组织中花生四烯酸、肺损伤及肺组织C-PLA2蛋白和mRNA表达水平较单肺通气组下降(P0.05),而CCSP蛋白和mRNA表达增加;单肺通气+不同浓度七氟醚组肺组织中花生四烯酸含量、肺损伤程度及C-PLA2蛋白和mRNA表达水平随浓度的增加而逐渐降低(P0.05),而CCSP蛋白及mRNA表达无显著性差异。结论七氟醚保护单肺通气所致肺损伤的作用机制可能与下调C-PLA2途径,减少肺组织中AA生成有关。     

白三烯B4在单肺通气致肺微血管内皮细胞通透性增加中的作用机制

目的 观察运用乌苯美司减少单肺通气(OLV)兔肺内白三烯B4(LTB4)生成对肺组织磷脂酶Cεl(PLCE l)表达变化的影响,阐明LTB4在OLV致肺微血管内皮细胞(PMVEC)通透性增加中的作用机制.方法 48只健康日本大耳白兔随机均分为:对照组(C组)、溶剂(生理盐水)预处理组(S组)、(乌苯美司+生理盐水)预处理组(B组)、OLV组(O组)、生理盐水预处理+OLV组(SO组)和(乌苯美司+生理盐水)预处理+OLV组(BO组).ELISA检测肺内LTB4含量.Western blotting和定量PCR分别用于检测白三烯A4水解酶(LTA4H)和PLCE1蛋白及各自mRNA表达水平.以肺通透性指数、肺湿/干(W/D)比值和肌球蛋白轻链激酶(MLCK)蛋白及mRNA表达水平反映PMVEC通透性,并通过肺组织形态学评分对肺损伤的严重程度进行评价.结果 除LTA4H表达水平在B组明显下降外(P<0.05),C组、S组和B组其它各检测指标均无显著性差异;OLV兔肺组织LTA4H表达水平上调(P<0.05),肺内LTB4生成增多(P<0.05),同时伴有PLCE1表达水平、PMVEC通透性和肺组织学评分的显著增加(P<0.05).生理盐水预处理对OLV实验动物上述指标变化无显著影响;乌苯美司预处理可显著抑制LTA4H表达(P<0.05),减少OLV实验动物肺内LTB4生成(P<0.05),下调肺组织PLCE1表达(P<0.05),明显减轻OLV诱导的PMVEC通透性增加和肺损伤(P<0.05).结论 乌苯美司可通过下调OLV兔LTA4H表达,减少肺内LTB4生成,继而发挥抗OLV致肺损伤保护作用.LTB4致OLV兔PMVEC通透性增加的作用机制与其上调PLCE1表达有关.     

从COX2和5-LOX途径探讨七氟醚抗单肺通气致急性肺损伤的作用机制（英文）

目的从COX₂和5-LOX途径探讨七氟醚抗单肺通气致急性肺损伤作用机制。方法 18只健康日本大耳白兔随机分为假手术组（S组）,单肺通气组（O组）,单肺通气+七氟醚组（OS组）,每组6只。用Western blotting和定量RT-PCR分别检测肺组织环氧化酶-2（COX₂）、5-脂氧化酶（5-LOX）蛋白和mRNA表达水平。ELISA检测肺组织白细胞三烯B₄（LTB₄）、血栓素A₂（TXA₂）和前列腺素I₂（PGI₂）含量。以肺湿/干（W/D）比值和肺组织学评分评价肺损伤的严重程度。结果与S组相比,O组和OS组动物肺组织COX₂、5-LOX蛋白和mRNA表达水平,LTB₄、TXA₂、PGI₂含量,肺W/D比值及肺组织学评分均明显升高（P<0.05）,而肺组织PGI₂/TXA₂比值明显降低（P<0.05）。与O组相比,OS组肺组织PGI₂/TXA₂比值明显增高（P<0.05）,而其它各项指标均明显降低（P<0.05）。结论本研究首次证实单肺通气可使实验动物肺组织COX₂、5-LOX的蛋白和mRNA表达水平增高。七氟醚具有抗单肺通气致急性肺损伤的作用,其机制可能与下调肺组织COX₂和5-LOX的表达水平,减少肺组织PGI₂、TXA₂和LTB₄生成及调控PGI₂/TXA₂比值有关。     

胞质型磷脂酶A2与核因子κB在单肺通气致兔肺损伤中的相互作用

目的 探讨胞质型磷脂酶A2(C-PLA2)与核因子κB(NF-κB)间相互作用关系,阐明单肺通气上调C-PLA2表达的作用机制.方法48只健康日本大耳白兔随机均分为8组:对照组;溶剂预处理组;NF-κB抑制剂(PDTC)/溶剂预处理组;C-PLA2抑制剂(AACOCF3)/溶剂预处理组;单肺通气组;溶剂预处理+单肺通气组;NF-κB抑制剂(PDTC)/溶剂预处理+单肺通气组和C-PLA2抑制剂(AACOCF3)/溶剂预处理+单肺通气组.Western-blot和定量PCR分别用于检测肺组织C-PLA2和NF-κB蛋白及mRNA表达水平;ELISA检测肺组织花生四烯酸含量;支气管-肺泡灌洗液嗜中性粒细胞计数、肺组织髓过氧化物酶活性、肺干/湿重比值和肺组织学评分用于反映肺损伤的严重程度.结果 单纯给予溶剂未对实验动物造成明显副作用.给予AACOCF3或PDTC,但未行单肺通气的实验动物除C-PLA2或NF-κB明显下调外(P<0.05),其余指标无显著变化.单肺通气实验动物肺组织C-PLA2和NF-κB表达水平均显著上调(P<0.05),出现明显的肺损伤(P<0.05);AACOCF3或PDTC预处理均可显著降低单肺通气实验动物肺组织C-PLA2和NF-κB表达水平(P<0.05),同时肺损伤程度明显减轻(P<0.05).结论 C-PLA2和NF-κB在单肺通气致肺损伤中均发挥重要作用,二者相互调控,相互影响.     

Protective mechanisms of sevoflurane against one-lung ventilation-induced acute lung injury: role of cyclooxygenase-2 and 5-lipoxygenase pathways

目的从COX2和5-LOX途径探讨七氟醚抗单肺通气致急性肺损伤作用机制。方法18只健康日本大耳白兔随机分为假手
术组（S组）,单肺通气组（O组）,单肺通气+七氟醚组（OS组）,每组6只。用Western blotting和定量RT-PCR分别检测肺组织环
氧化酶-2（COX2）、5-脂氧化酶（5-LOX）蛋白和mRNA表达水平。ELISA检测肺组织白细胞三烯B4（LTB4）、血栓素A2（TXA2）和
前列腺素I2（PGI2）含量。以肺湿/干（W/D）比值和肺组织学评分评价肺损伤的严重程度。结果与S组相比,O组和OS组动物肺
组织COX2、5-LOX蛋白和mRNA表达水平,LTB4、TXA2、PGI2含量,肺W/D比值及肺组织学评分均明显升高（P<0.05）,而肺组
织PGI2/TXA2比值明显降低（P<0.05）。与O组相比,OS组肺组织PGI2/TXA2比值明显增高（P<0.05）,而其它各项指标均明显降
低（P<0.05）。结论本研究首次证实单肺通气可使实验动物肺组织COX2、5-LOX的蛋白和mRNA表达水平增高。七氟醚具有
抗单肺通气致急性肺损伤的作用,其机制可能与下调肺组织COX2和5-LOX的表达水平,减少肺组织PGI2、TXA2和LTB4生成及
调控PGI2/TXA2比值有关。
     

单肺通气致兔急性肺损伤的蛋白质组学分析

【目的】探讨兔单肺通气肺损伤后肺组织蛋白组表达变化。【方法】新西兰白兔12只随机分为双肺通气组(TLV组)和单肺通气组(OLV组),每组6只。TLV组行双肺通气;OLV组行右肺通气。监测氧合指数(OI)。术后对两组左、右肺行组织学检查并评分。对两组左肺组织提取的总蛋白进行双向差分凝胶电泳,DeCyder软件寻找差异表达的蛋白质点,进行质谱分析鉴定。【结果】OLV组在单肺通气3 h时OI<300 mmHg,明显低于TLV组(P<0.05)。OLV组左、右肺损伤评分均高于TLV组左、右肺(P<0.05)。OLV组与TLV组之间,检测并鉴定出6个差异蛋白,包括ATP合成酶、肌动蛋白及过氧化还原酶等。【结论】成功建立兔单肺通气急性肺损伤模型;单肺通气比双肺通气更引起肺损伤。单肺通气肺损伤可引起肺组织蛋白表达改变,这些差异蛋白主要与能量代谢、细胞骨架及氧化应激相关。     

不同浓度七氟醚预处理对内毒素性 急性肺损伤大鼠肺组织的影响

目的：比较3种不同浓度(3.6%,2.4%和1.2%)七氟醚预处理对内毒素性急性肺损伤大鼠肺组织的影响。方法：健康雄性SD大鼠36只,随机分为6组（n=6）：对照组（A组）、单纯七氟醚吸入组（B组）、3.6%七氟醚预处理组（C组）、2.4%七氟醚预处理组（D组）、1.2%七氟醚预处理组（E组）、内毒素组（F组）。分别在给药后（LPS或生理盐水）6 h 处死大鼠, 观察肺组织病理学结果,测定肺组织湿干比(W/ D)、髓过氧化物酶(MPO)活性及肺组织ICAM-1mRNA的表达。结果：与对照组比较,F组和不同浓度七氟醚预处理组肺组织病理损伤加重,肺W/D、MPO活性、ICAM-1mRNA表达升高(P＜0.05)。与F组比较,C组肺组织病理损伤减轻,MPO活性和ICAM-1mRNA表达降低(P＜0.05),但肺W/D无明显降低（P＞0.05）;D组肺组织病理损伤减轻,肺W/D、MPO活性、ICAM-1mRNA表达均降低(P＜0.05),F组肺组织MPO活性降低(P＜0.05),但肺W/D和ICAM-1mRNA表达无明显降低（P＞0.05）。结论：2.4%七氟醚预处理可以减轻内毒素所致急性肺损伤,作用机制可能与其降低肺组织ICAM-1mRNA的表达上调,从而减少肺内中性粒细胞的浸润相关。     

血红素氧合酶-1在七氟醚减轻大鼠内毒性急性肺损伤中的作用

目的 探讨血红素氧合酶-1在七氟醚减轻大鼠内毒性急性肺损伤中的作用.方法 健康雄性SD大鼠36只,体重220～250 g,随机分为6组(n=6):生理盐水对照组(C组);锌原卟啉IX(ZnPP)预处理组(ZnPP组);七氟醚吸入组(Sev组);脂多糖(LPS)+七氟醚后处理组(LPS-Sev组);ZnPP预处理+LPS+七氟醚后处理组(ZnPP-LPS-Sev组)和LPS组.ZnPP组和znPP-LPS-Sev组股静脉注入特异性HO-1拮抗剂ZnPP(10mg/kg),其余各组注入1mL/kg等体积生理盐水.10min后,C组、ZnPP组和LPS组分别经股静脉注入生理盐水和LPS 5 mg/kg;LPS-Sev组和znPP-LPS-sev组股静脉注入LPS 5 mg/kg 2 h后吸入七氟醚(呼气末浓度2.4%)4h;Sev组注入生理盐水2h后再吸入2.4%七氟醚4h.于给LPS或生理盐水6 h时心脏放血处死大鼠,取肺组织计算湿干重(W/D)比;进行肺组织病理学评分;测定肺组织髓过氧化物酶(MPO)活性、丙二醛(MDA)含量、超氧化物歧化酶(SOD)活性、HO-1 mRNA和蛋白的表达水平.结果 静脉注入LPS可使肺组织SOD活性减弱、W/D比、MDA含量和MPO活性升高、肺组织病理学评分增加、HO-1和HO-1 mRNA表达上调;吸入七氟醚使肺组织SOD活性增加、W/D比、MDA含量和MPO活性降低、肺组织病理学评分降低、HO-1和HO-1 mRNA表达上调;七氟醚的肺保护作用可被ZnPP消除.结论 七氟醚可能部分通过上调HO-1的表达减轻大鼠内毒素性急性肺损伤.     

单肺通气早期七氟醚肺摄取的临床研究

目的 观察比较七氟醚在单肺通气(OLV)和双肺通气(TLV)早期吸入过程中的肺摄取情况及对麻醉深度的影响.方法 全身麻醉下行食道肿瘤切除术病人30例,随机分成OLV组和TLV组,均于全麻诱导后插入双腔支气管导管行控制呼吸,OLV组于术者打开胸壁时开始行右侧单肺通气,TLV组保持双肺通气不变.七氟醚吸入后记录每组病人各个时点的SpO2,MAP,HR,BIS、七氟醚吸入气浓度(FI)和呼出气浓度(ET)并计算ET/FI.结果 两组间SpO2,MAP,HR,BIS相比差异均无显著性 (P>0.05),两组间FI差异均无显著性(P>0.05),OLV组ET高于TLV组(P<0.05),ET/FI高于82.5%TLV组(P<0.05).结论 OLV早期对七氟醚的肺摄取速率高于同期TLV,两组患者BIS反映的麻醉深度无明显差别.     

不同浓度七氟醚对人脑胶质瘤细胞U251替莫唑胺抵抗的影响及机制初探

目的 探究不同浓度七氟醚对人脑胶质瘤细胞U251替莫唑胺(TMZ)抵抗的影响,并探讨其可能的作用机制.方法 培养对数生长期的人脑胶质瘤细胞U251,传代后将细胞分为3组:对照组、低七氟醚组及高七氟醚组.对照组在5%CO2气体条件下培养,低七氟醚组在5%CO2+1%七氟醚气体条件下培养,高七氟醚组在5%CO2+2.5%七氟醚气体条件下培养,总气流量为2 L/min.MTT法检测3组细胞TMZ半抑制浓度(IC50)的变化,荧光定量链式聚合酶反应(qPCR)检测细胞缺氧诱导因子-1α(HIF-1α)mRNA表达水平的变化,蛋白免疫印迹(Western blotting)检测HIF-1α蛋白表达水平的变化.结果 MTT结果显示对照组细胞TMZ IC50值显著高于高七氟醚组IC50值(P<0.05),而与低七氟醚组IC50值差异无统计学意义(P>0.05).qPCR结果显示对照组HIF-1αmRNA相对表达水平显著高于低七氟醚组及高七氟醚组(P<0.05),且低七氟醚组HIF-1αmRNA相对表达水平显著高于高七氟醚组(P<0.05),Western blotting结果显示对照组HIF-1α蛋白表达水平明显高于低七氟醚组及高七氟醚组,且低七氟醚组HIF-1α蛋白表达水平明显高于高七氟醚组.结论 七氟醚促进人脑胶质瘤细胞U251对TMZ的敏感性,可能与下调HIF-1α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.     

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.