通络保肾复方对糖尿病大鼠肾脏内质网应激指标P-IRE1α、GRP78的影响

目的探讨通络保肾复方及其拆方对链脲佐菌素(STZ)诱导糖尿病大鼠高血糖肾损伤内质网应激反应(ERS)启动因子P-IRE1α和分子伴侣GRP78的影响。方法将雄性SD大鼠随机分成正常组和造模组。造模组大鼠采用腹腔注射STZ方法建立糖尿病大鼠模型。造模成功后将造模组大鼠随机分成模型对照组、缬沙坦组(8.93 mg/kg)、通络保肾复方组(19.43 g/kg)、通络保肾补虚组(6.92 g/kg)、通络保肾解毒组(12.5 g/kg)。观察各组大鼠日常活动的一般情况;应用免疫组化法及IPP软件半定量分析6周和16周各组大鼠p-IRE1α及GRP78的蛋白表达。结果普通光镜下可见P-IRE1α、GRP78主要位于造模组大鼠肾脏近段、远端肾小管细胞及肾小球细胞的胞浆内;IPP免疫组化半定量法显示:6周和16周模型组与正常组大鼠相比较P-IRE1α、GRP78的蛋白表达增加(P0.05);与模型组大鼠相比,6周和16周缬沙坦组、通络保肾复方组、通络保肾补虚组、通络保肾解毒组P-IRE1α、GRP78的蛋白表达减少(P0.05),各治疗组之间无差别(P0.05)。结论糖尿病高血糖诱导肾损伤大鼠模型中存在内质网应激反应的激活;通络保肾复方及其拆方均可能通过抑制内质网应激而发挥肾脏保护作用;同时可推测糖尿病高血糖肾损伤的中医学核心病机是本虚标实。     

丹蛭降糖胶囊对肥胖大鼠骨骼肌IRE1α-JNK信号通路的干预效应

目的 探讨丹蛭降糖胶囊对高脂饮食诱导的肥胖大鼠骨骼肌内质网应激（ERs）相关因子肌醇需求激酶1α（IRE1α）、磷酸化IRE1α（p-IRE1α）、c-jun氨基末端激酶（JNK）、磷酸化JNK（p-JNK）表达的影响。方法 30只雄性SD大鼠随机分为普通饮食组（NC组）、单纯高脂饮食组（HF组）、高脂饮食＋丹蛭降糖胶囊组（FD组）,每组各10只。应用全自动生化分析仪测定骨骼肌三酰甘油（TG）含量;Western blot检测骨骼肌组织IRE1α、p-IRE1α、JNK、p-JNK的蛋白表达水平。结果 1NC组、HF组以及FD组骨骼肌内TG含量分别为（1.87±0.72）、（3.03±0.71）、（2.71±0.58）μmol/g。与NC组比较,HF组大鼠骨骼肌TG含量显著增高（P=0.005）;与HF组比较,FD组大鼠骨骼肌TG含量明显下降（P=0.024）。2Western blot检测结果显示,HF组p-IRE1α/IRE1α及p-JNK/JNK较NC组明显升高（P〈0.05）;FD组p-IRE1α/IRE1α及p-JNK/JNK较HF组明显降低（P〈0.05）。3Pearson相关性分析发现,大鼠骨骼肌TG含量与HOMA-IR、p-IRE1α/IRE1α及p-JNK/JNK均呈正相关（r=0.63、0.66、0.57,均P〈0.01）。结论丹蛭降糖胶囊可减轻骨骼肌脂质沉积,调节ERs相关IRE1α-JNK通路,从而改善骨骼肌胰岛素抵抗。     

α-硫辛酸对糖尿病大鼠肾脏c-Jun氨基末端激酶通路的影响

目的 探讨α-硫辛酸(ALA)对糖尿病(DM)大鼠肾脏c-Jun氨基末端激酶(JNK)信号通路及足细胞的影响.方法 链脲佐菌素诱导糖尿病大鼠模型,大鼠分为正常组(NC组)、糖尿病组(DM组)和ALA干预组(ALA组),8周后测各组大鼠血尿素氮(BUN)、血肌酐(Scr)、尿白蛋白排泄率(UAER)、血糖、肾皮质超氧化物歧化酶(SOD)和丙二醛(MDA);透射电镜观察足细胞超微结构;Western blotting法测.肾脏P-JNK、JNK蛋白的表达;免疫组织化学法测足细胞Nephrin蛋白的表达.结果 与NC组比较,DM组BUN、Scr、UAER和血糖均显著增加;肾皮质MDA含量显著增加,SOD活性显著降低;透射电镜示:DM组足突增宽,肾小球基底膜增厚,系膜基质增多;肾脏p-JNK、JNK蛋白的表达及p-JNK/JNK均显著增加;Nephrin的表达显著降低.与DM组比较,ALA组BUN、Scr、UAER和MDA含量均显著降低;SOD活性显著增加;足细胞超微结构明显改善;肾脏p-JNK、JNK蛋白的表达及P-JNK/JNK均显著降低;Nephrin的表达显著增加.结论 ALA可能通过抑制DM大鼠JNK信号通路的活性,上调足细胞Nephrin蛋白的表达而发挥对糖尿病肾痛的肾保护作用.     

选择性血管紧张素Ⅱ受体拮抗剂对糖尿病大鼠血管单核细胞趋化蛋白-1表达的影响

目的:研究选择性血管紧张素Ⅱ受体拮抗剂(缬沙坦)对STZ诱导的糖尿病大鼠血管组织单核细胞趋化蛋白-1(MCP-1)表达的影响.方法:将SD大鼠随机分成三组:正常对照组(NC组)、糖尿病组(DM组)、糖尿病 缬沙坦干预组(DV组).观察各组大鼠的血糖、体重、Hb1Ac,于8周时用RT-PCR和Westem blot的方法检测链脲佐菌素(STZ)诱导的糖尿病大鼠血管组织中MCP-1的表达的变化.结果:DM和DV组大鼠体重较NC组明显降低(均P＜0.01),DM和DV组间糖化血红蛋白(HbA1c)及血糖无显著性差异(P＞0.05);DM和DV组大鼠血管组织中MCP-1 mRNA的表达明显高于NC组(均P＜0.01),而DV组明显低于DM组(P＜0.01);DM和DV组大鼠血管组织中MCP-1蛋白的表达明显高于NC组(均P＜0.01),而DV组明显低于DM组(P＜0.01).结论:糖尿病SD大鼠血管组织单核细胞趋化蛋白-1(MCP-1)表达明显增加,缬沙坦通过降低血管组织炎症因子MCP-1表达,对糖尿病大血管并发症起防治作用.     

心肝宝对糖尿病大鼠肾脏MCP（-1）、MIF表达的影响

目的研究糖尿病大鼠中MCP-1、MIF等细胞因子的表达以及心肝宝对糖尿病大鼠肾脏MCP-1、MIF表达的影响。方法选取雄性Wistar大鼠35只,行右肾切除术后两周,随机分成模型组和正常对照组（A组）,将糖尿病模型组大鼠随机分为糖尿病大鼠对照组（B组）和糖尿病大鼠治疗组（C组）。采用HE、PAS染色,行肾脏组织形态学分析,用Real time FQ-PCR检测MCP-1、MIF等细胞因子的mRNA表达情况。结果糖尿病组大鼠肾脏MCP-1、MIF的mRNA表达均明显升高。治疗组大鼠肾脏MCP-1、MIF的mRNA表达均有不同程度下调。结论 DN大鼠肾脏MCP-1、MIF炎症相关的细胞因子表达水平显著升高,是DN炎症相关的直接证据。DN大鼠肾脏肥大、系膜ECM沉积以及UAER增加均与肾脏MCP-1、MIF细胞因子的高表达有关。提示炎症参与了DN肾脏病理改变和肾功能损害的发生和发展。心肝宝可下调肾脏MCP-1、MIF等细胞因子mRNA的表达,从而减少ECM沉积、抑制肾脏肥大、降低尿蛋白,防止DN的发生发展。心肝宝可通过非特异性抗炎作用对DN产生保护作用并且对DN脂代谢紊乱有显著调节作用。     

雌二醇通过上调IRE1α-XBP1信号轴抑制小鼠腹腔巨噬细胞的分化

目的 研究雌二醇其通过内质网应激通路影响巨噬细胞免疫特性的可能机制。方法 提取C57小鼠腹腔巨噬细胞,IFN-γ60 ng/mL作用下体外培养巨噬细胞,分组检测雌激素对巨噬细胞影响：实验组为雌二醇（1.0 nmol/L）处理;抑制剂组为雌二醇（1.0 nmol/L）和雌激素受体拮抗剂（Acolbifene, 4 nmol/L）同时作用;对照组加等量PBS处理,培养48 h后通过Western blot法检测比较巨噬细胞极化蛋白MHC-II、iNOS和内质网应激标志性蛋白IRE1α、eIF2α和ATF6的表达水平,通过RT-PCR法检测巨噬细胞TGF-β、IL-6、IL-10、TNFα mRNA水平变化。随后分组检测内质网应激对巨噬细胞的影响：雌激素处理组;雌激素和内质网IRE1α信号抑制剂（4 μ 8 C,50 μmol/L）处理组;IRE1α激动剂组（TG,0.2 nmol/L）处理组;对照组加等量PBS处理,随后检测巨噬细胞的分化情况。结果 和对照组比较,雌激素处理后巨噬细胞M1相关蛋白MHC-II （P=0.021）和iNOS（P<0.001）表达显著降低,促炎细胞因子TNF-α（P=0.003）和IL-6 mRNA（P=0.004）表达下调,抗炎的M2型细胞因子TGF-β（P=0.002）和IL-10（P=0.008）mRNA表达上升,同时发现内质网相关的IRE1α（P<0.001）蛋白活化水平升高,其下游转录因子XBP-1（P<0.001）表达上调,加入雌激素受体阻断剂能够改变这种变化。和单纯雌激素处理组比较,在培养基中加入雌激素的同时加入IRE1α抑制剂4 μ 8 C会导致巨噬细胞 M1 相关蛋白 MHC-II（P=0.002）和 iNOS（P=0.003）表达显著上调,促炎细胞因子 TNF-α（P=0.003）和 IL-6mRNA（P=0.024）表达上调,抗炎的M2型细胞因子TGF-β（P<0.001）和IL-10（P<0.001）mRNA表达下调,而激动IRE1α通路会矫正这种变化。结论 雌激素能够通过上调IRE1α-XBP-1信号轴抑制巨噬细胞促炎表型的分化,从而对炎症反应发挥抑制作用。     

G1对EA.hy926内皮细胞内质网应激的抑制作用

【摘要】目的：观察GPR30受体激动剂G1对高糖诱导的eahy926内皮细胞内质网应激（endoplasmic reticulum stress,ERS）的影响。方法：选用eahy926内皮细胞为研究对象,分为3组：正常对照组（Con,17.51mmol/L）、高糖组（HG,33.3mmol/L）、高糖 G1组（HG G1,HG 1umol/L G1）,利用流式细胞术检测三组细胞凋亡率,Western blot法检测ERS相关分子BIP、IRE1、PERK及凋亡分子BAX、Bcl-2的表达变化,RT-PCR法检测BIP和CHOP的mRNA表达变化。结果：HG组与Con组比较,细胞凋亡率明显升高（P<0.01）,BIP、IRE1、PERK及凋亡分子BAX表达上调（P<0.01或P<0.001）,Bcl-2的表达下调（P<0.05）,BIP、CHOP mRNA 表达上调（P<0.01）,HG G1组与HG组比较,细胞凋亡率明显降低（P<0.01）,BIP、IRE1、PERK及凋亡分子BAX表达下调（P<0.05或P<0.01或P<0.001）,Bcl-2的表达上调（P<0.05）,BIP、CHOP mRNA 表达下调（P<0.01）。结论：GPR30受体激动剂G1可抑制eahy926内皮细胞内质网应激。     

解毒通络调肝方对脂肪细胞内质网应激和炎症的影响

目的通过观察解毒通络调肝方对内质网应激(ERS)的3T3-L1脂肪细胞肌醇依赖酶(IRE1)、c-Jun氨基末端激酶(JNK)、激活核因子B(NF-κB)蛋白表达以及白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)和脂联素(ADPN)分泌的影响,探讨解毒通络调肝方对3T3-L1脂肪细胞内质网应激的炎症调节作用。方法将3T3-L1前脂肪细胞诱导为成熟的脂肪细胞,随机分为空白对照组、模型组、解毒通络调肝方低、中、高浓度组和二甲双胍组,除空白对照组外,各组均通过2 mg/L衣霉素诱导为ERS脂肪细胞,分别给予对应药物进行24 h干预后,采用酶联免疫吸附实验(ELISA)检测脂肪细胞上清中IL-6、TNF-α、CRP和ADPN的分泌情况,通过蛋白质印迹法(Western-blot)检测脂肪细胞内IRE1、JNK、NF-κB蛋白表达。结果 Western-blot检测显示解毒通络调肝方低、中、高浓度组的IRE1、JNK和NF-κB蛋白表达明显低于模型组,特别是中、高浓度组效果显著(P 0. 01),其差异有统计学意义。ELISA检测显示ADPN表达在解毒通络调肝方低、中、高浓度组中均有上升(P 0. 01),解毒通络调肝方中、高浓度组均能降低IL-6、TNF-α、CRP表达,其中解毒通络调肝方高浓度组效果显著(P 0. 01),对JNK和IL-6表达的下调较二甲双胍组更优(P 0. 01)。结论解毒通络调肝方可能通过抑制炎症相关因子、促进脂联素的分泌,减轻脂肪细胞炎症反应,降低UPR通路中关键蛋白IRE1的表达,以多靶点方式缓解ERS。     

肝宁方对衣霉素诱导肝细胞内质网应激生存信号分子的影响

目的 研究肝宁方对衣霉素诱导的人肝细胞内质网应激条件下的生存信号分子的影响。方法 将肝细胞分正常组、模型组、治疗组：正常组给予正常大鼠血清培养基培养48h,模型组在正常组基础上给予衣霉素诱导48h,治疗组在模型组基础上给予肝宁方继续培养24h。Western blot法检测各组蛋白ATF6、IRE1α、PERK、GRP78的表达量,分析蛋白表达差异。结果 肝宁方治疗组与衣霉素诱导模型组比较,治疗组内质网应激信号分子的蛋白ATF6、IRE1α、PERK的表达明显减少（P<0.05）;模型组与对照组比较,模型组GRP78、内质网应激信号分子的蛋白ATF6、IRE1α、PERK的表达明显增多（P<0.05）。结论 衣霉素诱导正常肝细胞后可激活ATF6、IRE1α、PERK及GRP78蛋白的表达,肝宁方对衣霉素诱导内质网应激生存信号分子蛋白ATF6、IRE1α、PERK的表达及内质网应激标记蛋白均有抑制作用,从而达到阻止未折叠蛋白的错误激活、抑制肝细胞凋亡,对肝细胞具有保护作用。     

霉酚酸酯对糖尿病肾病大鼠肾脏足细胞的保护作用

目的:探讨霉酚酸酯对糖尿病肾病大鼠肾脏足细胞相关蛋白Nephrin及炎性因子单核细胞趋化因子-1表达的影响及机制。方法:建立糖尿病肾病大鼠模型,将模型大鼠随机分为糖尿病肾病组及霉酚酸酯干预组,干预组给予霉酚酸酯15 mg/(kg·d)灌胃,8周末处死动物,常规检测尿蛋白、肾功能、肾质量/体质量,光镜及电镜观察肾小球及肾小管变化,RT-PCR及免疫组化法检测Nephrin及MCP-1 mRNA及蛋白表达。结果:与正常对照组相比,糖尿病组大鼠肾脏组织肾小球肥大、部分纤维化,肾小球滤过膜损伤严重,尿蛋白增加,Nephrin蛋白及mRNA表达减少,MCP-1蛋白及mRNA表达增加;与糖尿病组相比,霉酚酸酯干预组尿蛋白较正常对照组增加,但较糖尿病组有改善(P<0.01),肾小球滤过膜病变较糖尿病组改善,Nephrin蛋白及mRNA表达较糖尿病组增加(P<0.01),MCP-1蛋白及mRNA表达减少(P<0.01)。结论:霉酚酸酯可减少糖尿病肾病大鼠尿蛋白水平,下调MCP-1等炎症介质,上调Nephrin蛋白。霉酚酸酯对糖尿病肾病大鼠肾脏足细胞的保护可能通过干预Nephrin蛋白及炎症因子MCP-1的表达实现。     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.