一氧化氮检测在新生儿败血症中的应用

为探讨一氧化氮（ＮＯ）在新生儿败血症中的作用，测定了２０例新生儿败血症外周血亚硝酸／硝酸根离子（ＮＯ２＾－／ＮＯ３＾－）水平。结果表明：新生儿败血症外周血ＮＯ２＾－／ＮＯ３＾－水平与肿瘤坏死因子水平密切相关（Ｐ＜０．０５）。８例外周血ＮＯ２＾－／ＮＯ３＾－水平高于２００μｍｏｌ／Ｌ者，６例发生休克；其余１２例ＮＯ２＾－／ＮＯ３＾－水平低于此标准者，无一例发生休克，差别显著（Ｐ＜０．０５）。本文显示     

用镉还原NO3^—法测定小鼠血清及肝组织一氧化氮的含量

采用镉还原法测定了小鼠血清及肝组织内一氧化氮（ＮＯ）的含量，并观察了ｉｐ细菌内毒素（ＬＰＳ）后小鼠血清ＮＯ含量变化。通过检测ＮＯ在体内稳定的代谢产物ＮＯ２－／ＮＯ３－来表示ＮＯ的含量。用本法测定的正常昆明、ＩＣＲ、ＢＡＬＢ／ｃ小鼠血清及肝组织内ＮＯ２－／ＮＯ３－含量分别为３８．７±７．９，４８．８±４．４，４４．２±５．９μｍｏｌ／Ｌ及６４．４±２．２，７９．５±１２．１，７３．３±２９．３ｎｍｏｌ／ｇ；应用本法测定的正常ＩＣＲ小鼠血清及肝组织内ＮＯ２－／ＮＯ３－含量与应用硝酸根还原酶试剂合法测得值基本吻合；ｉｐ１，２，３ｍｇ／ｋｇ细菌内毒素后，ＩＣＲ小鼠血清的ＮＯ２－／ＮＯ３－含量分别上升至１６２．５±４７．８，４９４±１２３．６，６７４．８±２５９．７μｍｏｌ／Ｌ。表明本法测定这些生物样品中ＮＯ的含量是简便、可靠、有效的     

一氧化氮介导大鼠低氧性肺动脉高压的实验研究

为了解一氧化氮（ＮＯ）在低氧性肺动脉高压中的作用，并探讨其可能机理，检测正常对照组及缺氧１、２、３周组大鼠血浆ＮＯ水平，并给缺氧２周组大鼠注入左旋精氨酸及Ｎ＾Ｇ－硝基－左旋精氨酸，观察其对大鼠血流动力学及肺病理改变的影响。结果：ＮＯ水平在缺氧１、２、３周时分别为５±２．６７μｍｏｌ／Ｌ、２．１±．０．４１μｍｏｌ／Ｌ和０．５±０．１６μｍｏｌ／Ｌ，明显低于正常对照组６．７３±１．８３μｍｏｌ／Ｌ（     

妊娠肝内胆汁瘀积症对母儿的危害分析

为探讨妊娠肝内胆汁瘀积症（ＩＣＰ）对母儿的影响,对１９８９～１９９６年在我院住院分娩的４７１例ＩＣＰ患者的症状、肝功及妊娠结局进行了回顾性分析。结果：搔痒出现孕周平均３２．４±４．７周（１２～４０周）;早产率１６．６％（７８例）;围产儿死亡率１２．７‰（６例）;羊水Ⅱ°～Ⅲ°１１４例（２４．２％）;分娩方式（自然产＝１,阴道助产＝２,剖宫产＝３）与新生儿Ａｐｇａｒ评分呈正相关（ｒ＝０．１１８８,Ｐ＜０．０５）;３０～３３＋６周组羊水性状明显比３７周组差（０．８９±１．１１比０．５５±０．９６,Ｐ＜０．０５）;血总胆红素＞３４μｍｏｌ／Ｌ组羊水性状明显比１７．１～３４μｍｏｌ／Ｌ组差（０．９６±１．１１比０．６５±１．０４,Ｐ＜０．０５）;血总胆汁酸＞４０μｍｏｌ／Ｌ组羊水性状比正常组（≤２０μｍｏｌ／Ｌ）差（０．８９±１．１比０．３３±０．８８,Ｐ＜０．０５）。由此提示：搔痒出现孕周的提前（３０～３６＋６周）、血总胆红素及总胆汁酸的增加可作为ＩＣＰ程度划分的指标,适时的剖宫产可以提高新生儿Ａｐｇａｒ评分。     

全胃切除术后肠外结合肠内营养支持

目的：对比全胃切除术后的肠外营养（ＰＮ）结合肠内营养（ＥＮ）与标准ＰＮ的支持效果。方法：１６例患者随机分为两组，两组患者从术后ｄ１到术后ｄ１１进行等氮、等热量营养支持。结果：（１）ＰＮ＋ＥＮ组体重下降（１．２±０．２２）ｋｇ，ＰＮ组体重下降（２．６１±０．１６）ｋｇ；（２）ＰＮ＋ＥＮ组１１ｄ累积氮平衡（２２３．３±３２．９）ｍｇ／ｋｇ，ＰＮ组１１ｄ累积氮平衡（１３４．６±１８．５）ｍｇ／ｋｇ；（３）ＰＮ＋ＥＮ组血清白蛋白下降（０．６±０．２）ｇ／Ｌ，ＰＮ组下降（６．０＋０．３）ｇ／Ｌ；（４）ＰＮ＋ＥＮ组德中谷氨酰胺下降（１８±６．４）μｍｏｌ／Ｌ，ＰＮ组下降（１０７±７．８）μｍｏｌ／Ｌ；（５）ＰＮ＋ＥＮ组血中Ｃ３补体下降（１１±３２）ｍｇ／Ｌ，ＰＮ组下降（１０２±６２）ｍｇ／Ｌ。结论：ＰＮ结合ＥＮ较标准ＰＮ更适合于全胃切除术后的肠功能恢复特点，有更好的代谢效果     

新生儿行为神经测定在高胆红素血症的应用

对新生儿进行行为神经测定可以了解新生儿行为及神经系统情况。鲍秀兰教授等根据近年最具有代表性的新生儿行为和神经测定方法（美国Ｂｒａｚｅｌｔｏｎ和法国Ａｍｉｅｌ－Ａｉｓｏｎ）,结合我国实际情况制定了新生儿行为神经评分法２０项（ＮＢＮＡ）。本研究应用ＮＢＮＡ测定新生儿高胆红素血症患儿３０例及正常新生儿５０例,现报告如下。１　对象和方法选择１９９８年６月至１２月出生于我院产科的高胆红素血症患儿３０例,男１４例,女１６例,在生后第５～７天时查血清胆红素为（２６３．４１±２９．５１）μｍｏｌ·Ｌ１。除血清…     

血β_2－微球蛋白在慢性肺心病缓解期判定肾功能减退的价值

对３０例慢性肺心病缓解期患者及５０例正常人采用ＲＩＡ法测定了血清的β_２－微球蛋白（β_２－ＭＧ），结果显示：慢性肺心病缓解期患者血清β_２－ＭＧ值为３．５±０．５８ｍｇ／Ｌ，较正常人血清β_２－ＭＧ值３．２４±０．４５ｍｇ／Ｌ为高（ｔ检验，Ｐ＜０．０１），肺心病缓解期患者中有１４例（Ａ组）血清β_２－ＭＧ值为４．２９±０．３８ｍｇ／Ｌ，超过正常上限，且血ＢＵＮ６．８ｍｍｏｌ／Ｌ，Ｃｒ１３２μｍｏｌ／Ｌ，Ｃｃｒ６４ｍｌ／ｍｉｎ；另１６例（Ｂ组）血清β_２－ＭＧ值（３．１２±０．３４ｍｇ／Ｌ）正常，血ＢＵＮ５．４ｍｍｏｌ／Ｌ，Ｃｒ１１４μｍｏｌ／Ｌ，Ｃｃｒ１０２ｍｌ／ｍｉｎ，两组β_２－ＭＧ及Ｃｃｒ比较有显著差异（ｔ检验，Ｐ＜０．０１）。提示血清β_２－ＭＧ测定在慢性肺心病缓解期患者中较ＢＵＮ、Ｃｒ能更早地发现肾功能减退。     

血清亚硝酸盐的快速测定

目的：建立一种无需去蛋白的血清亚硝酸盐的快速测定方法。方法：加入蛋白活化剂后，直接用Ｇｒｉｅｓ试剂显色分光光度测定。结果：方法的检测下限为０．２μｍｏｌ／Ｌ，相对标准差为５．１３％～８．８６％，回收率为９４．５％～９９．８％（平均为９７．８％）。血清ＮＯ－２浓度为１４．３８±０．２５μｍｏｌ／Ｌ时，批内变异系数为１．７５％，ＮＯ－２浓度为５．６９±０．２５μｍｏｌ／Ｌ时，批间变异系数为４．４６％。测定５５例正常人血清，得到血清中ＮＯ－２浓度的平均值分别为５．３６±２．１６ｕｍｏｌ／Ｌ；对糖尿病病人血清测定结果表明，亚硝酸盐浓度明显高于正常人。与去蛋白的Ｇｒｉｅｓ试剂分光光度法比较，结果无统计学差异。结论：用蛋白活化剂替代蛋白沉淀剂，减少操作步骤和干扰，测定准确、简便、快速，适用于血清中ＮＯ－２的测定。     

肾病综合征病人抗氧化功能的研究

为研究肾病综合征（ＮＳ）时抗氧化功能状况，我们测定３６例患者血超氧化物歧化酶（ＳＯＤ）、丙二醛（ＭＤＡ）及维生素Ｅ，以及尿ＳＯＤ、ＭＤＡ。结果表明：ＮＳ患者血总ＳＯＤ、Ｃｕ－Ｚｎ－ＳＯＤ及维生素Ｅ水平明显低于正常对照组（分别为７６．２２±２７．４８μＵ／Ｌ比１０４．２０±１８．８０μＵ／Ｌ，Ｐ＜０．００１；２０．４０±２２．６３μＵ／Ｌ比６２．９９±１５．６０μＵ／Ｌ，Ｐ＜０．００１；６．６８±３．５２ｍｇ／Ｌ比１６．３８±１．０５ｍｇ／Ｌ，Ｐ＜０．００１）；尿ＳＯＤ及ＭＤＡ明显高于对照组（分别为：１１４．９８±３１．７３μＵ／Ｌ比８２．３４±２６．５０μＵ／Ｌ，Ｐ＜０．００１；３．９９±１．９８μｍｏｌ／Ｌ比２．６４±０．７８μｍｏｌ／Ｌ，Ｐ＜０．００１）．研究提示，ＮＳ时抗氧化功能减退，肾脏易遭受氧自由基损害。     

高浓度二氧化碳致大鼠全身性水肿的机理研究

目的　探讨高碳酸血症时大鼠全身性水肿发生的机理。方法　给大鼠呼吸高浓度二氧化碳气体（８ ％ Ｃ Ｏ２ 、２１ ％ Ｏ２ ,７１ ％ Ｎ２） ,每天７ 小时,连续４ 周。观察高碳酸血症大鼠各项指标的变化,并设对照组。结果　对照组平均肺动脉压（ｍ Ｐ Ａ Ｐ） 为（１９４ ±０２８） ｋ Ｐａ, Ｐａ Ｃ Ｏ２ 为（４６ ±０９） ｋ Ｐａ 。大鼠循环血中１２５ Ｉ牛血清白蛋白半排出时间（ Ｔ１／２） 为（２３８ ±３０） ｍｉｎ ;血浆过氧化脂质（ Ｌ Ｐ Ｏ） 为（３０ ±０６）ｎｍｏｌ／ｍｌ,红细胞超氧化物歧化酶（ Ｓ Ｏ Ｄ） 活性为（１ ０４２ ±１３５） Ｕ／ｇ Ｈｂ 。肺组织中水含量为（７６２ ±１０） ％ ,肌组织为（７４１ ±２８） ％ 。高碳酸血症组ｍ Ｐ Ａ Ｐ 为（２０ ±０４） ｋ Ｐａ 、 Ｐａ Ｃ Ｏ２ 为（７４ ±０４） ｋ Ｐａ 、 Ｔ１／２ 为（１５０ ±２３） ｍｉｎ 、 Ｌ Ｐ Ｏ 为（８８ ±２０） ｎｍｏｌ／ｍｌ、 Ｓ Ｏ Ｄ 为（６８２ ±３４１） Ｕ／ｇ Ｈｂ 、肺组织中水含量为（７８８±１８） ％ 、肌组织为（７６０ ±１０） ％ 。两组比较ｍ Ｐ Ａ Ｐ 差异无显著意义（ Ｐ＞ ００５） ; Ｐａ Ｃ Ｏ２ 、     

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.