肝动脉注射^32P—玻璃微球对家猪肝细胞损伤的超微形态定？…

目的：对肝动脉注射＾３２Ｐ－玻璃微球（＾３２Ｐ－ＧＭＳ）的肝细胞损伤进行电镜形态计量，为肝癌的放射介入治疗提供形态学依据。方法：７只家猪经肝动脉注脉直径为４６￣７６μｍ的ＧＭＳ，其中４只注射性＾３２Ｐ－ＧＭＳ，３只注射＾３１Ｐ－ＧＭＳ（对照），术后２、４、１６周分批取不同部位的肝组织进行常规电镜制样和电镜形态计量分析。结果：＾３２Ｐ－ＧＭＳ术后２周和４周时，核异常率及线粒体变异率均明显高于＾３１Ｐ     

地塞米松对大鼠内毒素肝损伤保护作用的探讨

Ｗｉｓｔａｒ大白鼠腹腔注射Ｅ．ｃｏｌｉ内毒素纯制剂（２ｍｇ／Ｋｇ体重），１２小时后，其肝脏线粒体琥珀酸脱氢酶（ＳＤＨ）活力显著降低（Ｐ＜０．０１），胞浆还原型谷胱甘肽（ＧＳＨ）水平明显下降（Ｐ＜０．０５）。线粒体内丙二醛类脂质过氧化物（ＬＰＯ）含量和超氧化物歧化酶（ＳＯＤ）活力显著增加（Ｐ均小于０．０１）。线粒体膜脂质成分ＰＥ、ＰＳ、ＰＣ含量均明显下降，ｌｙＳｏ－ＰＣ显著增加。组织学和电镜观察表现为一定程度的肝细胞损伤。用地塞米松按４ｍｇ／Ｋｇ体重，分别在内毒素处理的同时、２小时后４小时后注射。结果显示：同时注射和２小时后注射组，上述各项生化指标与内毒素组比较均有显著改善，而４小时后注射组无明显改善。     

^32磷玻璃微球内放射栓塞治疗肝癌的临床研究

目的：探讨＾３２磷玻璃微球（＾３２Ｐ－ＧＭＳ）对中晚期肝癌的内放射治疗效果。方法：应用＾３２Ｐ－ＧＭＳ治疗肝癌２１例。结果：治疗后彩色多谱勒超声检查，１７例肿瘤血流明显减少甚至完全减少；ＳＰＥＣＴ肝扫描显示，＾３２Ｐ－ＧＭＳ聚集在肿瘤区内，平均癌／肝比２．５：１；治疗后６，１２，１８个月生存率分别为８５．７％，６１．９％，５７．１％；１６种肿瘤有不同程度的缩小；无明显毒副反应。结论：＾３２Ｐ－ＧＭ     

内毒素对大鼠肝线粒体损害的生化机制研究膜──结构损害及脂质过氧化

本文观察了大鼠腹腔注射较低剂量Ｅ．Ｃｏｌ；内毒素纯制剂（ＬＰＳ，２ｍｇ／ｋｇ体重）后不同时间肝线粒体膜结构损害、自由基代谢，以及脂质过氧化物（ＬＰＯ）水平的变化。琥珀酸脱氢酶（ＳＤＨ）活性在注射内毒素后１４小时下降至对照组酶活性的７６．２％（Ｐ＜０．０１），２４小时后酶活性趋于回升。ＬＰＯ４小时增高，２４小时达对照组的１７３．２％（Ｐ＜０．０１），４８小时明显恢复。ＳＯＤ和ＧＳＨ－ｐｘ活性分别于４小时和２４小时下降，此后趋于增高并超过对照组水中。电镜观察肝细胞线粒体在１４和２４小时损害较严重。上述结果提示：实验选用剂量的内毒素引起肝细胞可逆性损害并出现膜的脂质过氧化，ＳＯＤ和ＧＳＨ－Ｐｘ活性可于降低后出现诱导性增高。本文结合前期工作讨论了磷脂酶Ａ的激活与膜脂质过氧化是导致膜磷脂组分改变的两个主要起始点，它们在肝细胞损害发展中具有重要作用。     

肝细胞生长因子与三七皂苷对自体肝细胞脾内移植的影响

目的：探索促进肝化脾增量及缩短其再生周期的新途径。方法：应用肝细胞生长因子（ＰＨＧＦ）与三七皂苷（ＰＮＧＳ）于自体肝细胞脾内移植（ＩＨＡＰ）的动物模型上，分别于移植术后２周、１２周时对病理组织学、电镜形态、肝化脾匀浆谷丙转氨酶含量及脾内肝细胞增殖指数等指标进行观察分析。结果：移植术后２周，三七皂苷组脾内肝细胞水肿、变性程度较轻，肝化脾匀浆丙氨酸转氨酶（ＡＬＴ）含量达（９２８．０±２６８．１）Ｕ／ｇ，较对照组［（６３９．４±１３８．４）Ｕ／ｇ］明显增高（Ｐ＜０．０１）；移植术后１２周，肝细胞生长因子组脾内肝细胞生长好，数量、面积大，肝化脾匀浆ＡＬＴ含量达［（２３２４．８±４００．８）Ｕ／ｇ］，增殖指数（Ｉｐ达３．８３％±０４２％［对照组分别为（１８３９．４±３６８．４）Ｕ／ｇ、２．８９％±０．４４％］，与对照组相比差异均有显著性意义（Ｐ＜０．０５）。结论：三七皂苷在早期对脾内肝细胞有一定的抗损伤保护作用，而肝细胞生长因子对加速肝化脾增量及缩短其再生周期有明显作用。     

大鼠隔-海马投射纤维损伤对内侧隔核NOS阳性神经元的影响

目的：观察离断成年大鼠一侧隔－海马投射纤维后内侧隔核（ＭＳ）一氧化氮合成酶（ＮＯＳ）阳性神经元的变化情况。方法：成年ＳＤ大鼠，切断一侧穹窿海马伞（ＦＦ），术后分别存活１、２、 ３、４周，进行 ＮＡＤＰＨ－ｄ组织化学方法染色。结果：损伤后１周， ＭＳ的ＮＯＳ阳性神经元减少了２１ ２８％，Ｐ＜０．０５；损伤２周减少了３６．０５％，Ｐ＜０．０１；损伤３～４周减少了３７．０１～３９．２９％，Ｐ＜０．０１。结论：受损侧ＭＳ的ＮＯＳ阳性神经元发生了一定程度的演变。     

~(32)磷-玻璃微球区域给药治疗肝癌的实验研究和组织吸收剂量估算

目的：研究３２磷－玻璃微球（３２Ｐ－ＧＭＳ）区域给药的药代动力学特点，探讨靶组织内辐照量和吸收剂量的估算方法。方法：模拟人类对７只家猪经肝动脉灌注给药或间质注射，对２０只人肝癌移植瘤裸鼠瘤体内注射，动态观测３２Ｐ－ＧＭＳ的分布与放射性计数率的衰减。结果：３２Ｐ－ＧＭＳ通过肝动脉给药，可有效栓塞至肝窦前小动脉，通过瘤体内注射可滞留在靶组织内不被排泄，给药第１４天的衰减分数为０．４８，其有效半减期与３２Ｐ物理半衰期值接近。经计算，３２Ｐ－ＧＭＳ放射性活度为３７ＭＢｑ时，在１ｋｇ肝组织内完全衰变，组织所接受的宏观平均吸收剂量是７３２ｃＧｙ。结论：本研究为３２Ｐ－ＧＭＳ对肝癌治疗的实验研究和临床应用提供了科学的剂量学依据。３２Ｐ－ＧＭＳ区域给药的稳定性使它逐步成为一种安全有效的内放射治疗肝癌的重要手段。     

经肝动脉灌注~(32)磷-玻璃微球治疗不能切除的原发性肝癌

目的：探讨３２磷玻璃微球（３２ＰＧＭＳ）治疗手术不能切除的原发性肝癌的效果。方法：用３２ＰＧＭＳ通过皮１下埋藏药盒注入肝动脉，选择性内放射治疗（ＳＩＲＴ）８例经手术证实不可切除的原发性肝癌，３２ＰＧＭＳ用量为０．６～１．８ＧＢｑ。并与同期的２０例肝动脉化疗栓塞（ＨＡＣＥ）治疗病例比较。结果：ＳＩＲＴ组无治疗死亡，治疗后３、６、１０个月生存率分别为１００％、６３．５％、３２．８％，中位生存期１０．３个月；ＡＦＰ有不同程度下降，幅度８７．５％～９９．８％，Ｂ型超声、电子计算机体层扫描显示肿瘤体积平均缩小３１．０％（２１．０％～６３．５％），有效率７５．０％，明显优于ＨＡＣＥ。结论：经肝动脉灌注３２ＰＧＭＳ治疗手术不能切除的原发性肝癌，兼有栓塞和放射治疗的双重优点，临床使用安全、方便，疗效较肝动脉化疗栓塞为优     

HSS介导依托泊甙对人肝细胞癌裸鼠移植瘤的抑制作用

目的：了解肝细胞生长刺激物质（ＨＳＳ）介导依托泊甙（ＶＰ－１６）对肝癌裸鼠移植瘤的抑制作用。方法：建立人肝细胞癌裸鼠移植瘤模型,对荷瘤小鼠腹腔内注射不同剂量ＶＰ－１６及ＨＳＳ治疗２周;治疗结束后,于不同时间处死动物,进行病理学检查,并计算肿瘤生长抑制率。结果：与对照组相比,中、大剂量ＶＰ－１６（０．７５,１．５ μｇ／ｇ）联合ＨＳＳ（１ μｇ／ｇ）组肿瘤生长明显受抑,抑瘤率分别为７１％ 和６９％ （Ｐ＜ ０．０１）,但中、小剂量组之间差异无显著性（Ｐ＞ ０．０５）;而小剂量联合（ＶＰ－１６ ０．３８ μｇ／ｇ）组及单用ＨＳＳ（１ μｇ／ｇ）组较对照组无明显差异（Ｐ＞ ０．０５）,抑瘤率分别为２３％ 和５％ 。单用大剂量ＶＰ－１６副作用明显。中、大剂量ＶＰ－１６联合ＨＳＳ均可显著延长小鼠存活期。结论：ＨＳＳ介导大、中剂量ＶＰ－１６具有明显抑瘤效应,以中剂量为佳。     

NK活性与裸鼠体内移植肿瘤生长的关系

Ｂａｌｂ／Ｃ－ｎｕ／ｎｕ裸小鼠２４只，随机分为两组。环磷酰胺组１２只，腹腔注射环磷酰胺２ｍｇ／只，１周后随机抽取６只作为受瘤鼠，皮下接种ＳＭＭＣ—７７２１人肝癌细胞（１×１０７个／只），另６只处死后测定脾脏淋巴细胞自然杀伤活性（ＮＫ活性）；对照组１２只，腹腔注射等渗盐水０．４ｍｌ／只，１周后处理同环磷酰胺组。结果表明，注射环磷酰胺后裸小鼠ＮＫ活性从２６．６７±６．３２％降至１５．００±３．８０％（Ｐ＜０．０１），环磷酰胺组肿瘤生长速度明显快于对照组（３３．９２±１０．２１ｖｓ２０．０３±８．３１ｍｍ／周，Ｐ＜０．０５），且环磷酰胺组肿瘤成瘤率高，而潜伏期短。提示ＮＫ活性在裸小鼠抗肿瘤免疫中具有重要的作用     

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.     

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.     

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.