青蒿琥酯对肺纤维化大鼠热休克蛋白47表达的影响

目的：探讨青蒿琥酯对肺纤维化大鼠热休克蛋白47（Hsp47）表达的影响。方法雄性 SD 大鼠30只,分为对照组、模型组和青蒿琥酯干预组（简称干预组）。对照组一次性气管内滴入生理盐水约0．4 mL,模型组和干预组一次性气管内滴入博来霉素5 mg／kg。对照组和模型组次日每天腹腔注射生理盐水1．0 mL。干预组每天腹腔注射青蒿琥酯10 mg／100 g。记录0、14、28 d 大鼠的体质量。各组大鼠于第28天处死,计算肺系数,取肺组织进行苏木精-伊红（HE）染色、Masson 染色、羟脯氨酸检测和Hsp47、Ⅰ型胶原 RT-PCR 和 Western blot 检测。结果（1）对照组大鼠体质量增长明显高于其他两组（P ＜0．05）。（2）肺系数：模型组[（12．31±1．89）mg／g]＞干预组[（8．54±0．67）mg／g]＞对照组[（4．81±0．38）mg／g],P ＜0．05。（3）Ashcroft 评分：模型组[（5．70±1．09）分]＞对照组[（3．08±0．56）分],模型组[（5．70±1．09）分]＞干预组[（4．01±1．25）分],P ＜0．05;对照组和干预组差异无统计学意义（P ＞0．05）。（4）羟脯氨酸含量：模型组（620．33±66．16）μg／g＞对照组（379．00±35．51）μg／g,模型组（620．33±66．16）μg／g＞干预组（429．00±36．51）μg／g,P ＜0．05;对照组和干预组间差异无统计意义（P ＞0．05）。（5）Hsp47 mR-NA：模型组高于对照组,模型组和干预组比较差异无统计意义（P ＞0．05）。Ⅰ型胶原 mRNA：模型组＞干预组＞对照组（P ＜0．05）。（6）Hsp47蛋白表达水平模型组明显高于对照组和干预组。结论青蒿琥酯可能通过下调 Hsp47表达水平来抑制胶原的合成进而减轻肺纤维化。     

ISCOM 型白血病瘤苗联合1-甲基色氨酸免疫治疗荷瘤小鼠疗效观察

目的：探讨免疫刺激复合物（ISCOM ）型白血病肿瘤疫苗（简称瘤苗）联合1-甲基色氨酸对荷瘤小鼠的治疗作用。方法皂苷溶液中加入脂肪酶蛋白（1 mg／mL ）7℃反应12 h ,加入80μL 脂类混合物溶液和5 mL 皂苷溶液（1 mg／mL ）制备ISCOM 型白血病瘤苗。 C57BL／6小鼠分为模型组、ISCOM 型白血病瘤苗组、1-甲基色氨酸组和联用组（ISCOM 型白血病瘤苗＋1-甲基色氨酸）,小鼠注射 FBL-3细胞建立白血病荷瘤小鼠模型,模型组给予等量生理盐水,其余各组接受对应药物治疗4周后,记录体质量,NK 细胞、Mφ细胞和细胞毒 T 淋巴细胞（CTL）细胞杀伤活性、血清 IL-10和 IL-12表达水平。结果联用组瘤质量低于1-甲基色氨酸组和 ISCOM 型白血病瘤苗组[（0．64±0．26）g vs ．（2．49±0．91）g ,P＜0．01;（0．64±0．26）g vs ．（1．28±0．73） g ,P＜0．05）];联用组 M φ细胞杀伤活性显著高于1-甲基色氨酸组[（55．69±13．69）％ vs ．（69．47±14．79）％,P＜0．01）];联用组NK 细胞杀伤活性显著高于1-甲基色氨酸组[（38．41±8．27）％ vs ．（67．22±12．74）％,P＜0．01];联用组 CTL 细胞杀伤活性高于1-甲基色氨酸组和 ISCOM 型白血病瘤苗组[（43．77±8．89）％ vs ．（69．68±11．44）％,P ＜0．01;（58．87±9．45）％ vs ．（69．68±11．44）％,P＜0．05）];联用组 IL-10均显著低于1-甲基色氨酸组、ISCOM 型白血病瘤苗组[（76．2±6．82）pg／L vs ．（98．3±13．4） pg／L ,P＜0．01;（76．2±6．82）pg／L vs ．（202．3±44．5）pg／L ,P＜0．01）];联用组 IL-12高于1-甲基色氨酸组、ISCOM 型白血病瘤苗组[（381．2±47．3）pg／L vs ．（332．1±30．2）pg／L ,P ＜0．05;（381．2±47．3）pg／L vs ．（291．2±17．3）pg ／L ,P＜0．01）。结论ISCOM 白血病瘤苗联合1-甲基色氨酸具有较佳的抗瘤活性,其机制可能是通过介导 IL-10和 IL-12的表达。     

腹腔镜肝切除术治疗肝内胆管结石的临床效果对比研究

目的：探讨应用腹腔镜肝切除术治疗肝内胆管结石的可行性和治疗效果。方法回顾性分析该院2003年11月至2012年11月75例肝内胆管结石患者的手术治疗。其中35例患者进行腹腔镜肝切除术（腹腔镜组）,40例患者采用开腹肝切除术进行治疗（开腹组）。两组患者的手术方式包括左肝外叶切除术、左半肝切除术、胆总管切开探查、胆道镜探查取石、T 管引流、胆囊切除。分析和对比两组患者的临床指标,包括手术时间、术中出血量、止痛药使用情况、下床活动时间、恢复饮食时间、术后住院时间、并发症、结石清除率以及复发率。结果腹腔镜组的手术时间长于开腹组[（205．0±40．9）min vs ．（155．0±26．6）min ,P＜0．01]。腹腔镜组的术后住院时间比开腹组短[（12．3±2．6）d vs ．（15．6±4．3）d ,P ＜0．01];术中出血量稍多于开腹手术组[（330．0±259．7）mL vs ．（151．5±137．0）mL ,P＜0．01],然而腹腔镜组后10例患者的出血量与开腹组相当[（81．0±19．7）mL vs ．（78．0±22．0）mL ,P＞0．05]。腹腔镜组术后止痛药使用率低于开腹组（0 vs ．62．5％,P＜0．01）;比开腹组更早地恢复下床活动[（1．5±0．5）d vs ．（3．6±0．7）d ,P＜0．01]和进食[（2．4±0．5）d vs ．（4．0±0．7）d ,P ＜0．01]。两组总并发症发生率（2．9％ vs ．16．0％）、结石清除率（即时清除率91．4％ vs ．90％和最终清除率97．1％ vs ．100％）及手术优良率（97．1％ vs ．100％）差异无统计学意义（P＞0．05）,且均无围术期死亡病例。结论对于符合入选标准的病例,腹腔镜肝切除术联合胆道镜治疗肝内胆管结石是安全可行的,可以达到与开腹手术同样良好的效果。腹腔镜肝切除治疗肝内胆管结石具有伤口小、痛苦轻、恢复快、并发症少等微创手术的优势。     

心理应激大鼠血浆 NO 水平及内皮细胞 NO 调控蛋白表达的变化

目的：心理应激对血管内皮细胞（ vascular endothelial cells， VEC）损伤的确切机制尚未清楚。文中拟建立空瓶刺激心理应激大鼠血管内皮损伤模型，探讨心理应激所致VEC损伤大鼠血浆中NO水平的改变及NO相关调控蛋白表达的变化。方法将20只雄性SD大鼠按随机数字表法分为对照组和模型组，各10只。对照组：群居饲养，早晚9点规律饮水10 min；模型组：孤独饲养，前7 d固定早晚9点饮水10 min，第8天开始造模，早晚9点按随机表给予饮水或空瓶刺激10 min。造模时间为期90 d。2组均按体重腹腔注射等渗盐水（0．2 mL／100 g），2次／d。用旷场实验观察大鼠行为学变化；酶联免疫吸附法（ enzyme linked immunosorbent assay， ELISA）检测血浆中皮质醇、肾上腺素、内皮素-1含量，硝酸还原酶法检测血浆NO含量，LC-ESI-MS分析VEC NO调控相关蛋白的表达。结果对照组垂直得分（7．00±0．70）分、水平得分（37．60±4．50）分、总得分（44．50±5．50）分，模型组分别为（11．28±1．79）分、（56．25±1．71）分、（67．25±2．98）分，2组差异均有统计学意义（P＜0．01）；对照组血浆皮质醇、肾上腺素[（65．28±2．21）ng／mL、（3．85±0．35）pg／mL]较模型组[（83．85±1．95）ng／mL、（15．14±3．97）pg／mL]明显降低（P＜0．01）；对照组NO／内皮素-1（1．04±0．19）较模型组（0．64±0．08）明显升高（P＜0．01）。LC-ESI-MS分析得知，与对照组比较，模型组差异蛋白表达数为238，其中上调134，下调104；与对照组比较，模型组与NO调控相关的蛋白表达均下降。透射电镜显示，模型组VEC的线粒体嵴模糊，部分线粒体出现空泡；对照组 VEC线粒体结构完整，嵴清晰、排列紧密。结论空瓶刺激心理应激引起NO水平降低及其相关调控蛋白的表达下降，是造成VEC功能和结构损伤的重要机制之一。     

糖尿病大鼠创面愈合中巨噬细胞的浸润变化

目的：对糖尿病创面中巨噬细胞浸润变化的了解有助于探索糖尿病慢性创面愈合困难的原因。文中通过观察糖尿病大鼠全层皮肤缺损创面愈合过程中巨噬细胞浸润的数量及炎症因子的表达,初步探讨其与糖尿病鼠创面愈合延迟的相关性。方法以雄性SD大鼠为实验动物,采用链脲佐菌素诱导形成糖尿病模型鼠设为模型组,对照组为健康同龄SD大鼠,每组15只。在大鼠背部形成面积为1 cm2为全层皮肤缺损,分别于术后第3、7、14天切取创面及创周组织,观察并比较创面的愈合率、巨噬细胞浸润密度及创面组织中IL-12B、诱导型一氧化氮合酶（ inducuble nitric oxide synthase , iNOS）、TNF-αmRNA表达量,倒置荧光显微镜观察高倍视野下CCRT阳性细胞染色情况。结果术后第3、7、14天时模型组创面愈合率均低于对照组[（29．5±5．4）％vs （45．9±12．8）％、（71．6±3．1）％ vs （80．1±6．9）％、（93．9±2．8）％ vs （99．4±1．4）％],差异有统计学意义（ P＜0．05）;HE染色显示第3天时模型组创面组织内的炎症细胞浸润密度低于对照组,而第14天时高于对照组;CD68免疫组化染色显示第3天时模型组大鼠创面组织内巨噬细胞的浸润密度低于对照组（ P＜0．01）,而第14天时则明显高于对照组（P＜0．01）;针对2组小鼠相关性分析显示,第3天时创面巨噬细胞数和创面愈合率呈正相关（r＝0．909,P＜0．01）,第14天时两者间呈负相关（r＝-0．962, P＜0．01）;模型组创面组织中的炎症因子IL-12B、iNOS、TNF-α的mRNA表达量术后第3天时较对照组降低（ P＜0．05）,而第14天时较对照组升高（ P＜0．05）;创面组织CCR7荧光染色显示第14天时仍有较多阳染细胞残留于模型组创面组织内。结论糖尿病大鼠创面愈合过程中巨噬细胞早期进入创面的数量减少,而晚期则持续停留于创面,同时伴随着相关炎症因子表达量的改变,这可能与糖尿病创面愈合困难具有一定的相关性。     

卡维地洛对慢性心力衰竭大鼠心肌酪氨酸羟化酶表达的影响

目的：评价卡维地洛（Carvedil01）对慢性心力衰竭（CHF）大鼠心肌酪氨酸羟化酶（TH）表达的影响．方法：应用阿霉素腹腔注射制作CHF大鼠模型,根据干预药物的不同随机分为Carvedilol治疗组（CHF—C组,n=9）,倍他乐克（Betaloc）治疗组（CHF-M组,n=9）,CHF安慰剂治疗组（CHF—P组,n=9）和正常对照组（NC组,n=6）．阿霉素应用第5周后采用灌胃给药途径,CHF,C组以Carvedilol 0．25mg／kg,1次／d进行干预;CHF-M组以Betaloc0．25mg／kg,10〈／a进行干预;CHF—P组和NC组加以食用淀粉0．25mg／kg,1次／d进行干预．10wk后透射电镜检测大鼠心肌超微结构,并采用RT-PCR和WesternBlot方法检测大鼠心肌TH表达水平．结果：大鼠心肌THmRNA和蛋白表达水平CHF—C组明显低于NC组[（0。94±0．31）US（1．18±0．39）,（0．91±0．50）vs（1．32±0．41）,均P〈0．05];但明显高于CHF—P组[（0．94±0．31）VS（0．47±0．12）,（0．91±0．30）US（0．41±0．14）,均P〈0．05];也明显高于CHF—M组[（0．94±0．31）掷（0。66±0。20）,（0．91±0．30）vs（0．58±0．19）,均P〈0．05]．结论：CHF大鼠心肌TH表达水平明显下调,Carve-dilol治疗能够阻止CHF心肌TH下调,有助于改善CHF大鼠心肌交感神经重构．     

三磷酸肌醇和PTEN基因表达在槲皮素抑制裸鼠肝癌增长中的作用

目的探讨三磷酸肌醇（IP3）和PTEN基因表达变化在槲皮素（quercetin）治疗裸鼠移植人肝癌中的作用。方法以裸鼠移植人肝癌为对照组．槲皮素治疗组腹腔注入槲皮素50mg／（kg·d）,对照组腹腔注入含0．04％DMSO的RPMll640培养基0．05mL／g,3周后观察肝癌增长情况,并应用同位素试剂盒检测肝癌组织IP3含量,RT-PCR分析癌组织PTENmRNA表达,Westernblotting分析肝癌组织PTEN蛋白表达。结果治疗组肝癌体积和重量均显著低于对照组[体积（15．8±10．1）mm^3vs（52．3±26．5）mm^3,重量（44．8±10．4）mgvs（91．3±31．4）mg],PTENmRNA表达显著高于对照组[RI（灰度与面积之积的相对强度）0．81±0．24US0．36±0．09]（P〈0．01）,PTEN蛋白表达显著高于对照组[RI（灰度与面积之积的相对强度）3．14±0．13vs 1．08±0．15]。结论槲皮素能减少IP3生成,上调肝癌组织PTEN基因表达．抑制裸鼠移植人肝癌增长。     

红细胞生成素对高糖诱导人肾小管上皮细胞转分化的影响及其可能机制

目的：肾间质纤维化（ renal interstital fibrosia , RIF）的核心是肾小管上皮细胞转分化。探讨促红细胞生成素（Erythropoietin, EPO）对高糖诱导的正常人肾小管上皮细胞（human kidney cells, HK-2）转分化的影响及其可能机制。方法体外培养HK-2细胞,按随机数字表法分为空白对照组、高糖诱导组（高糖终浓度30 mmol/L）、甘露醇对照组（甘露醇浓度24．5 mmol/L）、EPO对照组（ EPO终浓度为20 U/mL）、5 U/mL EPO干预组、10 U/mL EPO干预组、20 U/mL EPO干预组及ROCK抑制剂（ Y27632）组（ Y27632终浓度为30μmol/L,加入Y2763230 min后加高糖,高糖终浓度为30 mmol/L）,各组均刺激24 h。应用RT-PCR法检测细胞 RhoA mRNA、ROCK1 mRNA 的水平;细胞免疫荧光法检测细胞 E-钙黏蛋白、α-平滑肌肌动蛋白（αsmoothmuscleactin,α-SMA）的表达;ELISA法检测上清液纤维连接蛋白（fibronectin, FN）的表达。结果 RT-PCR结果显示高糖诱导组RhoA mRNA及ROCK1 mRNA表达较空白对照组显著升高（1．400±0．022 vs 0．945±0．132,1．913±0．011 vs 1．007±0．002,P＜0．05）;5、10、20 U/mL EPO干预组,RhoA mRNA的表达水平（0．278±0．006、0．770±0．005、0．334±0．009）均较空白对照组（0．945±0．131）减少（P＜0．05）,ROCK1 mRNA的表达水平（1．418±0．006、0．919±0．004、0．477±0．002）较空白对照组（51．007±0．002）减少（P＜0．05）;ELISA及细胞免疫荧光结果显示高糖诱导组FN、α-SMA蛋白的表达较空白对照组明显增加[（14545．53±317．27）ng/mL vs （2582．50±87．20）ng/mL,0．335±0．006 vs 0．224±0．006,P＜0．05];直线相关性分析,高糖诱导组,5、10、20 U/mL EPO干预组RhoA mRNA与ROCK1 mRNA表达均呈正相关（P＜0．05）。高糖诱导组α-SMA较空白对照组上升,E-钙黏蛋白较空白对照组下降（P＜0．05）;EPO干预组及ROCK抑制剂组E-钙黏蛋白表达较高糖诱导组增加,而α-SMA表达下降（P＜0．05）;ELISA结果显示,EPO干预组ROCK抑制剂组FN表达较高糖诱导组下降（P＜0．05）,且下降程度与EPO浓度相关。结论 EPO可抑制高糖诱导的HK-2细胞转分化,从而延缓肾间质纤维化,其机制可能与RhoA/ROCK信号通路有关。     

饮食诱导非酒精性脂肪性肝病大鼠脂联素受体2基因的表达及其意义

[目的]探讨脂联素受体-2（AdipoR2）在饮食诱导非酒精性脂肪性肝病大鼠模型肝脏组织中的表达差异[方法]采用反转录PCR（FIT—PCR）法检测饮食诱导非酒精性脂肪性肝病与对照组大鼠肝脏中的AdipoR2 mRNA表达差异,同时检测大鼠脂联素、胰岛素抵抗指数及血糖水平。[结果]模型组大鼠肝脏组织中AdipoR2 mRNA为0．3964±0．0988,而对照组为1．2254±0．1462,两者间差异有显著性意义（P〈0．01）。模型组血糖为（5．44±0．58）mmol／L,与对照组（5．25±0．14）mmol／L比较差异无显著性意义;模型组脂联素水平（3．56±0．78）mg／mL,低于对照组的（4．71±0．30）mg／mL,P〈0．05,而前者胰岛素抵抗指数为2．39±0．16,较后者1．32±0．30明显增高（P〈0．01）。[结论]肝脏脂联素受体2表达下调可能是引起非酒精性脂肪性肝病的原因;与糖、脂肪代谢障碍,胰岛素抵抗程度提高有关。     

地黄多糖对过表达Notch1（NICD）大鼠骨髓间充质干细胞诱导分化及增殖的影响

目的：探讨地黄多糖对过表达Notch1（NICD）大鼠骨髓间充质干细胞（BMSCs）诱导分化及增殖的影响。方法以P3～P5代大鼠B MS C s为研究对象,将细胞随机分为正常对照组、空载体组和转染组。脂质体法转染Notch1（NICD）过表达真核载体,转染后以地黄多糖（0．2 mg／mL）进行诱导分化,转染和诱导后行细胞一般状态观察,采用免疫细胞化学法和Western blotting法检测Notch1（NICD）蛋白、神经元特异性烯醇化酶（NSE）和胶质纤维酸性蛋白（GFAP）表达,CCK-8检测细胞存活率。结果转染后转染组细胞似神经胶质样细胞形态改变,诱导后各组细胞似神经元样细胞形态结构,转染组显著。转染组Notch1和GFAP蛋白表达阳性率显著高于正常对照组和空载体组（P＜0．05）,而NSE在3组间差异无统计学意义（P＞0．05）;诱导后转染组NSE阳性率高于正常对照组和空载体组（P＜0．05）。转染后与诱导后比较,转染组Notch1表达阳性率降低（P＜0．05）,且正常对照组与空载体组亦降低（P＜0．05）;转染组NSE表达阳性率明显升高（P＜0．01）,且正常对照组与空载体组明显升高（P＜0．01）;转染组GFAP表达阳性率明显降低（P＜0．01）。CCK-8检测显示,地黄多糖诱导后,随时间延长各组细胞存活率略呈下降趋势。结论转染高表达Notch1（NICD）大鼠BMSCs具有向神经胶质样细胞分化倾向,地黄多糖显著抑制Notch1蛋白的表达,诱导BMSCs向神经元样细胞分化。     

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.