血中内皮素、一氧化氮水平与妊高征的关系研究

目的　探讨内皮素 (ET)和一氧化氮 (NO)在妊高征发病中的作用。方法　采用放射免疫法和硝酸还原酶法检测 31例妊高征患者 (妊高征组 )与 2 7例正常足月妊娠妇女 (正常妊娠组 )的血浆ET和血清NO水平。结果　妊高征组血浆ET水平为 10 5 .78± 2 2 .77ng/L ,明显高于正常妊娠组 (6 8.38± 13.2 3ng/L) (P <0 .0 0 1) ,病情越重 ,其值越高 ;妊高征组血清NO水平为 2 1.96± 13.40 μmol/L ,明显低于正常妊娠组 (86 .76± 2 6 .72 μmol/L) (P <0 .0 0 1) ,病情越重 ,其值越低 ;正常妊娠组ET和NO相关不显著 ,妊高征组ET和NO呈负相关关系 (P <0 .0 1)。结论　ET和NO在妊高征的发病中起重要作用 ,ET/NO比值越大 ,病情越重。     

血浆中一氧化氮及内皮素含量与大鼠弥漫性脑损伤关系的研究

目的 :观察大鼠弥漫性脑损伤后血浆中一氧化氮 (NO)及内皮素 (ET 1)含量的变化。方法 :利用Mar marou创立的模型造成大鼠不同程度的弥漫性脑损伤 ,于伤后 6h抽血检测血浆中NO及ET 1含量。结果 :轻、重度弥漫性脑损伤后血浆中NO及ET 1均有明显升高 ,(P <0 .0 5 )。其中轻度损伤后血浆中NO含量从 (2 6 .70±3.30 ) μmol/L升高至 (35 .6 8± 2 .39) μmol/L ,ET 1含量从 (85 .0 7± 2 .89)ng/L升高至 (94 .2 0± 3.4 6 )ng/L。重度弥漫性脑损伤后血浆中NO含量升高至 (46 .86± 4 .1) μmol/L ,ET 1含量升高至 (131.0 4± 9.0 )ng/L。 结论 :NO和ET 1参与弥漫性脑损伤的原发及继发性神经组织损伤的病理过程 ,且二者的血浆浓度与脑损伤程度密切相关。     

布-加综合征患者血浆NO、CO及内皮素测定

目的 :探讨布 加综合征患者血浆一氧化碳 (CO)的水平和影响因素 ,以及CO在布 加综合征发病中的作用和意义。方法 :测定了 30例布 加综合征患者分流减压术前后外周血浆中CO、一氧化氮 (NO)及内皮素 1 (ET 1 )的水平 ,并以 30例正常人为对照。结果 :布 加综合征患者手术前血浆CO、NO及ET 1的水平均显著高于正常对照组 (CO (0 .89± 0 .1 1 )mg/L ,(0 .42± 0 .1 3)mg/L ;NO(87.31± 1 0 .41 ) μmol/L ,(55 .2 3± 1 0 .2 3) μmol/L ;ET 1(80 .0 2± 1 0 .89)ng/L ,(48.75± 1 1 .50 )ng/L ,P均 <0 .0 5) ,分流术后 3者的水平有明显下降 (P均 <0 .0 5)。 结论 :CO可能参与了布 加综合征的病理生理过程 ,增高的门静脉压力可能是刺激机体合成CO增多的原因之一     

L-精氨酸对接振家兔外周血管功能保护作用的研究

目的探讨L 精氨酸对后肢接振家兔外周血管功能的保护作用及意义。方法将家兔随机分为单纯接振组 (A组 ) ,L 精氨酸组 (B组 )和对照组 (C组 ) ,并进行接振试验。从试验第 11天起 ,每隔 2d给予B组L 精氨酸 2 0mg/kg ,分别测定各组血浆一氧化氮 (NO)、内皮素 (ET)浓度进行测定分析。结果试验前及试验后第 10天、2 0天、3 0天 ,A组NO浓度分别为 ( 172 .40 0± 12 .3 5 0 ) μmol/L、( 167.915± 7.879) μmol/L、( 15 0 .0 88± 7.45 3 ) μmol/L、( 13 2 .3 13± 8.747) μmol/L ,ET浓度分别为 ( 4 3 .5 75±8.166) μg/L、( 4 6.2 13± 5 .44 8) μg/L、( 5 3 .788± 6.0 3 7) μg/L、( 66.613± 9.485 ) μg/L ;B组浓度分别为 ( 172 .85 0± 13 .3 2 3 ) μmol/L、( 167.788± 10 .5 3 1) μmol/L、( 164 .12 5± 8.3 80 ) μmol/L、( 161.813± 7.63 9) μmol/L ,ET浓度分别为 ( 4 3 .5 13± 4.90 1) μg/L、( 4 7.175± 7.481) μg/L、( 4 7.0 2 5± 5 .0 2 6) μg/L、( 4 7.60 0± 4.883 ) μg/L。随接振时间延长 ,A组NO浓度有明显降低、ET浓度有明显升高趋势 (P <0 .0 1) ;B组也有类似变化 ,但变化幅度较小。结论L 精氨酸可通过影响接振家兔血管内皮活性物质而保护外周血管功能。     

硫酸镁治疗重型颅脑损伤的近期疗效研究

目的:探讨硫酸镁治疗重型颅脑损伤患者的近期疗效.方法:选择78重型颅脑损伤病人为研究对象,随机分成实验组和对照组,实验组静脉使用硫酸镁,对照组不用此药,监测两组患者治疗的第1、3、7日的GCS和血浆ET,血清NO水平,并进行统计学分析处理.结果:在治疗的第3日和第7日,GCS:实验组为8.50±2.62 和 9.87±2.92,对照组为7.71±2.75和8.19±2.86,实验组患者的GCS高于对照组;血浆ET:实验组为92.45±14.38ng/L和94.47±18.27ng/L,对照组为108.12±14.38ng/L和113.47±19.57ng/L;血清NO:实验组为92.84±33.43μmol/L和 96.18±21.35μmol/L对照组为110.48±23.59μmol/L and 116.64±26.36μmol/L,实验组血浆ET和血清NO水平低于对照组;两组间GCS、ET和NO差异有显著意义(P<0.05).结论:早期应用硫酸镁治疗,能减轻继发性脑损伤,改善重型颅脑损伤患者的预后.     

SLE患者血浆中神经肽Y、内皮素和一氧化氮的检测及意义

[目的 ]探讨系统性红斑狼疮 (SLE)患者血浆中神经肽Y、内皮素及一氧化氮水平的变化及其意义。 [方法 ]采用放射免疫分析法及酶法对 30例女性SLE患者及 2 0例正常对照血浆中神经肽Y、内皮素及一氧化氮水平进行了检测。[结果 ]SLE患者血浆中神经肽Y (90 .5 1± 38.2 0 )ng/L、内皮素 (79.4 3± 2 0 .2 6 ) μmol/L及一氧化氮 (78.31± 1 2 .92 )ng/L水平明显高于正常对照组 ,有显著性差异 (P <0 .0 1 ) ;病情活动期SLE患者神经肽Y(1 1 4 .0 2± 33.2 6 )ng/L、内皮素 (98.6 1±1 9.5 2 ) μmol/L水平高于病情非活动期 ,有显著性差异 (P <0 .0 1 )。 [结论 ]女性SLE患者血浆中神经肽Y、内皮素及一氧化氮水平的变化可能与SLE的发病有关。     

低分子量肝素钙对不稳定性心绞痛的疗效及QTcd改善的临床研究

目的:观察低分子量肝素(LMWH)和普通肝素对不稳定性心绞痛(UA)的疗效和QTcd的改善程度.方法:将145例住院的UA患者随机分为2组,分别用LMWH和普通肝素治疗1周.结果:LMWH治疗组有效率:94.4%,普通肝素对照组组81.6%(P＜0.01);QTcd的改善LMWH治疗组也明显优于普通肝素对照组(P＜0.01).结论:早期应用LMWH治疗UA可以改善预后,降低副反应的发生率.     

茶色素对早期糖尿病肾病患者血浆GMP-140和血浆内皮素的影响

目的 :探讨茶色素对早期糖尿病肾病患者血浆GMP - 14 0和血浆内皮素 (ET)的影响及临床意义。方法 :6 8例早期糖尿病肾病患者随机分成对照组 (n =34)和治疗组 (n =34)两组 ,对照组采用糖尿病 (DM )常规治疗 ,治疗组在常规治疗基础上加用茶色素治疗 ,每天 3次 ,每次 0 .2 4 g口服。两组疗程均为 8周。另选取 30名正常人为健康人组。采用放射免疫法和酶联免疫吸附法分别测定健康人组、对照组与治疗组治疗前后血浆ET、2 4h尿白蛋白排泄率 (UAER)和血浆GMP - 14 0。结果 :糖尿病肾病 (DN)患者血浆ET、血浆GMP - 14 0水平显著高于健康人 (均P <0 .0 1) ,治疗组治疗后血浆ET、血浆GMP - 14 0、UAER水平分别为 70 .6± 19.7ng/L、6 8.9± 19.7μg/L、6 9.5 2± 4 0 .2 7μg/min ,较治疗前的 10 3.2± 2 6 .3ng/L、10 1.2± 39.5 μg/L、10 9.31±72 .15 μg/min明显降低 (均P <0 .0 1) ,对照组治疗后血浆ET、血浆GMP - 14 0、UAER水平分别为 98.4±2 4 .2ng/L、89.2± 35 .9μg/L、95 .35± 4 9.92 μg/min ,较治疗前的 10 1.8± 2 5 .9ng/L、98.9± 37.1μg/L、10 8.2 3±6 9.72 μg/min无明显变化 (均P >0 .0 5 ) ,治疗组治疗 8周后血浆ET、血浆GMP - 14 0、UAER较对照组显著下降 (P <0 .0 1,P <0 .0 5 ,P <0     

代谢综合征患者循环内皮细胞和血浆NOS/NO系统及内皮素改变

目的 对代谢综合征(membolic syndrome,MS)患者循环内皮细胞(circulation endothelial cells,CECs)、血浆一氧化氮合酶和一氧化氮(nitric oxide synthase/nitric oxide,NOS/NO)系统及血浆内皮素(en-dothelin,ET)进行测定,探讨MS对此三方面的影响.方法 根据MS诊断标准选取34例患者作为MS患者组和47例正常人群作为健康对照组,分别计数CECs、测定血浆NOS和NO水平及ET水平.结果 ①与对照组相比较,MS患者组CECs](3.11±0.69)vs(9.47±1.15),P=0.0011显著升高.②与对照组相比较,MS患者组NOS[(28.17±3.11)μmol/L vs(34.28±1.97)μmol/L,P=0.0361和No [(58.33±2.49)μmol/L vs(70.03±1.09)¨mol/L.P=0.0141均显著降低.③与对照组相比较,MS患者组ET[(56.35±10.15)vs(126.58±12.37),P=0.001]显著升高.④MS与CECs(P=0.001)和ET(P=0.001)呈正相关,而与NOS(P=0.011)和NO(P=0.006)呈负相关;CECs和ET(P=0.001)呈正相关而与NOS(P=0.035)和No(P=0.024)呈负相关.结论 MS患者血浆NOS和NO水平显著降低,同时致CECs增多和血浆ET水平升高.     

窒息新生儿血浆NO、NOS水平及对预后的影响

目的　探讨新生儿窒息时一氧化氮 (Nitrogenmonoxide ,NO)、一氧化氮合成酶 (Nitrogenmonoxidesyntase ,NOS)水平的变化及其对判断预后的指导意义。方法　采用比色等方法测定 32例窒息新生儿及 30例正常新生儿血浆一氧化氮、一氧化氮合成酶活性水平。结果　正常对照组NO、NOS水平分别为 (72 .84± 1 2 .35) μmol/L和 (0 .2 0 3± 0 .0 5)U/mg ,窒息组为 (1 2 9.80± 32 .66) μmol/L和(0 .352± 0 .1 2 4 )U/mg ;其中轻度窒息组为 (1 0 5 .65± 36 .30 ) μmol/L和 (0 .2 89± 0 .0 9)U/mg ;重度窒息组为 (1 4 4 .55± 2 6 .32 ) μmol/L和 (0 .364± 0 .0 1 0 )U/mg。窒息新生儿NO、NOS水平较正常新生儿明显升高 (P <0 .0 1 ) ,重度窒息患儿较轻度窒息患儿升高 (P <0 .0 1 )。结论　NO、NOS水平高低与窒息新生儿脑损伤程度和预后有关 ,可作为判断新生儿窒息及其所致新生儿缺氧缺血性脑病(HIE)病情及预后的指标之一     

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.