应用顺铂建立C57小鼠感音神经性聋模型的实验研究

目的探讨顺铂诱发C57小鼠感音神经性聋模型的制备方法。方法将C57BL／6J小鼠随机分成4组,A组：耳蜗圆窗龛生理盐水给药5μL;B组：耳蜗圆窗龛顺铂给药5μL（1mg／mL）;C组：经鼓膜中耳腔顺铂给药10μL／d×5d（1mg／mL）;D组：腹腔注射顺铂6mg／（kg·d）×5d。用全频程脑干听觉诱发电位（ABR）检测4个组动物的听觉反应阈为指标,以动物各频率听觉反应阈上升≥10dB定为听力减退,并通过异硫氰酸荧光素（FITC）标记的鬼笔环肽染色观察用药后毛细胞的形态学变化。结果A、C、D组ABR反应阈用药前后无明显变化（P〉0．05）;B组小鼠顺铂用药后48h全频程ABR反应阈均升高（P〈0．05）,且毛细胞出现损伤、脱落,其损伤从顶回到底回有逐渐加重的趋势,外毛细胞较内毛细胞损伤严重。结论圆窗龛给药途径是建立顺铂诱发C57小鼠耳聋模型的有效途径。     

庆大霉素耳毒性的遗传性实验研究

目的观察庆大霉素致聋豚鼠的遗传作用。方法将30只(雄10只,雌20只)健康杂色豚鼠随机分成实验组和对照组(各雄5只,雌10只)。实验组豚鼠肌内注射硫酸庆大霉素100 mg.kg-1.d-1,直至耳聋后,待其繁殖;对照组豚鼠肌内注射生理盐水2 ml.kg-1.d-1,用药时间同实验组,待其繁殖。两组所生子代豚鼠分组同母代相同,分别为实验组和对照组。以耳廓反射(PR)及脑干听觉诱发电位(BAEP)监测作为指标,观察子代豚鼠是否发生耳聋。结果耳聋豚鼠的子代PR阈值及BAEP反应阈值、各波潜伏期及波峰间期与对照组子代比较均未见显著差异(P>0.05)。结论庆大霉素致聋豚鼠对子代未发现遗传性致聋作用。     

熊果酸对顺铂所致小鼠耳毒性的防护作用研究

目的研究熊果酸对顺铂所致小鼠耳毒性的防护作用。方法 40只健康成年BALB/c小鼠随机分成对照组(腹腔注射等量生理盐水)、顺铂组(腹腔注射顺铂4.5 mg/kg)、顺铂+熊果酸组(一侧腹腔注射顺铂4.5 mg/kg,同时对侧腹腔注射熊果酸80 mg/kg)和熊果酸组(腹腔注射熊果酸80 mg/kg),每组10只。各组动物均连续注射5 d,每天1次。应用听脑干反应(auditory brainstem response,ABR)测试,观察用药前后小鼠听功能的改变;并采用异硫氰酸四甲基罗丹明(tetramethylrhodamine isothiocyanate,TRITC)标记的鬼笔环肽荧光染色方法,观察小鼠耳蜗毛细胞的形态变化。结果顺铂组小鼠ABR阈移较对照组明显增大(P<0.05),并且耳蜗毛细胞破坏严重;而给予熊果酸可有效降低顺铂对小鼠耳蜗的破坏(P<0.05)。结论熊果酸可有效防护顺铂的耳毒性,改善听功能。     

脑神经生长素防护顺铂致耳蜗螺旋神经节损伤的研究

目的探讨脑神经生长素 (cerebralnervegrowthfactor,CNG)作为防护药物拮抗顺铂致耳蜗螺旋神经节毒性作用。方法选 2 4只豚鼠 ,随机分为 3组 ,每组 8只。顺铂组连续 5d腹腔注射顺铂 2mg/(kg·d) ;CNG组在给予顺铂前 2d开始大腿内侧肌肉注射CNG 2mg/(kg·d) ;正常对照组连续 5d腹腔注射生理盐水 2mg/(kg·d) ;用药前后测试听性脑干反应 (auditorybrainstemresponse ,ABR)阈值 ,处死动物制作耳蜗标本 ,应用透射电镜观察并用免疫组化法测定诱导型一氧化氮合酶 (inducednitricoxidesynthase ,iNOS)的表达。结果顺铂组动物ABR听阈值显著升高 ,透射电镜下见螺旋神经节细胞的细胞器损伤严重 ,iNOS阳性染色 ,呈棕黄色。CNG组动物ABR阈值略有升高 ,但较顺铂组为低 (P <0 .0 1)。螺旋神经节细胞的细胞器损伤较轻 ,iNOS显色浅 ,呈浅黄色。结论CNG可减少耳蜗iNOS表达 ,保护耳蜗螺旋神经节 ,从而保护听力     

丹参在防治顺铂耳毒性中对豚鼠耳蜗血管纹的作用

目的探讨丹参在防治顺铂耳毒性中对豚鼠血管纹的作用。方法将 1 8只豚鼠随机分成 3组 ,对照组连续 5d腹腔注射生理盐水 2ml/ (kg·d) ,丹参组连续 7d肌注丹参 8g/ (kg·d) ,第 3d时加腹腔注射顺铂 2ml/(kg·d) ,观察豚鼠的一般状况和耳廓反应。应用电反应测听仪测试听觉阈值 ,应用激光多普勒探测耳蜗血流的变化 ,并铺片观察血管纹的改变 ,统计学处理。结果丹参组豚鼠实验后一般情况较顺铂组明显减轻 ,除 3只豚鼠耳廓反应迟缓外 ,余反应灵敏 ,听觉阈值为 (32 .5± 7.5 )dB ,耳蜗底转血流测试为 1 5 5 .8mV ,与对照组相比均无显著性改变 (P <0 .0 1 )。耳蜗铺片显示红细胞聚集及血管扩张程度较轻 ,偶尔可见到细胞碎片及溶解 ,未见血池现象。结论丹参通过改善血管纹功能 ,对顺铂内耳毒性可起到一定的防治作用     

川芎嗪对顺铂耳毒性保护作用的实验研究

目的探讨活血化瘀中药川芎嗪是否对顺铂的耳毒性具有保护作用。方法将听力正常的30只豚鼠随机分为3组,每组10只。对照组：生理盐水3 ml/（kg.d）腹腔注射6天;顺铂组：顺铂3 mg/（kg.d）腹腔注射6天;顺铂加川芎嗪组：先腹腔注射川芎嗪140 mg/（kg.d）3天,从第4天起腹腔注射川芎嗪140 mg/（kg.d）后再注射顺铂3 mg/（kg.d）6天。给药前后通过听觉脑干诱发电位（ABR）检测豚鼠听功能的变化;然后在麻醉状态下断头取耳蜗,半数标本切片后用DNA末端转移酶介导的缺口末端标记法（TUNEL）检测耳蜗内细胞凋亡情况;半数标本进行耳蜗基底膜铺片观察毛细胞形态及酶学变化。结果顺铂组用药后ABR阈值升高,毛细胞受损,琥珀酸脱氢酶（SDH）活性减弱,有部分毛细胞凋亡,与对照组及川芎嗪组比较差异具有统计学意义（P〈0.05）。顺铂加川芎嗪组用药后ABR阈值升高,毛细胞受损较轻,凋亡细胞较少,与顺铂组比较差异有统计学意义（P〈0.05）。结论川芎嗪能降低顺铂的耳毒性。     

顺铂对豚鼠耳蜗损害作用实验研究

目的观察顺铂对耳廓反射正常的健康豚鼠耳蜗功能的损害作用，以探讨顺铂对豚鼠耳蜗毒性作用及其损伤机制，为防治顺铂耳毒性作用提供理论依据。方法将60只耳廓反射灵敏的健康豚鼠随机分成两组，顺铂组腹腔注射顺铂4mg／（k·d），1次／d，连续注射5d。正常对照组腹腔注射同等剂量的生理盐水。实验前和实验5d后分别行耳廓反射和听性脑干反应测听。测定麻醉状态下豚鼠听觉脑干诱发电位，比较实验前后两组听觉诱发电位阈值及各波潜伏期、波幅变化。结果顺铂组豚鼠听性脑干反应测试听闽明显提高，各波潜伏期延长，波幅降低，甚至出现波形变异不易辨认，两组比较差异有显著性。结论顺铂可导致豚鼠耳蜗功能损害，表现为豚鼠耳蜗听性脑干反应阂值显著提高，各波潜伏期延长。波幅降低。     

电针对庆大霉素耳中毒豚鼠耳蜗内琥珀酸脱氢酶的影响

目的　观察电针对豚鼠庆大霉素 (gentamicin ,GE)耳中毒引起的耳蜗琥珀酸脱氢酶 (succinatede hydrogenase ,SDH)变化的影响。方法　将动物随机分成 3组 :GE组动物肌肉注射GE80mg·kg-1 d-1,连续注射 2 0天 :针刺组肌肉注射GE同GE组 ,每天电针双侧听宫、翳风、肾俞穴 1次 ,持续刺激 15min ;对照组动物不做任何处理。以脑干听觉诱发电位 (BAEP)、SDH组织化学检测为观察指标。结果　对照组BAEP和SDH两项指标无明显变化 ;GE组BAEP反应阈明显升高 ,SDH显色变淡或消失 ,毛细胞受损显著 ;针刺组BAEP反应阈升高幅度和SDH变化及毛细胞损害程度均明显低于GE组。结论　针刺组能减轻GE耳毒性 ,对SDH有保护作用     

二十二碳六烯酸对豚鼠顺铂所致耳毒性的影响

目的：通过动物实验,研究二十二碳六烯（DHA）全身给药对顺铂所致豚鼠耳毒性的保护作用。方法将健康豚鼠24只分为正常对照组、DHA加顺铂组、顺铂组,DHA加顺铂组连续给予植物油稀释后的DHA灌胃,500 mg?kg －1? d－1,共30 d。在灌胃22 d时,开始生理盐水稀释后的0．25 mg／mL的顺铂溶液腹腔注射,连续9 d ,正常对照组和顺铂组只给予相同剂量植物油灌胃。结果顺铂造模后,顺铂组和DHA加顺铂组 ABR阈值明显高于正常对照组,DHA加顺铂组明显低于顺铂组。DHA加顺铂组外毛细胞残存数明显高于顺铂组,组织形态优于顺铂组,螺旋神经节细胞形态顺铂组差于DHA加顺铂组。结论 DHA 灌胃给药对临床顺铂化疗耳毒性并发症有一定的保护作用。     

L-精氨酸在过量水杨酸钠致豚鼠内耳损伤中的保护作用

目的观察L -精氨酸在过量水杨酸钠致豚鼠内耳损伤中的作用。方法①将 48只健康且耳廓反射正常的花色豚鼠随机分为四组 :A组 :对照组 (给等量生理盐水 ) 1 2只 ;B组 :水杨酸钠 [45 0mg/(kg·d)组 ;C组 :水杨酸钠 [45 0mg/(kg·d) ]+L -精氨酸 [2 0 0mg/(kg·d) ]组 ;D组 :水杨酸钠 [45 0mg/(kg·d) ]+L -精氨酸 [2 0 0mg/(kg·d) ]组 +亚硝基左旋精氨酸甲酯 [L -NAME 3mg/(kg·d) ]。②测试ABR听反应阈和Ⅰ波潜伏期。③以磷酸二酯酶测定法检测耳蜗组织CaM活性。④用比色测量血浆中的NO含量。结果①各给药组给药后的第 2、4和第 6天ABR阈值均有明显提高 ,对照组ABR阈值没有明显改变。B组给药后阈值抬高最明显 ,于给药后的第 6天达最高。同期各给药组组间比较发现C组用药后第 4、6、8、1 0天ABR阈值明显低于B组和D组 (P <0 .0 5 )。②A组在各时间段所测ABRⅠ波潜伏期无显著波动。B组、D组在给药后的第 4、6、8、1 0天ABRⅠ波潜伏期与同期对照组比较有显著延长 (P <0 .0 5 ) ,这种变化在水杨酸钠给药组尤为明显 (P <0 .0 1 )。③L -Arg治疗组豚鼠耳蜗组织CaM活性明显低于水杨酸钠组 (P <0 .0 1 )及水杨酸钠 +L -Arg +L -NAME组 (P <0 .0 1 )。而血浆NO含量水杨酸钠组明显低于对照组 (P <0 .0 1 )和水杨酸钠     

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.     

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.     

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.