延髓腹面降压区与肾血管阻抗的关系（Ⅰ）

实验用３００～３５０ｇ雄性Ｗｉｓｔａｒ大鼠，氨基甲酸乙酯腹腔麻醉。电刺激（０．２ｍｓ４０μＡ１００Ｈｚ８ｓ）并经兴奋性氨基酸Ｌ－谷氨酸（Ｌ－Ｇｌｕ）检测性验证，提示大鼠延髓尾端Ⅻ对脑神经丛第三支根部１ｍｍ×１ｍｍ区域为降压区（ｄｅｐｒｅｓｓｏｒａｒｅａｉｎｖｅｎｔｒａｌｓｕｒｆａｃｅｏｆｍｅｄｕｌｌａｏｂｌｏｎｇａｔａ，ＶＳＭｄ）。电刺激该区可见平均动脉血压（ＭＡＰ）以１６．９９的斜率下降，最大百分数为２６．８２±８．９３（Ｐ＜０．０１　。ｎ＝１０）．其下降率与刺激时间呈对数式关系。Ｌ－Ｇｌｕ微量注射后。在降压的同时心率（ＨＲ）减慢，分别为２．６７±０．４７ｋＰａ（Ｐ＜０．０１）和３０．３３±４．２３ｍｉｎ￣（－１）（Ｐ＜０．００１，ｎ＝６）。切断双侧迷走神经后降压和减心率反应减弱，分别为１．４６±０．４５ｋＰａ和５．６±４．８ｍｉｎ￣（－１）（Ｐ＜０．０１；ｎ＝５）；双侧损毁肾交感神经，基础ＭＡＰ下降，同时降压反应被削弱，为１．８１±０．４９ｋＰａ（Ｐ＜０．０１）但对减心率反应无影响（Ｐ＞０．０５，ｎ＝５）。     

经皮球囊扩张术治疗二尖瓣狭窄的临床研究

用经皮二尖瓣狭窄球囊扩张术（ＰＢＭＶ）治疗风湿性心脏病二尖瓣狭窄１０５例，手术前后二尖瓣口面积分别为０．９２±０．１８ｃｍ２和１．８６±０．２０ｃｍ２（Ｐ＜０．００１），左心房平均压力分别为２．５８±０．８２ｋＰａ和１．３４±０．６４ｋＰａ（Ｐ＜０．００１），左心房内径分别为４．６±０．４ｃｍ和４．４±０．３ｃｍ（Ｐ＜０．０５），心脏功能明显改善，平均每例好转１．３３级。术中术后无死亡和动脉栓塞病例，出现严重二尖瓣关闭不全、心包填塞、一过性低血压各１例，５例发生短暂性心动过缓，总成功率为９７％。     

损毁迷走神经背核翻转室旁核降低胃内压的观察

选用ＳＤ大鼠３８只，乌拉坦麻醉下观察电刺激下丘脑室旁核（ＰＶＮ）对大鼠胃内压的影响以及侧脑室注射阿托品和双侧迷走神经背核被损毁后翻转ＰＶＮ降低胃内压（ＩＧＰ）的效应。其结果是：（１）电刺激ＰＶＮ可明显降低胃内压（刺激前ＩＧＰ为０．６２±０．０１ｋＰａ，刺激后ＩＧＰ降至０．３９±０．０１ｋＰａ．Ｐ＜０．０１）；胃内压变化率为３７．１％。（２）侧脑室内微注射阿托品可明显减弱电刺激ＰＶＮ对ＩＧＰ的影响，有５只大鼠出现胃位相性收缩波。（３）直流损毁双侧迷走神经背核后，则电刺激ＰＶＮ引起的ＩＧＰ下降效应明显减弱，出现胃内压翻转效应（由刺激前的０．６０±０．１７ｋＰａ升高至０．８０±０．３ｋＰａ，Ｐ＜０．０５）；胃内压变化率为＋３３．３％。有８只大鼠出现胃位相性收缩波增强。本实验结果表明：中枢胆碱能神经系统可能参与ＰＶＮ对ＩＧＰ的作用，且迷走神经背核可能是调节途径的重要结构之一。     

1,6—二磷酸果糖抗失血性休克实验研究

本实验观察了ＦＤＰ抗失血性休克作用。３组失血性休克大鼠分别接受５％ＦＤＰ溶液（Ａ组）、５％葡萄糖溶液（Ｂ组）和生理盐水（Ｃ组）静注。给药６０ｍｉｎ后，Ａ组ＭＡＰ为１０．４±２．１ｋＰａ，与Ｂ、Ｃ组７．９±２．４和７．７±２．６ｋＰａ间均有差异（Ｐ＜０．０１）；Ａ组动物存活率７５％，而Ｂ、Ｃ组分别为２５％和１５％（Ｐ＜０．０１）；Ａ组动脉血ｐＨ和ＰａＯ２分别为７．２４±０．１４和１３．４６±１．２２ｋＰａ，与Ｂ、Ｃ组７．１４±０．１４和１０．２９±３．８４ｋＰａ与７．０２±０．１０和７．２５±２．１２ｋＰａ间有显著差异（Ｐ＜０．０１）；Ａ组回输血液再灌流后血浆ＳＯＤ和ＭＤＡ分别为１２００±１２６Ｕｍｌ－１和０．４７±０．２５ｎｍｏｌｍｌ－１，同Ｂ、Ｃ组１０８１±１１９Ｕｍｌ－１和０．９１±０．２９ｎｍｏｌ－１与８３５±９Ｕｍｌ－１和１．１３±０．１６ｎｍｏｌ－１间均有显著差异（Ｐ＜０．０１）。结果表明ＦＤＰ保护组织损伤而产生抗休克作用。     

脊柱手术控制性降压对肺分流和动静脉氧差的影响

目的了解脊柱手术硝普钠控制性降压对肺分流百分率（Ｑｓ／Ｑｔ）和动脉－静脉氧差（ａｖＤＣＯ２）的影响。方法１８例脊柱手术病人,手术中应用硝普钠控制性降压,观察降压过程中肺分流和动脉－静脉氧差的变化。结果降压１０ｍｉｎ、３０ｍｉｎ收缩压分别下降了３．９９ｋＰａ（２７％）和４．１２ｋＰａ（２８％）,Ｑｓ／Ｑｔ分别增加了７．４５和１３．５６,显著高于术前（Ｐ＜０．０１）,３０ｍｉｎ时伴有Ａ－ａＤＯ２增加和ＰａＯ２下降（与降压前比Ｐ＜０．０１）。停降压后１５ｍｉｎＱｓ／Ｑｔ、ＡａＤＯ２和ＰａＯ２均恢复正常,在降压１０ｍｉｎ、３０ｍｉｎ和停降压后１５ｍｉｎａｖＤＯ２均低于降压前（Ｐ＜０．０１）,降压３０ｍｉｎ和停降压后１５ｍｉｎ伴有ＢＥ降低（Ｐ＜０．０５）。结论脊柱手术硝普钠控制性降压能增加肺分流,降低动脉静脉氧差。     

培哚普利对老年高血压病患者的降压效应及对脑血流的影响

目的观察培哚普利对老年原发性高血压患者的降压效应及对脑血流的影响。方法对３５例老年原发性高血压患 者,予培哚普利治疗,剂量为２～６ｍｇ／ｄ,疗程１２周,观察治疗前后血压的变化,并用经颅多普勒超声（ＴＣＤ）观察主要大 中型脑动脉的平均血流速度（υｍ）、搏动指数（ＰＩ）、阻力指数（ＲＩ）的变化。结果血压从治疗前２４．２／１４．３ ｋＰａ降至 １８．５／１０．５ｋＰａ（Ｐ＜０．０５）,各脑动脉的ＰＩ和ＲＩ治疗后均叫治疗前明显降低（Ｐ＜０．０１）,υｍ均较治疗前明显增快（Ｐ＜０．０５）。结 论　培哚普利治疗老年高血压病患者降压平稳有效,并对脑血流有明显的改善作用。     

组氨酸对光化学诱导的血栓性局部脑缺血时脑代谢及心功能的影响

用光化学法诱导大鼠血栓形成性局部脑缺血，观察组氨酸对脑血栓形成后皮层Ｎａ＋，Ｃａ２＋含量、脑水肿及心功能障碍的影响，脑血栓形成后皮层Ｎａ＋，Ｃａ２＋及脑水份明显增加（ｐ＜０．０ｌ），左室收缩压峰值（ＬＶＳＰ）由１９１０±１．４４ｋＰａ降至１７．２±１５．３０ｋＰａ，心室收缩与舒张最大速率（±ｄｐ／ｄｔｍａｘ）分别由８４０．００±１３５．９０ｋＰａ和６３８．９０±１４６、１０ｋＰａ降至６４５．００±ｌ１０．２０ｋＰａ和４７０．３０±１０６．４０ｋＰａ（Ｐ＜０．０５）．ｉＶ组氨酸５ｍｇ·ｋｇ－１可明显改善脑缺血所致脑水肿从心功能障碍，而只有保护作用．给药后２４ｈ动物平均动脉压（ＭＡＰ）及ＬＶＳＰ比照组高（Ｐ＜０．０５），机理有待研究。     

SHR与SD杂交大鼠血压与细胞内阳离子含量的关系

观察ＳＨＲ与ＳＤ杂交大鼠血淋巴细胞内阳离子含量以及与血压的关系，拟阐明是否细胞膜阳离子转运异常是一种先天性遗传缺陷。结果显示，杂交大鼠淋巴细胞内Ｋ＋、Ｎａ＋、Ｍｇ２＋的含量与血压值并不相关，但淋巴细胞内Ｃａ２＋的含量与杂交大鼠的收缩压（ＳＢＰ）和舒张压（ＤＢＰ）呈明显正相关（ＳＢＰｒ＝０．５２，Ｐ＜０．０５；ＤＢＰｒ＝０．６２，Ｐ＜０．０１），血压增高的杂交大鼠（ＢＰ≥１７．３／１２．０ｋＰａ）细胞内Ｃａ２＋浓度（１．３±０．５ｆｍｏｌ／细胞）显著高于对照组（０．９±０．３ｆｍｏｌ／细胞，Ｐ＜０．０５）。提示，原发性高血压的发生与细胞膜存在特异性缺陷及遗传性离子转运障碍有关，而这一转运障碍的离子主要为Ｃａ２＋。     

经皮穿刺二尖瓣球囊成形术135例临床应用

目的研究总结１３５例经皮穿刺二尖瓣球囊成形术（ＰＢＭＶ）的成功率、效果及并发症。方法采用改良Ｉｎｏｕｅ单球囊技术对１３５例风湿性二尖瓣狭窄（ＭＳ）患者行ＰＢＭＶ。结果术后血液动力学显著改善,左心房平均压（ＭＬＡＰ）从２３．５±６．２降至１０．７±５．１ｍｍＨｇ（Ｐ＜０．００１）,跨二尖瓣压力阶差（ＭＶＰＧ）从１９．４±６．８降至３．８±２．９ｍｍＨｇ（Ｐ＜０．００１）,二尖瓣口面积（ＭＶＡ）从１．０３±０．３２ｃｍ２扩大到２．１４±０．２８ｃｍ２（Ｐ＜０．００１）,左心房内径（ＬＡＤ）从４７．７±６．８ｍｍ缩小至４０．２±６．５ｍｍ（Ｐ＜０．０１）;有１例手术未成功,无１例发生严重并发症。结论表明只要术前准备充分,术中仔细操作,ＰＢＭＶ已成为治疗风湿性ＭＳ安全有效的方法。     

自发性高血压大鼠血管结构与功能的观察

观察１６周龄ＳＨＲ大鼠与同龄ＷＫＹ大鼠之间血管结构与功能的差异及其在高血压形成中的作用。用尾袖法测量大鼠动脉血压,动脉环实验测定主动脉与肠系膜动脉血管平滑肌的反应性,用肉眼数点计算法测定主动脉中膜腔壁厚度／管腔面积（Ｗ／Ｌ）,图像分析仪摄像求积法测定肠系膜动脉Ｗ／Ｌ。结果：１６周龄ＳＨＲ大鼠血压明显高于ＷＫＹ大鼠（２８．２４±１．１２ｋＰａ与１７．１５±０．７５ｋＰａ,Ｐ＜０．０５）。ＳＨＲ大鼠主动脉和肠系膜动脉的Ｗ／Ｌ明显大于ＷＫＹ大鼠（０．３３±０．０３与０．２４±０．０５,Ｐ＜０．０５;及０．７５±０．０９与０．２６±０．０２,Ｐ＜０．０５）。硝普钠引起的ＳＨＲ大鼠血管舒张率明显低于ＷＫＹ,而去甲肾上腺素引起的ＳＨＲ大鼠血管收缩率明显高于ＷＫＹ。结果表明：ＳＨＲ大鼠阻力血管结构的改变可能是高血压形成的重要因素,ＳＨＲ大鼠血管功能改变与高血压形成密切相关。     

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.