茶多酚对麻醉大鼠血流动力学的影响

[目的]观察茶多酚(tea polyphenols,TP)对麻醉大鼠血流动力学的影响。[方法]将麻醉大鼠随机分为4组:生理盐水组、低剂量组(TP 25 mg/kg)、中剂量组(TP 50 mg/kg)、高剂量组(TP100 mg/kg),用在体心脏法测定血流动力学参数LVSP、LVEDP、±dp/dtmax、CO、BP、HR。[结果]TP 25 mg/kg低剂量组静脉给药对麻醉大鼠的BP无明显影响,但可以显著提高麻醉大鼠的LVSP,±dp/dtmax,CO;TP 50、100 mg/kg中高剂量组静脉给药可明显降低麻醉大鼠BP,HR,LVSP,±dp/dtmax,CO。[结论]TP静脉给药在一定剂量范围内有降压作用,同时随着剂量的增加,心功能由强心转为抑制作用。     

龙芽葱木皂苷对离体工作心脏的正性肌力作用

目的:观察龙芽葱木皂苷(Aralosides,As)对大鼠离体工作心脏的作用.方法:采用Langendorff离体心脏灌流方法,以动脉血压(AP)、左室收缩压(LVSP)、左室舒末压(LVEDP)、室内压最大上升速率(+dp/dtmax)、室内压最大下降速率(-dp/dtmax)及心率(HR),主动脉流量(AF)、冠脉流量(CF)8项血流动力学参数为指标,观察龙芽葱木皂苷对心肌收缩性能的直接影响.结果:10、20、40 mg*L-1 As均可使AP、LVSP、±dp/dtmax的绝对值明显升高,说明As可引起心肌收缩性能增强,且呈明显的剂量依赖关系,洗脱后作用即时下降,并观察到As的这种正性肌力作用可被0.02 mg*L-1的钙通道阻滞剂维拉帕米所拮抗.结论:As可使离体工作心脏产生剂量依赖性的正性肌力作用,且As的正性肌力作用是钙依赖性的.     

香加皮提取物对离体心脏心功能的影响

目的:观察香加皮提取物对离体心脏心功能的影响。方法:Witstar大鼠24只,随机分为3组,分别为空白组、香加皮提取物A组(简称A组)、香加皮有效部位B组(简称B组),应用Langendorff系统进行大鼠离体心脏灌注,记录给药前及给药后10min内LVSP、LVEDP、dp/dtmax和-dp/dtmax的变化情况。结果:香加皮提取物A能显著升高离体心脏的LVSP,增加±dp/dtmax,降低LVEDP。结论:香加皮提取物A能改善大鼠离体心脏心功能,具有强心作用。     

丹酚酸B对大鼠离体工作心脏血流动力学的影响

目的 研究丹酚酸B对离体大鼠工作心脏血流动力学的影响.方法 采用Langendorff离体心脏灌流的方法,以左室内压( LVSP)、左室舒末压(LVEDP)、室内压最大上升速率(+dp/dtmax)、室内压最大下降速率(- dp/dtmax)、心率(HR)等血流动力学参数为指标,观察丹酚酸B对心肌收缩性能的影响.结果 不同剂量(10、5、2.5 mg/L)的丹酚酸B可使LVSP、±dp/dtmax明显升高,同时使HR减慢,并呈剂量依赖性,但对LVEDP无明显作用.结论 丹酚酸B对离体工作心脏有剂量依赖性正性肌力作用.     

参芪益心颗粒对犬实验性心力衰竭的影响

目的:研究参芪益心颗粒对犬实验性心力衰竭的影响。方法:注射戊巴比妥钠复制心力衰竭模型,以生脉饮、地高辛为阳性对照药,研究参芪益心颗粒对犬实验性心衰的影响,观察左心室内压峰值(LVSP)、左心室内压变化速率最大值(dp/dtmax)、心输出量(CO)、左室心肌收缩力(LVMCF)、左心室舒张末压(LVEDP)和心室开始收缩的起点至dp/dtmax的间隔时间(R-dp/dtmax)等血流动力学指标。结果:2%戊巴比妥钠输入可导致急性心力衰竭,表现为LVSP、dp/dtmax、CO、LVMCF降低;LVEDP、R-dp/dtmax增加;参芪益心颗粒对戊巴比妥钠所致犬急性心力衰竭有明显的保护作用,升高LVSP、dp/dtmax、LVMCF、加强心脏收缩功能缩短R-dp/dtmax、降低LVEDP、改善心脏舒张功能增加CO提高心脏泵血功能。结论:参芪益心颗粒对犬实验性急性心力衰竭所致心脏血流动力学指标有明显的保护作用。     

放烧复合伤与单纯放射或烧伤对大鼠在体心室肌细胞动作电位影响的比较

本文用健康SD大鼠57只,随机分为6组,用悬浮微电极记录并比较了单纯~(50)Co照射或烧伤与二者结合的放烧复合伤对在体心室肌细胞动作电位的影响,同时观察了复合伤对心肌影响的恢复过程。结果表明:放烧复合伤与单纯放射或烧伤相似.明显地影响心室肌细胞的除极化和复极化过程。但有其特点:与对照组相比,复合伤后24h,动作电位幅度降低13.6％,最大除极速率减慢41.2％。各组的心率有所不同:烧伤组增加9.8％,放射组减少17.4％,复合伤后24h组却近于对照水平,但复合伤后3天组心率减少12％,伤后5天组才略有恢复。复合伤降低平均复极化速率(-13.2％～-26.3％)及延长动作电位持续时间(APD),尤其是APD50及APD90更为明显(分别为+22.9％～+33.7％和+6.0％～+18％)。实验结果表明,放烧复合伤对大鼠心室肌动作电位的影响并非单纯放射或烧伤两种致伤作用的简单相加,在有的方面(如最大除极速率)二者是协同作用;而在另外方面(如心率)二者又是互相抵消。本实验中复合伤的致伤作用是可逆的。一般说,损伤反应出现早的参数,恢复较快,反之较慢。     

1,6-二磷酸果糖对放射损伤、烧伤及放烧复合伤早期心功能的影响

目的：观察１，６－二磷酸果糖（１．６－ＦＤＰ）对放射损伤、烧伤及放烧复合伤早期心功能的影响。方法：应用离体心脏灌流技术，观察伤后立即及伤后３ｈ腹腔注射１，６－ＦＤＰ，对放射损伤、烧伤及放烧复合伤损伤后８ｈ心功能的变化。结果：ＦＤＰ对放射损伤、烧伤及放烧复合伤损伤后心功能均有不同程度改善。结论：ＦＤＰ的心功能保护作用可能与其改善心肌能量代谢有关。     

1,6—二磷果糖对放射损伤,烧伤及放烧复合伤早期心功能的影响

观察１，６－二磷酸果糖对放射损伤，烧伤及放烧复合伤早期心功能的影响。方法：应用离体心脏灌流技术，观察伤后立即及伤后３ｈ腹腔注射１，６－ＦＤＰ，对损伤，烧伤及放烧复合损伤后８ｈ心功能的变化。结果；ＦＤＰ对放射损伤，烧伤及放烧复合损伤后心功能均有不同程度改善。结论：ＦＤＰ的心功能保护作用可能与其改善心肌能量代谢有关。     

大鼠烫伤后心肌力学及血清心肌肌钙蛋白T变化在心肌损伤诊断中的应用

目的　为探索烫伤后心肌舒缩功能及心肌肌钙蛋白T(cTnT)变化在心肌损伤诊断中的应用。方法　复制大鼠 30 %TBSAⅢ度烫伤动物模型。 56只大鼠随机分成烫伤前及烫伤后 1、3、6、12、2 4、4 8、72h共8组 ,观察各时相点左心室力学参数 (LVSP、LVEDP、±dp/dtmax) ;血清cTnT、CK、LDH含量及心脏病理形态学变化。结果　①烫伤后 1h -dp/dtmax显著下降 ,LVEDP明显升高 ;LVSP、 dp/dtmax伤后 3h显著下降 ,均于 12h变化最大 ,至 72h变化仍较明显 (P <0 0 1)。 3h后光镜下可见心肌病理性改变。②cTnT于伤后 1h显著上升 ,12h比对照值升高 4 3倍 ,至 72h仍保持在高水平 ;而LDH、CK分别于伤后 3、6h开始上升 ,至 72h已接近正常 (P >0 0 5)。结论　①大鼠严重烫伤后左心室舒缩功能明显下降 ,且舒张功能障碍的发生早于收缩功能。②cTnT与心肌酶谱 (CK、LDH)比较 ,具有出现早、高特异、高灵敏等特点 ,是诊断烧伤后心肌损伤的可靠指标     

模拟海上颠簸刺激对严重烧伤家兔心肌力学指标的影响

目的 观察模拟海上颠簸刺激对烧伤早期家兔心肌力学和血流动力学指标的影响.方法 132只家兔随机分成正常对照组(N组,n=6)、单纯颠簸组(DN组,n=42)、单纯烧伤组(S组,n=42)和烧伤颠簸组(DS组,n=42),单纯烧伤组和烧伤颠簸组造成40%全身体表面积(total body surface area,TBSA)Ⅲ度烧伤,分别于2、6、8、12、24、36、48 h等7个时相点经颈动脉左心室内置管,应用RM6240系列生理信号采集仪记录左心室压力波形和主动脉压力波形并应用RM6240系列生理信号采集处理系统处理分析相应波形,测量得出主动脉收缩压(AOSP)、主动脉舒张压(AODP)、平均动脉压(MAP)、左心室收缩压峰值(LVSP)、左心室舒张末压(LVEDP)以及左心室内压变化最大速率(±dp/dtmax)等心肌力学指标.结果 单纯颠簸即可使家兔心肌力学指标显著降低,烧伤颠簸组心肌力学和血流动力学指标均低于单纯烧伤组.伤后2 h,烧伤颠簸组LVEDP即显著低于单纯烧伤组,LVSP、LV-dp/dtmax自伤后6 h开始显著低于单纯烧伤组,AOSP、AODP、MAP、LV dp/dtmax自烧伤后12 h开始均显著低于单纯烧伤组.结论 模拟海上颠簸刺激可明显加剧严重烧伤家兔心肌力学指标的下降和心功能损害.     

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.