红藤合剂灌肠联合输卵管通液术治疗输卵管阻塞性不孕的临床疗效及对盆腔局部微环境的影响

目的 评价红藤合剂灌肠联合输卵管通液术治疗对输卵管阻塞性不孕的临床疗效及对盆腔局部微环境的影响。方法 选取2019年5月—2020年9月海南省中医院140例输卵管阻塞性不孕患者作为研究对象,按照随机数字表法分为对照组和观察组,每组70例。对照组采用输卵管通液术治疗;观察组在对照组治疗的基础上给予红藤合剂灌肠。3个月后行子宫输卵管造影检查,比较两组输卵管再通情况;随访12个月,比较两组妊娠情况和复发情况;对所有患者进行治疗前后中医症候和局部体征评分;比较两组子宫内膜厚度和子宫内膜类型、子宫内膜动脉阻力指数（RI）、搏动指数（PI）及血管化血流指数（VFI）;检测治疗前后宫腔液白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、转化生长因子-β₁（TGF-β₁）及结缔组织生长因子（CTGF）水平;检测治疗前后月经血趋化因子1（CXCL1）、趋化因子13（CXCL13）、IL-6及TNF-α水平;对所有患者行安全性评价。结果 治疗后,观察组输卵管再通率为76.19%（48/63）,高于对照组的58.06%（36/62）（P <0.05）。12个月随访期间,观察组妊娠率为70.83%（34/48）,高于对照组的44.44%（16/36）（P <0.05）;观察组复发率为12.50%（6/48）,低于对照组的30.56%（11/36）（P <0.05）。治疗后两组患者中医症候和局部体征评分较治疗前均降低（P <0.05）,且观察组评分低于对照组（P <0.05）。治疗后两组患者子宫内膜厚度、A型子宫内膜类型比例及VFI增加（P <0.05）,RI和PI较治疗前降低（P <0.05）,且观察组VFI高于对照组,RI和PI低于对照组（P <0.05）。治疗后两组患者宫腔液IL-6、TNF-α、TGF-β₁及CTGF水平较治疗前降低（P <0.05）,且观察组低于对照组（P <0.05）。治疗后两组患者月经血CXCL1、CXCL13、IL-6及TNF-α水平较治疗前降低（P <0.05）,且观察组低于对照组（P <0.05）。研究期间未发现与使用红藤合剂灌肠相关的不良反应。结论 红藤合剂灌肠联合输卵管通液术治疗输卵管阻塞性不孕可减轻临床症状,改善局部微循环和局部微环境,提高输卵管再通率和临床妊娠率,并降低复发率,临床使用安全。     

经阴道子宫输卵管四维超声造影联合抗HCG抗体评估不孕症输卵管通畅程度的临床研究

目的 分析经阴道子宫输卵管四维超声造影（TVS4D-HyCoSy）联合抗人绒膜促性腺激素（HCG）抗体评估不孕症输卵管通畅程度的效果。方法 选取2019年1月—2021年3月就诊于阜阳市人民医院的98例不孕症患者。患者接受TVS4D-HyCoSy检查，造影3个月后接受腹腔镜通液术，使用酶联免疫吸附试验测定血清抗HCG抗体水平。不同输卵管系统检测患者血清抗HCG抗体阳性率，将腹腔镜通液术结果作为金标准，评估TVS4D-HyCoSy、抗HCG抗体及两者联合检测不孕症输卵管通畅的诊断效能。结果 不同输卵管系统评分患者血清抗HCG抗体阳性率比较，差异有统计学意义（P <0.05），Ⅲ度抗HCG抗体阳性率高于Ⅱ度，Ⅰ度最低。98例不孕症患者共检查193条输卵管（其中1例单角子宫，2例一侧输卵管切除），其中通畅40条，通而不畅73条，阻塞80条。联合诊断的敏感性、特异性、准确率高于TVS4D-HyCoSy、抗HCG抗体（P <0.05）。结论 TVS4D-HyCoSy联合抗HCG抗体在评估不孕症输卵管通畅程度中具有较高的敏感性、特异度及准确率，可指导临床诊治。     

格隆溴铵对高氧诱导幼鼠急性肺损伤的影响及其机制研究

目的 探究格隆溴铵对高氧诱导幼鼠急性肺损伤（ALI）的影响及作用机制。方法 从30只SD幼鼠中随机选取10只为对照组,其余幼鼠成功复制高氧诱导的ALI模型,随机分为ALI组、格隆溴铵组,每组10只。格隆溴铵组雾化吸入0.8 mg/（kg·d）格隆溴铵,ALI组、对照组吸入等体积生理盐水,连续给药7 d后,测量幼鼠肺组织湿/干重比值（W/D）、肺指数,检测白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）水平及血清活性氧基团（ROS）、超氧化物歧化酶（SOD）水平,比较肺组织病理学变化及Toll样受体4/髓分化因子88（TLR4/MyD88）通路蛋白的表达。结果 与对照组比较,ALI组W/D及肺指数升高（P <0.05）,血清IL-1β、IL-6、TNF-α、SOD水平升高（P <0.05）,ROS水平降低（P <0.05）,TLR4、MyD88蛋白相对表达量上调（P <0.05）;与ALI组比较,格隆溴铵组W/D及肺指数降低（P <0.05）,血清IL-1β、IL-6、TNF-α、SOD水平降低（P <0.05）,ROS水平升高（P <0.05）,TLR4、MyD88蛋白相对表达量下调（P <0.05）。结论 格隆溴铵能改善血清炎症指标及氧化应激指标,降低高氧诱导的ALI,其作用机制可能与TLR4/MyD88通路有关。     

自拟补肾祛瘀方对多囊卵巢综合征模型大鼠的作用及机制研究

目的 探究自拟补肾祛瘀方治疗多囊卵巢综合征（PCOS）的疗效及机制。方法 选取SD雌性大鼠,复制PCOS模型后随机分为对照组、模型组、西药组及联合组。对照组和模型组根据大鼠体重给予1 mL/（kg·d）氯化钠溶液灌胃,联合组每天根据体重给予补肾祛瘀汤剂11 g/kg和4.5 mg/kg二甲双胍灌胃,西药组仅给予4.5 mg/kg二甲双胍灌胃。药物干预后分别采用Western blotting、qRT-PCR、免疫组织化学法检测肿瘤坏死因子-α（TNF-α）、核因子κB（NF-κB）、核因子IκB（IκBα）的蛋白、mRNA及阳性表达。比较各组大鼠的体重及血清睾酮（T）、促卵泡激素（FSH）、黄体生成素（LH）水平。结果 各组大鼠药物干预前的体重比较,差异无统计学意义（P >0.05）;各组大鼠药物干预28 d后的体重比较,差异有统计学意义（P <0.05）;进一步两两比较,模型组的体重高于另外3组（P <0.05）,西药组高于联合组和对照组（P <0.05）,联合组高于对照组（P <0.05）。各组大鼠血清T、FSH、LH水平比较,差异有统计学意义（P <0.05）;进一步两两比较,模型组血清T、FSH、LH水平高于另外3组（P <0.05）,西药组高于联合组与对照组（P <0.05）,联合组高于对照组（P <0.05）。各组大鼠卵巢组织TNF-α、NF-κB、IκBα蛋白相对表达量比较,差异有统计学意义（P <0.05）;进一步两两比较,模型组大鼠卵巢组织TNF-α、NF-κB蛋白相对表达量高于另外3组,IκBα蛋白相对表达量低于另外3组（P <0.05）;西药组大鼠卵巢组织TNF-α、NF-κB蛋白相对表达量高于联合组与对照组（P <0.05）,联合组高于对照组（P <0.05）;西药组大鼠卵巢组织IκBα蛋白相对表达量低于联合组与对照组（P <0.05）,联合组低于对照组（P <0.05）。各组大鼠卵巢组织TNF-α、NF-κB、IκBα mRNA相对表达量比较,差异有统计学意义（P <0.05）;进一步两两比较,模型组大鼠卵巢组织TNF-α、NF-κB mRNA相对表达量高于另外3组,IκBα mRNA相对表达量低于另外3组（P <0.05）;西药组大鼠卵巢组织TNF-α、NF-κB mRNA相对表达量高于联合组与对照组（P <0.05）,联合组高于对照组（P <0.05）;西药组大鼠卵巢组织IκBα mRNA相对表达量低于联合组与对照组（P <0.05）,联合组低于对照组（P <0.05）。各组大鼠卵巢组织TNF-α、NF-κB、IκBα的OD值比较,差异有统计学意义（P <0.05）;进一步两两比较,模型组大鼠卵巢组织TNF-α、NF-κB的OD值高于另外3组,IκBα的OD值低于另外3组（P <0.05）;西药组大鼠卵巢组织TNF-α、NF-κB的OD值高于联合组与对照组（P <0.05）,联合组高于对照组（P <0.05）;西药组大鼠卵巢组织IκBα的OD值低于联合组与对照组（P <0.05）,联合组低于对照组（P <0.05）。结论 自拟补肾化瘀方治疗PCOS可通过影响TNF-α调控的NF-κB/IκBα信号通路促进LH、FSH、T的恢复。     

星状神经节阻滞术对大鼠急性心肌梗死后炎症反应的影响

目的 探讨星状神经节阻滞术（SGB）对大鼠急性心肌梗死（AMI）后心肌细胞炎症的保护作用。方法 选取8周龄雄性SPF级Wistar大鼠60只,体重200～250 g,随机分为假手术组、AMI组和SGB组,每组20只。假手术组只打开胸腔暴露心脏,不结扎冠状动脉;AMI组结扎冠状动脉左前降支复制AMI模型;SGB组在AMI模型复制成功后行SGB。模型复制成功后1周采集各组大鼠血清及心脏组织,qRT-PCR检测各组大鼠心肌组织中炎症因子（IL-6、IL-1β及TNF-α）mRNA;酶联免疫吸附试验检测各组大鼠血清中炎症因子（IL-6、IL-1β及TNF-α）,全自动生化分析仪检测各组大鼠血清中心肌酶（AST、LDH和CK-MB）。结果 各组大鼠心肌组织中炎症因子IL-6、IL-1β及TNF-α mRNA相对表达量比较,差异有统计学意义（P <0.05）,SGB组IL-6、IL-1β及TNF-α mRNA的相对表达量均较AMI组降低（P <0.05）。各组大鼠血清中炎症因子IL-6、IL-1β及TNF-α表达水平比较,差异有统计学意义（P <0.05）,AMI组、SGB组IL-6、IL-1β及TNF-α表达水平较假手术组升高（P <0.05）,SGB组IL-6、IL-1β及TNF-α表达水平较AMI组降低（P <0.05）。各组大鼠血清AST、LDH及CK-MB表达水平比较,差异有统计学意义（P <0.05）,AMI组、SGB组AST、LDH及CK-MB表达水平较假手术组升高（P <0.05）,SGB组AST、LDH和CK-MB表达水平较AMI组降低（P <0.05）。结论 SGB对大鼠AMI后心肌细胞炎症有一定的保护作用。     

针刺对乳腺癌化疗后癌因性疲乏模型小鼠肠-脑轴相关因子的影响

目的 观察针刺对乳腺癌化疗后癌因性疲乏（CRF）模型小鼠肠-脑轴相关因子的影响,探讨针刺改善乳腺癌CRF的可能机制。方法 将BALB/c小鼠随机分为空白组、模型组、针刺组和假针刺组,以荷瘤加化疗的方法复制乳腺癌化疗后CRF模型小鼠。针刺足三里、三阴交、百会、关元、气海穴位,1次/d,30 min/次,干预14 d。通过小鼠一般情况、强迫游泳实验、旷场实验评估小鼠体力和疲劳情况;Western blotting检测下丘脑和结肠组织中炎症因子白细胞介素-1β（IL-1β）、IL-6、肿瘤坏死因子-α（TNF-α）蛋白表达;酶联免疫吸附试验检测血清HPA轴相关因子皮质醇（CORT）、促肾上腺皮质激素（ACTH）表达。结果 模型组模型复制后强迫游泳不动时间长于空白组（P <0.05）。模型组干预后强迫游泳不动时间长于针刺组（P <0.05）,假手术组干预后长于针刺组（P <0.05）。模型组模型复制后水平运动得分、垂直运动得分低于对照组（P <0.05）。针刺组干预后水平运动得分、垂直运动得分高于模型组、假针刺组（P <0.05）。模型组、假针刺组小鼠下丘脑中IL-1β、IL-6、TNF-α蛋白相对表达量高于空白组（P <0.05）,针刺组低于模型组、假针刺组（P <0.05）。针刺组、模型组、假针刺组结肠组织中IL-1β、IL-6、TNF-α蛋白相对表达量高于空白组（P <0.05）,针刺组低于模型组、针刺组（P <0.05）。模型组、假针刺组ACTH蛋白水平高于空白组（P <0.05）,CORT蛋白水平低于空白组（P <0.05）;针刺组ACTH蛋白水平低于模型组（P <0.05）,CORT蛋白水平高于模型组（P <0.05）;针刺组ACTH蛋白水平低于假针刺组（P <0.05）,CORT蛋白水平高于假针刺组（P <0.05）。结论 针刺可能通过降低乳腺癌CRF模型小鼠中枢和结肠中促炎因子的表达水平,调节HPA轴功能紊乱状态,进而改善乳腺癌化疗后CRF的疲乏症状,这可能是针刺治疗CRF的作用机制之一。     

帕瑞昔布钠超前镇痛对人工膝关节置换术后患者镇痛、炎症因子及认知功能的影响

目的 探究帕瑞昔布钠超前镇痛对换膝骨关节炎人工膝关节置换患者术后镇痛、炎症因子及认知功能的影响。方法 选取2017年1月—2019年9月成都医学院第二附属医院就诊的膝骨关节炎患者共100例，全部行人工膝关节置换术，随机将其分为实验组和对照组，每组50例。对照组不予以任何超前镇痛，实验组麻醉前静脉注射帕瑞昔布钠40 mg，两组术后均静脉注射舒芬太尼自控镇痛。分别于术前1 h、术后6 h、术后12 h、术后24 h、术后48 h采用视觉模拟评分（VAS）进行疼痛评分；HSS膝关节功能评分法对膝关节功能进行评分；简易智力状态检查量表（MMSE）进行认知功能评分。酶联免疫吸附试验（ELISA）测定各时间点血清中IL-6、IL-10、TNF-α的表达水平。结果 两组患者术后VAS评分随着时间延长逐渐降低，其中实验组在术后6 h、12 h、24 h及48 h评分与对照组比较，差异有统计学意义（P <0.05），实验组低于对照组；两组HSS膝关节评分随着时间延长逐渐升高，实验组在术后12 h、24 h及48 h评分与对照组比较，差异有统计学意义（P <0.05），实验组低于对照组；术后两组患者的IL-6、TNF-α水平均升高，但实验组在术后各时间点的水平较对照组低（P <0.05）；两组患者术后IL-10水平均降低，但实验组在术后各时间点的水平较对照组高（P <0.05）。两组术后早期认知功能评分均下降，但实验组术后6 h、12 h、24 h及48 h评分较对照组高（P <0.05）。实验组的不良反应总发生率为6.0％，低于对照组的不良反应总发生率16.0%。结论 帕瑞昔布钠超前镇痛对实施人工膝关节置换术的膝骨关节炎患者的术后镇痛效果良好，术后炎症因子水平降低，抗炎因子水平升高，炎症反应减少，有效保护患者认知功能，且不良反应少，可推广应用于临床。     

孟鲁司特联合丙酸氟替卡松鼻喷剂治疗儿童鼾症的临床研究

目的 探讨孟鲁司特联合丙酸氟替卡松鼻喷剂治疗儿童鼾症的临床疗效。方法 选取2015年7月—2018年5月湖南省直中医医院收治的82例鼾症患儿作为研究对象。按照随机数字表法将患儿分为观察组和对照组。对照组采用丙酸氟替卡松鼻喷剂治疗。观察组在对照组基础上，采用孟鲁司特治疗。比较两组患者治疗后的总有效率。检测全部患者治疗前后血清白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）的水平。运用多导睡眠监测系统监测患儿睡眠效率、最低血氧饱和度（LSaO₂）、每小时睡眠内呼吸暂停加上低通气的次数（AHI）、微觉醒指数的水平。运用生活质量调查表评估患者的生活质量。结果 观察组临床总有效率较对照组高（P <0.05）。观察组治疗前后IL-6和TNF-α的差值较对照组高（P <0.05）。观察组治疗前后睡眠效率、LSaO₂、AHI、微觉醒指数的差值较对照组高（P <0.05）。观察组治疗前后睡眠障碍、情绪状况、白天功能、身体状况、对监护人影响的差值较对照组高（P <0.05）。结论 孟鲁司特可提高儿童鼾症的疗效，改善患者的睡眠质量和生活质量，降低炎症因子水平。     

全胃肠外营养对幼鼠肠道炎症损伤作用研究

目的 探讨全胃肠外营养对幼鼠肠道炎症损伤的作用及机制。方法 选取18只6～8周龄雄性SD幼鼠，随机分为正常组、对照组和观察组，每组6只。观察组幼鼠行右颈静脉置管后给予全胃肠外营养治疗，并禁食、水；对照组幼鼠行右颈静脉置管后给予生理盐水治疗；正常组不予以置管。正常组和对照组幼鼠均喂食标准鼠粮和水，14 d后处死幼鼠，获取肠道组织。采用HE染色观察各组幼鼠肠道组织的病理变化，TUNEL染色观察各组幼鼠小肠上皮细胞凋亡情况，实时荧光定量聚合酶链反应（qRT-PCR）和Western blotting检测各组幼鼠肠道组织中的肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）和白细胞介素-10（IL-10）、Occludin和ZO-1的mRNA和蛋白表达，免疫组织化学检测各组幼鼠肠道组织中的Occludin、ZO-1的表达。结果 观察组幼鼠的肠道组织均出现不同程度的损伤；与正常组和对照组比较，观察组肠上皮细胞凋亡率升高（P <0.05），TNF-α、IL-1β的mRNA和蛋白表达升高（P <0.05），而IL-10、Occludin、ZO-1的mRNA和蛋白表达降低（P <0.05）；免疫组织化学结果显示，Occludin、ZO-1表达下降（P <0.05）。结论 持续2周的全胃肠外营养可导致幼鼠肠道功能受损，促炎因子增加，肠道机械屏障功能受损，尽可能恢复肠内营养对于减少肠道并发症具有重要意义。     

MicroRNA-181a、SIRT1水平与新生儿急性呼吸窘迫综合征严重程度及预后的相关性

目的 分析新生儿急性呼吸窘迫综合征（ARDS）血清microRNA-181a（miR-181a）、沉默信息调节因子2相关酶1（SIRT1）水平变化，探讨二者与其病情严重程度及预后的关系。方法 选取2017年10月—2021年7月东南大学附属中大医院江北院区收治的162例ARDS患儿为ARDS组，根据氧合指数分为轻度组60例、中度组53例、重度组49例；根据预后情况分为预后不良组68例和预后良好组94例。另选取同期64名健康新生儿为对照组。实时荧光定量聚合酶链反应（qRT-PCR）检测血清miR-181a mRNA相对表达量，酶联免疫吸附试验（ELISA）检测血清SIRT1、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平。Pearson/Spearman相关性分析ARDS患儿血清miR-181a、SIRT1水平与氧合指数、炎症因子的相关性。ROC曲线分析血清miR-181a、SIRT1水平单独及联合对ARDS患儿预后不良的评估价值。结果 ARDS组血清miR-181a mRNA相对表达量、IL-1β、IL-6、TNF-α水平均高于对照组（P <0.05）；SIRT1水平低于对照组（P <0.05）。重度组和中度组患儿血清miR-181a mRNA相对表达量、IL-1β、IL-6、TNF-α水平高于轻度组，且重度组血清miR-181a mRNA相对表达量、IL-1β、IL-6、TNF-α水平高于中度组（P <0.05）；而重度组和中度组患儿血清SIRT1水平低于轻度组，且重度组血清SIRT1水平低于中度组（P <0.05）。相关性分析显示，ARDS患儿血清miR-181a与SIRT1水平呈负相关（r_s =-0.788，P <0.05），与氧合指数、IL-1β、IL-6、TNF-α水平呈正相关（r =0.780、0.833、0.776和0.804，均P <0.05）；SIRT1与氧合指数、IL-1β、IL-6、TNF-α水平呈负相关（r_s/r =-0.836、-0.716、-0.691和-0.754，均P <0.05）。预后不良组血清miR-181a mRNA相对表达量高于预后良好组，SIRT1水平低于预后良好组（P <0.05）。ROC曲线结果显示，miR-181a评估ARDS患儿预后不良的最佳截断值为1.59，敏感性为80.88%（95% CI：0.717，0.857），特异性为70.21%（95% CI：0.652，0.757）；SIRT1评估ARDS患儿预后不良的最佳截断值为0.70 ng/ml，敏感性为76.47%（95% CI：0.712，0.796），特异性为87.23%（95% CI：0.832，0.917）。两者联合评估ARDS患儿预后不良的敏感性为85.29%（95% CI：0.788，0.902），特异性为81.91%（95% CI：0.774，0.886）。结论 新生儿ARDS血清miR-181a、SIRT1水平与ARDS患儿病情严重程度及预后密切相关，可作为新生儿ARDS预后评估指标。     

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.