兔血清载脂蛋白A1亚类的研究──Ⅳ．实验性动脉粥样硬化兔血清载脂蛋白A1、B及其比值的变化

喂胆固醇诱导大耳白兔形成动脉粥样硬化（Ａｓ）模型并观察其血清载脂蛋白Ａ１（ａｐｏＡ１）、Ｂ（ａｐｏＢ）及其比值和血脂的变化，实验结果表明：Ａｓ模型组兔血清ａｐｏＢ、总胆固醇（Ｔｃｈ）、（βｖＬＤＬ＋ＬＤＬ）－ｃｈ、过氧化脂质（ＬＰｏ）明显升高，ＨＤＬ－ｃｈ／Ｔｃｈ、ａｐｏＡ１／ａｐｏＢ比值明显降低，而ａｐｏＡ１与对照组比较无明显差异。提示：胆固醇诱导兔Ａｓ形成的原因主要是含ａｐｏＢ脂蛋白量与质的变化和多种致Ａｓ因子的升高。     

实验性慢性肾衰早期血浆脂质水平动态变化的研究

本文对Ｗｉｓｔａｒ鼠５／６肾切除ＣＲＦ条件形成分别在１０、２０、３０、４０ｄ各时相点，同时测定试组对照组血浆中ＴＧ、Ｔ－Ｃｈ、Ｔ－ＰＬ及相关的载体白（ａｐｏＡ＝１、ａｐｏＢ）和脂蛋白（ＬＤＬ－Ｃｈ，ＨＤＬ－Ｃｈ）等项水平进行了系统动态观察。结果显示，ＴＧ水平在１０ｄ，Ｔ－ＣＬ、ＬＤＬ一Ｃｈ和ａｐｏＢ含量在２０ｄ时相点上始增多，并呈上升趋势。ＴＧ在２０ｄ，Ｔ－Ｃｈ、ＬＤＬ－Ｃｈ在３０ｄ分别开始明显高于同时相点对照组（Ｐ＜０．０５）ａｐｏＢ在４０ｄ明显高于同时相点对照组（Ｐ＜０．０５）．而ａｐｏＡ－１、ＨＤＬ－Ｃｈ、ＰＬ－Ｐ含量均在１０ｄ开始下降，并呈下降趋势，在３０ｄａｐｏＡ－１、ＨＤＬ－Ｃｈ开始明显低于同时相点对照组（Ｐ＜０．０５）．揭示了ＣＲＦ早存在着脂质代谢异常，并提示尤为ＴＧ的增高，可能成为脂质代谢异常最早期的诊断指标。本文从分子水平阐明了ＣＲＦ早期脂质代谢异常的发生、发展及各组份的分布状态，它们之间的相互关系和作用。无疑为ＣＲＦ脂质代谢异常早期预防。治疗提供一定的理论根据。     

影响糖尿病患者胆固醇水平的多因素分析(附80例临床分析)

本文观察８０例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者的病程、糖化血红蛋白（ＧＨｂ）、甘油三脂（ＴＧ）、高密度脂蛋白－胆固醇（ＨＤＬ－Ｃ）、低密度脂蛋白－胆固醇（ＬＤＬ－Ｃ）、ＨＤＬ－Ｃ／ＬＤＬ－Ｃ、载脂蛋白Ａ１（ａｐｏＡ１）、载脂蛋白Ｂ１００（ａｐｏＢ１００）、ａｐｏＡ１／ａｐｏＢ１００、雌二醇（Ｅ２）、睾酮（Ｔ）、Ｅ２／Ｔ、尿白蛋白排泄率（ｕＡＥＲ）等因素对总胆固醇（ＴＣ）的影响，应用ＳＡＳ统计软件进行逐步回归分析。结果显示：ＴＣ与ＬＤＬ－Ｃ、ｕＡＥＲ显著正相关，与Ｅ２或Ｅ２／Ｔ显著负相关；而ｕＡＥＲ又与ＴＣ、ＧＨｂ、病程均显著正相关，提示ＮＩＤＤＭ患者胆固醇异常与脂蛋白代谢、性激素代谢、肾功能以及糖代谢等紊乱有关。     

原发性肾病综合征患儿血脂及载脂蛋白变化

目的：了解原发性肾病综合征（ＰＮＳ）患儿的血脂及载脂蛋白的变化。方法：测定２０例原发性肾病综合征（ＰＮＳ）患儿血脂及载脂蛋白,并与对照组比较。结果：ＰＮＳ患儿组的血清总胆固醇（ＴＣＨ）,游离胆固醇（Ｆ－ｃｈ）,胆固醇酯（Ｃｈｅ）,甘油三酯（ＴＧ）,磷酯（ＰＬ）,及载脂蛋白Ｂ均较对照组显著升高（ｐ〈０．０１）,而ＡｐｏＡ１差异不大（ｐ〉０．０５）。ＰＮＳ组治疗前后血脂及载脂蛋白对比也有统计学差异。结     

脑卒中恢复期的尿微量蛋白观察

目的 探讨脑卒中恢复期尿微量蛋白含量及其临床意义。方法 用速率散射法免疫浊度测定６８例脑卒中患者（其中脑梗死３５例,脑出血３３例）和３０例高血压病患者的尿微量蛋白蛋白（ＭＡ）、转铁蛋白（ＴＲＦ）、免疫球蛋白Ｇ（ＩｇＧ）、α１微球蛋白（α１－ＭＧ）,用酶法测定血总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、载脂蛋白Ａ１（ａｐｏＡ１）载脂蛋白Ｂ１００（ａｐｏＢ１００）及空腹血为离卒中组尿ＭＡ、ＴＲＦ、ＩｇＧ、α     

兔血清载脂蛋白A1亚类的研究：IV.实验性动脉粥样硬化兔血清载…

喂胆固诱导大耳白兔形成动脉粥样硬化（Ａｓ）模型并观察其血清脂蛋白Ａ１（ａｐｏＡ１），Ｂ（ａｐｏＢ）及其比值和血脂的变化，实验结果表明，Ａｓ模型组兔血清ａｐｏＢ，总胆固醇（Ｔｃｈ），（βＶＬＤＬ＋ＬＤＬ）－ｃｈ，过氧化脂质（ＬＰ）明显升高，ＨＤＬ－ｃｈ／Ｔｃｈ，ａｐｏＡ１／ａｐｏＢ比值明显降低，而ａｐｏＡ１与对照组比较无明显差异，提示，胆固醇诱导兔Ａｓ形成的原因主要含ａｐｏＢ脂蛋白量与质的变化和多种     

不同年龄组血脂及甲状腺机能的关系

观察１５９例健康体检人员血清甲状腺激素水平，甲状腺有关自身抗体及血脂，载脂蛋白浓度与年龄的关系，结果发现随年龄增加，血清胆固醇（ＴＣ），甘油三脂（ＴＧ），载脂蛋白Ｂ（ａｐｏＢ）及促甲状腺激素（ＴＳＨ）抗甲状腺球蛋白抗体（ＴＧＡ）呈增加趋势，其中ＴＣ，ＴＧ及ＴＳＨ与年龄在成显著正相关，而血清游离三碘甲腺原氨酸（ＦＴ３）游离甲状腺素（ＦＴ４）及高密度脂蛋白（ＨＤＬ－Ｃ），载脂蛋白Ａｌ（ａｐｏＡｌ）则呈     

国人Ⅱ型糖尿病患者载脂蛋白A—Ⅳ血清水平的研究

用酶联免疫吸附法（ＥＬＩＳＡ）检测了我国Ⅱ型糖尿病（ＮＩＤＤＭ）患者血清中载脂蛋白Ａ－Ⅳ（ａｐｏＡ－Ⅳ）的水平，并分析了它与其他７项血清参数ＴＧ、ＴＣ、ＨＤＬ－Ｃ、空腹血葡萄糖（ＦＰＧ）、ａｐｏＡ－Ⅰ、ａｐｏＢ１００和对数Ｌｐ（ａ）之间的关系。结果显示：与正常人群相比，ＮＩＤＤＭ患者ａｐｏＡ－Ⅳ和ＦＰＧ的血清水平显著增高（皆Ｐ＜０００１），ＨＤＬ－Ｃ和ａｐｏＡ－Ⅰ的血清水平显著降低（Ｐ＜０００１，Ｐ＜００５）。通过简相关分析和多元回归分析，两组人群ａｐｏＡ－Ⅳ的血清水平与ＨＤＬ－Ｃ和ＦＰＧ的血清水平呈正相关，与ＴＧ血清水平无显著相关性。可看出：ＮＩＤＤＭ患者血清ＨＤＬ中的两种主要载脂蛋白Ａ－Ⅰ和Ａ－Ⅳ的分布比例可能发生异常，致使ＨＤＬ逆向转运胆固醇的功能减弱，推测这可能与ＮＩＤＤＭ患者伴发动脉粥样硬化的机率增高有关     

四金化石胶囊降低豚鼠实验性胆红素结石模型血脂的实验研究

采用中药复方四金化石胶囊大、小剂量，灌胃治疗１４只胆红素结石模型豚鼠，其治疗后的血脂水平与模型组、正常组血脂比较。结果显示：模型组及大剂量组豚鼠血清的总胆固醇（Ｔ－ｃｈ）、甘油三酯（ＴＧ）浓度均较高，而高密度脂蛋白胆固醇（ＨＤＬ－ｃｈ）、载脂蛋白Ａ１（ａｐｏ－Ａ１）浓度较低；小剂量组豚鼠血清的Ｔ－ｃｈ、ＴＧ浓度较低，近似正常组（Ｐ＞０．０５），同时ＨＤＬ－ｃｈ、ａｐｏ－Ａ１浓度升高。参考肝组织超微结构，本研究认为，复方四金化石胶囊的降脂效果与剂量有关     

脑梗塞病人血浆LCAT活性与脂蛋白及红细胞膜脂质含量的关系

①目的探讨脑梗塞病人血浆卵磷脂－胆固醇酰基转移酶（ＬＣＡＴ）活性与脂蛋白及红细胞膜脂质含量的关系，②方法应用外加底物法铡定４８例脑梗塞病人和３６例健康人血浆ＬＣＡＴ括性，并检测血浆高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）和亚组分（ＨＤＬ２－Ｃ，ＨＤＬ３－Ｃ）、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）、载脂蛋白Ａ－１和Ｂ（ａｐｏＡ－１，ａｐｏＢ）、红细胞膜胆固醇（ＲＢＣＭ－ＣＨ）和红细胞膜磷腊（ＲＢＣＭ－ＰＬ）的含量变化。③结果脑梗塞病人血浆ＬＣＡＴ活性、ＨＤＬ－Ｃ，ＨＤＬ２－Ｃ及ａｐｏＡ－１含量明显降低，血浆ＬＤＬ－Ｃ，ａｐｏＢ，ＲＢＣＭ－ＣＨ及ＲＢＣＭ－ＣＨ／ＲＢＣＭ－ＰＬ比值显著增高，与对照组比较差异有显著性（ｔ＝２．１４－３．２５，Ｐ＜０．０５，０．０１），血浆ＬＣＡＴ活性与ＨＤＬ－Ｃ，ＨＤＬ２－Ｃ及ａｐｏＡ－１呈正相关（ｒ＝０．３８４，Ｐ＜０．０１；ｒ＝０．２９８，Ｐ＜０．０５；ｒ＝０．３１９，Ｐ＜０．０５），而与ＬＤＬ－Ｃ，ＲＢＣＭ－ＣＨ呈负相关（ｒ＝－０．２９０，－０．３２３；Ｐ＜０．０５）。④结论脑梗塞病人脂质代谢异常与血浆ＬＣＡＴ活性降低有关。     

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.     

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.