半导体激光诱导的鼠脉络膜新生血管模型研究

目的 评价半导激光诱导Brown Norway(BN)大鼠的脉胳膜新生血管(choroidal neovaseularizafion，CNV)模型的可行性。方法用半导体激光(波长810nm，曝光时间0．1s。光斑100μm，能量100～140mV)对10只BN大鼠视乳头附近的视网膜进行光凝。每眼10个激光点，光凝后2小时。3天，1、2,4周行病理组织学检查，观察光斑区CNV的产生及变化过程。结果 激光照射后2小时及3天无DNV形成，激光光凝后1周出现CNV。且病理切片证实激光光凝后1、2．4周CNV发生率分别为35．7％、72．2％、70．6％。结论 通过半导体激光诱导BN大鼠CNV模型是可行的有效的。特别是针对CNV的药物干预及相关基因水平研究。     

色素上皮衍生因子抑制脉络膜新生血管的实验研究

目的：观察重组人色素上皮衍生因子（recombinant human Pigment Epithelium—Derired Factor．rhPEDF）对氩激光诱导的棕色挪威（brown Norway,BN）大鼠脉络膜新生血管的抑制作用。方法：对2组10只BN大鼠单眼行氩激光视网膜光凝,建立脉络膜新生血管模型。光凝后1周,一组动物玻璃体内注射2ug rhPEDF／10uL PBS;另一组动物玻璃体内注射10uL的PBS作为对照组。光凝后2周,对2组动物进行眼底荧光血管造影（fundus fluorescence vascular imaging,FFA）、组织病理学检查及光镜下测量脉络膜新生血管（choroidal neovasculanzation,CNV）厚度并对FFA结果及CNV厚度进行图像及统计学分析,以评估rhPEDF对脉络膜新生血管的抑制效果。结果：视网膜光凝后2周,FFA检查对照组与rhPEDF组相比,荧光素渗漏明显增加,差异有统计学意义（P〈0．05）;CNV厚度检测结果,rhPEDF组光凝区CNV厚度低于对照组,差异有统计学意义（P〈0．05）。结论：对氩激光诱导形成CNV的BN大鼠玻璃体腔内注射rhPEDF,可以抑制CNV的增殖。     

半导体激光诱导大鼠脉络膜新生血管模型的实验研究

目的：评价532nm半导体激光诱导棕色挪威(brown norway,BN)大鼠脉络膜新生血管（choroidal neovasularization,CNV）模型的可行性。方法：使用半导体激光（功率150mW,光斑直径75μm,曝光时间0.1s）对10只BN大鼠建立CNV模型。分别于光凝后7、14、21和28?d随机选取5只行眼底荧光素血管造影术（fundus fluorescein angiogrphy,FFA）和光学相干断层成像术（optical coherence tomography,OCT）检查,比较FFA早期（<2min）和晚期（>10min）荧光渗漏斑数/平均渗漏面积（mm²）的变化,并行统计学分析。结果：光凝后FFA检查经组间两两比较,14、21和28d的早期荧光渗漏斑数/渗漏面积差异无统计学意义(P>0.05),14、21和28d与7d相比差异有统计学意义(P<0.05);7、14、21和28d早期和晚期荧光渗漏斑数差异无统计学意义(P>0.05)。激光斑视网膜的平均厚度与平均荧光渗漏面积有相关性（r=0.73,P<0.05）。结论：半导体激光诱导BN大鼠的CNV模型是可行的。FFA联合OCT可有效检测CNV的形成和变化。     

经瞳孔温热疗法治疗黄斑部脉络膜新生血管的初步报告

目的探讨经瞳孔温热疗法（Traspupillary Thermotherapy，TTT）治疗黄斑部脉络膜新生血管（Choroidal neovascularization，CNV）的临床效果。方法采用810nm半导体激光经瞳孔温热疗法治疗经眼底荧光血管造影（FFA）证实的黄斑部CNV患者19例20眼，治疗参数为光斑直径800～3000μm，能量120～480mw，曝光时间均为60S，光凝数量1～4点。随访视力、中心视野及FFA，时间为2～8个月（平均4．90个月）。结果视力改善6眼（占30．00％），视力稳定13眼（占65．00％），视力下降1眼（占5．00％）。治疗后视力平均为0．12，与治疗前的平均视力0．09比较有改善，但差异无显著性（P〉0．05）。FFA显示治疗后CNV完全闭合者占20．00％，CNV较治疗前面积减小、渗漏减轻者占70．00％，CNV增大和渗漏增加者占10．00％。结论TTT是一种安全有效的黄斑部CNV治疗方法，可使大部分患者视力稳定或提高。     

半导体激光诱导大鼠脉络膜新生血管模型的建立

目的 探讨应用半导体激光诱导建立BN大鼠脉络膜新生血管(choroidal neovascularization，CNV)模型的可行性。方法 雄性棕色挪威(Brown Norway，BN)大鼠30只，9只为对照组，21只为实验组；用半导体激光光凝实验组BN大鼠的视网膜，分别于光凝后1h，3、7及14d行眼底荧光造影(fiundus fluorescein angiography，FFA)检查，3、7和14d行病理组织学检查。结果 光凝后7dFFA及光镜检查均证实CNV开始形成。14dCNV大量形成。结论 半导体激光损伤可以成功地诱导BN大鼠形成CNV模型，成模时间短，成模率高，是一种较为理想的CNV动物模型。     

色素上皮衍生因子在大鼠脉络膜新生血管中的表达

目的：探讨激光诱导BN大鼠脉络膜新生血管（choroidal neovascularization，CNV）中色素上皮衍生因子（pigment epithelium—derived factor，PEDF）的表达及意义。方法：对3组18只BN大鼠行单眼视网膜氩绿激光光凝，诱导脉络膜新生血管形成。分别在光凝后1周、2周、3周摘除眼球，对光凝区进行病理学检查、Ⅷ因子相关抗原（FⅧR：Ag）的免疫组织化学检查。应用免疫组织化学检测CNV形成过程中PEDF的表达及变化。结果：病理学检查及FⅧR：如免疫组织化学检查显示，光凝后1周开始形成CNV，3周达到高峰。正常BN大鼠PEDF在视网膜神经节细胞、内核层部分细胞、视网膜色素上皮层表达。视网膜光凝后，PEDF阳性染色信号可见于视网膜神经节细胞层、内核层、视网膜色素上皮层、外核层和脉络膜的损伤区；光斑边缘近脉络膜侧PEDF阳性表达信号明显高于光斑内部。光凝后1周至3周，光斑区内FⅧR：Ag阳性染色密度逐渐增加（P〈0．05），PEDF阳性染色密度逐渐下降（P〈0．05），PEDF与FⅧR：Ag阳性染色密度呈负相关（r=-0．832，P〈0．05）。结论：CNV形成与PEDF表达量负相关，提示PEDF表达不足可能是CNV形成和增生的素因之一。     

实验性视网膜下新生血管的荧光造影与眼底病理改变的相关性及意义

目的　探讨视网膜下新生血管 (SRNV)的发生、发展特征 ,为治疗和预防提供理论依据 .方法　用高强度氩激光光凝兔视网膜 ,经眼底镜、眼底荧光血管造影 (FFA ) ,确定病理组织学及超微结构变化 .结果　光凝后 1wk～ 2 mo,光斑区渗出渐增多 ,FFA渗漏渐增强 ,范围扩大 .光、电镜下见脉终膜新生血管 (CNV)增生长入光斑 ,大部分位于光斑边缘 .光凝后 3～ 4m o,光斑区出现瘢痕样物质 ,荧光渗漏范围渐缩小 .光 .电镜下光斑区见大量胶原纤维 .结论　 SRNV的眼底改变、FFA、病理组织学之间有明确的相关性 .对分析判断SRNV的发展程度及掌握治疗时机有重要的临床价值     

实验性脉络膜新生血管动物模型的研究

目的 评价氪激光诱导棕色挪威(brown Norway,BN)大鼠脉络膜新生血管(choroidal neovascularization,CNV)模型的可行性和CNV病变特点.方法 通过氪激光(波长647 nm,光斑直径50 靘,功率360 mW,曝光时间0.05 s)围绕视盘光凝建立大鼠CNV模型.分别于光凝后第3、7、14、21、30 d进行荧光素眼底血管造影(fluorescein fundus angiography,FFA).造影后6 h待其体内荧光素染料大部分被排出后,处死动物,摘除眼球取眼后段组织制作石蜡切片.选取有明确血管化的激光斑连续切片中"最大CNV膜"切片,常规HE染色,并计算CNV膜相对厚度.随机选取光凝后21 d大鼠作电镜检查.结果 光凝后7d出现CNV,21 d达高峰,大鼠CNV发生率达77.78%.FFA表现为造影早期强荧光斑,晚期出现与视网膜血管无关的荧光素渗漏.光镜和电镜下可见到CNV自脉络膜穿过破裂的Bruch膜突向视网膜下,以及巨噬细胞浸润、视网膜色素上皮(retinal pigment epithelium,RPE)细胞迁移增生等.CNV相对厚度在光凝后7～21 d逐渐增加(P<0.01),21 d达高峰,之后变化不显著(P>0.05).结论 氪激光诱导BN大鼠CNV模型具有稳定、可靠、价廉、成模时间短,成模率较高等特点.激光诱导的CNV中有巨噬细胞浸润,存在炎症反应.     

半导体激光诱导大鼠脉络膜新生血管形成

目的探讨应用810 nm半导体激光诱导棕色挪威(BN)大鼠脉络膜新生血管(CNV)模型建立的可行性。方法雄性BN大鼠35只,随机等分为7组,每组各取1只作为对照,其余4只采用810 nm半导体激光光凝大鼠双眼视网膜,于光凝后1、3、7、14、21、28、56 d观察眼底情况,并行眼底荧光血管造影(FFA)和吲哚菁绿血管造影(ICGA),于检查后立即处死,摘取眼球行光学显微镜(LM)检查。结果FFA、ICGA和LM检查均证实,光凝后7 d见CNV开始形成,14 d逐渐增多,21 d达到高峰并能保持稳定,56 d CNV有所减少。结论810 nm半导体激光能成功诱导BN大鼠CNV模型建立,成模所需时间短,成模率高,持续时间较长,操作方便,是一种比较理想的CNV动物模型。     

半导体激光诱导大鼠脉络膜新生血管形成

目的探讨应用810 nm半导体激光诱导棕色挪威(BN)大鼠脉络膜新生血管(CNV)模型建立的可行性.方法雄性BN大鼠35只,随机等分为7组,每组各取1只作为对照,其余4只采用810 nm半导体激光光凝大鼠双眼视网膜,于光凝后1、3、7、14、21、28、56 d观察眼底情况,并行眼底荧光血管造影(FFA)和吲哚菁绿血管造影(ICGA),于检查后立即处死,摘取眼球行光学显微镜(LM)检查.结果FFA、ICGA和LM检查均证实,光凝后7 d见CNV开始形成,14 d逐渐增多,21 d达到高峰并能保持稳定,56 d CNV有所减少.结论810 nm半导体激光能成功诱导BN大鼠CNV模型建立,成模所需时间短,成模率高,持续时间较长,操作方便,是一种比较理想的CNV动物模型.     

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.