敬告读者

目的：评价注射用丹参冻干粉针和丹参注射液治疗冠心病心绞痛的临床疗效。方法：将符合冠心病心绞痛诊断标准的患者110例随机分为治疗组58例，对照组52例。治疗组给予注射用丹参冻干粉针，对照组给予丹参注射液静滴，两组应用其他常规药物治疗相同。结果：治疗组心绞痛总有效率94．8％，对照组为84．6％；治疗组心电图有效率87．9％，对照组为80．8％。两组总有效率比较差异有显著性（P〈0．05）。结论：注射用丹参冻干粉针与丹参注射液均能缓解心绞痛症状和改善心肌缺血，但注射用丹参粉针质量标准比丹参注射液易控制，因此其质量稳定，疗效更好。     

血府逐淤丸对不稳定型心绞痛的临床疗效观察

目的：研究血府逐淤丸对不稳定型心绞痛患者的治疗作用。方法：虚用血府逐淤丸治疗了32例不稳定型心绞痛患者，并与对照组比较。结果：缓解心绞痛症状的疗效比较，对照组总有效率为86．7％，治疗组总有效率为93．8％，两组之间疗效比较有显著性差异（P〈0．05）。改善缺血性心电图改变的疗效比较，对照组总有效率为43．3％，治疗组总有效率为56．3％，两组之间比较差异有显著性（P〈0．05）。结论：血府逐淤丸对不稳定型心绞痛患者有很好的治疗作用。     

丹参川芎嗪注射液治疗冠心病不稳定型心绞痛的疗效观察

目的观察丹参川芎嗪注射液治疗冠心病不稳定型心绞痛的临床效果及安全性。方法将113例不稳定型心绞痛患者随机分为治疗组和对照组，两组均给予常规治疗方法，冶疗组在此基础上，加用注射用丹参川芎嗪注射液静滴。结果治疗组和对照组的临床总有效率分别为85．7％和63．2％，两者比较差异有统计学意义（P〈0．01）。两组心电图总有效率分别为76．8％和54．4％，两者比较差异有统计学意义（P〈0．05）。未见明显药物副反应。结论丹参川芎嗪注射液治疗冠心病不稳定型心绞痛疗效好，副反应少。     

血塞通注射液治疗冠心病心绞痛的临床观察

目的：观察血塞通注射液治疗冠心病心绞痛的疗效。方法：采用随机单盲方法，将78例冠心病心绞痛患者随机分为2组，血塞通治疗组40例，对照组38例，观察2组临床总有效率，ECG总有效率及治疗前后血液流变变化。结果：治疗组临床总有效率90．0％，对照组临床总有效率71．0％，组间比较P＜0．05；治疗组ECG总有效率62．5％，对照组ECG总有效率36．8％，组间比较P＜0．05；对血液流变学指标观察显示，治疗后两组有显著性差异（P＜0．01）；治疗组在治疗前后血液流变学有显著性差异（P＜0．01）；结论：冠心病心绞痛患者常规治疗的基础上加用血塞通注射液可提高疗效。     

疏血通注射液治疗冠心病心绞痛58例临床研究

目的：观察疏血痛注射液治疗冠心病心绞痛的临床疗效。方法：治疗组应用疏血通注射液静滴合并注射硝酸甘油，对照组单纯注射硝酸甘油，观察临床症状心电图、血脂等变化。结果：治疗组总有效率为94．5％，对照组总有效率为64．5％。两组疗效经统计学处理，差异有显著性（P〈0．01）。两组缺血性ST—T改变的时间经统计学处理，差异有显著性（P〈0．01）。结论：疏血通注射液治疗冠心病心胶痛疗效确切，临床值得推广应用。     

益气化痰祛瘀法治疗不稳定性心绞痛疗效观察

目的：观察益气化痰祛瘀法治疗不稳定性心绞痛的临床疗效。方法：将已确诊的123例不稳定性心绞痛患者随机分为两组。对照组47例，予以抗心绞痛常规西药治疗；治疗组76例，在对照组治疗基础上加用益气化痰祛瘀中药（药用黄芪、党参、元参、半夏、茯苓、白僵蚕、丹参、水蛭、廑虫）治疗，4周为1个疗程。结果：①两组心绞痛疗效：治疗组76例中显效23例，有效46例，无效7例，总有效率90．8％；对照组47例中显效7例，有效26例，无效14例，总有效率70．2％。两组显效率比较，差异有显著性意义（P〈0.05）；②两组心电图疗效比较：治疗组76例中显效23例，有效43例，无效10例，总有效率86，8％；对照组47例中显效7例，有效23例，无效17例，总有效率63．8％。两组显效率比较，差异有显著性意义（P〈0．05）；③两组血清低密度脂蛋白胆固醇（LDL—C）、甘油三酯（TG）、C-反应蛋白（CRP）、血清高密度脂蛋白胆固醇（HDL-C），与治疗前比较，差异均有显著性意义（P〈0．05）。两组治疗后比较，差异有显著性意义（P〈0．05）。结论：益气化痰祛瘀法有较好的调脂及改善供血、稳定动脉粥样斑块的作用，是治疗不稳定性心绞痛的有效疗法，其中化痰必不可少。     

刺五加注射液辅助治疗冠心病心绞痛疗效观察

目的观察刺五加注射液对冠心病心绞痛的疗效。方法将冠心病心绞痛患者110例随机分为治疗组56例和对照组54例,对照组用常规治疗（阿司匹林、硝酸酯类、β-阻滞剂、钙拮抗剂及他汀类药物）,疗程14d;治疗组在常规治疗的基础上加用刺五加注射液250ml静脉滴注,1次/d,疗程为14d。观察两组用药前后心绞痛发作次数、持续时间及心电图结果的变化。结果治疗组总有效率92．9％,对照组总有效率81．5％,治疗组疗效明显优于对照组（P〈0．05）。结论刺五加注射液辅助治疗冠心病心绞痛有明显效果。     

阿魏酸钠治疗VB142例疗效观察

目的：观察阿魏酸钠注射液治疗椎基底动脉供血不足（VBI）的近期疗效。方法：42例VBI病人随机分为两组。每组21例．治疗组用阿魏酸钠注射液300mg加入5％的葡萄糖250ml注射液静滴,每日1次,疗程14天;对照组丁咯地尔注射液100mg加入5％葡萄糖注射液静滴,每日1次,疗程14天。结果：治疗组总有效率为90．47％,对照组总有效率为76．19％,两组比较有显著性意义（P〈0．05）。结论：采用阿魏酸钠不失为目前治疗VBI的有效药物     

中西医结合治疗老年性肺炎38例

[目的]观察中西医结合治疗老年性肺炎的临床疗效。[方法]将74例老年性肺炎患者随机分为两组，治疗组38例，采用左氧氟沙星注射液、哌拉西林注射液、参附注射液静滴；对照组36例，单用西药抗感染治疗。治疗1个疗程（10～14天）后，进行疗效比较。[结果]治疗组总有效率94．7％，对照组总有效率80．6％，经Ridit分析，两组有显著性差异（P〈0．05），治疗组优于对照组。[结论]中西医结合治疗老年性肺炎疗效显著。     

丹参川芎嗪注射液治疗冠心病心绞痛疗效观察

目的：观察丹参川芎嗪注射液治疗冠心病心绞痛的临床疗效。方法：将104例患者随机分为对照组和治疗组各52例,对照组予以常规综合治疗,治疗组在此基础上使用丹参川芎嗪注射液治疗14d。结果：治疗组的总有效率为92．3％,心电图检测总有效率为88．5g;对照组总效率为73．1％,心电图检测总有效率为53．8％;两组比较差异均有显著性（P〈O．05）。结论：冠心病心绞痛在常规综合治疗基础上联合使用丹参川芎嗪注射液可提高疗效。     

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.