肾上腺器官内淋巴管比较解剖学研究

采用墨汁硝酸银水溶液局部动脉灌注方法，对人胎儿和犬，大鼠，牛，家兔肾上腺器官内淋巴管的分布进行了比较解剖学研究。观察结果表明，（１）人胎儿和牛，犬肾上腺器官内淋巴管的分布相同。在肾上腺被膜内和腺体内的中央静脉周围，存在淋巴管毛细淋巴管；家兔和大鼠肾上腺器官内淋巴管较少，仅在肾上腺的被人观察到淋巴管和毛细淋巴管。     

肾上腺器官内淋巴管的研究

作者也用光、电镜观察方法研究新生儿尸体的肾上腺器官内淋巴管的微细分布及超微结构。结果在肾上腺被膜内有毛细淋巴管及淋巴管，而肾上腺皮质、髓质的实质内及腺体内大静脉周围均不存在毛细淋巴管及淋巴管。肾上腺器官内淋巴管的超微结构与其他器官淋巴管的结构基本相同。     

兔胰腺器官内淋巴管

本文对家兔胰腺器官内的淋巴管进行了光镜和电镜观察。胰腺毛细淋巴管和淋巴管存在小叶间和被膜下。毛细淋巴管的超微结构与其他器官所见相同。     

家兔肝脏淋巴管的微细分布

目的：研究家兔肝脏内淋巴管的微细分布及各叶淋巴管的分布密度。方法：采用半薄切片光镜观察和超薄切片电镜观察方法。结果：肝脏的毛细淋巴管和淋巴管仅见于小叶间的门管区结缔组织内，而肝小叶及肝被膜内均未见到毛细淋巴管和淋巴管。肝脏各叶淋巴管的检出率：右外侧叶占17％，右内侧叶占23％，左外侧叶占27％，左内侧叶占17％，尾状叶占20％。结论：家兔肝小叶内不存在淋巴管及肝脏各叶淋巴管的分布密度无显差异。     

睾丸和附睾内淋巴管及其淋巴流向

本文用普鲁士蓝间接注射法和墨汁硝酸银动脉内注入法,在24具胎儿尸体上观察了睾丸和附睾器官内淋巴管及其淋巴流向,结果表明,睾丸淋巴管仅存在于睾丸白膜、睾丸小叶间结缔组织及睾丸纵隔内,睾丸小叶内没有发现淋巴管及毛细淋巴管。睾丸输出小管间存在淋巴管、睾丸和附睾淋巴大部分汇入腰淋巴结。     

家兔肺内淋巴管的形态、分布特点与淋巴液生成的关系

目的：观察家兔肺内淋巴管的形态、分布特点，为探讨肺淋巴液生成机制提供形态学依据。方法：取家兔肺组织用半薄切片光镜观察、超薄切片透射电镜观察肺内淋巴管的形态、分布特点，并用计算机图像分析测量了有关数据。结果：肺的淋巴管主要位于富含结缔组织区，多位于支气管、肺动脉及肺静脉周围，起始于呼吸性支气管，肺泡隔内未见淋巴管分布。肺内毛细淋巴管内皮细胞内富含质膜小泡，内皮细胞连接有三种类型，端端连接、插入连接和重叠连接，偶见开放连接。结论：在肺脏淋巴液的生成机制中，毛细淋巴管内皮细胞的转运功能可能是以质膜小泡的运输为主，内皮细胞间连接所形成的通道作用为辅。     

肝脏毛细淋巴管的分布和形态学测量

目的 :研究家兔肝脏毛细淋巴管的分布和形态学特征 ,并测量了有关数据 ,为研究肝脏淋巴生成机理提供必要的依据。方法 :采用免疫组织化学染色法和半薄切片光镜观察、超薄切片电镜观察方法。结果 :肝脏毛细淋巴管仅存在于小叶间的结缔组织内 ,而肝小叶内无毛细淋巴管。毛细淋巴管在门管区的出现率约31% ;其平均最大直径为 (33.6± 3.2 )um ;平均横截面积为 (4 32 .3± 5 6 .7)um2 ;数密度为 (4 .1± 0 .3)个 /mm2 ;体密度为 0 .0 0 17± 0 .0 0 0 2 3。出现起始淋巴管的门管区最小面积 (5 .8± 0 .9)mm2 。结论 :肝小叶内不存在毛细淋巴管 ,毛细淋巴管仅存在于较大门管区的结缔组织内     

家兔肺内淋巴管的微细分布

目的:研究家兔肺内淋巴管的微细分布.方法:采用半薄切片光镜观察和超薄切片电镜观察方法.结果:①肺内淋巴管存在于富含结缔组织区,延伸至终末细支气管及呼吸性细支气管区,但不延伸至肺泡区.并在呼吸性细支气管区起始,肺泡隔内未见毛细淋巴管和淋巴管.②伴行肺动脉的淋巴管为肺深淋巴管系的主流,其末梢向小叶中央延伸到末级微动脉附近.③伴行肺静脉的淋巴管位于静脉外膜的结缔组织中,通常位于外膜的边缘,一侧为静脉壁的结缔组织,而另一侧与肺泡紧密相邻.结论:肺内淋巴管存在于富含结缔组织的终末细支气管及呼吸收细支气管区.     

鼠小肠壁内淋巴管的微细分布

本文应用光镜和电镜方法研究了大鼠小肠壁内淋巴管的微细分布。结果在小肠壁内各层中均见有毛细淋巴管分布，除粘膜层外，粘膜下层、肌层和浆膜层还见有淋巴管。粘膜层的毛细淋巴管位于粘膜肌附近。粘膜下层的毛细淋巴管和淋巴管多位于粘膜肌的直下方。肌层的毛细淋巴管和淋巴管，存在于环，纵肌间的结缔组织中及纵行肌纤维间。在浆膜层见到较大的淋巴管，有瓣膜，而毛细淋巴管的数量相对较少。     

家兔子宫毛细淋巴管内皮细胞间连接的电镜观察

家兔子宫毛细淋巴管内皮细胞间连接的电镜观察应用透射电镜观察到家兔子宫毛细淋巴管内皮细胞间的连接，有３种基本方式：（１）端对端连接，即相邻内皮细胞端与端互相对接，在对接处，可见粘着装置和伸向管腔外的锚丝（ａｎｃｈｏｒｉｎｇｆｉｌａｍｅｎｔ），内皮细胞质...     

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.