家兔急性DIC血清和肺血管紧张素转换酶的变化

目的：观察急性实验性弥散性血管内凝血（ＤＩＣ）家兔血清和肺组织血管紧张素转换酶（ＡＣＥ）活性变化。方法：用４％兔脑粉（组织凝血活酶）浸液（２ｍｌ／ｋｇ＋生理盐水稀释至３０ｍｌ）静脉注射复制家兔急性ＤＩＣ动物模型，紫外分光光度法测定ＡＣＥ活性。结果：家兔血清ＡＣＥ活性在注射脑粉浸液开始后１５ｍｉｎ时，与－５ｍｉｎ比较无显著性差异（Ｐ＞００５）；３０ｍｉｎ开始下降；６０ｍｉｎ显著下降（Ｐ＜０．０１）。家兔肺组织ＡＣＥ活性６０ｍｉｎ时升高，但与对照组比较无显著性差异（Ｐ＞０．０５）。血浆纤维蛋白原含量与血清ＡＣＥ活性存在相关性（ｒ＝０．５０４１，Ｐ＜０．０５）。结论：ＤＩＣ时凝血、纤溶紊乱与血清ＡＣＥ活性变化有关，肾素－血管紧张素系统（ＲＡＳ）参与ＤＩＣ发病机制。     

一氧化氮在实验性脑缺血中作用机制的研究

目的为研究脑缺血和缺血再灌注对各脑区一氧化氮（ＮＯ）的变化，以及一氧化氮合成酶（ＮＯＳ）抑制剂ＷＮ－硝基左旋精氨酸（Ｌ－ＮＮＡ）对脑缺血和缺血再灌注时各脑区ＮＯ生成的影响。方法采用四动脉阻断的全脑缺血模型，通过组化方法、荧光方法和放射免疫方法，观察脑缺血５ｍｉｎ、１０ｍｉｎ、１５ｍｉｎ、３０ｍｉｎ和６０ｍｉｎ，以及脑缺血１０ｍｉｎ再灌注１５ｍｉｎ、缺血３０ｍｉｎ再灌注１５ｍｉｎ，大脑皮质、海马、纹状体和小脑组织中ＮＯＳ表达、ＮＯＳ活性、ＮＯ２和ｃＧＭＰ的变化；同时观察了Ｌ－ＮＮＡ对脑缺血１０ｍｉｎ、缺血１０ｍｉｎ再灌注１５ｍｉｎ，各脑区ＮＯ２生成量的影响。每组大鼠８～１０只。结果（１）大鼠四个脑区ＮＯＳ表达、ＮＯＳ活性、ＮＯ２和ｃＧＭＰ的含量，在缺血５～１５ｍｉｎ明显高于假手术组（Ｐ＜０．０５或Ｐ＜０．０１），在缺血３０～６０ｍｉｎ开始下降。（２）在缺血１０ｍｉｎ、３０ｍｉｎ再灌注１５ｍｉｎ，它们的含量可明显增加，与单纯缺血组相比，有显著性差异（Ｐ＜０．０１）。（３）Ｌ－ＮＮＡ可使脑缺血１０ｍｉｎ和缺血１０ｍｉｎ再灌注１５ｍｉｎ，各脑区ＮＯ２的生成量明显减少（Ｐ＜０．０５或Ｐ＜０．０１）；左旋精氨酸可部分逆     

急性酒清中毒对兔外伤性脑水肿的影响

目的：探讨急性酒精中毒对兔务必一脑水肿的影响。方法：采用经胃管注入乙醇致使家兔急性酒精中毒，自由落体打击法制作外伤性水肿模型，测定伤后４ｈ脑眼氧化物歧化（ＳＯＤ）活性、脂质过氧化物（ＬＰＯ）含量及脑组织含水量，并连续监测颅内压（ＩＣＰ）变化，结果：急性酒精中毒加脑外伤组伤后４ｈ脑组织ＳＯＤ活性明显下降（Ｐ〈０．０５），ＬＰＯ含量明显增高（Ｐ〈０．０１），脑含水量显著增加（Ｐ〈０．０５），伤后ＩＣＰ     

凝血酶－抗凝血酶_Ⅲ复合物和D－二聚体测定在急性白血病凝血障碍中的诊断价值

用单抗酶联免疫法和乳胶凝集法分别测定７例急性白血病患者凝血障碍过程中血浆凝血酶－抗凝血酶＿Ⅲ（ＴＡＴ）复合物和Ｄ－二聚体水平，并将３２份测试标本分为ＤＩＣ、无ＤＩＣ和肝损害组做比较。ＴＡＴ复合物总的和在３个组中的水平均明显增加（Ｐ分别＜０．０１），ＤＩＣ与无ＤＩＣ组间差异不显著（Ｐ＞０．０５）。Ｄ－二聚体总的和在ＤＩＣ和无ＤＩＣ组中的水平均明显增加（Ｐ分别＜０．０１），３组间差异显著（Ｐ分别＜０．０１）。在一些指标的相关性分析中，ＴＡＴ复合物和Ｄ－二聚体相关不明显（γ＝－０．１５，Ｐ＞０．０５），ＴＡＴ复合物和ＡＴ＿Ⅲ呈明显正相关（γ＝０．５２，Ｐ＜０．０１），Ｄ－二聚体和纤维蛋白原／纤维蛋白降解产物（ＦＤＰｓ）亦呈明显正相关（γ＝０．６０，Ｐ＜０．０１）。这一初步结果提示：在ＡＬ凝血障碍中，ＴＡＴ复合物是凝血系统激活的敏感指标，但可能易受外源或内源ＡＴ＿Ⅲ的影响；Ｄ－二聚体是继发性纤溶的敏感和特异性指标，其明显增加意味着ＤＩＣ的存在。     

氯胺酮-安定静脉麻醉下小儿手术时的内分泌功能变化

检侧了２０例小儿手术期间肾素活性（ＰＲＡ）、血管紧张素Ⅱ（ＡｇⅡ）。醛固酮（ＡＬＤ）及皮质醇（ＣＯＲ）的变化。氯胺酮 安定静脉麻醉下，分别于麻醉前、麻醉后２０ｍｉｎ，切皮后５ｍｉｎ，３０ｍｉｎ及术后１ｈ，２４ｈ分取５ｍｌ静脉血，检测ＰＲＡ，ＡｇⅡ，ＡＬＤ，ＣＯＲ含量的变化。结果：麻醉后２０ｍｉｎ的ＣＯＲ值较对照值增高（Ｐ＜００５）切皮后５ｍｉｎ，３０ｍｉｎ和６０ｍｉｎ的ＡＬｄ，Ｃｏｒ值均较对照值有显著性增高（Ｐ＜００５或＜００１），且切皮后５ｍｉｎ，３０ｍｉｎ和６０ｍｉｎＡＬＤ，ＣＯＲ值均明显高于麻醉后２０ｍｉｎ值（Ｐ＜００１）。直至手术后２４ｈ时的ＡＬＤ值仍分别较对照值和麻醉后２０ｍｉｎ值有高度显著性（Ｐ＜００１）。提示本麻醉法不能阻止手术的伤害性剌激，引起应激效应激素的分泌过度增加。     

犬失血性休克早期血浆3种酶活性值的变化

用１０只犬复制失血性休克模型,观察休克前、休克３０ｍｉｎ及回输血后３０ｍｉｎ时,血浆中心肌相关酶—肌酸激酶（ＣＫ）、谷草转氨酶（ＧＯＴ）、α－羟丁酸脱氢酶（ＨＢＤ）活性值的变化。结果发现：失血性休克３０ｍｉｎ时,ＣＫ、ＧＯＴ较休克前显著下降（Ｐ＜０．０５,Ｐ＜０．０１）;ＨＢＤ值也下降,但无统计学意义（Ｐ＞０．０５）。输血后３０ｍｉｎ时,ＣＫ、ＧＯＴ、ＨＢＤ值回升,与休克３０ｍｉｎ时比显著升高（Ｐ＜０．０５）,与休克前比无显著性差别（Ｐ＞０．０５）。提示：失血性休克早期心肌细胞可能存在有一种保护性反应,心肌细胞没有发生明显损伤。     

油酸致ARDS过程脂质过氧化和一氧化氮的动态变化

观察急性呼吸窘迫综合征（ＡＲＤＳ）合并左心功能降低时血心肌组织脂质过氧化和一氧化氮（ＮＯ）的动态变化,以了解它们在左心功能降低中的作用。方法：用油酸缓慢注射诱发兔肺损伤所致ＡＲＤＳ模型并为３０ｍｉｎ、６０ｍｉｎ、９０ｍｉｎ和１２０ｍｉｎ４组。结果：（１）油酸各时间组血浆和心肌组织的ＧＳＨ－Ｐｘ和ＭＤＡ含量与对照组相朋显著差异（Ｐ〈０．０５－０．０１）,而且二者呈相关（ｒ＝－０．９８,Ｐ〈０．０１）     

银杏叶总黄酮对缩血管物质活性的影响

目的 研究银杏叶总黄酮在体内对缩血管物质活性影响。方法 用银杏叶的乙醇（７５％）提取液（总黄酮含量０．５ｇ／ｍｌ）给大鼠腹腔注射（每日１ｍｌ／ｋｇ体重）４０ｄ,取颈静脉血,测试血管紧张素转换酶（ＡＣＥ）、内皮素（ＥＴ）活性及一氧化氮（ＮＯ）含量变化。结果 银杏叶总黄酮体内实验对ＡＣＥ无抑制作用（Ｐ〉０．０５）;对ＥＴ有明显抑制作用（Ｐ〈０．０２）;ＮＯ含量明显降低。结论 银杏叶总黄酮对缩血管物质Ｅ     

普鲁卡因静脉复合与静吸互补麻醉的血流动力学改变

择期２４例ＡＳＡⅠ～Ⅱ级胸内手术患者，随机分为两组（静脉组１３例，静吸组１１例），于麻醉后５ｍｉｎ、１５ｍｉｎ、３０ｍｉｎ、６０ｍｉｎ测定ＰＲ、ＳＶ、ＣＯ、ＳＩ、ＣＩ、ＶＰＥ、ＭＡＰ、ＴＰＲ分析比较。结果表明：静脉组ＰＲ前３０ｍｉｎ稳定，６０ｍｉｎ增快（Ｐ＜０．０１），ＭＡＰ下降４％（ｐ＞０．０５），ＳＶ、ＣＯ、ＳＩ、ＣＩ、ＶＰＥ进行性下降（ｐ＜０．０１）；静吸组ＰＲ前３０ｍｉｎ增快７％（Ｐ＞０．０５），６０ｍｉｎ时正常，ＭＡＰ稳定，其他指标前３０ｍｉｎ呈下降趋势（Ｐ＜０．０５），６０ｍｉｎ恢复正常。两组ＴＰＲ增高幅度近似（６７．２％～７０．１％）。     

地奥心血康对大鼠实验性心肌缺血的保护作用

研究地奥心血康对大鼠实验性心肌缺血的影响。方法：结扎ｗｉｓｔａｒ大鼠左冠状动脉造成急性心肌缺血，设缺血对照组（生理盐水）、地奥心血康组（地奥心血康０．１０ｇ／ｋｇ），阳性药普萘洛尔组（普萘洛尔０．０１ｇ／ｋｇ），各组均在结扎冠脉１５ｍｉｎ后经十二指肠给药，记录给药前后不同时间胸前多导联心电图（９个点），以ΣＳＴ和ＮＳＴ来反映心肌缺血程度和范围，结扎冠脉３ｈ，摘取心脏，用Ｎ—ＢＴ染色确定心肌梗塞面积。结果：地奥心血康０１０ｇ／ｋｇ在３０、６０、１２０、１８０ｍｉｎ使ΣＳＴ分别下降２４％、２９％、３０％、２７％（与对照组比Ｐ＜０．０１、Ｐ＜０．０５）；使ＮＳＴ降低１６％、１７％、１６％、１７％（与对照组比Ｐ＜０．０１）持续１８０ｍｉｎ，使梗塞面积由对照组的１５１４％降到９．６０％（Ｐ＜０．０５）。结论：地奥心血康可降低大鼠实验性心肌缺血程度和缺血范围，减少梗塞面积。     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.