苦参素联合拉米夫定治疗慢性乙肝42例疗效观察

选择 42例慢性乙肝患者用苦参素 ( 40 0mg/d)和拉米夫定 ( 10 0mg/d)联合治疗 (治疗组 ) ,选择 40例慢性乙肝患者单独服用拉米夫定 ( 10 0mg/d)治疗 (对照组 ) ,共治疗 12周。疗效评估包括肝功能、HBVM及HBVDNA。结果 :疗程结束时 ,治疗组ALT下降幅度好于对照组 ( 3 93 .4± 5 0 5 .1nmol·s-1/L与 675 .1± 64 8.5nmol·s-1/L ,P <0 .0 5 ) ,HBeAg阴转率高于对照组 ( 47.6%对 2 2 .5 % ,P <0 .0 5 ) ,HBeAg血清转换高于对照组 ( 2 6.2 %对7.5 % ,P <0 .0 5 )。提示苦参素与拉米夫定联合治疗慢性乙肝近期疗效肯定     

鼠心肌成纤维细胞NOS活性的变化和AVP对NO合成的影响

目的　探讨在基础状态和精氨酸升压素 (AVP)干预下 ,心肌成纤维细胞 (CFs)一氧化氮合酶 -一氧化氮 (NOS-NO)系统活性的变化 .方法　胰酶消化法分离、培养新生 SD大鼠 CFs,采用硝酸还原酶法和分光光度法分别测定基础状态和 AVP干预下 CFs的 NOS活性和 NO含量 .结果　 1基础状态下 CFs的 36 h组 NO含量 (4 2± 5 ) μm ol· L- 1 和 NOS活性 (6 17± 83)μkat· L- 1 ,显著高于 6 h组 (14± 3)μmol·L- 1 ,(16 7± 6 7)μkat· L- 1 . 2 AVP干预下 36 h组 NO含量(6 2± 1) μm ol· L- 1和 NOS活性 (115 0± 10 0 ) μkat· L- 1也显著高于 6 h组 (34± 4) μmol· L- 1 ,(6 0 0± 33) μkat· L- 1 ,且AVP干预组的 NO含量和 NOS活性均高于同时间点基础状态组(P<0 .0 5 ) . 3CFs的 NO含量和 NOS活性随 AVP浓度的增高而增加 ,其中 10 - 6mol· L- 1 AVP组 (6 3± 6 ) μmol· L- 1 ,(110 0± 5 0 )μkat· L- 1 和 10 - 7mol· L- 1 AVP组 (6 9± 6 )μmol· L- 1 ,(12 0 0± 5 0 )μkat· L- 1 都显著高于对照组 (2 9± 5 )μmol· L- 1 ,(4 5 0± 83) μkat· L- 1 ,10 - 9mol· L- 1 AVP组(32± 2 )μmol· L- 1 ,(5 0 0± 133)μkat· L- 1 和 10 - 8mol·L- 1 AVP组 (37± 2 ) μmol· L- 1 ,(6 0 0     

风湿性心脏病心房纤颤和非心房纤颤患者心房肌细胞内钙离子浓度变化

目的　观察风湿性心脏病 (RHD)心房纤颤 (AF)患者心房肌细胞内是否存在 Ca2 + 超载 .方法　急性分离 RHD伴 AF和非 AF患者的心房肌细胞 ,用 Fluo- 3作为钙指示剂 ,用共聚焦显微镜测定细胞内 Ca2 +浓度 .结果　 AF组心房肌细胞内 Ca2 +浓度明显高于非 AF组心房肌细胞内 Ca2 +浓度(5 17± 98) nmol· L- 1 vs(2 6 2± 6 5 ) nmol· L- 1 ,两组间差异显著 (P<0 .0 1) .结论　 RHD伴 AF患者心房肌细胞内存在Ca2 +超载     

致敏后重复抗原攻击的大鼠肺组织环核苷酸磷酸二酯酶活性的变化

目的 :探讨致敏后重复抗原攻击大鼠肺组织 c GMP- PDE、c AMP- PDE活性变化。方法 :HPL C法测定致敏后重复抗原攻击的大鼠 (抗原攻击组 )、致敏不攻击的大鼠 (致敏组 )和正常大鼠 (正常组 )肺组织 c GMP- PDE、c AMP- PDE活性。结果 :抗原攻击组肺组织 c GMP- PDE、c AMP- PDE活性分别为 798.76± 5 2 9.2 3、5 97.5 0± 2 2 0 .75nmol·g-1protein·min-1,其中抗原攻击组大鼠肺组织 c GMP- PDE活性较正常组明显升高 (P<0 .0 5 ) ,抗原攻击组大鼠肺组织 c AMP- PDE活性较致敏组和正常组均明显升高 (P<0 .0 5 )。结论 :大鼠哮喘发病过程中肺组织c GMP- PDE、c AMP- PDE活性明显升高     

不同龄大鼠大脑皮层及脑干一氧化氮合酶活性比较

目的:探讨不同龄大鼠大脑皮层及脑干组织中一氧化氮合酶(NOS)活性变化。方法:采试剂盒法测定3月龄、12月龄和18月龄组Wistar大鼠大脑皮层及脑干中NOS活性。结果:老龄组(18月龄)大鼠大脑NOS活性为(44.96±7.11)noml·g~(-1)/min,明显高于3月龄和12月龄组(38.65±7.23,39.53±8.26)nmol·g~(-1)/min,P<0.01,后二组的NOS活性无显著差异,P>0.05;而老龄组(18月龄)大鼠脑干NOS活性为(45.84±7.53)nmol·g~(-1)/min,明显高于3月龄和12月个龄组(38.68±7.81)nmol·g~(-1)/min,(32.13±6.26)nmol·g~(-1)/min,P<0.01;12月龄的NOS活性也明显高于3月龄组,P<0.05。结论:大鼠脑中NOS活性随年龄而增高,但不同部位增高的时间段有所差异。     

乙胺嗪对大鼠急性肝损伤的保护作用

实验观察乙胺嗪对大鼠急性肝损伤模型的影响,结果表明:乙胺嗪组血清天门冬氨酸氨基转移酶 AST(936.8±428.3 nmol·s~(-1)/L)明显低于模型组(2 104.9±546.8 nmol·s/L,P<0.05),乙胺嗪组血清丙氨酸氨基转移酶 ALT(4 349.2±1 178.6 nmol·s~(-1)/L)显著低于模型组(9 768.6±2 760.6 nmol·s~(-1)/L,P<0.01),反映肝脂质过氧化物水平的丙二醛MDA(1.89±0.62nmol/mg 蛋白)显著低于模型组(3.87±1.70 umol/mg 蛋白,P<0.05),同时肝病理损伤也有明显减轻。认为乙胺嗪通过抑制白三烯合成、减少白细胞数量和抑制多核白细胞炎性浸润,降低氧自由基水平而有护肝作用。     

中、晚期慢性肾衰竭患者的蛋白摄入及营养状况

目的　评估非限制饮食的中、晚期慢性肾衰 (CRF)患者饮食蛋白摄入 (DPI)和营养状况。方法　在 36例中、晚期透析前CRF患者和 2 0例正常对照组中 ,测定DPI和营养指标 ,包括血清白蛋白 (Alb)、转铁蛋白 (TF)、前白蛋白 (pre Alb)、胰岛素样生长因子 1(IGF 1)。结果　CRF患者DPI(0 78± 0 2 5 )g·kg-1·d-1低于正常对照组 (1 0 4± 0 31)g·kg-1·d-1,P <0 0 1;Alb、TF亦显著减低 (P均 <0 0 1)。其中 10例CRF患者DPI <0 6 g·kg-1·d-1(2 8% ) ;DPI <0 6g·kg-1·d-1的CRF患者 (n =10 )与DPI≥ 0 6g·kg-1·d-1(n =2 6 )比较 ,Alb为 (2 7 7± 6 1) g·L-1、(35 3± 8 9) g·L-1,TF为 (1 5 8± 0 31) g·L-1、(2 74± 0 5 6 ) g·L-1,pre Alb为 (0 2 3± 0 0 8) g·L-1、(0 33± 0 10 ) g·L-1,P <0 0 1;IGF 1(1 36± 0 30 )nmol·L-1、(2 2 4± 0 6 2 )nmol·L-1,P<0 0 5。结论　大多数中、晚期CRF患者在透析前已发生营养不良 ,而伴有低饮食蛋白摄入患者更为明显。应适时监测并纠正营养不良的发生     

新生儿窒息脐血一氧化氮和血糖水平与其预后关系

目的　探讨新生儿窒息脐血一氧化氮 (NO)及血糖的变化。方法　对 30例窒息新生儿脐血NO和血糖水平进行检测 ,并与 32例正常新生儿比较。结果　窒息组的脐血NO-2 (43.74± 13.2 0 μmol·L-1)、血糖 (5 .6 3± 1.2 0mmol·L-1)明显高于对照组脐血NO-2 (2 7.2 8± 9.5 2 μmol·L-1)和血糖 (3.6 5± 0 .79mmol·L-1) (P <0 .0 1) ;重度窒息组脐血NO-2 (6 0 .17± 9.93μmol·L-1)和血糖 (7.2 5± 0 .5 4mmol·L-1)显著高于轻度窒息组 (36 .72± 6 .33μmol·L-1和 4.93± 0 .5 3mmol·L-1) (P <0 .0 1) ;NO和血糖水平呈显著正相关 ,而且脐血NO水平与新生儿缺氧缺血性脑病密切相关。结论　新生儿窒息脐血NO和血糖水平的测定具有重要临床意义     

两类心绞痛患者胰岛素抵抗和纤溶酶原激活抑制物-1的比较

目的　两种不同类型心绞痛胰岛素抵抗和纤溶功能的比较 .方法　狭窄性心绞痛 (AP)组 2 7例 ;微血管性心绞痛(MV)组 17例 ;对照组 13例 .分别测量患者身高 ,体质量和血压 .冠状动脉造影前 ,空腹 12 h抽取静脉血 ,测定血脂 ,空腹血糖 ,胰岛素 (Ins) ,C-肽 (C- P)和纤溶酶原激活抑制物 - 1(PAI- 1) .结果　 AP和 MV组血清 Ins分别为 (2 3± 8)m IU· L- 1 和 (2 5± 6 ) m IU· L- 1 ,均明显高于对照组 (15± 5 )m IU· L- 1 (P<0 .0 5 ) ;C- P分别为 (2 .7± 0 .9) μg· L- 1和 (3.1± 0 .8)μg· L - 1 均明显高于对照组 (2 .0± 0 .9)μg· L- 1 (P<0 .0 5 ) ,AP和 MV组胰岛素敏感性指数 (Ins I)均明显低于对照组 0 .0 1± 0 .0 1vs 0 .0 2± 0 .0 1(P<0 .0 5 ) ,以上各指标在AP和 MV组间没有差异 (P>0 .0 5 ) .AP组血浆 PAI- 1为(3.2± 0 .9) AU· m L- 1 ,明显高于 MV组 (2 .5± 0 .6 ) AU·m L- 1和对照组 (2 .5± 0 .4) AU·m L- 1 (P<0 .0 5 ) ,MV组和对照组间没有差异 (P>0 .0 5 ) . AP患者血浆 PAI- 1分别与血清Ins(r=0 .484,P<0 .0 5 )和 C- P(r=0 .5 2 1,P<0 .0 5 )正相关 .AP和 MV组 TG,TC明显高于对照组 (P<0 .0 5 ) ,此两组间没有差异 (P>0 .0 5 ) .结论　 AP和 MV患者都存在胰岛素抵抗 ,     

芪丹通脉片对大鼠心肌线粒体损伤的保护作用

目的 :探讨芪丹通脉片 (QDTMT)对异丙肾上腺素(Iso)所致急性心肌缺血的防治作用 .方法 :给大鼠灌服QDTMT(2g·kg-1) 2wk ,皮下注射异丙肾上腺素 (Iso ,5mg·kg-1) ,诱导急性心肌缺血模型 ,测定心肌线粒体 (Mit)中丙二醛 (MDA)、超氧化物歧化酶 (SOD)、谷胱甘肽过氧化物酶(GXH PX)及琥珀酸脱氢酶 (SDH) .结果 :模型组线粒体中MDA含量增加 ,QDTMT组线粒体MDA含量显著低于模型组 [(8.9± 0 .6 )vs (5 .5± 0 .6 ) μmol·g-1,P <0 .0 1];线粒体中模型组SOD活性降低 ,QDTMT组SOD活性升高 ,两者相比较有显著性差异 [(6 73.2± 2 5 .2 )vs (5 36 .2± 2 0 .3)kNU·g-1,P <0 .0 1].QDTMT组GSH PX活力显著高于模型组 [(5 5 .3± 6 .0)vs (4 0 .7± 7.1)kNU·g-1,P <0 .0 1].QDTMT组线粒体中SDH活性明显升高 [(0 .0 7± 0 .0 1)vs (0 .0 5± 0 .0 1)kat·g-1,P <0 .0 1].结论 :QDTMT可通过降低心肌线粒体中MDA含量 ,增加SOD ,GSH PX及SDH活力 ,减轻氧自由基对心肌线粒体的损伤 .     

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.