舒肝明目汤含药血清调节HIF1α-VEGF-Notch1通路活性影响脉络膜血管新生作用的研究

[目的] 探讨舒肝明目汤含药血清对大鼠脉络膜血管内皮细胞（CECs）增殖的影响及与HIF1α-VEGF-Notch1通路相关的调节机制。[方法] CECs细胞在常氧和低氧条件下进行培养,检测低氧条件下舒肝明目汤含药血清对CECs增殖移行能力的影响;并采用实时荧光定量PCR法（RT-PCR）和免疫印迹法（Western blot）技术检测细胞中低氧诱导因子1α（HIF1α）、血管内皮生长因子（VEGF）和Notch1 mRNA和蛋白表达的水平。[结果] 与正常组相比,低氧组CECs的增殖移行能力明显提高（P<0.01）,CECs中HIF1α、VEGF和Notch1 mRNA及蛋白表达明显增多（P<0.01）.经含药血清处理后,CECs增殖移行能力较低氧组显着下降（P<0.01）,同时HIF1α和VEGF mRNA及蛋白表达降低（P<0.01,P<0.05）,而Notch1表达进一步增高（P<0.01）.[结论] 舒肝明目汤含药血清通过上调Notch1表达及下调HIF1α-VEGF通路活性抑制CECs增殖迁移,从而减少脉络膜新生血管生成。     

斑马鱼模型在中药活性筛选中的适用性研究

目的 考察斑马鱼血管生成抑制模型在中药各类样品活性筛选中的适用性。方法 选用TG（VEGFR2:GFP）系血管荧光转基因斑马鱼和AB系斑马鱼作为筛选模型,分别用中药单体靛玉红、单味药材（虎杖、长春花）提取物、复方（西黄丸）处理斑马鱼胚胎,以节间血管数作为指标,考察不同类型中药样品对斑马鱼胚胎血管生成的影响。结果 靛玉红高剂量（50 μg/mL）明显抑制斑马鱼节间血管的生成（P＜0.05）;虎杖醋酸乙酯提取部位随着质量浓度的升高抑制作用增强,10 μg/mL时与对照组比较差异显著（P＜0.05）;长春花醋酸乙酯提取部位100 μg/mL时明显抑制斑马鱼血管生成（P＜0.01）,同时未见胚胎死亡;西黄丸质量浓度大于50 μg/mL时,抑制斑马鱼血管生成作用与对照组比较差异显著（P＜0.05）,100 μg/mL时呈非常显著的统计学差异（P＜0.01）。结论 斑马鱼模型对于成分复杂的中药样品具有很好的适应性,这对于从我国丰富的中药资源中发现结构新颖、活性独特的先导化合物具有重要价值。     

紫河车联合寿胎丸加味治疗冷冻胚胎移植术后雌激素低下先兆流产患者临床研究

[目的] 以冷冻胚胎移植（FET）术后雌二醇（E₂）低的先兆流产患者为对象,采用紫河车联合寿胎丸加味治疗,观察临床疗效。[方法] 选择FET术后14 d,100 < E₂ < 200 pg/mL的先兆流产患者160例,随机分配至治疗组和对照组。观察治疗前后中医症状评分,E₂、血清绒毛膜促性腺激素（β-HCG）上升情况及妊娠成功率。[结果] 两组患者治疗后中医临床症状积分较治疗前显著下降（P<0.01）;血清E₂、β-HCG水平均显著高于本组治疗前水平（P<0.01）。与对照组相比,治疗组治疗后所有症状积分显著下降（P<0.05）;E₂、β-HCG水平显著升高（P<0.05）。治疗组和对照组妊娠成功率分别为77.5%、62.5%,差异有统计学意义（P<0.05）。[结论] 紫河车联合寿胎丸加味中药可有效改善FET术后雌激素低下先兆流产中医临床症状,显著提升雌激素及β-HCG水平,提高妊娠成功率,值得临床中推广使用。     

肺闭宁颗粒止咳、抗炎及促进PM2.5颗粒物排出作用的研究

[目的]考察肺闭宁颗粒在止咳、抗炎以及对促进PM2.5排出方面的药效学作用研究,为其临床用药提供数据支持。[方法]采用二氧化硫引咳小鼠模型、内毒素诱导的肺损伤小鼠模型以及斑马鱼PM2.5排出模型,给予不同浓度的肺闭宁颗粒干预后,观察其止咳、抗炎以及对纳米颗粒从斑马鱼体内排出进入肠道的影响。[结果]肺闭宁颗粒中（3.69 g/kg）、高（7.38 g/kg）剂量组可明显改善二氧化硫引咳模型小鼠咳嗽潜伏期时间及咳嗽次数;可降低内毒素诱导的肺损伤小鼠肺灌流液中白细胞介素-6（IL-6）浓度（P<0.05）;在斑马鱼PM2.5超细颗粒物排出模型中,肺闭宁颗粒125 mg/mL时,纳米活性炭排出发生率为63.3%,与模型对照组（16.7%）比较有统计学差异（P<0.05）。[结论]肺闭宁颗粒具有止咳、抗炎的作用,此外在促进PM2.5超细颗粒物排出、减少PM2.5对机体的损伤方面也有一定的效果,提示其在对抗雾霾天气引起的呼吸道系统疾病治疗中具有一定作用。     

复荣通脉胶囊联合贝前列素钠片治疗糖尿病性周围血管病变临床研究

[目的]观察复荣通脉胶囊联合西药贝前列素钠片治疗糖尿病性周围血管病变的疗效。[方法]将100例糖尿病性周围血管病变患者,按照随机数字表法分为治疗组及对照组,各50例。治疗组于复荣通脉胶囊+贝前列素钠片,对照组单用贝前列素钠片,观察两组治疗后的间歇性跛行、静息痛、足部冷凉感、踝肱指数（ABI）的变化。[结果]两组患者的症状均得到有效改善,治疗组疗效更佳（P<0.05）;两组患者ABI较治疗前明显提高（P<0.01）,治疗组较对照组改善更为显著（P<0.01）;两组患者血脂、纤维蛋白原均较前改善（P<0.01）,治疗组下降更为显著（P<0.05或P<0.01）。[结论]复荣通脉胶囊联合贝前列素钠片治疗糖尿病性周围血管病变疗效确切,值得进一步推广。     

银杏内酯注射液治疗急性脑梗死疗效及对神经功能的影响

[目的] 探讨银杏内酯注射液治疗急性脑梗死（ACI）的临床疗效及对神经功能的影响。[方法] 将96例ACI患者按照随机数字表法随机分为2组,每组48例,对照组给予卧床休息、吸氧、营养脑细胞、改善脑循环、抗血小板聚集等常规治疗,治疗组在常规治疗基础上给予银杏内酯注射液静脉滴注,10 mL/次,1次/d,两组均连续治疗14 d。比较两组治疗前后国立卫生研究院卒中量表（NIHSS）评分、Barthel指数评分、血液流变学指标及血清血管内皮生长因子（VEGF）、血管生成素-Ⅱ（Ang-Ⅱ）和胶质纤维酸性蛋白（GFAP）水平,并比较两组总有效率。[结果] 治疗后治疗组NIHSS评分低于对照组（P<0.01）,Barthel指数评分高于对照组（P<0.01）;血清VEGF、Ang-Ⅱ水平高于对照组（P<0.01）,GFAP水平低于对照组（P<0.01）;全血高切黏度（HSV）、全血低切黏度（LSV）、血浆黏度（PSV）和红细胞比容（HCT）均低于对照组（P<0.01）,治疗总有效率高于对照组（P<0.05）。[结论] 银杏内酯注射液治疗ACI有利于改善血液流变学指标、有效调节血清VEGF、Ang-Ⅱ、GFAP含量,改善神经功能,效果显著。     

正常和缺氧条件下磁场对人脑微血管内皮细胞增殖的影响

[目的] 观察不同强度的永磁磁场对正常和缺氧条件下人脑微血管内皮细胞（HBMEC）增殖的影响。[方法] 采用正常和缺氧两种条件体外培养HBMEC,实验分为10组,即对照组、药物组（银杏叶注射液350 mg/L）、不同强度磁场组（3.4、5.6、13.8、27.8、52.6、107.0、178.9、292.2 mT）,各组细胞于磁场作用48 h后收集样本,用四甲基偶氮唑盐法（MTT法）检测细胞增殖。[结果] 正常和缺氧条件下,与对照组相比较,药物组有统计学意义（P<0.05）,各磁场组差异均无统计学意义（P>0.05）;磁场组组间比较,差异无统计学意义（P>0.05）.[结论] 正常和缺氧条件下,磁感强度3.4、5.6、13.8、27.8、52.6、107.0、178.9、292.2 mT的磁场对人脑微血管内皮细胞的增殖无影响。     

芪丹利心丸对心肌梗死后慢性心力衰竭大鼠心肌纤维化的影响

[目的] 观察芪丹利心丸对心肌梗死后慢性心力衰竭大鼠心肌纤维化的影响。[方法] 通过结扎大鼠左冠状动脉（冠脉）前降支的方法诱导形成慢性心力衰竭模型,经过芪丹利心丸药物[1.1、2.2、4.4 g/（kg·d）]4周干预后,利用超声心动仪和左心室压力-容积环检测评价心功能。采用Masson染色观察各组心脏病理学变化,采用反转录-聚合酶链反应（RT-PCR）测定各组胶原蛋白（Collagen I和Ⅲ）的mRNA水平,采用蛋白质免疫印迹实验（Western Blot）检测各组转化生长因子-β1（TGF-β1）、Smad3、Smad7的蛋白表达水平。[结果] 模型组心功能显著下降[左室射血分数（LVEF）、左室短轴缩短率（LVFS）、左室内压上升或下降最大速率（±dp/dt max）,P<0.05],心室重构明显[室间隔厚度（IVST）、左室收缩末期内径（LVESD）,P<0.05];与模型组比较,芪丹利心丸能够明显改善慢性心力衰竭大鼠心功能,延缓心室重构进程,其中芪丹利心丸中剂量组和芪丹利心丸高剂量组效果较为明显（P<0.05）,并且抑制胶原蛋白CollagenI和Ⅲ的mRNA表达（P<0.05）,减少心肌纤维细胞形成,下调心肌纤维化相关蛋白TGF-β1、Smad3蛋白表达（P<0.05）,提高抗纤维化蛋白Smad7水平（P<0.05）。[结论] 益气活血利水方芪丹利心丸能改善心肌梗死后慢性心力衰竭大鼠心功能,延缓心室重构和心肌纤维化水平,其机制可能与调控TGF-β1/Smads的信号通路有关。     

乌梅丸联合四君子汤治疗放射性肠炎30例(脾胃气虚型)的临床观察

[目的]观察乌梅丸联合四君子汤治疗放射性肠炎的有效性,以期为临床治疗放射性肠炎提供有效治法。[方法]将60例放射性直肠炎（脾胃气虚型）患者随机分为治疗组和对照组,其中对照组给予蒙脱石散口服;治疗组在对照组基础上给予乌梅丸联合四君子汤,观察两组临床症状、放射性损伤（RTOG/EORTC）分级、中医证候量表评分及卡氏评分（KPS）等。[结果]两组治疗后治疗组中医证候量表评分、RTOG分级、KPS生活质量评分、治疗效果总缓解率,两组对比有统计学意义（P<0.05）。两组服药后未出现不良反应。[结论]乌梅丸联合四君子汤治疗放射性肠炎（脾胃气虚型）确有良好疗效,值得临床应用推广与研究探讨。     

槲皮黄酮改善心肌细胞肥大过程中对线粒体功能及动力学的影响

[目的]探讨槲皮黄酮对原代心肌细胞肥大、线粒体功能及动力学的影响。[方法]原代培养大鼠心肌细胞,采用血管紧张素Ⅱ（AngⅡ）及槲皮黄酮共同干预细胞48、72 h后,BCA试剂盒检测细胞中蛋白浓度,倒置显微镜分析心肌细胞直径;酶标仪检测心肌细胞内三磷酸腺苷（ATP）及活性氧（ROS）含量,JC-1方法分析心肌细胞线粒体膜电位（MMP）;蛋白免疫印迹（Western Blot）方法测定线粒体动力学相关蛋白视神经萎缩蛋白（OPA1）、动力相关蛋白（Drp1）及磷酸化动力相关蛋白1（p-Drp1）表达量。[结果]与空白组比较,模型组心肌细胞中总蛋白浓度、细胞直径大小及ROS水平显著升高（P<0.05）,ATP和MMP值则显著降低（P<0.05）,Western Blot结果发现OPA1蛋白表达水平显著降低（P<0.05）,p-Drp1蛋白表达水平显著升高（P<0.05）;与模型组比较,槲皮黄酮处理72 h后心肌细胞中总蛋白浓度、细胞直径大小及ROS水平显著降低（P<0.05）,ATP和MMP值则显著升高（P<0.05）,Western Blot结果发现OPA1蛋白表达水平显著增高（P<0.05）,p-Drp1蛋白表达水平显著降低（P<0.05）。[结论]槲皮黄酮对AngⅡ引起的心肌细胞肥大具有保护作用,其作用机制可能与降低心肌细胞线粒体功能障碍、稳定线粒体动力学平衡相关。     

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.