定量组织速度成像对非洛地平治疗轻度高血压疗效的评价

目的:观察不伴有心肌肥厚的高血压病患者左心室舒张功能的变化及非洛地平降压治疗对其产生的影响。方法:应用定量组织速度成像技术(QTVI)测定40例不伴有心肌肥厚的高血压病患者舒张期二尖瓣环运动速度,并与40例健康对照组比较,同时比较服用非洛地平前后各参数的变化。结果:高血压病患者二尖瓣环舒张早期峰值速度(Em)比对照组降低(8.33±2.14 cm/s vs 11.21±2.14 cm/s,P<0.01),舒张早期与舒张晚期速度比值(Em/Am)也降低(0.87±0.24 vs 1.20±0.22,P<0.01);服用非洛地平降压治疗4周与8周后Em较治疗前均显著升高(分别10.14±2.32 vs 8.33±2.14 cm/s,11.01±2.18 vs 8.33±2.14 cm/s,P均<0.01),同时Em/Am较治疗前也升高(1.01±0.24 vs 0.87±0.24,1.17±O.30 vs 0.87±0.24,P均<0.01)。结论:QTVI证实高血压病不伴心肌肥厚的患者左心室舒张功能减退,而非洛地平可逆转其受损的舒张功能。     

调控全段甲状旁腺素对糖尿病肾病血管钙化及 预后的影响

目的 探讨调控全段甲状旁腺素对糖尿病肾病患者血管钙化及预后的影响.方法 方便选取2013年1月—2016年12月收治的237例糖尿病肾病(IV期及V期)患者并随机分为治疗组(n=129)和对照组(n=108).对照组接受常规治疗包括饮食控制、胰岛素降血糖治疗及血液净化治疗,治疗组在常规治疗的基础上联合碳酸司维拉姆口服.对比两组治疗前后血磷、钙磷乘积、甲状旁腺素水平,并统计3年后冠状动脉钙化积分、冠状动脉钙化率、心血管事件病死率.结果 治疗前两组血磷、血钙、钙磷乘积、全段甲状旁腺素水平差异无统计学意义(P>0.05),治疗后对照组上述指标水平与治疗前差异无统计学意义(P>0.05)、而治疗组上述指标水平均较治疗前显著降低[(1.8±0.4)mmol/L vs(2.1±0.5)mmol/L;(1.6±0.2)mmol/L vs(1.8±0.2)mmol/L;(3.1±0.6)mmol2/L2 vs(4.3±0.7)mmol2/L2;(244.2±21.5)ng/L vs(383.2±29.3)ng/L](P<0.05),且治疗后组间差异有统计学意义(P<0.05);3年后冠状动脉钙化积分、冠状动脉钙化率、心血管事件病死率治疗组均显著低于对照组[(32.1±7.1)分vs(83.5±22.4)分;8.73％vs 51.04％;2.33％vs 11.11％](P<0.05).结论 糖尿病肾病(IV期及V期)患者采用碳酸司维拉姆口服治疗能够通过下调全段甲状旁腺素水平减轻血管钙化,进而可以显著改善预后.     

芪苈强心改善糖尿病心力衰竭大鼠左心室功能及血管内皮功能

目的：以糖尿病大鼠作为实验模型,观察芪苈强心改善糖尿病大鼠心功能的同时,能否改善其血管内皮功能。 　方法：选用Sprague-Dawley（SD）雄性大鼠随机分为3组：对照组、糖尿病组（DM）和芪苈强心组。DM组和芪苈强心组大鼠腹腔注射链脲佐菌素（STZ）诱导糖尿病模型,造模成功后（随机血糖>16.7mmol/L）即开始分别给予生理盐水和芪苈强心灌胃,对照组给予生理盐水灌胃。灌胃8周后各组大鼠测定体重,超声心动图检查测左室舒张末期内径(LVIDD)、左室收缩末期内径（LVIDS）、射血分数（EF）、左室短轴缩短率（FS）,血流动力学检查测左室收缩峰压（LVESP）、左室舒张末压（LVEDP）、左室内压最大上升( dp/dtmax)和下降速率(-dp/dtmax),并测心脏重量指数。分离胸主动脉,以血管环技术观察离体胸主动脉环对内皮依赖性扩血管物质乙酰胆碱的舒张反应,以之代表大鼠血管内皮功能。 　结果：1）一般情况：与对照组比,糖尿病组大鼠体重明显减轻（221±46 vs 421±62 g, p<0.01）,心肌重量/体重比明显增高（4.07±0.67 vs 3.23±0.14 mg/g,p<0.01）,心率变慢（350±54 vs 432±44次/每分,p<0.01）。与糖尿病组比,芪苈强心组大鼠体重、心肌重量/体重比没有改善,心率增高（368±60 vs 350±54次/每分,p<0.01）。2）心脏超声检测：与正常组比,糖尿病组LVIDD明显减小（6.79±0.58 vs 7.73±1.19 mm,p<0.05）,EF,FS降低分别为 37.15±8.81 vs 52.04±9.68%, p<0.01 和 0.72±0.11 vs 0.86±0.09, p<0.01);与糖尿病组比,芪苈强心组LVIDD无明显变化,但LVIDS明显减小（3.82±0.66 vs 4.25±0.53, p<0.05）,EF,FS增高（分别为43.31±6.87 vs 37.15±8.81% , p<0.05和 0.81±0.07 vs 0.72±0.11, p<0.01）。3）血流动力学检测：与正常对照组比,糖尿病组 dp/dt明显下降（4044.66±1303.27 vs 6015.63±905.70,p<0.01 ）,LVSP、LVEDP、-dp/dtmax无显著性差异;与DM组相比,芪苈强心组 dp/dt明显增高(5338.33±946.37 vs 4044.66±1303.27,p<0.01),LVSP、LVEDP、-dp/dtmax无显著性差异。4）胸主动脉环对乙酰胆碱的反应性测定：与正常组比,糖尿病组胸主动脉环对乙酰胆碱介导的舒张百分比降低,最大舒张百分比下降33%;与糖尿病组相比,芪苈强心组改善乙酰胆碱介导的舒张反应,最大舒张百分比增加12%,说明芪苈强心组大鼠血管内皮舒张功能得到改善。 结论：芪苈强心能改善糖尿病大鼠的血管内皮的舒张功能,这可能是其改善心力衰竭大鼠左室收缩功能的机理之一。     

过氧化亚硝酸离子(ONOO-)在血管组织损伤中的作用

建立了高胆固醇血症(hypercholesterolem ia,HC)的动物模型,旨在研究HC机体生理机能的改变以及外源性抗氧化剂对细胞的保护作用 .NEW兔分别给予正常饮食、高胆固醇饮食、高胆固醇饮食加卡维地洛或普萘洛尔.8周后动物处死,取出胸主动脉,分别进行以下试验:(1)动脉组织中谷胱甘肽(GSH)定量;(2)主动脉环对外源性ONOO-的反应;(3)主动脉组织匀浆ONOO-中NO的再生;(4)ONOO-引起的动脉组织损害.结果表明:(1)HC减少了血管组织中GSH的量[(0.52±0.08) μmol/g vs 对照组的(0.86±0.04) μmol/g,P<0.01];(2)减少了血管对ONOO-的舒张反应(40%±4.1% vs对照组的76%±3.2%,P<0.01);(3)由ONOO-中NO 的再生减少[(387±40) pmol/L vs 对照组的(662±51) pmol/L,P<0.01];(4) 加重ONOO-对血管组织的损害,表现为LDH的释放量增加(37%±4.4% vs 对照组的14% ±2.6%,P<0.01);(5)具有自由基清除作用的β-受体阻滞剂卡维地洛处理的HC动物呈显著的保护作用,血管组织GSH的量增加[(0.79±0.05) μmol/g,P< 0.01 vs对照组];血管对ONOO-反应增强(61%±2%,P<0.01);由ONOO -中NO的再生增加[(583±39) pmol/L,P<0.01];减少ONOO-引起的组织损害,LDH释放减少(19.0%±1.8%,P<0.01).这些结果表明HC损害了GSH调节的抗ONOO-毒性的机制,致使血管组织易遭受氧化损伤.     

钙化大鼠心血管组织肾上腺髓质素及其受体系统的变化

目的:探讨钙化大鼠心血管组织肾上腺髓质素(adrenomedullin, ADM)生成和ADM及其受体系统--降钙素受体样受体(calcitonin receptor-like receptor, CRLR)与受体活性修饰蛋白(receptor activity modifying protein, RAMPs)基因表达的改变及其病理意义.方法:放射免疫法测定血浆、心肌和血管组织ADM含量;半定量RT-PCR方法测定心肌和血管ADM、降钙素受体样受体(CRLR)和RAMP2/3 mRNA水平.结果:与对照组大鼠比较,钙化大鼠心肌和主动脉钙含量分别高342 %和606 %(P<0.01);心肌和主动脉碱性磷酸酶活性分别高66.5 % (P<0.05)和82.7 % (P<0.01).钙化组大鼠血浆、心肌和血管ADM含量分别较对照组高58 %(P<0.01),14.3 %(P<0.01)和27.8 %(P<0.05);心肌ADM、CRLR和RAMP2 的mRNA水平较对照组分别高 90.6 %,157.5 %和119.6 %(均P<0.01), 而RAMP3 mRNA水平较对照组低14.1 %(P<0.01);血管组织ADM、CRLR、RAMP2 和RAMP3 的mRNA水平较对照组分别高37.7 %(P<0.01),41.4 %(P<0.01), 60.1 %(P<0.05)和13 %(P< 0.01).心血管组织中ADM与其受体系统mRNA变化水平有一定的相关性.结论:钙化大鼠心血管组织ADM生成增加,ADM、CRLR和RAMP2/3基因表达亦有不同程度的变化,提示ADM 及其受体系统可能参与心血管钙化的调节过程.     

超氧阴离子与硝酸甘油耐药关系的实验研究

目的 :采用持续经皮贴硝酸甘油 ( 0 .4mg/h) 72小时建立大白兔耐药模型 ,用鲁米诺化学发光技术测量血管壁超氧阴离子 (·O-2 )水平 ,探讨·O-2 水平与硝酸酯耐药性的关系。方法 :动物随机分为硝酸甘油组和对照组 ,贴膜 72小时后获取胸主动脉 ,观察血管环对不同浓度硝酸甘油的舒张反应和测量血管组织·O-2 、丙二醛 (MDA)水平和超氧化物歧化酶 (SOD)活性。结果 :硝酸甘油组血管环对硝酸甘油舒张反应明显减弱 (最大舒张反应 58.76±1 2 .96%vs94.68± 3.2 3% ,P <0 .0 5) ,硝酸甘油组血管组织·O-2 水平较对照组显著增加 ( 2 31 7.38± 889.0 3vs50 8±1 70 .94cps/g .ml,P <0 .0 5) ,而SOD活性和MDA水平无显著改变 (P >0 .0 5)。结论 :持续经皮贴硝酸甘油 72小时血管环产生了明显耐药 ,耐药的产生可能与血管壁超氧阴离子增加有关     

心肌缺血、缺血-再灌注和大血管缺氧对Wistar大鼠NO活性的影响

探讨心肌缺血、缺血/再灌注(I/R)损伤和大血管缺氧对EDRF/NO的影响。方法检测心肌缺血、I/R损伤和大血管缺氧动物模型的损害指标,观察内皮和非内皮依赖性NO释放剂离体灌流对冠脉舒张反应和冠脉流量的影响。结果①与对照组比较,异丙肾上腺素(ISO)组大鼠血浆和心肌cGMP含量分别降低27％和43％,血浆乳酸脱氢酶(LDH)活性、心肌MDA含量分别升高68％和200％;②与对照组比较,ISO组乙酰胆碱(Ach)灌流,使冠脉血管的舒张反应和冠脉流量降低,而硝普钠(NPS)灌流,冠脉流量未有明显变化;③与对照组比较,I/R组冠脉灌注压升高1.4倍,心肌cGMP降低69.7％,心肌LDH和蛋白漏出量分别1.33倍和2.1倍;Ach灌流组与I/R组比较,冠脉灌注压、LDH、蛋白漏出量无明显差异;④NPS灌流组与I/R组比较,冠脉灌注压、LDH和蛋白的漏出明显降低;⑤在内皮细胞完整情况下,与对照组比较,缺氧组主动脉cGMP降低80.28％(P<0.01);与缺氧组比较,L-Arg灌流、L-NNA灌流组和NTG灌流组分别使主动脉cGMP增加278.57％(P<0.01)、降低42.86％(P<0.01)和增加914.29％(P<0.01);与NTG组比较,MB+NTG组可使主动脉cGMP降低35.94％(P<0.01);⑥去内皮情况下,缺氧组对EDRF/NO的影响与内皮完整时相似,但L-Arg组或L-NNA组都不明显改变血管cGMP水平,NTG组明显升高cGMP水平,MB组可部分阻断这一作用。结论心肌缺血、I/R损伤和大血管缺氧显著抑制EDRF/NO生成与释放,使NO生成缺陷和释放减少,使其介导的内皮依赖性血管舒张严重受损。     

VEGF测定在急性心肌梗死中的意义

目的探讨急性心肌梗死(AMI)患者血清血管内皮生长因子(VEGF)含量的变化及意义。方法观察16例AMI患者经过冠状动脉成型术,以及肝素、硝酸酯类药物、阿斯匹林等治疗前后血清VEGF的变化。于发病第1、3、14d和28d分别测定血清VEGF的含量。结果发病后第1 d血清VEGF的浓度与对照组无显著差别(85±11)vs(72±2)pg/mL(P>0.05)。发病后第3 d,VEGF的浓度较第1 d明显升高(150±46)vs(85±11)pg/mL(P<0.001)。发病后第7 d达高峰(171±31)vs(85±11)pg/mL(P<0.0001)。之后开始下降,但第28 d仍明显高于第1 d(142±132)vs(85±11)pg/mL(P<0.001)。结论AMI治疗后VEGF的水平明显持续增高,可能与缺血心肌的血管新生及冠状血管侧枝循环的建立有关。     

舒张性心力衰竭兔Ca2+调控蛋白相关基因表达的变化

目的探讨舒张性心力衰竭(DHF)时Ca2+调控蛋白相关基因表达的变化,以阐明DHF发生的分子机制.方法建立DHF兔模型,并设假手术为对照组,分别测定2组兔心肌细胞内Ca2+含量和肌浆网(SR)Ca2+-ATPase(钙泵)活性,并以定量RT-PCR和Westernblot技术检测Ca2+调控蛋白相关基因的转录和蛋白质表达水平.结果(1)DHF兔心肌细胞内Ca2+含量(μg/ml)显著高于对照组(1728±545vs633±168,P＜0.01);(2)DHF兔SR钙泵活性,细胞膜L型Ca2+通道和SR钙泵mRNA水平(μmol*mg-1*h-1)明显低于对照组(10.5±2.8vs21.1±5.7;0.75±0.11vs1.20±0.33;0.76±0.12vs1.24±0.38,P＜0.05～0.01);(3)DHF兔细胞膜L型Ca2+通道mRNA水平与左室舒张末压中度负相关(r=-0.74,P＜0.05),SR钙泵mRNA水平与左室舒张末压和左室松弛时间常数中度负相关(r分别为-0.81、-0.64,P＜0.05～0.01);DHF兔兰尼碱受体mRNA水平与左室松弛时间常数负相关(r=-0.71,P＜0.05);(4)DHF兔SR钙泵的蛋白质表达明显低于对照组(0.75±0.06vs1.02±0.09,P＜0.05).结论细胞膜L型Ca2+通道和SR钙泵mRNA和蛋白质表达减低是导致心肌细胞内Ca2+超负荷及DHF发生的重要因素.     

圣地红景天对自发性高血压大鼠左室重构的影响及其机制探讨

目的 探讨圣地红景天对自发性高血压大鼠(SHR)左室重构的影响。 方法 将30只雄性SHR随机分为治疗组与对照组,分别予以圣地红景天500 mg/(kg·d)和蒸馏水灌胃,共8周,每两周测尾动脉收缩压(SBP)一次。实验结束时,测量大鼠体质量(BM)与左室质量(LVM),计算左室质量指数(LVMI=LVM/BM);采用放射免疫法分别测定血浆与心肌组织匀浆上清液中血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)以及心肌组织匀浆上清液蛋白含量,计算心肌匀浆上清液每克蛋白AngⅡ与ALD含量;将左室心肌切片分别进行胶原染色及免疫组化技术处理,用Simple PCI全自动图像分析系统检测心肌胶原容积分数(CVF)、心肌细胞AngⅡ1型受体(AT₁)灰度值。 结果 与对照组比较,治疗组SBP下降(P<0.05)、LVMI(mg/g,2.84±0.13 vs.2.97±0.12,P=0.044)、心肌CVF(%,4.41±0.53 vs.4.89±0.53,P=0.021)、血浆AngⅡ(ng/L,77.61±14.12 vs.92.59±16.64,P=0.042)与ALD(ng/L,73.52±18.61 vs.90.11±19.67,P=0.005)、心肌组织匀浆上清液中AngⅡ(ng/g·protein,40.03±5.36 vs.46.02±6.78,P=0.005)与ALD(ng/g·protein,37.61±6.25 vs.43.70±5.09,P=0.049)均降低。而圣地红景天对心肌细胞AT₁蛋白表达的影响与对照组比较差异无统计学意义。 结论 圣地红景天可改善SHR左室重构,其机制与降压作用、肾素-血管紧张素系统(RAS),特别是心肌局部RAS的受抑有关。     

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.     

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.     

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.     

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.