改良法建立小鼠颈部异位心脏移植模型

目的 探索小鼠颈部异位心脏移植技术的改进,建立稳定、可靠的小鼠异位心脏移植模型.方法 采用供心升主动脉与受体颈总动脉,供心肺动脉与受体颈外静脉吻合的方法进行小鼠颈部异位心脏移植.结果 应用本方法完成手术50例,成功46例,供心缺血时间平均为40min,总手术时间在90～100min之间.结论 经改进的手术方法降低了手术难度,缩短了手术时间,能够建立稳定、可靠的小鼠异位心脏移植模型.     

改良协调性金黄地鼠到大鼠的异位腹腔异种心脏移植模型的建立

目的:建立一种改良的异位腹部异种心脏移植模型,解决模型建立中的技术问题. 方法:利用袖套法和cuff套管法完成从金黄地鼠到大鼠的异种心脏移植模型. 将供心的颈总动脉与受者左肾动脉进行袖套式吻合,将供心右肺动脉与受者左肾静脉利用套管法吻合. 每日通过对受体进行左侧腹壁触诊完成对供心功能的评价. 结果:共实施105例异位腹部异种心脏移植模型,95例成功. 异种移植物生存期为移植后3～4 d,并且发生经典急性血管性排斥反应. 结论:建立了一种简便、实用、稳定的用于研究协调性异种移植免疫排斥反应发生机制的动物模型.     

小鼠颈部异位心脏移植技术的改进

目的 建立简便易行的同种小鼠颈部异位心脏移植模型，探讨小鼠颈部异位心脏移植模型的建立与手术方式的改进。方法 在显微镜和低温条件下切取供心；分离受体右侧的颈外静脉及颈总动脉。采用供心主动脉与受体颈总动脉侧壁长度相近的切口行端—侧间断缝合，供心肺动脉与受体颈外静脉后壁连续缝合、前壁间断缝合的吻合方法进行小鼠颈部异位心脏移植。术后通过视诊和触诊检测供心心跳，病理学检查确定排斥情况。结果 应用该方法共进行移植正式实验40次，成功36次，供心总缺血时间为30min，7d存活率达90％。结论 这种移植术式降低了手术难度，易于暴露，手术时间短，创伤小、污染少，观察方便，成功率高，是一种简单、实用的方法。     

改良Cuff技术建立小鼠颈部异位心脏移植模型

 目的 改进Cuff技术制作小鼠颈部异位心脏移植模型，以简化手术操作，提高手术成功率。方法 使用自制套管将供心肺动脉套接于受体右颈外静脉，将供心升主动脉套接于受体右颈总动脉。结果 正式实验40例，手术成功率92.5%。手术时间约60min，供心冷缺血时间小于30min。结论 改良Cuff技术建立小鼠颈部异位心脏移植模型，无需显微外科操作，是一种经济实用、稳定可靠、易于复制的动物模型。     

犬颈部心脏移植模型10例

目的 总结犬颈部异位心脏移植模型建立的体会,分析影响手术成功的主要原因.方法 建立犬颈部异位心脏移植模型,供心与受体行主动脉-颈总动脉端侧吻合、肺动脉-颈外静脉吻合.供心存活>24 h为实验成功.结果 10例手术供心均成功复跳,1例术后12 h内供心停止跳动,手术成功率90%.结论 犬颈部异位心脏移植是一种简便易行的心脏移植大动物模型,影响手术成功的关键在于选择体质量匹配的供受体和掌握娴     

鼠异种异位心脏移植模型建立与病理特征观察

目的采用改良袖套法建立小鼠→大鼠颈部异位异种心脏移植动物模型,动态观察移植心脏病理特征。方法NIH小鼠和Wistar大鼠作为供、受体,用聚乙烯硬膜外麻醉导管和静脉留置针管制作带短臂动、静脉套管,将小鼠升主动脉、肺动脉分别与大鼠右颈总动脉、右颈外静脉端端套入吻合,建立小鼠→大鼠颈部异位心脏移植模型。在移植术后3h(n=4)、8h(n=4)、16h(n=4)、24h(n=4)供心仍跳动时取心,另一组(n=16)在供心停跳时取心并以此决定移植心脏存活时间,未移植小鼠心脏设为对照组(n=4),各组标本作组织病理学检查。结果移植手术40次,成功32次,移植成功率80.0%。移植心脏平均存活时间(49.3±16.2)h。移植心脏病理检查表现为血管内皮损伤、血栓形成、心肌实质损伤、间质出血、炎症细胞浸润等特征随移植术后时间逐渐加重趋势,完全排斥时部分心肌凝固性坏死及溶解、广泛间质出血、血管结构崩解及血管内血栓形成、严重炎症细胞浸润。结论改良袖套法建立鼠颈部异位心脏移植模型操作简便、易于观察、稳定可靠,是研究异种移植较理想的动物模型。动态观察组织病理学特征可为异种移植排斥反应诊断提供依据。     

改良袖套法建立异种心脏颈部移植模型

目的:采用改良Heron袖套法建立小鼠→大鼠异种心脏颈部移植模型.方法:选择NIH小鼠和Wistar大鼠分别作为供体和受体.用聚乙烯套管将小鼠升主动脉与大鼠右颈总动脉端端套入吻合,同法将小鼠肺动脉与大鼠右颈外静脉端端套入吻合,以建立小鼠→大鼠颈部异位心脏移植模型.结果:进行移植手术30次,成功率93.3%.移植后心脏平均存活时间2.13±0.8天.结论:改良袖套法操作简单、迅速、稳定、便于观察,是较理想的动物模型.     

大鼠异位心脏移植模型的建立

目的建立一种快速、有效的大鼠异位心脏移植模型.方法以雄性SD大鼠为供体,Wistar大鼠为受体,将供心的升主动脉与受体的腹主动脉行端侧吻合,切除受体的左肾,将供心的肺动脉与受体的左肾静脉以自制聚乙烯管直接插入法连接.结果35例实验成功32例,成功率91.4%,供心平均缺血时间为（37.8±1.8）min.失败的原因：吻合口出血,血栓形成.结论本术式操作简单实用,不需手术显微镜,易于推广.     

大鼠异位心脏移植模型80例制作体会

目的　总结制作大鼠腹腔异位心脏移植模型的体会。方法　健康雄性Wistar大鼠为供体 ,SD大鼠为受体 ,各 80只。供心的升主动脉及主肺动脉分别与受体的腹主动脉和下腔静脉做端侧吻合 ,供心移植于受体的腹腔内。结果　共建立 80只大鼠异位心脏移植模型 ,供心缺血时间 (2 5± 5 )min ,手术成功率为 92 5 %。结论　手术成功的关键 :①麻醉及肝素化剂量合适 ;②供心的灌注及保护 ,缩短供心缺血时间 ;③提高血管吻合质量和速度 ,减少出血 ;④术后保温 ,及时补充液体     

联合药物预处理及TGF-β1转基因治疗对豚鼠-大鼠非协调性异种心脏移植物的影响

目的 对Heron法进行部分改进．建立简化的豚鼠-SD大鼠异种异位心脏移植模型。方法 采用改进的套管技术通过自制Cuff管将豚鼠供心的升主动脉、肺动脉与SD大鼠受体的右侧颈总动脉、颈外静脉分别进行吻合连接。结果 单人操作连续进行正式试验95次．手术成功率100％．无吻合口漏血或血管回流受阻．移植物复跳率100％。总手术时间45～60min．吻合时间2～5min，供心冷缺血平均15min。结论 改良Heron法建立大鼠颈部异种心脏移植无需显微外科操作，是一种简便、经济实用、稳定可靠和易于复制的器官移植研究动物模型。     

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.