血中内皮素、一氧化氮水平与妊高征的关系研究

目的　探讨内皮素 (ET)和一氧化氮 (NO)在妊高征发病中的作用。方法　采用放射免疫法和硝酸还原酶法检测 31例妊高征患者 (妊高征组 )与 2 7例正常足月妊娠妇女 (正常妊娠组 )的血浆ET和血清NO水平。结果　妊高征组血浆ET水平为 10 5 .78± 2 2 .77ng/L ,明显高于正常妊娠组 (6 8.38± 13.2 3ng/L) (P <0 .0 0 1) ,病情越重 ,其值越高 ;妊高征组血清NO水平为 2 1.96± 13.40 μmol/L ,明显低于正常妊娠组 (86 .76± 2 6 .72 μmol/L) (P <0 .0 0 1) ,病情越重 ,其值越低 ;正常妊娠组ET和NO相关不显著 ,妊高征组ET和NO呈负相关关系 (P <0 .0 1)。结论　ET和NO在妊高征的发病中起重要作用 ,ET/NO比值越大 ,病情越重。     

慢性肺心病急性加重期血清内皮素和一氧化氮水平变化及临床意义

采用放射免疫分析法和鲁米诺化学发光法测定42例肺心病急性加重期患者治疗前后血清内皮素(ET)及一氧化氮(NO)含量,并与25例正常对照组进行比较。结果表明肺心病急性加重期患者血清ET和NO水平均较缓解期(治疗后)及正常对照组显著增高(ET分别为:55.21±28.34ng/L,40.62±15.66ng/L及33.64±10.25ng/L;NO分别为7.36±3.42nmol/L,6.33±2.14nmol/L及5.24±1.86nmol/L);合并呼衰组血清ET和NO水平较非呼衰组均明显增高(ET分别为:62.45±27.42ng/L及47.98±16.35ng/L;NO分别为:8.12±2.88nmol/L及6.61±1.65nmol/L);心功能Ⅲ～Ⅳ级组患者血清ET和NO水平较心功能Ⅱ级组亦明显升高(ET分别为65.23±29.87ng/L和45.19±27.33ng/L;NO分别为8.24±2.56nmol/L和6.48±2.78nmol/L);血清ET含量与NO含量呈显著正相关系(r=0.63,P<0.05)。提示ET和NO是参与肺心病发病过程的重要因子,其血清水平高低与病情轻重密切相关,可作为反映病情及预后,判效疗效的参考指标。     

血浆中一氧化氮及内皮素含量与大鼠弥漫性脑损伤关系的研究

目的 :观察大鼠弥漫性脑损伤后血浆中一氧化氮 (NO)及内皮素 (ET 1)含量的变化。方法 :利用Mar marou创立的模型造成大鼠不同程度的弥漫性脑损伤 ,于伤后 6h抽血检测血浆中NO及ET 1含量。结果 :轻、重度弥漫性脑损伤后血浆中NO及ET 1均有明显升高 ,(P <0 .0 5 )。其中轻度损伤后血浆中NO含量从 (2 6 .70±3.30 ) μmol/L升高至 (35 .6 8± 2 .39) μmol/L ,ET 1含量从 (85 .0 7± 2 .89)ng/L升高至 (94 .2 0± 3.4 6 )ng/L。重度弥漫性脑损伤后血浆中NO含量升高至 (46 .86± 4 .1) μmol/L ,ET 1含量升高至 (131.0 4± 9.0 )ng/L。 结论 :NO和ET 1参与弥漫性脑损伤的原发及继发性神经组织损伤的病理过程 ,且二者的血浆浓度与脑损伤程度密切相关。     

2型糖尿病患者血内皮素和一氧化氮的改变

目的观察2型糖尿病(DM)患者血内皮素(ET)和一氧化氮(NO)的改变.方法选择确诊的2型DM患者46例,正常健康自愿者22例,测定血ET和NO,并比较2组间水平的差异.结果DM组血ET[(122.34±36.75)ng/L]较正常对照组[(39.37±8.39)ng/L]明显升高(P＜0.01),而NO水平[(7.28±4.12)μmol/L]较正常对照组[(15.68±2.58)μmol/L)]显著下降(P＜0.01).结论DM患者血NO和ET平衡失调可能同DM广泛血管损伤有关,临床使用ET拮抗剂和NO生成剂有可能对血管病变有益.     

冠状动脉粥样硬化与脂质过氧化损伤和血管内皮功能之间的关系

目的 :通过观察临床特点和实验室检查 ,探讨冠状动脉粥样硬化形成与血管内皮功能、体内脂质过氧化之间的关系。　方法 :血生化检查包括三酰甘油、胆固醇、低密度脂蛋白、高密度脂蛋白和血糖以及测定氧化修饰低密度脂蛋白 (OxLDL)、一氧化氮 (NO)和内皮素 (ET)。使用PHILIPS 980 0型数字减影心血管造影仪进行选择性冠状动脉造影。　结果 :75例患者中 ,冠状动脉损伤 (1支或多支 )组 5 0例 (6 6 .6 7% )。冠状动脉无损伤组 2 5例(33.33% )。冠状动脉损伤组与无损伤组的特殊实验室检查结果 :OxLDL分别为 (6 5 .73± 5 .37)mmol/L和(4 6 .95± 7.74 )mmol/L(P <0 .0 5 ) ,NO分别为 (6 5 .31± 9.87) μmol/L和 (87.6 2± 10 .0 9) μmol/L(P <0 .0 5 ) ;ET分别为 (91.92± 8.5 0 )ng/L和 (82 .81± 7.37)ng/L(P <0 .0 5 )。　 结论 :高脂血症、原发性高血压、糖尿病是冠状动脉粥样硬化的危险因素。OxLDL、NO和ET与冠状动脉粥样硬化的形成和发展有着密切的关系     

内皮素/一氧化氮系统失调在妊高征发病中的作用

目的 :观察妊高征患者血浆一氧化氮 (NO)和内皮素 (ET)含量的变化并探讨其在妊高征发病中的意义。方法 :应用镉柱比色法和放射免疫法分别对 43例妊高征患者 (妊高征组 )、36例正常妊娠妇女 (对照组 )和 19例正常非孕妇 (正常组 )血浆中NO代谢产物亚硝酸盐 /硝酸盐 (NO-2 /NO-3 )及ET - 1含量进行了检测。结果 :正常妊娠妇女血浆中NO-2 /NO-3 含量 (34.2 9± 10 .15 ) μmol/L明显高于非孕正常组妇女 (11.98± 3 .99)μmol/L ,并随孕周的增加而增加 ,孕中期达高峰 (39.45± 9.16 ) μmol/L ,到孕晚期有所下降 (31.42± 7.86 5 )μmol/L。血浆中ET的含量有所上升 ,但与非孕正常组妇女相比则没有显著差异 (P >0 .0 5 ) ;与正常晚期妊娠对照组相比 ,轻、中度妊高征妇女血浆中NO-2 /NO-3 含量虽有所上升 ,但没有明显差异 (P >0 .0 5 ) ,而重度妊高征妇女则有明显上升 (P <0 .0 5 )。妊高征妇女血浆ET含量 (96 .0 5± 13 .5 7)ng/L与正常晚期妊娠妇女(36 .48± 6 .17ng/L)相比有极显著的上升 (P <0 .0 1) ,并且与妊高征的严重程度成正比 (r =0 .5 2 ,P <0 .0 1) ,ET/NO比值 (2 .47)明显大于正常晚期妊娠对照组妇女 (1.13,P <0 .0 5 )。结论 :妊高征患者内皮细胞损伤导致ET/NO系统平衡失调可能在妊高征的发病机     

膳食补充条斑紫菜对高血压患者血管内皮功能的影响

目的了解膳食补充条斑紫菜(Porphyra yezoensis)对原发性高血压(EH)患者血管内皮功能的影响。方法采取随机、空白对照、交叉设计的方法,将36名EH患者〔男,24人,平均年龄(55.0±7.9)岁;女,12人,平均年龄(50.5±7.1)岁〕分为2组,观察膳食补充条斑紫菜(45g/d)28d后血清内皮素(ET)及一氧化氮(NO)水平的变化情况。结果2组受试者补充条斑紫菜后ET水平分别降低了(16.3±8.6)ng/L和(22.2±8.8)ng/L,(P<0.05)。血清亚硝酸盐/硝酸盐(NO2-/NO3-)浓度分别升高了(15.8±5.8)μmol/L和(12.7±9.2)μmol/L,(P<0.05);且膳食补充组与空白对照组相比,ET和NO水平的变化均具有统计学意义(P<0.05)。结论条斑紫菜能改善EH患者血管内皮功能,舒张血管,降低血压。     

布-加综合征患者血浆NO、CO及内皮素测定

目的 :探讨布 加综合征患者血浆一氧化碳 (CO)的水平和影响因素 ,以及CO在布 加综合征发病中的作用和意义。方法 :测定了 30例布 加综合征患者分流减压术前后外周血浆中CO、一氧化氮 (NO)及内皮素 1 (ET 1 )的水平 ,并以 30例正常人为对照。结果 :布 加综合征患者手术前血浆CO、NO及ET 1的水平均显著高于正常对照组 (CO (0 .89± 0 .1 1 )mg/L ,(0 .42± 0 .1 3)mg/L ;NO(87.31± 1 0 .41 ) μmol/L ,(55 .2 3± 1 0 .2 3) μmol/L ;ET 1(80 .0 2± 1 0 .89)ng/L ,(48.75± 1 1 .50 )ng/L ,P均 <0 .0 5) ,分流术后 3者的水平有明显下降 (P均 <0 .0 5)。 结论 :CO可能参与了布 加综合征的病理生理过程 ,增高的门静脉压力可能是刺激机体合成CO增多的原因之一     

血浆内皮素和降钙素基因相关肽浓度与心力衰竭的相关性

目的　探讨心力衰竭 (心衰 )与血浆内皮素 (ET)、血浆降钙素基因相关肽 (CGRP)之间的关系。方法　用特异性放射免疫分析法测定 3 8例心衰患者血浆ET和血浆CGRP水平。结果　心衰组血浆ET水平 ( 12 0 .4 2± 8.18)ng/L明显高于对照组 ( 4 8 66± 6 4 8)ng/L ,P <0 0 0 1。而心衰组血浆CGPR水平 ( 16 70± 4 13 )ng/L明显低于对照组 ( 64 70± 11 76)ng/L ,P<0 0 0 1。心衰严重程度与血浆ET和CGRP水平相关。心衰患者血浆ET与GCRP水平之间呈负相关关系 (r =- 0 82 3 6,P <0 0 0 1)。结论　循环血中ET与CGRP可能参与心衰的发生和发展 ,CGRP可能拮抗ET的心肌损伤作用     

鱼胆中毒致急性肾衰竭患者血浆内皮素的变化

目的　探讨鱼胆中毒患者血浆内皮素 (ET)水平的变化特点与急性肾衰竭 (ARF)发生、发展的关系。方法　采用放射免疫法测定并比较 3 5例鱼胆中毒并发ARF患者、3 0例单纯鱼胆中毒患者以及 2 0名健康人血浆ET水平 ,分析对比治愈组和死亡组ET水平。结果　鱼胆中毒并发ARF组血浆ET水平 13 0 .8± 60 .5ng/L比正常对照组 5 1.6± 9.2ng/L显著升高 (P <0 .0 1) ,单纯鱼胆中毒组血浆ET水平 63 .3± 10 .5ng/L与正常对照组比较差别无显著性 (P >0 .0 5 ) ;鱼胆中毒治愈组和死亡组ET水平分别为 78.6± 2 5 .9ng/L和 2 2 7.8± 82 .6ng/L ,差异有高度显著性 (P <0 .0 1)。结论　ET参与了鱼胆中毒并发ARF的发生与病情的进展 ,血浆ET水平可作为判断鱼胆中毒患者病情和预后的一个重要临床指标。     

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.