葛根素通过Fetuin B-AMPK/ACC信号通路减轻2型糖尿病小鼠肝脏胰岛素抵抗

目的 探讨葛根素通过Fetuin B-AMPK/ACC信号通路对高脂饮食联合链脲佐菌素诱导的2型糖尿病小鼠肝脏胰岛素抵抗的调控机制。方法 C57BL/6J小鼠随机选取10只正常饮食作为正常对照组,其余40只通过高脂饲料喂养联合腹腔注射100 mg/kg链脲佐菌素建立2型糖尿病小鼠模型,造模成功后采用随机数字表法将小鼠分为模型对照组、葛根素低剂量组（Pue-50 mg/kg）、葛根素中剂量组（Pue-100 mg/kg）和葛根素高剂量组（Pue-200 mg/kg）,干预8周。末次给药后,尾静脉取血检测各组小鼠空腹血糖（FBG）,取血和肝组织;ELISA法检测各组小鼠血清空腹胰岛素（FINS）,肝脏甘油三酯、胆固醇、游离脂肪酸水平;HE染色法观察小鼠肝脏病理变化;免疫组化法检测小鼠肝脏Fetuin B含量;实时荧光定量聚合酶链式反应法检测小鼠肝脏Fetuin B、AMPK、ACC mRNA表达;Western blot法检测小鼠肝脏Fetuin B、AMPKα1、ACC、P-AMPKαT183/T172、P-ACCS79蛋白表达。结果 末次给药后,Pue-100 mg/kg、Pue-200 mg/kg剂量组甘油三酯、胆固醇、游离脂肪酸及FBG低于模型对照组（P<0.01）;葛根素不同剂量给药组较正常对照组,FINS和胰岛素抵抗指数(HOMA-IR)降低（P<0.01）。与正常对照组比较,模型对照组小鼠肝脏 Fetuin B、ACC mRNA表达明显上升,AMPK mRNA表达降低（P<0.01）;Fetuin B、ACC蛋白表达升高,AMPKα1、P-AMPKαT183/T172、P-ACC S79蛋白表达降低（P<0.01）;病理学观察到肝脏脂肪变性明显,肝脏Fetuin B表达含量增加。与模型对照组比较,葛根素呈剂量依赖性抑制肝脏Fetuin B、ACC mRNA表达和Fetuin B、ACC蛋白表达,上调AMPK mRNA表达和AMPKα1、P-AMPK αT183/T172、P-ACC S79蛋白表达（P<0.01）。Pue-50 mg/kg给药组上调AMPK mRNA表达,下调ACCmRNA表达差异无统计学意义（P>0.05）。结论 葛根素可能通过调节肝脏Fetuin B-AMPK/ACC信号通路减轻2型糖尿病小鼠胰岛素抵抗,进一步改善糖脂代谢。     

电针对肥胖大鼠骨骼肌AMPK/ACC/CPT-1信号通路的影响

目的 观察电针对肥胖大鼠骨骼肌腺苷酸活化蛋白激酶(AMPK)信号通路的影响,探讨电针治疗肥胖的机制。方法 30只刚断乳（3周龄）的SPF级SD雄性大鼠,随机挑选6只普通饲料喂养并设为正常组,另24只高脂饲料喂养造模12周,将造模成功的12只随机分为模型组和电针组。测定各组大鼠体质量、脂肪质量、血脂等相关指标,qPCR检测各组大鼠骨骼肌中AMPKα1、乙酰辅酶A羧化酶(ACC)、肉毒碱棕榈酰转移酶1(CPT-1)的mRNA表达变化, Western blot 法检测骨骼肌AMPK、ACC磷酸化水平和CPT-1蛋白水平。结果 与正常组比较,模型组体质量显著升高（P<0.01）,显示肥胖大鼠造模成功。与模型组相比,电针组大鼠的体质量、内脏脂肪质量和血脂均显著降低（P<0.05~0.01）;骨骼肌AMPKα1、ACC、CPT-1 mRNA的表达量显著上升（P<0.05~0.01）。电针使AMPK磷酸化水平显著提高（P<0.01）,激活AMPK的活性;ACC磷酸化水平显著提高,抑制ACC活性;同时提高CPT-1蛋白水平。结论 电针可以降低肥胖大鼠的体质量并改善其脂肪代谢的紊乱,其机制可能通过调节骨骼肌组织AMPK/ACC/CPT-1信号通路实现的。      

白藜芦醇通过上调脂肪变性HepG2细胞Sirt3表达改善线粒体功能

目的 探讨白藜芦醇(resveratrol,RSV)对脂肪变性肝细胞线粒体功能的影响,以及沉默信息调节因子3(sirtuin 3,Sirt3)在其中的重要作用.方法 用0.2 mmol/L棕榈酸(palmitic acid,PA)处理HepG2细胞24 h建立肝细胞脂肪变性模型,再用40 μmol/L RSV和/或50 μmol/L Sirt3抑制剂3-TYP处理24 h.实验分为对照组、PA组、PA+ RSV组、PA+ RSV+ 3-TYP组、PA+ 3-TYP组.用相关试剂盒检测甘油三酯(TG)含量、沉默调节蛋白3(sirtuin 3,Sirt3)活性、ATP合酶活性、ATP生成量以及线粒体基础呼吸率,使用DCFH-DA荧光探针检测细胞活性氧(reactive oxygen species,ROS)含量,Westernblot检测Sirt3蛋白表达.Sirt3 siRNA处理HepG2细胞后再用PA和/或RSV处理,分析ROS和甘油三酯含量.结果 相对于PA组,PA+RSV组HepG2细胞的甘油三酯、ROS含量明显降低(P＜0.05),ATP合酶活性、ATP生成量和基础呼吸率明显提高(P＜0.05).而3-TYP或Sirt3 siRNA处理后,RSV的上述作用被削弱(P＜0.05).结论 RSV通过上调脂肪变性肝细胞Sirt3的表达与活性而改善其线粒体功能.     

葛根素通过AMPK-mTOR通路激活自噬改善大鼠激素性股骨头坏死的研究

目的 探讨葛根素通过自噬信号通路对激素性股骨头坏死早期血管内皮细胞自噬的干预作用。方法 48只雄性SD大鼠随机分成4组（每组12只）。对照组：单纯肌肉注射生理盐水，2ml/只/次，共3次，间隔24h；模型组：肌肉注射甲基强的松龙，20mg/kg共3次，间隔24h。葛根素干预组：同模型组方法造模，在最后一次臀肌注射完甲基强的松龙后给予葛根素（100mg/kg?d)腹腔注射。雷帕霉素干预组：同模型组方法造模，在最后一次臀肌注射完甲基强的松龙后同时给予雷帕霉素（1.2mg/kg?d，自噬特异性激动剂)腹腔注射。造模后二周、四周后处死实验动物，取出双侧后肢的股骨头及主要供血血管。HE染色光镜下观察股骨头坏死情况；利用免疫组化法和RT-PCR方法检测Beclin1、LC3、P62、AMPK,mTOR和ULK1的mRNA与蛋白的表达；采用ELISA法检测血管内皮损伤标记物6-keto-PGF1a的表达。结果 与对照组比较，模型组大鼠骨细胞坏死加重，血管内皮细胞6-keto-PGF1a的表达增加（P<0.05），血管内皮细胞中自噬相关蛋白AMPK、ULK1、Beclin1、LC3表达降低（P<0.05）、mTOR、P62表达增高（P<0.05）；与模型组比较，葛根素干预组大鼠的骨坏死程度明显改善，6-keto-PGF1a的表达降低（P<0.05），自噬相关蛋白AMPK、ULK1、Beclin1、LC3表达增高（P<0.05）、mTOR、P62表达降低（P<0.05）。结论 葛根素可能通过AMPK-mTOR-Ulk1 信号通路激活血管内皮细胞的自噬，从而减轻激素所造成的股骨头坏死。     

沉默信息调节因子3对白藜芦醇诱导的人卵巢癌SKOV3细胞凋亡的影响

目的：检测沉默信息调节因子3（Sirt3）对白藜芦醇（Res）诱导的人卵巢癌SKOV3细胞凋亡的影响,探讨其促进凋亡的机制。方法：人卵巢癌SKOV3细胞加入不同浓度（0、2.5、5.0、10.0、20.0、40.0和80.0 mg·L^-1）Res培养24h,MTT法检测细胞存活率。将细胞随机分为对照组、Sirt3抑制剂3-（1H-1,2,3-三唑-4-基）吡啶（3-TYP）组、Res组和3-TYP+Res组,培养24h后,MTT法检各组细胞增殖抑制率;采用Hoechst 33342进行细胞核染色,激光共聚焦显微镜观察细胞核形态;采用活性氧（ROS）探针检测细胞中ROS水平;Western blotting法检测各组细胞中Sirt3、B细胞淋巴瘤/白血病-2（Bcl-2）、Bcl-2相关X蛋白（Bax）和含半胱氨酸的天冬氨酸蛋白水解酶3（cleavedcaspase-3）蛋白表达水平。结果：MTT实验,随着Res浓度的增加,细胞存活率明显降低,Res的半数抑制浓度（IC₅₀）为42.73 mg·L^-1。与对照组比较,Res组和3-TYP+Res组细胞增殖抑制率明显升高（P<0.05）;与Res组比较,3-TYP+Res组细胞增殖抑制率明显升高（P<0.05）。与对照组比较,3-TYP+Res组细胞核出现固缩、染色增强、核碎裂增多。与对照组比较,3-TYP组细胞红色荧光无明显变化,Res组和3-TYP+Res组细胞红色荧光明显减少。Western blotting法检测,与对照组比较,3-TYP组细胞中Sirt3蛋白表达水平明显降低（P<0.05）,Bcl-2、Bax和cleaved caspase-3蛋白表达水平无明显变化（P>0.05）,Res组细胞中Sirt3和Bcl-2蛋白表达水平明显降低（P<0.05）,Bax和cleaved caspase-3蛋白表达水平明显升高（P<0.05）;与Res组比较,3-TYP+Res组细胞中Bax和cleaved caspase-3蛋白表达水平明显升高（P<0.05）,Bcl-2和Sirt3蛋白表达水平明显降低（P<0.05）。结论：Res可以诱导SKOV3细胞的凋亡,3-TYP通过抑制Sirt3表达可增强Res的作用。     

葛根素激活SIRT_3/SOD_2信号通路缓解多柔比星心脏毒性实验研究

目的:探究葛根素(Pue)能否减轻多柔比星(DOX)引起的心脏毒性及其具体机制。方法:通过一次性腹腔注射多柔比星(15 mg/kg)建立小鼠多柔比星心脏毒性急性模型。DOX给药前3 d每日通过腹腔注射给予SIRT_3特异性阻断剂3-TYP[50 mg/(kg·d)]给药3 d。DOX给药后每日通过腹腔注射给予葛根素[10 mg/(kg·d)],给药5 d。实验小鼠随机分为正常组(Control组),葛根素组(Pue组),多柔比星组(DOX组),多柔比星+葛根素组(DOX+Pue组),3-TYP+多柔比星+葛根素组(3-TYP+DOX+Pue组),3-TYP+多柔比星组(3-TYP+DOX组)。DOX给药5 d后检测小鼠心脏收缩舒张功能、心脏组织病理改变、血清LDH水平、氧化应激和凋亡情况。结果:与Control组小鼠相比,DOX组小鼠心功能明显受损,心肌细胞出现"空泡化"反应,血清内LDH水平、心肌组织心肌细胞内氧活性(ROS)产量、丙二醛(MDA)含量和心肌凋亡水平明显增加。葛根素给药可以有效减轻多柔比星心脏毒性,抑制心肌组织氧化应激损伤和凋亡,伴随SIRT_3/SOD_2信号的激活。而用SIRT_3特异性抑制剂3-TYP抑制SIRT_3信号通路后,葛根素的保护作用明显减弱(均P<0.05)。结论:葛根素可以通过激活SIRT_3/SOD_2信号通路抑制氧化应激损伤和凋亡缓解多柔比星心脏毒性。     

单味中药治疗非酒精性脂肪肝机制研究进展

非酒精性脂肪肝(non-alcoholic fatty liver disease,NAFLD)在全球成年人中发病率为25%,单味中药干预NAFLD的作用靶点及机制已被广泛研究。研究表明,泽泻、山楂叶黄酮等通过抑制脂肪合成的AMPK/SREBP1c/PPAR/ACC/FAS信号通路治疗NAFLD。姜黄素、紫苏油等治疗NAFLD的机制是通过调节胆固醇代谢FXR/LXR信号通路实现的。红景天苷、黄连素等通过抑制炎症及抗氧化应激相关通路起到治疗NAFLD的作用。虎杖苷、人参皂苷等治疗NAFLD的作用与自噬相关mTOR信号通路有关。绞股蓝、槲皮素等通过调节肠道菌群而人参皂苷通过延缓肝脏纤维化通路有效干预NAFLD。     

异芒果苷对高脂饮食诱导大鼠肝脏损伤的改善作用

目的?探讨异芒果苷对高脂饮食诱导大鼠非酒精性脂肪肝的影响。方法?将动物随机分为4组:空白组、高脂组、异芒果苷(20、40?mg/kg)组。除空白组外,其它组动物以高脂肪饮食喂养6周,空白组给予正常饲料,从第5周起,异芒果苷组给予相应的药物治疗2周。ELISA法检测丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、甘油三酯(TG)、胆固醇(TC)、细胞因子白介素-1β(IL-1β)、白介素-6(IL-6),肿瘤坏死因子-α(TNF-α),采用HE染色观察肝脏病理改变,Western blot法检测肝脏Sirt1/NF-κB信号通路蛋白的表达。体外实验采用棕榈酸诱导肝脏L02细胞损伤模型,检测细胞活性以及细胞上清IL-1β、IL-6、TNF-α水平,检测细胞Sirt1/NF-κB信号通路蛋白表达。结果?体内实验结果显示,异芒果苷显著降低ALT、AST活性及TG、TC、IL-1β、IL-6、TNF-α水平（P<0.01）,改善肝组织病理学改变,增加肝脏Sirt1蛋白表达（P<0.01）,降低NF-κB信号通路蛋白表达（P<0.01）。体外实验结果表明,异芒果苷能显著增加L02细胞活性（P<0.01）,降低细胞上清炎症因子水平（P<0.01）,增加细胞Sirt蛋白表达（P<0.01）,降低NF-κB信号通路蛋白表达（P<0.01）。结论?异芒果苷能显著改善高脂饮食诱导的非酒精性脂肪肝,其机制可能与调节Sirt1/NF-κB信号通路有关。      

七氟醚预处理通过线粒体NAD+-SIRT3通路减轻大鼠心肌缺血再灌注损伤

目的：缺血再灌注损伤(ischemia reperfusion injury,IRI)常发生于缺血性心脏疾病。七氟醚预处理有减轻心肌IRI的作用。保存线粒体结构和功能的完整是减轻心肌IRI的关键,线粒体内重要的信号调节分子沉默信息调节因子3(silent information regulator 3,SIRT3)是一类依赖于烟酰胺腺嘌呤二核苷酸(nicotinamide adenine dinucleotide,NAD⁺)的去乙酰化酶。本研究旨在探讨NAD⁺-SIRT3通路在七氟醚预处理减轻大鼠心肌IRI中的作用。方法：将60只健康成年雄性SD大鼠随机分为5组(n=12)：假手术组(Sham组)、缺血再灌注组(IR组)、七氟醚预处理组(Sev组,给予2.5%七氟醚吸入30 min)、七氟醚预处理+SIRT3抑制剂3-TYP干预组(Sev+3-TYP组,给予尾静脉注射5 mg/kg 3-TYP和2.5%七氟醚吸入30 min)、3-TYP干预组(3-TYP组,给予尾静脉注射5 mg/kg 3-TYP)。Sham组只开胸不结扎,其他4组采用结扎...     

基于AMPK通路探讨茶多酚改善糖尿病大鼠糖脂代谢机制

目的：探讨茶多酚从AMP活化蛋白激酶（AMPK）通路途径调控糖尿病大鼠糖脂代谢的机制。方法：经糖耐量试验筛选6周龄SD大鼠45只,按随机数字表法分为正常组10只和造模组35只,造模组糖尿病造模成功后剩余30只,根据体质量分层法和血糖水平分为模型组、二甲双胍组和茶多酚组,每组各10只。各组均于每日下午灌胃,正常组与模型组给予无菌生理盐水,二甲双胍组给予二甲双胍水溶液,茶多酚组给予茶多酚。干预120 d后,检测各组大鼠的空腹血糖（FBG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）;酶联免疫吸附试验法检测肝脏乙酰辅酶A羧化酶（ACC）和激素敏感性脂肪酶（HSL）;实时荧光定量法检测肝脏ACCmRNA、转录因子胆固醇调节元件结合蛋白1(SREBP-1)mRNA、3-羟基-3-甲基戊二酸单酰辅酶A还原酶（HMGCR）mRNA;免疫印迹法检测肝脏AMPKα1、磷酸化AMP活化蛋白激酶α1(P-AMPKα1)、SREBP1、HMGCR、肉毒碱棕榈酰转移酶1(CPT1)、葡萄糖转运蛋白4(GLUT4)和磷酸烯醇丙酮酸羧化激酶（PEPCK）。...     

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.