络沙坦对急性坏死性胰腺炎保护作用的实验研究

目的研究络沙坦（Losartan）对急性坏死性胰腺炎（ANP）大鼠是否有保护作用。方法SD大鼠40只．随机分为4组：正常对照组、ANP组、Losartan预防组、Losartan治疗组。采用大剂量精氨酸腹腔注射诱导ANP模型．预防组于造模前90min给予Losartan200μg／kg体重，两次，间隔1h，治疗组于造模后30min给予Losartan200μg／kg体重，两次，间隔1h。各组于造模后24h处死大鼠，观察大鼠血浆血管紧张素Ⅱ（AngⅡ）、肾素（PRA）、淀粉酶（AMY）、TNF-α、IL-1β变化．RT—PCR法检测胰腺组织血管紧张素原、肾素及AngⅡ受体AT1mRNA的水平．检测胰腺／体重比，观察胰腺组织病理变化。结果ANP组AngⅡ、PRA、AMY、TNF—α、IL-1β、胰腺／体重比值较对照组明显升高；胰腺组织血管紧张素原、肾素和AT1mRNA的水平也较对照组升高．Losartan预防组和治疗组血浆AMY、TNF-α、IL-1β较ANP组明显下降．胰腺组织病理损伤明显减轻．但AngⅡ、PRA变化不明显。结论络沙坦对血浆AngⅡ、PRA及血管紧张素原、。肾素和AT1mRNA无明显影响．可以减少TNF-α、IL-1β的产生，对ANP具有保护作用。     

Losartan对实验性糖尿病大鼠一氧化氮及内皮素的影响

Losartan为血管紧张素Ⅱ受体拮抗剂,能够阻断血管紧张素Ⅱ的生物学效应,我们了Losartan 对实验性糖尿病大鼠血清,尿液,肾组织匀浆一氧化氮（NO）,血浆内皮素（ET）水平,初步探讨其对肾脏的保护机制。     

坎地沙坦对老年充血性心力衰竭患者利钾尿肽、心房钠尿肽和内皮素水平的影响

目的: 探讨血管紧张素II受体拮抗剂（ARB）坎地沙坦治疗充血性心力衰竭（CHF）时对外周血中利钾尿肽（KP）、心房钠尿肽（ANP）和内皮素（ET）水平的影响。方法: 94例老年CHF患者随机分为常规治疗组（硝酸酯类药物+利尿剂+地高辛）和坎地沙坦组（常规治疗药物+坎地沙坦）,随访12 周,采用放射免疫分析方法测定两组治疗前后和34例健康者（正常对照组）外周血浆中KP、ANP和ET水平。同时用核素心室显像测定CHF患者左心室射血分数（LVEF）。结果: CHF患者的血浆KP、ANP和ET水平较正常对照组显著升高,随着病情的好转其水平逐渐降低,且不同的心功能分级之间有显著差异（P<0.05）。治疗后,坎地沙坦组外周血中KP、ANP和ET水平较常规治疗组下降更显著。结论: 坎地沙坦有抑制CHF患者神经内分泌的过度激活和肾素-血管紧张素-醛固酮(RAAS)系统亢进的作用。     

福辛普利对糖尿病大鼠肾脏损伤的保护作用

目的探讨福辛普利对糖尿病大鼠肾脏损伤的保护机制。方法制备大鼠糖尿病模型并分别给予不同剂量福辛普利灌胃。12周后检测血糖、血清肌酐、肾重指数,观察肾小球体积、肾小球基底膜变化,测定肾小球平均截面积（MGA）和肾小球平均体积（MGV）。结果DM组及不同剂量福辛普利组间血糖、血清肌酐均无统计学差异;与DM组相比,5mg·kg^-1·d^-1组肾重指数降低（P〈0．05）,10mg·kg^-1·d^-1组肾重指数明显降低（P〈0．01）,各福辛普利组MGA和MGV均缩小（P均〈0．01）。结论早期应用福辛普利在一定程度上可减轻糖尿病大鼠肾脏的损伤。     

MMP－2、MMP－3、TIMP－1及氯沙坦与氨氯地平在老年前期自发性高血压大鼠肾硬化中的作用及其机理探讨

目的 探讨MMPs/TIMPs与高血压性肾损害的关系。方法 将SHR随机分为3组,每组10只。氨氯地平10mg·kg~(-1)·d~(-1)或氯沙坦30 mg·kg~(-1)·d~(-1)治疗3个月,为实验组;以模型SHR为空白对照组。同时以10只WKY大鼠为健康对照组。测量治疗前、后血压变化,血尿素氮、肌酐和24 h尿蛋白定量,观察Ⅳ型胶原(COⅣ)、层连蛋白(LM)、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶抑制剂-1(TIMP-1)在肾组织中的表达。结果 ①SHR血压显著增高;肾功能明显受损;肾组织病理改变显著。肾小球细胞外基质(ECM)成分(如:COⅣ、LM)及TIMP-1表达增多;MMP-3、MMP-2表达减少;②治疗后,血压明显降低;肾功能损害减缓;肾组织病理改变减轻。肾组织中COⅣ、LM、TIMP-1表达减少;MMP-3、MMP-2表达增多。结论 氯沙坦与氨氯地平能延缓高血压性肾损害,改善已失调的MMPs/TIMPs比例;减少ECM在肾小球中的聚积,具有延缓高血压性肾硬化的作用。     

肾血管性高血压大鼠心脏肥厚不同时期血浆及组织心钠素、内皮素含量变化

目的 了解高血压心脏病左室结构、功能变化时血浆及心肌组织中心钠素(atrial natriuretic peptide ANP)、内皮素(endothelin ET)含量变化。方法 应用放免法监测二肾一夹意义型(2K1C)肾血管性高血压大鼠(RHR)血浆及心肌组织中ANP、ET含量变化，并根据超声心动图评价高血压大鼠心脏结构、功能动态变化，将高血压大鼠进行分组。结果 高血压左室向心性肥厚期血浆及心肌组织(左心室)中ANP、ET含量明显升高；左室离心性肥厚期血浆ET较向心性肥厚期组更高，但心肌组织中ET含量与其无显著差别，而血浆及心肌组织中．ANP含量均较向心性肥厚期组低。结论 2K1C型高血压大鼠血浆及心肌组织中ANP、ET含量均升高；血浆ET与．ANP含量变化在左室肥厚中可能起着更为重要作用。     

血管活性肽在双肾双夹高血压动物模型中的动态变化

以双肾双夹（2K2C）动物高血压模型为基础,在高血压不同时期观察内皮素（ET）,心钠素（ANP）和血管紧张素Ⅱ（AngⅡ）的改变。实验分手术组和对照组,各40只SD大鼠,每周测尾动脉血压一次,手术后1,4,8,12周取血浆和肾组织用放免法测定ET、ANP、Ang Ⅱ浓度。结果发现,手术组术后第1周血压开始上升,第4周显著升高并趋稳定。血浆ET（PET）第1周开始升高,第4周显著升高（11.02±2.04υs7.25±1.82P<0.01）,第8周则明显下降（P<0.05）,肾组织ET（TET）与血浆ET明显正相关（r=0.68,P<0.05）。ANP在第1周开始上升,第4周后持续显著升高（328.7±42.5υs 162.5±28.6,P<0.01）。Ang Ⅱ也在第1周显著升高（415.2±52.4,υs 95.3±32.7,P<0.01）以后持续在一较高水平。结果表明ET、ANP、Ang Ⅱ在双肾双夹高血压动物模型的发病机理中可能起重要作用。     

络沙坦对急性坏死性胰腺炎保护作用的实验研究

目的 研究络沙坦(Losartan)对急性坏死性胰腺炎(ANP)大鼠是否有保护作用.方法 SD大鼠40只,随机分为4组:正常对照组、ANP组、Losartan预防组、Losartan治疗组.采用大剂量精氨酸腹腔注射诱导ANP模型,预防组于造模前90 min给予Losartan 200 μg/kg体重,两次,间隔1 h,治疗组于造模后30 min给予Losartan 200 μg/kg体重,两次,间隔1 h.各组于造模后24 h处死大鼠,观察大鼠血浆血管紧张素Ⅱ(AngⅡ)、肾素(PRA)、淀粉酶(AMY)、TNF-α、IL-1β变化,RT-PCR法检测胰腺组织血管紧张素原、肾素及AngⅡ受体AT1 mRNA的水平,检测胰腺/体重比,观察胰腺组织病理变化.结果 ANP组AngⅡ、PRA、AMY、TNF-α、IL-1β、胰腺/体重比值较对照组明显升高;胰腺组织血管紧张素原、肾素和AT1 mRNA的水平也较对照组升高,Losartan预防组和治疗组血浆AMY、TNF-α、IL-1β较ANP组明显下降,胰腺组织病理损伤明显减轻,但AngⅡ、PRA变化不明显.结论 络沙坦对血浆AngⅡ、PRA及血管紧张素原、肾素和AT1 mRNA无明显影响,可以减少TNF-α、IL-1β的产生,对ANP具有保护作用.     

牛磺酸对自发性高血压大鼠血压和心肌、血管组织促增殖因子的影响

观察牛磺酸对自发性高血压大鼠（SHR）血压、心肌和主动脉组织促增殖因子（ATⅡ，ET，NE，DA）的影响。结果表明，SHR心肌、主动脉组织AT　Ⅱ，ET含量显著增加，而DA，NE含量则呈消耗性减少。口服牛磺酸能纠正SHR心肌组织牛磺酸的缺乏，降低心肌、主动脉ATⅡ，ET含量，增加DA，NE含量，同时显著降低大鼠血压。提示牛磺酸的降压作用机制可能与抑制心肌血管组织促增殖因子的生成及释放有关。     

环孢霉素A抑制肾性高血压大鼠重要脏器钙调神经磷酸酶活化

目的研究一肾一夹肾性高血压大鼠组织钙调神经磷酸酶（calcineurin,CaN）活性变化及环孢霉素A（CyclosporineA,CsA）的调控作用。方法取20只Wistar大鼠随机分为3组:假手术组（n=6）,一肾一夹手术组（n=7）和CsA干预组（n=7）。采用放免法测定血浆血管紧张素Ⅱ（angiotensinⅡ,AngⅡ）、醛固酮（Aldosterone,Ald）和内皮素（endothelin,ET1）浓度,采用比色测定一氧化氮（NO）浓度。以PNPP为底物测定术后4周大鼠各组织器官CaN活性。结果肾性高血压大鼠心脏、脾、肾脏、肺、脑CaN活性较假手术组显著升高（均P<0.05）,干预组上述组织器官CaN活性较手术组显著下降（P<0.05）。肾性高血压大鼠组肝脏CaN活性较假手术组显著下降,环孢霉素A干预组肝细胞CaN活性较手术组继续显著下降（P<0.05）。各组大鼠主动脉中CaN活性无明显变化。各组大鼠血浆Ald、AngⅡ、ET1及NO浓度亦无明显变化。结论肾性高血压大鼠心、脑、肾、脾、肺脏组织CaN活性均显著升高,CsA对肾性高血压大鼠上述各组织脏器CaN活性具有广泛的抑制作用。     

Research and Evaluation of the Influence of the Construction of the Gate and the Influence of the Piston Velocity on the Distribution of Gases into the Volume of the Casting

Distribution of gasses to the cast volume and volume of pores can be maintained within the acceptable limits by means of correct setting of technological parameters of casting and by selection of suitable structure and gating system arrangement. The main idea of this paper solves the issue of suitability of die casting adjustment—i.e., change of technological parameters or change of structural solution of the gating system—with regards to inner soundness of casts produced in die casting process. Parameters which were compared included height of a gate and velocity of a piston. The melt velocity in the gate was used as a correlating factor between the gate height and piston velocity. The evaluated parameter was gas entrapment in the cast at the end of the filling phase of die casting cycle and at the same time percentage of porosity in the samples taken from the main runner. On the basis of the performed experiments it was proved that the change of technological parameters, particularly of pressing velocity of the piston, directly influences distribution of gasses to the cast volume.     

Weighing the QT Intervals with the Slope or the Amplitude of the T Wave

Objective: The reproducibility of QT interval measurements is low, even for the mean QT interval based on the standard ECG. In this study we analyzed whether the reproducibility of the mean weighed QT interval was better than the simple mean QT interval. The weighing was based on the amplitude of the T wave or the slope of the steepest tangent on the terminal part of the T wave. Material and methods: 12‐lead ECGs of 130 postmyocardial infarction patients were obtained. The QT intervals were measured by the tangent‐method on two occasions by the same observer Mismatch QT intervals were defined as QT intervals that were measured at only one occasion. Sixteen ECGs were rejected. The data were split into 34 and 80 ECGs for optimization and validation of the weighing, respectively. The weighed QT dispersion was calculated as the weighed mean of the three longest minus the weighed mean of the three shortest QT intervals. Results: Weighing with the slope increased the reproducibility by 41% (P = 3 10^‐6), but weighing with the amplitude reduced it by 20% (P = 0.02). However, if measurements with errors above 75 ms were rejected, weighing with the slope or the amplitude increased the reproducibility with 26% and 20% (P = 0.02), respectively. Weighing did not change the reproducibility of the weighed QT dispersion. Conclusion: Weighing with the slope improved the reproducibility of the mean weighed QT interval. However, if measurements with errors above 75 ms were rejected, weighing with the amplitude also increased the reproducibility. Weighing did not change the reproducibility of the weighed QT dispersion. Weighing is particularly efficient at reducing the negative impact of mismatch QT intervals on the reproducibility. A.N.E. 2002;7(1):4–9     

县级以下综合医疗机构医务人员对现代结控知识的认识现状调查

目的本文旨在了解医务人员现代结控知识掌握的现状及培训效果?方法于培训前后进行问卷调查,内容包括:病例发现?结核病诊断及化疗?结果培训前疫情报告和转诊,回答正确者占75.2%?71.7%;对临床表现?查痰和诊断依据,回答正确者占83.5%?42.5%?40.8%;抗痨药物?用药方法?化疗原则?短化方案?短化疗程?治愈标准六项,回答正确者占58%?14.4%?20.8%?9.2%?17%?24.3%?培训后再次调查发现,90%以上医务人员对现代结控基本知识已掌握?结论各级医务人员现代结控知识是很贫乏的,因此,对其进行系统培训是极为必要的,此项工作省时?省力?投入少,可收到事半功倍的效果。     

大骨节病病区水,粮实验对动物的骨和软骨中化学元素组成的影响

用质子激发 X 线荧光分析方法(PIXE)测定了大骨节病病区和非病区的水、粮以及用该水粮喂养的大白鼠的肋软骨和硬骨中22种化学元素的含量。结果发现水粮中存在差异的元素反应在用该水粮喂养的大白鼠的骨、软骨中也存在差异,含量都低的元素有 P、Mn、Cu、As、Zn。都高的有铅。其中锌低在水、粮、硬骨和软骨中都完全一致呈非常显著性差异(p<0.01)。提示病区水、粮中化学元素对骨质的影响不是单一元素缺乏或过多所致,而是多种元素的复合因素。     

Assessment of the Soft-Tissue Seal at the Interface between the Base of the Fixed Denture Pontic and the Oral Mucosa

Fixed dentures (bridges) are often selected as a treatment option for a defective prosthesis. In this study, we assess the contact condition between the base of the pontic and oral mucosa, and examine the effect of prosthetic preparation and material biocompatibility. The molars were removed and replaced with experimental implants with a free-end type bridge superstructure after one week. In Experiment 1, we assessed different types of prosthetic pre-treatment: (1) the untreated control group (Con: mucosa recovering from the tooth extraction); (2) the laser irradiation group (Las: mucosa recovering after the damage caused by a CO₂ laser); and (3) the tooth extraction group (Ext: mucosa recovering immediately after the teeth extraction). In Experiment 2, five materials (titanium, zirconia, porcelain, gold-platinum alloy, and self-curing resin) were placed at the base of the bridge pontic. Four weeks after the placement of the bridge, the mucosa adjacent to the pontic base was histologically analyzed. In Experiment 1, the Con and Las groups exhibited no formation of an epithelial sealing structure on the pontic base. In the Ext group, adherent epithelium was observed. In Experiment 2, the sealing properties at the pontic interface were superior for titanium and the zirconia compared with those made of porcelain or gold-platinum alloy. In the resin group, a clear delay in epithelial healing was observed.     

高胆红素血症对肿瘤标志物测定的影响探讨

目的探讨高胆红素血症对Ca19-9、Ca24-2和CEA检测的影响.方法对320例胆管、胆囊良恶性疾病病人,15例胆囊炎病人的胆汁和血清以及10例肝硬化、10例黄疸肝炎病人进行Ca19-9、Ca24-2和CEA检测.结果在良性胆管、胆囊疾病中,Ca19-9的假阳性最高;在胆红素增高的良性疾病中,Ca19-9假阳性率达46.7%;15例胆汁和血清以及10例肝硬化和10例黄疸肝炎病人中,Ca19-9的假阳性率分别为93%、20%、80%和80%.结论高胆红素血症对Ca19-9检测影响最明显,胆囊、胆管良恶性疾病鉴别时,以Ca24-2和CEA检测为佳.     

Echocardiography in the Emergency Department: From the Perspective of the Emergency Physician and the Cardiologist

Echocardiography performed in the emergency department must adapt to this new setting for noninvasive diagnostic testing. Emergency physicians require echocardiography to provide rapid diagnosis in life-threatening emergencies. New initiatives are being proposed by emergency physicians in the delivery of this test. Cardiologists now use echocardiography in the emergency-department to make the diagnosis of heart disease earlier and with greater accuracy.