新生脉片治疗慢性充血性心力衰竭临床观察

[目的]探讨中药新生脉片对慢性充血性心力衰竭的治疗作用。[方法]在常规治疗基础上加用院内制剂新生脉片治疗4周,观察治疗前后临床症状、心衰积分、各症状积分、血浆肾素(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)等指标的改善情况,并采用常规治疗为对照组。[结果]两组患者在常规治疗基本相似的情况下,治疗组总有效率为83.72%,心衰积分、各症状积分、PRA、AngⅡ、ALD等改善均优于对照组(P<0.05,P<0.01)。[结论]新生脉片具有一定的抗心室重塑作用。     

高效液相色谱法测定养血生发胶囊中羌活醇和异欧前胡素的含量

[目的] 建立高效液相色谱法(HPLC)测定养血生发胶囊中羌活醇和异欧前胡素的含量测定方法。[方法] 色谱柱:Agilent Zorbax Eclipse XDB-C₁₈(250 mm×4.6 mm,5 μm),流动相:乙腈-0.1%磷酸水溶液(45:55),流速:1 mL/min,检测波长:310 nm,柱温:25 ℃。[结果] 羌活醇和异欧前胡素分别在0.204~1.224 μg(r=0.999 7)和0.103~0.616 μｇ(r=0.999 8)线性关系良好,平均回收率分别为99.24%(RSD=0.74%)和99.86%(RSD=1.36%)。[结论] 该方法简便易行、重复性好,可用于养血生发胶囊中羌活醇和异欧前胡素的质量控制。     

生脉注射液对心力衰竭患者地戈辛血药浓度和药动学参数影响的临床研究

[目的]探讨生脉注射液对心力衰竭患者地戈辛血药浓度和药动学参数的影响。[方法]选择符合标准的充血性心衰患者40例,随机分为地戈辛组和地戈辛+生脉注射液20、40、60mL3个剂量组,每组10例,采用放免法(RIA)分别测定4组患者不同时间地戈辛血药浓度,以3P97药动学软件拟合地戈辛药动学参数。[结果]生脉注射液小剂量(20mL)组对心衰患者地戈辛血药浓度和消除半衰期(T_1/2)、表观分布容积(Vd)、血浆清除率(CL)等药动学参数有显着影响(P<0.05),而中剂量(40mL)和大剂量(60mL)组无明显影响(P>0.05)。[结论]提示生脉注射液在小剂量应用时具有降低充血性心衰患者地戈辛血药浓度、缩短消除半衰期的作用。     

复荣通脉胶囊联合贝前列素钠片治疗糖尿病性周围血管病变临床研究

[目的]观察复荣通脉胶囊联合西药贝前列素钠片治疗糖尿病性周围血管病变的疗效。[方法]将100例糖尿病性周围血管病变患者,按照随机数字表法分为治疗组及对照组,各50例。治疗组于复荣通脉胶囊+贝前列素钠片,对照组单用贝前列素钠片,观察两组治疗后的间歇性跛行、静息痛、足部冷凉感、踝肱指数（ABI）的变化。[结果]两组患者的症状均得到有效改善,治疗组疗效更佳（P<0.05）;两组患者ABI较治疗前明显提高（P<0.01）,治疗组较对照组改善更为显著（P<0.01）;两组患者血脂、纤维蛋白原均较前改善（P<0.01）,治疗组下降更为显著（P<0.05或P<0.01）。[结论]复荣通脉胶囊联合贝前列素钠片治疗糖尿病性周围血管病变疗效确切,值得进一步推广。     

首乌丹参方预处理对缺血再灌注损伤大鼠心肌保护作用研究

[目的] 观察首乌丹参方对大鼠缺血再灌注(I/R)损伤心肌梗死范围及血清中乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)活性以及超氧化物歧化酶(SOD)、丙二醛(MDA)的影响。[方法] 采用结扎大鼠冠状动脉前降支30min/开放120min,建立心肌I/R模型,通过首乌丹参方预处理,观察I/R大鼠心肌梗死范围,血清乳酸脱氢酶(LDH)、CK、CK-MB活性及SOD、MDA的变化熏同时电镜下观察心肌超微结构变化。[结果] 首乌丹参方高、中剂量组梗死程度明显减轻,梗死区质量占全心脏及左心室的百分比与I/R组比较均有显著性差异(P<0.01雪,以首乌丹参方中剂量组为优;首乌丹参方能够使血清中的SOD值增加(P<0.01),MDA含量有不同程度的降低;能够减少心肌酶的漏出;电镜下I/R组心肌组织严重损伤,首乌丹参方用药后偶见局灶性损伤和毛细血管狭窄,心肌轻度损伤。[结论] 首乌丹参方对心肌缺血再灌注损伤具有保护作用,减少心肌酶漏出、减少自由基损伤是其保护心肌的重要机制之一。     

复方丹参注射液配伍黄芪注射液治疗冠心病疗效Meta分析

[目的]评价复方丹参注射液配伍黄芪注射液治疗冠心病的临床疗效。[方法]检索文献,提取数据资料,运用Meta分析法,即对研究结果进行一致性检验,并采用相应数学模型进行数据的合并与分析。[结果]符合纳入标准的文献4篇。心绞痛发作缓解率的合并效应量d的95%CI为26%～10%;心电图改善有效率的合并效应量d的95%可信区间(confienceinterval,CI)为27.38%～7.66%。[结论]复方丹参注射液配伍黄芪注射液对气虚血瘀型心绞痛的治疗效果优于单用复方丹参注射液。     

草菊饮及膳食纤维素联合治疗儿童单纯性肥胖临床研究

[目的]观察用草菊饮及膳食纤维素联合治疗儿童单纯性肥胖的临床疗效。[方法]将117例学龄期单纯性肥胖儿童随机分为观察组(n=64),对照组(n=53)。两组小儿在家中进食量和次数无任何要求,两组小儿同时加用膳食纤维素3片(安利产品),观察组加服草菊饮500mL,随饮。[结果]治疗后15d后观察组小儿进食量及摄入的总热量显著减少,饥饿感显著减轻,粪便排泄增加(P<0.001)。体质量、脂肪百分率、体质量指数显著下降(P<0.01)。[结论]1)草菊饮及膳食纤维素联合具有良好的减肥效果,治疗儿童单纯性肥胖无不良反应。2)儿童单纯性肥胖与脂肪含量相关,提示吸收能力较强与便秘可能是儿童单纯性肥胖病因之一。     

芎蚓中风颗粒的质量标准研究

[目的] 建立芎蚓中风颗粒的质量标准。[方法] 采用薄层色谱法对其进行定性分析。采用高效液相色谱（HPLC）法测定其中阿魏酸和芍药苷的含量。阿魏酸：C18色谱柱（250 mm×4.6 mm,5 μm）;甲醇-1%醋酸溶液（35：65）为流动相;流速为1 mL/min;检测波长为321 nm.芍药苷：C18色谱柱（250 mm×4.6 mm,5 μm）;乙腈-0.01%磷酸溶液（15：85）为流动相;流速为1 mL/min;检测波长为230 nm.[结果] 建立了该药中川芎、当归、地龙、赤芍的鉴别方法。阿魏酸在4.286～42.86 μg/mL（r=1.000）线性关系良好,平均回收率为99.7%.RSD=2.8%（n=6）.芍药苷在0.058 72～0.587 2 mg/mL（r=0.999 99）线性关系良好,平均回收率为99.5%,RSD=0.67%（n=6）.[结论] 该方法简便、可靠、重复性好,可用作芎蚓中风颗粒的质量控制。     

不同浓度葛根素溶液对人皮肤成纤维细胞生物学效应的影响

[目的] 观察不同浓度的葛根素溶液对人皮肤成纤维细胞(HDF)生物学效应的影响。[方法] 体外培养人皮肤成纤维细胞,选用葛根素溶液100、200、300、400、500 μg/mL五个不同的药物浓度,观测葛根素溶液在5个药物浓度下对HDF的生物学效应的影响。[结果] 与对照组相比较,药物浓度为100、200、300、400 μg/mL的葛根素溶液,对体外培养的HDF的生物学效应无影响(P>0.05);药物浓度为500 μg/mL的葛根素溶液,对体外培养的HDF的增殖有抑制作用(P<0.05),且对HDF的细胞膜有一定的损伤作用(P<0.05)。[结论] 药物浓度500 μg/mL的葛根素溶液对体外培养的HDF有抑制增殖和细胞膜损伤的作用,此药物浓度可作为干预HDF的作用剂量,对瘢痕组织的治疗将起到一定作用。     

顶空进样气相色谱法测定脑脉通软胶囊中有机溶剂残留量

[目的]建立测定脑脉通软胶囊中有机溶剂残留量的方法,为质量评价提供依据。[方法]采用顶空进样气相色谱法,以50%二甲基甲酰胺水溶液为提取溶剂,色谱柱为DB-624石英毛细管柱,75 m×0.530 mm,df=3.00μm;FID检测器温度为250℃;氮气为载气,流速15 mL/min,恒流方式;程序升温,起始温度50℃维持18 min,以100℃/min升温速率升至80℃,再以2℃/min的升温速率升至112℃,再以100℃/min的升温速率升至160℃,维持10 min,再以100℃/min的升温速率升至200℃,维持5 min;气化室温度为250℃;顶空瓶温度90℃,顶空时间40 min,进样时间1 min。[结果]脑脉通软胶囊中各残留溶剂均未检出,6种溶剂在0～40μg/mL的浓度范围内线性关系良好,最小检测限为0.2～2.8μg/mL;精密度RSD小于5.6%(n=5),平均回收率为18.8%～48.3%(RSD为5.1%～6.4%,n=5),所以采用标准加入法进行测定计算;对照品溶液中各成分24 h之内均稳定(RSD为0.5%~8.9%,n=5)。[结论]所建立的方法准确、快速、灵敏,该方法能够控制脑脉通软胶囊中有机溶剂残留量。     

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.     

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.