RETN、IFN-γ、TNF-α及TGF-β在痛风性关节炎患者外周血和滑膜液中的表达及意义

【摘要】 目的 探讨痛风性关节炎患者外周血及滑膜液中尿酸（UA）、抵抗素（RETN）、γ 干扰素（IFN γ）、肿瘤坏死因子 α（TNF α）及转化生长因子 β（TGF β）的表达水平及其临床意义。方法 选择本院2016年5月~2017年7月收治的112例痛风性关节炎患者（40例急性期、35例慢性期和37例间歇期患者）为痛风性关节炎组,另选择35例骨性关节炎患者（骨性关节炎组）和35例身体健康者为对照组。用酶联免疫（ELISA）方法检测各组外周血及滑膜液中UA、RETN、IFN γ、TNF α及TGF β水平,并分析其与临床病理特征的关系。结果 与骨性关节炎组及健康对照组比较,痛风性关节炎组患者外周血及滑膜液中UA、RETN、IFN γ、TNF α及TGF β水平显著升高（P＜005）。与慢性期比较,急性期痛风患者外周血及滑膜液中RETN、IFN γ、TNF α及TGF β水平均显著升高（P＜005）;与间歇期比较,慢性期患者外周血及滑膜液中UA、TNF α、TGF β水平亦显著升高（P＜005）。与病程＜5年组比较,病程≥5年组患者外周血中UA、IFN γ、TNF α及TGF β水平均显著升高（P＜005）;滑膜液中RETN、IFN γ、TNF α及TGF β水平亦显著升高（P＜005）。与受累关节数＜5个组比较,受累关节数≥5个组患者外周血中UA、RETN及TNF α水平均显著升高（P＜005）;滑膜液中RETN、IFN γ、TNF α及TGF β水平亦显著升高（P＜005）。与发作频率＜3次/12个月组比较,发作频率≥3次/12个月组患者外周血中UA、RETN及TNF α水平均显著升高（P＜005）;滑膜液中UA、RETN、TNF α及TGF β水平亦显著升高（P＜005）。痛风患者血清及滑膜液中UA水平与RETN、IFN γ、TNF α及TGF β呈正相关（P＜005）。结论 RETN、IFN γ、TNF α及TGF β在痛风性关节炎患者外周血及滑膜液中均呈高表达,且病情与发展程度有关,提示其在痛风性关节炎的炎症反应过程中可能发挥了重要作用。     

丙戊酸钠联合拉莫三嗪对原发性癫痫患者 外周血细胞因子与疗效的影响

【摘要】 目的 探讨丙戊酸钠与拉莫三嗪联用对原发性癫痫患者疗效、安全性及对外周血TNF α、IL 2水平的影响。方法 纳入2014年3月～2016年3月就诊于本院的确诊为原发性癫痫的患者150例,随机分为对照组和观察组,每组各75例,对照组采用丙戊酸钠单独给药,观察组予以丙戊酸钠联合拉莫三嗪给药。进行随访,比较两组脑电图结果好转时间及异常放电率、治疗后发作频次、自尊量表SES评价分数、外周血TNF α、IL 2水平、总有效率及不良反应情况。结果 观察组脑电图好转时间及异常放电率结果显著低于对照组（P＜005）;观察组3个月及6个月发作频次明显少于对照组（P＜005）;观察组的SES自尊评价平均分数显著高于对照组（P＜005）;两组患者治疗6个月后 TNF α、IFN γ、IL 2、IL 6、 IL 17A水平均比治疗前显著降低（P均＜005）,且观察组的 TNF α、IFN γ、IL 2、IL 6、 IL 17A水平均显著低于对照组（P均＜005）,但两组IL 10、IL 4、IL 23和IL 1β治疗前后无显著差异（P＞005）;观察组总有效率显著高于对照组（P＜005）;观察组不良反应出现率显著低于对照组（P＜005）。结论 丙戊酸钠与拉莫三嗪联合治疗原发性癫痫疗效确切,能更好地降低血TNF α、IL 2水平,副作用较小,可在临床推广。     

戊乙奎醚预处理对内毒素性脑损伤大鼠CD14和TLR4mRNA的影响

【摘要】 目的 探讨盐酸戊乙奎醚预处理对内毒素性脑损伤大鼠CD14和TLR4mRNA的影响。方法 将40只Wistar大鼠随机分为生理盐水对照组（NS组）,内毒素性脑损伤模型组（LPS组）,低剂量戊乙奎醚干预组（PL组）,高剂量戊乙奎醚干预组（PH组）4组,每组各10只,实验大鼠注射内毒素4h后处死,留取脑组织标本。光镜下观察脑组织病理变化,RT PCR法检测CD 14和TLR4 mRNA表达,ELISA法测定TNF a的含量。结果 光镜下LPS组脑细胞损伤严重,PL组、PH组与LPS组对比脑损伤减轻。与NS组相比较,LPS组、PL组及PL组脑组织TLR4和CD14 mRNA表达水平均升高（P＜005）;与LPS组比较,PL组和PH组脑组织TLR4和CD14 mRNA表达水平均降低（P＜005）;与PL组比较,PH组TLR4和CD14 mRNA表达水平降低（P＜005）。与NS组相比较,TNF α含量升高（P＜005）;与LPS组比较,PL组和PH组脑组织TNF α含量降低（P＜005）;与PL组比较,PH组TNF α降低（P＜005）。结论 盐酸戊乙奎醚预处理可减轻大鼠内毒素的脑损伤,机制可能与降低CD14及TLR4mRNA的表达,阻断炎症信号传导通路,减轻炎症介质的释放有关。     

新生儿呼吸窘迫综合征与感染性肺炎患儿血清炎症因子和甲状腺激素的变化及相关性分析

【摘要】 目的 探讨新生儿呼吸窘迫综合征（neonatal respiratory distresssyndrome, NRDS）、感染性肺炎患儿血清炎症因子和甲状腺激素的变化情况及相关性。方法 选取NRDS患儿（NRDS组）、感染性肺炎患儿（感染性肺炎组）及正常新生儿（对照组）,每组各35例,三组均做炎症因子白细胞介素 6（IL 6）、肿瘤坏死因子 α（TNF α）及甲状腺激素检测,同时疾病患儿给予对症治疗,对比其不同阶段检测结果差异并做相关性分析。结果 NRDS组治疗前T3、T4、FT3、FT4、γT3、IL 6、TNF α与对照组比均有明显差异（P＜005）;组内比较,治疗后患儿T3、T4、FT3、FT4明显升高,IL 6明显降低（P＜005）;治疗后NRDS仅γT3明显低于对照组（P＜005）,其他指标无明显差异（P＞005）。感染性肺炎组患儿较对照组T3明显降低（P＜005）,TSH、IL 6、TNF α明显升高（P＜005）,治疗后T3与治疗前相比明显升高,TSH、IL 6、TNF α明显降低（P＜005）,且治疗后患儿各指标与对照组比无明显差异（P＞005）;相关性分析显示,新生儿呼吸窘迫组血清IL 6和T3、T4、FT3、FT4等甲状腺激素为负相关（r依次为 0794、 0572、 0369、 0517,P依次为0000、0000、0029、0001）;感染性肺炎组患儿血清IL 6、TNF α和T3为负相关（r依次为 0887、 0783,P依次为0000、0000）。结论 新生儿呼吸窘迫组血清IL 6和T3、T4、FT3、FT4等甲状腺激素为负相关,感染性肺炎组患儿血清IL 6、TNF α和T3为负相关,测定甲状腺素水平在监测病情轻重中具有一定的临床参考价值。     

施他宁联合血必净治疗重症急性胰腺炎的疗效及其对患者血清细胞因子水平的影响

【摘要】 目的 探讨施他宁联合血必净治疗重症急性胰腺炎的疗效及其对患者血清白细胞介素10（IL 10）、白细胞介素18（IL 18）、肿瘤坏死因子α（TNF α）水平的影响。方法 选择2016年9月～2017年2月我院接诊的80例重症急性胰腺炎患者为研究对象,按照抽签法将患者分为实验组和对照组,每组40例。对照组在常规治疗的基础上给予施他宁治疗,实验组在对照组治疗方案基础上联合血必净治疗。比较两组治疗中的临床症状减轻及恢复时间,血检结果,尤其是血清淀粉酶的指标恢复;另外,比较两组血清IL 10、IL 18、TNF α水平。结果 治疗前,两组血清淀粉酶、血尿素氮、血糖、白细胞记数,IL 10、IL 18、TNF α比较差异无统计学意义（P＞005）;治疗后,实验组总有效率高于对照组（P＜005）,血清淀粉酶、血尿素氮、血钙、血糖、白细胞记数治疗前后差值大于对照组（P＜005）。治疗后,两组血清IL 10显著上升,IL 18、TNF α显著下降,实验组IL 10、IL 18、TNF α治疗前后差值大于对照组,差异均有统计学意义（P＜005）。结论 施他宁联合血必净治疗能提高重症急性胰腺炎的疗效,能够有效恢复血清IL 10水平、降低血清IL 18、TNF α水平。     

全氟化碳对脂多糖诱导肺泡上皮细胞炎性反应及单免疫球蛋白白介素1相关蛋白表达的影响

【摘要】 目的 探讨全氟化碳（PFC）对脂多糖（LPS）诱导人肺泡上皮A549细胞炎性反应及单免疫球蛋白白介素 1受体相关蛋白（SIGIRR）表达的影响。方法 实验分为正常细胞组、全氟化碳+脂多糖（PFC+LPS）组、全氟化碳（PFC）组及脂多糖（LPS）组。各组细胞经相应处理24 h后,用酶联免疫吸附法（ELISA）检测培养上清中的TNF α、IL 6和IL 10含量,用蛋白免疫印迹法（Western blot）检测核转录因子 κB （NF κB）和SIGIRR的表达。结果 ELISA结果显示,LPS组TNF α、IL 6水平较正常细胞组升高（P＜005）;PFC+LPS组TNF α、IL 6水平较LPS组下降（P＜005）;与正常细胞组相比,PFC组IL 10水平升高（P＜005）,PFC+LPS组IL 10水平较LPS组升高（P＜005）。Western blot 结果显示,与正常细胞组相比,LPS组核内磷酸化NF κB p65表达上调（P＜005）,PFC+LPS组核内磷酸化NF κB p65表达水平较LPS组降低（P＜005）;与正常细胞组相比,LPS组SIGIRR表达水平下调（P＜005）,PFC+LPS组SIGIRR表达水平较LPS组上调（P＜005）。PFC本身对TNF α、IL 6含量及NF κB p65表达无影响,但PFC可促进A549细胞释放IL 10及上调SIGIRR表达（P＜005）。结论 PFC可减轻A549细胞对LPS诱导的炎性反应,促进抗炎因子IL 10分泌及上调负调控分子SIGIRR表达是可能的分子机制。     

盐酸氨基葡萄糖对膝关节骨性关节炎患者血清IL-1β、IL-6、TNF- α的影响

【摘要】 目的 研究盐酸氨基葡萄糖对膝关节骨性关节炎患者血清白介素 1β（IL 1β）、白介素 6（IL 6）、肿瘤坏死因子 ɑ（TNF α）的影响。方法 回顾性分析本院2014年4月～2016年2月收治的100例膝关节骨性关节炎患者的临床资料。按照不同治疗方式将患者分成两组,每组50例,观察组予以盐酸氨基葡萄糖治疗,对照组予以美洛昔康治疗,两组患者同时治疗1个疗程（8周为1个疗程）。采用酶联免疫吸附法（ELISA）检测两组患者治疗前、后血清IL 1β、IL 6、TNF α水平变化情况。同时观察两组患者治疗前、后膝关节功能LKSS评分、疼痛VAS评分、缓解疼痛时间的变化及治疗过程中有无明显不良反应。结果 治疗前,两组患者血清IL 1β、IL 6、TNF α水平比较差异无统计学意义（P>005）;治疗后,观察组血清IL 1β、IL 6、TNF α表达水平明显低于对照组（P<005）;治疗前,两组患者膝关节功能LKSS评分比较无差异（P>005）;治疗后,观察组患者膝关节功能LKSS评分明显高于对照组（P<005）,两组患者同治疗前比较均有差异（P<005）;治疗前、后两组患者疼痛评分、疼痛缓解时间、不良反应情况比较均无差异（P<005）。结论 膝关节骨性关节炎患者各种炎症因子的表达明显上升,盐酸氨基葡萄糖能够抑制膝关节骨性关节炎患者血清IL 1β、IL 6、TNF α的上升,改善患者的膝关节功能,可在临床推广应用。     

miR-487b/IL-33/ST2在脓毒症中的表达及意义

【摘要】 目的 探讨miR 487b/IL 33/ST2在脓毒症中的表达及意义。方法 选取2015年1月～2017年12月在西安交通大学第二附属医院ICU收治的80例脓毒症患者（脓毒症组）及同期行健康检查的80例志愿者（对照组）。ELISA检测血清白介素 33（IL 33）及生长抑素2（ST2）水平;qRT PCR检测血清miR 487b表达进行对比。选取成年雄性C57BL/6小鼠60只,随机分为空白组、假手术组、脓毒症模型组、脓毒症+IL 33组、浓毒症+miR 487mimics组、脓毒症+miR 487mimics+IL 33组,每组10只。RT PCR检测小鼠血清中IL 33、ST2、miR 487b、肿瘤坏死因子 α（TNF α）及IL 6水平变化。荧光素酶报告实验验证miR 487b及IL 33相关性。结果 脓毒症患者血清IL 33、ST2明显升高,miR 487b下调（P＜005）;脓毒症小鼠血清IL 33、TNF α、IL 6上调,miR 487b下调（P＜005）,miR 487b表达恢复可部分逆转IL 33、TNF α及IL 6的上调。荧光素酶报告实验证实miR 487b可直接负向调控IL 33表达（P＜005）。结论 miR 487b可以负向调控IL 33/ST2信号通路,诱导TNF-α和IL-6表达降低,减轻脓毒症炎症反应,有望成为脓毒症治疗的新分子靶点。     

血清胃蛋白酶原联合肿瘤坏死因子α检测在幽门螺杆菌相关性胃疾病诊断中的意义

【摘要】目的 检测幽门螺杆菌（Hp）相关性胃疾病患者血清中胃蛋白酶原（PG）与肿瘤坏死因子（TNF α）,并探讨PG与TNF α在Hp相关性胃疾病诊断中的意义。方法 选取2018年1月~2019年3月于本院接受治疗的237例Hp相关性胃疾病患者为研究对象作为Hp相关性胃疾病组,其中73例为非萎缩性胃炎,66例为萎缩性胃炎,68例为消化性溃疡,30例为胃癌;同期选取195例健康体检者作为对照组（CG组）。采用乳胶免疫比浊法检测各组血清中的PGⅠ、PGⅡ以及酶联免疫吸附法（ELISA）TNF α水平,同时检测各组患者Hp感染情况;分析PGⅠ、PGⅡ及PGR和TNF α对Hp相关性胃疾病的诊断价值。结果 Hp相关性胃疾病组血清中TNF α、PGⅠ、PGⅡ水平均显著高于CG组,PGR水平显著低于CG组（P＜005）;萎缩性胃炎患者血清中PGⅠ、PGR水平显著低于非萎缩性胃炎（P＜005）;消化性溃疡患者血清中TNF α、PGⅡ水平显著高于非萎缩性胃炎和萎缩性胃炎,PGⅠ水平显著高于萎缩性胃炎,PGR水平低于非萎缩性胃炎高于萎缩性胃炎（P＜005）;胃癌患者血清中PGⅠ、PGR水平显著低于非萎缩性胃炎、萎缩性胃炎及消化性溃疡,TNF α、PGⅡ水平高于非萎缩性胃炎和萎缩性胃炎（P＜005）;Hp阳性的非萎缩性胃炎、萎缩性胃炎患者血清中TNF α水平均显著高于Hp阴性组（P＜005）;Hp阳性的萎缩性胃炎、消化性溃疡、胃癌患者血清中PGⅠ水平均显著高于Hp阴性组（P＜005）;Hp阳性的非萎缩性胃炎、萎缩性胃炎、消化性溃疡、胃癌患者患者血清中PGⅡ、PGR水平均显著高于Hp阴性组（P＜005）;TNF α、PGⅠ、PGⅡ、PGR诊断Hp相关性胃疾病患者的AUC分别为0842（95%CI:0807~0877）、0.844（95%CI:0808~0879）、0864（95%CI:0831~0896）、0874（95%CI:0789~0906）,截断值分别为14563、114404、25483、4710,特异性分别为645%、698%、755%、657%,敏感度分别为897%、877%、862%、959%;PGⅠ、PGⅡ、PGR分别与TNF α联合诊断Hp相关性胃疾病患者的AUC分别为0922（95%CI:0898~0945）、0925（95%CI:0902~0948）、0937（95%CI:0916~0951）,特异性分别为792%、857%、804%,敏感度为933%、851%、938%。结论 PGⅠ、PGⅡ、PGR联合TNF α可作为诊断Hp相关性胃疾病的参考指标,对Hp感染胃疾病的癌前病变及早期胃癌诊断有重要意义。     

硫糖铝混悬液联合奥美拉唑肠溶片治疗隆起糜烂性胃炎

【摘要】目的 探讨硫糖铝混悬液联合奥美拉唑肠溶片治疗隆起糜烂性胃炎（REG）的疗效。方法 选取2016年5月~2019年5月四川大学华西医院收治的REG患者82例,采取抽签法随机分为观察组和对照组,每组各41例。观察组患者予以硫糖铝混悬液联合奥美拉唑肠溶片治疗,对照组患者予以奥美拉唑肠溶片治疗,幽门螺杆菌（Hp）阳性患者予以抗生素进行根除Hp治疗。比较两组患者临床疗效、Hp转阴率的差异性,观察治疗前后血清胃蛋白酶原（PGⅠ、PGⅡ）、胃泌素 17（GAS 17）、炎症因子［白介素 8（IL 8）、IL 10、肿瘤坏死因子 α（TNF α）］水平及胃黏膜组织中表皮生长因子（EGF）、碱性成纤维细胞生长因子（bFGF）、抗原Ki 67表达情况。结果 观察组患者治疗总有效率高于对照组（P＜005）;两组患者Hp转阴率比较差异无统计学意义（P＞005）;治疗8周后,两组患者血清PGⅠ、GAS 17水平和PGR均较治疗前升高,且观察组高于对照组（P＜005）,血清PGⅡ、IL 8、IL 10、TNF α水平较治疗前降低,且观察组低于对照组（P＜005）;治疗8周后,两组患者胃黏膜EGF、bFGF、Ki 67表达水平均较治疗前降低,且观察组低于对照组（P＜005）。结论 硫糖铝混悬液联合奥美拉唑肠溶片治疗REG具有良好的协同作用,可有效减轻炎症反应,促进胃黏膜功能恢复,有利于疾病转归。     

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.