补阳还五汤在急性脊髓损伤中的治疗作用

目的 观察补阳还五汤（BYHWD）在急性脊髓损伤（ASCI）中的治疗作用及潜在机制。方法 SD 大鼠随机分为空白组、损伤对照组、BYHWD治疗组,采用ALLEN’S打击法建立急性脊髓损伤模型,各组分别于术后1、7、14d观察其行为学BBB评分,14d通过免疫组化的方法观察脊髓损伤部位神经细胞凋亡(caspase-3p20、Bcl-2与Bax)、血管内皮生长因子（VEGF）的表达水平。结果 （1）行为学观察评分：BYHWD治疗组与损伤对照组下肢功能均有恢复(P＜0.05）,且BYHWD治疗组较损伤对照组恢复更明显(P＜0.05）;（2）免疫组化检测：caspsase-3阳性细胞数BYHWD治疗组表达较损伤对照组少(P＜0.05）;Bcl-2阳性细胞BYHWD治疗组的表达较损伤对照组多(P＜0.05）;Bax阳性的细胞BYHWD治疗组的表达较损伤对照组少(P＜0.05）;VEGF阳性的细胞BYHWD治疗组的表达较损伤对照组多(P＜0.05）。结论 BYHWD可提高脊髓损伤部位VEGF的表达,使细胞凋亡明显减少,从而促进功能的恢复的作用,因此BYHWD有可能成为治疗脊髓损伤的药物之一。     

3D打印支架联合iPSCs-NSCs对大鼠脊髓损伤后神经细胞凋亡及运动功能的影响

目的探讨3D打印支架载重编程诱导性多能干细胞(iPSCs)-神经干细胞(NSCs)移植对大鼠脊髓损伤的作用机制。方法制备3D脊髓支架,将人尿液细胞来源iPSCs分化为NSCs,选择成年雄性SD大鼠42只,按随机数字表法分为假手术组、模型组、iPSCs-NSCs组,每组14只。采用改良Allen's重物打击法制作脊髓损伤大鼠模型,1周后假手术组不做处理,模型组植入DMEM培养液0.2mL,i PSCs-NSCs组植入载iPSCs-NSCs的2～3mm支架预处理。于实验干预后1、3、7、14、28天采用BBB评分评估大鼠运动能力,28天后处死大鼠,苏木精-伊红(HE)染色观察伤段脊髓组织改变;免疫组化与RT-PCR检测脊髓组织中Bax、Bcl-2、Caspase-3的表达。结果 (1)BBB评分:术后7、14、28天iPSCs-NSCs组与模型组下肢功能均有恢复(P0.05),且iPSCs-NSCs组较模型组恢复更明显[(3.76±0.65)分比(2.22±0.46)分,(7.02±0.68)分比(4.41±0.42)分,(11.72±0.81)分比(7.52±0.53)分,P0.05]。(2)HE染色:假手术组脊神经生长良好;模型组脊神经受损,组织水肿,细胞稀疏,细胞之间的间隙增大;iPSCs-NSCs组细胞生长较模型组紧密,各组织生长间隙缩小,空泡减小,组织水肿消失。(3)免疫组化检测:iPSCs-NSCs组Bcl-2阳性细胞的表达较模型组增加[(0.32±0.02)个/mm~2比(0.14±0.01)个/mm~2,P0.05],Bax阳性细胞的表达较模型组减少[(0.08±0.00)个/mm~2比(0.23±0.02)个/mm~2,P0.05];(4)RT-PCR检测:iPSCs-NSCs组Caspase-3 mRNA表达较模型组减少[(0.96±0.07)比(1.33±0.03),P0.05]。结论 3D打印支架联合iPSCs-NSCs移植可以显著改善脊髓损伤引起的运动功能下降,其机制可能与上调Bcl-2表达及下调Bax、Caspase-3表达,降低脊髓神经元细胞凋亡相关。     

补阳还五汤对脊髓损伤后胶质瘢痕及GFAP表达的影响

目的探讨补阳还五汤对脊髓损伤(SCI)后胶质瘢痕及胶质纤维酸性蛋白(GFAP)表达的影响.方法成年雌性SD大鼠24只,随机分为假手术组、实验组和对照组,每组8只,实验组和对照组在C3～4右外侧索横断后分别以补阳还五汤和蒸馏水连续灌胃8 w,取脊髓损伤部位,行苏木素染色和GFAP免疫组化染色,对胶质瘢痕的体积、GFAP阳性细胞相对面积和相对灰度值进行测定.结果实验组胶质瘢痕的体积小于对照组(P＜0.01);实验组GFAP阳性细胞相对面积和相对灰度值明显低于对照组(P＜0.01).结论补阳还五汤能减少脊髓损伤后胶质瘢痕的体积,抑制星形胶质细胞的活化和增生.     

补阳还五汤对大鼠脑缺血再灌注损伤后神经细胞凋亡和Caspase-3基因表达的影响

目的:研究补阳还五汤对大鼠脑缺血再灌注损伤后神经细胞凋亡和Caspase-3基因表达的影响。方法:成年健康雌性Wistar大鼠40只,随机选取10只作为假手术组,其余应用线栓法建立大鼠大脑中动脉闭塞-再灌注模型,将造模成功的20只大鼠随机分为阴性对照组,补阳还五汤治疗组(补阳还五汤组),每组10只。补阳还五汤组经腹腔注射补阳还五汤(用量为每公斤体重16 g)治疗,阴性对照组和假手术组给予等量的0.1mol/L PBS缓冲液腹腔注射。原位末端标记(TUNEL)技术检测神经细胞凋亡,免疫组化技术和酶联免疫(ELISA)技术检测Caspase-3的表达。结果:假手术组大鼠皮质、纹状体、海马区脑组织凋亡细胞数量较少,呈散在分布,而Caspase-3表达微弱。阴性对照组大鼠脑组织各区凋亡细胞数量较假手术组显著增多(P0.05),Caspase-3表达增强,显著高于假手术组(P0.05)。补阳还五汤组各区脑组织TUNEL阳性细胞数量及Caspase-3表达均明显低于阴性对照组(P0.05)。结论:补阳还五汤可下调Caspase-3表达而抑制大鼠脑缺血再灌注损伤诱导的细胞凋亡。     

补阳还五汤对氧化应激诱导心肌细胞凋亡及5-LOX表达的影响

目的探讨补阳还五汤对氧化应激诱导乳鼠心肌细胞凋亡及5脂氧合酶(5-LOX)表达的影响。方法 SD乳鼠心肌细胞原代培养,不同剂量补阳还五汤预处理24 h后过氧化氢(H2O2)诱导心肌细胞氧化损伤。采用MTT法测定细胞活力,流式细胞术检测心肌细胞凋亡情况,Western-blot检测5脂氧合酶(5-LOX)、Bax和Bcl-2的表达。结果 MTT结果显示,与对照组及补阳还五汤组比较,H2O2组心肌细胞活力显著降低(P0.01);与H2O2组相比,补阳还五汤组心肌细胞活力显著提高(P0.01)。流式细胞仪分析显示,H2O2组心肌细胞凋亡率为(19.47±1.31)%,明显高于对照组的(1.36±2.30)%,差异有统计学意义(P0.01);补阳还五汤低、中、高剂量组的细胞凋亡百分率分别为(13.25±2.84)%、(11.50±3.43)%、(9.94±4.01)%,明显低于H2O2组(19.47±1.31)%,差异有统计学意义(P0.01)。Western-blot结果显示,H2O2组心肌细胞Bcl-2蛋白表达比对照组及补阳还五汤组减少,5-LOX及Bax蛋白表达比对照组及补阳还五汤组高,差异均有统计学意义(P0.01)。不同剂量的补阳还五汤组Bcl-2蛋白表达高于H2O2组,5-LOX及Bax蛋白表达比H2O2组少(P0.01)。结论补阳还五汤能显著抑制氧化应激诱导的乳鼠心肌细胞凋亡,并且呈剂量依赖性,补阳还五汤抑制心肌细胞凋亡的作用可能与抑制5-LOX表达有关。     

补阳还五汤对血管性痴呆大鼠海马NR2B蛋白及其mRNA表达的影响

目的 观察补阳还五汤对血管性痴呆(vascular dementia,VD)大鼠海马N-甲基-D-门冬氨酸受体亚单位2B(N-Methyl-D-asparate receptor subunit 2B,NR2B)蛋白及其mRNA表达的影响,探讨补阳还五汤治疗VD的机制.方法 四血管阻断(four vessel occlusion,4VO)法制备VD大鼠模型.设立假手术组、VD模型组、尼莫地平组(20mg·kg-1·d-1,灌胃30d)和补阳还五汤治疗组(50g生药·kg-1·d-1,灌胃30d).Morris水迷宫检测大鼠学习记忆能力的改变,免疫组化和Western-Blot技术检测大鼠海马神经元NR2B蛋白的变化,实时荧光定量PCR技术检测大鼠海马NR2B mRNA表达的变化.结果 与假手术组大鼠逃避潜伏期[(24.18±7.90)s]和平均探索次数[(7.99±1.32)次/min]相比,VD模型组大鼠逃避潜伏期[(51.25±18.28)s]延长和平均探索次数[(5.26±0.74)次/min]减少(P<0.05);补阳还五汤组[(25.91±9.56)s和(7.52±1.27)次/min]明显改善了模型大鼠学习、记忆成绩(P<0.05);假手术组、尼莫地平组与补阳还五汤治疗组之间差异无显著性(P>0.05).VD模型组大鼠的NR2B蛋白(0.33±0.06)及其mRNA(593±53)表达水平较假手术组(0.71 ±0.13)、(5887±501)明显降低(P<0.05);补阳还五汤治疗组大鼠海马的NR2B蛋白(0.66±0.11)及其mRNA(5692±482)表达水平较模型组的表达明显升高(P<0.05);假手术组、尼莫地平组组与补阳还五汤治疗组之间差异无显著性(P>0.05).结论 补阳还五汤可以改善VD大鼠学习记忆能力,其机制可能与减轻脑缺血再灌注对海马CAI区神经元的损伤及促进海马组织NR2B蛋白及其mRNA的表达有关.     

督脉电针联合康复训练对脊髓损伤模型大鼠NGF、bFGF、BDNF表达的影响

目的研究督脉电针联合康复训练对脊髓损伤模型大鼠神经生长因子(NGF)、碱性成纤维细胞生长因子(bFGF)、脑源性神经营养因子(BDNF)表达的影响。方法将64只成年健康雌性SD大鼠按照随机数字表法分成对照组、督脉电针组、康复训练组、督脉电针联合康复训练组,每组再分成4周组、8周组两个亚组,共8组,每组8只。建立大鼠脊髓损伤模型,各治疗组给予不同方案干预,对各组大鼠分别采用Basso,Beattie and Bresnahan行为评分法(BBB)评分,采用蛋白免疫印迹法(WB)测定NGF、bFGF、BDNF表达。结果 BBB评分:4周亚组中,督脉电针组、督脉电针联合康复训练组BBB评分较对照组明显升高[(13.26±0.38)分、(15.35±0.42)分比(6.48±0.37)分,P均0.05],康复训练组与对照组比较,差异无统计学意义(P0.05)。8周亚组中,督脉电针组、康复训练组、督脉电针联合康复训练组BBB评分较对照组明显升高[(16.41±0.75)分、(13.53±1.20)分、(18.94±0.92)分比(9.21±0.51)分,P均0.05],且督脉电针联合康复训练组高于督脉电针组、康复训练组[(18.94±0.92)分比(16.41±0.75)分、(13.53±1.20)分,P均0.05];与督脉电针联合康复训练4周组相比,督脉电针联合康复训练8周组BBB评分升高更显著[(18.94±0.92)分比(15.35±0.42)分,P0.05]。NGF、bFGF、BDNF的表达:4周亚组中,督脉电针组、督脉电针联合康复训练组显著高于对照组[NGF:(0.45±0.04)、(0.60±0.01)比(0.26±0.05);bFGF:(0.52±0.04)、(0.59±0.02)比(0.31±0.03);BDNF:(0.47±0.07)、(0.61±0.07)比(0.23±0.04),P均0.05];康复训练组与对照组比较,差异无统计学意义(P0.05)。8周亚组中,督脉电针组、康复训练组、督脉电针联合康复训练组表达明显高于对照组[NGF:(0.67±0.09)、(0.59±0.02)、(0.85±0.10)比(0.31±0.01);bFGF:(0.64±0.05)、(0.53±0.02)、(0.77±0.06)比(0.30±0.05);BDNF:(0.66±0.01)、(0.58±0.05)、(0.75±0.05)比(0.24±0.06),P均0.05],且督脉电针联合康复训练组高于督脉电针组、康复训练组[NGF:(0.85±0.10)比(0.67±0.09)、(0.59±0.02);b FGF:(0.77±0.06)比(0.64±0.05)、(0.53±0.02);BDNF:(0.75±0.05)比(0.66±0.01)、(0.58±0.05),P均0.05]。结论督脉电针、康复训练能通过增加受损脊髓神经营养因子的表达促进脊髓损伤模型大鼠功能恢复。     

补阳还五汤对大鼠局灶性脑缺血后血管内皮生长因子及其受体Flk1的影响

目的探讨补阳还五汤对大鼠局灶性脑缺血后血管内皮生长因子(VEGF)及其受体(Fetal liver kinase1,Flk1)的影响。方法大鼠随机分为假手术组、模型组、尼莫地平组、补阳还五汤组,大脑中动脉线栓法复制局灶性脑缺血模型,采用免疫组织化学法和酶联免疫法检测各组动物脑内VEGF、Flk1的表达和蛋白水平,同时评价动物神经功能。结果在正常大鼠脑内有少量VEGF和Flk1阳性细胞,脑缺血后VEGF和Flk1阳性细胞增加;与模型组比较,尼莫地平、补阳还五汤均能改善模型大鼠的神经功能缺失症状,增强VEGF和Flk1的表达,提高VEGF蛋白水平(P<0.05);于7、14d补阳还五汤作用强于尼莫地平(P<0.05)。结论补阳还五汤增强大鼠局灶性脑缺血后VEGF及Flk1的表达和提高VEGF蛋白水平,是其抗脑缺血的可能作用机制之一。     

补阳还五汤对脊髓损伤大鼠脊髓组织血小板活化因子受体mRNA表达的影响

[目的]观察补阳还五汤对脊髓损伤(SCI)模型大鼠脊髓组织血小板活化因子受体(PAF-R)mRNA表达的影响.[方法]选用SPF级Wistar大鼠,随机分为4组:正常组、模型组、补阳还五汤组(剂量为40 g·kg-1·d-1)、金纳多组(剂量为45.5 mg·kg-1·d-1);采用Allen's法复制中度SCI模型,造模成功后观察1周;连续给药2周后,取各组脊髓组织,采用实时逆转录聚合酶链反应(RT-PCR)法检测各组脊髓组织PAF-R mRNA表达水平.[结果]模型组大鼠脊髓组织PAF-R mRNA表达显著降低(P＜0.01);补阳还五汤组及金纳多组均可抑制脊髓组织PAF-R mRNA表达,与模型组比较差异有显著性意义(P＜0.01),而两给药组之间比较无显著性差异(P＞0.05).[结论]补阳还五汤对损伤脊髓的保护作用可能与其能减少PAF-R数目,抑制PAF-R活性,从而阻断PAF发挥损伤效应有关.     

补阳还五汤对脊髓损伤大鼠脊髓组织 Caspase －3表达的影响

目的：观察补阳还五汤对脊髓损伤（SCI）后大鼠脊髓神经细胞凋亡相关蛋白 Caspase －3及 mRNA表达的影响,初步探讨补阳还五汤抑制脊髓神经细胞凋亡的作用机制。方法Wistar 大鼠40只,随机分为正常对照组、SCI 模型组、补阳还五汤组和阳性药物对照（MP）组,每组10只。各组分别于建立 SCI 模型后1、7、14、21、28 d 观察大鼠后肢运动功能恢复情况并进行 BBB 功能评分,观察大鼠 SCI 模型建立及恢复情况,并于第28天处死各组大鼠,采用 real －time PCR 法检测脊髓组织 Caspase －3 mRNA 的表达情况,Western blot 法检测脊髓组织 Caspase－3蛋白的表达情况。结果大鼠麻醉清醒后,SCI 模型组大鼠损伤平面以下完全瘫痪。 BBB 评分结果显示：术后第1～28天,与正常对照组比较,SCI 模型组 BBB 评分明显降低（P ＜0．05）;术后第7～28天,与 SCI 模型组比较,补阳还五汤组和 MP 组大鼠 BBB 评分明显增高（P ＜0．05）;补阳还五汤组和 MP 组大鼠 BBB 评分差异无统计学意义。 Real －time PCR 和 Western blot 结果显示：与正常对照组比较,SCI 模型组 Caspase －3蛋白及 mRNA 表达明显升高（P ＜0．05）;与 SCI 模型组比较,补阳还五汤组和 MP 组大鼠脊髓组织 Caspase －3蛋白及 mRNA 表达明显降低（P ＜0．05）。补阳还五汤组和 MP 组大鼠脊髓 Caspase －3蛋白及 mRNA 表达差异无统计学意义。结论补阳还五汤可改善 SCI 大鼠后肢运动功能,通过下调 Caspase －3的表达,从而抑制 SCI 大鼠脊髓神经细胞的凋亡,对脊髓神经细胞有保护作用。     

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.