益气通络方对大鼠短暂性脑缺血后海马DND的保护作用

目的：探讨益气通络方对大鼠短暂性脑缺血后海马迟发性神经元死亡（ＤＮＤ）的保护作用及其机制。方法：用Ｐｕｌｓｉｎｅｌｌｉ四血管闭塞法制作全服缺血模型。实验动物随机分为假手术对照组、脑缺血加生理盐水组和脑缺血加益气通络方组。缺血再灌３天后进行ＨＥ染色、ＴＵＮＥＬ染色。结果：①ＨＥ染色,光镜下观察ＣＡ１区组织病理学变化,并用显微测微尺测量ＣＡ１区存活锥体细胞密度（存活锥体细胞的上数／ｍｍ）,表明益气通络     

亚低温对大鼠短暂性脑缺血迟发性神经元死亡的影响

目的 观察亚低温（33℃）对大鼠短暂性脑缺血后神经元的保护作用。方法 32只DS大鼠分为假手术组、常温缺血组和即刻亚低温组，采用尼氏体亚甲蓝特殊染色观察存活神经元、原位细胞凋亡检测法（TUNEL染色）检测及电镜观察脑缺血后大鼠CA1区神经元凋亡情况。结果 与假手术组相比，常温缺血组海马CA1区存活的锥体细胞数目减少（P＜0．01）；与常温缺血组相比，亚低温缺血组海马CA1区存活的锥体细胞数目明显增多（P＜0．01）。亚低温缺血组大鼠海马CA1区TUNEL染色阳性细胞数目明显少于常温缺血组（P＜0．01）。结论 脑缺血后迟发性神经元死亡很可能通过凋亡途径，亚低温对缺血后神经元的保护作用与减少神经元凋亡有关。     

促红细胞生成素对大鼠全脑缺血再灌注后海马 CA1区神经元的保护作用

目的　观察促红细胞生成素 (EPO)对短暂性全脑缺血再灌注后海马神经元凋亡的影响 ,探讨其对缺血脑组织的保护作用。方法　应用四动脉血流阻断法制作大鼠短暂性全脑缺血再灌注模型 ;于再灌注开始时经腹腔注入EPO(3 0 0 0U/Kg) ;48h后灌注取脑。H -E染色观察细胞死亡情况。应用末端脱氧核苷酸转移酶缺口标记 (TUNEL)法检测海马CA1区神经元凋亡情况。结果　全脑短暂缺血 15min再灌注后 48h ,H -E染色海马CA1区存活神经元细胞数正常组为 2 11.2 8± 7.95,假手术组为 2 0 9.2 8± 11.3 4 ,EPO治疗组为 170 .2 8± 8.12 ,缺血组为14 6.84± 8.3 5。EPO治疗组与缺血组比较有显著性差异 (P <0 .0 1)。TUNEL法凋亡细胞测定 ,正常组无阳性细胞 ,假手术组单位面积内阳性细胞为 152 .48± 18.52 ,EPO治疗组阳性细胞为 1797.51± 151.3 5,缺血组阳性细胞为2 2 50 .41± 180 .0 6,后两者比较有显著性差异 (P <0 .0 1)。结论　EPO可减少大鼠短暂性全脑缺血脑组织神经元的死亡和凋亡 ,对缺血神经元具有保护作用     

内侧隔区预毁损对海马CA1区迟发性神经元死亡的影响

目的 :探讨乙酰胆碱 (ACh)对短暂性全脑缺血再灌后海马CA1区迟发性神经元死亡 (DND)的作用。方法 :46只健康雄性Wistar大鼠随机分为 3组 :Ⅰ 手术对照组 ;Ⅱ MS假性损毁脑缺血再灌组 ;Ⅲ MS预损毁缺血再灌组 ,动物先行MS损毁 ,第 15天再行 4 VO ,使脑缺血 2 0min恢复灌注 72h后取材 ,采用NissleHE和TUNEL染色 ,在光镜下观测计数 ,经统计学处理。结果 :①Ⅱ、Ⅲ组缺血再灌后海马CA1出现迟发性神经元死亡 ;②Ⅲ组较Ⅱ组迟发性神经元损伤明显减轻。结论 :乙酰胆碱参与短暂性全脑缺血再灌后海马CA1区迟发性损伤过程 ,MS预毁损能使死亡细胞明显减少     

亚低温对大鼠短暂性脑缺血后APE／Ref-1表达、神经元凋亡的影响

目的　 (1 )探讨短暂性脑缺血后无嘌呤 /无嘧啶核酸内切酶 /氧化还原因子 - 1 (APE/ Ref- 1 )在海马 CA1区的变化过程。 (2 )探讨短暂性脑缺血后海马 CA1区发生的神经元凋亡情况。 (3)探讨 APE/ Ref- 1在海马 CA1区的变化及其与该区神经元凋亡的内在联系。 (4 )探讨采取亚低温干预措施后APE/ Ref- 1与神经元凋亡在短暂性脑缺血后海马 CA1区的变化。 (5 )探讨亚低温干预后 APE/ Ref- 1的变化在亚低温脑保护中的作用。　方法　采用大鼠短暂性脑缺血模型及亚低温方法 ,通过神经元尼氏体染色、TU NEL 染色、APE/ Ref- 1蛋白免疫组织化学染色、APE/ Ref- 1蛋白免疫组织化学与TU NEL双重染色等方法 ,观察短暂性脑缺血后海马 CA1区神经元存活、凋亡、APE/ Ref- 1蛋白表达情况及亚低温的影响。　结果　 (1 )与假手术组相比 ,常温缺血组脑海马CA1区神经元缺失远较亚低温缺血组多 (P<0 .0 1 )。 (2 )常温缺血组及亚低温缺血组脑海马 CA1区均存在神经元凋亡。亚低温缺血组神经元凋亡出现的时间比常温缺血组迟 ,且凋亡数较常温组少 (P<0 .0 1 )。 (3)假手术组海马 CA1区神经元广泛表达 APE/ Ref- 1蛋白 ,常温缺血组及亚低温缺血组缺血后 APE/ Ref- 1蛋白表达均有下降 ,亚低温缺血组APE/ Ref- 1蛋白表达下降程度较常     

高血糖对短暂脑缺血海马CA1区迟发性神经元死亡的影响

目的 :通过对大鼠局灶性脑缺血再灌注海马 CA1区神经元形态学观察 ,探讨高血糖对海马迟发性神经元死亡的影响。方法 :术前给大鼠腹腔内注射生理盐水和葡萄糖造成正常血糖和高血糖状态 ,参考 Zea- L onga法制备大脑中动脉阻塞及再灌注模型。于再灌注后 1、3、7d取材 ,进行 HE染色 ,观察正常神经元。结果 :缺血再灌注后 1、3、7d正常血糖组海马 CA1区正常神经元计数为 1 76.0 0± 4.2 4 ,1 1 0 .75± 7.89,5 9.0 0± 8.41 ;高血糖组为1 68.2 5± 7.1 4,89.5 0± 8.2 0 ,39.75± 8.42 ,3d和 7d时两组之间存在显著性差异 ( P<0 .0 5 )。结论 :高血糖可加重局灶性脑缺血再灌注后海马 CA1区迟发性神经元死亡     

大鼠短暂性全脑缺血后STAT3表达与神经原凋亡的关系

目的 探讨短暂性全脑缺血/再灌注(I/R)大鼠海马CA1区信号转导和转录激活子-3(STAT3)表达与迟发性神经元凋亡的关系.方法 30只健康雄性SD大鼠,随机分为假手术组(n=5)和全脑I/R后4、24、48、72、96 h组(n=5).双侧颈总动脉阻断+全身低血压法建立大鼠短暂性全脑缺血模型;运用Nissl和TUNEL染色观察海马CAI区神经元存活数和凋亡细胞数;免疫组化法检测STAT3蛋白在全脑I/R后的表达.结果 全脑I/R后24 h,海马CA1区STAT3阳性细胞数显著增多,72 h达峰值,至96 h开始下降.TUNEL染色显示,在I/R后24 h即出现少量凋亡细胞,48～72 h显著增多;STAT3蛋白高表达与神经元凋亡两者的部位和时间段基本一致.结论 STAT3蛋白表达增强可能介导缺血性脑损伤的信号转导过程,其在脑缺血损伤神经元凋亡过程中起关键作用.     

高血糖对短暂脑缺血海马CAl区迟发性神经元死亡的影响

目的通过对大鼠局灶性脑缺血再灌注海马CA1区神经元形态学观察,探讨高血糖对海马迟发性神经元死亡的影响.方法术前给大鼠腹腔内注射生理盐水和葡萄糖造成正常血糖和高血糖状态,参考Zea-Longa 法制备大脑中动脉阻塞及再灌注模型.于再灌注后1、3、7d取材,进行HE染色,观察正常神经元.结果缺血再灌注后1、3、7d正常血糖组海马CA1区正常神经元计数为176.00±4.24, 110.75±7.89, 59.00±8.41;高血糖组为168.25±7.14,89.50±8.20,39.75±8.42,3d和7d时两组之间存在显著性差异(P＜0.05).结论高血糖可加重局灶性脑缺血再灌注后海马CA1区迟发性神经元死亡.     

大鼠短暂性全脑缺血后STAT3表达与神经原凋亡的关系

目的探讨短暂性全脑缺血/再灌注(I/R)大鼠海马CA l区信号转导和转录激活子-3(STAT3)表达与迟发性神经元凋亡的关系。方法30只健康雄性SD大鼠,随机分为假手术组(n=5)和全脑I/R后4、24、48、72、96 h组(n=5)。双侧颈总动脉阻断 全身低血压法建立大鼠短暂性全脑缺血模型;运用N issl和TUNEL染色观察海马CA1区神经元存活数和凋亡细胞数;免疫组化法检测STAT3蛋白在全脑I/R后的表达。结果全脑I/R后24 h,海马CA l区STAT3阳性细胞数显著增多,72 h达峰值,至96 h开始下降。TUNEL染色显示,在I/R后24 h即出现少量凋亡细胞,48~72 h显著增多;STAT3蛋白高表达与神经元凋亡两者的部位和时间段基本一致。结论STAT3蛋白表达增强可能介导缺血性脑损伤的信号转导过程,其在脑缺血损伤神经元凋亡过程中起关键作用。     

尼卡地平对脑缺血再灌注后海马CA1区细胞凋亡的影响

目的　研究沙土鼠短暂性脑缺血再灌注后细胞凋亡及尼卡地平处理的影响。方法　实验动物随机分为正常组、假手术组、对照组、尼卡地平处理组。正常组不进行手术操作 ,不进行脑缺血 ;假手术组只进行手术操作 ,不进行脑缺血 ;对照组阻断双侧颈总动脉 15min造成完全性前脑缺血模型 ;尼卡地平处理组在脑缺血前 30min给予腹腔注射尼卡地平 2mg/kg。用TdT介导的原位末端标记 (TUNEL)法来检测死亡神经元的DNA片段。HE染色计数海马CA1区 1mm长度内正常的锥体细胞数。结果　 (1)缺血再灌注后 2～ 4d ,对照组海马CA1区正常锥体细胞数比假手术组明显减少 (P <0 .0 1)。 (2 )缺血再灌注后 2～ 4d ,尼卡地平处理组海马CA1区正常锥体细胞数明显比对照组多 (P <0 .0 1)。 (3)尼卡地平处理组明显减少缺血再灌注后海马CA1区细胞凋亡 (P <0 .0 1)。结论　完全性前脑缺血再灌注后存在细胞凋亡 ;尼卡地平可抑制脑缺血再灌注后海马CA1区细胞凋亡。     

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.