动脉压力感受性反射功能受损与高血压靶器官损伤

目的:研究自发性高血压大鼠(SHR)动脉压力感受性反射(ABR)功能的改变及其与心、肾、血管等靶器官损伤(TOD)间的关系.方法:分别测定清醒、自由活动状态下SHR及WKY大鼠24 h动脉血压、心率、血压波动性(BPV)及心率波动性(HRV);测定ABR对心率及对血压的控制功能(ABR-HP, ABR-BP);按预先制定的评分标准对高血压TOD进行评估.结果:SHR的24 h收缩压(SBP)、舒张压(DBP)及收缩压波动性(SBPV)、舒张压波动性(DBPV)显著高于对照WKY大鼠,心率二者间无差异,但SHR的HRV显著低于WKY大鼠.SHR的ABR功能显著低于WKY大鼠(P<0.01).SHR靶器官损伤明显,TOD评分显著高于对照的WKY大鼠.直线相关分析结果表明:SHR的TOD得分与SBP及DBP呈正相关(P<0.05);与BPV也呈正相关(P<0.01);与ABR功能呈负相关(P<0.01);TOD得分与心率间无相关关系,但与心率波动性间呈负相关 (P<0.05).TOD得分与ABR功能间相关系数高于与血压、BPV等其他血流动力学变量间相关系数.多元逐步回归分析结果进一步表明:在血压、心率、BPV、HRV及ABR功能等一系列变量中,ABR功能对SHR的靶器官损伤影响作用最强,血压水平次之.结论:ABR功能与高血压TOD密切相关,ABR功能降低可能加重高血压TOD.     

氯沙坦对原发性高血压病患者血压变异性的影响

目的观察氯沙坦对原发性高血压病(EH)患者血压变异性(BPV)的影响。方法临床观察EH患者108例,用氯沙坦治疗5周前后分别采用无创性携带式动态血压监测仪监测动态血压(BP)及血压变异性(BPV),同时选取健康人54例作对照组观察BP及BPV。结果108例EH患者中94例完成试验及观察,治疗前EH组BP及BPV较对照组明显增高(P<0.01),服用氯沙坦后EH患者的BP及BPV与用药前比较均明显降低(P<0.05或P<0.01)。结论EH患者BPV增高,氯沙坦在稳定降压的同时可降低BPV。     

酮合林对清醒高血压大鼠动脉压力感受性反射血压控制的影响

在清醒自由活动的自发性高血压大鼠和肾血管性高血压大鼠研究了Ket对动脉压力感受性反射血压控制成分(ABR-BP)的影响。ABR-BP的测定采用比较化学阻断反射弧的传出通路前、后血管紧张素Ⅱ升压面积的方法。结果表明Ket能非常显著地增强2种高血压大鼠的ABR-BP(SHR由51％到74％,RVHR 59％到77％)。Ket的降压作用可能与其升高ABR-BP有关。     

替米沙坦联合氨氯地平改善原发性高血压合并2型糖尿病患者的血压变异性

血压变异性(blood pressure variability,BPV)也叫血压波动性,其阐明了平稳降压的重要性,影响着降压治疗的最终结局.有研究表明,血压变异性增大导致终末期靶器官损害,且独立于血压的绝对值[1].对BPV治疗不佳的难治性高血压患者,即使平均血压得到控制,但仍有不良的临床预后[1-2].理想的降压药物改变BPV,也对靶器官具有保护作用.为了更好地关注降压药物对原发性高血压合并2型糖尿病患者的血压波动情况,本研究选择了108例原发性高血压合并2型糖尿病患者,观察比较苯磺酸左旋氨氯地平和替米沙坦片两药单用或联合用药的降压疗效和BPV的变化.     

盐酸乌苏里藜芦碱对肾性高血压大鼠降压机理的探讨

以酚妥拉明及新斯的明为工具药，从鼠侧脑室注入盐酸乌苏里藜芦碱研究其中枢降压机制，实验表明：侧脑室注入Ｖｅｒａ－Ｕ可显著降低肾性高血压大鼠的血压，其降压作用可被侧脑室预先注入的α受体阻断剂酚妥拉明完全阻断；侧脑室注入胆碱酯酶抑制剂后，肾性高血压大鼠血压明显升高，新斯的明升高和用不受预先注入的Ｖｅｒａ－Ｕ的影响。结果提示：Ｖｅｒａ－Ｕ侧脑室注射对肾性高血压大鼠具有迅速而显著的降压作用；其中枢机制在降压     

硫氮酮协同降压作用的实验研究

在Wistar京都种大鼠制成的二肾一夹型高血压模型中,硫氮(艹卓)酮(diltiazem)灌胃无论一次或连续两周(每天两次)给药均有温和而显著的降压作用。一次给药时血压下降13±4.4mmHg。连续用药后,随时间延长,降压作用逐渐增强。14天时血压下降23±6.3mmHg,显著低于3天时的降压幅度。硫氮(艹卓)酮20mg/kg与硝苯吡啶6.7mg/kg合用,其降压幅度相当于两药单用之和。合用两周时,血压下降83±6.8mmHg,而硫氮酮与硝苯吡啶单用时分别为23±6.3和64±7.0mmHg,这提示两药合用具协同降压作用。这种协同作用的产生与硫氮酮和硝苯吡啶作用机制及血液动力学作用不同可能有关。硫氮酮与双氢氯噻嗪合用时未发现有协同作用产生,加用双氢氯噻嗪前后血压分别为166±6.4和170±5.8mmHg,前后无显著差异。     

单硝酸异山梨酯对老年纯收缩期高血压病人的降压疗效

目的评价单硝酸异山梨酯对老年纯收缩期高血压(ISH)病人的降压作用.方法16例Ⅰ、Ⅱ级ISH病人给予48周单硝酸异山梨酯单药治疗,30～120mg,每天1次.观察治疗前后诊室血压(CBP)和24小时动态血压(ABPM)的变化,计算平稳指数(SI)考察降压作用的均匀性.结果(1)单硝酸异山梨酯对CBP的收缩压有显著的降压作用,有效率为75%,而对舒张压的影响不明显;(2)显著降低24小时平均收缩压、白昼收缩压、夜间收缩压、白昼收缩压负荷和夜间收缩压负荷,心率和舒张压改变不显著;(3)每4周平均血压下降曲线表明,血压的降低是一个缓慢而持久的过程,无耐药现象;(4)SI为1.13.治疗后血压波动曲线呈杓型比例,由治疗前的50%提高到81.25%,晨间血压无明显升高.结论单硝酸异山梨酯治疗老年纯收缩期高血压,降压效果确切,作用平稳,无耐药现象,并能恢复血压波动生理节律,但头痛发生率高.     

吲哒帕胺联合依那普利对自发性高血压大鼠的降压效果

目的研究吲哒帕胺联合依那普利对自发性高血压大鼠(SHR)的降压效果。方法40只SHR随机分成四组(n=10):空白对照组、吲哒帕胺组、依那普利组、吲哒帕胺 依那普利组。以灌胃方式分别给予不同剂量药物。观察不同剂量及药物处理状况下,SHR体质量、心率和血压的变化。结果给药期间及给药后,各药物组不同剂量给药对SHR体质量的增长和心率均无明显影响。吲哒帕胺 依那普利组SHR经不同剂量给药后,血压均较给药前显著降低(P均<0.05),其降压程度与单一药物组相比效果更明显(P<0.05)。结论吲哒帕胺联合依那普利比单一降压药更能显著降低SHR的血压。     

潜降颗粒对高血压肝阳上亢证患者血压变异性的影响

【目的】观察平肝潜阳方药潜降颗粒对高血压肝阳上亢证患者血压变异性(blood pressure variability,BPV)的影响。【方法】将60例高血压肝阳上亢证患者随机分为治疗组32例与对照组28例。2组均给予苯磺酸氨氯地平口服,治疗组加用潜降颗粒,疗程4周。在治疗前后分别行动态血压监测,观察2组BPV的变化。【结果】(1)治疗后,2组BPV各项指标均明显下降(P0.05或P0.01),且治疗组对BPV各项指标的下降作用均明显优于对照组(P0.05)。(2)2组均能在降压的同时保持原有的昼夜节律,均能显著降低清晨高峰期(6∶00-12∶00)血压;治疗组经潜降颗粒治疗后获24 h全程平稳降压,但夜间降幅较白天略低,对夜间血压降低较对照组小,因而治疗后夜间的血压谷相对变浅。【结论】潜降颗粒不仅有助于降压达标,亦能有效减少血压变异性。     

侧脑室内注射葛根素对大鼠血压和心率的影响

目的:探讨侧脑室内注射葛根素降低大鼠动脉血压(BP)和心率(HR)的作用及机制.方法:连续观察室内注射葛根素的大鼠60 miBP和HR变化曲线,并与对照组比较.结果:给药后大鼠BP和HR明显降低,在5 min-15 min达最低值,与生理盐水对照组比较差异显著(P＜0.01).结论:侧脑室内注射葛根素有明显降低大鼠BP和HR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.     

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.