皮尔复液预防腹腔粘连实验研究

目的　探讨用皮尔复液灌注腹腔对术后腹腔粘连形成和腹腔粘连松懈后粘连再形成的影响。方法　选用中国本犬 2 4只 ,随机分成生理盐水组和皮尔复组各 12只。每间隔 2周做 1次腹腔手术 ,并观察腹腔粘连情况 ,共观察 4次。生理盐水组和皮尔复组于术毕前分别腹腔灌生理盐水和皮尔复液 2 5ml。结果　皮尔复液腹腔灌注能显著降低腹腔术后腹腔粘连的发生率 (P <0 .0 0 5 )。结论　皮尔复液腹腔灌注是一种安全的用药途径     

皮尔复腹腔灌注预防肠粘连的实验研究

目的探讨皮尔复腹腔灌注预防肠粘连的作用. 方法用80只白兔,采用4种不同方法建立腹腔粘连模型,随机在腹腔内灌注皮尔复液或生理盐水,比较粘连发生率. 结果实验动物粘连形成率皮尔复组7/40,对照组36/40（P＜0.04）. 结论皮尔复液腹腔灌注可以预防腔粘连的发生.     

右旋糖酐和皮尔复预防腹腔粘连实验研究

为探讨用右旋糖酐70葡萄糖注射液和皮尔复液灌注腹腔对术后腹腔粘连形成和腹腔粘连松解后粘连再形成的影响。选用中国本犬36只,随机分成生理盐水组、右旋糖酐组和皮尔复组各12只。每次于术毕前相应组分别腹腔灌注生理盐水、右旋糖酐和皮尔复各25mL。每间隔2周做1次腹腔手术,并观察腹腔粘连情况,共观察4次。结果右旋糖酐(P<0.05)和皮尔复(P<0.005)腹腔灌注能显著降低腹腔术后腹腔粘连的发生率。结果提示右旋糖酐和皮尔复腹腔灌注是一种安全的用药途径。     

腹腔注射IL-2对小鼠单核吞噬细胞吞噬功能的影响

目的观察不同浓度IL-2对小鼠单核吞噬细胞吞噬功能的影响。方法取20只健康昆明小鼠随机分为五组:正常对照组和4个不同浓度的实验组。将浓度分别为20,40,80和160 U/ml的IL-2(实验组)经腹腔注入小鼠体内,观察小鼠腹腔巨噬细胞吞噬鸡红细胞的吞噬能力,计算出不同浓度IL-2作用后吞噬细胞的吞噬百分率和吞噬指数,并与正常对照组作比较。结果正常对照组小鼠巨噬细胞吞噬百分率为(16.98±1.22)%,20 U/ml组为(39.66±0.98)%,40 U/ml组为(57.61±1.04)%,80 U/ml组为(60.22±1.32)%,160 U/ml组为(61.11±0.99)%;吞噬指数依次为0.21±0.048,0.52±0.032,0.79±0.041,0.82±0.057和0.83±0.028。实验组与正常对照组之间具有显著性差异(P<0.05)。结论腹腔注射IL-2可以显著增强小鼠单核吞噬细胞的吞噬功能。     

丹参对ARDS大鼠肺泡巨噬细胞分泌肿瘤坏死因子、白介素—1的调节作用

目的:了解ARDS大鼠肺泡巨噬细胞分泌肿瘤坏死因子(TNFα)、白介素—1(IL—1)的变化及丹参的调节作用。方法:静注油酸制造大鼠ARDS模型为油酸组,静注生理盐水作对照组,静注油酸同时用丹参灌胃为治疗组。静注油酸及生理盐水6小时后,分离培养各组大鼠肺泡巨噬细胞。采用MTT方法测定TNFα、IL—1。结果:TNFα分别:油酸组(72.06±5.64)％,对照组(7.75±1.05)％,治疗组(35.44±4.55)％。IL—1分别为:油酸组(96.22±11.61)U/ml,对照组(21.05±3.11)U/ml,治疗组(70.66±8.23)U/ml。油酸组分泌TNFα、IL—1水平显著高于对照组(P<0.001),治疗组亦显著高于对照组,但明显低于油酸组(P<0.001)。结论:丹参具有抑制ARDS大鼠肺泡巨噬细胞过度活化,减少分泌TNFα,IL—1的作用。研究肺泡巨噬细胞分泌细胞因子的变化,对认识ARDS发病机制和临床治疗有重要意义。     

盆腔子宫内膜异位症患者血清与腹腔液中CA125相关性研究

目的探讨盆腔内异症与非内异症患者血清及腹腔液中CA125相关性。方法将56例腹腔镜检查患者分为盆腔内异症38例(病例组)及非盆腔内异症18例(对照组),应用磁性分离酶联免疫法测定两组血清及腹腔液中CA125水平。结果内异症组血清及腹腔液中CA125水平显著高于对照组(血清39.72±40.15U/ml对比10.25±7.23 U/ml,P=0.000;腹腔液1494.08±1256.55 U/ml对比815.40±652.85U/ml,P=0.002),且两者呈线性正相关(r=0.592);内异症组分期越晚的患者血清及腹腔液中CA125值均显著升高(P=0.000)。结论盆腔内异症与非内异症组患者血清及腹腔液中CA125水平呈正相关,且腹腔液中CA125水平显著增高。内异症的发展可能与血清及腹腔液中CA125水平的显著升高有关。     

含聚合血红蛋白的St.Thomas液对低温保存离体大鼠心脏的保护作用

目的 研究含聚合血红蛋白(polymerized hemoglobin,PolyHb)的心脏停搏保存液(St.Thomas液)对离体大鼠心脏低温保存8 h复灌后缺血再灌注损伤的保护作用.方法 将60只成年SD大鼠随机分成3组(n=20):假手术组(sham组)、对照组(St.Thomas solution组,STS组)和实验组(PolyHb组).利用Langendorff离体心脏灌流法,观察心脏在4 ℃含或不含PolyHb的St.Thomas液中保存8 h复灌120 min心脏功能的变化情况,比较冠脉流出液中肌酸激酶(CK)和乳酸脱氢酶(LDH)的释放量和心肌梗死面积.结果 与STS组比较,含PolyHb的St.Thomas液可增强再灌注时左室发展压(P<0.001)和左室压力变化率(P<0.001),减少冠脉流出液中CK和LDH的含量(P<0.001),减少心肌梗死面积百分比(P<0.001).结论 含PolyHb的St.Thomas液对低温保存8 h后离体鼠心的缺血再灌注损伤有明显的保护作用.     

血清与腹腔液CA125测定对子宫内膜异位症的诊断价值

目的 探讨血清及腹腔液CA125测定对子宫内膜异位症(endometriosis,EM)的诊断价值.方法 对212例行腹腔镜手术的患者,于术前抽取血清,术中抽取腹腔液测定CA125浓度;根据腹腔镜检查结果 分为子宫内膜异位症组(143例)和对照组(69例).回顾性分析两组的血清和腹腔液CA125值.结果 子宫内膜异位症组的血清CA125值为(36.48±10.52)U/mL,显著高于对照组(18.74±12.35)U/mL(P＜0.05);子宫内膜异位症组的腹腔液CA125值为(1 237.0±248.6)U/mL,显著高于对照组(521.0±98.2)U/mL(P＜0.05).以血清CA125≥35 U/mL为标准,子宫内膜异位症组诊断子宫内膜异住症的阳性率为71.33%(102/143),对照组为8.7%(6/69);子宫内膜异位症患者血清CA125的阳性率显著高于对照组(P＜0.001).子宫内膜异位症组血清CA125敏感性及特异性分别为71.33%及91.30%.以腹腔液CA125≥800 U/mL为标准,子宫内膜异位症组诊断子宫内膜异位症的阳性率为93.71%(134/143),对照组为0.00%(0/69);子宫内膜异位症患者腹腔液CA125的阳性率显著高于对照组(P＜0.001).子宫内膜异位症组腹腔液CA125敏感性及特异性分别为93.70%及100.00%.结论 腹腔液CA125可提高诊断EM的灵敏度,较血清CA125具有更高的敏感性.     

大黄素对肝细胞模拟冷缺血再灌注损伤的保护作用及机制

目的:观察中药大黄素对肝细胞模拟冷缺血再灌注损伤是否具有保护作用,探讨其可能的保护机制.方法:体外培养肝细胞株HL-7702,随机分为对照组和大黄素处理组.对照组未予大黄素处理,大黄素处理组分为100,10,1 μmol/L3个浓度组,建造模拟冷缺血再灌注模型,分别检测各组上清液中乳酸脱氢酶(LDH),细胞内超氧化物岐化酶(SOD)和丙二醛(MDA)水平;流式细胞技术检测细胞内活性氧(ROS)水平.结果:冷缺血8 h再灌注6 h后,中、高浓度大黄素处理组LDH分别为(198.83±14.22)U/L,(179.67±18.57)U/L,显著低于对照组的(351.33±34.16)U/L(P<0.01);MDA分别为(7.80±0.88)μmol/L,(4.97±0.71)μmol/L,显著低于对照组的(16.67±1.14)μmol/L(P<0.01);SOD分别为(14.32μ1.53)×103U/L,(18.64±1.38)×103U/L,显著高于对照组的(8.56±0.94)×103U/L(P<0.01).高、中、低浓度大黄素处理组ROS阳性细胞率分别为0.1140±0.0037,0.1599±0.0039,0.9527±0.0080,均低于对照组的0.9974±0.0006(P<0.01);各浓度大黄素处理组之间差异具有统计学意义(P<0.05).结论:大黄素对肝细胞模拟冷缺血再灌注损伤具有保护作用,其保护机制可能与清除氧自由基,降低细胞内活性氧水平有关.     

子宫内膜异位症患者腹腔液Epo水平检测及其临床意义

目的:探讨子宫内膜异位症(内异症)患者腹腔液中红细胞生成素(Epo)水平的变化及其在内异症发病中的作用.方法:收集40例不同程度内异症惠者和25例非内异症患者(对照组)的腹腔液,以化学免疫发光方法检测Epo水平.结果:内异症组腹腔液Epo水平明显高于对照组[分别为(13.64±3.84)mTU/ml和(7.54±1.13)mlU/ml,P＜0.01].轻度组又较重度组高[分别为(17.63±2.67)mIU/ml和(11.06±1.23)mlU/ml,P＞0.01].结论:内异症患者腹腔液中Epo水平明显升高,并随疾病的严重程度而降低,可能在内异症的发生发展中发挥重要作用.     

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.