表没食子儿茶素没食子酸酯对大鼠胰岛素抵抗的影响

目的 研究表没食子儿茶素没食子酸酯(EGCG)对自发性2型糖尿病GK大鼠的胰岛素抵抗的影响及作用机制.方法 自发性2型糖尿病GK大鼠40只,同系健康对照Wistar大鼠10只,大鼠随机分为:正常对照组、2型糖尿病对照组、2型糖尿病低剂量EGCG( 50 mg/kg)治疗组、中剂量(100 mg/kg)组、高剂量EGCG( 300 mg/kg)组.干预6周后,分别检测葡萄糖耐量试验、胰岛素耐受试验、肝脏GcK、G6P以及PEPCKmRNA表达情况,以及骨骼肌细胞膜GLUT4含量的变化.结果 各剂量治疗组的糖耐量均得到明显改善(P＜0.05),胰岛素耐量在240 min时较模型对照组有明显差异(P＜0.05).与模型组比较,低剂量和中剂量治疗组均能提高肝脏葡萄糖激酶(GcK) mRNA的表达(P＜0.05),同时抑制葡萄糖-6-磷酸酶(G6P)和磷酸烯醇式丙酮酸激酶(PEPCK) mRNA的表达(P＜0.05);高剂量治疗组肝脏三类酶mRNA的表达与模型对照组相比无明显差异.各剂量治疗组GK大鼠的骨骼肌细胞膜GLUT4的含量较模型对照组均具有明显上调(P＜0.05).结论 中低剂量EGCG可以改善GK大鼠胰岛素抵抗,其作用机制可能与抑制肝脏糖异生作用以及骨骼肌GLUT4的转位水平有关,并且EGCG具有代偿胰岛素的作用.     

2型糖尿病GK大鼠病程进展与组织形态学改变

目的研究自发性2型糖尿病GK大鼠随病程进展的病理生理和组织形态学改变。方法选择自发性2型糖尿病GK大鼠为糖尿病动物模型,同源Wistar大鼠为正常对照组,检测其血糖、血脂、血胰岛素等生化指标,定期行口服葡萄糖耐量试验检测血糖,HE染色观察心肌和胰腺组织形态学改变。结果自发性2型糖尿病GK大鼠生长缓慢,体重随病程延长与正常对照组呈显著差异（P〈0.05）;血糖轻、中度升高（P〈0.05）。血清甘油三酯水平显著升高,血清总胆固醇水平亦升高（P〈0.05）。GK大鼠呈高胰岛素血症,胰岛素抵抗指数也较对照组有统计学意义（P〈0.05）。胰岛在病程早期表现为肥大增生,晚期破坏、纤维化程度明显高于Wistar大鼠;GK大鼠心肌横纹欠清晰,纤维排列稍扭曲紊乱,部分可见心肌细胞溶解和间质纤维化。结论自发性2型糖尿病GK大鼠表现为轻中度高血糖、中度胰岛素抵抗,血脂升高,胰岛功能不足和温和的糖尿病心肌病变,且不伴随肥胖,是良好的2型糖尿病动物模型。     

胰岛素抵抗大鼠前列腺微血管新生的实验研究

目的探讨2型糖尿病胰岛素抵抗大鼠前列腺微血管新生与良性前列腺增生症发生发展的关系。方法(1)正常对照组大鼠(Normal组,n=15):8~10周龄正常雄性Wistar大鼠;(2)单纯良性前列腺增生组大鼠(BPH组,n=15):手术去势后外源性给予高剂量雄激素;(3)胰岛素抵抗前列腺增生组大鼠(GK+BPH组,n=15):8~10周龄自发型非肥胖型2型糖尿病Wistar大鼠(GK大鼠),手术去势后外源性给予高剂量雄激素;(4)胰岛素抵抗前列腺增生血糖干预组大鼠(GK+BPH+PH组,n=15):8~10周龄GK大鼠手术去势后外源性给予高剂量雄激素,同时给予盐酸吡格列酮灌胃。光化学法检测大鼠空腹血糖水平;ELISA双抗体夹心法检测大鼠血清胰岛素水平及前列腺DHT含量;real-time PCR法检测大鼠前列腺VEGF、Ang-1、Ang-2 mRNA表达量;免疫组化S-P法检测前列腺组织CD31表达并根据阳性结果计数MVD。结果 (1)GK+BPH、GK+BPH+PH组空腹血糖水平及胰岛素抵抗指数高于Normal组及BPH组(P0.05);GK+BPH组指标高于GK+BPH+PH组(P0.05);Normal组及BPH组上述指标差异无统计学意义(P0.05)。BPH组、GK+BPH组、GK+BPH+PH组前列腺组织中DHT含量与Normal组相比明显增高(P0.05);GK+BPH组、GK+BPH+PH组高于BPH组,且GK+BPH组高于GK+BPH+PH组(P0.05);(2)各组前列腺组织中VEGF、Ang-1、Ang-2 m RNA表达量及MVD计数结果为GK+BPH组GK+BPH+PH组BPH组Normal组,组间差异有统计学意义(P0.05);(3)GK+BPH组、GK+BPH+PH组大鼠前列腺组织中DHT含量与胰岛素抵抗指数呈正相关(P0.05),相关性显著。结论 2型糖尿病伴胰岛素抵抗时,可通过增加前列腺组织DHT的含量从而上调VEGF、Ang-1、Ang-2的表达,促进前列腺组织局部血管新生以加速良性前列腺增生症的进展。     

升清与健脾理气药物抗高脂饮食诱导肥胖大鼠的作用及对脂联素和炎症因子的影响

目的 观察升清和健脾理气药物对饮食诱导肥胖(DIO)大鼠肥胖程度及对脂联素和炎症因子的影响.方法 Wistar大鼠120只,10只作为空白对照组,给予基础饲料,其余110只给予高脂高营养饲料17周,按照体重,得到DIO大鼠40只和肥胖抵抗(DIO-R)大鼠10只,将DIO大鼠又分为DIO模型组、西布曲明组、健脾理气组和升清组,每组10只,分别以生理盐水(2 mL/d)、西布曲明1.6 mg/(kg·d)、健脾理气药物3.2 g/(kg·d)、升清药物3.2 g/(kg·d)灌胃,空白对照组与DIO-R组予生理盐水(2 mL/d)灌胃.灌胃期间空白对照组予基础饲料,余5组继续高脂饲料.灌胃16周后,测量体重、身长,取腹腔内全部脂肪,测量肥胖程度及脂肪含量.取血测定胰岛素抵抗指数(IRI)、血糖、甘油三酯、胆固醇、肿瘤坏死因子(TNF-α)、脂联素.取脂肪匀浆测定TNF-α、脂联素.结果 DIO模型组比正常大鼠体重、体重指数、脂肪系数、胆固醇、IRI明显升高(P＜0.05,P＜0.01);血清和脂肪中脂联素均下降(P＜0.05),TNF-α均升高(P ＜0.05,P＜0.01).与DIO模型组比较,DIO-R组体重、体重指数、脂肪系数、IRI均降低(P ＜0.05,P＜0.01);血清和脂肪中脂联素升高(P＜0.01),TNF-α降低(P ＜0.05,P＜0.01).健脾理气药物可降低脂肪匀浆中TNF-α水平(P＜0.05);升清药物可以升高血清及脂肪匀浆中脂联素水平,降低TNF-α(P＜0.05,P＜0.01).结论 升清药物能抑制高脂饲料诱导的肥胖和胰岛素抵抗,其机制与促进脂联素分泌,降低TNF-α水平有关.“脾不升清”可能是肥胖的病机关键之一.     

肥胖的非糖尿病大鼠对急性炎症刺激的耐受性研究

目的 比较由高脂膳食诱发肥胖的非糖尿病和2型糖尿病大鼠对急性炎症刺激的反应能力.方法 对2型糖尿病GK大鼠(GK组)和Wistar大鼠(Wistar组)进行高脂饲料喂养14周,观察两组大鼠体质量的变化情况.按随机数字表法将高脂饲料喂养14周后的大鼠再分为GK高脂喂养基线组(GK+ HFF组)、Wistar+HFF组、GK高脂喂养后内毒素(LPS)注射组(GK+ HFF+LPS组)和Wistar+ HFF+ LPS组,每组6只.取GK+ HFF+ LPS组和Wistar+ HFF+LPS组大鼠,分别以5 mg/kg LPS经腹腔注射建立脓毒血症危重病模型,观察大鼠血糖波动情况,Real-Time PCR检测肝脏、肺脏、肾脏和心肌组织中肿瘤坏死因子α(TNF-α)、白介素1β (IL-1β)、IL-6和IL-10等炎症细胞因子mRNA的表达.结果 高脂喂养14周后,Wistar组大鼠的体质量明显大于GK组(P＜0.05),GK组大鼠血糖浓度显著高于Wistar组(P＜0.05).LPS注射后,CK+ HFF+ LPS组大鼠血糖浓度上升趋势明显,而Wistar+ HFF+ LPS组大鼠的血糖浓度无明显变化.炎症细胞因子mRNA表达的检测结果显示:Wistar+ HFF+LPS组显著高于Wistar +HFF组(P＜0.05),GK+ HFF+ LPS组显著高于GK+ HFF组(P＜ 0.05);Wistar+ HFF+ LPS组炎症细胞因子mRNA表达的上升幅度与GK+ HFF+ LPS组比较,差异无统计学意义(P＞0.05).结论 正常大鼠经高脂膳食诱发肥胖后,对急性炎症刺激出现一定的耐受性,且较2型糖尿病大鼠更为显著.     

肿瘤坏死因子—α与2型糖尿病关系的探讨

目的探讨2型糖尿病患者肿瘤坏死因子-α(Tumornecrosisfactor-alphaTNF-α)血清浓度表达。方法测定85例2型糖尿病患者的血清TNF-α浓度、空腹血糖、基础胰岛素水平、血三酰甘油、血高密度脂蛋白-胆固醇(HDL-C)水平和肾功能,并以59例无糖尿病的冠心病患者作对照,并对相关资料作对比分析。结果血清TNF-α浓度在糖尿病组较非糖尿病组显著增高(P＜0.01);糖尿病组中血清TNF-α浓度男女性别间无差异(P＞0.05);与胰岛素作用指数(IAI)相关(r＜0.05);血HDL-C水平与TNF-α浓度负相关(P＜0.05)。结论血清TNF-α浓度过度表达可能在胰岛素抵抗和2型糖尿病及其慢性并发症发病机制中起一定作用。     

枸杞多糖对2型糖尿病大鼠血糖、血脂及TNF-α水平的影响

目的观察枸杞多糖对2型糖尿病大鼠血糖、胰岛素、血脂及血清TNF-α水平的影响。方法采用高脂高糖饲料喂养8周联合腹腔注射小剂量链脲佐菌素的方法,建立2型糖尿病大鼠模型。将未予上述处理的大鼠设为正常对照组,成模大鼠按血糖再随机分为糖尿病对照组、枸杞多糖（LBP）低、中、高剂量干预组和二甲双胍组,药物干预6周后,处死动物取血测定血脂、空腹血糖,应用放射免疫分析法测定空腹胰岛素及血清TNF-α水平。结果LBP中、高剂量干预组及二甲双胍组空腹血糖水平较糖尿病对照组降低（P〈0.05,P〈0.01）,较正常对照组高（P〈0.05）;LBP高剂量干预组及二甲双胍组ISI较糖尿病对照组升高（P〈0.05）;LBP中、高剂量干预组血清TC水平较糖尿病对照组降低（P〈0.05）,LBP各剂量组血清TNF-α水平较糖尿病对照组有所下降,但差异无统计学意义（P〉0.05）。二甲双胍组血清TNF-α水平较糖尿病对照组降低（P〈0.05）。结论LBP能够降低2型糖尿病大鼠血糖及血脂水平,增加组织的胰岛素敏感性,改善糖尿病大鼠糖脂代谢紊乱及胰岛素抵抗。     

高血压脑出血患者血清TNF-α、VEGF、ET-1水平的变化及意义

目的:探讨高血压脑出血(hypertensive cerebral hemorrhage,HICH)患者血清肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)和内皮素-1(ET-1)水平的变化及临床意义.方法:采用ELISA法检测HICH患者及健康体检者血清TNF-α、VEGF和ET-1的水平,并分析不同GCS评分HICH患者血清TNF-α、VEGF和ET-1水平的变化情况.结果:HICH患者血清TNF-α、VEGF和ET-1水平均明显高于健康体检者(P＜0.05).并且,随着HICH患者GCS评分的降低,血清TNF-α、VEGF和ET-1水平逐渐升高(P＜0.05).结论:检测HICH患者血清TNF-α、VEGF和ET-1水平,对于HICH患者病情和预后判断有重要意义.     

The relationship between serum adipocytokine level and insulin resistance in type 2 diabetes mellitus

目的 探讨2型糖尿病患者血清脂肪细胞因子水平变化及其与胰岛素抵抗之间的相关性.方法 随机选择30例非肥胖2型糖尿病患者、30例肥胖2型糖尿病患者、30例健康对照者,用酶联免疫吸附法测定血清Resistin、TNF-α、FFA水平,同时测定空腹血糖、糖化血红蛋白、空腹胰岛素、总胆固醇、甘油三酯,测量身高、体重、腰围、臀围及血压,并计算出体重指数(BMI)和腰臀比(WHR),用Homa公式计算胰岛素抵抗指数(IRI),并对它们进行相关分析和逐步回归分析.结果 非肥胖糖尿病组和肥胖糖尿病组空腹血浆Resistin、TNF-α、FFA水平均明显高于正常对照组,差异有显著性(P＜0.05);肥胖糖尿病组的抵抗素、TNF-α、FFA水平与非肥胖糖尿病组,差异有显著意义(P＜0.05).肥胖糖尿病组血抵抗素与BMI、FPG、HbAlC、TG呈显著正相关;与IRI呈显著正相关(P＜0.05),与FINS、TC、SBP、DBP及WHR无相关性.血清TNF-α、FFA水平与BMI、FPG、HhAlC、TG、FINS呈显著正相关(P＜0.05);与IRI呈显著正相关,与WHR、SBP、DBP无相关.非肥胖2型糖尿病组和对照组抵抗素、TNF-α、FFA与所有因素无明显相关性.多元逐步回归分析结果显示抵抗素、TNF-α和FFA与IRI显著相关.结论 2型糖尿病患者特别是肥胖者胰岛素抵抗更为显著,抵抗素、TNF-α和FFA均参与胰岛素抵抗,可能是影响体内胰岛素抵抗的重要相关因素.     

胰岛素抵抗大鼠的肝脏中丝氨酸/酪氨酸磷酸化异常与血清TNF-α相关

目的 探讨胰岛素抵抗大鼠胰岛素受体底物-1丝氨酸,酪氨酸磷酸化与肿瘤坏死因子α(TNF-α)的关系.方法 雄性Wistar大鼠30只(体质量80～120 g),随机分为普通饮食组(NC)及高脂饮食组(FH)2组,每组15只.喂养10周,以高胰岛素-正常血糖钳夹技术评估胰岛素抵抗大鼠模型.应用ELISA法检测大鼠血清TNF-α含量,Western Blot法检测肝脏组织中胰岛素受体底物-1丝氨酸磷酸化(IRS-ISer636)及酪氨酸磷酸化(IRS-ITyr456)表达.结果 FH组葡萄糖输注率(GIR)60-120水平明显低于NC组[(1.56±0.43 vs.5.15±0.66)mg/(kg·min),P<0.01];FH组大鼠TNF-α、IRS-ISer636均高于NC组[(15.43±2.16 vs.5.4±2.16)pg/mL,P<0.01;(109.45±13.75 vs.94.23±15.05),P<0.05],IRS-ITyr456水平低于NC组[(111.08±14.28 vs.125.77±14.51),P<0.05].TNF-α水平与IRS-ISer636呈正相关(r=0.503,P=0.024),与IBS-ITyr456呈负相关(r=-0.521,P=0.019).结论 胰岛素抵抗大鼠TNF-α水平与IRS-ITyr456负相关,与IBS-ISer636正相关,提示TNF-α引起胰岛素抵抗机制可能与IBS-1磷酸化异常有关.     

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.