中药在急性肺损伤中抗氧自由基的作用

目的 探讨不同中药在急性肺损伤中的抗氧自由基作用.方法 将实验动物随机分为油酸对照、VC治疗、参脉治疗、葛根素治疗、清开灵治疗5组,每组6只.用检测丙二醛(MDA)、超氧化物歧化酶 (SOD)、谷光甘肽(GSH)和谷光甘肽过氧化物酶(GSH-PX)来评定氧自由基水平;用肺系数评定急性炎症和肺水肿程度;用右肺尖组织光镜病理学检查观察炎症浸润程度.结果 肺系数:葛根素注射液组明显高于其他各组(P＜0.01);MDA:葛根素注射液组、清开灵注射液组明显低于其他3组(P＜0.01 或P＜0.05);T-SOD:葛根素注射液组明显低于其他组(P＜0.05);GSH:VC注射液组明显高于其他组(P＜0.05);GSH-PX:油酸组、葛根素注射液组明显高于其他3组(P＜0.01).光镜见炎细胞浸润与肺泡充血水肿程度依次为:脉注射液组＜葛根素注射液组＜VC注射液组＜清开灵注射液组＜油酸组.结论 VC、参麦、葛根素、清开灵均是可用的抗氧自由基药物,葛根素和清开灵降低MDA的作用略强于其他药物;葛根素升高T-SOD的作用弱于其他药物,但升高GSH-PX作用较强;损伤后12 h参脉可明显升高GSH-PX.光镜观察损伤后12 h病理变化组间有差异.     

清开灵注射液对急性肺损伤大鼠肺组织及CD4^＋T细胞数目的影响

目的探讨清开灵注射液对急性肺损伤大鼠免疫功能的影响。方法32只sD雄性大鼠随机分4组（对照组、模型组、治疗组、预防组），每组8只；各组均从尾静脉注药。对照组：注入1mL生理盐水；模型组：注入内毒素5mg／kg；治疗组：注入内毒素5mg／kg，45min后，注入清开灵注射液0.05mL／kg；预防组：注入清开灵注射液0．05mL／kg，45min后，注入内毒素5mg／kg。从第一次注液起5h后，取外周血2mL肝素抗凝，流式细胞仪测大鼠外周血中CD4^＋T细胞、CD8^＋T细胞数目及CD4^＋／CD8^＋的比值。结果CD4^＋T细胞数目、CD4^＋／CD8^＋的比值在各组之间差异均有显著性（P〈0．05）。结论清开灵注射液对大鼠急性肺损伤具有明显的修复作用，其机制可能与增加CD4^＋T细胞数目、改善CD4^＋／CD8^＋比例有关。     

依达拉奉在急性肺损伤大鼠中的抗氧自由基作用

目的 了解依达拉奉在大鼠急性肺损伤中抗氧自由基作用。方法 将实验大鼠随机分为对照组（A组）、油酸损伤组（B组）、油酸损伤＋依达拉奉预防组（C组）、油酸损伤＋依达拉奉治疗组（D组）。注入油酸6h后检测血浆丙二醛（MDA）、超氧化物歧化酶（SOD）、谷光甘肽（GsH）及谷光甘肽过氧化物酶（GSH—px）含量来评定氧自由基水平；计算肺湿／干重比（W/D）及肺泡灌洗液（BALF）中总蛋白含量来评定急性炎症肺水肿程度；取右肺尖做光镜病理切片检查。结果 C组和D组MDA明显低于B组，而SOD、GSH、GSH-px水平明显高于B组（P〈0．01），肺湿／干重比及肺泡灌洗液（BALF）中总蛋白含量也低于B组（P〈0．01）；C组和D组肺组织病理切片显示损伤较轻。结论 依达拉奉可以保护油酸所致的大鼠急性肺损伤。     

参附注射液预防老年患者术后认知功能障碍的研究

目的探讨参附注射液对老年患者髋关节置换术术后认知功能障碍的影响。方法将90例接受髋关节置换术患者随机分成参附注射液组（Ⅰ组）,生脉注射液组（Ⅱ组）和对照组（C组）。Ⅰ组给予参附注射液50ml加入5%葡萄糖溶液250ml静脉滴注;Ⅱ组给予生脉注射液50ml加入5%葡萄糖溶液250ml静脉滴注;C组给予5%葡萄糖溶液300ml静脉滴注。分别在拔管后1h、24h4、d、7d进行简易智力状态检查评分。结果 3组患者髋关节置换术术后简易智力状态检查评分均有不同程度的下降,拔管后1h最明显,且认知功能障碍的严重程度在拔管后1h对照组与术前相比具有统计学意义（P〈0.05）;简易智力状态检查评分Ⅰ组Ⅰ、Ⅰ组在术后1h2、4h与C组相比,差异有统计学意义（P〈0.05）;Ⅰ组与II组在所有时点两两比较,差异无统计学意义（P〉0.05）。结论参附注射液可降低老年患者术后早期POCD的发生率,并减轻其严重程度。     

参附对严重烧伤早期大鼠心脏功能保护作用的研究

目的观察严重烧伤大鼠早期应用参附注射液后心脏功能的改变。方法健康雄性SD大鼠80只,随机分为正常对照组8只（A组）、假伤组8只（B组）、烧伤组32只（C组）和参附治疗组32只（D组）,其中烧伤组和参附治疗组大鼠处理成30%的Ⅲ度烧伤,于伤后6h检测血流动力学和心肌力学指标（SAP、DBP、LVSP、LVEDP、＋LVdp/dt-max、-LVdp/dtmax）,并分别在伤后12h、24h及48h三个时相点检测其心肌酶谱（AST、LDH）的改变。结果烧伤后6hLVSP、＋LVdp/dtmax、-LVdp/dtmax较对照组均明显降低（P〈0.01）,LVEDP明显增高（P〈0.01）,而给予参附治疗后均较烧伤组明显减轻。同时参附治疗组血清LDH、AST检测值也明显低于烧伤组（P〈0.01）。结论在严重烧伤早期应用参附注射液治疗可以明显减轻心肌损害程度,改善心脏功能。     

参附注射液减轻健择联合顺铂治疗非小细胞肺癌的呕吐反应

目的观察参附注射液对健择联合顺铂方案（GP）治疗非小细胞肺癌消化道副反应的影响。方法46例拟行GP方案化疗的非小细胞肺癌患者，分为参附先期治疗组和参附后期治疗组（每组23例）。参附先期治疗组：于第1疗程化疗前3d开始用参附注射液静脉滴注，化疗实施GP方案；第2疗程仅用GP方案作自身对照。参附后期治疗组：第1疗程仅实施GP化疗；第2疗程化疗前3d开始用参附注射液，后实施GP方案。通过随机自身前后交叉对照，观察参附注射液对CP方案消化道反应的影响。结果GP方案主要消化道反应为Ⅰ-Ⅳ度呕吐和 Ⅰ-Ⅱ度便秘。总体参附＋GP方案的呕吐反应均较GP方案低（P〈0．01），参附先期治疗组和参附后期治疗组参附＋GP方案的消化道反应均较GP方案低（P〈0．01，P〈0．05）。参附注射液对气虚痰湿型和气阴两虚型患者显示较好的止呕作用（P〈0．01或P〈0．05）。结论参附注射液能减轻GP方案治疗非小细胞肺癌时的呕吐反应，对气虚痰湿型和气阴两虚型患者的止呕作用较明显；早期联合应用参附注射液显示出更好的作用。     

犬全脑缺血后头部选择性浅低温对脑内源性神经保护的影响

目的研究犬全缺血后浅低温对脑内源性神经保护的影响。方法15只健康杂种犬随机分为3组：手术对照组（A组,n=4只）,缺血再灌注组（B组,n=5只）,浅低温治疗组（C组,n=6只）。A组动物完成麻醉和手术后心脏不停跳观察8h。B组和C组动物心脏停跳18min,心脏复苏成功后,B组动物观察8h,C组动物接受浅低温[（34±0．5）℃]治疗。实验结束时开颅取右顶叶脑皮质供测超氧化物歧化酶（SOD）、谷胱甘肽（GSH）、谷胱甘肽过氧化物酶（GSH—Px）含量和免疫组织化学法显示小白蛋白（PV）和热休克蛋白70（HSPm）阳性神经元。结果B组动物脑内GSH、GSH-Px、T-SOD、Mn-SOD、Cu-ZnSOD、PV阳性神经元数量显著低于A组（P〈0．05或P〈0．01）,而HSP70—LI阳性神经元数量明显高于A组[（15．6±3．7）vs（5．5±2．1）,P〈0．05]。C组动物脑内GSH、T-SOD、Cu-ZnSOD、PV阳性神经元和HSP70-LI阳性神经元数量明显高于B组PV-Ⅰ神经元密度：（34．7±6．3）vs（23．8±5．3）,P〈0．05;HSP70—LI阳性神经元密度：（27．1±4．9）vs（15．6±3．7）,P〈0．05。结论脑内内源性神经保护作用增强可能是浅低温治疗脑缺血的机制之一。     

鼠尾悬挂试验在大鼠急性坏死性胰腺炎中的实验意义

目的：探讨鼠尾悬挂试验（TST）在大鼠急性坏死性胰腺炎中的实验意义。方法：SD大鼠被分为三组：急性坏死性胰腺炎组（A组，n=8）、急性坏死性胰腺炎鱼油干预组（F组，n=8）和对照组（C组，n=8）。观察各组大鼠胰腺组织病理变化及TST静止时间，同时测定各组5d后血清SOD、GSH—Px活力和淀粉酶浓度。结果：A组、F组TST静止时间各时间段均显著高于C组（P〈0．01）；自第2天起F组的数值均小于A组，其中第4、第5天的数值差异有显著性（分别为P〈0.05、P〈0.01）。病理学检查提示F组的炎性细胞浸润显著低于A组（P〈0.01）。A组SOD、GSH—Px显著低于C组（P〈0.01），而F组SOD、GSH—Px显著高于A组（P〈0.01）。TST静止时间和病理学改变、SOD、GSH—Px活力具有相关性（P〈0.01）。结论：TST静止时间在一定程度上反映了急性坏死性胰腺炎的严重程度；鱼油在改善急性坏死性胰腺炎大鼠的氧化应激指标的同时，对大鼠的TST静止时间产生影响。     

参脉注射液对ALI大鼠氧化损伤的影响

目的分析参麦注射液对大鼠急性肺损伤(ALI)的影响。方法大鼠随机分为空白对照组、模型组和参脉治疗组,采用尾静脉注射油酸建立急性肺损伤的大鼠模型。给药后8 h检测肺组织HE染色病理改变及血清中超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽(GSH)和谷胱甘肽过氧化物酶(GSH-Px)的变化。结果与模型组比较,参脉治疗组能够减轻肺组织水肿液,减少炎细胞浸润;降低血清MDA的表达,同时使血清SOD、GSH、GSH-Px含量增加。结论参麦注射液对ALI大鼠具有抗氧化损伤的保护作用。     

局麻膝关节镜围手术期疼痛控制研究

目的研究罗哌卡因与氟比洛芬酯两种药物在局麻膝关节镜围手术期的镇痛效果。方法将72例膝关节镜局麻手术患者随机分为安慰剂（P）组：脂肪乳＋0.9%氯化钠注射液;氟比洛芬酯（F）组：氟比洛芬酯＋0.9%氯化钠注射液;罗哌卡因（R）组：罗哌卡因＋脂肪乳;联合应用（C）组：氟比洛芬酯＋罗哌卡因。比较4组术中和术后1、2、4、8、12、24h的疼痛视觉模拟评分（Visual Analog Scale,VAS）、不良反应发生率、补充性曲马多用量及时间、患者满意度以评价各组的临床效果。结果术后2、4h静息和运动时罗哌卡因、氟比洛芬酯均有效且两种药物具有协同作用,术后8h静息和运动时只有氟比洛芬酯有效。术后1、12、24h时各组VAS评分无统计学差异。F组与P组行射频消融术时VAS评分差异有统计学意义（P=0.015）。结论氟比洛芬酯超前镇痛在局麻膝关节镜围手术期具有良好的镇痛效果,联合应用罗哌卡因在术后早期具有协同作用。     

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.