白介素-9与COPD大鼠气道炎症的研究

目的探讨白细胞介素-9(IL-9)在慢性阻塞性肺疾病(COPD)发病机制中的作用。方法单纯熏香烟法建立大鼠COPD模型,测定支气管肺泡灌洗液(BALF)中细胞计数和百分比;酶联免疫吸附法(ELISA)测定血清、BALF和肺组织中IL-9的浓度;肺组织切片行苏木素-伊红(HE)染色观察形态学改变;采用图像分析系统定量测定肺平均内衬间隔(Lm)、平均肺泡数(MAN)和支气管壁厚/外径。结果(1)COPD组Lm、支气管壁厚/外径比正常对照组增高,而MAN低于对照组,差异有统计学意义(P<0.01)。(2)COPD组血清、BALF、肺组织中IL-9浓度与正常对照组比较均增高;(3)COPD组BALF与正常对照组比较,白细胞总数、巨噬细胞绝对计数、中性粒细胞绝对计数均增高,差异有统计学意义;(4)COPD组BALF中白细胞总数、巨噬细胞绝对计数、中性粒细胞绝对计数与BALF、肺组织中的IL-9浓度均呈正相关。结论IL-9与COPD的气道炎症密切相关,可作为COPD气道炎症的一个检测指标。     

泼尼松对MCP-1及IL-8在COPD大鼠气道表达的影响

目的研究单核细胞趋化蛋白-1（MCP—1）及白细胞介素8（IL-8）在慢性阻塞性肺疾病（COPD）大鼠气道的表达及泼尼松对其的影响。方法Wistar大鼠随机分为3组：正常对照组（A组）、COPD模型组（B组）和泼尼松干预组（C组）。采用单纯熏香烟法建立COPD模型,泼尼松隔日灌胃,计数支气管肺泡灌洗液（BALF）中细胞数,以酶联免疫吸附法（ELISA）测定BALF和血清中的MCP-1及IL_8浓度。肺组织切片观察形态学改变,采用图像分析系统分析肺气肿程度。结果B组气管及支气管的慢性炎症改变及肺气肿改变较C组明显。B组BALF中MCP-1、IL-8浓度、细胞计数及血清中IL-8浓度均高于A组,但血清MCP-1的升高无统计学差异。与B组相比,C组BALF中MCP—1、IL-8浓度及细胞计数均下降,但血清中MCP-1及IL_8的浓度下降无统计学意义。B组BALF中MCP-1浓度与肺泡巨噬细胞（AM）数日及BALF中IL_8与中性粒细胞数目呈正相关（r=0．861,P〈O．01;r=0.735,P〈O．05）,但血清中MCP-1、IL-8浓度与BALF中的细胞数目均无相关性。结论MCP-1和IL-8与COPD的气道炎症密切相关。泼尼松早期干预可通过对MCP-1、IL-8及AM、中性粒细胞的抑制而减轻COPD气道炎症。     

白三烯B4在慢性阻塞性肺疾病中的变化与氨茶碱对其的影响

目的:探讨白三烯B4(1eukotriene B4,LTB4)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)气道局部与血循环中的变化与氨茶碱对其影响.方法:32只雄性Wistar大鼠按随机数字表法分成A组(正常对照组)、B组(COPD组)、C组(氨茶碱低剂量组)、D组(氨茶碱高剂量组),每组8只.测定各组大鼠肺功能,观察肺组织病理改变,对支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)行细胞计数与分类,并检测BALF、血浆及肺组织匀浆液中白细胞介素-8(IL-8)、LTB4的水平.结果:COPD大鼠BALF中LTB4水平较正常对照组明显增高,并与中性粒细胞百分比(r=0.794,P=0.007)、IL-8水平呈显著正相关(r=0.863;P=0.012),与呼气峰流速(peak expiratoryflow,PEF)呈显著负相关(r=-0.718,P=0.028),并与小气道病变中的炎症细胞浸润评分显著正相关(r=0.836,P=0.036).氨茶碱的干预可降低COPD大鼠BALF中LTB4水平及中性粒细胞%,改善小气道黏液细胞渗出,杯状细胞化生,炎症细胞浸润,纤维结缔组织增生,平滑肌增生等各项病理评分及病理总分,其中,对杯状细胞化生,炎症细胞浸润的作用在高剂量组更明显.氨茶碱对PEF无明显改善.结论:LTB4在COPD疾病中表达水平增高,参与气道炎症过程.氨茶碱的治疗可降低COPD大鼠BALF中LTB4水平以及中性粒细胞%,改善小气道病变.     

噻托溴铵在COPD大鼠气道炎症中的作用

目的 探讨噻托溴铵对COPD气道炎症和气道阻力的影响.方法 30只大鼠随机分为3组,每组10只.正常对照组:正常饲养28 d;模型组:第1 d和第14 d气管内滴入脂多糖200μg,每日烟熏(第1 d和第14 d除外),共28 d;治疗组:与模型组相同的方法 建立COPD模型,并于每日烟熏前30 min雾化吸入噻托溴铵(生理盐水溶解,0.12 mmol/L,10 min)共28 d.大鼠处死前行肺功能测定;取左肺BALF进行细胞分类计数;肺组织HE染色行病理学评价;ELISA法测定BALF及血清IL-8和白三烯B4(LTB4)浓度.结果 ①模型组大鼠的气道阻力显著高于正常对照组,顺应性明显降低(P<0.01);治疗组大鼠气道阻力较模型组明显降低(P<0.01),顺应性明显增加(P<0.05).②模型组气道炎症加重,且出现明显肺气肿;治疗组也出现了炎症和肺气肿,但程度较轻.③模型组BALF中细胞总数、中性粒细胞比例明显升高;治疗组细胞总数、中性粒细胞比例较模型组明显降低.④模型组血清及BALF中IL-8和LTB4浓度均较正常对照组明显升高(P<0.01),治疗组与模型组比较IL-8和LTB4水平显著降低(P<0.01).结论 噻托溴铵可以减轻COPD大鼠的气道炎症,延缓肺功能恶化,这一作用可能是通过抑制炎症介质的释放来实现的.     

慢性烟曲霉暴露对哮喘大鼠气道嗜酸粒细胞性炎症及气道高反应性的影响

目的探讨慢性烟曲霉暴露对哮喘大鼠气道嗜酸粒细胞的募集活化及气道反应性的影响。方法使用卵白蛋白腹腔注射后雾化吸入法制备Wistar大鼠哮喘模型,采用雾化吸入孢子悬液的方式模拟慢性烟曲霉暴露,并设置相应的生理盐水对照组。测定反映大鼠气道反应性的指标Penh值,ELISA法测定支气管肺泡灌洗液（BALF）中自细胞介素5（IL-5）、嗜酸粒细胞趋化因子（Eotaxin）浓度,肺组织切片HE染色观察气道炎症性病理改变,测定嗜酸粒细胞浸润程度。瑞士姬姆萨复合染色计数BALF中嗜酸粒细胞比例。结果烟曲霉可引起哮喘大鼠气道反应性升高及气道嗜酸粒细胞增多,加重哮喘大鼠气道过敏性炎症。烟曲霉暴露组中气道嗜酸性细胞增加与IL-5、Eotaxin水平升高相一致。但烟曲霉对生理盐水对照组大鼠的气道反应性、嗜酸粒细胞及IL-5、Eotaxin水平改变无显著作用。结论烟曲霉孢子雾化吸入可促进IL-5、Eotaxin的生成从而加重哮喘大鼠气道的嗜酸粒细胞性炎症,并可加重气道高反应性。     

泼尼松对IL-8在COPD大鼠肺组织表达的影响

目的 研究IL-8在慢性阻塞性肺病(COPD)大鼠肺组织中的表达及泼尼松对其表达的影响.方法 Wistar大鼠24只随机分为:正常对照组(A组)、单纯熏烟组(B组)和熏烟 泼尼松组(C组),每组各8只.单纯熏香烟法建立COPD模型,C组于熏香烟前予泼尼松5 mg/kg隔日灌胃.模型建立后,行支气管肺泡灌洗,测定支气管肺泡灌洗液(BALF)中细胞数,酶联免疫吸附法(ELISA)测定BALF上清液和血清中的IL-8和TNF-α浓度,并对肺组织切片行苏木精-伊红(HE)染色观察形态学改变,采用图像分析系统定量测定肺平均内衬间隔(MLI)、平均肺泡数(MAN)和肺泡腔面积与总面积比(PAA).结果 B组MLI、PAA比A组增高,而MAN低于A组,C组与B组相比MLI、PAA降低,MAN升高,差异均有统计学意义(P＜0.01).与A组比较,B组BALF中IL-8、TNF-α、白细胞总数、中性粒细胞绝对计数和中性粒细胞百分比均增高(P＜0.05),C组较B组上述指标均下降(P＜0.05).B组血清中IL-8和TNF-α浓度亦比A组增高(P＜0.05),C组较B组下降,但IL-8的浓度差异无统计学意义.B组BALF中IL-8与中性粒细胞绝对计数、TNF-α呈正相关(r=0.735、0.987,P＜0.05);与血清中IL-8和TNF-α、血气分析的所有指标及形态学定量分析的任一指标均无相关性.血清IL-8与上述任一指标亦均无相关性.结论 BALF中的IL-8与COPD的气道炎症密切相关,IL-8与TNF-α相互作用,通过趋化激活中性粒细胞等炎性细胞共同参与COPD发病.泼尼松可能通过抑制IL-8的表达,从而减轻炎症介质和炎性细胞对气道的损害,延缓COPD的进展.     

慢性阻塞性肺疾病大鼠肺内白细胞介素9和γ干扰素的表达

目的观察大鼠烟雾暴露慢性阻塞性肺疾病(COPD)模型白细胞介素9(IL-9)和γ干扰素(IFN-γ)的表达,探讨IL-9和IFN-γ与COPD气道炎症的关系。方法单纯熏香烟法建立大鼠COPD模型。收集支气管肺泡灌洗液(BALF)行白细胞总数和分类计数检测;酶联免疫吸附法(ELISA)测定血清、BALF和肺组织中IL-9及IFN-γ的浓度;肺组织切片行HE染色观察形态学改变;采用图像分析系统定量测定肺平均内衬间隔(Lm)、平均肺泡数(MAN)和支气管壁厚/外径比值。结果(1)COPD组Lm及支气管壁厚/外径高于正常对照组,MAN低于正常对照组,差异有统计学意义(P均<0.01)。(2)COPD组血清、BALF和肺组织中IL-9浓度较正常对照组显著增高[血清:(4.02±2.12)pg/mL比(1.12±0.73)pg/mL;BALF:(5.73±2.60)pg/mL比(0.97±0.45)pg/mL;肺组织:(24.92±6.65)pg/mL比(11.42±4.23)pg/mL;P均<0.01]。COPD组血清、肺组织和BALF中IFN-γ的浓度与正常对照组比较均降低,前两者差异有统计学意义[血清:(21.54±7.65)pg/mL比(69.59±13.68)pg/mL;肺组织:(21.88±6.11)pg/mL比(69.84±15.35)pg/mL;P均<0.05]。(3)与正常对照组比较,COPD组BALF中白细胞总数[(5.29±1.61)×108/L比(2.10±1.19)×108/L,P<0.01]、巨噬细胞绝对计数[(4.42±1.38)×108/L比(1.84±0.93)×108/L,P<0.01]、中性粒细胞绝对计数[(1.32±0.36)×108/L比(0.093±0.043)×108/L,P均<0.01]均显著增高。(4)COPD组BALF中白细胞总数、巨噬细胞绝对计数、中性粒细胞绝对计数与BALF中IL-9浓度均呈正相关(r分别为0.9290、.835和0.924,P均<0.05),与肺组织中IL-9浓度呈正相关(r分别为0.8850、.983和0.775,P均<0.05),与血清中IL-9浓度无明显相关性。血清及BALF中IL-9浓度与IFN-γ无明显相关性,肺组织中IL-9与肺组织中IFN-γ则呈负相关(r=-0.818,P<0.05)。结论吸烟可使IL-9升高,IFN-γ水平降低,可能是吸烟导致COPD的原因之一。气道局部的IL-9表达与COPD气道炎症密切相关,可作为COPD气道炎症的检测指标之一。     

糖皮质激素和抗胆碱能药物对慢性阻塞性肺疾病大鼠模型肺组织腺苷A1受体表达的影响

目的研究腺苷A1受体在慢性阻塞性肺疾病(COPD)大鼠模型肺组织内的表达水平,旨在探讨腺苷在COPD中的作用及吸入糖皮质激素和抗胆碱能药对其的影响。方法单纯烟熏法建立COPD动物模型。将30只大鼠分为4组:正常对照组、COPD组、布地奈德组及异丙托溴铵组。计数支气管肺泡灌洗液(BALF)中细胞总数及中性粒细胞,逆转录多聚酶链反应(RTPCR)方法测定肺组织腺苷受体mRNA表达,观察布地奈德和异丙托溴铵对腺苷受体表达的影响。结果COPD组BALF白细胞总数和中性粒细胞数显著高于干预组和正常对照组(P<0.01);布地奈德组与异丙托溴铵组BALF细胞总数及中性粒细胞数高于对照组,有显著性差异(P<0.05);两干预组之间比较无显著性差异(P>0.05)。COPD组腺苷A1受体mRNA表达明显高于干预组和对照组,有显著性差异(P<0.05);布地奈德组和异丙托溴铵组腺苷A1受体mRNA表达显著高于对照组,两干预组之间比较无显著性差异(P>0.05)。各组BALF中性粒细胞计数和腺苷A1受体mRNA表达水平有相关性(P<0.05)。结论COPD模型大鼠存在以中性粒细胞为主的气道炎症,肺组织腺苷A1受体mRNA表达与气道炎症呈正相关。推测腺苷参与慢性支气管炎与肺气肿气道炎症形成。吸入激素可使腺苷A1受体mRNA表达下调并可抑制气道炎症,但不能恢复至正常水平。吸入抗胆碱药亦可下调腺苷A1受体mRNA表达,但机制不明。     

幽门螺杆菌对慢性阻塞性肺疾病大鼠气道黏膜炎症的影响

目的 探讨幽门螺杆菌（Hp）感染对慢性阻塞性肺疾病（COPD）大鼠气道炎症因子的影响。方法选取25只8周Wistar大鼠,随机分为COPD+Hp组11只,COPD组11只,空白对照组3只。采用NaHCO3联合Hp复制Hp感染大鼠模型。香烟烟熏联合气管内滴注脂多糖方法复制COPD大鼠模型。模型复制后4周,收集COPD+Hp组、COPD组大鼠的支气管肺泡灌洗液（BALF）,采用酶联免疫吸附试验测定大鼠BALF的炎症因子白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平。结果 COPD组大鼠BALF的IL-6、IL-8、TNF-α水平分别为（51.20±14.13）、（103.33±15.36）和（150.40±19.82） pg/mL,COPD+Hp组大鼠BALF的IL-6、IL-8、TNF-α水平分别为（87.51±7.66）、（188.73±6.83）和（227.78±33.16） pg/mL,COPD+Hp组大鼠BALF的IL-6、IL-8、TNF-α水平均高于COPD组（P <0.05）。结论 Hp可导致COPD大鼠气道炎症因子水平升高...     

辛伐他汀对COPD大鼠模型炎症的干预作用

目的  观察辛伐他汀对慢性阻塞性肺疾病（COPD）大鼠模型炎症因子及其肺组织病理的影响,探讨辛伐他汀在COPD治疗中的抗炎作用及其机制。方法  采用熏香烟加气管内滴入LPS法建立大鼠COPD模型,随机将30只雄性Wistar大鼠分为正常对照组、COPD模型组和辛伐他汀治疗组,治疗组在造模两周后给予辛伐他汀2.5mg/kg灌胃治疗,每天1次,治疗6周后,观察各组大鼠的体质量增长率,肺组织的病理改变,行支气管肺泡灌洗液(BALF)细胞计数和分类,先分别测定BALF和血清中IL-8及TNF-α的水平、再测定血清中C-反应蛋白（CRP）的水平。结果  治疗组较模型组体质量增长率显著提高（P＜0.05）;模型组大鼠出现明显慢性支气管炎特征性病理改变,出现肺气肿,气管及血管周围大量炎症细胞浸润,治疗组也出现肺气肿和炎症浸润,但程度较模型组轻;治疗组BALF细胞总数和中性粒细胞比例较模型组均有显著下降（P＜0.05）;治疗组 BALF及血清中IL-8 、TNF-α、CRP水平均较模型组显著降低（P＜0.05）。结论  辛伐他汀可降低COPD大鼠模型BALF和血清中的炎症因子,减轻肺组织及气道炎症,对COPD大鼠的炎症有抑制作用。     

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.