老年冠心病患者血浆内皮素浓度变化

采用放射免疫法测定３６例老年及老年前期冠心病患及健康人血浆内皮素水平的变化。结果显示：（１）老年前期组冠心病患与健康人血浆内皮素水平（９．８２±２．５８）ｎｇ’Ｌ和（７．２６±１．４５）ｎｇ／Ｌ无明显差异；老年组冠心病患与健康人血浆ＥＴ水平（１３．６３±３．１０）ｎｔ／Ｌ和（７．９３±１．８６）ｎｇ／Ｌ差异显。（２）老年组冠心病患血浆ＥＴ水平（１３．６３±３．１０）ｎｇ／Ｌ较老年前期组ｎ     

肾脏病患者血浆内皮素水平观察

目的观察肾脏病患者（包括尿毒症血透病人）血浆内皮素水平。方法用放射免疫方法测定了３７例肾脏病患者和６３例健康成人血浆内皮素（Ｅｎｄｏｔｈｅｌｉｎ，ＥＴ）的含量。结果①正常人ＥＴ水平较低（８４．５３±２２．１６ｎｇ／Ｌ）。尿毒症非透析组（１４２．６１±６６．３６ｎｇ／Ｌ）、尿毒症透析前（２４９．０７±６３．０４ｎｇ／Ｌ）、尿毒症透析后（１６４．０４±７４．８７ｎｇ／Ｌ）、肾炎组（１２０．４２±３６．１０ｎｇ／Ｌ）血浆ＥＴ水平皆较正常人高（Ｐ＜０．０１）；②血透后ＥＴ水平下降（Ｐ＜０．０１）；③血透治疗患者的血浆ＥＴ水平高于非透析治疗组（Ｐ＜０．０１）。结论肾脏病患者（包括尿毒症血透病人）血浆内皮素水平升高。     

经皮二尖瓣球囊扩张术对血浆降钙素基因相关肽、内皮素失衡的影响

为探讨经皮二尖瓣球囊扩张术（ＰＢＭＶ）对血浆降钙素基因相关肽（ＣＧＲＰ）及内皮素（ＥＴ）的影响，采用放射免疫分析法（ＲＩＡ）测定了３０例二尖瓣狭窄（ＭＳ）患者经皮二尖瓣球囊扩张术前后血浆降钙素基因相关肽、内皮素水平。结果显示：１、ＰＢＭＶ前后血浆ＣＧＲＰ水平分别为３５．６０１±１７．２９４ｎｇ／Ｌ，３９．２４６±１８．５２８ｎｇ／Ｌ（Ｐ＞０．０５）；血浆ＥＴ分别为１１７．５２４±４０．６３１ｎｇ／Ｌ，９４．９４９±３１．７９９ｎｇ／Ｌ（Ｐ＜０．０５）；ＣＧＲＰ／ＥＴ分别为０．３０２±０．１４１、０．４５２±０．１６１。２、血浆ＣＧＲＰ水平与平均肺动脉压呈负相关（ｒ＝－０．４３５，Ｐ＜０．０５），而与血浆ＥＴ呈显著正相关（ｒ＝０．７３５，Ｐ＜０．００１）。研究表明，ＭＳ患者血浆ＣＧＲＰ／ＥＴ严重失衡，ＰＢＭＶ对恢复ＣＧＲＰ／ＥＴ间平衡有积极作用，测定其血浆含量可做为判定病情程度及ＰＢＭＶ疗效的一项指标     

生长落后儿童血中内皮素测定

以激发试验将３６例生长落后儿童分为生长激素（ＧＨ）反应正常组和生长激素反应缺乏组，用放射免疫分析法分别测定其血浆内皮素（ＥＴ）水平。结果：ＧＨ反应正常组血浆ＥＴ水平为（３８．８９±１４．２３）ｎｇ／Ｌ，ＧＨ反应缺乏组儿童为（３７．５８±１９．５５）ｎｇ／Ｌ，正常对照组（５２．８３±１１．８９）ｎｇ／Ｌ，生长落后儿童不论其激发试验ＧＨ反应正常或缺乏，其血浆ＥＴ水平均低于正常儿童（Ｐ＜０．０５）。     

正常人血浆内皮素水平及其动态变化

作采用特异内皮素（ＥＴ）抗体，通过放射免疫分析法，检测４０名健康人血浆ＥＴ水平。同时，对其中２０名分别持续观察了１５０ｍｉｎ内的６次空腹及试餐后（面食１５０ｇ，水１００ｍｌ）血浆ＥＴ水平的动态变化。结果表明：４０名健康人血浆ＥＴ含量均值为１１．５３±５．７８ｎｇ／Ｌ；男性为１３．１４±６．１２ｎｇ／Ｌ，女性为１１．３８±５．８０ｎｇ／Ｌ（Ｐ〉０．０５）；大于３０岁年龄组为１２．８７±６．０６ｎｇ     

支气管哮喘急性发作期患者血浆内皮素水平的变化

为探讨内皮素（ＥＴ）与支气管哮喘急性发作的相互关系，采用放射免疫分析法对２３例支气管哮喘急性发作期患者和１２例正常人血浆ＥＴ水平进行检测，并与动脉血氧分压（ＰａＯ２）和最大呼气流量（ＰＥＦ）进行相关分析。结果发现哮喘急性发作期患者血浆ＥＴ水平为８９．２±８．４ｎｇ／Ｌ，明显高于正常组的５２．２±６．５ｎｇ／Ｌ（Ｐ＜０．００１）；且ＥＴ水平与ＰａＯ２和ＰＥＦ呈明显负相关（ｒ分别为－０．７８９３和－０．７１２４，Ｐ＜０．０１）。提示ＥＴ可能与哮喘患者的急性发作有一定的关系，并可反映病情的严重程度。     

急性白血病患者血浆内皮素变化及其临床意义

应用放射免疫分析法（ＲＩＡ）检测５３例急性白血病（ＡＬ）患者血浆内皮素（ＥＴ）水平，以探讨其血浆ＥＴ变化的临床意义。结果显示：ＡＬ组血浆ＥＴ水平为（９９．９２±ｌ２．３２）ｎｇ／Ｌ，明显高于正常对照组［（６２．２８±８．９１）ｎｇ／Ｌ，Ｐ＜０．０１］。化疗达完全缓解者血浆ＥＴ水平为（７３．５３±８．４２）ｎｇ／Ｌ，较未缓解组明显下降（Ｐ＜０．０１）。ＡＬ并出血的轻、中度组血浆ＥＴ水平明显高于无出血组（Ｐ＜０．０５），而重度出血组血浆ＥＴ水平却显著低于无出血组和轻、中度出血组（均为Ｐ＜０．０１）。ＡＬ血浆ＥＴ水平与骨髓白血病细胞比例呈正相关（ｒ＝０．９０６５，Ｐ＜０．０１）．提示ＡＬ血浆ＥＴ水平明显升高，并与病情演变及转归密切相关。     

内皮素测定与新生儿缺氧缺血性脑病预后

应用放射免疫测定法检测２０例缺氧缺血性脑病患儿和１５例正常新生儿血浆内皮素（ＥＴ－１）浓度，并对１７例患儿进行治疗前后的动态观察。结果显示２０例患儿治疗前ＥＴ－１水平为８５．１±１．１ｎｇ／Ｌ，明显高于正常对照组６０．７±３．６（Ｐ〈０．０１）１７例治疗好转后ＥＴ－１水平为６６．８±４．３ｎｇ／Ｌ，较治疗前８１．４±９．６ｎｇ／Ｌ明显下降（Ｐ〈０．０５），与正常对照无差异（Ｐ〉０．０５）；重症患     

肝硬化患者血浆内皮素变化意义探讨

观察正常人、肝硬化患者综合治疗前后血浆内皮素含量变化。结果肝硬化患者血浆内皮素含量为（６４．３±１５．３）ｎｇ／Ｌ，显著高于正常人（４２．５±７．４）ｎｇ／Ｌ，Ｐ＜０．０１；肝硬化伴腹水患者为（７５．５±９．５）ｎｇ／Ｌ，高于无腹水患者（５４．１±１２．１）ｎｇ／Ｌ。肝硬化患者经综合治疗１月后，伴或无腹水组分别为（７０．５±１０．０）和（５２．８±１３．１）ｎｇ／Ｌ，与同组治疗前比较无显著差异。提示血浆内皮素与肝硬化腹水形成的病理生理过程有关；一般内科治疗不能显著降低血浆内皮素水平。     

生长落后儿童血中内皮素测定

以激发试验将３６例生长落后儿童分为生长激素（ＧＨ）反应正常组和生长激素反应缺乏组，用放射免疫分析法分别测定其血浆内皮素（ＥＴ）水平。结果：ＧＨ反应正常组血浆ＥＴ水平为（３８．８９±１４．２３）ｎｇ／Ｌ，ＧＨ反应缺乏组儿童为（３７．５８±１９．５５）ｎｇ／Ｌ，正常对照组（５２．８３±１１．８９）ｎｇ／Ｌ，生长落后儿童不论其激发试验ＧＨ反应正常或缺乏，其血浆ＥＴ水平均低下正常儿童。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.