盆痛灵方对子宫内膜异位症大鼠神经生长因子及其受体表达的影响

目的:探讨盆痛灵方对子宫内膜异位症(EMs)大鼠异位内膜神经生长因子(NGF)及其受体酪氨酸激酶受体A(TrkA)和神经营养因子受体p75(p75NTR)表达的影响。方法:采用自体内膜移植法建立大鼠EMs模型。取造模成功的大鼠随机分为模型组、消炎痛组和盆痛灵低、中、高剂量组,每组10只;另设假手术组10只(仅切除单侧结扎段子宫)。消炎痛组大鼠给予3 mg·kg~(-1)·d~(-1)消炎痛混悬液,盆痛灵低、中、高剂量组大鼠分别给予10.2、20.4、40.8 g·kg~(-1)·d~(-1)盆痛灵方水煎液,各组均采用直肠给药方式,每日1次,连续4周;模型组和假手术组给予等体积0.9%NaCl溶液。末次给药后,采集各组大鼠的子宫内膜组织。PCR检测各组大鼠异位内膜NGF、p75NTR、TrkA的mRNA表达,Western blot和免疫组化法检测异位内膜NGF、p75NTR、TrkA蛋白表达。结果:①PCR检测显示,模型组大鼠内膜组织NGF、TrkA、p75NTR的mRNA表达较假手术组显著升高(P0.01);与模型组相比,消炎痛组和盆痛灵中、高剂量组NGF和TrkA的mRNA表达明显降低(P0.05,P0.01),消炎痛组和盆痛灵高剂量组p75NTR的mRNA表达亦明显降低(P0.01);与盆痛灵低剂量组相比,高剂量组大鼠的内膜组织NGF、TrkA、p75NTR的mRNA表达均显著降低(P0.01),中剂量组TrkA mRNA表达亦明显降低(P0.05);与盆痛灵中剂量组相比,高剂量组p75NTR mRNA表达明显降低(P0.01)。②Western blot检测显示,模型组大鼠内膜组织NGF、TrkA、p75NTR蛋白表达水平较假手术组显著升高(P0.01);与模型组相比,消炎痛组及盆痛灵高、中、低剂量组NGF、TrkA、p75NTR蛋白表达水平均明显降低(P0.01);与盆痛灵低剂量组相比,中、高剂量组大鼠子宫内膜NGF、TrkA、p75NTR蛋白表达水平均显著降低(P0.01);与盆痛灵中剂量组相比,高剂量组NGF、TrkA、p75NTR蛋白表达水平亦显著降低(P0.01)。③免疫组化检测显示,与假手术组相比,模型组NGF及其受体p75NTR、TrkA在异位内膜的腺上皮细胞与间质细胞胞浆呈高表达,仅少量表达于胞核;与模型组相比,消炎痛组及盆痛灵中、高剂量组NGF、p75NTR、TrkA的阳性表达明显减弱;与盆痛灵低剂量组相比,盆痛灵中、高剂量组NGF、p75NTR、TrkA的阳性表达明显减弱。结论:盆痛灵方可能通过降低异位内膜NGF及其受体p75NTR、TrkA的表达,对子宫内膜异位症起治疗作用,且其作用具有一定的剂量依赖性。     

骨癌痛大鼠脊髓背根神经节主要组织相容复合物Ⅱ表达变化的研究

目的  建立大鼠胫骨的骨癌痛模型,观察骨癌痛发生时脊髓背根神经节内主要组织相容复合物Ⅱ（MHCⅡ）的表达变化情况。方法  雌性SD大鼠33只,随机分为正常组（Naive组,n =9）、假手术组（Sham组,n =12）和骨癌痛组（骨癌痛组,n =12）。骨癌痛组右侧胫骨的骨髓腔内接种Walker 256乳腺癌细胞,Sham组注射相等体积的D-Hanks液。于手术前1天及手术后3、7、10和14 d使用von-Frey丝测定手术侧的机械缩爪阈值;于手术后14 d采集各组（n =9）的L3～L5的右侧背根神经节,每3只大鼠的背根神经节标本作为一组提取总的蛋白质,采用蛋白免疫印迹法（Western blot）检测MHCⅡ的变化情况;于手术后14 d多聚甲醛灌注Sham组（n =3）和骨癌痛组（n =3）大鼠,取L3～L5的右侧背根神经节制作冷冻切片,采用免疫荧光双标染色观察MHCⅡ的变化情况以及与神经元和卫星细胞的关系。结果  手术前各组大鼠的机械缩爪阈值,差异无统计学意义;骨癌痛组在骨癌痛模型建立7 d后较基础值显著降低,差异有统计学意义（P <0.05）,且显著低于Naive组,差异有统计学意义（P <0.05）。免疫荧光染色显示MHCⅡ表达于背根神经节的卫星细胞;同时Western blot定量结果发现骨癌痛组的MHCⅡ表达水平显著高于Naive组,而Sham组变化差异无统计学意义。结论  骨癌痛大鼠背根神经节的MHCⅡ表达升高,可能参与骨癌痛的外周敏化。

     

骨癌痛模型大鼠脊髓背根神经节P2X3受体的表达变化

目的:观察骨癌痛模型大鼠脊髓背根神经节中P2X3受体及其mRNA的表达变化,初步探讨其可能的意义。方法:60只雌性Wistar大鼠随机分为3组（每组n=20）：空白对照（C）组;骨癌痛模型（CP）组,左胫骨内接种含2×105个Walker-256大鼠乳腺癌细胞的悬液10 μl;假手术（S）组,左侧胫骨骨髓腔内注入等体积的生理盐水。在接种后第4、7、10、14、17、21天进行疼痛行为学测试,在第14、21天各组分别选10只大鼠,取背根神经节,5只行免疫组化染色,另5只抽提RNA行实时PCR,检测背根神经节中P2X3受体及其mRNA的表达。结果:CP组大鼠在胫骨内接种肿瘤后第10天开始出现痛觉过敏,第14~21天最为明显。CP组接种肿瘤后第14、21天患侧背根神经节神经元中P2X3受体免疫阳性细胞率明显增高（P<0.05）,mRNA表达水平显著增高（P<0.05）。结论:骨癌痛模型大鼠存在痛觉敏化,可能与P2X3受体表达增高有关。     

电针对骨癌痛-吗啡耐受大鼠痛行为和降钙素基因相关肽的影响

目的 探讨电针治疗对骨癌痛吗啡耐受模型大鼠痛行为的影响以及背根神经节降钙素基因相关肽(CGRP)表达的变化.方法 40只SD大鼠随机分为4组,每组10只:假手术组(Sham)、骨癌痛+吗啡耐受组(BM)、骨癌痛+电针组(BE)和骨癌痛+吗啡耐受+电针组(BME).BM、BE和BME组制备胫骨癌痛模型,接种后第7天3组分别实施吗啡、电针、吗啡+电针治疗,连续9d.电针选择足三里(ST36)和三阴交(SP6)穴位.痛行为采用机械刺激缩足阈值测定,以50％缩足阈表示.免疫组织化学测定背根神经节CGRP表达水平.结果 电针治疗第5天,BME组50％缩足阈值(10.9±0.8)g,与BM组[(8.7±0.6)g]和BE组[(6.2±0.9)g]相比,差异有统计学意义(P＜0.01),并持续至第9天.BME组背根神经节CGRP免疫阳性表达的IOD值(9026.5±1827.4),与BM组(14803.1±2086.7)和BE组(15730.6±2712.5)比较,差异有统计学意义(P＜0.01).结论 电针能够改善骨癌痛-吗啡耐受大鼠机械痛阈,机制可能与减少背根神经节CGRP过度释放有关.     

大鼠初级感觉神经元内PKA/CREB通路在骨癌痛中的作用

目的:观察蛋白激酶A拮抗剂H-89对骨癌痛大鼠疼痛行为和背根神经节环磷腺苷效应元件结合蛋白(c AMP-response element binding protein,CREB)磷酸化水平的影响。方法:1检测骨癌痛大鼠背根神经节CREB磷酸化水平:将32只雌性SD大鼠随机分为假手术组和骨癌痛组(n=16),分组后在大鼠右侧胫骨髓腔内分别注射PBS或乳腺癌Walker 256细胞,肿瘤细胞接种后1,3,7,10,14 d检测大鼠机械痛阈,第14天提取骨癌痛组大鼠第2至第5腰椎右侧的背根神经节,应用免疫印迹法检测磷酸化CREB(p-CREB)的表达量。2检测H-89对大鼠疼痛行为及CREB磷酸化的影响:将32只骨癌大鼠随机均分为DMSO组和H-89组。在肿瘤细胞接种后的第9天至第14天每天鞘内注射DMSO或H-89。分别在给药前、给药后15,30,45和60 min进行疼痛行为测试。在第14天最后一次鞘内给药1 h后,快速提取大鼠右侧背根神经节,应用免疫印迹法检测p-CREB的表达量。结果:与假手术组比较,骨癌痛组大鼠机械痛阈明显降低,背根神经节中CREB磷酸化水平升高(P<0.05)。鞘内注射DMSO或H-89后,H-89组大鼠机械痛阈较DMSO组明显升高。同时H-89组CREB磷酸化水平较DMSO组明显降低(P<0.01)。结论:蛋白激酶A通过CREB磷酸化加剧大鼠骨癌痛。     

p75神经营养素受体在新生和成年大鼠背根神经节中的不同表达

目的：研究神经生长因子低亲和力受体p75NTR在新生和成年大鼠背根经节中的表达，以探讨p75NTR在背根神经节神经元中的作用。方法：取新生和3月龄大鼠背根神经节，免疫组化ABC法观察p75NTR在神经元中分布和表达。结果：新生大鼠背根神经节中可见较多的p75NTR阳性反应神经元，免疫反应产物主要位于胞浆。成年大鼠背根神经节大多数神经元有p75NTR阳性免疫反应产物，主要位于细胞核。结论：p75NTR在新生和成年大鼠背根神经节神经元中表现为不同表达方式，提示其在神经元发育和分化的不同阶段发挥着一定的作用。     

脊髓CXCL13在大鼠骨癌痛形成中的作用

目的 探讨脊髓趋化因子CXC配体13(CXCL13)在大鼠骨癌痛形成中的作用.方法 健康雌性SD大鼠20只,体质量160～200 g,分为4组(n=5):假手术组(S组)、骨癌痛组(BP组)、小干扰RNA(siRNA)阴性对照(NC-siRNA)组(NC组)和CXCL13-siRNA组(CS组).S组胫骨骨髓腔内注射生理盐水,BP组、NC组和CS组均采用胫骨髓腔内注射等量Walker-256乳腺癌细胞的方法建立大鼠胫骨癌痛模型,NC组和CS组分别鞘内注射NC-siRNA慢病毒和CXCL13-siRNA慢病毒10μL.分别于造模前1d及术后第7、9、14、21天时测定机械痛阈值,痛阈测定结束后处死大鼠,取脊髓和胫骨组织,采用免疫荧光双标染色检测脊髓CXCL13、小胶质细胞特异性标记物(Iba-1)和神经元特异核蛋白(NeuN)的共表达情况;采用Western-blot、RT-PCR法测定脊髓CXCL13、Iba-1的蛋白及mRNA表达;采用HE染色光镜下观察胫骨骨结构破坏情况.结果 与S组比较,BP和NC组接种后7～21 d机械痛阈下降(P＜0.05),CXCL13在神经元中表达显著上调,小胶质细胞明显活化(P＜0.05),CXCL13和Iba-1蛋白及mRNA水平明显升高(P＜0.05);与NC组比较,CS组造模后9～21 d机械痛阈升高(P＜0.05),CXCL13在神经元中表达明显下调,小胶质细胞活化减少(P＜0.05),CXCL13和Iba-1蛋白及mRNA水平明显下降(P＜0.05);HE染色显示BP、NC组、CA组均出现骨髓腔内肿瘤生长且向外侵蚀破坏骨皮质,S组未见异常.结论 脊髓CXCL13通过激活小胶质细胞参与大鼠骨癌痛的形成.     

小剂量氯胺酮对慢性神经痛大鼠的镇痛效应和背根神经节P2X3受体表达的影响

【 目的 观测腹腔注射小剂量氯胺酮对慢性神经痛大鼠镇痛效应和背根神经节P2X3受体表达的影响，以探讨其在神经性疼痛中的作用。方法 大鼠随机分为4组：空白对照组(C组)、假手术组(S组)、腹腔注射生理盐水组(NS组)与氯胺酮组(K组)，每组8只。在大鼠右后足检测冷刺激反应、热痛敏阈基础值后，腹腔注射10%水合氯醛400 mg∕kg进行麻醉。NS组和K组构建大鼠右侧坐骨神经慢性结扎损伤模型，S组暴露坐骨神经但不结扎，C组不进行手术。手术后K组每天上午10时腹腔注射10mg·kg-1氯胺酮(用生理盐水稀释至0.5ml)，NS组则腹腔注射等量生理盐水，连续2周。14d后测定各组大鼠右后足冷刺激反应、热痛敏阈值。尔后各组取手术侧L4背根神经节，并采用免疫组化法观测P2X3受体的表达。结果 手术后14 d，NS组和K组大鼠右足热痛敏阈值均明显低于C组和S组（P<0.05），冷刺激反应则显著高于C组和S组（P<0.05）；但K组大鼠右足热痛敏阈值明显高于NS组，而冷刺激反应明显低于NS组(P<0.05)；NS组和 K组大鼠背根神经节P2X3受体免疫反应阳性细胞数量多于C组和S组，但K组显著少于NS组比较则明显降低(P<0.05)；NS组与S组大鼠背根神经节神经元P2X3受体免疫组化评分高于C组和S组，而K组却低于NS组，(P<0.05)。结论 腹腔注射小剂量氯胺酮可提高慢性神经性疼痛大鼠痛敏阈值及减弱冷刺激反应，其作用机制可能与减少背根神经节神经元P2X3受体表达有关。 【关键词】背根神经节 神经痛 氯胺酮 三磷酸腺苷 P2X3     

连续小剂量吗啡腹腔注射对CCI大鼠抗伤害效应的实验研究

目的观察坐骨神经慢性收缩损伤(CCI)后小剂量吗啡(5 mg·kg-1)连续腹腔注射对大鼠痛敏的影响,以脊髓后角C-fos及TrkA受体表达的改变为观测指标,探讨吗啡耐受可能的脊髓机制.方法选择雌性SD大鼠40只,随机分为4组,A组假手术组,B组CCI组,Cd组CCI+生理盐水组,D组CCI+吗啡组(5 mg·kg-1·d-1×14 d),分别于术前2 d,术后7 d、14 d给予热痛阈测试,免疫组织化学方法检测C-fos及TrkA受体的表达.结果①A组术后术侧热痛阈轻度下降,与术前相比差异无显著性,P＞0.05.B、C、D组术后术侧呈现不同程度热痛阈下降,术后14 d降至最低点,B组、C组与A组相比,差异具有极显著性,P＜0.01,D组与A组相比,差异具有显著性,P＜0.05.②CCI术后14 d脊髓C-fos、TrkA受体的表达较术后7 d明显增加,C-fos的表达主要集中于脊髓背角表层Ⅰ～Ⅱ、Ⅲ～Ⅳ层的中间内侧部,TrkA受体分布于Ⅱ～Ⅴ层.C-fos、TrkA受体的表达在B、C、D三组与A组相比,差异具有显著性,P＜0.05.连续小剂量吗啡腹腔注射不能有效的减少坐骨神经慢性收缩损伤大鼠热痛觉过敏程度及脊髓C-fos、TrkA受体的表达,与CCI组(B组)相比,差异无显著性,P＞0.05.结论小剂量吗啡(5 mg·kg-1)连续腹腔注射不能有效抑制坐骨神经损伤后热痛觉过敏及脊髓背角C-fos、TrkA受体的表达,可能是由于长时间使用吗啡导致脊髓背角神经元兴奋性进一步升高,发生中枢可塑性改变,以及脊髓背角神经元μ-阿片受体脱敏感有关.     

CD147参与大鼠神经病理性疼痛发生与发展中的作用

目的 探讨CD047在大鼠神经损伤后痛觉敏化形成中的作用.方法 分别采用免疫荧光染色法和Western blotting法检测大鼠脊神经结扎(SNL)后脊髓与背根神经节CD147的表达,采用实时定量聚合酶链反应(RT-PCR)检测大鼠背根神经节内CD147 mRNA的表达.大鼠背根神经节内注射CD147过表达RNA或干涉RNA后,观察机械性缩足反应阈值(MWT)的变化.结果 正常大鼠脊髓几乎不表达CD147,且SNL后脊髓CD147表达几乎无变化;正常大鼠背根神经节有少量CD147表达,SNL后CD147和mRNA表达均升高;大鼠背根神经节内注射对照RNA或过表达RNA后,对照组大鼠MWT未见明显变化,差异无统计学意义(P＞0.05),RNA过表达组大鼠的痛域降低,差异有统计学意义(P＜0.05).大鼠背根神经节内注射对照RNA或干涉RNA后,对照组MWT下降,干涉RNA组痛域亦下降,但仍高于对照组,差异有统计学意义(P＜0.05).结论 外周神经损伤后,大鼠背根神经节内CD147及其mRNA表达均上调;CD147过表达可诱发神经病理性疼痛,干涉CD147 RNA表达,抑制神经病理性疼痛.     

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.