脑外伤后局部应用山莨菪碱对家兔脑血流速度的影响

目的：脑外伤后常出现脑组织区域性缺血，为防治这种病理现象，通过局部应用山莨菪观察其对脑血流速度的影响。方法：１０只家兔采用额顶骨骨窗成形后硬脑膜外打击法制作动物模型，损伤性质为脑皮层挫裂伤。双侧硬脑膜外打击后形成双侧大脑半球脑皮层挫裂伤。设左半球为Ａ侧（对照侧），右半球为Ｂ侧（治疗侧）。致伤后应用局部微量等距离扩渗法分层浸注山莨菪碱稀释液于家兔右半球皮层，而而半球采用同样方法分层浸注等量盐水作对照     

脑外伤后局部应用地塞米松对家兔脑病理改变的影响

目的 :通过研究脑外伤后脑皮层局部应用地塞米松对家兔脑组织形态和脑电图的影响 ,探讨地塞米松对损伤灶部位的治疗作用或负面影响。方法 :15只家兔随机分为A、B 2组 ,A组 10只 ,B组 5只。采用额顶骨骨窗成形后硬脑膜外打击法制作动物脑损伤模型。致伤后应用局部微量等距离扩渗法分层浸注地塞米松 ,实施皮层损伤灶给药。A组为单侧骨窗成形 ,即单侧皮层损伤 ,10只家兔随机平均分为A1和A2 2组。A1组为生理盐水对照组 ,于致伤侧按上述方法给予同A2 组等体积的生理盐水。A2 组于致伤侧局部给予地塞米松作为治疗组。B组双侧骨窗成形后造成双侧脑皮层损伤模型 ,设左侧为生理盐水对照侧 (B1) ,右侧为地塞米松治疗侧 (B2 ) ,方法同A组。分别于致伤前后、用药前后动态观察脑电图。 72h后行病理切片检查。结果 :2组家兔致伤后均呈损伤性脑电图。用药后 4 0～ 90min ,A2 组和B2 侧脑皮层脑电图好转 ,4 8h后接近正常。A1组和B1侧异常脑电图则持续存在。病理学检查可见治疗组 (侧 )较对照组 (侧 )脑组织挫伤、水肿程度明显为轻。结论 :家兔脑损伤后局部应用微量地塞米松可明显减轻损伤灶脑挫伤和脑水肿程度 ,并能改善脑电图而未发现有负面影响或癫痫样脑电图。     

脑外伤后局部应用地塞米松对家兔脑病理改变的影响

目的：通过研究脑外伤后脑皮层局部应用地塞米松对家兔脑组织形态和脑电图的影响，探讨地塞米松对损伤灶部位的治疗作用或负面影响。方法：１５只家兔随机分为Ａ、Ｂ２组，Ａ组１０只，Ｂ组５只。采用额顶骨骨窗成形后硬脑膜外打击法制作动物脑损伤模型。致伤后应用局部微量等距离扩渗法分层浸注地塞米松，实施皮层损伤灶给药。Ａ组为单侧骨窗成形，即单侧皮层损伤，１０只家兔随机平均分为Ａ１Ｔ Ａ２ ２组。Ａ１组为生理盐水对照     

大鼠急性创伤性脑水肿模型的建立

本文报道了作者所建成的一种大鼠急性创伤性脑水肿模型。取30cm高,100g重的砝码,以自由落体法作用于去骨瓣大鼠的硬膜外,致局限性脑挫裂伤。6小时后断头去脑,计算脑含水量和伊文氏蓝含量,观察伊文氏蓝染色范围。实验结果表明,实验组挫裂伤侧脑含水量(％)为79.03±0.62,比对侧及对照组左、右半球(78.14±0.82,78.33±0.45,78.14±0.59)明显增加(P<0.05),伊文氏蓝含量(μg/g于脑重)为58.78±27.19),也较对侧(26.03±25.62)及对照组左半球(5.10±3.22)、和右半球(6.8n±2.47)显著增多(P<0.01),创伤周围有明显的蓝染带。     

经颅彩色多普勒对大脑血流动力学的研究

目的 :探讨认知过程中脑血流动力学的变化。方法 :应用经颅彩色多普勒对不同生理情况下大脑半球血流速度的变化进行监测。结果 :每项试验前后比较 ,血流速度的增加有显著差异 (P <0 0 1) ,语言试验血流速度增加偏侧在左半球 ,面视试验偏侧在右半球 ,光刺激试验时枕区血流速度最快。结论 :经颅多普勒能监测认知过程中半球血液动力学变化的差异     

消炎痛对急性脑外伤家兔大脑中动脉血流速度的影响

探讨消炎痛对家兔急性脑外伤后早期脑血流速度的影响，评价消炎痛在脑外伤治疗中对颅内压 的作用。方法：采用自由落体打击法建立家兔急性颅脑损伤模型，并于致伤后 １０ｍｉｎ开始经静脉推注消炎痛４ ｍｇ·ｋｇ－１。应用经颅多谱勒超声，监测其对大脑中动脉血流速度的影响；同时用颅内压监护仪观察其对脑外伤后颅 内压的影响。结果：消炎痛可使脑外伤后心缩期脑血流速度显著降低（Ｐ＜０．０１），而对舒张末期脑血流速度影响 不大（Ｐ＞０．０５）。随着脑血流速度的降低，颅内压升高的速度及幅度也显著低于对照组（Ｐ＜０．０１）。结论：消炎痛 可在不影响正常脑循环的基础上，降低脑血流速度，减少脑血流量，防止脑血流过度灌注，从而有效地控制颅内压 的过度升高。     

右美沙芬对兔急性脑外伤后脑血流速度的影响

目的 :应用经颅多普勒超声 (TCD)技术研究右美沙芬治疗兔颅脑急性损伤后脑血流速度的变化及其意义。方法 :健康雄性白家兔 2 0只 ,随机分为 2组。A组 (n =1 0 )为脑外伤组 ,B组 (n =1 0 )为脑外伤后右美沙芬治疗组。应用TCD分别测定外伤前、伤后 5min、6h、72h、1 6 8h兔大脑中动脉 (MCA)脑血流速度。观察指标为收缩期血流速度 (vS) ,舒张期血流速度 (vD)和脉动指数 (PI)。结果 :A组伤前、后 5min、1 6 8hvS 与B组比较 ,差异无统计学意义 ;A组伤后 6h、72hvS((39.4 5± 7.5 )cm/s,(4 1 .2 0± 5 .94 )cm/s)与B组 ((5 1 .6 8± 1 0 .32 )cm/s,(5 2 .4 1± 8.5 6 )cm/s)比较差异有统计学意义 (P <0 .0 5 ) ;A组伤前、后 5min、1 6 8hvD 与B组比较 ,差异无统计学意义 ;A组伤后 6h、72hvD((2 6 .33± 3.4 6 )cm/s,(2 5 .84± 5 .6 9)cm/s)与B组 ((33.6 4± 4 .2 7)cm/s ,(34.86± 7.4 8)cm/s)比较差异有统计学意义 (P <0 .0 5 ) ;A组伤前、后 5minPI值与B组比较差异无统计学意义 ,A组伤后 6h、72h、1 6 8hPI(2 .0 6±0 .5 8,2 .2 5± 0 .36 ,1 .5 3± 0 .39)与B组 (1 .2 6± 0 .2 9,1 .38± 0 .2 9,0 .96± 0 .1 7)比较差异有统计学意义 (P <0 .0 5 )。结论 :提示右美沙芬可通过改善脑血流速度、降低脉动指     

TRH对兔急性颅脑损伤后早期脑血流的影响

目的 :探讨TRH对急性颅脑损伤后早期脑血流的影响。方法 :采用自由落体打击法致伤家兔 ,致伤力80 0× 80g·cm。 2 2只家兔随机分 2组。TRH治疗组 ,n =10 ,伤后 0 .5h开始静脉注射TRH ,此后每 0 .5h注射 1次 ,至伤后 4h。对照组n =12 ,按上述方法给予等量生理盐水。测量颅内压 (ICP)、脑组织含水量 ,应用经颅多谱勒超声 (TCD)测量舒张期末血流速度 (Vd)和脉动指数 (PI)。结果 :伤后 3h ,TRH治疗组Vd值显著增加 ,PI值降低 (P <0 .0 1) ;给药后ICP递增速度明显减慢 ,伤后 1.5h ,ICP显著低于对照组 (P <0 .0 1) ;脑组织含水量明显低于对照组(P <0 .0 1)。结论 :TRH能够显著增加颅脑损伤后的脑血流量 ,改善脑血流 ,降低ICP ,减轻脑水肿     

急性脑梗死后尿失禁与病灶部位、大小的关系

目的：探讨急性脑梗死后尿失禁与病灶部位，大小的关系。方法：采取回顾性分析方法，对该院近10年来收治的急性单侧大脑半球梗死患者分尿失禁组和无尿失禁组作对比分析。结果：左半球梗死者尿失禁发生率（46．5％）明显高于右半球者（24．1％）（P＜0．01），同侧皮层＋皮层下梗死者尿失禁发生率（66．1％）明显高于单纯皮层（15．2％）和皮层下梗死者（11．1％）（P均＜0．001）；尿失禁者皮层＋皮层下梗死发生率（80．4％）比无尿失禁者（24．1％）高得多（P＜0．001）；尿失禁者失语率（73．9％）明显高于无尿失禁者（24．1％）（P＜0．001），结论：脑梗死后尿失禁与病灶部位，大小关系密切，左半球梗死，皮层＋皮下梗死者尿失禁发生率高。     

视网膜脱离扣带术后视网膜中央动脉血液动力学的改变

目的 :探讨视网膜脱离巩膜扣带术后眼视网膜中央动脉血流动力学的改变。方法 :对 2 6例单眼孔源性视网膜脱离行局部外加压术 (16眼 )或环扎术 (10眼 )巩膜扣带手术方法后 ,应用彩色多普勒成像检测视网膜中央动脉血流速度 ,对侧健眼为对照眼。结果 :局部巩膜外加压术后 16眼视网膜中央动脉血流平均流速值 [(4.0 5± 0 .35 ) cm / s]较对侧健眼 [(5 .5 4± 1.2 6 )cm/ s]明显降低 (P <0 .0 1) ;环扎术 10眼视网膜中央动脉血流平均流速值 [(3.10± 0 .5 4 ) cm / s]较对侧健眼 [(5 .0 9± 0 .94 )cm/ s]明显降低 (P <0 .0 1)。环扎术眼视网膜中央动脉血流平均流速值较外加压术眼明显降低 (P <0 .0 1)。结论 :局部巩膜外加压术和环扎术均可引起视网膜中央动脉血流速度改变 ,以环扎术后视网膜中央动脉血流速度改变较为明显     

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.     

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.     

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.