20lA中药合剂对大鼠抗肾小球基底膜肾炎病变的影响

目的 观察201A中药合剂防治大鼠抗肾小球基底膜(GBM)肾炎的疗效。方法 建立大鼠抗GBM肾炎模型。实验分3组：201A处理组、肾炎对照组及正常对照组。201A处理组大鼠一次性尾静脉注射抗GBM抗血清后即刻给予201A合剂(0．42g／kg，灌胃)，至第21天。对照组则给予等量的生理盐水。定期于第4天、第14天和第21天，检测大鼠尿蛋白，观察肾组织病理学改变。结果 肾炎对照组大鼠注射抗血清后于第4天即出现异常蛋白尿，肾小球内可见细胞数增加和新月体形成，肾小管内大量蛋白管型，GBM呈不规则增厚。而201A处理组鼠上述病变均明显好转。结论 201A能够明显改善抗肾小球基底膜肾炎大鼠的肾功能。     

201A中药合剂对大鼠抗肾小球基底膜肾炎免疫功能的影响

目的 观察201A中药合剂防治大鼠抗肾小球基底膜(GBM)肾炎的疗效。方法 建立大鼠抗GBM肾炎模型。实验分3组：201A处理组、肾炎对照组及正常对照组。201A处理组大鼠一次性尾静脉注射抗GBM抗血清后即刻给予201A合剂(0．42g／kg，灌胃)，肾炎对照组大鼠一次性尾静脉注射抗GBM抗血清后则给予等量的生理盐水，均至第21天。定期于第4、14和21天，检测大鼠尿蛋白，并收集血标本检测T淋巴细胞转化功能、血清中循环免疫复合物及抗GBM自身抗体。结果 肾炎对照组大鼠注射抗血清后第4天即出现异常蛋白尿，T淋巴细胞转化功能明显高于正常，并于第14天血中检测到高滴度的抗GBM自身抗体；而201A处理组鼠上述病变均明显好转。结论 201A中药合剂能够改善大鼠抗GBM肾炎的肾功能。     

大鼠抗GBM肾炎模型的建立及不同病期的生化指标和肾组织病理学观察

目的：为研究人类新月体抗肾炎的发病机制，建立大鼠抗肾小球基底膜（BGM）肾炎的动物模型，方法：提取S－D大鼠GBM抗原，将此抗原免疫新西兰白兔获得抗血清，再将此抗血清从尾静脉一次性注射给S－D大鼠。实验分2组：肾炎模型组及正常对照组。定期于第4天、第14天第第21天检测大鼠24h尿蛋白，血肌酐及血尿素的含量和肾组织病理学改变。结果：大鼠肾炎模型组：大鼠注射抗血清后于第4天出现大量蛋白尿，第14天血肌酐，血尿素显著升高，并持续上升，肾组织病理表现为肾小球内细胞数明显增加，大量新月体形成及蛋白管型，GBM呈不规则增厚，足突融合，内皮细胞脱落，坏死，免疫荧光检查见IgG、鼠IgG沿GBM线形分布，大鼠正常对照组以上指标均无明显改变。结论：通过动态观察大鼠抗GBM肾炎的病变变化，证实该模型病变与人类新月体性肾炎的病变较为一致，该模型可用于探讨人类新月体体肾炎的实验研究。     

抗大鼠肾小球基底膜肾炎模型建立方法的改进

目的探讨快速建立抗大鼠肾小球基底膜（glomerular basement membrane，GBM）肾炎动物模型的方法。方法30只正常SD大鼠随机分为三组，肾炎模型A、B组和正常对照组。肾炎模型A、B组大鼠一次性尾静脉注射兔抗GBM血清；正常对照组，尾静脉注射等量正常兔血清。肾炎模型A组大鼠尾静脉注射兔抗大鼠GBM血清前一周，通过足垫皮内注射正常兔血清进行预免疫。上述三组大鼠于尾静脉注射兔血清后第2、7、14和21天，检测24h尿蛋白、血肌酐、血尿素氮含量；第21天处死大鼠取肾组织观察肾小球和肾小管的病理变化。结果肾炎模型A、B组，尾静脉注射兔抗大鼠GBM血清后，24h尿蛋白，血肌酐和血尿素氮含量均明显升高（P〈0．01），A组升高程度均较B组明显（P〈0．05）。光镜检测A组新月体形成率较B组明显升高，肾小管内蛋白管型较B组多，部分肾小球不完全纤维化，B组肾小球未见纤维化。对照组上述指标均无明显变化。结论大鼠注射兔抗GBM血清之前，进行正常兔血清预免疫，可以更快诱导大鼠产生抗GBM肾炎。     

两种方法建立小鼠抗GBM肾炎模型的比较

目的探讨建立小鼠抗肾小球基底膜（GBM）肾炎模型的方法。方法72只昆明小鼠随机分为3组,肾炎模型A组、B组和正常对照组。肾炎模型A、B组小鼠一次性尾静脉注射兔抗小鼠GBM血清（16ml／kg）,正常对照组小鼠注射等量正常兔血清。肾炎模型A组小鼠尾静脉注射兔抗小鼠GBM血清前1周,背部皮内注射正常兔血清进行预免疫;肾炎模型B组小鼠尾静脉注射兔抗小鼠GBM血清后24h,尾静脉注射脂多糖（1mg／kg）。于实验第7、14、21、28天取尿液和血清标本,分别检测尿蛋白、血肌酐、血尿素氮含量。并于上述时间点分别取。肾组织观察病理变化。结果。肾炎模型组小鼠注射兔抗小鼠GBM血清后,第7天尿蛋白、血肌酐和血尿素氮含量均明显升高,均高于正常对照组,且A组升高更明显（P〈0．05）。肾组织病理表现为：。肾炎模型A组肾小球基底膜明显增厚,系膜区大量电子致密物沉积,足突融合;壁层上皮细胞增生,大量新月体形成,肾小球囊腔变窄,并可见肾小球纤维化形成,其病变程度均高于肾炎模型B组。正常对照组小鼠肾组织无明显病理变化。结论免疫球蛋白预免疫法可以更好地建立小鼠抗GBM肾炎模型。     

NF-κBp65在主动性Heymann肾炎肾小球损伤中的作用

目的：探讨主动性Heymann肾炎(AHN)肾小球内NF—κBp65的活化及意义。方法：8—10周龄Wistar雌性大鼠20只平均分2组，肾炎模型组予皮下免疫FxlA／CFA，对照组予皮下注射CFA。免疫组化染色观察大鼠肾小球内NF—κBp65的活化及其与肾组织病理和生化指标改变的相互关系。结果：与对照组比较，肾炎模型组大鼠肾小球基底膜((GBM)明显增厚、肾小球NF—κBp65的话化明显增加，差异有显著性(P＜0．01)；肾小球内NF—κBp65的活化与GBM增厚程度呈明显的直接正相关(P＜0．05)。结论：NF—κBp65的话化参与了AFN的肾小球的病理损害过程。     

低分子肝素对兔抗肾小球基底膜肾炎的疗效观察

目的　观察低分子肝素 (LMWH)对兔抗肾小球基底膜 (GBM)肾炎的疗效。方法　建立兔抗GBM肾炎模型 ;实验分两组 :LMWH治疗组和对照组。LMWH治疗组注射肾毒血清后 6h内开始给药 ,对照组仅给等量的生理盐水。定期观察一般情况 ,并测定尿蛋白、血肌酐水平 ,2周后宰杀兔 ,观察肾组织病理改变。结果　LMWH组尿蛋白、纤维素沉积数、新月体数、肾小球细胞总数、肾小管间质损伤指数、炎细胞浸润数均较对照组显著减少。结论　低分子肝素可显著改善抗GBM肾炎兔的肾脏病变。     

CD4+T细胞免疫应答介导小鼠抗GBM肾小球肾炎

目的 探讨CD4+T细胞免疫应答在小鼠抗GBM肾小球肾炎中的作用.方法 将C57BL/6小鼠随机分为肾炎模型组和正常对照组,两组均给予兔IgG预致敏,10d后肾炎模型组给予兔抗GBM血清(0.2 mL/20 g)尾静脉注射,正常对照组给予正常兔血清,分别于第7、14、21、28天行以下处理:收集尿和血清样本检测血肌酐(Scr)、血尿素氮(BUN)和尿蛋白/尿肌酐(UmAlb/c)的含量;光镜和电镜观察肾组织病理学改变;流式细胞仪检测淋巴器官和肾脏局部免疫细胞分布情况;Real-time PCR检测肾组织中IFN-γ、IL-4、IL-17A、TGF-β1、CCL-2、CCL-4、CCL-5和CXCL-1等细胞因子mRNA的含量;ELISA检测血清中IFN-γ、IL-4、IL-17A、IL-12、IL-10和TGF-β1等细胞因子的表达水平.结果 与正常对照组小鼠相比,肾炎模型组小鼠的Scr、BUN和UmAlb/c均明显升高(P＜0.05);光镜下可见典型新月体肾炎样病理改变,免疫荧光可见兔IgG和鼠IgG沿GBM呈线性沉积;小鼠脾脏中Th1、Th2、Th17和Treg细胞比例明显增加,同时肾脏局部有大量Th1、Th2和Th17细胞浸润;血清及肾脏局部IFN-y、IL-4、IL-17A和TGF-β1等细胞因子表达水平相应上调.结论 CD4+T细胞免疫应答能介导小鼠抗GBM肾小球肾炎并在其病理进程中发挥促进作用.     

吗替麦考酚酯对SD大鼠抗肾小球基底膜肾炎模型的治疗效果

目的：探讨吗替麦考酚酯（MMF）对SD大鼠抗肾小球基底膜（GBM）肾炎模型的治疗作用。方法将实验动物分为空白对照组、模型对照组和M M F治疗组,利用兔抗SD大鼠GBM抗体血清制备SD大鼠抗GBM 肾炎模型。检测各组动物在给药后第0、1、2、3和4周的24 h尿蛋白、血肌酐和尿素氮等生化指标;采用酶联免疫吸附法检测在给药后第0、4周各组动物外周血中IL‐1、TGF‐β1的水平;HE染色和碘酸雪夫氏（PAS）染色分析各组动物肾脏组织病理形态学变化。结果 MMF治疗1周后,24 h尿蛋白的排泄量开始下降;MMF治疗4周后,相较于同期的模型对照组,MMF治疗组SD大鼠的24 h尿蛋白的排泄量显著性下降,外周血尿素氮、血肌酐以及与免疫相关的细胞因子IL‐1和 TGF‐β1的水平也远远低于模型对照组（P＜0．05）。 HE和PAS染色结果表明,M M F治疗组大鼠的肾小球及其周围间质区炎性细胞浸润较模型对照组减少,新月体数量明显下降。结论 MMF可提高抗GBM肾炎SD大鼠的肾功能,抑制IL‐1和TGF‐β1的产生,阻止模型大鼠的肾脏病变。     

小鼠抗GBM肾炎模型的复制与鉴定

目的 为研究人类新月体性肾炎的发病机制,建立小鼠抗肾小球基底膜（GBM）肾炎的动物模型.方法 60只健康昆明小鼠随机分为肾炎模型组和正常对照组.肾炎模型组小鼠一次性尾静脉注射兔抗小鼠GBM血清（16 ml/kg）,正常对照组注射等量正常兔血清.肾炎模型组小鼠尾静脉注射兔抗小鼠GBM血清前1周,背部皮内注射正常兔血清进行预免疫.于兔抗小鼠GBM血清注射后第7、14、21、28天取尿液、血清、肾组织标本,检测尿蛋白、血肌酐、血尿素氮含量,观察肾组织病理变化.结果 肾炎模型组小鼠注射兔抗小鼠GBM血清后,第2天蛋白尿、血肌酐和血尿素氮含量均明显升高,于第14天尿蛋白浓度达到高峰,而血肌酐和血尿素氮含量仍持续上升.肾炎模型组肾组织病理表现为：第7天大量炎症细胞浸润;第21天 GBM增宽增厚,足突融合,大量免疫复合物沉积,内皮细胞及系膜细胞显著增生,新月体形成.结论 成功建立了小鼠抗GBM肾炎模型.     

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.