川芎嗪在促进大鼠结肠上皮细胞Cl-和HCO3-分泌中的作用

目的探讨川芎嗪对大鼠结肠上皮水、电解质转运的影响和内在的机制.方法在药物和特异性通道阻断剂的作用下,用短路电流(Isc)技术,体外测量结肠上皮短路电流的变化.结果离体大鼠远端结肠,在基础状态下的跨上皮电位差(PD)和Isc分别为(-5.5±0.8)mV(n=8)(黏膜面为负)和(60.3±6.7)μA/cm2(n=16),Rt为(94.9±5.9)Ω@cm2.在结肠上皮的基底膜加入川芎嗪(0.01～5 mmoL/L),能记录到一个呈剂量依赖性升高的短路电流,EC50为0.5 mmol/L(n=16);将Cl-或HCO3-从溶液中替换,分别抑制了该电流的58.4%(n=5,P＜0.01)和70.8%(n=4,P＜0.01),2种离子都被替换时,该电流减少了98.1%(n=6,P＜0.001);川芎嗪在结肠上皮产生的短路电流能被顶膜Cl-通道阻断剂DPC(2 mmol/L)(一种非选择性的Cl-通道阻断剂)和glibenclamide(1mmol/L)[囊性纤维变性跨膜电导调节器(CFTR)的特异性阻断剂]完全阻断,但对DIDS(100 mmol/L)[Ca2+激活的Cl-通道(CaCC)阻断剂]不敏感;在结肠上皮的顶膜加入Na+通道阻断剂amiloride(10 mmol/L)或将Na+从顶膜侧的溶液中替换,不影响随后川芎嗪产生的短路电流;将Na+从结肠上皮基底膜侧的溶液中替换或从顶膜和基底膜侧同时替换,完全抑制了川芎嗪在结肠上皮产生的短路电流;在结肠上皮的基底膜加入Na+-K+-Cl-共转运体(NKCC)阻断剂bumetanide(100 mmol/L)或基底膜Na+HCO3-共转运体(NBC)和Cl-/HCO3-交换器抑制剂DIDS(100 mmol/L)分别使川芎嗪产生的短路电流减少了89.3%(n=6,P＜0.001)和68.9%(n=4,P＜0.01),DIDS对川芎嗪的抑制作用与HCO3-从溶液中替换时产生的抑制作用相似,差异无统计学意义(P＞0.05);基底膜非选择性K+通道阻断剂Ba2+(3 mmol/L)完全抑制了川芎嗪在结肠上皮产生的短路电流(n=4,P＜0.001),基底膜Ca2+激活的K+通道阻断剂TEA(5 mmol/L)对此电流无影响;用BAPTA-AM(100 mmol/L)螯合细胞内、外的Ca2+,不影响川芎嗪在结肠上皮产生的短路电流.结论川芎嗪能刺激大鼠远端结肠上皮分泌Cl-和HC03-,作用呈量效关系;川芎嗪在结肠上皮产生的短路电流是由位于结肠上皮顶膜的CFTR,以及位于基底膜的Na+-K+泵、NKGC、NBC、Cl-/HCO3-交换器和基底膜K+通道共同作用的结果.     

兔食管和结肠上皮对水、电解质转运的差异

目的 :探讨兔食管和远端结肠上皮对水、电解质转运的差异。方法 :在药物和特异性通道阻断剂的作用下 ,用短路电流技术 ,体外测量两类上皮基本电参数的改变。结果 :远端结肠上皮的短路电流显著高于食管上皮 ;在食管上皮的顶膜加入amiloride ,短路电流从基础状态下的 (17.4± 2 .2 ) μA/cm2 (n =15 )减少到 (7.5± 1.7) μA/cm2 (n =13) ,P <0 .0 0 1。在基侧膜加入Ba2 + ,短路电流从基础状态减少到 (13.5± 0 .3) μA/cm2 (n =4 ) ,P <0 .0 5 ;在结肠上皮的顶膜加入Diphenylamine 2 ,2’ dicarboxylicacid (DPC) ,短路电流从 (119.7± 19.0 ) μA/cm2 (n =8)减少到 (4 9.8± 15 .5 ) μA/cm2 (n =5 ) ,P <0 .0 0 1;indomethacin和TTX不改变食管上皮的基础电参数 ,却使结肠上皮的短路电流从基础状态减少到 (71.1± 11.1) μA/cm2 (n =4 ) ,P <0 .0 0 5。结论 :与相对疏漏、具有较低电阻的远端结肠相比 ,食管是具有较高电阻的紧密上皮 ;在稳定的基础状态下 ,钠离子吸收和氯离子分泌分别是构成食管上皮和结肠上皮的跨上皮电压和短路电流的主要原因 ;钾通道分布在食管上皮的基侧膜 ,在基础条件下处于开放状态 ;粘膜下神经丛和前列腺素的作用不参与构成食管上皮的基础电流 ,却是结肠上皮基础电流形成的原因之     

机械刺激诱导的远端结肠黏膜离子转运在腹泻型肠易激综合征大鼠模型中的变化

目的探讨在腹泻型肠易激综合征(D-IBS)大鼠中,机械刺激诱导的远端结肠黏膜离子转运是否发生改变。方法将Sprague-Dawley大鼠分为对照组和模型组,采用孤养+慢性非预见刺激的方法制备D-IBS大鼠模型,通过排便和蔗糖偏嗜度来检测D-IBS大鼠模型,采用短路电流技术结合去除溶液中阴离子和运用各种阻断剂的方法,观察机械刺激诱导的远端结肠黏膜离子转运。结果同对照组比较,模型组大鼠的排便数量显著增加,蔗糖偏嗜度显著降低,差异均有统计学意义(P<0.05)。2组大鼠结肠黏膜的基础电生理特性无显著差异(P>0.05)。机械刺激引起对照组和模型组大鼠结肠黏膜的短路电流均显著增加,但是模型组中增加的短路电流,显著高于对照组,差异有统计学意义(P<0.05)。去除溶液中的HCO3-并不能改变2组的短路电流,但是去除溶液中的Cl-均显著降低2组的短路电流,差异有统计学意义(P<0.001)。运用Ca2+激活的Cl-通道(CaCC)阻断剂4,4'-二异硫氰酰芪-二苯乙烯-2,2二磺酸二钠盐(DIDS)并不能改变2组的短路电流,但是运用囊性纤维变性跨膜电导调节器(CFTR)的抑制剂CFTR(inh)-172或Na+-K+-2Cl-共转运体(NKCC)的阻断剂bumetanide均显著降低2组的短路电流,差异有统计学意义(P<0.001)。结论在D-IBS大鼠模型中,机械刺激诱导的远端结肠黏膜Cl-分泌增加可能是D-IBS大鼠产生腹泻的原因之一。     

连续应用川芎嗪对大鼠结肠黏膜阴离子分泌的影响

目的:探讨连续应用川芎嗪对大鼠结肠黏膜阴离子分泌的影响.方法:健康SD大鼠随机分为2组:川芎嗪组[腹腔注射川芎嗪40 mg/(kg·d)]和对照组(腹腔注射等量生理盐水),7 d后剥离结肠黏膜,采用短路电流技术在正常KHS、Cl-free KHS、HCO3-free KHS 3种培养液中观察川芎嗪对结肠黏膜阴离子分泌的影响.结果:①在正常KHS培养液中,对照组结肠黏膜的基底膜加入1 mmol/L的川芎嗪后,短路电流增加,在30 min内转运的电荷数增加了(365±68)C/m2;川芎嗪组在30 min内转运的电荷数增加了(483±69)C/m2,2组差异有统计学意义.②在Cl--free KHS培养液中,对照组结肠黏膜的基底膜加入1 mmol/L的川芎嗪后,短路电流增加,30 min内转运的电荷数增加了(72±11)C/m2;川芎嗪组30 min内转运的电荷数增加了(163±21)C/m2,2组差异有统计学意义.③在HCO3-free KHS培养液中,对照组结肠黏膜的基底膜加入1 mmol/L的川芎嗪后,短路电流增加,在30min内转运的电荷数增加了(96±19)C/m2;川芎嗪组30 min内转运的电荷数增加了(83±18)C/m2,2组差异无统计学意义.结论:连续应用川芎嗪可以促进HCO3-的分泌.     

苯扎氯铵对大鼠降结肠上皮离子转运的影响

目的探讨苯扎氯铵对大鼠降结肠上皮离子转运的影响。方法8～9周龄SD大鼠40只,随机分为两组。氯胺酮麻醉下开腹,实验组用0.1%苯扎氯铵处理大鼠降结肠浆膜40min,温盐水冲洗后关腹,对照组用生理盐水代替苯扎氯铵。分别于术后1,2,3,4,8周取处理段结肠,利用短路电流技术检测结肠上皮离子转运的变化。结果实验组大鼠结肠上皮各时间点跨膜电压、基础电流明显降低,钠离子吸收电流占基础电流的百分比升高。另外,由Forskolin所引起的氯离子分泌电流也明显高于对照组,但DPC阻断Forskolin所引起的短路电流的百分比下降且小于100%(对照组大于100%),而结肠跨膜电阻两组之间无差异。结论苯扎氯铵不影响大鼠结肠黏膜屏障功能,但可造成结肠上皮离子转运功能紊乱,提示与结肠失神经有关。     

结直肠腺瘤患者血脂水平测定及其临床意义

目的 研究结直肠腺瘤患者的血脂水平及其临床意义.方法 采用酶法、化学修饰酶法分别测定79例结直肠腺瘤患者及68例对照组的血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)及低密度脂蛋白(LDL-C),并进行统计学比较分析.结果 结直肠腺瘤组、远侧结肠腺瘤组的血清TG水平分别为(1.70±1.08)mmol/L、(1.91±1.20)mmol/L,均高于对照组及近侧结肠腺瘤组,差异有统计学意义(P＜0.05);而远侧结肠腺瘤组的血清HDL-C水平为(1.16±0.27)mmol/L,低于近侧结直肠组,差异有统计学意义(P＜0.05);男性结直肠腺瘤组的血清TG水平为(1.84±1.17)mmol/L明显高于女性患者的(1.41±0.83)mmol/L,差异有统计学意义(P＜0.05);各组间血清TC、LDL-C水平差异则均无统计学意义(P0.05).结论 结直肠腺瘤患者TG水平较高,尤其是远侧结肠及男性患者;HDL-C水平较高者结肠腺瘤的发病率较低.     

急诊严重高钠血症患者的临床症状及病死率相关因素分析

目的 探讨急诊科就诊高钠血症患者的一般临床特征、症状与病死率的关系.方法 对2014年4月到2016年4月到郑州大学附属洛阳中心医院急诊科就诊的高钠血症患者进行了回顾性分析.239例患者血钠离子(Na+ )＞145 mmol/L,平均年龄(65.13±12.14)岁,平均Na+水平为(157.71±9.42) mmol/L;根据血Na+水平分为血Na+ 145～＜160 mmol/L组与血Na+≥160 mmol/L组;比较两组患者的一般临床特征、症状、疾病及病死率.结果 血Na+≥160 mmol/L组老年痴呆症发病率较血Na+ 145～＜160 mmol/L高(P=0.012),血肌酐、氯离子(Cl-)、血浆渗透压水平均较高(P=0.014,P=0.001,P=0.004);血Na+≥160 mmol/L组患者的平均动脉压(MAP)和格拉斯哥昏迷评分(GCS)较血Na+ 145～＜160 mmol/L组低(P=0.001,P=0.000),脉搏较快(P=0.000);血Na+≥160 mmol/L组低血压、气促、消化道出血和神经精神症状发生率较血Na+ 145～＜160 mmol/L组高(P＜0.01),脱水、肺炎、尿路感染的发病率较血Na+ 145～＜160 mmol/L组高(P＜0.01);Na+≥160 mmol/L组病死率明显高于Na+ 145～＜160 mmol/L组(P=0.000).多因素Logistic回归分析显示,低血压、发热、气促、消化道出血及神经精神症状与高钠血症患者病死率有相关性.结论 严重高钠血症患者病死率较高,如患者合并低血压、发热、气促、消化道出血及神经精神症状等症状,临床医生需高度警惕,积极救治,尽力降低病死率.     

过氧化氢对大鼠心室肌细胞钠通道电流的影响

目的 研究过氧化氢(H2O2)对单个大鼠心室肌细胞钠通道电流(INa)的影响.方法 用急性酶解法获得单个大鼠心室肌细胞;用标准的全细胞膜片钳技术记录钠通道电流,观察1 mmol/L H2O2引起单个大鼠心室肌细胞INa改变.结果 在1 mmol/L H2O2作用下,大鼠心室肌细胞INa峰值电流密度从(19.95±4.58)pA/pF减少至(15.19±4.15)pA/pF(n=8,P＜0.05),电流-电压曲线上移,翻转电位左移,但对激活电位、峰电位无明显影响;H2O2对INa稳态激活曲线无明显改变,V0 5从(-64.54±0.16)mV左移至(-66.28±0.32)mV(n=8,P＞0.05),对其稳态失活曲线无明显改变,V0 5从(-91.46±0.17)mV左移至(-94.52±0.25)mV(n=8,P＞0.05);H2O2对INa失活后再激活曲线有明显改变,对照组τ为(6.43±1.04)ms,H2O2组τ为(8.31±1.48)ms(n=6,P＜0.05).结论 过氧化氢可以减少大鼠心肌细胞INa,且使其复活明显减慢.     

阴离子交换蛋白2功能异常对结肠分泌及蠕动功能的影响

目的 探讨阴离子交换蛋白2(AE2)功能异常对结肠黏膜上皮细胞分泌功能及肠管蠕动功能的影响.方法 通过复方地芬诺酯灌胃建立SD大鼠便秘模型(模型组,n=17),以未建模SD大鼠作为对照(对照组,n=28).体外分离培养大鼠结肠黏膜上皮细胞,单细胞离子成像技术比较两组大鼠结肠黏膜上皮细胞培养液中加入AE2抑制剂DIDS前后pH变化值.利用Powerlab系统及Chart 5软件绘制离体肠管蠕动曲线,比较两组大鼠离体肠管的蠕动幅度和频率,评价肠管蠕动功能.通过急性滴加试验观察和比较在对照组离体肠管培养液中滴加AE2抑制剂DIDS前后肠管蠕动功能的变化.结果 单细胞离子成像技术检测显示,结肠黏膜上皮细胞培养液中加入DIDS后,模型组细胞内pH值继续升高,与加入DIDS后对照组细胞内pH值比较差异有统计学意义(P＜0.01).肠管蠕动曲线观测显示,模型组大鼠离体结肠平滑肌蠕动幅度和频率均明显低于对照组(P＜0.05或P＜0.01);急性滴加试验表明,培养液中滴加DIDS后,对照组离体结肠平滑肌蠕动幅度和频率均显著降低(P＜0.05或P＜0.01).结论 AE2离子转运活性下降可导致结肠分泌功能紊乱及蠕动功能障碍.     

高糖对大鼠肾系膜细胞IкB-α表达影响的泛素化研究

目的 探讨高糖对大鼠肾小球系膜细胞IkB-α表达的影响及其可能的作用途径.方法 将大鼠HBZY-1肾小球系膜细胞进行体外培养,设立正常对照组(5.6 mmol/L葡萄糖)、高糖组(包括10、20和30mmol/L葡萄糖)、甘露醇组、30 mmol/L高糖加特异性泛素蛋白酶体阻断剂MG132组及5.6 mmol/L葡萄糖加MG132组,作用48h,用Western Blotting法检测各组IkB-α蛋白的表达,实时定量PCR法检测各高糖组IkB-α及泛素mRNA的表达.结果 各高糖组IkB-α蛋白的表达下降(P＜0.05),具有浓度依赖效应;各高糖组IkB-α mKNA的表达差异无统计学意义(P＞0.05);各高糖组泛素mRNA的表达增加(P＜0.05);30mmol/L高糖加MG132组较30mmol/L高糖组IkB-α蛋白的表达下降被明显逆转(P＜0.0).结论 高糖可增加大鼠肾系膜细胞泛素表达,上调泛素蛋白酶体系统活性,增加IkB-α蛋白泛素化降解.     

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.