干地黄在金匮肾气丸中抗衰老实验研究

目的：探讨干地黄在金匮肾气丸中延缓衰老作用机理，方法：采用D－半乳糖背部皮下注射造成昆明种小鼠亚急性衰老模型，用干地黄，金匮肾气丸，金匮贤气丸去干地黄等水煎剂灌胃给药，对照组及模型组给以等量的蒸馏水，以小鼠学习记忆功能，巨噬细胞吞噬指数及吞噬百分率等作为指标，观察干地黄等用药组及模型组和对照组的实验结果。结果：用药组均有抗衰老作用且金匮肾气丸抗衰老作用优于干地黄和金匮肾气丸去干地黄，结论：干地黄是作为整体发挥抗衰老作用的金蒉肾气丸中不可缺少的主药。     

金匮肾气丸延缓衰老作用的实验研究

目的：探讨金匮肾气丸延缓衰老作用的机理。方法：用环磷酰胺（ＣＰＰ）诱致小鼠骨髓细胞ＤＮＡ损伤，以微核（ＭＮ）和姐妹染色单体互换（ＳＣＥ）为指标，观察温补肾阳、延缓衰老代表方金匮肾气丸的抗ＤＮＡ损伤作用。结果：金匮肾气丸对由环磷酰胺所致ＤＮＡ损伤具有良好的拮抗作用。结论：提高机体抗ＤＮＡ损伤能力可能是金匮肾气丸延缓衰老作用的主要机理所在。     

金匮肾气丸对亚急性衰老小鼠逼尿肌SOD活性的影响

目的 :探讨中药经方金匮肾气丸对亚急性衰老小鼠膀胱逼尿肌超氧化物歧化酶 ( SOD)活性的影响。方法 :将 60只昆明种小鼠分为空白对照组、D-半乳糖造模组、金匮肾气丸经方组、干地黄组和金匮肾气丸经方去干地黄组 ,造模后 6周测各组小鼠膀胱逼尿肌的 SOD活性。结果 :三种不同用药组与 D-半乳糖造模组相比 ,小鼠膀胱逼尿肌 SOD活性都有显著性差异 ( P<0 .0 1 ) ,其中金匮肾气丸经方组的 SOD活性值最高 ,与其它用药组相比有显著差异性 ( P<0 .0 1 )。结论 :金匮肾气丸有抗逼尿肌衰老的作用。     

金匮肾气丸加味治疗支气管哮喘缓解期的临床疗效观察

目的：探讨金匮肾气丸加味治疗支气管哮喘缓解期的临床疗效.方法：我院收治的108例支气管哮喘缓解期患者,随机分为观察组和对照组各54例,观察组采用金匮肾气丸加味治疗,对照组采用常规西医治疗,比较两组患者的临床疗效.结果：治疗后,观察组的TNF-α和IL-2改善程度均明显优于对照组,且差异具有统计学意义（P＜0.05）,观察组的总有效率为96.30％,明显高于对照组,且差异具有统计学意义（P＜0.05）.结论：采用金匮肾气丸加味辨证治疗支气管哮喘缓解期患者具有显著疗效,值得临床广泛推广和应用.     

金匮肾气丸对肾阳虚小鼠血浆内皮素一氧化氮含量的影响

目的：了解金匮肾气丸对肾阳虚状态下血浆内皮素、一氧化氮含量改变的影响,以进一步明确其温肾壮阳（温阳）作用的分子机制。方法：用腺嘌呤灌胃复制小鼠肾阳虚模型,并在肾阳虚形成过程中予金匮肾气丸干预,通过硝酸还原酶法和放射免疫法分别检测血浆一氧化氮（NO）和内皮素（ET）的含量。结果：血浆内皮素含量在肾阳虚组高于正常对照组（P〈0.05）,在金匮肾气丸组则低于肾阳虚组（P〈0.05）,一氧化氮在肾阳虚组低于正常对照组及金匮肾气丸组,但3组间比较无统计学意义（P〉0.05）。结论：金匮肾气丸可抑制血浆ET水平升高而纠正肾阳虚状态下缩血管与舒张血管因素的动态平衡失调,这也是其温阳作用的分子机制之一。     

三种补肾方含药血清对衰老骨髓间充质干细胞中COLⅠ和ALP的影响

目的 研究健骨二仙丸、金匮肾气丸和六味地黄丸含药血清对衰老骨髓间充质干细胞（bone marrow mesenchymal stem cells, BMSCs）成骨分化过程中Ⅰ型胶原蛋白（collagen typeⅠ, COLⅠ）和碱性磷酸酶（alkaline phosphatase, ALP）表达的影响,探讨3种补肾方治疗骨质疏松症的机制。方法 将40只SD大鼠分为健骨二仙丸组、金匮肾气丸组、六味地黄丸组、空白对照组,每组10只。分别灌胃75.9 g/kg健骨二仙丸、89.1 g/kg金匮肾气丸、85.8 g/kg六味地黄丸和等体积生理盐水,每天定时灌胃2次,连续7 d,制备含药血清。用H2O2将P3代BMSCs处理成衰老细胞,采用β-半乳糖苷酶染色进行观察。衰老BMSCs分为6组：模型组、诱导组、健骨二仙丸含药血清组、金匮肾气丸含药血清组、六味地黄丸含药血清组、空白血清组,于诱导第4、8、12、16天采用Real-time PCR法和Western blot法检测COLⅠmRNA及蛋白表达水平,并在第4、8天时收集细胞上清液检测ALP活性。结果 衰老BMSCs被β-半乳糖苷酶染色成...     

金匮肾气丸对脾肾阳虚型尿毒症血液透析患者血液中分子毒素的影响

目的：探讨金匮肾气丸对脾肾阳虚型尿毒症患者的治疗作用。方法：选取脾肾阳虚型尿毒症患者50例,随机分成A常规透析组治疗组及B金匮肾气丸加透析组,每组患者25例。A组给予以常规透析治疗;B组在常规治疗的基础上予以口服金匮肾气丸,连续治疗给药30d。观察2组患者治疗透析后,血液中小分子毒素（BUN、Scr）和中、大分子（β2-MG、PTH）的变化。结果：与A组比较,B组患者BUN、Scr和下降有统计学意义（P〈0．05）;β2-MG和PTH下降无统计学意义（P〉0．05）。结论：金匮肾气丸能抑制脾肾阳虚型尿毒症患者体内小分毒素的形成,以此达到治疗作用。     

金匮肾气丸改善去卵巢幼鼠学习记忆功能的研究

目的：探讨金匮肾气丸对去卵巢幼鼠大脑海马体的影响及其学习记忆功能的关系。方法：将20只雌性幼鼠随机分为5组,假手术对照组、去卵巢模型组、雌激素组、金匮肾气丸低剂量和高剂量组。均于相应措施干预4周后,各组均进行Morris水迷宫实验、血清性激素及海马乙酰胆碱酯酶（AchE）水平检测、大脑组织病理学形态观察,并比较其差异性。结果：金匮肾气丸高剂量组水迷宫实验上台前路程较模型组明显缩短（P<0.05）,且其雌二醇和海马AchE水平较模型组高（P<0.001）,卵泡刺激素和黄体生成素较模型组低（P<0.001,P<0.05）,与雌激素治疗组均无统计学差异。在海马组织形态学方面,金匮肾气丸高剂量组及雌激素组可见海马体神经细胞增殖。结论：金匮肾气丸可一定程度改善去卵巢幼鼠的学习记忆能力,可能与性腺轴的调节和海马形态功能改善相关。     

金匮肾气丸治疗糖尿病50例疗效观察

目的探讨金匮肾气丸治疗糖尿病的临床疗效及安全性。方法入选的100例糖尿病患者均为2型糖尿病患者,根据用药方法不同随机分为治疗组和对照组两组各50例,两组均给予格列美脲2mg,餐前30min口服,1次／日,早晚口服,根据血糖的水平调整剂量。治疗组同时给予金匮肾气丸加味,开水煎服,每日l剂,比较两组的疗效。结果治疗组的疗效明显优于对照组（P〈0．01）,且治疗组的空腹血糖、餐后2h血糖均较对照组改善明显（P〈0．05或P〈O．01）。结论在西医治疗的基础上应用金匮肾气丸治疗糖尿病,疗效确切,值得临床推广应用。     

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.