暴发性肝衰竭大鼠肠系膜微循环变化与血浆内毒素水平的关系

采用硫代乙酰胺复制暴发性肝衰竭大鼠模型，观察暴发性肝衰竭时大鼠肠系膜微循环变化，同时测定了血浆内毒素水平。结果表明：暴发性肝衰竭时大鼠肠系膜微循环灌流量明显减少，血浆内毒素水平升高，两者间存在正相关关系。提示暴发性肝衰竭时多脏器功能衰竭与肠原性内毒素血症导致的微循环灌流量减少有关     

暴发性肝衰竭大鼠肠系膜微循环变化与血浆内毒素水平的关系

采用硫代乙酰胺复制暴发性肝衰竭大鼠模型观察暴发性肝衰竭时大鼠系膜微循环变化，同时测定了血浆内毒素水平，结果表明，暴发性肝衰竭时大鼠肠系膜微循环灌流量明显减少，血浆内毒素水平升高，两者间存在相关关系，提示暴发性肝衰竭时多脏器功能衰竭与肠原性内毒素血症导致的微循环灌流量减少有关。     

大鼠实验性肝硬变腹水形成及其与肿瘤坏死因子α关系的研究

目的：研究大鼠实验性肝硬变晚期腹水形成与肿瘤坏死因子α（ＴＮＦα）及肠源性内毒素血症的关系，探讨肝硬变腹水形成的机理。方法：以大鼠为实验对象，分为正常对照组（ｎ＝８）、肝硬变对照组（ｎ＝１２）和肝硬变伴腹水组（ｎ＝１８）。实验组采用复合因子复制肝硬变动物模型。各组均测定腹主动脉血中ＴＮＦα和内毒素水平，肝硬变组还测定了腹水量。结果：随着肝硬变形成，大鼠血中ＴＮＦα水平增高，各组含量分别为９０８３±１０７１ｎｇ／ｍｌ和９５７７±１２７６ｎｇ／ｍｌ（肝硬变组和肝硬变伴腹水组）。相关分析表明，肝硬变组腹水量与血中ＴＮＦα成正相关（ｒ＝０８６，Ｐ＜００５），内毒素水平增高，并与ＴＮＦα的浓度成正相关（ｒ＝０７５，Ｐ＜００５）。结论：肝硬变腹水形成与血中ＴＮＦα升高有关，而ＴＮＦα的升高则源于肠源性内毒素血症的形成。     

氧自由基损伤在烫伤大鼠延迟复苏后肠道细菌和内毒素移位中的作用

为了了解烧伤延迟复苏后肠粘膜氧自由基损伤情况及其对肠源性细菌、内毒素移位的影响，将６６只悉生大鼠分为以下四组：（１）对照组（ｎ＝６）。（２）立即复苏组（ｎ＝２４），４０％烫伤后立即按Ｐａｒｋｌａｎｄ公式复苏。（３）延迟复苏组（ｎ＝２４），伤后６小时开始复苏。（４）药物治疗组（ｎ＝１２），大鼠延迟复苏加上维生素Ｃ、Ｅ联合治疗。在伤后８、２４、４８和７２小时活杀动物（各时间点６只）进行下列指标检测：回肠粘膜超氧化物歧化酶（ＳＯＤ）、谷胱甘肽过氧化物酶（ＧＳＨＰｘ）及丙二醛（ＭＤＡ）含量，回肠粘膜病理形态学观察、二胺氧化酶（ＤＡＯ）活性，血和肠系膜淋巴结、肝、脾、肾、肺细菌培养，血浆内毒素水平。结果显示，伤后ＳＯＤ、ＧＳＨＰｘ含量下降，ＭＤＡ升高，同时肠粘膜病理改变加重、ＤＡＯ活性下降，血和脏器细菌移位率、血浆内毒素水平增高。这些改变在延迟组更明显，使用维生素Ｃ、Ｅ治疗后减轻。表明，烧伤延迟复苏加重肠粘膜氧自由基的损伤，促进肠道细菌和内毒素移位。     

Ⅱ型糖尿病患者血浆氧化修饰低密度脂蛋白水平变化初探

目的：探讨血浆ＯＸ－ＬＤＬ水平变化与Ⅱ型糖尿病的关系。方法：采用酶联免疫吸附双抗体夹心法测定７４例Ⅱ型糖尿病患者血浆ＯＸ－ＬＤＬ水平,与对照组（ｎ＝３２）比较。结果：Ⅱ型糖尿病伴血管病变血浆ＯＸ－ＬＤＬ水平为８２５３±１５１７ｕｇ／ｄｌ;无血管病变组为６０２３±４０６ｕｇ／ｄｌ;对照组为４２６８±１０５８ｕｇ／ｄｌ。Ⅱ型糖尿病患者血浆ＯＸ－ＬＤＬ水平显著高于对照组（Ｐ＜００１）,且伴血管病变组血浆ＯＸ－ＬＤＬ水平显著高于无血管病变组（Ｐ＜００１）。结论：检测血浆ＯＸ－ＬＤＬ水平可作为糖尿病患者及伴血管病变者病程控制、疗效和预后观察的一项指标。     

大黄治疗坏死性胰腺炎的机理探讨

为探讨大黄治疗坏死性胰腺炎的效果和机理，作者采用脱氧胆酸胰管注入法制备成大鼠坏死性胰腺炎模型，术后每８小时分别经口饲喂１０％的大黄汤剂１．５ｍｌ（治疗组，ｎ＝８）或生理盐水１．５ｍｌ（对照组，ｎ＝９）。模拟手术组（模拟组，ｎ＝８）大鼠仅胰管注射生理盐水，作为对照。术后４８小时处死动物。分别测定肠运动，血内毒素和淀粉酶水平，并做肠系膜淋巴结和胰腺的细菌培养。结果：对照组中５只大鼠（５／９），治疗组中１只大鼠（１／８）在实验期内死亡，模拟组无死亡；对照组较模拟组有显著的肠运动抑制，而治疗组较对照组肠运动明显改善；对照组大鼠的血内毒素（６１．３６±２８．３０ｐｇ／Ｌ）明显高于治疗组（５．４１±３．５８ｐｇ／Ｌ，Ｐ＜０．００１）；模拟组大鼠无明显的内毒素血症；对照组的淋巴结（４／４）和胰腺（４／４）细菌培养均阳性，而治疗组中淋巴结和胰腺仅各１份（１／７）培养阳性，模拟组的淋巴结和胰腺培养均阴性。以上结果说明大黄通过促进肠运动，能防治坏死性胰腺炎时的细菌移位，避免胰腺感染，改善坏死性胰腺炎的预后。     

暴发性肝衰竭血脑屏障通透性改变对肝性脑病发生发展的影响

暴发性肝衰竭血脑屏障通透性改变对肝性脑病发生发展的影响许瑞龄，尹镭，陈贤明等（山西医学院病理生理教研室）中国病理生理杂志１９９４；１０（２）：１６０采用硫代乙酰胺所致大鼠暴发性肝衰模型，以脑组织浸泡液中Ｅｖａｎｓ蓝含量为血脑屏障通透性指标。结果表明，...     

氨氯西林栓剂含量测定方法的制定

采用反相高效液相色谱法，选用磺胺甲基异恶唑为内标物，氨苄西林、氯唑西钠林在１０～１００ｍｇ／Ｌ的浓度范围内，线性关系良好。相关系数分别为０９９９８、０９９９６（ｎ＝６），平均回收率分别为９８２（Ｒｓ＝１６１％，ｎ＝６）；９９２（Ｒｓ＝１２８％，ｎ＝６），该方法简单易行，重现性好，准确度高，专属性强     

心力衰竭患者卡托普利治疗前后血浆内皮素变化及临床意义

目的：探讨充血性心力衰竭（ＣＨＦ）与血浆内皮素（ＥＴ）之间的关系和意义，以及卡托普利治疗对ＣＨＦ和血浆ＥＴ的影响。方法：用放射免疫法（ＲＩＡ）测定４２例ＣＨＦ患者卡托普利治疗前后血浆ＥＴ浓度，２３例健康老年者血浆ＥＴ浓度做为对照组。结果：４２例ＣＨＦ患者治疗前血浆ＥＴ浓度６２６±０８ｐｇ／ｍｌ明显高于对照组（４０８±０６ｐｇ／ｍｌ，Ｐ＜０００１），随心力衰竭程度加重而血浆ＥＴ升高，心功能Ⅳ级（７０２±１０１ｐｇ／ｍｌ）＞Ⅲ级（６２１±０８ｐｇ／ｍｌ）＞Ⅱ级（５２１±０５７ｐｇ／ｍｌ），各组间比较差异显著。加用卡托普利治疗４周后，心功能改善，ＥＴ浓度为５１０±０７２ｐｇ／ｍｌ，与治疗前比较差异显著（Ｐ＜００１）。结论：ＥＴ参与了心衰的病理过程，其血浆浓度与心衰程度一致。卡托普利显著改善心功能可能与降低血浆ＥＴ浓度密切相关     

HPLC法测定卫肺特片中利福平异烟肼和吡嗪酰胺的含量

建立了高效液相色谱法同时测定卫肺物片中利福平、异烟肼、吡嗪酰胺的含量。采用Ｃ１８柱，以００１ｍｏｌ／Ｌ磷酸二氢铵甲醇为流动相，检测波长２５４ｎｍ，柱温３５℃，流速１０ｍｌ／ｍｉｎ。利福平、异烟肼、吡嗪酰胺的线性范围分别为：２７～４３２μｇ／ｍｌ（ｒ＝０９９９５，ｎ＝５），１５６２５～２５０μｇ／ｍｌ（ｒ＝０９９９８，ｎ＝５），６２５～１０００μｇ／ｍｌ（ｒ＝０９９９３，ｎ＝５）。加样回收理想，方法准确、简便、快速。     

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.