X线造影剂影响肺阻力动脉张力的中介因子:内皮素和内皮来源舒张因子的研究

目的：观察Ｘ线造影剂引起肺阻力动脉（ＰＲＡ）张力改变是否由内皮素和内皮来源舒张因子（ＥＤＲＦ）介导。方法：（１）离体ＰＲＡ分别于内皮素Ａ／Ｂ受体拮抗剂ＳＢ－２０９６７０处理前后暴露于泛影葡胺或其等容甘露醇对照溶液，观察其收缩反应。（２）离体ＰＲＡ依次由前列腺素Ｆ２α（ＰＧＦ２α）和左旋－硝基精氨酸甲基酯（Ｌ－ＮＡＭＥ）＋ＰＧＦα诱发２次程度相似的收缩反应后分别暴露于低渗显影葡胺，观察其舒张反应。结果：（１）泛影葡胺及甘露醇对照组ＳＢ－２０９６７０处理前后的２次ＰＲＡ收缩反应均无显著差异；（２）ＰＧＦ２α或Ｌ－ＮＡＭＥ＋ＰＧＦ２α收缩ＰＲＡ后低渗显影葡胺引起的舒张反应间无显著差异。结论：内皮素不介导泛影葡胺或高渗溶液引起的离体ＰＲＡ收缩反应，ＥＤＲＦ不介导低渗显影葡胺引起的离体ＰＲＡ舒张反应。     

大鼠血管中α_1－肾上腺素受体的同源性减敏不受β－肾上腺素受体和血管内皮影响

目的：确定在大鼠血管中β－肾上腺素受体和血管内皮对α＿１－肾上腺素受体（α＿１－ＡＲ）同源性减敏有否影响。方法：采用大鼠离体血管收缩功能实验。结果：经去甲肾上腺素（ＮＥ）预温育的主动脉和肾动脉由α＿１－ＡＲ介导的收缩效应较对照明显降低，而５－羟色胺和氯化钾引起的收缩效应均无明显改变，有或无β－ＡＲ激动内皮的存在对上述改变并无明显影响。结论：血管在α＿１－ＡＲ经激动剂持续作用后产生的减敏为同源性减敏，不受β－肾上腺素受体和血管内皮的影响。     

大鼠血管中α1—肾上腺素受体的同源性减敏不受β—肾上腺素…

目的：确定在大鼠血管中β－肾上腺素受体和血管内皮对α１－肾上腺素受体（α１－ＡＲ）同源性减敏有否影响。方法：采用大鼠离体血管收缩功能实验。结果：经去甲肾上腺素（ＮＥ）预温育的主动脉和肾动脉由α１－ＡＲ介导的收缩效应较对照明显降低，而５－羟色胺和氯化钾引起的收缩效应均无明显改变，有或无β－ＡＲ激动内皮的存在对上述改变并无明显影响。结论：血管在α１－ＡＲ经激动剂持续作用后产生的减敏为同源性减敏，不受β     

去窦弓神经对大鼠离体胸主动脉松缩功能的影响

作比较了去窦弓神经（ＳＡＤ）和假手术大鼠主动脉对多种激动剂和Ａｃｈ的收缩和松弛作用。发现ＳＡＤ使内皮完整的胸主动脉对ＮＥ３×１０＾－７～１０＾－５ｍｏｌ／Ｌ的收缩反应和Ａｃｈ １０＾－９ｍｏｌ／Ｌ的松弛反应明显增强，可能与血管反应增敏有关；但ＳＡＤ并不显改变胸主动脉对其他激动剂（ＰＥ，ＳＴ５８７，Ｂ－ＨＴ９２０，５－ＨＴ）的收缩反应和对Ａｃｈ １０＾－８～１０＾０４ｍｏｌ／Ｌ的松弛反应。     

糖尿病大鼠主动脉α1肾上腺素受体功能的改变

目的：观察糖尿病和糖尿病合并高血压大鼠主动脉α１肾上腺素受体（α１ＡＲ）及其亚型介导血管收缩反应的改变。方法：采用腹腔注射链脲佐菌素和结扎肾动脉加腹腔注射链脲佐菌素方法，复制糖尿病和糖尿病合并高血压大鼠模型，做离体灌流血管收缩功能实验；在ＨＥＫ２９３细胞株分别转染α１Ａ、α１Ｂ和α１ＤＡＲｃＤＮＡ并稳定表达受体，做放射配体结合实验。结果：与对照组相比，糖尿病大鼠主动脉的去甲肾上腺素浓度收缩效应曲线ｐＤ２值无显著性改变，最大收缩反应显著增加；而糖尿病合并高血压大鼠的去甲肾上腺素浓度收缩效应曲线ｐＤ２值显著降低，最大收缩反应无显著改变。在对照组α１ＡＲ亚型选择性拮抗剂（５ＭＵ，ｓｐｉｐｅｒｏｎｅ，ＢＭＹ７３７８，ＷＢ４１０１）拮抗去甲肾上腺素介导主动脉收缩的ｐＡ２值与克隆的α１ＤＡＲ的ｐＫＩ值呈高度相关（ｒ２为０．９），这些拮抗剂的ｐＡ２值在糖尿病和糖尿病合并高血压大鼠均与对照组差异无显著性。结论：大鼠发生糖尿病时主动脉α１ＡＲ介导的最大收缩反应增强，当合并高血压时这种增强作用消失，而且对去甲肾上腺素的敏感性降低     

Ketanserin降低清醒自发性高血压大鼠血压波动性的机理初探

应用计算机化清醒大鼠血流动力学测定技术，观察５－ＨＴ２受体阻滞剂Ｒｉｔａｎｓｅｒｉｎ（Ｒｉｔ）和α１受体阻滞剂哌唑嗪对清醒自发性高血压大鼠（ＳＨＲ）的血压、血压波动性（ＢＰＶ）和动脉压力感受性反射血压控制部分（ＡＢＲ－ＢＰ）的效应，旨在初步探讨兼具５－ＨＴ２受体和α１受体阻滞作用地新型抗高血压药Ｋｅｔａｎｓｅｒｉｎ降低ＢＰＶ的机制。结果表明：Ｒｉｔ对ＳＨＲ无降压作用，但侧脑室给药明显提高ＡＢＲ－Ｂ     

肾上腺素能α及β受体介导海马对细胞免疫功能的调节

本实验通过用ＭＴＴ法测定ＣｏｎＡ刺激脾淋巴细胞的增殖活性，研究了大鼠海马中微量注射去甲肾上腺素对细胞免疫功能的影响，并进一步探讨了α及β受体在此影响中的作用。结果发现（１）海马内微量注射ＮＥ对ＣｏｎＡ刺激的林巴细胞增殖反应产生抑制效应，此效应能被α及β受体阻断剂酚妥拉明，心理安所阻断。（２）β，β１、及β２受体激动剂异丙基肾上腺素（ＩＳＯ）、ＯＢＵＴＡＭＩＮＥ、ｍＥＴＡＰＲＯＴＥＲＥＮＯＬ均能抑制     

呼吸中枢M受体亚型与细胞内钙

目的探讨呼吸中枢Ｍ受体亚型与细胞内钙的关系。方法采用Ｆｕｒａ－２双波长荧光法测定Ｍ１和Ｍ２受体激动剂和拮抗剂对胎鼠桥脑和延脑神经细胞内游离钙浓度（［Ｃａ２＋］ｉ）的影响。结果在静息状态下，其［Ｃａ２＋］ｉ为７２±６ｎｍｏｌ／Ｌ，加入２００μｍｏｌ／ＬＡｃｈ，［Ｃａ２＋］ｉ升高３８％，匹鲁卡品（Ｐｉｌ）０．４～２００μｍｏｌ／Ｌ无明显的升高细胞内钙的作用，而Ｍ２受体激动剂６β－乙酰氧基去甲托烷（６β－ＡＮ）１～１０μｍｏｌ／Ｌ。对神经细胞内的游离钙均无明显影响。Ｍ１－Ｒ拮抗剂哌仑西平（Ｐｉ）６０μｍｏｌ／Ｌ能拮抗Ａｃｈ升高细胞内钙的作用，Ｍ２－Ｒ拮抗剂ＡＦ－ＤＸ１１６２０μｍｏｌ／Ｌ不能拮抗。结论Ｍ１－Ｒ兴奋与细胞内钙升高有关。     

大鼠尾动脉平滑肌中多巴胺受体亚型分布的分析

长期以来认为在内脏血管中含有两种亚型的多巴胺受体ＤＡ１和ＤＡ２，而躯体血管中只存在多巴胺受体ＤＡ２亚型。但在实验中偶然发现大鼠尾动脉对ＤＡ１亚型特异性激动剂ｆｅｎｏｌｄｏｐａｍ有明显反应，因此应用离体血管环法和反转录聚合酶链反应方法对大鼠尾动脉平滑肌中多巴胺受体两亚型的分布情况进行了观察。结果显示：亚型选择性多巴胺受体激动剂ｆｅｎｏｌｄｏｐａｍ和ＰＢＤＡ（ＤＡ２亚型激动剂）在尾动脉均产生浓度依赖性舒张反应，该效应分别被亚型特异性拮抗剂部分或完全阻断；来自尾动脉之ＲＮＡ的ＰＣＲ结果可见到预期长度为２４７ｂｐ的特异性阳性扩增条带，而未加反转录酶之结果呈现阴性，说明该产物来自ｃＤＮＡ而非基因组ＤＮＡ。结论：大鼠尾动脉平滑肌中同时存在有多巴胺受体ＤＡ１和ＤＡ２两种亚型     

人与大鼠皮下脂肪细胞分解的受体调节差异研究

用不同的选择性β受体激动剂分别作用于人和大鼠脂肪细胞，用放射免疫法测定ｃＡＭＰ浓度，并观察不同的选择性β受体阻断剂对激动剂阻断作用的强度，结果表明：选择性β３受体激动剂作用于大鼠脂肪细胞后能产生８．３２μｍｏｌ／Ｌ的ｃＡＭＰ作用人脂肪细胞后仅能产生１．４０μｍｏｌ／Ｌ的ｃＡＭＰ。选择性β１和β２受体阻断剂阻断异丙肾上腺素对大鼠脂肪细胞的激动作用较弱（分别较１５％和２７％）选择性β２受体阻断剂的能阻     

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.