雷公藤多甙对哮喘豚鼠炎症的抑制作用

目的：通过哮喘豚鼠模型研究雷公藤多甙对哮喘豚鼠类症的抑制作用。方法：用卵白蛋白诱发致敏豚鼠哮喘发作，同时进行ＴⅡ与地塞米松（ＤＥＸ）的对照治疗，观察豚鼠支气管－肺泡灌洗液（ＢＡＬＦ）中细胞学、肺组织病理及超微结构的变化。结果：豚鼠诱发哮喘后２４ｈ和７２ｈＢＡＬＦ中炎性细胞、嗜酸细胞总数及其分类计数的结果显示，哮喘组较正常对照组明显增多，而ＴⅡ和ＤＥＸ治疗组尤其是ＴⅡ大剂量组则明显减少，与正常对照组     

雷公藤甲素对哮喘动物模型气道反应性的作用及机理

用卵白蛋白致敏和激发豚鼠，形成哮喘动物模型（哮喘组）。用雷公藤甲素（简称“雷公藤组”）处理哮喘模型后，测定以上二组和正常对照组豚鼠对组织胺的气道反应性、支气管肺泡灌洗液（ＢＡＬＦ）中的嗜酸性粒细胞（Ｅｏｓ）绝对计数、低密度Ｅｏｓ（ＨＥｏｓ）百分比以及ＥＡＬＦ中的嗜酸性粒细胞活力增强活性（ＥＶＥＡ）。发现哮喘组气道反应性非常显著高于正常组（Ｐ＜０．００１）、雷公藤组（Ｐ＜０．０１），雷公藤组显著高于正常组（Ｐ＜０．０５）。而且，哮喘组Ｅｏｓ绝对计数和ＨＥｏｓ％均与气道反应值（ＰＣ２０值）显著相关（ｒ＝－０．７６和－０．８８，Ｐ＜０．０５和０．０１）。雷公藤甲素处理不能抑制哮喘模型肺内的Ｅｏｓ聚集，但却降低ＨＥｏｓ％至正常组水平。哮喘组ＢＡＬＦＥＶＥＡ显著高于对照组、雷公藤组。哮喘组ＢＡＬＦＥＶＥＡ与ＨＥｏｓ％呈显著的正相关（ｒ＝０．７５，Ｐ＜０．０５）。以上结果表明，雷公藤甲索具有降低哮喘动物模型气道反应性的作用，其机理可能与减少“活化”的ＨＥｏｓ有关。雷公藤甲素可能有潜在的临床应用价值。     

CLINICAL SIGNIFICANCE OF COMPLETE LEFT BUNDLE BRANCH BLOCK IN DILATED CARDIOMYOPATHY

ＣＬＩＮＩＣＡＬＳＩＧＮＩＦＩＣＡＮＣＥＯＦＣＯＭＰＬＥＴＥＬＥＦＴＢＵＮＤＬＥ　ＢＲＡＮＣＨＢＬＯＣＫＩＮＤＩＬＡＴＥＤＣＡＲＤＩＯＭＹＯＰＡＴＨＹＨｕａｎｇＸｉｕｈｕｉ（黄秀惠），ＳｈｅｎＷｅｉｆｅｎｇ（沈卫峰）ａｎｄＧｏｎｇＬａｎｓｈｃｎｇ（龚...     

豚鼠支气管哮喘时血管紧张素系统的变化及糖皮质激素对其的作用

目的：通过实验性哮喘豚鼠的肺组织、支气管肺泡灌洗液（ＢＡＬＦ）和血浆中的血管紧张素系统（ＡＴｓ）的变化,探讨ＡＴｓ与哮喘发病的关系以及吸入糖皮质激素对其的作用。方法：将２７只豚鼠随机分为哮喘组（向豚鼠腹腔内注射含有卵清蛋白的致敏剂致敏,３周后,经超声雾化吸入１％卵清蛋白气雾剂诱发豚鼠哮喘）、激素组（吸入卵清蛋白前,预先吸入４０ｍｇ／ｄｌ地塞米松２０ｍｉｎ,余同哮喘组）和对照组（以等量生理盐水代替卵清蛋白）,每组９只,分别检测它们的肺切碎活组织、ＢＡＬＦ和血浆中的血管紧张素Ｉ（ＡＴＩ）、血管紧张素Ⅱ（ＡＴⅡ）水平和血清血管紧张素转换酶（ＡＣＥ）的活性。结果：哮喘组肺碎活组织、ＢＡＬＦ中ＡＴＩ、ＡＴⅡ水平及ＡＣＥ活性均较对照组显著升高（Ｐ＜０．０１）;激素组显示糖皮质激素可使ＢＡＬＦ中ＡＴｓ各成分降低,但三组间血浆     

哮喘气道炎症粘附机制的实验研究

目的：评价细胞间粘附分子１（ＩＣＡＭ－１）、Ｐ选择素在哮喘气道炎症粘附机制中的作用,进一步阐明哮喘的发病机理。方法：用酶联免疫吸附试验、肺组织免疫组化检查和呼吸生理学方法系统观察正常组和哮喘组豚鼠各项指标。结果：（１）哮喘组豚鼠肺潮气量、动态肺顺应性（Ｃｄｙｎ）和肺气道阻力与对照组比较差异有显著性（Ｐ＜０．０１及Ｐ＜０．０５）。（２）哮喘组豚鼠血浆和肺泡灌洗液（ＢＡＬＦ）可溶性ＩＣＡＭ－１（ｓＩＣＡＭ－１）、可溶性Ｐ选择素、血清和ＢＡＬＦ嗜酸粒细胞阳离子蛋白（ＥＣＰ）与对照组比较,差异有显著性（Ｐ＜０．０１）;ＢＡＬＦ中白细胞介素８（ＩＬ－８）与对照组比较差异也有显著性（Ｐ＜０．０１）。（３）哮喘组豚鼠肺组织（气道上皮和血管内皮）ＩＣＡＭ－１和ＩＬ－８表达与对照组比较,差异有显著性（Ｐ＜０．０１）。结论：ＩＣＡＭ－１、Ｐ选择素、ＩＬ－８、ＥＣＰ参与介导了哮喘气道炎症的粘附过程。     

银杏苦内酯B对哮喘豚鼠气道反应性和嗜酸性粒细胞的影响

作利用豚鼠哮喘模型观察豚鼠吸入卵蛋白（ＯＡ）或血小板激活因子（ＰＡＦ）后引起的气道反应，血浆和支气管肺泡灌洗液（ＢＡＬＦ）中溶血－ＰＡＦ（Ｌｙｓｏ－ＰＡＦ）含量和肺组织中嗜酸性粒细胞（Ｅ０）改变，及ＰＡＦ拮抗剂银杏苦内酯Ｂ（ＧＢ）的影响。结果提示致敏豚鼠ＯＡ激发和正常豚鼠ＰＡＦ激发后，与对照组相比，豚鼠血浆和ＢＡＬＦ中Ｌｙｓｏ－ＰＡＦ含量增高（Ｐ〈０．０１），肺组织中Ｅ０数增多（Ｐ〈０．０１），     

开博通、硝苯啶对原发性高血压患者血浆内皮素、肾素─血管紧张素─醛固酮系统的影响

本文对２４例原发性高血压（ＥＨ）患者随机分为应用升博通组及硝苯啶组，各１２例，均进行１４ｄ治疗，探讨这两种药物对血浆内皮素（ＦＴ）、肾素（ＰＲＡ）、皿管紧张素Ⅱ（ＡＴⅡ）及醛固酮（ＡＬＤ）系统、血压和心率的影响。结果表明：ＥＨ患者治疗前血浆ＦＴ、ＰＲＡ、ＡＴⅡ及ＡＬＤ浓度与正常对照组相比差异有显著性意义（Ｐ＜Ｏ．０１和Ｐ＜０．０５）．开博通组治疗后，血浆ＡＴⅡ、ＡＬＤ、血压及心率平均值与治疗前相比差异有显著性意义（Ｐ＜０．０１和Ｐ＜０．０５），ＦＴ和ＰＲＡ差异无显著意义（Ｐ＞０．０５）；硝苯啶组治疗后血浆ＥＴ、血压平均值与治疗前相比差异有极显著性意义（Ｐ＜０．０１）、ＡＴⅡ、ＡＬＤ虽有下降但差异无显著性意义（Ｐ＞０．０５），心率平均值增加（Ｐ＜０．０１）。以上两种药物从不同作用机制影响血管活性物质的皿浆浓度来降低血压，提示将此两种药物联合使用，呵更有效地发挥降压效果。     

实验性慢性肾衰早期血浆脂质水平动态变化的研究

本文对Ｗｉｓｔａｒ鼠５／６肾切除ＣＲＦ条件形成分别在１０、２０、３０、４０ｄ各时相点，同时测定试组对照组血浆中ＴＧ、Ｔ－Ｃｈ、Ｔ－ＰＬ及相关的载体白（ａｐｏＡ＝１、ａｐｏＢ）和脂蛋白（ＬＤＬ－Ｃｈ，ＨＤＬ－Ｃｈ）等项水平进行了系统动态观察。结果显示，ＴＧ水平在１０ｄ，Ｔ－ＣＬ、ＬＤＬ一Ｃｈ和ａｐｏＢ含量在２０ｄ时相点上始增多，并呈上升趋势。ＴＧ在２０ｄ，Ｔ－Ｃｈ、ＬＤＬ－Ｃｈ在３０ｄ分别开始明显高于同时相点对照组（Ｐ＜０．０５）ａｐｏＢ在４０ｄ明显高于同时相点对照组（Ｐ＜０．０５）．而ａｐｏＡ－１、ＨＤＬ－Ｃｈ、ＰＬ－Ｐ含量均在１０ｄ开始下降，并呈下降趋势，在３０ｄａｐｏＡ－１、ＨＤＬ－Ｃｈ开始明显低于同时相点对照组（Ｐ＜０．０５）．揭示了ＣＲＦ早存在着脂质代谢异常，并提示尤为ＴＧ的增高，可能成为脂质代谢异常最早期的诊断指标。本文从分子水平阐明了ＣＲＦ早期脂质代谢异常的发生、发展及各组份的分布状态，它们之间的相互关系和作用。无疑为ＣＲＦ脂质代谢异常早期预防。治疗提供一定的理论根据。     

急性胰腺炎大鼠血浆内皮素的变化及意义

应用牛磺胆酸钠溶液注入大鼠胆胰管内，诱发大鼠急性胰腺炎（ＡＰ）。术后１．６、１２ｈ分别检测血浆内皮素（ＥＴ）、胰组织血流量（ＰＢＦ）及灌注量（ＰＴＰ）、胰组织丙二醛（ＭＤＡ）和钙离子（Ｃａ６＾２＋）的变化，并探讨ＥＴ与其它指标的相关性。结果显示：与假手术组相比，ＡＰ大鼠术后随时间延长，ＥＴ、ＭＤＡ和Ｃａ＾２＋含量则递增，ＰＢＦ、ＰＴＰ呈递减。ＥＴ与ＰＢＦ、ＰＴＰ呈负相关（Ｐ〈０．０５）、与ＭＤＡ、     

52例轻中度高血压病24小时动态血压参数与左室舒张功能的相关分析

目的：探讨动态血压监测在临床应用中的价值。方法：对５２ 例轻、中度高血压病（ Ｅ Ｈ）患者和３０ 例正常人进行 ２４ ｈ 动态血压监测（ Ａ Ｂ Ｐ Ｍ）,同时应用多普勒超声心动图测定其左室舒张功能（ Ｌ Ｖ Ｄ Ｆ）,并对两者参数进行相关性分析。结果： Ｅ Ｈ 组舒张晚期最大血流速度（ Ｐ Ｖ Ａ）、舒张晚期血流速度时间积分（ Ａｉ）及 Ｐ Ｖ Ａ／ Ｐ Ｖ Ｅ比值增大,舒张早期血流速度时间（ Ｅｔｉｍ ｅ） 延长、 Ｅ峰充盈分数（ Ｅ Ｆ Ｆ）变小, Ａ 峰充盈分数（ Ａ Ｆ Ｆ）增大, Ｉ Ｖ Ｓ Ｔ、 Ｐ Ｗ Ｔ、 Ｌ Ｖ Ｍ、 Ｌ Ｖ Ｍ Ｉ增加, Ｌ Ａ Ｄ 扩大,均与对照组相差显著（ Ｐ＜ ０．０５～０．０１）。其中日间、夜间 Ｓ Ｂ Ｐ及其负荷值均与 Ｉ Ｖ Ｓ Ｔ、 Ｐ Ｗ Ｔ、 Ｌ Ｖ Ｍ Ｉ、 Ｐ Ｖ Ａ　 Ｐ Ｖ Ｅ 具有较好的相关性（ｒ＝ ０．３１～０．６３）。结论： Ｅ Ｈ 患者早期出现 Ｌ Ｖ Ｄ Ｆ 异常; Ａ Ｂ Ｐ Ｍ 在评价 Ｅ Ｈ 心脏靶器官损害方面有更好的预测价值。     

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.