高血压病患者血栓前状态的研究

目的 :探讨高血压病易并发血栓性疾病的机制。方法 :分别采用放射免疫法、发色底物显色法、ELISA法等检测 16例健康人 (对照组 )、5 3例高血压病 1、2、3级患者血浆中的分子标志物—血栓素B2 (TXB2 )、6 -酮前列腺素F1α(6 -K -PGF1α)、组织型纤溶酶原激活物 (t-PA)、组织型纤溶酶原激活物抑制物 (PAI- 1)及血液流变学指标。结果 :1～ 2级高血压组及 3级高血压组病人 ,血浆TXB2 、t-PA含量、PAI- 1含量及活性、血粘度、纤维蛋白原水平均明显高于对照组 (P <0 .0 5 ) ;而t-PA活性、6 -K -PGF1α含量均显著下降 (P <0 .0 5 )。结论 :高血压病患者存在血栓前状态 ,血压升高可能是直接原因。这为解释及防治高血压病血栓性并发症提供了依据。     

前列腺素E_1对肺心病患者TXB_2和6 -K -PGF_(1α)的影响

目的　了解前列腺素E1 (PGE1 )治疗肺心病的机理。方法　对 56例肺心病患者应用前列腺素E1 治疗 2周 ,采用放射免疫法测定治疗前后血浆血栓素B2 (TXB2 )、6 -酮 -前列腺素F1α(6 -K -PGF1α)水平。结果　肺心病患者治疗后血浆TXB2 明显下降P <0 .0 5) ,6-K -PGF1α有明显升高 (P <0 .0 5)。结论　应用PGE1 可改善TXB2 /6 -K -PGF1α平衡 ,对治疗肺心病具有一定价值。     

激素替代治疗对前列腺素和血栓素的影响

目的　探讨绝经后妇女激素替代治疗 (HRT)对 6 -酮 -前列腺素F1α(6 -K -PGF1α)和血栓素B2(TXB2 )的影响。方法　 1 0 0例绝经后妇女随机分为A ,B两组 (各 50例 ) ,分别服 7-甲基异炔诺酮 2 5mg/d和维生素B6 1 0mg/d ,疗程 6个周期。另选 30例 2 5～ 45岁健康育龄妇女作为正常对照。监测服药前后患者的血浆 6 -K-PGF1α和TXB2 水平。结果　绝经后妇女 6 -K -PGF1α显著降低 ,而TXB2 显著升高。A组服药后 6 -K -PGF1α显著升高 ,TXB2 显著降低。B组服药前后 6 -K -PGF1α和TXB2 无明显改变。结论　HRT使绝经后妇女的 6 -K -PGF1α升高 ,TXB2 降低 ,这可能是HRT能预防冠心病的机制之一。     

B族维生素对冠心病患者血栓素B_2和6-酮-前列腺素F_(1a)的影响

目的　了解B族维生素对冠心病患者血栓素B2 (TXB2 )、6 -酮 -前列腺素 (6 -K -PGF1a)的影响。方法　对 2 7例经冠状动脉造影证实的冠心病患者应用叶酸、维生素B6治疗 2wk ,采用放射免疫法测定治疗前后血浆中TXB2 、6 -K -PGF1a水平。结果　冠心病患者治疗后血浆TXB2 无明显改变 ,6 -K -PGF1a有明显升高 (P <0 .0 5 )。结论　应用B族维生素可提高 6 -K -PGF1a水平 ,改善TXB2 / 6 -K -PGF1a平衡 ,对防治冠心病具有一定价值。     

肝阴虚证患者血浆血栓素A_2、前列环素I_2水平研究

为了比较慢性肝炎与其它疾病中肝阴虚证血浆血栓素B2 (TXB2 )和 6 -酮 -前列腺素F1α6 -Keto -PGF1α水平 ,用放射免疫法检测 2 8例肝阴虚证患者血浆TXB2 和 6 -Keto-PGF1α含量 ,又分慢性肝炎与其它疾病两组进行对比观测。结果表明 ,肝阴虚证患者血浆TXB2 水平、T/ 6 -K值显著高于健康对照组 (均P <0 0 1) ,6 -Keto-PGF1α水平显著低于健康对照组 (P <0 0 5 ) ,慢性肝炎组与其它疾病组TXB2 、T/ 6 -K值均显著高于健康对照组 (均P <0 0 1)、6 -Keto -PGF1a显著低于健康对照组 (均P <0 0 1) ,且两组组间比较差异无显著性 (P >0 0 5 )。提示肝阴虚证患者调节血管平滑肌舒缩功能的活性物质紊乱 ,存在微循环障碍。     

针刺对偏头痛大鼠血栓素B2和6-酮-前列腺素F1α的影响

目的 :探讨针刺对偏头痛大鼠颈静脉血浆中血栓素B2 (TXB2 )和 6 -酮 -前列腺素F1α(6 -keb -PGF1α)的影响。方法 :将 4 0只大鼠随机分成 4组 ,分别为正常对照组、模型对照组、针刺对照组和针刺治疗组。采用电刺激三叉神经节诱导偏头痛大鼠 ,用放射免疫法测定大鼠颈静脉血浆中TXB2 和 6 -keto -PGF1α的含量。结果 :模型对照组较正常对照组TXB2 显著降低 (P <0 .0 5 ) ,6 -keto -PGF1α显著升高 (P <0 .0 1) ,TKB2 / 6 -keto -PGF1α比值显著降低 (P <0 .0 5 ) ;针刺治疗组较模型对照组TXB2 显著升高 (P <0 .0 5 ) ,6 -keto -PGF1α显著降低 (P <0 .0 5 ) ,TXB2 / 6 -keto -PGF1α比值显著升高 (P <0 .0 5 )。结论 :针刺可以调节偏头痛大鼠TXB2 和 6 -keto-PGF1α的代谢 ,维持血浆中TXB2 和 6 -keto -PGF1α的动态平衡。     

川芎嗪对急性心肌梗死大鼠血浆TXB2、6-Keto-PGF1α的影响

目的研究川芎嗪 (TMP)对急性心肌梗死 (AMI)大鼠的心梗面积及血浆中TXB2 、6 Keto PGF1α含量的影响。方法制备大鼠AMI模型 ,腹腔注射 (ip)不同剂量的TMP ,3天后从鼠股动脉取血。采用免疫组织化学方法检测血浆中TXB2 、6 -Keto -PGF1α的含量。结果与生理盐水对照组比较TMP( 2 0mg·kg- 1～ 6 0mg·kg- 1,ip) ,血浆中TXB2 含量明显降低 ,血浆中 6 Keto PGF1α的含量明显升高 (P <0 .0 1 ) ,心梗面积明显减少 (P <0 .0 1 )。结论AMI大鼠血浆中TXB2 、6 Keto PGF1α含量的变化可能是AMI发生的重要体液因素 ,TMP(ip)可减少心梗面积并对血浆中TXB2 及 6 Keto PGF1α的含量有良性调节作用     

冠心病患者脂蛋白(α)与D-二聚体的变化及其相关性研究

目的　观察冠心病 (CHD)患者血清脂蛋白α[Lp(α) ]与血浆D -二聚体 (DD)水平的变化特点 ,并探讨它们之间的关系。方法　对 12 4例CHD患者和 2 6例正常人采用双抗体ELISA法测定Lp(α)浓度和DD水平。结果　CHD患者中 ,急性心肌梗死 (AMI)和不稳定性心绞痛 (UAP)组患者Lp(α)浓度显著高于对照组 (P <0 .0 1) ;陈旧性心肌梗死 (OMI)和稳定性心绞痛 (SAP)组患者Lp(α)浓度亦有一定程度的升高 (P <0 .0 5 )。与对照组相比 ,AMI组患者DD水平显著升高 (P <0 .0 1) ,UAP组患者DD水平亦有所升高 (P <0 .0 5 )。组间比较发现 ,Lp(α)水平在OMI与SAP、UAP与AMI组间差异无显著性 (P >0 .0 5 ) ;DD水平在OMI与SAP组间差异无显著性 (P >0 .0 5 ) ;UAP与AMI组比较有显著差异性 (P <0 .0 5 ) ,后者高于前者 ;UAP、AMI组与SAP、OMI组比较 ,前两组患者DD水平高于后两组 (P <0 .0 5 )。12 4例CHD患者相关分析显示 :Lp(α)与DD水平呈显著正相关 (r=0 .5 79,P <0 .0 0 1)。结论　冠心病患者Lp(α)显著升高且与反映继发性纤溶增强的指标DD有密切相关关系。     

川芎嗪对家兔肠缺血再灌注损伤时血浆TXA2/PGI2水平的影响

目的:探讨川芎嗪对小肠缺血再灌注损伤(ⅡRI)血浆血栓素A2(TXA2)/前列环素(PGl2)水平的影响.方法:19只实验兔随机分为2组:肠缺血再灌注组(ⅡR组,n=9)和肠缺血再灌注 川芎嗪治疗组(LGT组,n=10).用放免法分别测定不同时间点血浆TXB2、6-酮基-PGF1α含量及其比值.结果:ⅡR组家兔缺血60min后血浆TXB2含量、TXB2/6-酮基-PGF1α比值显著升高(P＜0.05和P＜0.01),再灌注15 min及30min血浆TXB2含量升高、血浆6-酮基-PGF1α明显下降(P＜0.01)、TXB2/6-酮基-PGF1α比值升高(P＜0.01);应用川芎嗪能降低血浆TXB2水平,升高血浆6-酮基-PGF1α水平,使TXB2/6-酮基-PGF1α保持正常;与IIR组比较,LGT组家兔缺血60min、再灌注15 min及30min时血浆TXB2含量、6-酮基-PGF1α含量及其比值差异均有显著性(P值分别＜0.05和＜0.01).结论:川芎嗪可纠正肠缺血再灌注损伤时血浆TXA2/PGI2的失调,通过遏制无复流现象,对肠缺血再灌注损伤起保护作用.     

急性心肌梗塞患者溶栓治疗前后若干血管活性物质的变化及临床意义

目的　探讨内皮素 (ET)、血栓素B2 (TXB2 )和 6 酮 前列腺素F1α( 6 keto PGF1α)在急性心肌梗塞 (AMI)溶栓治疗前后的变化及临床意义。方法　采用放射免疫分析方法对AMI组 (n =2 0 )及正常对照组 (n =2 0 )血浆ET、TXB2 和 6 keto PGF1α浓度分别于溶栓治疗前后进行测定。结果　AMI组溶栓前分别较溶栓后及对照组ET和TXB2升高 (P <0 0 1) ,6 keto PGF1α降低 (P <0 0 1和P <0 0 5 ) ,溶栓后TXB2 仍高于对照组 (P <0 0 1) ,6 keto PGF1α仍低于对照组 (P <0 0 5 ) ,ET则无统计学差异 (P >0 0 5 )。血浆ET浓度的升高与TXB2 6 keto PGF1α 比值呈正相关 (r =0 81,P <0 0 1)。结论　内皮素 ,TXB2 和 6 keto PGF1α代谢失调可加速AMI的发病。阻断ET分泌或拮抗ET的生理效应及恢复TXB2 6 keto PGF1α代谢平衡的措施有可能成为防治AMI发病的新途径     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.