丹参对窒息后脑组织中过氧化脂质和钙含量的影响

采用自制的窒息模型，利用19只新生大鼠，研究了脑组织中过氧化服质（LPO）和Ca在脑损伤中的作用以及丹参注射液对窒息脑组织中LPO和Ca含量的影响.结果表明：窒息组动物同对照组比较，脑组织LPO和Ca含量明显升高（P＜0.05）;丹参防治组脑组织LPO和Ca含量明显低于窒息组（P＜005），与对照组无显著差异（P＞0.05）。提示：氧自由基、钙超载等因素导致窒息后的脑损伤改变;丹参可降低窒息后脑组织中LPO和Ca含量，因而具有抗窒息性脑损伤的作用.     

脓毒血症大鼠脑组织Na+、K+、Ca2+含量变化与尼莫通脑保护作用及机制探讨

目的:探讨脓毒血症过程中大鼠脑组织Na~ 、K~ 、Ca~(2 )含量变化及机制,了解尼莫通的脑保护作用,为进一步研究与治疗脓毒血症提供试验依据。方法:将150只Wistar大鼠随机分为对照组、脓毒血症组、尼莫通治疗组,每组50只。脓毒血症组行盲肠结扎穿刺术(cecal ligation and puncture,CLP);治疗组行CLP术,并在腹腔注射尼莫通;对照组行假手术。每组按术后不同时间分为4、8、12、16、20 h组,每组10只。测定各组大鼠脑组织Na~ 、K~ 、Ca~(2 )含量及脑组织含水量。结果:脓毒血症20 h组脑组织Na~ 、Ca~(2 )含量及含水量增加,K~ 降低,与脓毒血症组其它时点比较差异均有统计学意义(P<0.05)。脓毒血症20 h组分别与对照组、治疗组20 h比较,Na~ 、Ca~(2 )含量及脑组织含水量明显增加,差异有统计学意义(P<0.05)。结论:脓毒血症晚期脑组织Na~ 、Ca~(2 )含量及含水量增加,出现脑水肿,脓毒血症时脑组织明显的器质性改变出现较晚。尼莫通对脓毒血症脑组织的病理性改变有一定的预防与治疗作用。     

老年性白内障患者房水中钙离子变化的分析

为进一步研究皮质性和核性老年性白内障患者房水中Ca~(2 )的变化,以探讨白内障的发病机制,检测了30例老年性白内障患者血清及房水中Ca~(2 )的浓度。结果显示:皮质性及核性白内障患者血清中Ca~(2 )浓度分别为2.3620±0.0874mmol/L、2.3713±0.0767mmol/L,两者均无显著增高(均P>0.05);房水中Ca~(2 )浓度分别为1.3267±0.0902mmol/L和1.3927±0.0573mmol/L,两者有显著性差异(P<0.05)。提示:皮质性及核性白内障患者房水中Ca~(2 )浓度存在差异,这可能与晶状体上皮细胞状况有关,房水中Ca~(2 )浓度变化可间接反映晶状体内的病理生理变化。     

分娩镇痛中蛛网膜下腔阻滞麻醉联合硬膜外阻滞麻醉对分娩结局的影响

目的 观察蛛网膜下腔阻滞麻醉联合硬膜外阻滞麻醉(简称腰-硬联合麻醉)时用罗哌卡因及芬太尼行分娩镇痛,对分娩结局的影响.方法 采用回顾性分析方法,将162例单胎,初产,无妊娠合并症及并发症,分娩时行腰-硬联合麻醉镇痛产妇与同期未行分娩镇痛的111例产妇作对照,观察产程、产时出血量、羊水粪染情况和新生儿窒息发生率.结果 镇痛有效率达100%.镇痛组第1产程时间、活跃期时间、第2产程时间、第3产程时间分别为(393.08±101.75)min、(139.97±56.01)min、(78.23±26.84)min和(6.62±3.38)min;对照组分别为(396.25±148)min、(121.77±59.69)min、(42.25±17.17)min和(7.25±5.19)min,两组比较,活跃期及第2产程时间差异有显著性(P＜0.05),其余差异无显著性(P＞0.05).镇痛组产后出血(163.36±86.49)mL,对照组(166.22±66.11)mL,两组比较差异无显著性(P＞0.05).镇痛组羊水粪染发生率20.38%(33/162),对照组19.11%(19/111),差异无显著性(P＞0.05).两组新生儿无1例重度窒息,镇痛组轻度窒息13.58%(22/162),对照组4.51%(5/111),两组比较差异有显著性(P＜0.05).镇痛组产钳助产8.02%(13/162),对照组3.24%(4/111),两组比较差异无显著性(P＞0.05).结论 产程中罗哌卡因混合芬太尼行腰-硬联合麻醉镇痛效果显著,第2产程及活跃期镇痛组较对照组时间长,未增加产钳助产率及产后出血,但新生儿轻度窒息的发生率有所增加.     

早期综合干预对重度窒息患儿预后的影响

目的:探讨早期干预、丽珠赛乐和复方丹参多疗程治疗及康复治疗对改善重度窒息患儿预后的作用。方法: 70例重度窒息患儿分为干预组和对照组各 35例,干预组自新生儿期开始实施综合干预措施至 2岁。结果:干预组 1岁、2岁时智力发育指数(MDI)和心理运动发育指数 (PDI)均高于对照组,差异呈显著性 (P<0. 01);干预组的后遗症发生率为 8. 57%,对照组的后遗症发生率为 28. 57%,两组患儿预后之间的差异有显著性意义 (P<0. 05 )。结论:早期综合干预可促进重度窒息患儿智力发育,预防及降低神经系统后遗症的发生,明显改善重度窒息患儿的预后。     

丹参治疗重型颅脑损伤的临床观察

目的探讨丹参治疗重型颅脑损伤的疗效及作用机制。方法将74例重型颅脑损伤的病人随机分为丹参组(n =36)和对照组(n=38),丹参组应用丹参注射液静滴和常规行药物治疗及手术治疗,比较两组疗效。结果丹参组外伤性脑水肿所致颅内高压持续时间平均为9.7天,对照组为13.6天,有显著性差异(P<0.05)。丹参组血液流变学指标与对照组比较有显著差异(P<0 05)。结论丹参可改善重型颅脑损伤病人的血液流变学指标,减轻脑水肿,对脑组织有保护作用。     

绞股蓝总皂甙抗大鼠海马结构缺血再灌注损伤的作用

为探讨绞股蓝总皂甙抗缺血再灌注损伤的作用,本文检沿了大鼠海马结构缺血再灌注损伤后腺苷三磷酸(ATP)酶活性,并观察了病理组织学的改变.结果:缺血再灌注损伤后,海马结构组织Na~ —K~ —ATPase,Ca~(2 )—ATPase活性为12.56±0.81和24.83±0.55,较正常对照组(Na~ —K~ —ATPase16.07±1.42,Ca~(2 )—ATPase31.46±4.81)的活性明显下降(P<0.01).绞股蓝防治组Na~ —K~ —ATPase,Ca~(2 )—ATPase活性为15.58±2.12和29.61±1.31,脑活素防治组Na~ —K~ —AT-Pase,Ca~(2 )—ATPase活性为15.04±1.50和29.19±1.92,较缺血再灌注组明显上升(P<0.01).绞股蓝总皂甙防治组与脑活素防治组之间无明显差异(P>O.05).同时,海马1区神经毡损伤明显减轻.提示绞股蓝总皂甙有改善ATPase的功能,进而减轻缺血再灌注损伤后海马1区神经组织损害的功效.     

新生儿窒息时自由基和前列腺素代谢的变化

测定18例轻度窒息新生儿、16例重度窒息新生儿和27例正常足月新生儿出生后6～16小时时的血浆血栓烷素B_2(TXB_2)和6-酮-PGF_(1α)含量,同时测定其中17例轻度窒息儿、15例重度窒息儿和24例正常足月新生儿血浆脂质过氧化物(LPO)的含量。结果:重度窒息组血浆TXB_2、6-酮-PGF_(1α)和LPO值均显著高于轻度窒息组和正常组(P<0.01);轻度窒息组与正常组的血浆TXB_2、6-酮-PGF_(1α)和LPO值无显著性差异(P>0.10)。提示在严重窒息时,由于脑缺氧缺血,脑组织中花生四烯酸羟环氧合酶途径代谢的速率增加,使自由基、前列腺素产生增加,可能与缺氧缺血性脑病的形成有关。     

丹参、三七、红花对脑出血后脑水肿作用的对比研究

目的研究活血化瘀中药丹参、三七、红花对大鼠脑出血后脑组织含水量、脑组织中一氧化氮(NO)及活性氧、过氧化氢酶(CAT)的影响。方法采用胶原酶与肝素复合法造成大鼠脑出血模型,分别给予甘油、丹参、红花、三七及生理盐水(NS)灌胃,观察对大鼠脑组织含水量及脑组织中NO、血活性氧、CAT的影响情况。结果丹参、三七、红花使大鼠脑组织中含水量降低,与NS组比较差异均有显著性(P＜0．05～0．01),其中三七作用较明显,与甘油组结果类似(P＞0．05)。丹参和红花也有类似甘油的作用但出现时间较晚。三七、丹参、红花均能使大鼠脑出血后NO、活性氧下降,CAT含量升高,各组与NS组比较差异均有显著性(P＜0．05～0．01),且比甘油的作用好,综合各指标显示三七的作用较好,丹参次之。结论三七、丹参、红花均能减轻大鼠脑出血后的脑水肿,与甘油的作用类似。3种中药都可升高CAT含量,降低活性氧及NO的含量,综合各指标分析和比较,三七的作用较好。     

丹参配伍人参、栝蒌对家兔急性心肌梗塞再灌注损伤的保护作用

丹参、丹参配伍人参和丹参配伍栝萎均能减少急性心肌梗塞(AMI)再灌注后梗塞心肌脂质过氧化物和 Ca~(2+)含量的增高反应,缓解 Mg~(2+)含量减少,降低 AMI 及再灌注后血清肌磷酸激酶(Cpk)活性的升高反应:而且在降低梗塞心肌丙二醛(MDA)方面两配伍组较丹参组效果更好,丹参配伍人参组比丹参组更能有效地减少梗塞心肌 Ca~(2+)含量.提示3组药物对 AMI 再灌注损伤均有保护作用,中医气、血药物配伍应用效果更佳.     

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.