脂氧素A4对心肌缺血再灌注损伤大鼠细胞因子和氧化应激的影响

目的 探讨脂氧素A4(LXA4)对心肌缺血再灌注损伤(MIRI)大鼠细胞因子和氧化应激的影响,明确其心肌保护作用.方法 72只雄性SD大鼠随机分成假手术一组(C1组)、假手术二组(C2组)、MIRI一组(I/R1组)、MIRI二组(I/R2组)、MIRI前用药组(LX1组)、MIRI后用药组(LX2组),每组12只.建立大鼠MIRI模型,各组于开胸前取血(T1)、实验结束后取血(T2)测IL-1β、IL-6、IL-8、IL-10、TNF-α、cTnI血清浓度,同时测定MPO、SOD活性、MDA含量及病理切片观察心肌炎性细胞浸润.结果 I/R1、LX1与C1组相比,I/R2、LX2与C2组相比,血清IL-1β、IL-6、IL-8、IL-10、TNF-α、cTnI浓度(均为T2),MPO、SOD活性和MDA含量显著增高;LX1组与I/R1组相比,LX2组与I/R2组相比,能显著降低血清IL-1β、IL-6、IL-8、TNF-α、cTnI浓度(均为T2)及MPO活性、MDA含量,并显著提高血清IL-10浓度(T2),SOD活性(P＜0.01).MIRI各组心肌炎性细胞浸润明显增多,而LX各组心肌炎性细胞浸润明显减少.结论 在MIRI前、后应用LXA4均能抑制中性粒细胞浸润和活化,降低促炎细胞因子释放,促进抑炎细胞因子分泌,减轻组织氧化应激,对大鼠MIRI起明显的保护作用.     

异丙酚对大鼠心肌缺血/再灌注损伤m-钙激活蛋白酶及线粒体膜通透性的影响

目的观察异丙酚对大鼠在体缺血/再灌注损伤心肌m-钙激活蛋白酶(m-calpain)激活和线粒体膜通透性转运的影响,探讨异丙酚对心肌缺血/再灌注损伤的保护机制。方法选用健康SD雄性大鼠24只,随机分为3组(n=8),假手术组(Sham组)、缺血/再灌注组(I/R组)、异丙酚组(P组)。分别在结扎左冠状动脉(LV)前即刻(T1)、缺血30min即刻(T2)及LV松开再灌注120min即刻(T3)3个时间点抽取动脉血2ml检测血浆超氧化物岐化酶(SOD)活性、丙二醛(MDA)和肌钙蛋白I(cTnI)浓度,免疫组织化学SP法检测各组大鼠m-calpain水平。结果与T1时间点相比,T2、T3时间点的血浆SOD活性降低(P<0.05),MDA及cTnI浓度升高(P<0.05);与T2时间点相比,T3时间点的血浆SOD活性降低(P<0.05),MDA及cTnI浓度升高(P<0.05)。在T2时间点,与I/R组相比,P组的血浆SOD活性升高(P<0.05),MDA及cTnI浓度降低(P<0.05);在T3时间点,与I/R组相比,P组的血浆SOD活性升高(P<0.05),MDA及cTnI浓度降低(P<0.05)。与对照组相比,I/R组和P组m-calpain水平均升高,与I/R组相比,P组m-calpain水平降低(P<0.05)。结论异丙酚对缺血/再灌注损伤心肌具有保护作用,通过抑制心肌缺血/再灌注损伤过程中m-calpain的激活而减轻缺血/再灌注损伤时线粒体膜通透性转运是其保护机制之一。     

腺苷A1受体激动剂延迟预处理对缺血再灌注兔心肌炎性细胞因子的影响

目的 探讨腺苷A1受体激动剂(2-氯环戊腺苷,CCPA)延迟预处理对兔心肌缺血再灌注损伤的保护机制及对炎性细胞因子的影响.方法 30只健康新西兰雄性大白兔随机分成3组:假手术组(C组)、缺血再灌注组(I/R组)、CCPA组(P组),每组10只.C组仅行左冠脉套线而不阻断160 min,I/R组行左冠脉阻断40min,再灌注120 min,P组在静注CCPA 0.1 mg/kg 24h后,处理同I/R组.各组分别于左冠前降支阻断前20min(T1)、左冠前降支阻断20 min(T2)、左冠前降支阻断40 min(T3)、心肌再灌注1 h(T4)心肌再灌注2 h(T5)5个时点抽取颈内动脉血测定血清中肌钙蛋白(cTnI)、白介素-10(IL-10)和白介素-6(IL-6)含量.再灌注结束后观察心肌细胞超微结构的变化,用伊文思蓝和TTC染色法测心梗面积.结果 与C组比,I/R组与P组cTnI、IL-10和IL-6含量均增高(P<0.05),但与I/R.组比,P组IL-10增高(P<0.05),心肌梗死面积减少(P<0.05),cTnl和IL-6降低(P<0.05).结论 腺苷A1受体激动剂延迟预处理通过调控炎性细胞因子平衡发挥心肌保护作用.     

胸交感神经阻滞对大鼠心肌缺血再灌注损伤的保护作用

目的探讨胸交感神经阻滞(TSNB)对大鼠心肌缺血再灌注损伤(MIRI)的保护作用。方法将30只健康成年雄性Wistar大鼠随机分为假手术组、心肌缺血再灌注(I/R)组和TSNB组,每组10只。TSNB组、I/R组大鼠结扎左冠状动脉前降支前分别向硬膜外隙给予体积分数0.5%罗哌卡因0.125 m L·kg-1和等量生理盐水,假手术组大鼠给予心脏左冠状动脉前降支穿线,但不结扎,穿线前硬膜外隙给予生理盐水0.125 m L·kg-1;TSNB组和I/R组大鼠均给予心脏左冠状动脉前降支穿线并结扎,40 min后解开结扎线复灌注120 min。记录各组大鼠开胸前(T_0)、缺血前(T_1)、缺血20 min(_2)、缺血40 min(T_3)、再灌注120 min(T_4)时的心率(HR)、平均动脉压(MAP),以及T0、T2~T4时血清肌钙蛋白I(cTnI)水平。再灌注120 min时2,3,5-氯三苯四唑(TTC)染色计算大鼠心肌梗死面积。Western blot法检测大鼠心肌组织自噬相关蛋白Beclin-1表达水平。结果与组内T0时及假手术组同时间点比较,T2~T4时I/R组和TSNB组大鼠HR、MAP显著降低(P<0.05);与I/R组同时间点比较,T_2~T_4时TSNB组大鼠HR、MAP显著升高(P<0.05)。与T0时比较,T2~T4时I/R组和TSNB组大鼠血清cTnI水平显著升高(P<0.01);与假手术组同时间点比较,T_2~T_4时I/R组和TSNB组大鼠血清cTnI水平显著升高(P<0.01);T2~T3时,I/R组大鼠血清cTnI水平与TSNB组比较差异无统计学意义(P>0.05),T_4时I/R组大鼠血清c Tn I水平较TSNB组显著升高(P<0.01)。与I/R组比较,TSNB组大鼠心肌梗死区和心肌缺血危险区的百分比显著降低(P<0.01),假手术组大鼠无心肌梗死。与假手术组比较,I/R组大鼠心肌组织中Beclin-1表达显著增高(P<0.01);与I/R组比较,TSNB组大鼠心肌组织中Beclin-1水平显著降低(P<0.01)。结论胸交感神经阻滞能够减轻大鼠MIRI,其机制可能与下调心肌组织自噬因子Beclin-1表达及冠状动脉扩张有关。     

白芷乙素通过抑制ERK1/2和NF-κB p65的活化缓解心肌缺血再灌注大鼠心肌损伤和氧化应激

目的 探讨白芷乙素通过抑制细胞外信号调节激酶1/2(ERK1/2)和核转录因子-κB(NF-kappaB p65)的活化,减轻心肌缺血再灌注(MI/R)大鼠心肌损伤和氧化应激的作用机制.方法 将SD大鼠随机分为五组:健康对照组(Con-trol组),心肌缺血再灌注模型组(MI/R组),低、中、高剂量白芷乙素组(6.25、12.50、25.00 mg/kg).小动物超声仪检测大鼠心率(HR)、左心室缩短分数(FS);酶联免疫吸附法(ELISA)检测心脏损伤指标肌酸激酶同工酶(CK-MB)和心肌肌钙蛋白(cTnI)水平;HE染色观察心肌组织损伤情况;末端脱氧核苷酸转移酶介导的dUTP镍端标记(TUNEL)检测心肌细胞凋亡情况;Western blot检测凋亡相关蛋白Bax、Bcl-2和caspase-3及通路蛋白ERK1/2和p65的表达情况;试剂盒检测超氧化物歧化酶(SOD)活性和丙二醇(MDA)含量.结果 与Control组比较,MI/R组的HR、FS降低(P<0.05);CK-MB和cTnI浓度升高(P<0.05);心肌组织损伤严重;凋亡细胞及Bax/Bcl-2表达比值增加(P<0.05);SOD活性降低(P<0.05),而MDA含量升高(P<0.05);ERK1/2和p65蛋白磷酸化升高(P<0.05).白芷乙素给药后,逆转了MI/R大鼠的上述结果 .与MI/R组比较,中、高剂量白芷乙素组的HR、FS回升(P<0.05);CK-MB和cTnI浓度回降(P<0.05);心肌组织损伤改善;凋亡细胞及Bax/Bcl-2表达比值回降(P<0.05);SOD活性回升(P<0.05),而MDA含量回降(P<0.05);ERK1/2和p65蛋白磷酸化回降(P<0.05).结论 白芷乙素可通过抑制ERK1/2和NF-κBp65通路蛋白活化,缓解MI/R大鼠心肌损伤及氧化应激.     

氙气预处理对心肌缺血再灌注损伤大鼠心肌细胞保护作用研究

目的:通过观察氙气预处理对心肌缺血再灌注损伤(MIRI)大鼠心肌梗死范围、心肌细胞凋亡指数、心肌组织酶类及氧化应激反应水平的影响,探讨氙气预处理对MIRI大鼠心肌细胞的保护作用及机制。方法:随机抽签方式将64只雄性SD大鼠均分为四组。假手术组(S组)仅做穿线但不结扎;MIRI组(模型组)阻断左冠状动脉前降支,使大鼠缺血30min,恢复灌注120min;0.5MAC疝气预处理+心肌I/R组(0.5XR组)和1MAC疝气预处理+心肌I/R组(1XR组)分别采用0.5MAC氙气和1 MAC氙气预处理大鼠心脏后,缺血30min,恢复灌注120min。灌注120min后,测定各组大鼠心肌梗死范围、心肌细胞凋亡指数、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)含量及血清中血清肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、一氧化氮合酶(eNOS)活性。结果:与S组相比,模型组心肌梗死范围明显增大,心肌细胞凋亡指数显著升高,心肌组织中SOD、GSH-PX和血清eNOS活性显著下降,MDA含量显著增加,血清CK、CK-MB活性显著增强(P<0.01);与模型组比,0.5XR组和1XR组大鼠心肌梗死范围显著缩小,心肌细胞凋亡指数显著下降,心肌组织中SOD、GSH-PX和血清eNOS活性显著增强,MDA含量显著下降,血清CK、CK-MB活性显著减小(P<0.05)。但0.5XR组和1XR组大鼠上述各指标间比较差异无统计学意义(P>0.05)。结论:氙气预处理对MIRI大鼠心肌组织及细胞具有保护作用,其作用机制可能与抑制机体心肌组织氧化应激反应有关。     

MicroRNA-451对大鼠心肌缺血/再灌注损伤的影响

目的:探讨MicroRNA(miR)-451在大鼠心肌缺血/再灌注(I/R)损伤中的作用及其作用机制。方法:将70只SD大鼠随机分为5组:假手术组(SO)、缺血再灌注组(I/R)、腺病毒空载体组(I/R+Ad-GFP)、miR-451上调组(I/R+Ad-miR-451)、miR-451下调组(I/R+Ad-asmiR-451)。心肌注射病毒液(1×1010 pfu/只)或PBS液(150μl/只)后3d建立缺血30min再灌注24h的心肌I/R模型。应用TTC+伊文思蓝双染法测定各组心肌梗死面积百分比,TUNEL法检测凋亡率,Western Blot法测定HMGB1和Caspase 3活化片段含量,应用试剂盒检测血清CK、LDH含量以及心肌组织SOD、MDA含量。结果:再灌注24h后,与SO组相比,I/R组和I/R+Ad-GFP组血清CK、LDH含量明显升高,心肌组织SOD活性降低、MDA含量升高,心肌组织HMGB1及Caspase-3活化片段蛋白含量显著上升,心肌细胞凋亡指数明显增加(以上P<0.05);与I/R组、I/R+Ad-GFP组相比,I/R+Ad-miR-451组血清CK、LDH含量显著下降,心肌组织SOD活性上升、MDA含量下降,心肌组织HMGB1和Caspase-3活化片段蛋白含量下降,心肌梗死面积百分比降低,心肌细胞凋亡指数降低(以上P<0.05);与I/R组、I/R+Ad-GFP组相比,I/R+Ad-asmiR-451组血清CK、LDH含量无明显上升,心肌组织MDA含量及SOD活性无明显变化,心肌组织HMGB1表达含量无明显上升,心肌梗死面积百分比及心肌细胞凋亡指数无显著升高(以上P>0.05),Caspase-3活化片段蛋白含量上升(P<0.05)。结论:MicroRNA-451通过调控HMGB1的表达,减轻凋亡和氧化应激进而减轻心肌I/R损伤。     

乳化异氟醚对乳鼠原代培养缺氧/复氧损伤心肌细胞保护效应的最适浓度研究

目的 探讨乳化异氟醚(EI)对乳鼠原代培养缺氧/复氧(H/R)损伤心肌细胞保护效应的最适浓度.方法 原代培养乳鼠心肌细胞,建立体外心肌细胞H/R损伤模型,随机分为13组:正常组(N组),缺氧/复氧组(H/R组),脂肪乳组(F组),按0.28 mmol/L EI的1、2、3、4、5、6、7、8、9、10倍分别分成EI1～ EI10组.各组取细胞培养上清液测定乳酸脱氢酶(LDH)活性和心肌肌钙蛋白I(cTnI)含量,细胞匀浆后测定心肌细胞超氧化物歧化酶(SOD)活性和丙二醛(MDA)含量.结果 与N组比较,各组的LDH、MDA、cTnI均升高(P<0.05),SOD下降(P<0.05).与H/R组比较,EI各组的LDH、MDA、cTnI均降低(P<0.05),SOD升高(P<0.05).与EI6组比较,EI其余各组的LDH、MDA、cTnI均升高(P<0.05),SOD下降(P<0.05).随着EI浓度(倍数递增)的增加,EI1~EI6组的LDH、MDA、cTnI逐渐下降,SOD逐渐升高(P<0.05),EI7~EI10组的LDH、MDA、cTnI逐渐升高,SOD逐渐下降(P<0.05).结论 EI对乳鼠离体心肌细胞H/R损伤具有保护作用,其最佳心肌保护效应浓度为1.68 mmol/L,其机制可能与其抗氧化作用有关.     

黄芪注射液预处理对大鼠急性心肌缺血再灌注损伤的保护作用

目的研究黄芪注射液对急性心肌缺血再灌注损伤(MIRI)的保护作用。方法 30只成年Sprague Dawley大鼠随机分为黄芪组、缺血再灌注(I/R)组和对照组。黄芪组大鼠腹腔注射黄芪注射液40 mg·kg~(-1),每日1次,连续6 d,第7天复制大鼠左冠状动脉前降支I/R模型;I/R组大鼠腹腔注射等量生理盐水,其余实验操作同黄芪组;对照组大鼠腹腔注射等量生理盐水,不复制I/R模型。记录各组大鼠结扎前、结扎30 min、再灌注120 min及再灌注180 minⅡ导联心电图;透射电子显微镜观察大鼠心肌细胞的超微结构;反转录-聚合酶链反应检测大鼠心肌组织Na~+-K~+-三磷腺苷(ATP)酶α1亚型mRNA表达。结果与对照组比较,黄芪组和I/R组大鼠心电图ST段在结扎30 min、缺血再灌注120 min、缺血再灌注180 min时均出现缺血性改变。黄芪组大鼠心电图ST值在各时间点均显著低于I/R组(P<0.05)。黄芪组和I/R组大鼠心肌超微结构均受损,黄芪组大鼠心肌超微结构受损程度轻于I/R组;黄芪组大鼠心肌Na~+-K~+-ATP酶α1亚型mRNA表达水平显著低于对照组(P<0.01),但高于I/R组(P<0.05)。结论黄芪注射液预处理可以减轻大鼠急性MIRI,保护大鼠心功能。     

维药爱维心口服液对心肌缺血再灌大鼠髓过氧化物酶和丙二醛的影响

目的 探讨维药爱维心口服液对心肌缺血再灌大鼠髓过氧化物酶(MPO)和丙二醛(MDA)的影响.方法 40只雄性Wistar大鼠,随机分为4组:假手术组、缺血再灌(I/R)组、爱维心预处理组及爱维心缺血期给药组,每组10只.建立大鼠心肌缺血再灌注损伤(MIRI)模型.采用BL-420生物信号采集系统全程记录心电图;检测血浆和心肌MPO、MDA的变化.结果 (1)与I/R组比较.爱维心预处理组与爱维心缺血期给药组血浆MDA的含量、MPO活性均降低,差异有统计学意义(P<0.05～0.01);与I/R组比较,爱维心预处理组与爱维心缺血期给药组心肌MDA的含量和MPO活性均降低,差异有统计学意义(P<0.01).(2)爱维心缺血期给药组与爱维心预处理组比较,血浆和心肌MDA、MPO差异无统计学意义(P>0.05).结论 维药爱维心口服液能降低MIRI大鼠的MPO和MDA,对大鼠MIRI的保护作用可能与抑制白细胞的聚集和抗膜脂质过氧化有关.     

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.