TRH对兔急性颅脑损伤后脑组织自由基反应的影响

目的 :探讨促甲状腺素释放激素 (TRH)对急性实验性颅脑损伤后脑组织自由基反应的影响。方法 :30只家兔随机分为A、B、C 3组。A组和B组采用自由落体直接打击法建立兔急性实验性颅脑损伤模型 ,C组不致伤。A、B 2组致伤后 0 .5h分别给予TRH或等量生理盐水至伤后 4h。检测脑组织SOD、LPO ,采用干燥重量法测定脑含水量。结果 :与B组比较 ,A组损伤后脑组织中SOD活性增加 ,LPO含量及脑组织含水量减少 (P <0 .0 5 ) ;A组与B组致伤后 5min颅内压均较C组及伤前升高 (P <0 .0 5 ) ,且随时间延长 ,颅内压递增 ,但A组给药后颅内压增高速度明显减慢 (P <0 .0 5 )。结论 :TRH能够显著减轻兔急性实验性颅脑损伤后脑组织自由基反应 ,减轻脑水肿     

TRH对兔急性颅脑损伤后脑组织自由基反应的影响

目的：探讨促甲状腺素释放激素（TRH）对急性实验性颅脑损伤后脑组织自由基反应的影响。方法：30只家兔随机分为A、B、C3组。A组和B组采用自由落体直接打击法建立兔急性实验性颅脑损伤模型,C组不致伤。A、B2组致伤后0．5h分别给予TRH或等量生理盐水至伤后4h。检测脑组织SOD、LPO,采用干燥重量法测定脑含水量。结果：与B组比较,A组损伤后脑组织中SOD活性增加,LPO含量及脑组织含水量减少（P＜0．05）;A组与B组致伤后5min颅内压均较C组及伤前升高（P＜0．05）,且随时间延长,颅内压递增,但A组给药后颅内压增高速度明显减慢（P＜0．05）。结论：TRH能够显著减轻兔急性实验性颅脑损伤后脑组织自由基反应,减轻脑水肿。     

异丙酚对脑创伤家兔脑组织钙磷及水含量的影响

目的 :探讨异丙酚的脑保护作用。方法 :70只健康新西兰家兔随机分为对照组和伤后 2 4h组、72h组、1w组以及伤后异丙酚治疗 2 4h组、72h组、1w组。分别取脑组织测定各组钙磷含量和水含量 ,并做脑组织NSE免疫组织化学染色和病理检查。结果 :受伤组伤后 2 4h ,72h ,1w脑组织钙含量显著高于伤前 (P <0 .0 1) ,磷含量伤后 2 4h ,72h明显低于伤前 (P <0 .0 5 ) ;Pro组脑组织钙显著低于同时段对照组 (P <0 .0 1) ,磷与对照组比较无明显差异 (P =0 .0 86 ) ;受伤组和异丙酚治疗组伤后 2 4h ,72h ,1w脑组织含水量均显著高于正常对照组 ,而且受伤侧明显高于对侧 (P <0 .0 5 ) ;异丙酚组显著低于同时段受伤组 (P <0 .0 1) ;脑组织NSE免疫组织化学染色和病理检查 :异丙酚组治疗组受伤脑组织或其周围损伤明显轻于同时段对照组 ,部分神经元细胞NSE表达明显。结论 :异丙酚能显著降低脑创伤家兔脑组织钙和水含量 ,对创伤性脑损害有保护作用。     

急性酒精中毒对兔外伤性脑水肿的影响

目的:探讨急性酒精中毒对兔外伤性脑水肿的影响.方法:采用经胃管注入乙醇致使家兔急性酒精中毒,自由落体打击法制作外伤性脑水肿模型;测定伤后4h脑组织超氧化物歧化酶(SOD)活性、脂质过氧化物(LPO)含量及脑组织含水量;并连续监测颅内压(ICP)变化.结果:急性酒精中毒加脑外伤组伤后4h脑组织SOD活性明显下降(P＜0.05),LPO含量明显增高(P＜0.01),脑含水量显著增加(P＜0.05),伤后ICP显著升高,但与单纯脑外伤组比较ICP的升高无显著差异.结论:急性酒精中毒可加重外伤性脑水肿,自由基反应是脑水肿加重的重要原因.     

急性酒精中毒对兔脑外伤后的影响

目的 :研究急性酒精中毒对兔脑外伤后的影响。方法 :家兔 30只 ,随机分为 3组 ,每组 10只。A组为正常对照组 ,B组为单纯脑外伤组 ,C组为酒精中毒加脑外伤组。乙醇灌胃法致使家兔急性酒精中毒 ,直接打击颅骨法制作急性颅脑损伤模型 ;于伤前、伤后一定时间测定呼吸频率、平均动脉压、颅内压、大脑中动脉血流速度(vmca)、脉搏指数 (PI)、脑血管直径指数 (CVI) ;伤后 4h处死动物 ,测定脑组织超氧化物歧化酶 (SOD)活性、脂质过氧化物 (LPO)含量及含水量。结果 :C组伤后立即出现显著的呼吸抑制及低血压 ,vmca明显减慢 ,PI值显著升高 ,CVI明显减小 ,伤后 4hSOD活性明显降低 ,LPO含量及脑含水量明显增高 (P <0 0 1)。结论 :伤前醉酒可使兔脑外伤后发生显著的呼吸抑制、低血压、脑血管收缩及脑末梢血管阻力增加 ,使脑血流量 (CBF)显著减少 ,并加重脑外伤后自由基反应 ,加重脑水肿     

颈总动脉推注高渗甘露醇对兔急性脑缺血疗效的试验研究

目的 :观察颈总动脉推注高渗甘露醇对减轻缺血性脑水肿的机制和效果。方法 :建立兔急性脑缺血模型 ,随机分为对照组、脑缺血 6h和 1 2h(非推药组 )、脑缺血 6h后和 1 2h后推药组 (颈总动脉推注2 0 %甘露醇 ) ,脑缺血 6h和 1 2h推药后 2 4h跟踪观察组 ,共 7组。用干湿重法测定脑组织含水量 ,光镜下观察脑组织病理变化 ,评价脑水肿程度。观察甘露醇脱水 2 4h后神经症状的恢复 ,评估兔运动功能。结果 :脑缺血 6h和 1 2h组脑组织含水量与对照组相比均明显升高 (P <0 .0 5 ,P <0 .0 1 ) ;脑缺血 6h、1 2h后推药组脑组织含水量显著低于非推药组 (P <0 .0 1 ,P <0 .0 0 1 ) ,脑组织病理变化也明显轻于非推药组 ,尤以 6h组效果最佳。结论 :颈总动脉推注高渗甘露醇可明显减轻缺血性脑水肿。     

亚低温配合等容量血液稀释治疗急性重型颅脑损伤的临床研究

目的 :研究亚低温配合等容量血液稀释对急性重型颅脑损伤的治疗作用及临床效果。方法 :将 70例患者随机分为治疗组和对照组。治疗组 35例 ,均于伤后 2 4 h内行亚低温治疗 ,温度控制在 34～ 35 .5℃ ,持续 2～ 10 d;同时于伤后 4 8h内行等容量血液稀释方法 (IHD)治疗。对照组 35例 ,行常规治疗。监测病人生命体征、GCS评分、颅内压 (ICP)、血糖、红细胞比容(HCT)、全套血液流变学指标、血气、电解质等。结果 :与对照组相比 ,治疗组病人伤后早期高 ICP、高血糖、高 HCT、高血黏度均显著下降 (P <0 .0 5 ) ;血气、血电解质无统计学意义 (P >0 .0 5 ) ;恢复良好率明显提高 (P <0 .0 5 ) ;病死率明显下降 (P <0 .0 5 )。结论 :亚低温配合 IHD治疗急性重型颅脑损伤安全有效 ,可降低 ICP、改善血液流变学指标 ,降低病死率 ,提高生活质量。     

红细胞致脑出血后血肿周围脑组织迟发性损伤的氧化机制

目的　研究脑出血 (intracerebralhemorrhage ,ICH)后血肿内的红细胞致血肿周边脑组织迟发性损伤的氧化机制 ,观察不同时间点脑组织含水量、血肿周边脑组织自由基含量的动态变化。方法　采用立体定向技术将自体浓缩红细胞注入大鼠脑基底节区制作实验动物模型 ,将动物随机分为假手术对照组、ICH组 ,在不同时间点断头取脑 ,应用干湿重法测定脑组织含水量、生化方法测定血肿周围脑组织匀浆中丙二醛 (MDA)的含量和超氧化物歧化酶 (SOD)活力的变化。结果　ICH组大鼠脑组织含水量在 2 4h内无明显变化 ,4 8h时有所增加 ;在 72h脑组织含水量明显增高并达峰值 (P <0 .0 1) ;随后逐渐下降 ,在 16 8h含水量缓慢恢复到假手术对照组水平。ICH组大鼠脑组织MDA在脑出血后 6h无明显变化 ;在 12h有所增加 ;于 72hMDA达到高峰 (P <0 .0 1) ,随后逐渐下降接近假手术对照组水平。SOD在脑出血后 6h无明显变化 ,与假手术对照组相比无统计学差别 (P >0 .0 5 ) ;随后逐渐下降 ,至第 4 8～ 72h下降达到最低值 (P <0 .0 1) ,后逐渐恢复 ,至第 16 8h接近假手术对照组水平。脑出血后血肿周围脑组织MDA的变化与脑组织含水量的变化呈正相关 (r =0 .82 3,P <0 .0 5 ) ,血肿周围脑组织SOD的变化与脑组织含水量的变化呈负相关 (r =- 0 .77     

异丙酚对脑创伤家免脑组织钙磷及水含量的影响

目的：探计异丙酚的脑保护作用。方法：70只健康新西兰家兔随机分为对照组和伤后24h组、72h组、lw组以及伤后异丙酚治疗24h组、72h组、lw组。分别取脑组织测定各组钙磷含量和水含量，并做脑组织NSE免疫组织化学染色和病理检查。结果：受伤组伤后24h，72h，lw脑组织钙含量显著高于伤前(P＜0．01)，磷含量伤后24h，72h明显低于伤前(P＜0、05)；Pro组脑组织钙显著低于同时段对照组(P＜0．01)，磷与对照组比较无明显差异(P＝0．086)；受伤组和异丙酚治疗组伤后24h，72h，lw脑组织含水量均显著高于正常对照组，而且受伤侧明显高于对侧(P＜0．05)；异丙酚组显著低于同时段受伤组(P＜0．01)；脑组织NSE免疫组织化学染色和病理检查：异丙酚组治疗组受伤脑组织或其周围损伤明显轻于同时段对照组，部分神经无细胞NSE表达明显。结论：异丙酚能显著降低脑创伤家免脑组织钙和水含量，对创伤性脑损害有保护作用。     

犬颅脑枪弹伤后脑组织BDNF蛋白的表达及意义

目的 :探讨犬颅脑火器伤后脑组织内脑源性神经生长因子 (Brain derivedneurotrophicfactor,BDNF)的变化规律及其对颅脑火器创伤神经元的保护作用 .方法 :建立犬颅脑枪弹伤模型 ,制备不同部位不同时间点脑组织切片 ,免疫组化法染色 ,检测BDNF的表达 .与设立的对照组相比较 ,并进行组间比较 .结果 :损伤组脑组织BDNF含量明显高于对照组 ,动物的伤情相对愈重 ,表达愈明显 .在 2～ 4h为表达高峰期 ,不同组织间亦存在明显差异 (P <0 .0 1 ) ,以海马及挫伤区含量高 .结论 :颅脑枪弹伤后不同部位脑组织BDNF随时间的变化出现不同表达 ,提示BDNF在颅脑枪弹伤的早期修复中发挥作用 .     

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.