某钢铁企业不同作业环境工人HSP70抗体水平的血清流行病学调查

探讨血清热应激蛋白70（HSP70）抗体作为工人长期经历某些环境应激后健康监测指标的可行性。采用Westernblot免疫印迹法检测接触不同有害作业环境因素和相对无有害接触的某钢铁企业795名职工的血清主要热应激蛋白70抗体水平。多种有害接触均可使工人血清HSP70抗体水平升高,特别是高温和粉尘的联合暴露,以及粉尘（石灰）暴露和噪声暴露工人血清HSP70抗体水平均明显高于对照组（P＜0．05）。毒物接触（锰）工人血清HSP50抗体也高于对照组,但差异无显著性（P＞0．05）。血清HSP70抗体水平有可能作为评价工人经历某些环境应激（如高温、粉尘、噪声）的血清学标记物或环境危害监测指标。     

免疫印迹法检测高温作业工人血清中热应激蛋白70ku抗原和抗体方法的研究

热应激蛋白70ku（heatstressprotein，HSP70）是主要的热应激蛋白。用已纯化的HSP70抗原和已制备好的HSP70抗体，采用十二烷基磺酸钠聚丙烯酰胺凝胶电泳的高分辨率和抗原抗体反应的特异性相结合的免疫印迹法（westernblot）检测17名高温作业工人和17名对照组人群血清中HSP70抗原和抗体。结果，与对照组相比，高温作业工人血清中HSP70含量增加，HSP70抗体阳性率为23.5％。结果表明westernblot法用于检测工人血清中HSP70抗原和抗体是可行的。     

不同苯接触水平工人血浆热应激蛋白70抗体滴度与健康状况的关系研究

目的 找出不同苯接触水平工人血浆热应激蛋白70抗体滴度与工人健康状况之间的关系。方法 在某两厂选择高暴露工人30名、36名分别作为高暴露组和低暴露组，另选择不接触苯的工人40名作为对照组，采用酶联免疫吸附法测定其血浆热应激蛋白70抗体滴度，分析与其它健康指标之间的关系。结果 高暴露组血浆热应激蛋白70抗体1：20阳性率(26．7％)明显高于对照组(7．5％)，并且高暴露组中血浆抗体阳性者不良症状发生率、阳性体征检出率、脂质过氧化水平均明显高于抗体阴性者。结论 不同苯接触水平工人健康状况与其血浆热应激蛋白70抗体滴度有密切关系。     

血浆热应激蛋白抗体与高血压及其新旧标准之间的关系

应用改进的酶联免疫反应技术测定血浆中热应激蛋白抗体的滴度，探讨血浆热应激蛋白（HSP）60、70、90α和90β抗体与高血压及新旧标准之间的关系。结果发现：随机180名人群中以18．67／12．00kPa为标准，高血压组血浆HSP70抗体1：10阳性率比对照组显著升高（P＜0．05）；以21．33／12．67kPa为标准，高血压组4种热应激蛋白抗体阳性比例也轻度升高，但无显著意义（P＞0．05）；按年龄分组，随年龄的增加，高血压比例和HSP70抗体阳性比例均增加，二者呈一定的相关性（r＝0．9284）。提示血浆HSP70抗体的产生可能参与了高血压的发病机理。以18．67／12．00kPa为标准，更能准确地划分高血压与正常血压。     

枸杞多糖对热暴露大鼠血浆CRH、Cor、HSP70含量及下丘脑NPY mRNA表达的影响

目的热暴露对大鼠应激器官重量和血浆中促肾上腺皮质激素释放激素(corticotropin-releasing hormone,CRH)和皮质醇(cortisol,Cor)和热休克蛋白70(heat shock 70 protein,HSP70)含量以及下丘脑神经肽Y(neuropeptide Y,NPY)mRNA表达水平的影响及枸杞多糖(lycium barbarum polysacharides,LBP)干预作用。方法雄性SD大鼠随机分为正常对照组(CN)、热暴露组(HE)及枸杞多糖干预组(HL)。对照组置于24℃人工环境下饲养,热暴露组与枸杞多糖干预组均置于32℃的人工环境中。经14d热暴露后,取脾脏、肝脏、胸腺、下丘脑器官精确称重;检测血浆中CRH、Cor和HSP70的含量;测定大鼠下丘脑NPY mRNA的表达水平。结果与对照组相比,热暴露组和枸杞多糖干预组大鼠的肝脏器官相对重量明显降低(P<0.05),血浆CRH、Cor及HSP70的含量明显升高(P<0.05);热暴露组大鼠NPY mRNA表达水平升高(P<0.05)。与热暴露组比较,枸杞多糖干预组大鼠的血浆HSP70含量升高(P<0.05),NPY mRNA表达水平降低(P<0.05)。3组大鼠脾脏、胸腺和下丘脑的器官相对重量无明显变化(P>0.05)。结论枸杞多糖可使应激大鼠血浆中热休克蛋白70含量升高,下丘脑NPY mRNA表达下调,因此枸杞多糖对热暴露环境下的机体有保护作用。     

噪声作业工人血浆热应激蛋白60抗体与高血压的关系研究

目的探讨噪声作业工人血浆热应激蛋白（HSP）60抗体与高血压之间的关系。方法用Western blot免疫印迹法测定噪声作业工人血浆HSP60抗体水平。用多因素Logistic回归模型分析HSP60抗体水平与高血压的关系。结果高血压组调查对象HSP60抗体阳性率为13．86％，血压正常组为6.55％，差别有显著性意义（P〈0．05）；在排除了常见高血压病危险因素的影响后，高血压与HSP60抗体之间仍然存在着较强联系（P〈0．05）。结论血浆HSP60抗体可能是噪声作业工人高血压的危险因素。     

高温作业人群血浆热休克蛋白70抗体与心血管病关系的研究

目的：通过测定高温作业人群热休克蛋白70抗体（HSP70-Ab）水平,探讨HSP70-Ab与高温对职业人员心血管损伤程度的关系及其在心血管病发病机制中的作用。方法：采用蛋白质免疫印迹-酶联免疫吸附测定法（Western blot-ELISA）分别检测高温作业人员（实验组,62例）、行政后勤服务人员（对照组,43例）血浆中HSP70-Ab抗体滴度。结果：高温组HSP70-Ab阳性率明显高于对照组,差异有统计学意义（P〈0.05）。结论：HSP70可能与高温作业人员心血管病的发病率有关,血浆HSP70-Ab可能是接触有害职业因素相关心血管病的生物学标志。     

汉坦病毒感染体外诱导VeroE6细胞热休克蛋白的表达

目的 研究汉坦病毒（HTV）感染后对细胞应激基因表达的影响。方法 用HTV感染其敏感细胞株VeroE6细胞,用Western印迹杂交、RNA斑点杂交及原位杂交分别分析热休克蛋白（HSP）的表达及编码HSP的mRNA水平的变化。结果 病毒感染后细胞内HSP70及热休克蛋白mRNA水平均有增高,而HSP65及HSP27的表达则无明显改变。结论 HTYV感染可以直接诱导HSP70的高表达,可能在保护细胞免受病毒感染损伤方面具有一定意义。     

轴索损伤后热休克蛋白70的变化对Tau蛋白表达的影响

目的观察大鼠轴索损伤后相应神经元内热休克蛋白（heat shock protein 70，HSP70）和Tau蛋白表达的变化及热应激对其表达的影响，探讨HSP70神经保护作用的机制。方法将57只雄性Wistar大鼠分为正常对照组（A组，3只）、单纯视神经牵拉伤组（B组，18只）、单纯热应激处理组（C组，18只）和热应激预处理牵拉伤组（D组，18只）。对B组大鼠右侧视神经施予牵拉，对C组大鼠施予热应激处理，D组大鼠经热应激预处理24h后再对右侧视神经施予牵拉。B、C、D组分别在伤后4、8、16h，1、3、5d各处死3只动物。光镜下观察视神经、视网膜神经节细胞（retinal ganglion cells，RGCs）的形态学变化，免疫组化染色检测各组动物RGCs中HSP70、Tau蛋白的表达情况。结果牵拉伤后视神经轴索、RGCs的形态发生明显的病理变化，热应激预处理再致伤后上述病理改变有显著改善。单纯牵拉伤可使RGCs中HSP70、Tau蛋白的表达增强，单纯热应激处理后HSP70的表达增强、Tau蛋白的表达不受影响，热应激预处理后再致伤使HSP70的表达明显增强、高峰表达时间提前、维持时间延长，而Tau蛋白的表达明显减弱。结论Tau蛋白表达增强可能参与了迟发性轴索断裂及迟发性神经元凋亡；HSP70可能通过减轻Tau蛋白的异常聚集而发挥神经保护作用；增强内源性神经保护作用可能是弥漫性轴索损伤治疗的新途径。     

精氨酸对热暴露小鼠肝脏HSP70表达的免疫组化研究

用免疫组织化学方法研究了热习服小鼠42℃热暴露50min恢复期0－24h肝脏热休克蛋白70（HSP70）表达的动态变化及L－精氨酸干预的热处理小鼠42℃热暴露50min后恢复期8h肝脏HSP70的表达。结果：（1）HSP70主要定位于肝脏胞质，细胞核中较少；（2）HSP70在热应激后8－12h达高峰；（3）精氨酸对热处理小鼠肝脏HSP70的表达有增强作用。     

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.