分泌型白细胞蛋白酶抑制剂对急性肺损伤大鼠趋化因子fractalkine表达的影响

目的: 探讨分泌型白细胞蛋白酶抑制剂(SLPI)对急性肺损伤新生大鼠肺组织中趋化因子fractalkine表达的影响.方法: 利用内毒素(LPS)气管内滴入制备新生大鼠急性肺损伤的模型;设立SLPI治疗组、LPS组、生理盐水(NS)对照组.SLPI治疗组在气管内滴入LPS前预先滴入400 μg SLPI.分别在6,12,24 h后取肺组织匀浆,用ELISA法分别测定各组趋化因子fractalkine蛋白水平.RT-PCR测定fractalkine的mRNA水平.结果: 在各时间点,SLPI治疗组肺组织中Fractalkine蛋白水平及mRNA水平均显著低于LPS组.24 h时SLPI治疗组肺组织中fractalkine蛋白为(3 124.9±155.6)pg/ml,显著低于LPS组的(4 231.4±177.9)pg/ml和NS对照组的(4 412.4±201.5)pg/ml,F=42.8, P＜0.05,差异有统计学意义.24 h时SLPI治疗组肺组织中fractalkine的mRNA相对水平为47.0±5.1,显著低于LPS组的87.3±8.2和NS对照组的81.1±9.9,F=33.2, P＜0.05,差异有统计学意义.结论: SLPI能有效抑制新生大鼠急性肺损伤时肺组织中趋化因子fractalkine的表达.     

1-羟基-2，3，5-三甲氧基[口山]酮对脂多糖致小鼠急性肺损伤的保护作用

目的探讨1-羟基-2,3,5-三甲氧基■酮(QGS)对脂多糖(LPS)致小鼠急性肺损伤的保护作用及其机制。方法采用ipLPS的方法建立小鼠急性肺损伤模型。检测肺脏指数,酶法检测支气管及肺泡灌洗液(BALF)中NO水平,Western blotting法检测核转录因子κB抑制蛋白IκB-α,诱导型一氧化氮合成酶(iNOS)及环氧合酶Ⅱ(COX-2)等蛋白的表达,HE染色观察肺组织病理学改变。结果QGS500mg/kg组能显著降低LPS引起的小鼠的肺脏指数(P<0.05)。QGS250、500mg/kg组均能显著降低LPS致伤小鼠BALF中NO水平,抑制率分别达到了37%和48.1%。同时QGS500mg/kg组还能够明显增加肺组织中IκB-α蛋白表达量并下调iNOS及COX-2蛋白表达量。结论QGS对LPS引起的小鼠急性肺损伤有保护作用,该作用与其增加IκB-α蛋白表达而抑制iN-OS和COX-2蛋白的表达有关。     

二烯丙基三硫对脂多糖诱导急性肺损伤小鼠肺组织TNF-α和IL-1β的影响

目的 探讨二烯丙基三硫(diallyl trisulfide,DATS)对脂多糖(lipopolysaccharide,LPS)致急性肺损伤(acute lung injury,ALI)小鼠肺组织肿瘤坏死因子(tumor necrosis factor-α,TNF-α)及白细胞介素-1β(interleukin-1β,IL-1β)表达的影响.方法 复制LPS致ALI小鼠模型.实验动物随机分为生理盐水对照组、ALI组、DATS预防组、DATS治疗组、DATS组.用酶联免疫吸附法测定各组2、6 h肺组织匀浆上清中TNF-α及IL-1β浓度.反转录PCR检测各组TNF-α及IL-1β mRNA表达.结果 ALI组2 h肺组织中TNF-α及IL-1β含量均明显升高(P＜0.01),6 h有所降低,但仍高于对照组(P＜0.01);DATS预防组可明显降低肺组织中TNF-α及IL-1β的含量,DATS治疗组无明显效果.对照组及DATS组肺组织中未检测到TNF-α及IL-1β mRNA表达;ALI组2 h时肺组织中TNF-α及IL-1β mRNA表达明显高于对照组(P＜0.01);DATS预防组与ALI组相比,肺组织中TNF-α及IL-1β mRNA表达显著降低(P＜0.05),DATS治疗组与ALI组相比无明显差异.结论 预先给予DATS对LPS诱导的ALI小鼠肺组织中TNF-α、IL-1β的生成及mRNA表达具有抑制作用.     

miR-141基因干扰靶向PTEN影响小鼠BMSCs成骨分化的实验研究

目的 探讨微小核糖核酸-141(micro-RNA-141,miR-141)基因干扰靶向蛋白酪氨酸磷酸酶基因(PTEN)对小鼠骨髓间充质干细胞(bone mesenchymal stem cells, BMSCs)成骨分化的影响。方法 取小鼠BMSCs并鉴定;构建miR-141 mimics、miR-141 inhibitor、miR-141 mimics-NC、miR-141 inhibitor-NC质粒,分别转染小鼠BMSCs,并记为过表达组、沉默组、过表达对照组、沉默对照组,另取小鼠BMSCs常规培养记为空白对照组。碱性磷酸酶(alkaline phosphatase, ALP)染色、茜素红染色检测各组成骨分化能力;检测各组miR-141、PTEN通路相关基因及蛋白表达;验证miR-141是否可靶向调控PTEN。结果 与空白对照组、过表达对照组相比,过表达组ALP定量,AKT、GSK3β mRNA及蛋白表达,Runx2、Osterix蛋白表达,p-AKT、p-GSK3β均下降(P<0.05),钙化结节大小、数量、密度均显著减少,miR-141 mRNA表达及PTEN mRN...     

水飞蓟素对急性肺损伤小鼠肺组织IL－1β、IL－6、趋化因子fractalkine表达的影响

目的:探讨水飞蓟素(silymarin,SIL)对急性肺损伤小鼠肺组织中白细胞介素(interleukin,IL)-1β?IL-6?趋化因子fractalkine表达的影响与意义?方法:利用内毒素(lipopolysaccharide,LPS)气管内滴入制备小鼠急性肺损伤的模型;设立SIL治疗组(S组)?LPS组(L组)?生理盐水对照组(N组),S组在气管内滴入LPS前6?4?2 h以200 mg/kg水飞蓟素灌胃,分别在LPS处理后6?12?24 h取肺组织匀浆,用ELISA法分别测定各组IL-1β?IL-6?fractalkine蛋白水平?结果:在各时间点,S组肺组织中IL-1β?IL-6?fractalkine蛋白表达水平均显著低于L组?结论:SIL能有效抑制小鼠急性肺损伤时肺组织中IL-1β?IL-6?趋化因子fractalkine的表达?     

LPS诱发急性肺损伤中miR-16的表达及功能研究

目的 观察脂多糖(LPS)诱发的急性肺损伤中microRNA-16 (miR-16) 的表达变化及其对炎症因子TNF-ɑ等表达的调节.方法 通过生物信息学分析不同物种间miR-16基因序列的保守性.通过小鼠气道向其肺内注入LPS(10 mg·kg-1),构建小鼠急性肺损伤模型,采用实时荧光定量PCR分析miR-16、IL-6、TNF-ɑ的表达水平;在培养的肺上皮细胞A549中采用miR-16 mimic对miR-16进行过表达研究.结果 miR-16基因序列在斑马鱼、大鼠、小鼠和人中序列高度保守;miR-16在急性肺损伤病理过程中表达明显降低(P＜0.05);A549细胞中miR-16的表达水平显著升高(P＜0.01),相反,LPS诱导的炎症因子IL-6、TNF-ɑ的表达水平显著降低(P＜0.05).结论 miR-16在LPS诱发的急性肺损伤病理过程中的表达降低,miR-16过表达能够显著抑制LPS对炎症的诱发作用,表明miR-16在急性肺损伤的炎症发生过程中发挥着重要功能.     

miR-200及其靶基因ZEB1/2在急性肺损伤后早期肺纤维化中上皮-间质转化(EMT)过程

目的 观察脂多糖(lipopolysaccharide,LPS)诱发小鼠急性肺损伤后早期肺纤维化过程中miR-200b/c及其靶基因ZEB1/2的表达变化.方法 应用LPS 3次打击的方法构建小鼠急性肺损伤后早期肺纤维化模型,分别于造模后第3、7、14、21天处死小鼠,留取肺组织备用.各组小鼠肺组织切片行HE和Masson染色并在光学显微镜下观察病理改变;Real-time PCR检测肺组织miR-200b、miR-200c、ZEB1 m RNA、ZEB2 m RNA表达;Western blot检测肺组织ZEB1、ZEB2、E-cadherin、Vimentin、α-SMA蛋白表达.结果 (1)病理结果:与对照组相比,LPS处理后第3天肺组织胶原纤维开始沉积,随着时间延长,肺纤维化程度逐渐加重;(2)Real time-PCR结果:随着肺纤维化程度加重,miR-200b、miR-200c水平均呈下降趋势,第7、14、21天时均显著低于对照组(P<0.01);ZEB1 m RNA、ZEB2 m RNA水平呈上升趋势,且ZEB2 m RNA较ZEB1 m RNA表达增加更显著;(3)Western blot结果:随着急性肺损伤后肺纤维化的进展,ZEB1、ZEB2蛋白表达亦升高,与其m RNA表达变化相一致;上皮标志物E-cadherin蛋白表达逐渐减少,间质标志物Vimentin、α-SMA蛋白表达逐渐增多.结论 在LPS诱发急性肺损伤后早期肺纤维化过程中miR-200b/c表达降低,并通过负性调控其靶控基因转录抑制因子ZEB1/2的表达促进上皮向间质转化.     

过氧化物酶增殖体激活受体β在急性肺损伤大鼠肺组织的表达及其意义

目的观察内毒素(lipopolysaccharide,LPS)复制的急性肺损伤(acutelunginjury,ALI)大鼠肺组织过氧化物酶增殖体激活受体β(peroxisomeproliferationactivatedreceptorβ,PPARβ)表达的变化,探讨PPARβ在ALI中可能的作用。方法将40只雄性Wistar大鼠随机分为对照组、LPS致伤1、2、4h组和8h组。用LPS(5mg/kg)静脉注射复制大鼠ALI模型,分别在LPS致伤后1、2、4、8h时活杀大鼠,测定各组肺组织湿/干重比(W/D)及肺组织病理变化;采用RTPCR法检测肺组织中PPARβmRNA的表达;采用免疫组化法检测肺组织中PPARβ的表达。结果LPS致伤后2、4、8h肺组织W/D较对照组均显著升高(F=19.61,P<0.01);LPS致伤后1、2、4hPPARβmRNA表达分别较对照组显著升高(F=86.96,P<0.01);而LPS致伤后2、4、8h组PPARβ表达阳性细胞光密度值较对照组显著升高(F=6.89,P<0.05)。结论PPARβ在ALI大鼠肺组织表达升高,提示其可能参与了急性肺损伤的发生发展。     

脂多糖和石墨粉诱导小鼠急性肺损伤病理形态学比较

【摘要】 目的:通过比较LPS和石墨粉颗粒分别诱导小鼠急性肺损伤的病理形态学差异,探讨不同来源细颗粒物成分导致急性肺损伤的可能机制。方法：将140只SPF级18-20g雄性KM小鼠随机分为7组,除正常对照组外其它组经气管内分别滴注LPS溶液及石墨粉混悬液制备急性肺损伤小鼠。记录各组动物死亡率,光镜和透射电镜下观察各组小鼠不同时间点肺组织病理变化。Western Blot检测肺组织中NE的蛋白表达,实时定量PCR法检测肺组织中MCP-1的mRNA表达。结果:与正常对照组相比,G(石墨粉)组和L(LPS)组均有不同程度病理学改变,G组小鼠肺部有大量巨噬细胞渗出,L组小鼠肺部渗出物以中性粒细胞为主;肺组织中NE蛋白表达均高于正常对照组（p＜0.05）,且L组与G组之间也有显著差异（p＜0.05）;肺组织中MCP-1mRNA表达均高于正常对照组（p＜0.01）,且L组与G组之间也有显著差异（p＜0.01）。结论：不同来源颗粒物引起肺部的病理损伤不同,可能引起炎症反应的机制也存在差异,即成分复杂的细颗粒物导致急性肺损伤的机制可能存在混合性。     

荆防药对正丁醇提取部位抗炎作用的NF-κB信号通路机制研究

目的观察荆防药对正丁醇提取部位对气管滴注脂多糖(LPS)所致小鼠急性肺损伤(ALI)模型及LPS刺激诱导的小鼠单核巨噬白血病细胞(RAW264. 7细胞)炎症模型的保护作用,探讨其抗炎效应的核转录因子-κB(NF-κB)信号通路机制。方法 (1)小鼠ALI模型:将雄性昆明种小鼠分为空白对照组,假手术组,模型组,地塞米松(5 mg/kg)+LPS组,荆防药对正丁醇部位低、中、高剂量(3. 33、6. 67、10. 01 g/kg)+LPS组,除地塞米松组于实验第2、4、5天腹腔注射给药1次外,其余各组动物连续灌胃给药5 d,1次/d,空白对照组、假手术组和模型组给予等体积0. 5%吐温溶液。末次给药30 min后,除空白对照组和假手术组外其余各组小鼠气管滴注LPS 100μL(5 mg/kg)制备小鼠ALI模型,假手术组小鼠行麻醉、气管滴注操作,但给予无菌生理盐水。造模后5 h各组再次给药1次,给予LPS后6 h处死小鼠,取小鼠肺组织进行病理形态学观察,Real-Time PCR法检测小鼠肺组织NF-κB p65、NF-κB p50、IκBαmRNA表达水平,Western-Blot法检测小鼠肺组织NF-κB p50蛋白表达水平。(2)RAW264. 7细胞炎症模型:取对数期RAW264. 7细胞悬液接种、培养24 h贴壁后,设空白对照组,LPS组(1 mg/L),LPS+DMSO对照组,LPS+地塞米松(5 mg/L)组,LPS+荆防药对正丁醇部位高、低剂量组(50、25 mg/L),LPS+5-O-甲基维斯阿米醇苷高、低剂量组(50、25 mg/L),LPS+橙皮苷组(50μg/L),LPS+迷迭香酸组(5 mg/L)。受试药物预处理3 h,除空白对照组外其余各组均加入1 mg/L LPS刺激12 h造模,吸取细胞上清,Griess法测定一氧化氮(NO)含量,ELISA法测定白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平;裂解细胞,Real-Time PCR法检测细胞NF-κB p65、NF-κB p50和IκBαmRNA表达水平。结果 (1)与LPS所致小鼠ALI模型组比较,荆防药对正丁醇部位各剂量组可减少ALI小鼠肺组织嗜中性粒细胞计数,其中低剂量组降低作用显著(P 0. 01);荆防药对正丁醇部位中、低剂量组显著下调ALI小鼠肺组织NF-κB p65mRNA及NF-κB p50蛋白表达水平(P 0. 01),中剂量组亦明显下调NF-κB p50 mRNA表达水平(P 0. 05)。(2)与细胞炎症模型组比较,所有受试药物均能明显降低细胞上清IL-6水平(P 0. 01或P 0. 05),荆防药对正丁醇部位(50、25 mg/L)、5-O-甲基维斯阿米醇苷低剂量组可显著降低细胞上清NO含量(P 0. 01或P 0. 05),荆防药对正丁醇部位高剂量组有减少细胞上清TNF-α含量的趋势;荆防药对正丁醇部位低剂量组显著下调细胞NF-κB p65、NF-κB p50、IκBαmRNA表达水平(P 0. 05或P 0. 01),高剂量组明显抑制细胞NF-κB p50、IκBαmRNA表达(P 0. 05或P0. 01),5-O-甲基维斯阿米醇苷和橙皮苷亦可显著下调细胞NF-κB p50 mRNA表达水平(P 0. 05),迷迭香酸明显抑制模型细胞NF-κB p50和IκBαmRNA表达的上调(P 0. 05)。结论荆防药对正丁醇提取部位具有抗急性炎症作用,抗炎作用发挥与抑制NF-κB信号通路中关键因子NF-κBp65、NF-κB p50、IκBα基因及NF-κB p50蛋白表达有关,5-O-甲基维斯阿米醇苷、橙皮苷与迷迭香酸可能为其主要有效物质基础。     

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.