起搏负荷超声与常规多普勒超声心动图对冠心病检出率的比较

目的　通过食道心房起搏负荷试验 ,使用彩色多普勒超声心动图对左心室室壁运动状态及左心室舒缩功能改变进行评价 ,以提高冠心病诊断的检出率 ;方法　使用心脏程序刺激仪经食道起搏导管调整心率达次极量 ;同时使用彩色多普勒超声心动仪进行左心室室壁运动记分并记录二尖瓣口及主动脉瓣环部血流频谱 ;结果　经食道心房起搏增加心脏负荷 ,应用左心室每搏量 (SV)、主动脉瓣环部流速积分 (VTIAO)、等容舒张时间 (IVRT)、二尖瓣口流速积分(VTIMV) )、快速充盈分数 (RFI)及室壁运动记分指数 (WMSI)作为指标在冠心病诊断中可提高检出率 ,以WMSI结合其它两项左心室舒缩功能阳性指标 ,其冠心病诊断的检出率为 95 % ,假阳性率为 3% ;结论　经食道心房起搏彩色多普勒负荷超声心动图 (TPDE)在冠心病诊断中有较高的应用价值 ,因其简便、实用和安全 ,宜在临床广泛推广使用     

Renal nerve activity and exaggerated natriuresis in conscious spontaneously hypertensive rats

Exaggerated natriuresis upon volume loading occurs in both human and animal hypertension and is mainly due to suppressed tubular reabsorption. To explore whether altered renal sympathetic activity contributes to this response, conscious male spontaneously hypertensive rats (SHR) were exposed to isotonic saline loading in comparison with normotensive male Wistar Kyoto rats (WKR). After a 60 min control hydropenic period, during which mean arterial pressure, heart rate, renal sympathetic nerve activity and urinary sodium excretion were followed, a 60 min period of intravenous volume expansion with isotonic saline (0.2 ml/minx 100 g b. w.) was started followed by a 60 min hydropenic recovery period. Already during the control period sodium excretion was significantly higher in SHR. During the volume load and subsequent recovery period a clearly exaggerated natriuresis occurred in SHR compared with WKR. Further, volume loading reduced renal sympathetic nerve activity in all animals, but significantly more in SHR. Moreover, volume loading reduced mean arterial pressure and heart rate in both groups. It is suggested that the accentuated reflex inhibition of renal sympathetic activity in SHR upon volume loading emanates from cardiac mechanoreceptors and partly explains the exaggerated natriuresis in SHR. This augmented ‘volume’ reflex response is probably due to reduced systemic venous compliance in SHR with a consequently increased central filling and cardiac receptor activation.     

肝纤维化门静脉压力改变与血清ET-1/NO关系的实验研究

目的制作兔肝纤维化模型，观察血管活性物质与门静脉压力变化的关系。方法40只家兔采用口服硫代乙酰胺方法造模，分别于造模第8、12、16、20周时检测内皮素（ET-1）及NO浓度，超声观察胆囊壁及肝脏血流动力学指标，直接穿刺测量不同时期门静脉压力。分析血管活性物质与肝脏血流动力学指标及门静脉压力变化间的关系。结果胆囊壁增厚是肝纤维化阶段的二维超声表现；随着纤维化程度的加重，血清ET-1、NO浓度逐渐增加，且以ET-1／N0比值增加更为明显；门静脉内压力、肠系膜上动脉、脾动脉搏动指数（PI）随纤维化程度逐渐增加，实验组与对照组间差异有统计学意义（P〈0．05），且与ET-1／NO值呈正相关（P〈0．01）。结论通过超声可无创检测肝脏血流动力学变化，对肝纤维化临床诊断及治疗效果的观察，具有积极的作用。     

碘化钾、碘酸钾对缺碘大鼠甲状腺形态与作用的实验研究

目的：研究碘化钾、碘酸钾对大鼠甲状腺形态学结构的影响。方法：将Wistar大鼠随机分为4组,低碘组（LI）、正常组（NI）、碘化钾组（KI）、碘酸钾组（KIO3）,3个月后观察形态学变化,并做体视学分析,获得定量参数后进行统计学处理。结果：LI组滤泡及滤泡腔的平均体积VQ、平均表面积SQ、体积密度VV、表面积密度SV均明显小于NI组,而数密度NV及比表面积S/V均明显高于NI组;经治疗3个月后,KI组和KIO3组的上述指标均有明显恢复,但尚未完全恢复正常。KI组和KIO3组之间无显著性差异。结论：低碘可致大鼠甲状腺形态典型的小滤泡增生性改变,而KI和KIO3在治疗缺碘性甲状腺肿方面均有很好的疗效,且在本实验期间两者的疗效无显著性差异。     

基于证效相关研究清利湿热方中医功效及降血尿酸作用机制

目的：建立湿热内蕴证候大鼠模型,研究具有降血尿酸作用的清利湿热方的中医功效,以证测效揭示清利湿热降血尿酸作用机制。方法：将48只SD大鼠随机分为空白组、模型组、四妙丸组以及清利湿热方低、中、高剂量组,每组8只。采用饲喂高脂高糖饲料,自由饮用蜂蜜水,并隔天灌胃猪油脂或酒,建立湿热内蕴证候大鼠模型,观察清利湿热方对大鼠一般状态的影响。采用酶联免疫吸附试验检测血清热激蛋白70（HSP70）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）,促胃液素（GAS）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）含量以及血浆胃动素（MTL）、肝脏组织Na+-K+-ATP酶含量,免疫组织化学法检测胃肠组织水孔蛋白3（AQP3）、水孔蛋白4（AQP4）含量,采用蛋白质印迹法检测结肠组织中TOLL样受体4(TLR4)、核因子κBp65表达量。结果：模型组体质量下降（P<0.05,P<0.01）,HSP70、TNF-α、IL-1β升高（P<0.05,P<0.01,P<0.001）,胃肠组织中AQP3表达量下降（P<0.05）,AQP4表达量上升（P<0.01,P<0.001）,GAS含量下降（P<0.01）,IgM含量升高（P<0.01）,结肠组织TLR4表达量增加（P<0.01）。清利湿热方能增加大鼠体质量,降低HSP70、TNF-α、IL-1β含量（P<0.05,P<0.01,P<0.001）,升高胃肠组织AQP3表达量（P<0.05,P<0.01,P<0.001）,降低AQP4表达量（P<0.05）,升高GAS、Na+-K+-ATP酶含量（P<0.05,P<0.001）,降低IgM含量（P<0.05,P<0.01）。结论：饲喂高脂高糖饲料,自由饮用蜂蜜水,并隔天灌胃油脂/酒,可以成功建立高尿酸血症湿热内蕴证候模型,清利湿热方可以从大鼠一般状态、体质量、热激蛋白以及炎症介质、水孔蛋白、胃肠激素、免疫等多方面改善大鼠湿热状态,发挥清利湿热功效。清利湿热方具有降血尿酸作用,其作用机制可能与下调TLR4,核因子κBp65有关。     

五味子中1个新的联苯环辛烯类木脂素

目的 研究中药五味子Schisandra chinensis的木脂素类化学成分。方法 采用硅胶柱色谱、中压反相柱色谱、半制备和制备液相对五味子中富含木脂素类成分的石油醚萃取部位进行分离、纯化,通过波谱数据鉴定化合物的结构。结果 从五味子中分离得到了26个化合物,分别鉴定为绿叶五味子素B(1)、sphaerandrin A(2)、sieverlignan E(3)、arisanschinin G(4)、widdaranalF(5)、戈米辛A(6)、戈米辛B(7)、戈米辛D(8)、戈米辛G(9)、(-)-戈米辛K1(10)、(+)-戈米辛K2(11)、(-)-戈米辛L₁(12)、(+)-戈米辛M1(13)、戈米辛N(14)、当归酰戈米辛H(15)、当归酰戈米辛O(16)、当归酰戈米辛Q(17)、苯甲酰戈米辛Q(18)、五味子醇甲(19)、五味子甲素(20)、五味子乙素(21)、五味子丙素(22)、五味子酯丙(23)、neglschisandrin E(24)、7(18)-dehydroschisandro A(25)、安五脂素(26),其中24个为联苯环辛烯类木脂素(...     

临沂市尘肺合并肺结核调查分析

目的 探讨尘肺合并肺结核的发病特点。方法 对历年来职业病档案中的现患及死亡病例逐个核实统计。结果 ①单纯尘肺560例,尘肺合并肺结核156例,合并率为21．79%。②退伍工程兵合并结核病死亡率高于厂矿企业工人。③尘肺合并肺结核死亡高于其他疾病。结论 ①尘肺合并肺结核率随期别的增加而显著增高;②尘肺合并肺结核发病率随年代的增加而降低;③尘肺合并肺结核死亡率高于单纯尘肺死亡率,随尘肺期别的增加而增高;④尘肺合并肺结核死亡所占比例随年代的增加而显著降低。     

Exogenous insulin-like growth factor II enhances post-infarction regional myocardial function in swine

OBJECTIVES: Insulin-like growth factor II (IGF-II) promotes cardiac myocytegrowth and contractility in vitro. This study was designed toinvestigate the effect of exogenous IGF-II on regional myocardialfun ction at the area of infarct in the pig. METHODS: Myocardial infarction was induced in 12 female anoesthetizedpigs by affigel blue beads, embolizing microvessels of the leftanterior descending coronary artery distribution. In the experimentalgroup (n=6), IGF-II (0.12 µg. kg^–1 in two animalsand 0.6 µg. kg^–1 in four) was incorporated intothe beads and delivered by them to the infarct area. Myocardialfunction was followed echocardiographically, and the excisedheart was analysed immunohistochemically and histopathologically. RESULTS: Myocardial function in injured zones, inversely related to anechocardiographic segmental wall motion score (mean ±SEM), was similar between the two groups at baseline, but at4 weeks post-infarction was significantly (P=0.008) reducedin the control group (0.58± 0.38 vs 3.42 ± 0.84),in contrast to nearly baseline values in the experimental group(0.58 ± 0.33 vs 1.17 ± 0.42, P=0.41). Cardiacperformance in injured segments was sign better after myocardialinjury in the experimental group (P=0.04). Tissue samples fromboth groups (4 weeks post-infarction), stained with haematoxylinand eosin demonstrated pen-infarct myocyte hypertrophy, correspondingto regions selectively stained by an antibody for CD56, whichhighlights growing cardiac myocytes. By image analysis semi-quantification,staining for CD56 was significantly (P=0.04) higher in the peri-infarctregion of the experimental group, as compared with controls(106.5 ± 2.8 vs 92 ± 4.4 gray level units). Microvesselsstained for von-Willebrand factor were similar in nwnber inboth groups (P=0.8), as were mesenchymal cells stained for vimentin(P=0.7). CONCLUSIONS: Exogenous IGF-II, delivered to the infarct area amelioratesregional cardiac function in the pig, perhaps by inducing peri-infarctmyocyte growth.     

护肝拔毒软膏质量标准研究

目的：建立护肝拔毒软膏(苦参、鲜青蒿、黄芪、赤芍等)的质量控制方法。方法：用TLC法鉴别制剂中的苦参、青蒿、黄芪、赤芍，用TLCS法测定制剂中苦参碱的含量。结果：鉴别方法专属性强，苦参碱平均回收率为97．11％，RSD为2．50％。结论：所建方法为制剂质量标准的制订提供了实验依据。