L—精氨酸对肾性高血压左室肥厚大鼠血液流变学的影响

目的：探讨L-Arg对肾血管性高血压左室肥厚大鼠血液流变学的影响。方法：采用放免法检测左室心肌AngⅡ含量,生化方法检测主动脉中钙调素含量,并观测不同组别血液流变学指标。结果：经过8周的治疗后,L-Arg能显著改善高血压左室肥厚大鼠血液流变学指标,并能显著减少左室心肌AngⅡ含量（P＜0.01)及主动脉中钙调素含量（P＜0.01)。结论：L-Arg能改善高血压左室肥厚大鼠血液流变学指标,并使左室心肌AngⅡ及主动脉中钙调素含量下降。     

苯那普利对心肌纤维化不同阶段的影响

目的　明确苯那普利对肾血管性高血压大鼠心肌反应性和修复性纤维化的影响。方法　建立肾血管性高血压大鼠模型 ,分别于术后 12周、2 0周予苯那普利 (7.5mg·kg-1·d-1、 15mg·kg-1·d-1)治疗 8周。测量收缩压、左室 /体重、胶原容积分数 (CVF)和血管周围胶原面积 (PVCA)。采用改良的Bergman法测定胶原浓度。聚丙烯酰胺凝胶电泳测定Ⅰ、Ⅲ型胶原比值 (Ⅰ /Ⅲ )。结果　低剂量苯那普利在反应性纤维化阶段 ,可逆转左室肥厚和胶原沉积 ;高剂量苯那普利在修复性纤维化阶段 ,虽可逆转左室肥厚 ,但只能减轻胶原堆积。 2种剂量在两个纤维化阶段均使心肌胶原比值恢复正常。结论　苯那普利在心肌纤维化不同阶段 ,可不同程度地消退沉积的胶原。早期治疗有益于逆转心肌纤维化     

卡托普利对肾性高血压心肌肥厚大鼠左室超微结构的影响

观察卡托普利对肾血管性高血压心肌肥厚大鼠左室肌超微结构的影响。方法：Ｃａｐ治疗高血压心肌肥厚大鼠８周后处死,是观察左室心肌亚细胞结构改变。结果经８周治疗后可见Ｃａｐ治疗组心肌细胞肌丝排列整、齐核规则、核仁清晰、线粒体形态结构正常。     

L—精氨酸对肾性高血压心肌肥厚大鼠左心室肌原癌基因c—fos mRNA表达的影响

目的：探讨L－精氨酸对肾性高血压心肌肥厚大鼠左室肌原癌基因c-fos mRNA表达的影响。方法：采用原位杂交方法检测原癌基因c-fos mRNA的表达。结果：经过8周后,L－Arg使高血压心肌肥厚大鼠左室肌原癌基因c-fos mRNA表达显著减少（P＜0．05）。结论：L－Arg能使高血压心肌肥厚大鼠左室肌原癌基因c-fos mRNA的表达量减少。     

氯沙坦、福辛普利对高血压大鼠心肌纤维化、血管紧张素Ⅱ及左室重构的影响

目的：评价氯沙坦、福辛普利对自发性高血压大鼠（SHR）心肌纤维化=、左室重构及血浆和心肌组织中血管紧张素Ⅱ的效应。方法：16周龄SHR随机分为3组,即氯沙坦治疗组（SHR-L组）、福辛普利治疗组（SHR-F组）、空白对照组（SHR-C组）,每组各10只。分别采用病理检查及放射免疫测定方法对治疗8周、16周的SHR心肌胶原容积分数（CVF）和心肌血管周围胶原面积（PVCA）、血浆和组织中血管紧张素Ⅱ进行检测。结果：在治疗8周、16周后,两治疗组的收缩压较对照组均有明显下降;治疗组组间比较差异无显著性（P＞0.05);心脏重量（HW）、心脏重量指数（HWI）、左室重量（LVW）、左室重量指数（LVMI）均有显著性改善,且治疗16周后SHR-F组较SHR-L组LVMI显著性降低（P＜0.05)。两治疗组CVF和PVCA与对照组比较明显下降（P＜0.01)。治疗16周后SHR-F组CVF较SHR-L组下降更明显。SHR-L组血浆及心肌组织中AngⅡ显著增加,而SHR-F组心肌组织AngⅡ显著下降,但对血浆AngⅡ无明显影响。结论：氯沙坦、福辛普利均能有效逆转心脏肥厚及抗心肌纤维化,以福辛普利作用显著。其作用机制可能与拮抗心肌组织中肾素-血管紧张素-醛固酮系统（RAS）效应有关。     

卡托普利对自发性高血压大鼠心肌间质纤维化的影响

目的：通过测定自发性高血压大鼠（SHR）左、右心室胶原含量和浓度．观察高血压时心肌间质的改变及卡托普利对其的影响。方法：尾动脉测压法测定大鼠收缩压；改良的Stagemann法间接测定胶原含量；放免法测定血醛固酮水平。结果：14周龄SHR出现血压升高、左室肥厚（LVH）的同时，心室胶原含量亦增加；12周后，治疗组SHR血压显著降低．LVH消退。并且，左、右室胶原浓度分别较未治疗组下降26％及13％，接近正常对照组水平。结论：SHR大鼠伴随心肌重量增加，其间质有胶原纤维异常堆积；卡托普利能预防和消退间质中胶原的过度堆积，具有抗纤维化作用。     

卡托普利联用倍他乐克逆转心肌肥厚的疗效观察

目的:探讨高血压并心肌肥厚的逆转机制及治疗方法.方法:对30例高血压并心肌肥厚患者应用卡托普利联用倍他乐克治疗,服药2周后观察血压;4周后观察心电图、胸片;6周后复查超声心动图.结果:发现所有经治疗患者平均血压治疗前后有非常显著的差异.治疗后窒间隔厚度(LVST)、左窒后壁厚度(PWT)指标显著降低(P<0.01).结论:高血压并心肌肥厚应用卡托普利联用倍他乐克逆转其心肌肥厚是可行的.     

氯少坦对高血压左室肥厚和左室舒张功能的影响

目的：研究氯沙坦对早期高血压心室肥厚和左室舒张功能的影响。方法：血浆肾素活性、血管紧张素Ⅱ、醛固酮及血清Ⅲ型前胶原的含量在治疗前后被测定。左心室肥厚指标及心肌舒张功能用彩色多谱心动仪测定。结果：治疗8周后血浆醛固酮及血清Ⅲ型前胶原的含量降低,快速充盈峰速（E）与心房收缩峰速（A）之比升高,而室间隔厚度（IVS）、左室后壁厚度（PWT）及左室心肌重量指数（LVMI）治疗前后未有明显变化。结论：氯沙坦在有效降低血压的同时,具有明显的降低血清前胶原和改善左心舒张功能的作用。     

阿霉素大鼠心肌重塑中PKC的表达

目的探讨蛋白激酶C（PKC）在阿霉素诱导大鼠心肌胶原重塑中的作用。方法20只8周龄雄性SD大鼠随机分为2组：对照组腹腔注射生理盐水2ml／kg,连续8周;模型组腹腔注射阿霉素（ADM）2mg／kg,连续8周;末次注射后无菌取心脏。光镜下观察心肌的病理改变;免疫组化法检测大鼠心肌组织I、Ⅲ型胶原的表达并计算二者比值;Western blotting方法检测大鼠心肌组织PKC的表达。结果光镜下心肌病理改变：对照组心肌细胞排列整齐,心肌纤维结构清晰,未见心肌纤维破坏;模型组心肌细胞肥大、伸长、灶状坏死,肌质变性,核大、深染,问质纤维化、胶原增生。心肌I、Ⅲ型胶原表达：与对照组相比,模型组I、Ⅲ型心肌胶原的表达及I／Ⅲ比值均升高（P〈0．01）。心肌组织PKC的表达：模型组PKC表达较对照组明显增加（P〈0．01）。结论PKC参与了阿霉素诱导的SD大鼠心肌纤维化。     

结缔组织生长因子在肾血管性高血压大鼠心肌中的表达及意义

目的：研究结缔组织生长因子（CTGF）的表达与肾血管性高血压（RVH）大鼠心肌肥厚的关系,探讨CTGF在RVH大鼠心肌肥厚发生、发展过程中的作用。方法：用两肾一夹方法构建RVH大鼠模型。构建成功的RVH大鼠随机分为RC1及RC2组,同时设置对照组（SC组）。以心肌胶原含量、左心室重量（LVW）、左心室重重与体重比值（LVW/BW）作为心肌肥厚的指标,应用免疫组化法检测CTGF蛋白的表达。结果：①RVH大鼠术后第8周出现心肌肥厚,第12周进一步加重。②RC1和RC2组CTGF蛋白表达显著增加（较假手术组）;且RC2较RC1组大鼠CT-GF蛋白表达增加更显著。结论：肾血管性高血压大鼠CTGF表达增多,提示CTGF参与了肾血管性高血压大鼠心肌肥厚的发生。     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.