低温灌洗UW液和Euro—Collins液保存离体鼠肺效果？…

目的 比较ＵＷ液和Ｅｕｒｏ－Ｃｏｌｌｉｎｓ液的肺保存效果。方法 选用２１只Ｗｉｓｔａｒ大鼠，应用１０℃ＵＷ液和Ｅｕｒｏ－Ｃｏｌｌｉｎｓ液同时分别进行左、右肺动脉内灌洗，灌洗前主肺动脉内快速推注ＰＧＥ１。灌洗结束后干肺充气状态下切取左、右肺，并迅速分别置于１０℃的ＵＷ液有Ｅｕｒｏ－Ｃｏｌｌｉｎｓ液中保存。分别于０，２，４，６ｈ取材，在光镜及电镜下观察肺组织形态学变化，并互相比较，以判定组织活力，一肺     

HX液和CollinsⅡ液对大鼠肝窦内皮细胞及肝脏生化功能影响的对比研究

为对比观在ＨＸ液和ＣｏｌｌｉｎｓⅡ液对被保存鼠肝肝窦内皮细胞损伤程度和肝脏生化功能的影响，作者将７０只Ｗｉｓｔａｒ大鼠随机分为对照组（ｎ＝１０），Ｈ组（ＨＸ液保存，ｎ＝３０）和Ｃ组（ＣｏｌｌｉｎｓⅡ液保存，ｎ＝３０），制成大鼠肝脏离体灌注模型，而后测定其肝窦内皮细胞死亡率，Ｋｒｅｂｓ－Ｈｅｎｓｅｌｅｉｔ液内酮体比、肝脏糖释放量和分泌胆汁的肝脏数量。实验结果表明，ＨＸ液在防止肝窦内皮细胞损伤和维持肝脏正常生化功能方面的作用明显优于ＣＯｌｌｉｎｓⅡ液。     

肺动脉灌注压力对兔离体肺脏保存质量的影响

目的 应用肺保存液Ｅｕｒｏ－ｃｏｌｌｉｎｓ（ＥＣ液），观察不同肺动脉灌注压力对兔离体肺脏保存质量的影响。方法 根据灌注压力１，２，３，４ｋＰａ的不同将兔分为Ｇ１、Ｇ２、Ｇ３、Ｇ４组，每组１０只，按７０ｍｌ／ｋｇ的总量经肺动脉灌注ＥＣ液，根本压力调节流量，灌注后肺脏置４℃保存液中冷藏４ｈ后予新鲜静脉血进行复灌，测定血气分析、肺阻力、气道压力、肺组织的湿／干重比例及病理发片光镜检查。结果 发现Ｇ２、Ｇ     

药物H、X对大鼠肝脏冷缺血损伤的保护作用

采用大鼠肝脏离体灌注模型观察药物Ｈ、Ｘ对大鼠肝脏冷缺血损伤的保护作用。发现鼠肝经加入药物Ｈ、Ｘ的ＣｏｌｌｉｎｓⅡ液低温保存１２小时后，其肝窦内皮细胞死亡率明显低于对照组　，且肝窦内皮细胞死亡率与ＣｏｌｌｉｎｓⅡ液内药物Ｈ、Ｘ剂量在一定范围内呈负相关关系，药物Ｈ、Ｘ对肝细胞氧化磷酸化功能具有一定保护作用，但对ＣｏｌｌｉｎｓⅡ液保存肝脏过程中产生的组织水肿无抑制作用。作者认为药物Ｈ、Ｘ保护鼠肝免受冷缺血损伤的作用机理可能与清除氧自由基、抑制Ｋｕｐｆｆｅｒ细胞活化有关。     

临床肺移植手术肺保存的进展

目前,临床肺移植手术肺保存(ｌｕｎｇｐｒｅｓｅｒｖａｔｉｏｎ)时间在4ｈ～6ｈ,即缺血时间最长不得超过6ｈ[1,2]。近年来虽然在动物实验肺保存可以长达18ｈ～24ｈ,甚至更长,但临床仅个别报道可保存9ｈ～12ｈ[3]。1　保存液较早被用来降低肺脏温度并同时保护肺脏组织的灌洗液是林格氏液、欧洲柯林液(ＥｕｒｏＣｏｌｌｉｎｓ,ＥＣ)。近10ａ,美国、英国、德国、法国及日本等各研究中心分别试验了改良的ＥＣ液、低钾右旋糖酐液(ｌｏｗｐｏｔａｓｓｉｕｍｄｅｘｔｒａｎ,ＬＰＤ)和威斯康星液(ＵｎｉｖｅｒｓｉｔｙｏｆＷｉｓｃｏｎｓｉｎ,ＵＷ)…     

联合应用UW液与Euro—Collins液供肝冷保存

１例原位人体肝移植中，应用ＵＷ液进行供肝灌洗，然后，应用Ｅｕｒｏ－Ｃｏｌｌｉｎｓ液体肝保存，该方法在临床取得成功。患者肝细胞电镜检查可见保存期间损伤较轻微，再灌注后２小时肝细胞即恢复正常。患者存活２０８天。     

缺血预处理对犬肺移植供体肺的保护作用

以１０例犬左侧单肺移植为基础，观察左侧肺门阻断１０ｍｉｎ再灌注１５ｍｉｎ的缺血预处理结合４ＣＥｕｒｏ－Ｃｏｌｌｉｎ’ｓ液对供体肺进行冷灌及保存，结果表明：采用肺缺血预处理，对供体肺具有更好的保护作用，其作用机制可能与抑制了中性粒细胞的肺内聚集与激活有关。     

缺血预处理对犬肺移植供体肺的保护作用

以１０例犬在左侧单肺移植为基础，观察左侧肺门阻断１０ｍｉｎ再灌注１５ｍｉｎ的缺血预处理℃Ｅｕｒｏ－Ｃｏｌｌｉｎ‘ｓ液对供体液进行冷灌及保存，结果表明，采用肺血处理，对供体肺具有变化的保护作用其作用机制可能与抑制了中性粒细胞的肺内聚集与激活有关。     

维拉帕米对大鼠肝脏低温保存再灌注损伤的防护机制

目的 在自制的器官保存液XJ－1液已取得较好结果的基础上,探讨维拉帕米对大鼠肝脏低温保存再灌注损伤的防护作用及其机制。方法 XJ－1液与XJ－1＋维拉帕米液保存大鼠肝脏18h后施行肝脏移植,检测术后血清转氨酶水平、肝组织钙离子及丙二醛含量等指标,观察大鼠术后1wk存活率及移植肝脏的组织病理学改变。结果 XJ－1＋维液保存的大鼠肝脏移植后4h,血清ALT,AST水平、肝组织钙离子含量、丙二醛含量均显低于XJ－1液组（P＜0．01,P＜0．05）,光镜与电镜下肝组织形态学改变较XJ－1液组好,同时术后生存状况及1wk存活率也优于XJ－1液（71％vs 57%)。结论 维拉帕米能够减轻肝脏体外保存再灌注损伤,明显增强了XJ－1液对大鼠肝脏的保存效果,原因在于其阻滞钙通道的钙离子拮抗作用。     

羟乙基淀粉及动脉灌注法结合持续低流量灌注对兔心肺联合保存的作用

目的研究胶体物质羟乙基淀粉（ＨＥＳ）及低流量灌注技术（ＬＦＰ）对兔心肺联合保存的作用。方法选用健康家兔５０只，２只用于正常心肺组织的超微结构观察，４８只随机均分为晶体液（ＣＳ）组、ＨＥＳ组及ＬＦＰ组，每组８对供、受体。用Ｓｔ．Ｔｈｏｍａｓ液及改良Ｅｕｒｏ－Ｃｏｌｌｉｎｓ液灌注ＣＳ组心、肺，含５％ＨＥＳ的Ｓｔ．Ｔｈｏｍａｓ液及改良Ｅｕｒｏ－Ｃｏｌｌｉｎｓ液灌注ＨＥＳ组及ＬＦＰ组心、肺，取心与左肺整体４℃保存７ｈ，保存期间ＬＦＰ组经主、肺动脉持续低流量（０．２５ｍｌ／ｇ心肺重量／ｈ）灌注４℃相应保存液。移植后每３０ｍｉｎ测定供体心左室收缩压（ＬＶｓｐ）、左室舒张末压（ＬＶｅｄｐ）、右房压（ＲＡＰ）及供体肺气道峰压（Ｐａｗ），取动脉血测氧分压（ＰａＯ２），实验结束时记录异丙肾上腺素用量，计算心肺重量增值，测定心肺组织丙二醛（ＭＤＡ）含量，取心肺组织观察超微结构。结果ＣＳ组心肺重量增值高于ＨＥＳ组（Ｐ＜０．０１），ＨＥＳ组与ＬＦＰ组无明显差异。ＣＳ组ＬＶｓｐ均低于ＨＥＳ组（Ｐ＜０．０５或＜０．０１），３０，６０ｍｉｎ时ＬＦＰ组高于ＨＥＳ组（Ｐ＜０．０５）。ＣＳ组ＬＶｅｄｐ均高于ＨＥＳ组（Ｐ＜０．０５或Ｐ＜０．０１）     

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.