高氧液对家兔心肌缺血再灌注损伤生化指标和超微结构的影响

目的 观察高氧液对家兔心肌缺血再灌注损伤的保护作用。方法 家兔36只随机分为非缺血对照组12只（A组）,缺血再灌注常规治疗组12只（B组）及缺血再灌注高氧平衡盐液治疗组12只（C组）。结果 与B组比较,C组心肌组织MDA含量、ET水平明显下降（P＜0.01）,心肌组织内T－SOD活性及血清NO水平显提高（P＜0.01）,心肌组织超微结构损伤程度明显减轻。结论 高氧平衡盐液可明显减轻家兔在体心肌缺血再灌注损伤。     

宽胸逐瘀汤对家兔心肌缺血再灌注损伤保护作用的实验研究

目的：探讨宽胸逐瘀汤对离体和在体家兔心肌缺血再灌注损伤的保护作用。方法：32只在体家兔结扎冠状动脉造成心肌缺血再灌注损伤模型，随机分为假手术组、缺血再灌注组、宽胸逐瘀汤组和复方丹参片组。每组动物均在末次给药后1h开胸，暴露心脏，于冠状动脉左室支中1／2处穿线，放置硅胶管后，以备一起结扎，假手术组不结扎．放置60min，其余各组均结扎30min，解除结扎再灌注30min。实验过程中动态观察心电图（ECG），以结扎后出现心电图ST段呈弓背向上抬高，T波高耸，放松结扎后拾高的sT段下降1／2以上为缺血再灌注成功。记录心电图肢体Ⅱ导联ST段抬高情况，并检测各组血清中超氧化物歧化酶（SOD）和肌酸激酶（cK）的活性。结果：宽胸逐瘀汤和复方丹参片均可降低心电图Ⅱ导联抬高的ST段，与缺血再灌注组比较，ST段抬高程度较轻（P〈0．01），宽胸逐瘀汤的作用优于复方丹参片（P〈0．01）；宽胸逐瘀汤和复方丹参片均可降低血清CK含量，升高血清SOD含量，与缺血再灌注组比较有显著性差异（P〈0．01，P〈0．05），且宽胸逐瘀汤的作用优于复方丹参片（P〈0．05）。结论：宽胸逐瘀汤具有保护心肌缺血再灌注损伤的作用，其机制可能与改善心肌能量代谢，减轻氧自由基损伤有关。     

蛇床子素预处理对兔心肌缺血／再灌注损伤的保护作用研究

目的：探讨蛇床子素预处理对兔急性心肌缺血／再灌注损伤的保护作用及其机制。方法：结扎新西兰大耳兔左冠状动脉前降支40min后，松开结扎线再灌注120min，制作急性心肌缺彬再灌注损伤模型。缺血／再灌注（I／R）组：缺．血40min，放松结扎线后再灌注120min；缺血预处理（IPC）组：缺血5min，再灌注5min，反复3次，余处理方法同I／R组；蛇床子素预处理（Ost）组：缺血前30min经耳缘静脉静注蛇床子素25mg／kg，5min内注完，余处理方法如I／R组。于实验结束时从右心室取血测定血清超氧化物歧化酶（SOD）、丙二醛（MDA）含量及心肌肌钙蛋白（cTnI）、乳酸脱氢酶同工酶（LDH）、肌酸激酶（CK）、肌酸激酶同功酶（CK—MB）漏出率；采用TUNEL法原位标记缺血区凋亡心肌细胞并计算凋亡率。结果：各实验组血清SOD活性均较对照组高，MDA含量、cTnI及心肌酶（LDH、CK及CK—MB）漏出率均较对照组低（P〈0．05）；各实验组心肌细胞凋亡率均低于对照组（P〈0．05）。结论：蛇床子素注射液预处理可减轻兔急性心肌缺血／再灌注损伤、减少心肌细胞凋亡，对心肌损伤可能有保护作用。     

绞股蓝总皂甙对大鼠心肌缺血再灌注损伤的影响

目的：观察绞股蓝总皂甙对大鼠心肌缺血再灌注损伤的影响。方法L采用结扎左冠状动脉前降支30min后再灌注40min的方法，建立在体大鼠心肌缺血再灌注损伤模型，实验分假手术组（sham）、缺血再灌注组（IR）、GP1（100mg/kg）组、GP2（50mg/kg)组和丹参（100mg/kg)组。测定心肌组织丙二醛（MDA）含量，超氧化物歧化酶（SOD）活性；血清肌酸激酶（CK）及血浆一氧化氮（NO）、内皮素（ET）水平。结果：IR组MDA、CK及ET显著增高，而SOD及NO则显著降低（与假手术组比，P＜0．01）。GP能显著降低心肌组织MDA，血清CK及血浆ET值，明显提高心肌SOD与血浆NO水平（与IR组比，P＜0．01），促进NO／ET比值恢复平衡，。结论：GP通过抑制脂质过氧化反应和ET释放，提高SOD活性及促进NO生成，对大鼠心肌缺血再灌注损伤具有保护作用。     

高氧液对家兔心肌缺血再灌注损伤的保护作用及与ICAM-1的关系

目的：研究高氧液对家兔心肌缺血再灌注损伤的保护作用与细胞间黏附分子（ICAM-1）的关系。方法：56只家兔随机分为3组：假手术对照组（P组）、缺血再灌注损伤组（IR组）、高氧液灌注组（HBO组）。分别取缺血危险区心肌,免疫组化法检测ICAM-1的表达;检测匀浆中超氧化物歧化酶（SOD）活性、丙二醛（MDA）含量;计算心肌梗死面积。结果：HBO组、IR组SOD活性均较P组降低（均P〈0.05）;MDA含量则较P组增加（均P〈0.05）。HBO组心肌梗死面积较IR组明显减小（P〈0.05）。ICAM-1的表达,IR组比HBO、P组都明显增高（均P〈0.05）。结论：高氧液处理可下调心肌缺血再灌注损伤时ICAM-1的表达,使SOD活性升高,从而降低心肌梗死面积。     

黄芩甙对大鼠心肌缺血再灌注所致脂质过氧化损伤的保护作用

目的：研究黄芩甙（baicalin,Bai)对大鼠心肌缺血再灌注所致脂质过氧化损伤的保护作用。方法：采用结扎在体大鼠冠状动脉左前降支造成心肌缺血30min,随后恢复血流行再灌注120min,复制心肌缺血再灌注损伤模型。结果：Bai能不同程度地降低缺血再灌注所引起心肌组织脂质过氧化物丙二醛（MDA）含量升高,提高超氧化物歧化酶（SOD）活性,保护Na^ -K^ -ATP酶活力,降低血清肌酸激酶（CK）和乳酸脱氢酶（LDH）水平。结论：Bai可通过保护脑组织抗氧化酶的活性,抑制脂质过氧化反应,减轻自由基对心肌组织的损害,对缺血再灌注心肌产生保护作用。     

丹参酮ⅡA磺酸钠对兔心肌缺血再灌注损伤脂质过氧化的影响

目的：观察丹参酮ⅡA磺酸钠对免心肌缺血再灌注损伤脂质过氧化的影响。方法：将20只家兔随机分成3纽,即假手术纽,缺血再灌注组（模型纽）,丹参酮ⅡA磺酸钠组（DS-201）。免冠状动脉左旋支结扎40min再灌注60min。再灌注60min后取血,检测血浆中MDA含量及CK、LDH、SOD活力,并检测心肌组织的SOD活力和MDA含量。结果：DS-201组与模型组相比,血浆中CK、LDH、活力,MDA含量和心肌组织MDA含量均显著降低（P〈0．01）。DS-201组与模型组相比,心肌组织和血浆中SOD活力均显著升高（P〈0．05）。结论：丹参酮ⅡA磺酸钠对兔心肌缺血再灌注损伤具有保护作用,其作用机制与提高SOD活性,清除自由基,抑制脂质过氧化反应有关。     

血府逐瘀汤对心肌缺血再灌注损伤保护作用的研究

目的观察血府逐瘀汤对家兔心肌缺血再灌注损伤的保护作用.方法结扎家兔左冠状动脉前降支制备缺血再灌注模型,观察血府逐瘀汤对家兔血清中磷酸激酶(CPK]、心肌组织的丙二醛(MDA)、超氧化物歧化酶(SOD)、肌酸激酶(CK)含量的影响;对心电图 ST段的影响.结果血府逐瘀汤各剂量组家兔血清中 CPK含量明显低于模型组(P<0. 01);心肌组织 MDA低于模型组(P<0. 01), SOD、 CK明显高于模型组(P<0. 01); ST段抬高的程度呈下降趋势.结论血府逐瘀汤对心肌缺血再灌注损伤有较强的保护作用.     

二氢石蒜碱对大鼠心肌缺血/再灌注损伤的保护作用

目的:观察二氢石蒜碱(DL)对大鼠心肌缺血/再灌注损伤的保护作用。方法:采用大鼠在体心肌缺血/再灌注损伤模型,缺血30min,再灌注2h。于结扎左冠状动脉前降支前15min颈静脉注射DL(10,20,40mg·kg-1)治疗,假手术组和模型组则注射生理盐水对照。观察不同剂量DL对大鼠缺血/再灌注损伤后心电图ST段变化、血清肌酸激酶(CK)、乳酸脱氢酶(LDH)活性,以及心肌组织超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量的影响。结果:与模型组相比,DL组大鼠心肌缺血/再灌注损伤后的心电图ST段抬高幅度明显减少,血清CK、LDH的活性明显减低,心肌组织MDA含量显著降低,SOD活性显著升高,以DL20及40mg/kg组作用更显著(P<0.05或P<0.01)。结论:DL对大鼠心肌缺血/再灌注损伤具有保护作用,可能与DL减少心肌组织脂质过氧化、提高心肌细胞抗氧化损伤的能力等有关。     

大豆苷元对离体心肌缺血/再灌注损伤时抗氧化作用的影响

目的：研究大豆苷元对离体心脏缺血/再灌注损伤时抗氧化能力的影响。方法：应用大鼠离体心肌缺血再灌注损伤模型,在灌流液中加入高、中、低剂量的大豆苷元进行再灌注。再灌注结束后,测定心肌组织超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）的活性及丙二醛（MDA）的含量和心肌组织乳酸脱氢酶（LDH）和心肌肌酸激酶（CK）活性的变化。结果：低剂量的大豆苷元能提高心肌组织SOD、GSH-Px的活性,降低MDA含量;中剂量的大豆苷元能提高心肌组织GSH-PX的活性,降低MDA的含量,高剂量的大豆苷元能提高心肌组织SOD及GSH-PX的活性,也能降低MDA含量;大豆苷元能使心肌LDH及CK的活性升高。结论：大豆苷元可通过提高抗氧化酶系统的功能、加速氧自由基的清除而保护缺血再灌注心肌。     

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.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.