晶状体囊膜抛光联合囊袋内注射透明质酸酶预防兔眼后囊膜混浊

目的 :探讨晶状体囊袋内注射透明质酸酶联合囊膜抛光是否可预防兔眼后囊膜混浊及其眼内应用的安全性。方法 :将 4 0只兔随机分为 4组 ,每组均进行超声乳化晶状体吸除联合囊袋内人工晶状体植入术 ,分别采用不抛光不用透明质酸酶、抛光不用透明质酸酶、水分离和抛光囊膜时用进口透明质酸酶和用国产透明质酸酶的方法。手术后不同时期进行组织病理学检查。术后 3个月对每组 5只兔眼的后囊膜混浊进行分级 ,并作组织病理学检查。结果 :术后 3个月经秩和检验第 1、2组的后囊膜混浊发生率与第 3、4组相比差异有显著性 ( P<0 .0 5 ) ;第 3组与第 4组、第1组与第 2组之间差异无显著性 ( P>0 .0 5 )。说明透明质酸酶联合抛光可以降低兔眼后囊膜混浊的发生率 ,而且进口与国产透明质酸酶同样有效。术后病理学检查提示抛光用联合囊袋内注射组术后残留的晶状体上皮细胞最少 ,而且该组的 Soemmering环、Elschnig小体和后囊膜上的细胞都比较少 ,出现晚 ,眼内其它组织未受损害。结论 :晶状体囊袋内注射透明质酸酶联合囊膜抛光可以预防兔眼后囊膜混浊的发生 ,而且眼内应用安全     

光动力疗法诱导Hela细胞凋亡的实验研究

1 一般资料 1．1准备工作：细胞复苏、培养、传代、冻存：人宫颈癌细胞系Hela为贴壁细胞，从液氮中取出冻存的细胞后立即置于37℃水浴中融解。1000r／min离心5分钟，弃上清后加入RP—M11640培养基离心洗涤1次。加入含10％小牛血清的RP—M11640培养基5ml悬浮起细胞后置于25ml细胞培养瓶中，     

老年性白内障的不同类型与晶状体上皮细胞密度的改变

【目的】探讨晶状体上皮细胞密度的改变与不同类型老年性白内障的关系。【方法】选取超声乳化白内障摘除手术病人的晶状体前囊膜标本 ,其中白内障的类型被分为皮质型 (成熟期 )、核硬化型 (≥NⅢ 级 )、后囊下型和混合型。健康成年人透明晶状体的前囊膜标本来源于眼库的供体眼球。所有前囊膜标本经铺片、固定染色后 ,细胞计数测定前囊膜中央区晶状体上皮细胞密度 (LECD)。【结果】健康成年男性透明晶状体LECD为 (4 15 2± 75 0 )个 /mm2 ,女性为 (4 874± 5 5 0 )个 /mm2 (P<0 0 1) ;核硬化型白内障 (≥NⅢ 级 )的LECD为 (5 12 0± 45 0 )个 /mm2 ,核硬化型白内障 (≥NⅢ 级 )晶状体上皮细胞密度高于其他各组及正常对照 (P <0 0 1) ,其中男性与女性的LECD分别为 (5 15 0± 35 0 )个 /mm2 和 (5 0 0 5± 480 )个 /mm2 (P >0 0 1)。【结论】健康成年女性的透明晶状体上皮细胞密度高于男性 ;核硬化型白内障 (≥NⅢ 级 )中男女晶状体上皮细胞密度无显著差异 ;以上结果结合当前流行病学的研究资料提示晶状体上皮细胞密度高可能是核硬化型白内障发生的易感因素 ,为研究老年性白内障的病理机制提供了新的线索     

联合抗肿瘤药物预防免疫后发性白内障的实验研究(简报)

本文旨在探讨联合抗肿瘤药物在预防后发性白内障中的作用及其机制。采用40只新西兰白兔随机分为两组。在兔晶状体超声乳化吸出术后，实验组右眼晶状体囊袋内注入含有0.2mg／ml丝裂霉素及12.5mg／ml 5-氟尿嘧啶的甲基纤维素，左眼晶状体囊袋内仅注入甲基纤维素设置空白对照组；对照组右眼晶状体囊袋内注入含有0.2mg／ml丝裂霉素的甲基纤维素，左眼晶状体囊袋内注入含有12.5mg／ml 5-氟尿嘧啶的甲基纤维素，所有实验的新西兰白兔前房使用高粘的粘弹剂爱维维持前房。5分钟后用灌注液置换前房及晶状体囊袋内的粘弹剂。部分新西兰白兔囊袋内植入人工晶体。手术后对动物进行1～12月临床观察并记录，对不同阶段进行晶状体囊膜组织和人工晶体病理学检查、晶状体囊膜组织平片检查及人工晶体电镜扫描。临床观察显示，空白对照组在手术后2周出现后囊膜混浊（posterior capsule opacification，PCO）和部分术眼有人工晶体前膜形成，随着术后时间的延长，PCO明显加重；对照组在术后1月发生不同程度PCO，而实验组临床观察12月，未见PCO发生。组织病理学检查表明，实验组手术后1月出现前囊中央3mm直径外晶状体上皮细胞（1ens epithelialcells，LEC）、晶状体赤道部生发区细胞发生空泡样变性，核固缩，甚至细胞溶解，2个月后，LEC基本消失；空白对照组手术后1月开始出现LEC增生，随着术后时间的延长，形成明显的soemeting环、晶状体后囊膜纤维化和囊袋皱缩；对照组手术后1月开始出现LEC和晶状体赤道部生发区细胞发生空泡样变性，核固缩，部分细胞溶解，但2个月后LEC开始增生，随着术后时间的延长，晶状体后囊膜开始纤维化。晶状体囊膜组织平片检查表明，实验组晶状体囊膜光滑，染色均匀，未发现细胞及纤维化，而空白对照组和对照组晶状体囊膜欠光滑，污浊，表面可见LEC增生和纤维样组织形成。人工晶体电镜扫描显示，实验组人工晶体表面光滑，而空白对照组和对照组人工晶体表面可见巨噬样细胞和纤维附着，表面污浊。本结果表明，晶状体囊袋内联合抗肿瘤药物能有效杀伤LEC、晶状体赤道部生发区细胞，较单一抗肿瘤药物更可靠预防PCO的发生，晶状体囊膜组织平片技术不失为实验性评价PCO的有效方法之一。晶状体囊袋内联合抗肿瘤药物可能为解决预防人类PCO提供一条新途径。     

透明晶状体和老年性白内障晶状体上皮细胞水通道蛋白1的表达

目的　探讨透明晶状体和老年性白内障患者晶状体上皮细胞水通道蛋白 1(aquaporin 1,AQP1)的表达水平。方法　收集 5例透明晶状体和 4 0例老年性白内障患者的前囊膜。应用免疫组织化学方法和计算机图像分析技术对前囊膜下晶状体上皮细胞AQP1进行检测。结果　AQP1阳性表达在透明晶状体和老年性白内障患者前囊膜下晶状体上皮细胞的细胞膜。图像分析透明晶状体和老年性白内障患者晶状体上皮细胞AQP1平均吸光度值差异有显著性意义 (P <0 0 5 )。老年性白内障患者晶状体上皮细胞AQP1平均吸光度值低于透明晶状体上皮细胞AQP1平均吸光度值。结论　透明晶状体和老年性白内障患者晶状体上皮细胞的细胞膜表达AQP1,AQP1可能在老年性白内障发生发展中起一定作用。     

家族性先天性无虹膜合并白内障患者晶状体前囊膜异常的临床病理学研究

目的:观察先天性无虹膜家系并发白内障患者的晶状体前囊膜的病理学变化,探讨晶状体前囊膜变薄,变脆的病理学机制及对手术方案的意义.方法:收集家族性先天性无虹膜并发白内障患者术中的晶状体前囊膜或晶状体,分别进行光镜和电镜检查.结果:家族性先天性无虹膜合并白内障患者的晶状体前囊膜明显脆弱、变薄.光镜和电镜见晶状体上皮细胞呈变性、坏死、脱失,致使上皮细胞层不连续;有的病例晶状体上皮细胞局灶性增生、复层化;前囊膜表层板层结构均变薄甚至消失.结论:晶状体上皮细胞的退行性和增殖性改变可能是导致先天性无虹膜合并白内障患者的晶状体前囊膜变薄、囊膜的脆弱性增加的原因.提高对前囊膜脆弱性的认识,有助于减少术中囊膜的并发症,达到安全的手术结果.     

兔晶状体上皮细胞的体外培养

目的：建立兔晶状体上皮细胞（RLEC）体外培养的模型。方法：采用组织块培养法，对兔晶状体前囊膜进行培养，并利用形态学检查方法鉴定。流式细胞仪检测细胞周期。结果：组织块接种72小时后可见细胞生长。且保持上皮细胞形态，12-14天细胞融合，体外传代5代以后，细胞呈纤维化生长，细胞周期分析提示体外培养的RLEC保持正常的增殖能力。结论：组织块培养法能在体外成功培养兔晶状体上皮细胞，可用于白内障术后前囊膜及后囊膜混浊发生机制的研究。     

老年性白内障晶状体上皮细胞的形态学变化

目的 观察老年性白内障晶状体上皮细胞的形态学改变，探讨其与白内障形成的关系。方法 采集老年性白内障晶状体囊外除术中取出的前囊膜，采用铺片及ＨＥ染色、平板包埋及制备超薄切片等技术，分别在光镜和电镜下观察晶状体上皮细胞的密度、细胞形态和超微结构变化。结果 白内障 晶状体上皮细胞密度较正常晶状体明显减小（Ｐ〈０．０１），６０岁以上组细胞低于６０岁以下组（Ｐ〈０．０１）。光镜下，形态异常的细胞散在分布，     

联合抗代谢药物预防兔后发性白内障的研究

目的 探讨联合抗代谢药物在预防兔后发性白内障（PCO）中的作用及其机制.方法 40只新西兰白兔随机分为两组。在兔晶状体超声乳化吸出术后，实验组右眼晶状体囊袋内注入含有02mg／ml丝裂霉素及12．5mg/ml 5-氟尿嘧啶的甲基纤维素，左眼晶状体囊袋内仪注入甲基纤维素设置空白对照组；对照组右眼晶状体囊袋内注入含有0．2mg/ml丝裂霉素的甲基纤维素，左眼晶状体囊袋内注入含有12．5mg/ml 5-氟尿嘧啶的甲基纤维素。部分动物囊袋内植入人工晶体。手术后对动物进行1～12个月临床观察，对不同阶段进行晶状体囊膜组织和人工晶体病理学检查、晶状体囊膜平片检查及人工晶体电镜扫描。结果 空白对照组在手术后2周出现后囊膜混浊，随着术后时间的延长，PCO明显加重；对照组在术后1个月发生不同程度PCO，而实验组观察12个月，未见PCO发生。结论 晶状体囊袋内联合抗肿瘤药物能有效杀伤晶状体上皮细胞（LEC）、晶状体赤道部生发区细胞，较单一抗肿瘤药物更可靠预防PCO的发生。晶状体囊袋内联合抗肿瘤药物可能为解决预防人类PCO提供一条新途径。     

老年性白内障晶状体上皮细胞超微结构的研究

目的观察老年性白内障晶状体上皮细胞超微结构的改变，探讨细胞凋亡在老年性白内障形成中的作用。方法老年性白内障患者24例，行囊外或超声乳化联合后房型人工晶状体植入术，术中取中央部晶状体前囊膜，分别行光镜、扫描电镜、透射电镜观察。结果老年性白内障晶状体上皮细胞的超微结构改变有细胞形态大小不一，扁平细胞多无正常细胞结构，低柱状及柱状细胞结构大体正常，但细胞间隙增大，胞浆内可见空泡变性，部分细胞溶解坏死或发生皱缩，未见凋亡细胞。结论老年性白内障的发生与晶状体上皮细胞变形坏死密切相关，与晶状体上皮细胞凋亡无关。     

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.