胰岛素对大鼠缺血性海马CA1区神经元的保护作用

目的：探讨胰岛素对海马ＣＡ１区神经元的保护作用。方法：在造成ＳＤ大鼠短暂全脑缺血后即刻、３０ｍｉｎ及１ｈ分别给予１Ｕ／ｋｇ常规胰岛素及２ｇ／ｋｇ２５％葡萄糖液。缺血７ｄ后，取脑固定染色，于前囟后３．８ｍｍ平面对海马ＣＡ１区１ｍｍ长范围内正常神经元进行了计数。结果：假手术组（ｎ＝６）正常神经元计数为１７４．６±１０．７，缺血后即刻（ｎ＝６）及再灌注３０ｍｉｎ给药组（ｎ＝６）正常神经元计数分别为８７．     

低温盐水局部灌注对脊髓缺血损伤的保护作用

目的 探讨低温生理盐水脊髓灌注对兔主动脉阻断致脊髓缺血的保护作用。方法 ２０只健康成年新西兰白兔,阻断肾动脉水平腹主动脉６０ｍｉｎ建立兔脊髓缺血损伤模型,随机分２组（ｎ＝１０）,Ａ组：缺血对照;Ｂ组：缺血＋脊髓低温盐水灌注。结果 （１）各组血压心率无明显差别;（２）Ｂ组兔下肢功能恢复良好,而Ａ组瘫痪;（３）脊髓形态学显示Ａ组中央灰质聚集性坏死,巨噬细胞浸润,尼氏体消失,核仁模糊,Ｂ组未见Ａ组的形态     

经皮腔内冠状动脉成形术对冠心病患者血、尿TM的影响

目的 观察经皮腔内冠状动脉成形术（ＰＴＣＡ）对冠状动脉硬化性心脏病（简称冠心病）血、尿血栓调节蛋白（ＴＭ）的影响。方法 设ＰＴＣＡ组与冠状动脉造影（ＣＡＧ）组在术前和术后５ｍｉｎ、３０ｍｉｎ、２ｈ、６ｈ、２４ｈ静脉采血,术前、术后６ｈ、２４ｈ留尿;另设对照组空腹采血、尿、用酶联免疫双抗体夹心法测定ＴＭ含量。结果 ＰＴＣＡ组术后５ｍｉｎ、３０ｍｉｎ、及术后６ｈ、２４ｈ血尿ＴＭ均较术前增高（ｔ＝２．３     

脊髓缺血性二次瘫痪与脊髓血流量

目的：观察脊髓缺血后二次瘫痪与脊髓血流量（ＳＣＢＦ）的关系。方法：以清醒兔肾下主动脉（ＩＲＡ）阻断致腰骶段脊髓缺血为实验模型，采用氢气清除法观测脊髓灰质和白质血流量（ｇＳＣＢＦ和ｗＳＣＢＦ）及Ｔａｒｌｏｖ六级分类法观测脊髓功能变化。结果：ＩＲＡ阻断平均３４ｓ双下肢运动功能完全消失，５５ｓ双下肢感觉功能消失；缺血２０ｍｉｎ再灌流后１～３ｈ内８７％动物的双下肢功能恢复，但再灌流１７～２６ｈ出现二次瘫痪。ＩＲＡ阻断后股动脉血压由１１．３～１６．６ｋＰａ降至２．６２ｋＰａ以下，Ｌ６的ｇＳＣＢＦ由（５１．９４±１３）ｍｌ１００ｇ－１ｍｉｎ－１降至（５．８６±６．０）ｍｌ１００ｇ－１ｍｉｎ－１，Ｌ６的ｗＳＣＢＦ由（３５．８０±７．０）ｍｌ１００ｇ－１ｍｉｎ－１降至（６．７±８．０）ｍｌ１００ｇ－１ｍｉｎ－１；缺血２０ｍｉｎ再灌流即刻（１５ｍｉｎ）股动脉血压和Ｌ６ＳＣＢＦ恢复正常，但再灌流１、３和２４ｈＬ６的ｇＳＣＢＦ和ｗＳＣＢＦ与缺血前相比显著下降，再灌流４８ｈＬ６ｗＳＣＢＦ仍显著下降；但Ｔ１０的ｇＳＣＢＦ和ｗＳＣＢＦ在缺血期和再灌流不同时间均无显著性变化。结论：提示兔脊髓缺血性二次瘫痪可能与继发性ＳＣＢＦ下降有关。     

预缺血处理对家兔全脑缺血保护效应的实验研究(摘要)

为探讨预缺血处理脑保护效应,以及神经细胞凋亡与缺血性脑损害的关系．用家兔１５只,随机分为３组,对照组（Ａ,ｎ＝５）,缺血组（Ｂ,ｎ＝５）,预缺血处理组（Ｃ,ｎ＝５）．Ａ组只作手术操作;Ｂ组采用二血管夹闭（双侧颈总动脉夹闭,ＭＡＰ＜４０ｍｍＨｇ）全脑缺血１０ｍｉｎ;Ｃ组在缺血前增加预缺血处理２ｍｉｎ,再灌注半小时．对比观察缺血后３ｄ海马ＣＡ１区神经元密度和缺血细胞数变化,同时使用ＴＵＮＥＬ原位标记法,检测缺血３ｄ后海马区的凋亡细胞．结果：（１）Ｃ组神经元密度与Ａ组相比差异无显著性（Ｐ＞００５）,…     

再灌注兔脑细胞膜功能的变化

利用“四血管”式造成兔脑完全性缺血３０ｍｉｎ，将动物随机分成未缺血、缺血３０ｍｉｎ后再灌注３０、１８０ｍｉｎ和３６０ｍｉｎ四组（每组ｎ＝８），观察了再灌注时脑细胞膜（ＢＣＭ）上ＡＴＰ酶、磷脂酶Ａ２（ＰＬＡ２）和总磷脂的变化。与未缺血动物相比，Ｎａ＋－Ｋ＋ＡＴＰ酶在再灌注３０、１８０和３６０ｍｉｎ时下降（Ｐ＜０．００１），而ＰＬＡ２升高（Ｐ＜０．００１），总磷脂在再灌注１８０ｍｉｎ和３６０ｍｉｎ时减少（Ｐ＜０．０５），结果提示，完全性缺血后再灌注时ＢＣＭ功能下降和结构受损，如能稳定ＢＣＭ，可望为完全复苏脑细胞提供条件     

交感神经兴奋在外伤性脑水肿发生中的作用及机制

目的 探讨交感神经兴奋在外伤性脑水肿发生中的作用。方法 家兔４８只分成Ａ、Ｂ、Ｃ、Ｄ４组,采用自由落体脑损伤模型,致伤前对拟受伤侧颈交感神经进行了不同处理,Ａ组（ｎ＝１２）为假手术对照,仅显露神经;Ｂ组（ｎ＝１２）为神经切断组,切断神经;Ｃ组（ｎ＝１２）为神经刺激组,电刺激神经;Ｄ组（ｎ＝１２）为切断后刺激组,切断神经后刺激该神经头端,于伤后２ｈ观察脑血管变化,２４ｈ观察脑组织Ｅｖｅｎｓｂｌｕｅ（     

PAF受体拮抗剂治疗颈髓损伤的早期观察

目的：探讨全血血小板活化因子（ＰＡＦ）受体拮抗剂ＢＮ５２０２１对颈髓损伤患者早期治疗的效果及其机制。方法：颈髓损伤患者分为地塞米松组和ＢＮ５２０２１组（ｎ＝１８），观察两组颈髓损伤患者ＰＡＦ、血浆血栓素Ｂ２（ＴＸＢ２）、６－酮－前列腺素１α（６－Ｋｅｔｏ－ＰＧＦ１α）含量的变化、多系统器官衰竭（ＭＳＯＦ）发生率及脊髓神经功能恢复状态。结果：ＢＮ５２０２１组血液中ＰＡＦ、ＴＸＢ２含量、Ｔ／Ｋ值、伤后ＭＳＯＦ发生率较地塞米松组明显降低，而脊髓神经功能恢复优于地塞米松组。结论：ＰＡＦ受体拮抗剂对颈髓损伤后神经功能具有较好的保护作用，并且是早期治疗脊髓损伤的潜在理想药物     

新生儿缺氧缺血性脑损伤亚低温干预大鼠模型的建立

为探讨不同疗程亚低温对新生儿脑损伤的保护作用,建立新生儿缺血缺氧性脑损伤亚 温干预大鼠模型,先在７日龄清洁级ＳＤ大鼠上以右颈总动脉结扎术和吸入低氧浓度气体法制备缺血缺氧性脑损伤（ＨＩＢＤ）模型,再将其随机分为室温恢复组（ＲｏＴ组,ｎ＝４４）和３种疗程（２４ｈ,４８ｈ,７２ｈ）的亚低温干预组（Ｈｙ２４组,ｎ＝２６,Ｈｙ４８组,ｎ＝１４,Ｈｙ７２组,ｎ＝２０）。亚低温干预期间采用配方奶喂养,并监测脑温     

低温钾葡聚糖液肺动脉灌注对体外循环下未成熟犬肺的保护

目的 探讨体外循环期间进行肺动脉灌注低温保护液对未成熟犬肺损伤的预防作用。方法 杂种幼犬（〈３０ｄ）１２只,随机分为对照组（ｎ＝６）和灌注组（ｎ＝６）,建立体外循环后,随机分为对照组（ｎ＝６）和灌注组（ｎ＝６）,建立体外循环后,灌注组在心脏停跳的同时,肺动脉灌注６０ｍｉｎ后,取肺组织观察肺表面活生剂（ＰＳ）、ＮＯ水平、肺湿干比（Ｗ／Ｄ）,肺血织观察肺活怀剂（ＰＳ）、ＢＯ水平、肺湿干比（Ｗ／Ｄ）,肺     

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.     

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.     

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.