双侧供肾大鼠原位肾移植模型的建立

目的建立一种改良的双侧供肾大鼠原位肾移植模型。方法第一阶段为基本技能训练。第二阶段为实验效果观察,供鼠取双侧肾脏;左侧原位移植,静脉用临时内支架端-端吻合,动脉端-侧吻合;输尿管带膀胱瓣与膀胱吻合;右肾蒂预留丝线体外延迟结扎代替肾切除。结果经4个月80多次训练,较为熟练的掌握了显微外科技术;第二阶段总手术时间180±15 min;手术成功率85%(34/40);受体存活4~9 d。并发症有吻合口出血、静脉血栓形成、排斥反应等。结论此模型经济实用、稳定可靠、成功率较高,一般实验室均可开展,对肾移植实验研究有应用价值。     

大鼠同种异体原位肾移植动物模型的建立

目的建立稳定的大鼠原位同种异体肾移植动物模型,为开展器官移植的实验研究提供依据。方法使用SD大鼠作为供受体,取供体左侧肾脏于灌注修整后,原位的移植至受体左侧肾窝,肾动脉采用端端吻合法,静脉则采用简化的端端吻合方式,输尿管则采用带部分膀胱瓣于受体膀胱吻合,受体右肾使用体外延迟结扎,从而复制出大鼠肾移植的动物模型。结果共行大鼠肾移植45对,模型成功率85%,整个手术时间平均(140±28)min,其中肾动脉吻合平均(10±3)min,供肾热缺血时间约3min。简化的肾静脉吻合平均(21±3)min,与传统吻合方法比较明显缩短了吻合时间(t=4.43,P<0.05)。结论该法有效地建立起大鼠原位肾移植模型,且并发症发生少,动物成活率高,简单实用。简化的静脉吻合方法有效的减少了静脉吻合时间。     

改良型小鼠肾移植动物模型的建立

目的：建立一种操作简便、手术时间短、效果确切的小鼠肾移植模型。方法：静脉采用套扎式吻合,将供肾下腔静脉穿过导管,外翻套扎于导管,将其插入受体肾静脉内,套扎受体肾静脉于腔静脉外,完成静脉端端吻合;动脉采用供体腹主动脉与受体腹主动脉端侧吻合,供体膀胱瓣与受体膀胱吻合。结果：开放血管后供肾颜色正常,动脉搏动正常,静脉充盈好,成功建立小鼠肾移植模型,静脉吻合（10±5） min,动脉吻合（10±5） min,膀胱瓣吻合2~5 min,总手术时间40~60 min。结论：采用改良的套扎式原位静脉吻合和膀胱瓣吻合,可以降低手术难度,缩短手术时间,成功建立小鼠肾移植模型。     

大鼠同种异体原位肾移植模型的建立及并发症的预防

目的为开展器官移植的移植免疫实验研究，建立大鼠同种异体原位肾移植模型，并探讨防止并发症发生的方法。方法Wistar系大鼠为供体，SD系大鼠为受体。采用左侧原位肾移植法，动脉端-端吻合，静脉袖套吻合，输尿管带膀胱瓣与膀胱吻合。结果共进行大鼠肾移植80次，存活73只，7只大鼠死于并发症，手术成功率为91．3％，建立了稳定、实用的大鼠肾移植动物模型。结论大鼠同种异体原位肾移植是一种成功率较高的动物模型。术前准备、术中操作及术后护理对建立稳定的模型有重要影响。加强并发症的预防可提高成功率。     

大鼠原位肾移植模型的建立

目的为进行移植免疫研究的需要,建立一种大鼠肾移植模型。方法采用原位低温灌注、手术显微镜下原位端——端吻合肾动、静脉,将输尿管带膀胱瓣吻合于膀胱。结果建立了稳定可靠的大鼠肾移植模型,手术成功率为86%。结论此方法建立的模型稳定可靠,较为理想的满足了肾移植研究的需要。     

一种大鼠异体肾移植模型的建立

目的:建立一种稳定,操作简便的肾移植模型.方法:以SD大鼠和Wistar大鼠分别作为供、受体.静脉用临时支架管,将供肾的下腔静脉与受体左肾静脉作端端吻合,供肾腹主动脉与受体腹主动脉端侧吻合,以及输尿管带膀胱瓣与膀胱吻合.结果:建立并改进了大鼠肾移植模型,手术总时间(130±16)min,热缺血时间小于20 s,冷缺血时间小于50 min,手术成功率90.77%.结论:此模型稳定、可靠,易于掌握.     

大鼠肾移植模型建立方法与比较

目的 :比较不同术式大鼠同种异体肾移植模型建立的方法。方法 :用五种不同的方法建立 10 0例大鼠肾移植模型 ,对其技术复杂性、吻合时间及血栓形成率三方面进行比较。结果 ::采用动脉、输尿管端端吻合、静脉cuff套管法吻合建立的模型吻合技术较简单 ,平均吻合时间 30min ,血栓形成率低。结论 :动脉、输尿管端端吻合 ,静脉套管法吻合为较理想的大鼠肾移植模型建立方法。     

大鼠肾移植模型建立方法与比较

目的：比较不同术式大鼠同种异体肾移植模型建立的方法。方法：用五种不同的方法建立100例大鼠肾移植模型．对其技术复杂性、吻合时间及血栓形成率三方面进行比较。结果：采用动脉、输尿管端端吻合、静脉cuff套管法吻合建立的模型吻合技术较简单，平均吻合时间30min，血栓形成率低。结论：动脉、输尿管端端吻合，静脉套管法吻合为较理想的大鼠肾移植模型建立方法。     

大鼠肾移植慢性排斥反应模型的建立

目的 建立一种稳定的大鼠原位肾移植慢性排斥反应模型.方法 供体为近交系F344大鼠,受体为Lewis大鼠,供肾采用左肾,在体修整,原位灌注.肾静脉用硬膜外导管做为临时内支架管端-端、六针法吻合,腹主动脉端-侧连续缝合,输尿管带膀胱瓣与膀胱吻合.受体术前3d开始环抱素A灌胃至术后30 d(5 mg/kg·d),以预防急性排斥反应.结果 手术时间120～180 min;手术成功率90.9% (40P44) ;受体均存活60 d.并发症有吻合口出血、静脉血栓形成、急性排斥反应等.结论 供肾原位灌注,在体修整是简单可靠的方法.静脉内支架管端端吻合,腹主动脉端侧吻合能够达到稳定的成功率,值得推广.熟练的外科操作技能和血管吻合技术是手术成功的关键.     

硬膜外导管在大鼠肾移植血管吻合中的应用

目的建立一种手术难度低,成功率高的大鼠肾移植模型。方法 Wistar大鼠作供体,SD大鼠作受体,将供体腔静脉与受体肾静脉端端吻合,供体腹主动脉与受体腹主动脉端侧吻合,供体膀胱瓣与受体膀胱吻合。根据血管吻合时应用硬膜外导管与否,将受体分为有支架组和无支架组两组。结果有支架组共进行肾移植30次,成活26只;无支架组共进行肾移植20次,成活10只。有支架组的成活率86.7%(26/30)较无支架组50.0%(10/20)明显提高(P0.05),血管吻合总时间(22±2)min较无支架组(32±2)min明显缩短(P0.05)。结论硬膜外导管应用于大鼠肾移植血管吻合,降低了手术难度,减少了吻合口出血,提高了手术成功率。     

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.