不育症妇女子宫和卵巢动脉血管阻力及其与激素水平的关系

对２２例月经正常的不育症妇女和２０例正常妇女进行经阴道多普勤超声子宫和卵巢动脉的阻力指教（ＲＩ）检测，以及激素水平测定。结果：不育症妇女黄体期子宫动脉ＲＩ大于正常妇女，Ｐ＜０．０５；卵泡期子宫动脉ＲＩ，及卵泡和黄体期卵巢动脉ＲＩ与正常妇女无差异，Ｐ＞０．０５；卵泡和黄体期血清的Ｅ２和Ｐ低于正常妇女，Ｐ＜０．０５。表明不育症妇女黄体期子宫的血流氓注低于正常妇女，Ｅ２和Ｐ低水平是导致子宫动脉高血管阻力的重要原因：卵巢动脉血流的调节陈说素外还受其它因素的影响。     

经阴道彩色多普勒超声在异位妊娠早期诊断中的临床价值

目的探讨经阴道彩色多普勒超声（TVCD）诊断早期异位妊娠（EP）的价值。方法采用TVCD对45例EP子宫内膜厚度、子宫内膜区螺旋动脉、EP区域滋养动脉血流进行检测,并与40例正常宫内早孕患者作对照分析。结果EP组子宫内膜厚度低于对照组（P〈0．01）;EP组子宫内膜区螺旋动脉仅5例显示,显示率10．9％;宫内早孕组35例（87．5％）显示,两组差异有统计学意义（P〈0．01）;而阻力指数EP组明显高于宫内早孕组（P〈0．05）;EP组中EP区域滋养动脉血流检出率为71．1％。结论经TVCD检测早期妊娠期间子宫内膜厚度、子宫内膜区螺旋动脉显示及血流参数,结合B．HCG检测,对早期EP的诊断有重要价值。     

子宫动脉栓塞术治疗妇科良性疾病对卵巢功能的影响

目的探讨子宫动脉栓塞（UAE）治疗子宫肌瘤及对子宫腺肌病患者卵巢功能的影响,为有生育要求的患者应用UAE提供理论依据。方法选择21～45岁,既往月经周期规则,因子宫肌瘤及子宫腺肌病行UAE的妇女37例。监测治疗后在栓塞前、栓塞后3个月及6个月,评估所有病人的症状改善情况,并且采用经阴道彩色能量多普勒超声对子宫及病灶进行动态监测,监测月经,子宫大小,子宫动脉和卵巢动脉血流动态改变及性激素水平情况。结果①子宫动脉栓塞术前后子宫体积和子宫动脉血流参数比较,术前与术后3个月、术后6个月比较差异有统计学意义（P〈0．05）;②子宫动脉栓塞术前后卵巢动脉血流、血性激素（FSH、LH、E2）与月经周期的情况比较差异无统计学意义（P〉0．05）。结论UAE是一项安全的治疗技术,不会引起永久性闭经,对卵巢内分泌功能及卵巢排卵功能影响是短暂、轻微、可逆的。     

经阴道彩色多普勒对多囊卵巢综合征治疗前后子宫卵巢动脉血流动力学的研究

经阴道彩色多普勒（TV-CDFI）观察多囊卵巢综合征（PCOS）患者药物治疗前后子宫、卵巢动脉的血流变化,旨在探讨TV-CDFI在不孕症及生殖内分泌领域的应用价值。对15例PCOS患者治疗前后采用TV-CDFI,对子宫卵巢动脉进行检测。结果表明PCOS患者治疗前子宫、卵巢动脉在月经的不同时期收缩期峰值速度（PSV）与阻力指数（RI）均无显著性差异（P<0.05）。经hMG治疗后,子宫、卵巢动脉恢复了周期性变化,且子宫内膜增厚。优势侧卵巢动脉PSV、RI均显著低于对侧（P<0.05）。结果提示通过检测子宫、卵巢动脉血流阻力的动态变化,不仅可判断药物对PCOS患者的疗效,而且子宫动脉血流阻力亦可作为子宫内膜接受性的良好指标,有助于预测妊娠。     

新生儿缺氧缺血性脑病治疗前后脑动脉血流速的检测

应用彩色多普勒对新生儿缺氧缺血性脑病（ＨＩＥ）治疗前后脑动脉血流速进行检测，并与正常对照组进行比较。结果表明，ＨＩＥ病儿治疗后各检测参数较治疗前均明显改变，差异均有极显著性（均为Ｐ＜０．０１）；治疗前较对照组除左大脑后动脉的搏动指数无明显变化外（Ｐ＞０．０５），其余各参数均有明显改变，差异均有显著性或极显著性（Ｐ＜０．０５或Ｐ＜０．０１）。治疗后与正常对照组比较各参数均无明显改变，差异均无显著性（均为Ｐ＞０．０５）。对ＨＩＥ病儿脑动脉血流速检测的意义进行探讨。     

应用双功能经颅彩色多普勒测定正常人脑动脉血流速度

对１８０名健康自愿者,１６２０段颅内动脉进行彩色多普勒超声检测。每例观察包括左右大脑前、中、后动脉,椎动脉（颅内段）及基底动脉,分别测量各段血管的收缩期峰值流速、舒张末期流速、搏动指数、阻力指数。并将其分成２０～２９岁,３０～３９岁,４０～４９岁,５０～５９岁,６０岁以上五个年龄组进行比较。统计学处理后结果显示：同名血管相同年龄组不同性别血流参数无显著差异（Ｐ＞０．０５）;同一受检者左、右两侧同名血管血流参数无显著差异（Ｐ＞０．０５）;血流速度随年龄增加而呈逐渐降低趋势（Ｐ＜０．０５）。并列出了正常人脑动脉血流速度的参考值。     

肝组织和血清中顺铂浓度与肝动脉血流关系的实验研究

在兔肝动脉阻断与非阻断条件下，经动脉导管灌注顺铂（ＤＤＰ），并利用原子吸收分光光度计测定血浆和肝脏组织中的药物浓度。结果显示：肝组织中ＤＤＰ浓度在肝动脉阻断组明显高于非阻断组，二者比较差异有极显著意义（Ｐ〈０．０１），而血浆中ＤＤＰ浓度非阻断组明显高于阻断组，两组差异同样有极显著意义（Ｐ〈０．０１）。研究结果证明，肝动因流直接影响了经动脉灌注化疗药物在肝脏和外周血中的分布；肝动脉血流阻断可提高药物     

宫内外早早孕子宫各段动脉血流动力学研究

目的：对比研究宫内、外早早孕（4～6周）子宫各段动脉血流特征,探索经阴道彩色多普勒对宫内、外早早孕诊断价值。方法：应用阴道彩色多普勒超声观察：妊娠4～6周的宫内孕35例、宫外孕30例子宫动脉、弓状动脉、放射动脉、螺旋动脉血流特征、频谱的特点,并检测收缩期峰值流速（PSV）、舒张末期流速（EDV）、搏动指数（PI）、阻力指数（RI）、收缩／舒张末流速比（S／D）,并进行统计学分析。结果：宫内早早孕螺旋动脉血流呈短条状花色血流信号,频谱为高速低阻;宫外早早孕螺旋动脉血流为繁星点状,频谱为低速高阻。宫内、外早早孕螺旋动脉各血流参数PSV、EDV、PI、RI、S／D比较均有非常显著性差异（P〈0．01）。结论：经阴道彩色多普勒超声能够检测到宫内、外早早孕子宫各段动脉血流,并能为临床鉴别宫内、外早早孕提供重要参考依据。     

经阴道多普勒超声诊断卵巢早衰

目的探讨经阴道彩色多普勒超声诊断卵巢早衰的临床价值。方法 36例卵巢早衰患者（早衰组）及36例正常育龄妇女（正常组）,行阴道彩色多普勒超声检查,观察两组卵巢、子宫声像图、卵巢动脉血流动力学参数的差异。结果早衰组子宫、卵巢体积、子宫内膜厚度小于正常组（P〈0.01）,卵泡数少于正常组（P〈0.01）;卵巢动脉的收缩期峰值流速（PSV）及舒张末期流速（EDV）下降,而阻力指数（RI）、搏动指数（PI）上升（P〈0.01）。结论卵巢早衰在经阴道彩色多普勒超声上表现为子宫、卵巢体积缩小、卵泡个数减少、内膜变薄、卵巢呈强回声及卵巢动脉的PSV、EDV降低及RI、PI升高的特征,对诊断有的重要参考价值。     

脐动脉多普勒血流测定在肝内胆汁淤积症的应用

目的：评价脐动脉多普勒血流测定（Ｓ／Ｄ）与无钢荷试验（ＮＳＴ）在妊娠期肝内胆汁淤积症（ＩＣＰ）中的应用价值。方法：应用Ｓ／Ｄ与ＮＳＴ对孕龄为３５～４０周１５７例ＩＣＰ患者进行动态监测,并对新生儿Ａｐｇａｒ评分和羊水粪染的情况进行比较。结果：脐动脉血流Ｓ／Ｄ〈３、ＮＳＴ≥７分,胎儿预后良好;脐动脉血流Ｓ／Ｄ≥３、ＮＳＴ〈７分,胎儿预后不佳,两者差异有显著性（Ｐ〈０．００５）。结论：脐动脉多普勒血流检测弥补单纯ＮＳＴ对ＩＣＰ患者胎儿预后判断的不足,提高临床诊断准确率。     

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.     

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.