上尿路尿路上皮癌术后膀胱复发危险因素分析

目的 探讨上尿路尿路上皮癌（UTUC）手术治疗后膀胱复发的危险因素。方法 收集2008年1月至2017年12月在我院行手术治疗且随访资料完整的445例UTUC患者病例资料。分析患者的基线数据、手术方法、术后病理结果、随访数据等资料,采用单因素和多因素Cox回归模型分析与UTUC术后膀胱复发相关的危险因素。结果 本研究纳入UTUC患者的术后中位随访时间为33.5个月,UTUC术后膀胱复发率为18.0%（80/445）,其中66.2%（53/80）的患者膀胱初次复发发生于术后1年内。单因素Cox回归分析发现患者年龄≥65岁（OR=1.99,95% CI：1.22～3.22,P<0.01）、有膀胱癌病史（OR=2.69,95% CI：1.71～4.24,P<0.01）、行保留肾单位肿瘤局部切除术（OR=2.15,95% CI：1.30～3.57,P<0.01）、输尿管下段肿瘤（OR=1.40,95% CI：1.11～1.78,P<0.01）与UTUC术后膀胱复发密切相关。将上述危险因素纳入多因素Cox回归模型,发现其均为UTUC术后膀胱复发的独立危险因素。结论 年龄≥65岁、有膀胱癌病史、行保留肾单位肿瘤局部切除术、输尿管下段肿瘤是UTUC术后膀胱复发的独立危险因素,存在上述危险因素的UTUC患者术后需加强随访监测,定期复查膀胱镜。     

中性粒-淋巴细胞比值与胃癌患者预后的关系

目的 探讨术前外周血中性粒细胞淋巴细胞比值（neutrophil to lymphocyte ratio,NLR）与胃癌患者预后的关系。方法 回顾性分析2012年10月~2016年12月在郑州大学第五附属医院普外科行胃癌根治术且有完整临床数据162例患者的资料,采用时间依赖性受试者工作特征（receiver operating characteristic,ROC）曲线确定NLR预测术后患者生存情况的最佳截断值,并将患者分为高NLR组和低NLR组,比较两组患者的临床病理特征及预后情况,采用单因素和多因素COX回归模型分析影响患者预后的临床因素。结果 NLR最佳截断值为3.11,由此将患者分为低NLR组（NLR≤3.11,n=116）和高NLR组（NLR>3.11,n=46）。两组患者的年龄、T分期、术前白蛋白含量、CA242水平及术后生存情况比较,差异有统计学意义（P值均<0.05）。单因素分析显示年龄、分化程度、TNM分期、T分期、N分期、术前血红蛋白含量、术前白蛋白含量、CEA水平、CA199水平、CA242水平及NLR与患者预后显著相关（P均<0.05）。多因素分析结果显示,年龄（HR=3.086,95% CI：1.835~5.192）、术前白蛋白含量（HR=0.405,95% CI：0.242~0.679）、CA199水平（HR=2.773,95% CI：1.033~7.448）及NLR（HR=2.736,95% CI：1.645~4.551）是影响胃癌患者预后的独立因素（P均<0.05）。结论 术前外周血NLR可作为胃癌患者的预后标志物,高NLR值提示预后较差。     

血清白蛋白对艾滋病合并重度肺孢子菌肺炎患者预后的评估价值

目的 探讨血清白蛋白水平对艾滋病（AIDS）合并重度肺孢子菌肺炎（PCP）患者预后的评估价值。方法 回顾性分析首都医科大学附属北京佑安医院感染科2008年1月~2015年12月收治的AIDS合并重度PCP患者的临床资料,根据住院期间是否死亡将患者分为存活组和死亡组。收集两组患者的一般资料及实验室检测结果,采用多因素Logistic回归分析筛选出影响患者预后的独立危险因素,绘制受试者工作特征曲线（ROC）对其预后价值进行评估。结果 共纳入94例AIDS合并重度PCP患者,男性88例,女性6例,患者平均年龄40.3±11.4岁;CD4计数0~289个/微升,中位数15个/微升。存活组43例,死亡组51例。死亡组患者年龄明显高于存活组（P<0.05）;而CD4计数、动脉氧分压（PaO₂）、血氧饱和度（SpO₂）以及血清白蛋白（ALB）水平明显低于存活组（P<0.05）,多因素Logistic回归分析显示血清ALB是影响AIDS合并重度PCP患者预后的独立危险因素（P=0.000）。血清ALB水平对AIDS合并重度PCP预后的ROC曲线下面积0.944（95%可信区间：0.890~0.998）,P=0.000,血清白蛋白<25.8g/L提示预后不良的敏感度为90.7%,特异性为94.1%。结论 AIDS合并重度PCP病死率高,血清白蛋白水平与其预后具有一定相关性,发生低蛋白血症会增加AIDS合并重度PCP患者的死亡风险,故监测血清白蛋白水平对评估患者预后具有重要意义。     

术前血清OPG、sRANKL对经皮冠状动脉介入术患者危险分层与评估预后的价值

目的 探讨术前血清骨保护素（OPG）、可溶性核因子κB受体活化因子配基（sRANKL）对经皮冠状动脉介入术（PCI）患者危险分层与评估预后的价值。方法 选取确诊为冠心病且行PCI患者223例,根据患者术前血清sRANKL/OPG比值将所有患者分为3组：A组、B组和C组。运用Gensini评分对患者血管狭窄程度进行判断。术后6个月内对患者进行随访,记录患者的主要心血管事件及分析患者血清OPG、sRANKL水平、sRANKL/OPG比值和血管病变支数、Gensini评分及主要不良心脏事件（MACE）和其他冠心病危险因素的关系。结果 3组患者在高血压病和血清OPG、sRANKL水平及sRANKL/OPG比值差异均有统计学意义（P<0.05）;术前血清OPG、sRANKL水平及sRANKL/OPG比值与高敏肌钙蛋白T（hs-cTnT）水平呈正相关（r=0.345、r=0.369、r=0.398,P=0.000、P=0.000、P=0.000）,而血清OPG、sRANKL水平及sRANKL/OPG比值与高密度脂蛋白胆固醇（HDL-C）则呈负相关（r=-0.182、r=-0.165、r=-0.176,P=0.005、P=0.006、P=0.006）;随着患者Gensini评分的升高,血清OPG、sRANKL水平及sRANKL/OPG比值亦升高（P<0.05）,Gensini评分为重度血管狭窄和中度、轻度血管狭窄患者血清OPG、sRANKL水平、sRANKL/OPG比值差异均有统计学意义（P<0.05）。双变量Spearman相关分析表明,术前血清OPG、sRANKL水平、sRANKL/OPG比值与Gensini评分的相关系数分别为0.22（P<0.05）、0.20（P<0.05）、0.17（P<0.05）。术后6个月内3组患者MACE发生率比较差异有统计学意义（P<0.05）,且3组患者靶病变血运重建率的比较差异有统计学意义（P<0.05）。术前血清OPG、sRANKL水平、sRANKL/OPG比值是患者发生MACE的独立危险因素（OR=2.17、2.23、2.26,95% CI：1.33~3.46、1.45~3.77、1.55~3.89,P=0.006、0.005、0.003）。结论 术前血清OPG、sRANKL水平及sRANKL/OPG比值与高血压、肌钙蛋白、冠脉病变呈正相关,与HDL-C呈负相关,为PCI术后心脏不良事件的独立危险因素,为PCI术后患者的危险分层和预后评估增添临床指标。     

结直肠癌患者血清前白蛋白与体成分之间的关系

目的 探讨结直肠癌患者血清前白蛋白水平与体成分之间的关系。方法 回顾性收集2020年6月至2021年6月江苏省肿瘤医院就诊并进行人体体成分测量的结直肠癌患者171例临床资料,根据患者血清前白蛋白水平分成正常前白蛋白组(n=125)和低前白蛋白组(n=46),对比两组患者性别、年龄、淋巴结转移、TNM分期、浸润深度、大便隐血以及体成分指标差异,采用Pearson相关系数评价血清前白蛋白水平与身体质量指数(BMI)、体脂肪百分比(BFP)、无脂肪重量指数(FFMI)、内脏脂肪指数(VFI)的关系,多元logistic回归分析血清前白蛋白水平的影响因素。结果 正常前白蛋白组浸润深度T₃~T₄、大便隐血阳性比例均低于低前白蛋白组,体成分指标BMI、BFP、FFMI、VFI均高于低前白蛋白组,差异均有统计学意义(P均<0.05);结直肠癌患者血清前白蛋白水平与BMI、BFP、FFMI、VFI均呈正相关(r=0.359、0.511、0.500、0.355,P均<0.05);多元logistic回归分析结果显示,浸润深度T₃~T₄、大便隐血阳性、BMI偏低、BFP偏低、FFMI偏低以及VFI偏低均为影响结直肠癌患者血清前白蛋白水平的危险因素(P均<0.05)。结论 结直肠癌患者血清前白蛋白水平与体成分密切相关,BMI、BFP、FFMI、VFI偏低均是患者血清前白蛋白水平异常的危险因素。     

维持性血液透析患者的血清肝细胞生长因子与蛋白质-能量消耗的相关性研究

目的 探究维持性血液透析的终末期肾病（ESRD）患者的血清肝细胞生长因子（hepatocyte growth factor,HGF）水平与蛋白质-能量消耗（protein-energy wasting,PEW）的相关性。方法 入选2013年1月~2015年12月在笔者医院血液透析中心进行血液透析的符合纳入标准和排除标准的ESRD患者128例。应用主观全面营养评估法（SGA）对患者的营养状况进行评分,根据评分将患者分为A （营养良好）、B （轻-中度营养不良）、C （重度营养不良）三组。采用ELISA法检测并比较各组患者透析前血清HGF的水平。应用Pearson相关分析法分析血清HGF水平与患者SGA评分、年龄、性别、病程、透析时间、血清总蛋白、白蛋白、前白蛋白、肌酐、尿素氮、体重指数及上臂肌围等的相关性。应用Logistic多因素回归法分析血清HGF是否是ESRD患者发生PEW的独立影响因素。结果 （B+C）组、B组、C组患者的血清HGF的平均水平均明显高于A组患者（P<0.01）,且C组患者的血清HGF的平均水平明显高于B组患者（P<0.01）;患者血清HGF水平与患者SGA评分呈负相关（r=-0.8791,P<0.01）。B、C两组患者的血清总蛋白、白蛋白、前白蛋白的水平以及体重指数、上臂肌围与A组相比均明显降低,差异均有统计学意义（P<0.05）。Pearson相关分析结果显示,血清HGF与与患者的血清总蛋白、白蛋白、前白蛋白水平以及体重指数、上臂肌围呈显著负相关（P<0.05）。Logistic多因素回归分析结果显示,血清HGF水平（OR=2.143,95% CI：2.096~2.193,P=0.004）和上臂肌围（OR=0.032,95% CI：0.015~0.164,P=0.012）是维持性血液透析ESRD患者发生PEW的独立影响因素。结论 维持性血液透析的ESRD患者发生蛋白质-能量消耗时血清HGF水平增加,血清HGF可能成为判断维持性血液透析的ESRD患者发生蛋白质-能量消耗的指标之一。     

个体化营养治疗对消化系统手术围手术期患者营养状况的影响

目的 探讨个体化营养治疗对存在营养风险的消化系统手术围手术期患者营养状况的影响。方法 本研究为前瞻性、随机对照临床试验。对择期行消化系统手术的患者进行营养风险筛查，将存在营养风险、筛选合格且签署知情同意书的231例患者随机分为研究组（n=115）和对照组（n=116），分别给予个体化营养治疗和非个体化营养治疗15 d（术前5 d至术后9 d）。采集基线数据，分别于入组时及营养治疗第5天、第9天、第15天采集患者空腹静脉血，测量患者BMI、血清总蛋白、血清白蛋白、血清前白蛋白、血糖、总胆固醇、三酰甘油、淋巴细胞计数及白细胞计数等指标。结果 最终纳入患者217例（研究组112例、对照组105例），中途退出14例（6.1%）。（1）组内比较：研究组患者在入组时及营养治疗第5天、第9天、第15天时血清总蛋白、血清白蛋白、血清前白蛋白均呈先上升后下降再上升趋势（P均<0.05），淋巴细胞计数、白细胞计数均呈先下降后上升趋势（P均<0.05），但均在正常范围内；对照组患者在入组时及营养治疗第5天、第9天、第15天时血清白蛋白呈先下降后上升趋势（P<0.05），血清前白蛋白、淋巴细胞计数呈先上升后下降再上升趋势（P均<0.05），但均在正常范围内；其余指标组内比较差异均无统计学意义（P均>0.05）。（2）组间比较：研究组患者血清总蛋白和血清白蛋白水平均高于对照组（P均<0.05）；术前1 d（营养治疗第5天）研究组白细胞计数低于对照组，但术后第9天（营养治疗第15天）研究组白细胞计数高于对照组（P<0.05）；其余指标组间比较差异均无统计学意义（P均>0.05）。（3）分组与时间交互效应：组间比较的结果表明时间因素不影响营养和免疫相关指标（P>0.05）。结论 个体化营养治疗有利于改善存在营养风险的消化系统手术围手术期患者的营养状况。     

IgA肾病患者外周血中性粒细胞与淋巴细胞比值的临床意义

目的 炎症与IgA肾病（IgAN）的发病机制密切相关，并可能影响血清中性粒细胞-淋巴细胞比值（NLR）。研究旨在探讨NLR与IgAN患者的临床病理表现和预后之间的关系。方法 收集2014年12月—2018年6月于郑州大学第一附属医院肾内科行肾穿刺确诊的397例原发性IgAN患者的临床病理资料，根据NLR中位数（2.01）分为两组，分析不同组之间临床指标、病理特征的差异。回顾性比较两组患者的临床病理特征，采用Kaplan-Meier法评估肾脏累计生存率，Cox比例风险模型分析NLR在IgAN患者肾病进展中的预后价值。结果 NLR高水平组的血清尿素氮、肌酐、尿酸和24 h尿蛋白总量较高（P <0.05）；肾小球内皮细胞增生和肾小管出现萎缩/肾间质纤维化程度更为严重（P <0.05），治疗后的缓解率较低（P <0.05）。Kaplan-Meier生存曲线结果表明，NLR高水平组肾脏总的生存率低于NLR低水平组（P <0.05）；经过多因素校正后，NLR不是影响IgAN患者预后的独立危险因素（P >0.05）。结论 作为一种方便有效的指标，NLR可作为评估IgAN严重程度的参考；NLR不是影响IgAN患者预后的独立危险因素。     

Fascin-1及CEA在非小细胞肺癌患者支气管肺泡灌洗液中的表达及意义

目的 探讨非小细胞肺癌患者支气管肺泡灌洗液（BALF）中Fascin-1检测的临床意义。方法 收集肺癌组60例及肺良性疾病组45例的BALF标本。采用双抗体夹心酶联免疫吸附试验（ELISA）方法检测BALF中的Fascin-1水平,采用放射免疫分析法检测BALF中的癌胚抗原（CEA）浓度。结果 肺癌组BALF中 Fascin-1及CEA水平均显著高于肺良性疾病组（P<0.01）。TNM分期中,有远处转移的肺癌Ⅳ期患者Fascin-1及CEA水平最高（P<0.05）,分期越晚,CEA浓度越高（P<0.05）。50例肺癌患者经治疗后,BALF中Fascin-1及CEA水平较治疗前有明显下降（P<0.01）。BALF中 Fascin-1水平与肺癌病理类型无关（P>0.05）。BALF中Fascin-1与CEA水平呈正相关（r=0.713,P<0.01）。结论 检测BALF中Fascin-1对于及时发现肺癌远处转移、估计预后、判断疗效具有重要的意义。     

颅脑创伤患者早期血清PDCD4 GDF11水平及其与病情和预后的关系

目的 探讨颅脑创伤患者血清程序性细胞死亡因子4 （PDCD4）、生长分化因子11 （GDF11）水平与患者病情、预后的关系。方法 选取112例2020年1月至2022年4月成飞医院收治的颅脑创伤患者为研究组,另选取110例同时期在成飞医院进行健康体检的志愿者为对照组。酶联免疫吸附（ELISA）法检测两组研究对象血清PDCD4、GDF11水平。根据格拉斯哥昏迷指数（GCS）将研究组患者分为轻度组（48例）,中度组（36例）,重度组（28例）。治疗后随访3个月,根据格拉斯哥预后评分（GOS）将研究组患者分为预后不良组（42例）,预后良好组（70例）。比较不同病情、不同预后患者血清PDCD4、GDF11水平。采用Pearson相关性分析研究组血清PDCD4水平与GDF11水平的相关性,Spearman相关性分析研究组患者血清PDCD4、GDF11水平与GCS、GOS评分的相关性。采用多因素logistic回归分析颅脑创伤患者预后的影响因素。采用受试者工作特征（ROC）曲线评价血清PDCD4、GDF11对颅脑创伤患者预后的预测价值。结果 研究组血清PDCD4、GDF11水平均低于对照组,差异有统计学意义（P＜0.05）。重度组患者血清PDCD4、GDF11水平均低于轻度组和中度组,差异有统计学意义（P＜0.05）,中度组患者血清PDCD4、GDF11水平均低于轻度组,差异有统计学意义（P＜0.05）。预后不良组血清PDCD4、GDF11水平均低于预后良好组,差异有统计学意义（P＜0.05）。Pearson相关性分析显示,研究组血清PDCD4水平与GDF11水平呈正相关（P＜0.05）; Spearman相关性分析显示,研究组血清PDCD4、GDF11水平与GCS、GOS评分均呈正相关（P＜0.05）。多因素logistic分析显示,脑疝影响是颅脑创伤预后的危险因素,GCS评分、PDCD4、GDF11是影响颅脑创伤预后的保护因素（P＜0.05）。血清PDCD4、GDF11联合预测颅脑创伤患者预后的ROC曲线下面积（AUC）大于PDCD4单独预测的AUC（Z=1.993,P=0.046）及GDF11单独预测的AUC （Z=2.907,P=0.004）。结论 颅脑创伤患者血清PDCD4、GDF11表达下调与患者病情相关,两者联合对颅脑创伤患者的预后具有较高的预测价值。     

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.     

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.