孕中期唐氏综合征产前筛查两种方式筛查效率比较

目的:比较孕中期唐氏综合征产前筛查中三联筛查方式与二联筛查方式的筛查效率。方法:选取进行唐氏综合征(DS)产前筛查的孕妇3 568例,采取时间分辨免疫荧光法检测孕妇血清中甲胎蛋白(AFP)、人绒毛膜促性腺激素游离β亚基(freeβ-HCG)、游离雌三醇(uE3)的浓度,结合孕妇的年龄、孕周、体重等信息,用配套软件采用二连筛查方式和三联筛查方式分别对其进行分析,评估唐氏综合征(DS)胎儿风险。比较三联筛查方式与二联筛查方式对唐氏综合征的检出率和假阳性率。结果:三联筛查方式的唐氏综合征(DS)胎儿检出率显著高于二连筛查方式。结论:孕中期孕妇血清AFP、freeβ-hCG、uE3三联筛查比AFP和freeβ-HCG二连筛查方式在评估唐氏综合征(DS)胎儿发生风险方面具有较高的参考价值。     

孕早期Down综合征(DS)的产前筛查

目的 :探讨孕早期Down综合征 (DS)的产前筛查。方法 :时间分辨荧光免疫法 (TRFIA)对孕 8～ 13周的 5 43 3例孕妇血清中 β hCG、PAPP A2两项血清标记物进行检测 ,比较分析 8例DS胎儿母血清与 184例对照病例血清中两种标记物水平。结果 :DS组母血中 β hCG、PAPP A平均值分别为 2 .3 1MoM和 0 .42MoM ,与对照组差别有显著性意义 (P <0 .0 5 ) ;β hCG、PAPP A两项指标联合筛查 ,DS的阳性检出率为 75 % ,假阳性率为8.3 5 %。结论 :孕早期 β hCG、PAPP A两联标记物筛查DS可以达到孕中期三联标记物筛查效果。     

化学发光、时间分辨和酶免三种方法学测定HBsAg

目的酶联免疫化学发光法、时间分辨荧光免疫法和酶联免疫吸附试验法,探讨这三种方法用于检测乙型肝炎病毒血清标志物的临床意义.方法采用酶联免疫化学发光法(CLIA)、时间分辨荧光免疫法(TRFIA)和酶联免疫吸附试验( ELISA)同时对655例患者 HBV 血清标本进行 HBsAg检测.结果 CLIA法检测患者标本乙型肝炎病毒表面抗原 HBsAg阳性率分别为16.64%,TRFIA阳性率分别为16.48%.结论化学发光法测定乙肝病毒血清标志物的相对灵敏度高、特异性好,且为定量检测,可为临床用药疗效观察及乙肝病毒感染的转归提供科学依据.     

罗氏电化学发光法在唐氏综合征产前筛查中的应用对比

在临床使用的唐氏综合征（DownSyndrome,DS）筛查方法中,有化学发光法、时间分辨荧光免疫法和酶免疫法等。本研究通过对罗氏电化学发光法和酶免疫法对DS的筛查效果进行对比分析,以观察罗氏电化学发光法在DS的产前筛查中的价值,现将结果报告如下。     

妊娠中期血清标记物检测在唐氏综合征产前筛查中的意义

目的探讨妊娠中期血清标记物在唐氏综合征(DS)产前筛查中的意义。方法分别用血清二联筛查与三联筛查方法进行孕中期胎儿唐氏综合征产前筛查试验,孕妇胎龄为15～21周,对两种筛查方法的检出率及假阳性率进行分析,同时结合ROC曲线分析两种血清筛查方法的敏感性并相互比较。结果在5 063例孕妇中6例为DS胎儿,二联和三联筛查的DS检出率分别是50%和83.3%,假阳性率分别为2.2%和2.1%,ROC分析得到的曲线下面积(AUC)分别为0.62(95%CI:0.583～0.707)和0.85(95%CI:0.795～0.880)。结论孕中期血清筛查胎儿DS试验具有很好的参考价值,而血清三联筛查方法明显优于血清二联筛查。     

23447例孕中期妇女血清学产前筛查结果回顾性分析

目的 了解孕中期妇女产前筛查对胎儿染色体异常及神经管畸形(NTD)的临床应用价值.方法 采用时间分辨荧光免疫法(DELFIA)对孕中期妇女进行血清二联法产前筛查,筛查结果应用Risks 2T分析软件计算唐氏综合征(DS)风险.DS和NTD的风险切割值为1∶270,18三体综合症的风险切割值为1∶350,筛查结果为DS高风险者,建议进一步做产前诊断.结果 在23 447例孕中期妇女中筛查出高危孕妇1 504例,总阳性率为6.41％,在随访的932例筛查高风险孕妇中,发现胎儿染色体异常14例,其他异常25例,总检出率4.18％.在随访的18008例筛查为低风险的孕中期妇女中,发现胎儿染色体异常6例,其他胎儿异常162例,总检出率0.93％.血清学筛查结果为高风险的孕中期妇女,其检出DS或其他异常胎儿的发生大于低风险孕中期妇女,两者差异有统计学意义(P＜0.01).结论 孕中期妇女血清二联筛查对产前筛查胎儿染色体异常和NTD有实用性价值,但在随访过程中,应注意假阴性和假阳性的解释工作.     

三种方法对乙型肝炎病毒血清标志物检测的结果分析

目的:比较分析酶联免疫吸附法(ELISA法)、时间分辨荧光免疫法(TRFIA法)和化学发光法检测乙型肝炎病毒血清标志物的检测结果。方法:用三种方法对200例血清标本进行检测,比较分析乙型肝炎五项检测结果的差异。结果:对高浓度乙型肝炎病毒血清,三种方法检测结果无差异,对于低浓度标本TRFIA法和化学发光法无差异,而ELISA法检测的阳性率则较低。结论:TRFIA法和化学发光法是目前较具优势的乙型肝炎两对半定量的检测方法,避免了假阳性和漏检问题,为乙型肝炎患者的早期预防及疗效观察提供了依据。     

酶联免疫法和化学发光法检测抗-HIV的效果比较

目的:比较酶联免疫法(ELISA法)与化学发光法(CLIA法)检测抗-HIV的效果。方法:选取10 000例血液标本作为研究对象,采用ELISA法和CLIA法两种方法进行检测,以免疫印迹法结果为金标准,比较两种检测方法的标本阳性率结果。结果:采用ELISA法所检测的标本阳性率为0.26%,采用CLIA法检测的标本阳性率为0.28%。采用免疫印迹法检测出的阳性率为0.24%,ELISA法所检测的假阳性率为0.02%,CLIA法所检测的假阳性率为0.04%,组间假阳性率差异无统计学意义(P>0.05)。结论:酶联免疫法(ELISA法)与化学发光法(CLIA法)两种方法测定抗-HIV的效果总体无明显差异。     

两种免疫检验方法检测乙型肝炎病毒感染血清学标志物的临床研究

目的研究时间分辨荧光免疫分析法与酶联免疫吸附法检测乙型肝炎病毒感染血清学标志物的临床效果。方法选取本院收治的90例乙型肝炎病毒感染患者,所有患者均接受时间分辨荧光免疫分析法与酶联免疫吸附法检测乙型肝炎病毒,比较两种检验精准度与血清学标志物呈阳性率。结果酶联免疫吸附法精准度为75.56%,低于时间分辨荧光免疫分析法(97.78%);时间分辨荧光免疫分析法对HBV表面抗原、HBV表面抗体、HBVe抗原呈阳性率均高于酶联免疫吸附法,差异均有统计学意义(P0.05)。结论与酶联免疫吸附法比较,时间分辨荧光免疫分析法检测精准度更高,临床效果显著。     

三种不同检测方法对检测低水平乙型肝炎表面抗原的价值

目的探讨化学发光法、酶联免疫法及胶体金免疫层析法对检测低水平乙型肝炎表面抗原的应用价值.方法利用化学发光法、酶联免疫法及金标法对86例低水平乙型肝炎表面抗原标本检测.结果化学发光法和酶联免疫法测定86例低水平乙型肝炎表面抗原含量符合率为95.34%,两种方法无差异性(p>0.05,X2=0.095).化学发光法与金标法符合率为70.93%,具有显著差异性(p<0.05,X2=7.69).结论化学发光法作为检测低水平乙型肝炎表面抗原的首选方法,但试剂成本昂贵,需要特定的的仪器,不宜在基层医院开展.酶联免疫法经济实惠,适合基层医院普查,但操作过程繁琐、时间长,不宜作为乙型肝炎表面抗原急诊筛查试验方法.而金标法操作简单、快捷及方便,适合急诊筛查实验,但容易漏诊,不宜作为普查试验方法.     

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.     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.