老年Ⅱ型糖尿病患者胰岛素抵抗与血脂代谢的关系

目的 探讨老年Ⅱ型糖尿病患者胰岛素抵抗（IR）与各种血脂成分的关系。方法 检测60例老年Ⅱ型糖尿病患者（Ⅰ组）和60例正常人（Ⅱ组）空腹及OGTT后2h血糖、空腹胰岛素及血脂,并计算胰岛素敏感指数（ISI）。结果 Ⅰ组较Ⅱ组TG、LOL－C显著升高,HDL－C和胰岛素敏感指数显著降低,TC无明显改变。结论 高TG、高LDL－C和低HDL－C存在于伴胰岛素抵抗的老年Ⅱ型糖尿病中,胰岛素指数结合低HDL－C及高TG可作为老年Ⅱ型糖尿病高危人群的指标。     

成纤维细胞生长因子-21与2型糖尿病大血管病变的相关性

【目的】探讨2型糖尿病（T2DM ）合并大血管病变患者血浆成纤维细胞生长因子‐21（FGF‐21）水平变化以及观察短期胰岛素强化治疗对FGF‐21水平的影响。【方法】采用酶联免疫法测定30例健康对照组和34例初诊T2DM患者（T2DM组）、28例T2DM合并大血管病变患者（合并大血管病变组）血浆FGF‐21水平以及胰岛素强化治疗前后的变化,分析血浆FGF‐21水平与体质量指数（BMI）、腰臀比（WHR）、血脂、血糖、空腹血浆胰岛素（FINS）和糖化血红蛋白（HbA1C）等水平的关系。【结果】T2DM 合并大血管病变患者FGF‐21水平明显升高,空腹血浆FGF‐21水平与FPG、HbA1C呈明显正相关,WHR、舒张压、HbA1C是影响血浆FGF‐21水平的独立相关因素。经胰岛素强化治疗后血浆FGF‐21水平较治疗前明显下降。【结论】血浆FGF‐21可能参与了 T2DM 及其大血管病变的发生和发展,胰岛素强化治疗可明显降低T2DM患者血浆FGF‐21水平。     

高同型半胱氨酸血症对糖尿病患者视网膜和肾脏病变的影响

目的：探讨血浆同型半胱氨酸水平对2型糖尿病（T2DM）视网膜病变（DR）和肾病（DN）的影响,分析血浆同型半胱氨酸浓度与胰岛素抵抗（ HOMA-IR、ISI）和血管内皮生长因子（ VEGF）的关系。方法纳入241例T2DM患者,根据2010版中国2型糖尿病防治指南视网膜病变和肾病诊断标准分组,分析其年龄、BMI、高血压病史、糖尿病病程、空腹胰岛素（FINS）、空腹血糖（FPG）、HOMA-IR、胰岛素敏感指数（ISI）以及糖化血红蛋白（HbA1c）、微量白蛋白（MAU）与VEGF及同型半胱氨酸（Hcy）水平。结果相关分析显示年龄、BMI、高血压病史、糖尿病病程、HOMA-IR、HbA1c以及MAU与VEGF及Hcy水平增高均呈正相关,ISI与VEGF及Hcy水平增高呈负相关;Hcy与VEGF两者之间也呈正相关（ r ＝0.498, P ＜0.01）;分组分析结果显示年龄较大、糖尿病病程较长、HbA1c和VEGF水平较高、ISI较低、Hcy≥10μmol/L可能为DR的危险因素（ P ＜0.05）,而较高的Hcy和VEGF水平可能为DN早期的危险因素（ P ＜0.05）。结论血浆VEGF和Hcy两者之间呈正相关,均与ISI呈负相关;高血浆Hcy、VEGF水平可能是T2DM患者患DR、DN早期的危险因素,较低ISI的患者DR的危险程度较高,但ISI降低可能并不是DN进展的主要影响因素。     

血浆脂联素与2型糖尿病及其大血管病变相关性研究

目的探讨血浆脂联素（adiponectin）在2型糖尿病及糖尿病大血管病变中的作用及相关性。方法2型糖尿病（T2DM）患者68例，分为单纯糖尿病组及糖尿病下肢血管病变组，对照组30例。对所有研究对象常规行空腹血糖（FPG）、血总胆固醇（TC）、甘油三酯（TG）、糖化血红蛋白（HbA1c）和空腹胰岛素（FINS）水平测定，并计算体重指数（BMI）及胰岛素敏感指数（ISI）；采用ELISA法测定各标本血浆脂联素水平，并对各组间临床指标进行比较，对各指标与脂联素水平的相关性进行相关和回归分析。结果与对照组比较，2型糖尿病患者FIG、TC、TG和FINS、BMI、HbA1c水平明显高于对照组（P〈0．05或P〈0．01），血浆脂联素水平及ISI糖尿病合并大血管病变组明显低于单纯糖尿病组和对照组（P〈0．01）。且血浆脂联素水平糖尿病下肢血管病变组也明显低于单纯糖尿病组（P〈0．01）；2型糖尿病病人血浆脂联素水平与下肢血管病变、FPG、TC、TG、BMI及HbA1c显著负相关，与ISI呈显著正相关。结论：血浆脂联素在2型糖尿病及糖尿病大血管病变的发生中可能发挥保护性作用，血浆脂联素水平降低可能是发生糖尿病及糖尿病大血管病变的一个独立危险因素。     

初诊2型糖尿病患者脂蛋白相关磷脂酶A2与胰岛素抵抗的相关性研究

目的：探讨初诊断2型糖尿病（T2DM）患者血浆脂蛋白相关磷脂酶A2（Lp?PLA2）水平与胰岛素抵抗的关系。方法：选取219例初诊断T2DM 患者,测定血浆Lp?PLA2、总胆固醇、甘油三酯、高密度脂蛋白胆固醇（HDL?C）、低密度脂蛋白胆固醇（LDL?C）、糖化血红蛋白（HbA1c）、空腹血糖和空腹胰岛素等指标,于口服葡萄糖耐量试验（OGTT）或馒头餐试验后检测30 min、120 min血糖和胰岛素。以Lp?PLA2水平分为正常组（＜200 ng/mL）和高值组（≥200 ng/mL）,分析两组胰岛素抵抗水平及二者的相关性。结果：初诊断T2DM患者Lp?PLA2高值组比正常组HOMA?IR值显著增高（P＜0.05）,而Matsuda ISI显著降低（P＜0.05）。相关分析进一步提示Lp?PLA2水平与HOMA?IR呈正相关（P＜0.05）,与Matsuda ISI呈负相关（P＜0.05）。多元线性回归分析结果显示,血浆Lp?PLA2是影响T2DM患者HOMA?IR 和Matsuda ISI的重要因素（P＜0.05）。结论：Lp?PLA2与T2DM胰岛素抵抗密切相关。Lp?PLA2作为简单易行的指标,除了作为T2DM心血管风险预测因素外,还可以反映糖尿病患者胰岛素抵抗程度,可作为T2DM重要的评估监测指标。     

糖尿病周围神经病变患者血浆纤维蛋白原水平 与神经传导速度的相关性

目的 探讨糖尿病周围神经病变（DPN）患者血浆纤维蛋白原（FIB）水平与神经传导速度的相关性, 并分析FIB 的影响因素。方法 选取2 型糖尿病（T2DM）患者252 例,根据是否合并DPN 分为DPN 组（150 例）和单纯T2DM 无并发症组（102 例）,另选取体检健康者100 例作为健康对照组（NC 组）,收集3 组临 床资料,比较纤维蛋白酶（FIB）水平。再根据FIB 水平将DPN 组分为低FIB 水平（FIB ≤ 4 mg/dl）亚组65 例和高FIB 水平（FIB>4 mg/dl）纤维蛋白酶亚组（85 例）,观察两亚组临床资料分布特点,检测神经传导速度。 采用Pearson 单因素相关和多元线性回归分析FIB 的影响因素。结果 ① DPN 组腰围（WC）、收缩压（SBP）、 舒张压（DBP）、空腹血糖（FPG）、餐后2 h 血糖（2 h PG）、空腹胰岛素（Fins）、糖化血红蛋白（HbA1c）、 HOMA-IR、TG、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）及FIB 均高于NC 组和T2DM 组（P < 0.05）;T2DM 组FPG、2 h PG、Fins、HbA1c、胰岛素抵抗指数（HOMA-IR）、TC、HDL-C、FIB 及吸烟 例数均高于NC 组（P <0.05）。② FIB>4 mg/dl 亚组年龄、糖尿病（DM）病程、BMI、FPG、2 hPG、Fins、 HbA1c、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、HOMA-IR 及吸烟例数均高于FIB ≤ 4 mg/dl 亚组 （P <0.05）。③ FIB>4 mg/dl 亚组SCV 和MCV 较FIB ≤ 4 mg/dl 亚组降低（P <0.05）。④ Pearson 相关分析显 示,血浆FIB 水平与年龄、糖尿病（DM）病程、体重指数（BMI）、FPG、HbA1c、TC、TG、LDL-C 及吸 烟呈正相关（P <0.05）。⑤多元线性回归分析显示,BMI、TG、HbA1c 及吸烟为FIB 的影响因素（P <0.05）。 结论 DPN 患者血浆FIB 水平升高,神经传导速度下降,BMI、TG,HbA1c 及吸烟是DPN 患者FIB 的影响因素。     

2型糖尿病大血管病变与血液流变学改变和胰岛素抵抗关系的相关性

目的研究血液流变学变化和胰岛素抵抗（IR）与2型糖尿病（DM）大血管病变的关系。方法检测108例2型DM患者，其中有大血管并发症54例，无大血管并发症54例，以及54例正常对照组的血液流变学、空腹血糖（FBG）、空腹胰岛素（INS），计算胰岛素敏感性指数（IAI），并进行了比较。结果DM两组血黏度显著高于正常对照组；IAI显著低于正常对照组（P〈O．01）。DM有大血管病变组血黏度显著高于无大血管病变组；IAI显著低于无大血管病变组（P〈O．01）。多元逐步回归分析显示，2型DM大血管病变与DM病程、血糖、血黏度呈显著正相关，与IAI呈显著负相关。结论2型DM大血管病变患者存在严重的持续性高血黏、高血糖。DM病程的延长、严重的IR为2型DM大血管病变的主要危险因素。     

超高龄2型糖尿病患者并发动脉粥样硬化的影响因素分析

目的探讨超高年龄2型糖尿病患者（T2DM）并发动脉粥样硬化（AS）的影响因素。方法选择2010年1月～2012年10月于海军总医院住院治疗的242例超高年龄老年T2DM患者,按有无AS分为动脉粥样硬化组（AS组）及非动脉粥样硬化组（NAS组）,比较两组患者性别、年龄、吸烟史、糖尿病病程、体重指数（BMI）、空腹血糖（FBG）、餐后血糖（PBG）、胰岛素抵抗指数（HOMA-IR）、收缩压（SBP）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL～C）、脂联素（APN）、超敏C反应蛋白（hs—CRP）水平差异。对阳性因素采用Logistic回归分析T2DM并发AS的相关影响因素。结果超高年龄老年T2DM患者AS发生率为54．5％,AS组同NAS组患者吸烟史、糖尿病病程、BMI、PBG、FBG、HOMA—IR、TC、LDL—C、HDL—C、APN、hs—CRP水平差异有统计学意义（P〈0．05）。Logistic回归分析显示,吸烟、HOMA—IR、SBP、TC、hs—CRP是超高龄老年T2DM患者并发AS的独立危险因素,APN是超高龄老年T2DM患者并发AS的保护性因素（P〈0．05）。结论超高年龄老年T2DM患者并发AS的危险因素较多,在控制血糖过程中要注意对危险因素的控制,减少大血管病变的发生。     

2型糖尿病大血管病变与血浆脂联素的相关研究

目的　探讨2型糖尿病及糖尿病大血管病变中血浆脂联素(adiponectin,APN)的变化及相关性。方法　选取健康对照组42例（G1组）,单纯2型糖尿病(T2DM)患者43例（G2组）,2型糖尿病合并下肢动脉病变组39例（G3组）。对所有研究对象常规行空腹血糖(FPG)、高密度脂蛋白（HDL）、甘油三酯(TG)、糖化血红蛋白(HbA1c)、空腹C肽（C-P）、空腹胰岛素(FINS)和血浆APN水平测定,计算体质指数(BMI)及胰岛素敏感指数(ISI),并对各组间临床指标进行比较,对各指标与脂联素水平的相关性进行相关分析。结果 与对照组比较,2型糖尿病患者FPG、TG、HDL、FINS、BMI、C-P、APN和HbA1c水平明显高于对照组( P＜0.05或P＜0.01),APN、C-P水平及ISI值糖尿病合并大血管病变组明显低于单纯糖尿病组和对照组(P＜0.01);2型糖尿病病人血浆APN水平与下肢血管病变、FPG、C-P、TG及BMI显著负相关,与HDL及ISI呈显著正相关。结论:血浆APN在2型糖尿病患者中明显降低,合并大血管病变患者降低更明显,提示血浆APN水平降低可能是发生糖尿病及糖尿病大血管病变的一个独立危险因素。     

2型糖尿病慢性血管并发症的危险因素分析

目的 探讨2型糖尿病(T2DM)患者慢性血管并发症的危险因素,同时了解T2DM慢性大血管并发症与微血管并发症的关系.方法 将141例住院的T2DM患者按是否伴有大血管并发症分为两组,分别比较其总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、尿微量白蛋白/肌酐(UALB/Cr)等指标,同时了解其微血管并发症发生率.结果 两组患者的性别、年龄、病程、舒张压(DBP)、体质指数(BMI)间差异无统计学意义(P>0.05).伴有大血管并发症组的T2DM患者收缩压(SBP)、TC、TG、LDL-C、HDL-C、FBG、HbA1c、FINS、HOMA-IR、UALB/Cr、微血管并发症发生率高于无大血管并发症组.多元logistic回归分析显示,年龄、DBP、SBP、UALB/Cr为T2DM慢性大血管并发症的重要危险因素.结论 伴有大血管并发症的T2DM患者中存在着更高的血糖水平及SBP、更严重的胰岛素抵抗及脂代谢紊乱,此外存在着高发的微血管并发症.年龄、高血压及微量白蛋白尿是T2DM慢性大血管并发症的重要危险因素.在治疗糖尿病同时应重视对血压、血脂的控制,从而更为有效地预防治疗糖尿病大血管并发症.     

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.     

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.     

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.