经鼻雾化吸入布地奈德混悬液联合克拉霉素治疗慢性鼻-鼻窦炎鼻息肉伴支气管哮喘患者的临床研究

目的分析经鼻雾化吸入布地奈德混悬液联合克拉霉素治疗慢性鼻-鼻窦炎（chronic rhinosinusitis，CRS）鼻息肉伴支气管哮喘的效果。 方法选取于河北保定市第四中心医院与河北医科大学第二医院耳鼻喉科诊断为CRS行鼻内镜手术且伴支气管哮喘的128例作为研究对象，按照抽签法分为克拉霉素组和联合组各64例。2组患者均行功能性鼻内镜手术（functional endoscopic surgery，FESS）手术治疗，2组患者在术前均行支气管哮喘常规治疗，克拉霉素组采用克拉霉素治疗，联合组在克拉霉素组的基础上经鼻雾化吸入布地奈德混悬液。评价患者临床症状改善时间、下气道肺功能、嗜酸粒细胞（eosinophils，EOS）计数、中性粒细胞/淋巴细胞比值（neutrophil/Lymphocyte ratio，NLR）、血小板/淋巴细胞比值（platelet/Lymphocyte ratio，PLR）、哮喘控制测试（asthma control test，ACT）评分、可溶性白细胞介素2受体（soluble interleukin-2 receptor，sIL-2R）、干扰素γ（interferon-γ，IFN-γ）、可溶性CD23（soluble CD23，sCD23）、白细胞介素4（interleukin-4，IL-4）水平及疗效。 结果与克拉霉素组相比，联合组湿罗音、哮鸣音、喘息、咳嗽改善时间均缩短（P＜0.05）。与克拉霉素组相比，联合组肺功能指标FEV1、FVC、PEF升高（P＜0.05）。与克拉霉素组相比，联合组EOS计数、NLR、PLR、sIL-2R、sCD23、IL-4水平降低，ACT评分、IFN-γ水平升高（P＜0.05）。与克拉霉素组相比，联合组治疗总有效率较高（P=0.023）。 结论CRS鼻息肉伴支气管哮喘患者采用经鼻雾化吸入布地奈德混悬液联合克拉霉素治疗，临床症状、肺功能显著改善，效果显著。     

慢性鼻窦炎、鼻息肉与支气管哮喘相关性120例临床分析

目的 探讨慢性鼻窦炎、 鼻息肉与支气管哮喘的相关性. 方法 整群选取2014年1月—2015年1月期间来该院进行诊治的慢性鼻窦炎、鼻息肉(CRS)患者120例,均行鼻内镜手术进行治疗,根据患者术后病理诊断是否伴随有鼻息肉的情况,将患者分为CRS组和CRS伴息肉组两组,每组60例.行鼻腔鼻窦CT检查和鼻内镜检查,根据检查与临床观察结果,分析慢性鼻窦炎、鼻息肉与支气管哮喘的相关性. 结果 患者鼻窦病变范围合并变应性鼻炎和支气管哮喘的发生率差异无统计学意义(x2=1.832;P>0.05).患者鼻息肉分级合并变应性鼻炎和支气管哮喘的发生率差异无统计学意义(x2=2.934;P>0.05).患者的CRS病变范围与其肺功能呈显著正相关(r=0.454,P=0.003).患者的CRS息肉分级与其肺功能无相关性(r=0.106,P=0.649). 结论 临床认为,对于慢性鼻窦炎、鼻息肉合并支气管哮喘的患者,对于鼻息肉进行积极有效的治疗,清除其鼻分泌物,对于改善支气管哮喘患者的肺功能具有很大的裨益.     

慢性鼻窦炎合并支气管哮喘22例的临床疗效观察

目的 探讨鼻窦内镜术在降低慢性鼻窦炎合并支气管哮喘患者哮喘症状发作频率中的作用.方法 收集2007年5月～2009年5月笔者所在医院门诊治疗的136例慢性鼻窦炎合并支气管哮喘患者的临床资料,其中22例合并哮喘,均行鼻窦内镜术,随访2年分析鼻窦炎手术在改善哮喘症状方面的作用.结果 术后2年随访鼻窦炎的治愈率为86.4%(19/22),好转率为13.6%(3/22),哮喘发作频率降低至(6.2±2.8)次/年,与术前及第1年相比差异均具有统计学意义(P＜0.05).结论 鼻窦内镜术在治疗鼻窦炎同时,可显著改善慢性鼻窦炎伴支气管哮喘患者的哮喘症状,这对合并症治疗具有一定的临床意义.     

葡萄球菌感染性鼻窦炎在支气管哮喘发病中的作用

目的 探讨葡萄球菌感染性鼻窦炎在支气管哮喘发病中的作用。方法 对85例同时患有难治性慢性鼻窦炎和支气管哮喘的病人进行了鼻内镜手术治疗。手术后测定鼻窦黏膜、鼻窦冲洗液中的葡萄球菌肠毒素B含量，手术前后和随访时分别测定血清总IgE，尘螨特异性IgE，抗葡萄球菌肠毒素B抗体、IL-4和INE-γ含量。结果 慢性鼻窦炎时鼻腔和鼻窦黏膜中葡萄球菌肠毒素B含量增多（P〈0．01）。鼻内镜手术后血清抗葡萄球菌肠毒素B抗体显著下降（P〈0．01）。鼻内镜术后血清IL-4降低，INF-γ升高，和术前比较有统计学意义（P〈0．01）；相关分析结果示IL-4和抗葡萄球菌肠毒素B抗体含量之间呈显著性正相关（P〈0．01），INF-γ和抗葡萄球菌肠毒素B抗体含量呈显著负相关（P〈0．01）。鼻内镜手术后慢性鼻窦炎临床症状显著改善（P〈0．01），术后肺功能测定示运动后第1秒用力呼气容积下降率显著小于术前（P〈0．01），相关分析结果提示病人的哮喘临床症状和血清抗葡萄球菌肠毒素B抗体水平显著相关（P〈0．01）。上呼吸道及周围组织器官多部位金黄色葡萄球菌感染对哮喘发病有影响。结论 体内较高水平葡萄球菌肠毒素B的慢性存在对支气管哮喘的发病和维持有重要作用。     

慢性鼻窦炎和鼻息肉病与下呼吸道炎性疾病相关性分析

目的：分析与探讨慢性鼻窦炎、鼻息肉病与下呼吸道炎性疾病相关性。方法：对548例慢性鼻窦炎、鼻息肉病患者的临床资料进行回顾分析。根据病变范围将慢性鼻窦炎分为单窦、多窦和全鼻窦3种类型；根据鼻内镜检查及CT扫描结果将鼻息肉分成4级；下呼吸道炎性相关疾病包括支气管哮喘和支气管炎两种常见疾病。结果：①慢性鼻窦炎组258例中12例合并支气管哮喘（单窦、多窦和全鼻窦病变分别为0．4和8例）；16例合并支气管炎（单窦、多窦、全鼻窦病变分别为0、8和8例）；不同病变程度的慢性鼻窦炎与哮喘、气管炎患病率的差异均有非常显著性统计学意义（P〈0．01）。②鼻息肉病组290例中16例合并支气管哮喘（Ⅰ-Ⅳ级分别为1、4、5和6例），14例合并支气管炎（Ⅰ级～Ⅳ级分别为0、4、8和2例）；在鼻息肉不同分级中下呼吸道炎性疾病患病率差异均无统计学意义（P〉0．05）。③下呼吸道炎性疾病在鼻息肉病组与慢性鼻窦炎组患病率差异无统计学意义（P〉0．05）。结论：虽然上下呼吸道炎性疾病相关性的机制尚不明确，但慢性鼻窦炎与鼻息肉病对下呼吸道炎性疾病的影响可能存在共性。     

IL-2、IL-2Rα及IFN-γ基因多态性与汉族儿童支气管哮喘的关联

目的探讨IL-2(rs6822844)、IL-2Rα(rs2104286)及IFN-γ(rs2430561)多态性位点与汉族儿童支气管哮喘的关联。方法选取144例汉族支气管哮喘患儿为研究组,并以性别、年龄配对的228例汉族无支气管哮喘儿童作为对照组。采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）技术检测IL-2(rs6822844)、IL-2Rα(rs2104286)及IFN-γ(rs2430561)的等位基因及基因型;采用实时荧光PCR检测对照组IL-2Rα各基因型外周血IL-2RαmRNA相对表达量,采用ELISA检测其各基因型血浆sIL-2Rα水平。结果IL-2Rα(rs2104286)位点等位基因A在研究组分布频率（86.8%）高于对照组（79.4%）（OR=1.708,95%CI：1.113~2.629,P=0.010）;研究组中AA基因型患者分布频率（75.0%）高于对照组（62.3%）（OR=1.745,95%CI：1.058~2.884,P=0.021）;未发现IL-2(rs6822844)位点有多态性分布,IFN-γ(rs2430561)位点等位基因及基因型频率在两组中分布差异均无统计学意义（P=0.182、0.205、0.421）。研究组中IL-2Rα(rs2104286)位点AA基因型个体外周血IL-2RαmRNA相对表达量以及血浆sIL-2Rα水平均显著高于AG基因型（P=0.043、0.018）。结论IL-2Rα(rs2104286)位点可能与汉族儿童支气管哮喘发生相关,而且该位点可能影响其转录表达。     

克拉霉素胶囊联合布地奈德混悬液治疗慢性鼻窦炎合并支气管哮喘鼻内镜术后患者的效果

目的：观察克拉霉素胶囊联合布地奈德混悬液治疗慢性鼻窦炎（CRS）合并支气管哮喘（BA）鼻内镜术后患者的效果。方法：选取2018年4月至2023年4月该院收治的180例经鼻内镜Messerklinger术治疗后的CRS合并BA患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各90例。对照组采用经鼻雾化吸入布地奈德混悬液治疗,观察组在对照组基础上联合克拉霉素胶囊口服治疗,比较两组治疗总有效率、气道阻力水平、血清炎性指标[白细胞介素-4(IL-4)、可溶性白细胞介素-2受体（sIL-2R）、环氧化酶-2(COX-2)]水平、鼻腔鼻窦结局测试20(SNOT-20)评分、哮喘控制测试（ACT）评分和不良反应发生率。结果：观察组治疗总有效率为93.33%,明显高于对照组的83.33%,差异有统计学意义（P<0.05）;治疗后,两组SNOT-20评分、气道阻力水平和血清IL-4、COX-2、sIL-2R水平低于治疗前,且观察组低于对照组,两组ACT评分高于治疗前,且观察组高于对照组,差异均有统计学意义（P<0.05）;两组不良反应发生率比较,差异无统计学意义（P>0.05）。...     

鼻窦冲洗对慢性鼻窦炎鼻内镜手术效果的影响

目的：观察鼻内镜手术联合鼻窦灌注冲洗治疗慢性鼻窦炎的疗效及其对细胞因子的影响。方法慢性鼻窦炎患者100例,按随机数字表法分为两组,两组患者均行鼻内镜手术治疗,观察组50例于术后1周采用自制的鼻窦灌注液进行鼻窦灌洗,2次／d,共4周,对照组50例手术后按常规治疗,未行鼻窦灌注冲洗。观察两组治疗效果及两组治疗前后鼻黏膜纤毛传输速度、血清干扰素γ（ IFN-γ）、白细胞介素（ IL）-2、IL-4、IL-5及鼻窦黏膜组织中嗜酸性粒细胞数。结果观察组疗效优于对照组（P＜0．05）。治疗后两组患者鼻黏膜纤毛传输速度均提高,而且观察组速度快于对照组（P＜0．05）;与治疗前比较,治疗后两组嗜酸性粒细胞数、IFN-γ、IL-2、IL-4、IL-5水平均明显降低（P＜0．05）,且观察组上述指标降低更明显（ P＜0．05）。结论鼻内镜手术联合鼻窦灌注冲洗治疗慢性鼻窦炎效果好,可有效提高鼻黏膜纤毛传输速度,减轻局部炎症反应,调节Th1／Th2免疫平衡,提高临床疗效。     

“三伏贴”防治支气管哮喘及对神经免疫相关细胞因子的影响

目的观察"三伏贴"疗法对防治支气管哮喘相关细胞因子的影响及疗效,初步探讨其神经免疫学机制。方法将60例支气管哮喘患者随机分为对照组和观察组各30例。对照组予西医常规治疗,观察组在对照组治疗基础上联合穴位敷贴治疗,共治疗2个月,观察周期为6个月。比较2组治疗前后哮喘急性发作次数、ACT评分、中医证候积分及肺功能指标、细胞因子。结果与治疗前比较,观察组治疗后哮喘急性发作次数明显降低（P<0.01）,ACT评分、中医证候积分以及白介素-2 （IL-2）、干扰素-γ（IFN-γ）、白细胞介素-4 （IL-4）、白细胞介素-5（IL-5）、神经生长因子（NGF）、血管活性肠肽（VIP）等细胞因子水平较前明显改善（P<0.01,P<0.05）,且均优于对照组（P<0.01,P<0.05）。结论"三伏贴"疗法防治哮喘临床疗效显著,能通过调节IL-2、IFN-γ、IL-4、IL-5细胞因子水平来调整Th1/Th1水平;其作用机制可能通过改善VIP、NGF水平来调节哮喘患者神经免疫功能。     

慢性持续期过敏性支气管哮喘外周血IL-17、IL-10与IL-4、IFN-γ失衡状态的研究

目的：探讨IL-17、IL-10与IL-4、IFN-γ失衡状态在慢性持续期过敏性支气管哮喘（简称哮喘）发病机制中的作用.方法：对23例未经过规范化治疗的慢性持续期哮喘患者给予吸入沙美特罗替卡松治疗,分别于治疗前、治疗1周、治疗1个月时检测血清IL-17、IL-10及IL-4、IFN-γ水平,同时检测12例正常人上述指标水平并进行比较分析.结果：（1）哮喘组治疗前外周血清IL 17水平为（227.17±17.76） ng/L,高于正常组水平（148.92±15.50）ng/L（P＜0.05）.治疗1周、1个月哮喘组IL-17水平较治疗前下降（P＜0.05）;哮喘组治疗前外周血清IL-10水平为（202.29±8.07） ng/L,低于正常组（265.11±12.97）ng/L（P＜0.01）.治疗1周、1个月哮喘组IL-10水平较治疗前上升（P＜0.05）.（2）哮喘组治疗前外周血IL-4水平为（139.45±5.52）ng/L,高于正常组（78.70±4.75）ng/L（P＜0.05）.治疗1周、1个月哮喘组IL-4水平较治疗前下降（P＜0.05）;哮喘组治疗前外周血IFN-γ为（6.58±1.80）ng/L,低于正常组（47.19±5.87）ng/L（P＜0.05）.治疗1周、1个月IFN-γ水平较治疗前上升（P ＜0.05）.结论：慢性持续期哮喘患者同时存在IL-17、IL-10和IL-4、IFN-γ的失衡状态,提示IL-17、IL-10与IL-4、IFN-γ失衡共同参与过敏性支气管哮喘发病过程.     

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.