血清降钙素原联合C反应蛋白、白细胞检测对脑膜炎患儿的诊断价值

目的 探讨降钙素原(PCT)、血白细胞(WBC)及C反应蛋白(CRP)水平对化脓性脑膜炎和病毒性脑膜炎的诊断价值.方法 选取该院2014年4月至2016年6月收治的168例脑膜炎患儿(感染组)及56例结缔组织疾病患儿(对照组)作为研究对象,将感染组患儿分为化脓性脑膜炎组(n=72例)、病毒性脑膜炎组(n=96),对各组患儿治疗前后血浆、脑脊液PCT、WBC、CRP水平进行比较分析.结果 感染组患儿血清和脑脊液PCT水平均明显高于对照组患儿(P＜0.05);与对照组相比,病毒性脑膜炎组患儿治疗前、治疗72 h及治疗1周后的血清和脑脊液PCT水平差异无统计学意义(P＞0.05);化脓性脑膜炎组患儿治疗前血清和脑脊液PCT均明显升高(P＜0.05);与对照组相比,病毒性脑膜炎组血CRP水平明显升高(P＜0.05),而血WBC水平差异无统计学意义(P＞0.05),化脓性脑膜炎组血WBC及CRP水平均明显增高(P＜0.05),差异有统计学意义(P＜0.05).结论 血清PCT水平结合WBC和CRP的水平变化及治疗过程中PCT水平的变化可对早期病毒性脑膜炎和化脓性脑膜炎进行鉴别并指导治疗方案的制订.     

血清与脑脊液降钙素原检测在儿童中枢神经系统感染的应用

目的探讨血清与脑脊液降钙素原(PCT)检测在儿童中枢神经系统(CNS)感染中的临床应用价值。方法采用双抗体夹心法测定82例CNS感染患儿血清及脑脊液PCT。结果细菌性脑膜炎组患儿血清PCT浓度及脑脊液PCT浓度明显高于病毒性脑炎组(P<0.01),差异均有统计学意义。结论血清及脑脊液PCT检测可作为细菌性脑膜炎鉴别于病毒性脑炎的一项特异、灵敏的指标,对儿科中枢感染性疾病的鉴别及诊治具有重要意义。     

一种新的诊断细菌性脑膜炎的指标

目的了解前降钙素(PCT)在儿童急性细菌性脑膜炎与病毒性脑炎鉴别诊断中的作用,并将其与C反应蛋白(CRP)进行比较。方法采用双抗体夹心免疫发光法测定急性细菌性脑膜炎与病毒性脑炎惠儿血浆中PCT含量,血中CRP含量采用ELISA法测定,并进行统计学分析。结果与病毒性脑炎组比较,化脓性脑膜炎组患儿血浆中PCT含量明显升高,具有统计学差异。与CRP相比,在诊断细菌性脑膜炎方面,PCT具有更高的灵敏性与特异性。结论PCT是一种鉴别小儿细菌性脑膜炎与病毒性脑炎的灵敏、有效的指标。     

降钙素原在儿科感染性疾病诊断中的应用

目的评价血清降钙素原(procalcitonin,PCT)在儿科感染性疾病实验诊断中的意义.方法采用半定量的胶体金免疫结合法,对56例临床疑似儿科感染性疾病的住院患儿作PCT测定,按临床第一诊断把患儿分成肺炎或肠炎、败血症等5组,并与C-反应蛋白(CRP)作比较.结果56例儿科感染性疾病患儿PCT检测阳性40例,阳性检测率71.4%,对全部56例检测对象中,CRP测定阳性10例,阳性检出率为18%,二者差异有显著性(P＜0.01).结论PCT检测应用于儿科感染性疾病可作为早期快速鉴别细菌感染的实验室新指标.     

不同炎性指标在诊断儿童化脓性脑膜炎中的比较

目的:探讨血清降钙素原(Procalcitonin,PCT)、CRP和IL-6对儿童化脓性脑膜炎(purulent meningitis,PM)的早期诊断价值。方法:2012年3月至2015年3月我院儿科收治的儿童化脓性脑膜炎29例为观察组、同期住院的儿童病毒性脑炎(viral encephalitis,VE)45例为对照1组,门诊20名健康体检儿童为对照2组。比较各组PCT、CRP和IL-6的差异;比较化脓性脑膜炎组患儿PCT、IL-6、CRP的ROC曲线下面积。结果:(1)观察组血清PCT水平为(6.87±5.53ng/ml),明显高于对照1组(0.123±0.902ng/ml)和对照2组(0.160±0.331ng/ml),差异有显著性意义(P0.01);观察组CRP为(78.02±24.321mg/L),明显高于对照1组(27.76±8.563mg/L)和对照2组(5.51±1.66mg/L),差异有显著性意义(P0.05);观察组IL-6水平为(173.87±99.68pg/ml),明显高于对照1组(51.72±20.84pg/ml)和对照2组(4.68±2.88pg/ml),差异有显著性意义(P0.05)。(2)化脓性脑膜炎患儿血清PCT水平ROC曲线下面积为0.632,明显高于IL-6、CRP在ROC曲线下面积(0.235、0.432)。结论:PCT、IL-6及CRP等炎症指标在早期诊断化脓性脑膜炎有指导价值;PCT对化脓性脑膜炎的诊断价值优于IL-6和CRP。     

CRP、PCT、WBC联合检测对儿童中枢神经系统感染性疾病的诊断价值探讨

目的探讨C反应蛋白(CRP)、降钙素原(PCT)、白细胞(WBC)联合检测在儿童中枢神经系统感染性疾病中的诊断价值。方法回顾性分析2016年3月至2017年3月商丘市中心医院收治的50例中枢神经系统感染患儿临床资料,根据感染致病菌类型将所有患儿分为化脓性脑膜炎组与病毒性脑膜炎组,各25例。检测两组血清及脑脊液中CRP、PCT、WBC水平,并进行比较分析。结果化脓性脑膜炎组患儿血清、脑脊液中感染指标水平均高于病毒性脑膜炎组患儿,血清与脑脊液中CRP、PCT阳性率均高于病毒性脑膜炎组,差异有统计学意义(P<0.05)。结论对于中枢神经系统感染,可通过联合检测CRP、PCT、WBC指标对疾病类型快速作出判断,使患儿得到及时与准确的治疗。     

血清降钙素原在新生儿感染性疾病诊治中的价值

目的:评价血浆降钙素原(Procalcitonin,PCT)在新生儿感染性疾病早期诊断中的作用和意义.方法:121例新生儿按感染情况分成重症感染、局部感染和非感染三组,测定比较其降钙素原(PCT)、C反应蛋白(CRP)及白介素6(IL-6)含量.结果:重症感染时,血清PCT、CRP和IL-6浓度升高均有显著性,但PCT显著性更高(P＜0.01).PCT阳性率重症感染组与其他两组比较差异有非常显著性(P均＜0.01),与CRP、IL-6的阳性率比较差异均有显著性(P＜0.01和P＜0.05).以2 ng/ml为临界值,诊断重症感染的特异度达94.12%,与CRP、IL-6相比,PCT诊断重症感染的敏感性、特异性更高.结论:PCT在严重细菌感染新生儿体内明显升高,可作为新生儿感染的早期检测指标,其诊断价值优于IL-6和CRP,对早期诊断与估计预后有重要意义.     

浅谈血清降钙素原、C-反应蛋白检测对小儿中枢神经系统感染性疾病的诊断价值

目的：探讨分析血清降钙素原、C-反应蛋白检测对小儿中枢神经系统感染性疾病的诊断价值。方法：选取2011年4月至2013年4月间我院收治的病毒性脑膜炎、细菌性脑膜炎及化脓性脑膜炎患儿140例作为研究对象,并根据患病类型的不同将其分为病毒性脑膜炎组（62例）、细菌性脑膜炎组（31例）和化脓性脑膜炎组（47例）,采用化学荧光法对这3组患儿血清降钙素的水平进行测定,采用免疫单扩散试验法对这3组患儿C-反应蛋白的水平进行测定,观察对比3组患儿的检测结果,并将对比的结果及3组患儿的临床资料进行回顾性的分析。结果：病毒性脑膜炎组患儿的CRP水平、PCT水平、WBC水平及脑脊液蛋白含量均明显低于细菌性脑膜炎组患儿和化脓性脑膜炎组患儿,且细菌性脑膜炎组患儿的CRP水平、PCT水平、WBC水平及脑脊液蛋白含量均明显低于化脓性脑膜炎组患儿,差异显著（P＜0.05）,具有统计学意义。结论：血清降钙素原检测及C-反应蛋白检测对临床鉴别诊断病毒性脑膜炎、细菌性脑膜炎和化脓性脑膜炎具有十分重要的意义。     

自然杀伤细胞检测对中枢神经系统感染的意义

目的:探讨自然杀伤(NK)细胞在中枢神经系统感染性疾病(中枢感染)中的变化。方法:采用免疫荧光法检测95例中枢感染患儿血NK细胞。结果:病毒性脑炎组NK细胞降低最明显,为7.2±3.,与正常对照组、结核性脑膜炎组、化脓性脑膜炎组相比(P均<0.01)均具有高度显著性差异。结论:NK细胞降低可作为区别病毒性脑炎与其他中枢感染的重要指标,也是病毒性脑炎的原因之一。     

PCT、LDH、β2-MG对儿童化脓性脑炎的鉴别诊断

目的:探讨血清降钙素原(PCT)和脑脊液乳酸脱氢酶(LDH)、β2-微球蛋白(β2-MG)对儿童化脓性脑炎和儿童病毒性脑炎的鉴别诊断.方法:经腰椎穿刺抽取患儿的脑脊液,采用单克隆抗体透射比浊法检测血清中的PCT含量,在生化分析仪上采用免疫比浊法检测脑脊液中β2-MG含量,采用速率法检测LDH水平.取得各项指标后,采用t检验做统计学分析.结果:化脓性脑炎组脑脊液LDH水平、β2-MG水平和PCT含量与病毒性脑炎组及对照组之间均存在统计学差异(即P＜0.01),而病毒性脑炎组与对照组LDH水平和PCT含量均无统计学差异(即P＞0.05);病毒性脑炎组β2-MG水平与对照组之间也存在统计学差异(P＜0.01).结论:脑脊液中PCT、LDH、β2-MG含量增高是人体中枢神经系统疾病早期诊断的标志物,在不同脑炎患者之间含量不同,可以作为不同脑炎鉴别诊断的标志物.     

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.