血清炎性因子、血浆Hcy和血液流变学指标在糖尿病微血管病变患者中的变化

目的 探究糖尿病不同程度微血管病变的患者中血清炎性因子、血浆同型半胱氨酸（homocysteine, Hcy）和血液流变学指标的变化。方法 随机选取笔者医院于2013年1月~2015年7月收治的2型糖尿病患者180例,按照视网膜病变程度分为3组：糖尿病无视网膜病变（no diabetic retinopathy, NDR）组60例,背景型糖尿病视网膜病变（background diabetic retinopathy, BDR）组60例,增殖型糖尿病视网膜病变（proliferative diabetic retinopathy, PDR）组60例,比较3组患者血清中高敏C反应蛋白（hypersensitive c-reactive protein, hs-CRP）、白介素-6（interleukin-6, IL-6）、肿瘤坏死因子-α（tumor necrosis factor-alpha, TNF-α）水平、血浆Hcy水平以及血液流变学指标。结果 BDR组和PDR组患者血清中hs-CRP、IL-6、TNF-α水平、血浆Hcy水平以及血液流变学指标均明显高于NDR组,差异有统计学意义（P<0.05）;PDR组患者血清中hs-CRP、IL-6、TNF-α水平、血浆Hcy水平以及血液流变学指标均明显高于BDR组 （P<0.05）。结论 糖尿病患者随着病情进展,包括hs-CRP、IL-6、TNF-α在内的血清炎性因子、Hcy以及血液流变学指标不断增高,可能与视网膜病变的发生发展过程有关。     

急性脑梗死患者神经功能恢复情况与炎症因子水平的相关性分析

目的 分析急性脑梗死神经功能恢复情况与炎症因子的相关性。方法 选取临床确诊的68例急性脑梗死患者为脑梗死组,选择同期体检的60例健康者为对照组,测定两组白介素-1β(IL-1β)、肿瘤坏死因子α(TNF-α)、可溶性细胞间黏附分子1(sICAM-1)、基质金属蛋白酶-9(MMP-9)、同型半胱氨酸(Hcy)、N末端脑钠素原(NT-proBNP)水平,比较脑梗死患者与正常健康人血清炎症因子水平;按照脑梗死体积将患者分为小梗死组(<5 cm³,n=24),中梗死组(5~15 cm³,n=25),大梗死组(>15 cm³,n=19),比较不同梗死体积患者炎症水平;按脑神经缺损程度(NIHSS)评分将患者分为轻度组(0~15分,n=26),中度组(16~30分,n=24),重度组(31~45分,n=18),比较不同脑缺损程度患者炎症因子水平变化。采用Pearson法分析急性脑梗死患者神经功能恢复情况、脑梗死体积与炎症因子水平的相关性。结果 脑梗死组TNF-α、IL-1β、sICAM-1、Hcy、NT-proBNP、MMP-9水平均高于对照组,差异有统计学意义(P<0.05);随脑神经损伤程度、梗死体积的增加,患者TNF-α、IL-1β、sICAM-1、Hcy、NT-proBNP、MMP-9均上升,重度神经损伤、大面积脑梗死组上升最明显(P<0.05);脑神经缺损程度、脑梗死体积与急性脑梗死炎症因子水平呈正相关。结论 急性脑梗死患者炎症因子水平高于正常人,其脑神经损伤程度、脑梗死体积与炎症水平呈正相关。     

同型半胱氨酸与2型糖尿病颈动脉斑块稳定性的关系

目的 探讨血浆同型半胱氨酸水平与2型糖尿病患者颈动脉斑块稳定性的关系。方法 选取2型糖尿病患者182例,根据颈动脉超声结果分为无斑块组、稳定斑块组、不稳定斑块组及血管狭窄组。观察4组患者的同型半胱氨酸、血糖、血脂、糖化血红蛋白及CRP等指标。结果 动脉狭窄组同型半胱氨酸水平明显高于另外3组(P<0.01),无斑块组同型半胱氨酸水平与不稳定斑块组及动脉狭窄组比较明显降低(P<0.01)。高同型半胱氨酸组脑卒中发生率明显高于低同型半胱氨酸组(P<0.05)。相关分析显示,糖尿病患者的血浆同型半胱氨酸水平与年龄呈正相关(r=0.15,P=0.040),与叶酸呈负相关(r=-0.32,P=0.001)。结论 2型糖尿病患者血同型半胱氨酸水平与颈动脉斑块稳定性及脑卒中发生密切相关。     

老年高血压糖尿病患者颈动脉粥样硬化与同型半胱氨酸水平的相关性分析

目的 分析老年高血压、糖尿病患者颈动脉粥样硬化与同型半胱氨酸（Hcy）水平的相关性。方法 选择2014年4月至2016年5月在合肥市滨湖医院就诊的老年高血压患者、糖尿病患者、高血压合并2型糖尿病患者各40例,设为高血压组、糖尿病组、高血压+糖尿病组,同期体检的40名老年健康人为对照组,分别检测4组受检人员的Hcy水平,同时通过彩色多普勒超声对患者颈动脉内中膜厚度（IMT）和动脉斑块进行检测。结果 对照组Hcy水平为（6.45±2.48）μmol/L,高血压组为（14.26±3.43）μmol/L,糖尿病组为（17.33±3.35）μmol/L,高血压+糖尿病组为（23.85±4.45）μmol/L;对照组颈动脉硬化检出率为37.50%,高血压组为75.00%,糖尿病组为77.50%,高血压+糖尿病组为95.00%。对照组Hcy水平及颈动脉硬化检出率显著低于高血压组、糖尿病组及高血压合并糖尿病组,差异有统计学意义（P<0.05）;高血压组、糖尿病组的Hcy水平及颈动脉硬化检出率低于高血压合并糖尿病组,差异有统计学意义（P<0.05）。老年高血压、糖尿病患者血清Hcy水平与颈动脉硬化呈正相关（r=0.561,P<0.05）。结论 老年高血压合并糖尿病患者血浆Hcy水平较老年高血压、老年糖尿病及老年健康人员明显增高,且与颈动脉硬化呈正相关。     

Hcy D-D UA水平联合检测在子痫前期诊断及重度子痫前期预测中的应用

目的 探讨同型半胱氨酸(Hcy)、D-二聚体(D-D)、尿酸(UA)血清水平联合检测在子痫前期(PE)诊断及重度PE预测中的应用价值。方法 回顾性分析2020年1月至2022年4月铜陵市妇幼保健院收治的229例孕妇的临床资料,参照《妇产科学》第八版中PE诊断标准将其分为PE组(n=148)与非PE组(n=81),根据PE病情严重程度将PE患者分为轻度PE组(n=85)与重度PE组(n=63)。记录并比较各组患者Hcy、D-D、UA水平,以《妇产科学》第八版中的PE、轻度PE、重度PE诊断标准为“金标准”绘制受试者工作特征(ROC)曲线,评价Hcy、D-D、UA水平联合检测在PE诊断及重度PE预测中的应用价值。结果 PE组孕妇收缩压、舒张压、平均动脉压、剖宫产史比例以及24 h尿蛋白均高于非PE组(P均<0.05)。PE组孕妇Hcy(12.85±1.4[JP2]3)μmol/L、D-D(2.39±0.42)μg/mL及UA(407.83±48.86)μmol/L均高于非PE组(9.51±1.14)μmol/L、(1.61±0.27)μg/mL、(321.43±41.67)μmol/L(P均<0.05)。Hcy+D-D+UA联合检测用于诊断PE的曲线下面积(AUC)为0.976,灵敏度为98.65%,特异度为97.53%,Hcy+D-D+UA联合检测PE诊断的效能优于Hcy、D-D、UA单独及任意两指标联合。重度PE组患者Hcy(13.98±1.52)μmol/L、D-D(2.12±0.35)μg/mL及UA(443.17±51.39)μmol/L均高于轻度PE组(12.01±1.37)μmol/L、(2.12±0.35)μg/mL、(381.64±46.98)μmol/L(P均<0.05)。PE患者Hcy水平分别与D-D、UA水平呈正相关(r=0.739、0.861,P均<0.05),D-D水平与UA水平呈正相关(r=0.708,P<0.05);而Hcy、D-D及UA水平分别与PE严重程度均呈正相关(r=0.654、0.813、0.776,P均<0.05)。Hcy+D-D+UA联合检测对重度PE预测的AUC为0.941,灵敏度为90.48%,特异度为95.29%,Hcy+D-D+UA联合检测较Hcy、D-D、UA单独及任意两指标联合用于重度PE预测的效能更优。结论 PE患者Hcy、D-D、UA水平均升高且相互呈正相关,而重度PE患者Hcy、D-D、UA水平均升高更为明显,Hcy+D-D+UA联合检测可提高PE诊断效能与重度PE预测效果,值得借鉴。     

肺功能及血清炎性因子与老年高血压合并冠状动脉疾病的关系

目的 探讨肺功能及血清炎性因子与老年高血压合并冠状动脉疾病的关系。方法 选择152例患高血压疾病的患者,根据是否合并冠状动脉疾病,将患者分为合并冠状动脉疾病组和非合并冠状动脉疾病组,合并冠状动脉疾病组84例,非合并冠状动脉疾病组68例。结果 对比两组的一般资料,发现高血压合并冠状动脉疾病组患者与非合并冠状动脉疾病组患者的年龄（75.23±7.49岁vs 71.42±8.21岁）、甘油三酯（1.59±0.41mmol/L vs 1.41±0.63mmol/L）、血肌酐（82.42±39.27μmol/L vs 70.39±25.76μmol/L）、血尿素氮（7.85±4.31mmol/L vs 6.12±2.49mmol/L）、IL-2（567.32pg/dl±191.53pg/dl vs 501.26±217.74）、IL-6（3.95±2.92pg/dl vs 3.04±2.61pg/dl）和CRP （1.75±1.84mg/dl vs 1.04±2.01mg/dl）相比较高,而FEV₁%（83.42%±24.57% vs 92.15%±19.38%）和FEV₁/FVC （62.91±13.65 vs 70.24±9.42）更低,差异均有统计学意义（P<0.05）;对差异有统计学意义的相关因素进行线性回归分析发现,FEV₁%（P=0.005）、FEV₁/FVC （P=0.003）、IL-2（P=0.012）和CRP （P=0.009）差异更明显,为高血压合并冠状动脉疾病的独立相关因素;对高血压患者的血清炎性因子IL-2、CRP与肺功能指标FEV₁%和FEV₁/FVC进行相关性分析发现,血清炎性因子IL-2与肺功能指标FEV₁%（r=-0.391,P=0.000）和FEV₁/FVC （r=-0.571,P=0.000）呈负相关,CRP也与肺功能指标FEV₁%（r=-0.437,P=0.000）和FEV₁/FVC （r=-0.559,P=0.000）呈负相关。结论 肺功能及血清炎性因子是老年高血压合并冠状动脉疾病的危险因素。     

系统性硬化病血脂和同型半胱氨酸水平异常的临床研究

目的 探讨系统性硬化病(SSc)患者血脂和同型半胱氨酸(Hcy)的变化及其与病情活动度的关系。 方法 对65例SSc患者和65名年龄、性别配对的健康体检者(对照组)的甘油三酯(TG)、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)、极低密度脂蛋白胆固醇(VLDL-C)、血清同型半胱氨酸(Hcy)、C反应蛋白(CRP)等的水平进行检测分析,并根据血脂情况把SSc患者分为高脂血症组和非高脂血症组,利用统计软件检验各组之间的差异,并进行相关分析。 结果 与对照组相比,SSc患者TG(P=0.000)、VLDL-C(P=0.000)升高,总胆固醇(P=0.025)、LDL-C(P=0.038)及HDL-C(P=0.000)下降。SSc患者高Hcy血症和高血脂率分别为69.23%和38.46%。血清Hcy水平与皮肤厚度总分值(r=0.759,P=0.006)和CRP(r=0.398,P=0.028)水平呈正相关,血清HDL-C水平与SSC疾病严重程度Valentini评分(r=-0.319,P=0.0413)和CRP(r=-0.270,P=0.045)呈负相关,而Hcy水平与TG、TC水平无明显相关性(P>0.05)。 结论 SSc 患者的血脂和Hcy的异常与疾病活动度有关,这有可能增加SSc患者发生心血管不良事件的风险。     

血清超敏C反应蛋白白介素6与冠状动脉病变程度的相关性

目的 探讨血清超敏C反应蛋白（hs-CRP）、白介素-6（IL-6）与冠状动脉病变严重程度的相关性。方法 选择2017年2月至2019年12月在昆明理工大学附属攀钢集团总医院住院并接受冠状动脉造影（CAG）检查的患者317例,根据CAG检查结果,将其分为正常组（n=81）与冠心病（CHD）组（n=236）。依据冠状动脉Gensini积分,将CHD组患者分为低危组132例（<20分）、中危组78例（20～40分）和高危组26例（>40分）。比较各组患者临床资料、血清hs-CRP和IL-6水平的差异。结果 CHD组患者年龄为（57.82±9.54）岁、高血压109例（46.19%）、糖尿病75例（31.78%）、低密度脂蛋白水平为（3.69±1.34）mmol/L、hs-CRP水平为（18.21±9.79）mg/L、IL-6水平为（25.70±12.62）pg/L,均高于正常组,差异有统计学意义（P<0.05）。低、中及高危组患者血清hs-CRP、IL-6水平进行比较,差异均有统计学意义（P<0.05）。高危组患者hs-CRP水平为（29.47±17.91）mg/L、IL-6水平为（35.31±8.69）pg/L,均高于低、中危组,差异有统计学意义（P<0.05）。血清hs-CRP、IL-6水平与冠状动脉Gensini积分呈正相关（P<0.05）。结论 血清hs-CRP和IL-6与冠状动脉病变程度具有一定的相关性。     

血浆同型半胱氨酸水平与慢性心力衰竭的相关性分析

目的 分析慢性心力衰竭（CHF）患者血浆同型半胱氨酸（Hcy）与脑钠肽（BNP）、心功能及心脏结构的相关性。方法 选取2013年9月至2016年7月滁州市第一人民医院心内科住院的71例CHF患者（慢性心衰组）和36例心功能正常的心脏病患者（对照组）为研究对象。慢性心衰组按照心功能诊断和分级标准（NYHA分级）分Ⅱ级（n=24）、Ⅲ级（n=31）、IV级（n=16）3个亚组。分别测量各组血浆Hcy、BNP水平、左室舒张末内径（LVEDD）和左室射血分数（LVEF）。分析各组血浆Hcy水平的差异及其与心脏功能和结构改变的相关性。结果 ①慢性心衰组血浆Hcy和BNP水平显著高于对照组,差异有统计学意义（P<0.05）。②随着心功能级别升高,Hcy、BNP水平升高,不同心功能级别组间比较,差异有统计学意义（P<0.05）。③慢性心衰组内,血浆Hcy水平与BNP和LVEDD呈正相关（r=0.394、0.449,P<0.05）,与LVEF呈负相关（r=-0.383,P<0.05）。结论 CHF患者血浆Hcy水平高于心脏病心功能正常者,且与BNP、LVEDD、LVEF密切相关,是影响心脏功能和结构的重要因素,可在一定程度上反映慢性心衰的严重程度。     

hs-CRP IL-6及PLR联合检测对维持性血液透析患者预后的预测价值

目的 探究超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)联合血小板与淋巴细胞比值(PLR)检测对维持性血液透析(MHD)患者预后的预测价值。方法 回顾性分析2018年6月至2020年5月宜兴市人民医院收治的82例MHD患者临床资料。按出院后1年是否生存分为死亡组(15例)和存活组(67例)。对比死亡组和存活组基线资料及临床资料,通过logistic多因素回归分析影响MHD患者生存的影响因素。绘制受试者工作特征(ROC)曲线,以曲线下面积(AUC)分析hs-CRP、IL-6联合PLR对MHD患者预后的预测效能。结果 死亡组营养不良占比、hs-CRP、IL-6、肿瘤坏死因子-α(TNF-α)及PLR均高于存活组,残肾滤过率低于存活组,差异均有统计学意义(P<0.05)。logistic回归分析显示,残肾滤过率、hs-CRP、IL-6及PLR均为影响MHD患者预后的危险因素(OR=2.863、3.108、2.754、3.330,P<0.05)。ROC曲线分析结果显示,hs-CRP、IL-6及PLR联合检测预测MHD患者预后的AUC为0.936,高于该3指标单独检测预测的AUC(Z=2.389,P=0.017;Z=2.540,P=0.011;Z=3.133,P=0.002)。结论 hs-CRP、IL-6联合PLR检测对MHD患者预后的评估效能较高,可作为临床评估该类患者预后的重要参考指标。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.