小儿支气管透X线异物放射诊断价值的探讨(附60例报告)

目的：探讨放射诊断对小儿支气管透X线异物的诊断价值。方法：回顾性分析近5年我院60例小儿支气管透X线异物的住院病例，年龄5岁以下，全部经X线透视及分别摄有呼、吸气相胸片，均经纤维支气管镜取出异物。结果：异物种类大多数为成形食物，少数为塑料制品；异物大部分位于右侧支气管，少部分位于左侧支气管；X线表现有：肺气肿、纵隔摆动、移位、横膈运动或位置异常、肺炎、肺不张等。结论：患支气管透X线异物的小儿，透视检查能够动态观察横膈运动及纵隔摆动移位．对判断异物存在与否及异物位置方面起重要作用。     

肺炎支原体肺感染的肺部影像学改变

目的探讨肺炎支原体（MP）肺感染的肺部影像学的变化规律。方法通过对肺炎支原体肺感染144例进行回顾性X线分析，总结小儿肺炎支原体肺感染的X线特征。结果肺炎支原体肺感染以间质炎症表现为主，144例中两肺问质炎症68例（47．2％），其次为肺实质炎症54例（37．5％）（X^2=6．43，P〈0．05）；左右两肺野病变比较，左肺占62例（43．1％），右肺占82例（56．9％）（X^2=5．55，P〈0．05）；上下肺野病变比较，两肺下叶70例（48．6％）较两肺上叶44例（30．6％）多见（X^2=9．32，P〈0．01）。结论肺炎支原体肺感染的肺部影像变化迅速。对完全阻塞性MP肺炎、肺不张者应常规拍侧位X线胸片及进一步行肺部CT检查，以明确有无局部压迫，也有助于具体确定肺段不张的位置。了解肺炎支原体肺感染的X线特征将为其早期诊断和治疗提供依据。     

不同分割剂量放疗联合唑来膦酸治疗骨转移癌的临床研究

目的探讨不同分割剂量放疗联合唑来膦酸治疗骨转移癌的疗效。方法将110例骨转移癌患者随机分为3组。3组均静脉点滴唑来膦酸4mg。A组40例采用低分割照射，DT30Gy／10次／3周；B组37例采用常规分割，DT40Gy／20次，4周；C组33例不照射。结果（1）治疗结束时疼痛缓解总有效率为A组90．0％，B组86．5％，C组66．7％（A组与C组X^2=6．03，P〈0．05，B组与C组X^2=3．80，P〈0．05；A组与B组X^2=0．02，P〉0．05）；（2）KPS评分变化为A组82．5％，B组70.3％，C组51．5％（A组与C组X^2=8．04，P〈0．05；B组与C组X^2=4.43，P〈0．05；A组与B组X^2=0．54，P〉0．05）；（3）骨转移灶修复情况A组84．3％，B组76．9％，C组57．7％（A组与C组X^2=10．69，P〈0．05；B组与C组X^2=4．94，P〈0．05；A组与B组X^=1．17，P〉0．05）。结论唑来膦酸联合放疗治疗骨转移癌疗效优于单纯唑来膦酸，但是低分割照射治疗周期短、费用低。     

海口垦区中小学生HBsAg携带及贫血调查

目的了解海口垦区中小学生乙肝及贫血状况，为防治提供科学依据。方法Hb：按《全国学生体质健康状况调查研究检测细则》，HBsAg检测用ELISA法。结果检测25479名学生，贫血学生5848人，平均贫血率22．95％，各年份学生贫血率在15．90％-31．80％之间，学生贫血率呈逐年下降趋势。差异有极显著性（X^2=499．91，P〈0．01），各年龄组之间贫血率差距有显著性（1996年X^2=8．88，P〈0．05；2000年X^2=174．69，P〈0．01），男女学生贫血率差异有显著性（1996年X^2=5．15，P〈0．05；2000年X^2=5．14，P〈0．05）。学生HBsAg携带2271人，平均携带率为8．91％，各年份学生HBsAg携带率为6．41％．11．50％之间，学生HBsAg携带率逐年下降。并亦有极显著性（X^2=118．78，P〈0．01），各年龄组之间HBsAg携带率亦有极显著性（1996年X^2=34．96，P〈0．01；2000年X^2=49．63，P〈0．01），男女学生HBsAg携带率为13岁组和16岁组差异有显著性（X^2=3．75，P〈0．05；X^2=4．50，P〈0．05），其他年龄组差异无显著性。结论海口垦区学生携带HBsAg和贫血现象仍是严重的，应加强监测，促进学生健康茁壮成长。     

结核性胸膜炎胸液体外凝固时间与胸膜肥厚及粘连形成的关系探讨

目的 探讨结核性渗出性胸膜炎胸液体外凝固时间与胸膜肥厚、粘连的关系。方法 216例初治单纯性渗出性胸膜炎患者按胸液体外凝固时间从短到长分为A、B、C3组，入院后第1次胸穿时测定胸液体外凝固时间和纤维蛋白原含量测定，在治疗15d时测量胸膜厚度，评估胸膜粘连情况。结果 组间胸液纤维蛋白原含量；A组与B组比较，t=2．10，P〈0．05；A组与c组比较，t=4．07，P〈0．01；B组与C组比较，t=2．08，P〈0.05。组间胸膜肥厚度：A组与B组比较．t=2．19，P〈0．05；A组与C组比较，t=2．96，P〈0．01；B组与C组比较，t=2.07，P〈0．05。组间胸膜粘连：A组与B组比较，X^2=1．09，P〉0．05；A组与c组比较，X^2=7．56，P〈0．01；B组与C组比较，X^2=4．27，P〈0．05。结论 胸液体外凝固时间与纤维蛋白原含量、胸膜肥厚度与胸膜粘连具有相关性。     

经食道超声和X线检查中的感染控制管理

目的分析经食道超声和X线检查的易感染因素,探讨预防感染的管理措施,以降低经食道超声检查的交叉感染。方法对比医院食道超声和X光室分区改进前后、医护人员洗手、消毒前后及食道超声探头正确消毒的细菌检测结果,制定出有效减少经食道超声和X线检查所致感染的措施。结果改进后检查室与消毒室内空气细菌检测合格率明显提高,与改进前相比差异有统计学意义（X^2=19．38,P〈0．05;X^2=26．70,P〈0．05）;改进后医护人员洗手后及键盘定期消毒后细菌检测合格率明显提高,与改进后相比差异有统计学意义（X^2=30．12,P〈0．05;X^2=42．57,P〈0．05）;食道超声探头经完全浸泡的细菌数明显下降,与部分浸泡相比差异有统计学意义（P〈0．05）。结论严格执行食道超声、X室分区、超声探头等地方的清洗消毒技术操作程序以及提高医护人员防控意识可以减少经食道超声使用过程中的医院感染。     

维汉族强直性脊柱炎患者HLA-B27抗原表达及与骨损害关系的临床研究

目的：探讨民族间HLA-B27表达与强直性脊柱炎患者骨代谢功能损伤的关系。方法：检测HLA-B27不同型别的强直性脊柱炎患者和对照群体骨代谢功能指标。结果：受检人群HLA-B27阳性检出率存在有民族差异（X^2=13．44，P〈0．01），汉族HIA-B27阳性检出率（44．15％）明显高于维吾尔族（27．17％）。0_和20_年龄段民族间存在有统计学差异（X2^2-段=10．61，P〈0．01；X20^2-段：7．46，P〈0．01），汉族HIA-B27阳性检出率明显高于维族，40_和60_年龄段民族间无统计学差异（X40^2-段=0．28，P〉0．05；X60^2-段：0．68，P〉0．05）。HLA-B27＋组AS确诊率明显高于HLA-B27-组（X^2强旋=44．34，P〈0．01；X^2汉族=25．91，P〈0．01）；无论HIA-B27阳性与否，维族AS确诊率均显著高与汉族（XB27^2＋=24，41，P〈0．01；XB^27-=6．21，P〈0．05）。在B27-对照组中，除CT外（t=2．99，P〈0，01），BGP和AKP均无统计学差异（t BGP=1．49，P〉0．05；r AKP=0．24，P〉0．05）；在B27＋对照组中，各项指标存在统计学差异（t CT=1．85，t AKP=0．96，t BGP=1．43，P〈0．05），均表现为维族高于汉族；在B27-AS组中，各项指标存在统计学差异（t CT=2．61，r AKP=3．91，t BGP=3．89，P〈0．01），维族CT和AKP水平低于汉族，而BGP明显高于汉族；在B27＋AS组中，各项指标存在统计学差异（r CT=4．14，P〈0．01；t AKP=2．42，P〈0．05；t BGP=2．71，P〈0，01），维吾尔族CT和BGP水平高于汉族，而AKP低于汉族。结论：民族间强直性脊柱炎患者HIA-B27抗原的表达存在不同程度的差异性，并与骨质损害具有一定的关联性，为临床深入研究提供了有益的线索。     

住院新生儿1237例疾病分析

目的了解本地区新生儿疾病谱及新生儿病死率的变化情况。方法分析两个时间段常见新生儿疾病的患病及死亡情况，并进行比较。结果两个时间段均以新生儿黄疸、新生儿肺炎、新生儿窒息、早产儿为多见，前后3年相比，新生儿窒息和新生儿肺炎呈减少趋势，差异有显著性（分别为X^2=6．45，P〈0．05；X^2=52．6，P〈0．01）；新生儿黄疸呈增多趋势（X^2=15．85，P〈0．01）；住院新生儿病死率亦明显下降（X^2=4．11，P〈0．05）。结论加强孕期及新生儿期保健，做好高危儿的管理，建立本地区NICU，对新生儿疾病防治至关重要。     

介入化疗加放疗治疗中晚期非小细胞肺癌的疗效分析

目的通过比较两种中晚期非小细胞癌治疗方法，寻找更佳治疗手段。方法中晚期非小细胞肺癌55例根据不同治疗方法分为两组，介入加放疗组28例，单纯介入组27例，对两组肿瘤治疗后大小改变及生存期进行对比。结果：介入加放疗组中晚期肺癌的总缓解率与单纯介入组（X^2=1．81 P〉0．05）相比无显著性差异，但完全缓解率介入加放疗组完全缓解率优于单纯介入组，（X^2=8．0 P〈0．05），介入加放疗组中1年生存率，2年生存率明显高于单纯介入组（X^2=11．4 P〈0．05，0=9．61 P〈0．05）结论：支气管动脉灌注加外放射是目前治疗中晚期肺癌的一种较有效的方法，可提高生存率。     

性病患者及性病高危人群解脲脲原体和人型支原体感染状况分析

目的 探讨泌尿生殖道支原体在STD患者及性病高危人群中的感染状况。方法 采用培养法对421例STD患者、84例性乱者和185例性病伴侣进行解脲脲原体（Uu）和人型支原体（Mh）的检测。结果 STD患者、性乱者和性病伴侣泌尿生殖道支原体感染率分别为42．28％、35．71％和40．0％．与健康人群（13．48％）比较，差异有显著性（X^2=56．61，19．44，38．16，P〈0．005）；前三者之间比较，差异无显著性（X^2=1．25，0．28，0．45，P〉0．05）。Uu感染率（15．22％）与Mh（5．22％）比较，前者明显高于后者（X^2=37．61，P〈0．005）。男性Uu和Mh感染率（分别为8．57％、2．08％）与女性（分别为23．61％、9．18％）比较，女性明显高于男性（X^2=29．82，17．36，P〈0．005）。Uu和Mh混合感染率（20．43％）明显高于Uu（15．22％）或Mh（5．22％）的单独感染（X^2=6．41，71．45，P值分别为P〈0．05，P〈0．005）。结论 Uu和Mh在STD患者、性乱者和性病伴侣中流行广、感染率高，在性病的防治和监测工作中应加以重视.     

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.