高血压患者血管内皮依赖性舒张功能失调的无创性检测

２无创性高分辨超声技术，检测３１例原发性高血压患者和３０例正常人休息时、反应性充血及含服硝酸甘油后肱动脉内径的变化。结果显示、原发性高血压肱动脉血管内皮依赖性舒张较正常组明显减弱，二者对硝酸甘油的反应差异地无显著性，提示原发性高血压患者存在血管内皮依赖性较好功能障碍。     

高血压患者内皮依赖血管舒张功能的研究

目的研究高血压（ＥＨ）患者内皮依赖血管舒张功能的变化及意义。方法应用Ｃｅｌｅｒｍａｊｅｒ方法观察肱动脉对增加流量（引致内皮依赖血管舒张）、含服硝酸甘油（引致非内皮依赖血管舒张）的反应性。结果对照组增加流量介导血管舒张（ＦＭＤ）与静息时血管内径（ＢＤ）呈负相关（ｒ＝－０．５７７，Ｐ＜０．０１）。ＥＨ患者ＦＭＤ较对照组显著减低（Ｐ＜０．０１），经协方差分析矫正ＢＤ的影响，ＥＨ患者ＦＭＤ仍低于对照组（Ｐ＜０．００１）。而硝酸甘油介导血管舒张（ＮＣＤ）两组间无明显差异（Ｐ＞０．０５）。　结论ＥＨ患者内皮依赖血管舒张功能减弱，可能与ＥＨ患者肱动脉内皮衍化舒张因子／一氧化氮（ＥＤＲＦ／ＮＯ）的贮备能力下降有关。     

糖尿病合并高血压对血管舒张功能的损害作用

目的：评价血管平滑肌功能（硝酸甘油引起的血管舒张）不全与内皮功能不全的联系，并同时探讨糖尿病与高血压对内皮功能的损害是否具有协同作用。方法：用高分辨率超声波仪测定肱动脉对硝酸甘油（ＴＮＧ）的扩张反应及血流介导的皮内依赖性血管舒张（ＥＤＤ）。结果：平滑肌功能受损与ＥＤＤ受损呈正相关（ｒ＝０．５４１３，Ｐ〈０．０１）；单纯糖尿病或高血压仅ＥＤＤ较对照组降低（分别Ｐ〈０．０５和Ｐ〈０．０１），糖尿病合并     

老年高血压病合并脑梗死血管内皮依赖性舒张功能的无创评价

目的了解老年高血压病合并脑梗死患者血管内皮依赖性舒张功能。方法对68例高血压病合并脑梗死老年患者（高血压病组）及46例无高血压病、糖尿病和心脑血管疾病的老年患者（对照组）进行血管内皮依赖性舒张功能无创检查，测定两组患者血管内皮依赖性舒张功能并进行对照分析。结果老年高血压病合并脑梗死患者反应性充血诱发的肱动脉内径百分变化率明显低于对照组（P〈0．01），硝酸甘油诱发的肱动脉内径百分变化率与对照组无明显差异（P〉O．05）。结论老年高血压病合并脑梗死患者存在严重血管内皮依赖性舒张功能障碍，超声检查对评价血管内皮依赖性舒张功能有重要价值。     

超声评价不同危险分层原发性高血压的肱动脉内皮依赖性舒张功能

目的比较不同危险分层原发性高血压的肱动脉内皮依赖性舒张功能。方法60例原发性高血压患者按危险因素进行分层（低危组14例,中危组10例,高危组16例,极高危组20例）,应用高分辨率超声测量其肱动脉内皮依赖性舒张功能,并作比较分析。结果低危组、中危组肱动脉内皮依赖性舒张功能与正常对照组比较差异无统计学意义（P〉0.05）,与高危组、极高危组比较差异有统计学意义（P〈0.01）。结论原发性高血压患者肱动脉内皮的依赖性舒张功能与危险分层有关。提示高血压高危、极高危组人群可常规进行肱动脉内皮依赖性舒张功能检测,预防和减少心血管临床事件的发生。     

伊贝沙坦对原发性高血压患者血管内皮功能的影响

目的 研究国产新型血管紧张素Ⅱ受体拮抗剂伊贝沙坦对原发性高血压患者血管内皮功能的影响。方法 应用2-D多普勒超声心动图观察30例原发性高血压患者口服伊贝沙坦(每日150-300mg)治疗16周前后内皮依赖性舒血管功能的变化。结果 肱动脉加压前后(流量介导的血管舒张，反映内皮依赖性舒血管功能)的血管内径变化百分比在治疗后明显增加；而含服硝酸甘油前后(硝酸甘油介导的血管舒张，反映非内皮依赖性舒血管功能)肱动脉内径变化百分比在治疗后无明显变化。结论 伊贝沙坦可以改善内皮依赖性舒血管功能。     

高血压合并高脂血症患者血管内皮依赖性舒张功能的损害

目的：探讨高血压合并高脂血症患者血管内皮依赖性舒张功能的变化。方法：采用无创伤性高分辨超声技术检测单纯高血压（n=14),高血压合并高胆固醇组（n=24),和健康人（n=20)休息时,反应性充血,舌下含服硝酸甘油（GTN）后肱动脉内径变化,结果：发现单纯高血压组和高血压合并高胆固醇组肱动脉血流介导性扩百分比明显低于正常组（P＜0．05）,尤以合并高胆固醇组患者下降璨明显,高血压组之间的差异亦有显著性（P＜0．05）,舌下含服GTN后肱动脉内径变化在单纯高血压组与正常对照组相比无显著性差异（P＞0．05）,但高血压合并,高胆固醇组与正常对照组相比有显著性显著（P＜0．05）,结论：原发性高血压存在血管内皮依赖性舒张功能失调,合并高胆固醇血症者尤为明显,提示高胆固醇血症可加重血管内皮依赖性舒张功能的损害。     

超声测定肱动脉管径变化率对原发性高血压患者外周血管内皮功能障碍的评价

目的:探讨高频超声检测原发性高血压患者肱动脉血管内皮依赖性舒张功能的临床应用及意义。方法:选取45例原发性高血压病患者与20例正常人,采用高频超声研究受检者的肱动脉反应性充血后内径变化率来评价血管内皮依赖性舒张功能。结果:与正常组相比,原发性高血压组肱动脉反应性充血后内径变化率显著减小(P<0.01)。结论:应用高频超声能够准确、简便、有效地评价动脉血管内皮依赖性舒张功能。     

颈动脉粥样硬化患者血管内皮功能的超声检测

目的 探讨颈动脉粥样硬化患者的血管内皮功能。方法 采用彩色多普勒超声对32例颈动脉粥样硬化患者和30名正常对照者肱动脉进行检测，观察反应性充血后和服用硝酸甘油后肱动脉内径的变化，并测定血脂水平。结果 加压释放后颈动脉粥样硬化组肱动脉内径变化率显著低于对照组，含服硝酸甘油后肱动脉内径变化率也明显低于对照组，差异均有统计学意义（分别P〈0．01和P〈0．05）。血管内皮功能与总胆固醇（TC）、低密度脂蛋白（LDL-C）水平均成负相关关系（均P〈0．01），与高密度脂蛋白（HDL-C）成正相关关系（P〈0．05）。结论 颈动脉粥样硬化患者既有血管内皮依赖性舒张功能障碍，又有血管非内皮依赖性舒张功能受损，超声是评价血管内皮功能简便可靠的方法。     

血管内皮依赖性舒张功能的无创性检测

采用高分辨超声测定２２名健康人休息时、反应性充血时和含服硝酸甘油（ＧＴＮ）后的肱动脉内径变化。结果表明：在反应性充血试验和含服ＧＴＮ后肱动脉明显扩张，与基础值比较分别增加１３．８±３．９％和２４．９±９．７％（Ｐ＜０．０１）。提示在正常人中血流增加可引起肱动脉内皮依赖性舒张，而含服ＧＴＮ后引起肱动脉非内皮依赖性舒张。介绍了无创性血管内皮依赖性舒张功能的测定方法，并证实该方法简便易行、可靠实用。     

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.