老年人慢性贫血72例分析

目的：了解老年人慢性贫血临床发病特点。方法：对72例老年人慢性贫血患者临床及骨髓学表现进行分析。结果：72例老年人慢性贫血其中继发性占84．7％，骨髓学主要表现为缺铁性贫血、巨幼细胞性贫血、双相性贫血及脾功能亢进。恶性血液病占11．1％，骨髓无明显异常占4．29％。结论：老年人慢性贫血多为继发性。     

老年人全血细胞减少的巨幼细胞性贫血23例临床分析

目的 探讨老年人全血细胞减少的巨幼细胞性贫血的临床特点。方法 分析23例老年人巨幼细胞性贫血住院患者的临床资料。结果 老年人全血细胞减少的巨幼细胞性贫血以男性为多见，男女比例为1．87：1，首发症状以头晕、乏力、纳差为主要表现。伴随其他疾病19例，占82．6％。骨髓有核细胞增生均在活跃以上。血清胆红素增高10例，占43．4％。血清乳酸脱氢酶升高21例，占91．2％。维生素B12减少者11例，占73．3％。检出伴有慢性消化道疾病者19例，占82．6％。用维生素B12和叶酸治疗效果显著。结论 老年人全血细胞减少的巨幼细胞性贫血常因非血液病就诊而易漏诊。临床上应与再生障碍性贫血及MDS相鉴别，以防误诊。同时，其发生与消化道疾病关系密切，应予以相关的检查和原发病的治疗。     

老年人巨幼细胞性贫血32例临床特点

目的 探讨老年人巨幼细胞性贫血的特点。方法 对32例老年人巨幼细胞性贫血住院患者进行临床分析，结果 老年人巨幼细胞性贫血男性多见，男女比例为1．46：1，头昏、乏力、纳差为主要症状。伴有其他疾病内科28例，占87．5％，以非血液病诊断入院的13例，占40．6％。外周全血细胞减少20例，占62．5％。骨髓有核细胞增生程度均在活跃以上，血清胆红素轻度增高16例，占50％，血清乳酸脱氢酶升高31例，占96．9％，检查伴有慢性消化道疾病者30例（其中慢性胃炎22例），占93．8％。结论 老年人巨幼细胞性贫血常因非血液病就诊而易于漏诊，其发生与存在的消化道疾病关系密切，治疗效果显著，治疗同时应治疗原发病和并发症。     

323例老年人血液病骨髓检查分析

目的 探讨老年人血液病患者骨髓涂片的血液学改变。方法 检查３２３例老年人血液病患者的骨髓涂片进行分析比较。结果 老年人血液病患者以贫血为主；依次为缺铁性贫血占１７．０３％；继发性贫血占１５．７９％，再生障碍性贫血占６．８１％，巨幼细胞性贫血占４．０２％。其次为白血病；依次为急性白血病占１２．３８％，慢性白血病占６．５０％。结论老年血液病患者中主要为缺铁性贫血；老年白血病患者中主要为急性白血病。     

老年人巨幼细胞性盆血20例临床分析

目的：探讨老年人巨幼细胞性贫血的临床特点。方法：对20例老年人巨幼细胞性贫血住院患者的资料进行分析。结果：老年人巨幼细胞性贫血，男性多见，男女比例1．8：1，多数为重度贫血，全血细胞减少者多见12例（60％）。伴有心、脑血管病等内科其他疾病15例（75％），以非血液病诊断入院的11例（55％），检出慢性消化道疾病者19例（95％），维生素B12减少者17例。用叶酸，维生素B12治疗效果显著。结论：老年人巨幼细胞性贫血的发生与存在的消化道疾病关系密切，且病情较重，进行相关检查可避免遗漏潜在的疾病。     

类风湿性关节炎患者贫血类型及其相关因素的研究

目的研究类风湿性关节炎患者贫血的主要类型，研究各种类型的贫血与患者年龄、性别、病程、病情活动度、血沉、C反应蛋白、类风湿因子、总蛋白、血清白蛋白、总胆固醇，以及药物等相关因素的关系。方法选择门诊连续就诊的明确诊断RA的患者，抽血化验，完善研究所需的各种相关检查，并进行统计学分析。用SPSS13．0统计软件包进行统计处理，计数资料用t检验，计量资料用χ^2检验。结果98例中有44例贫血，占患者总数的44．98％，其中慢性疾病性贫血21例（占总数21．42％），缺铁性贫血15例（占总数15．30％），巨幼细胞性贫血8例（占总数8．16％）；慢性疾病性贫血组的DAS、ERS、CRP值与无贫血组比较明显升高，分别为P〈0．05（P=0．046）、P〈0．01（P=0．00t），P〈0．05（P=0．016），均具有显著性差异；巨幼细胞性贫血患者的平均年龄为68．71岁，与无贫血患者（平均59．75岁）相比较年龄明显高于无贫血患者，两组比较P〈0．05（P=0．036），具有显著性差异；慢性疾病性贫血组、缺铁性贫血、巨幼细胞性贫血各组的白蛋白量与无贫血组比较均明显降低，P均〈0．05（P值分别为0．003、0．045、0．018），均具有显著性差异。结论①RA患者发生慢性贫血的发病率非常高，在本次研究中占总患者数的44．98％，其中频度依次是慢性疾病性贫血、缺铁性贫血、巨幼细胞性贫血。②慢性疾病性贫血的发生与RA患者的DAS、ERS、CRP相关，炎症反应明显、病情活动度高的RA患者极易于并发慢性疾病性贫血。③巨幼细胞性贫血的发生主要集中在服用甲氨蝶呤的老年女性患者身上，可能与老年女性患者对甲氨蝶呤的耐受性低下有关。@RA各类贫血患者血清白蛋白的水平均降低，因此RA患者的贫血的治疗和预防除了有效抑制慢性炎症和合理的药物以外，在饮食中     

城市老年人巨幼细胞贫血41例临床分析

目的:探讨城市老年人巨幼细胞贫血的临床特点。方法:对41例老年人巨幼细胞贫血患者的临床资料进行回顾性分析。结果:老年人巨幼细胞性贫血的发病原因主要为胃肠道疾病和膳食不合理;患者临床症状不典型;出现全血细胞减少21例(占51.2%)血清乳酸脱氢酶升高30例(占73.1%),总胆红素升高17例(占41.5%);误诊13例(误诊率31.7%)对叶酸、维生素B12治疗效果好。结论:老年人MA患者全血细胞减少发生率高,临床易出现漏诊和误诊。治疗同时应注意原发病和并发症的治疗。     

老年人巨幼细胞性贫血52例临床分析

目的:探讨老年人巨幼细胞性贫血的临床特点.方法:对52例老年人巨幼细胞性贫血住院患者的临床资料进行回顾分析.结果:①老年人巨幼细胞性贫血伴有其他内科疾病多,其中伴有慢性消化道疾病者48例,占92.3%,伴有心、脑血管疾病44例,占84.6%;31例患者外周血出现不同程度的全血细胞减少,占59.6%;②易误诊,24例(46.2%)患者就诊时误诊为心、脑血管等疾病;确诊后用叶酸、维生素B12治疗效果显著.结论:老年人巨幼细胞性贫血比较常见,全血细胞减少发生率高,其发生与慢性消化道疾病关系密切,易被误诊为心脑血管疾病,但正确诊治效果较好.     

老年人巨幼细胞性贫血18例分析

巨幼细胞性贫血是老年人贫血的常见原因之一，临床表现多样化，容易误诊。收集我院近３年收治的巨幼细胞性贫血３６例，其中６０岁以上者１８例，现就其临床资料与同期６０岁以下患者１８例对比分析，以探讨老年人巨幼细胞性贫血的特点。１临床资料１．１一般资料老年组男...     

老年人巨幼细胞性贫血31例分析

①目的探讨及时正确诊断老年人巨幼细胞性贫血(巨幼贫)的有效方法。②方法对31例已经确诊为巨幼细胞贫血的老年患者的临床资料进行回顾性分析。③结果老年人巨幼细胞贫血主要为消化系统疾病或偏食引起,诊断主要依靠骨髓象检查。④结论消化系统病变及膳食异常是引起老年人巨幼细胞贫血的主要原因,巨幼细胞贫血诊断后治疗效果显著,且疗效好。     

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.