老年腹部手术患者肺部感染的围手术期危险因素分析及护理对策

目的 探讨老年患者腹部手术后肺部感染的围手术期危险因素及护理对策.方法 收集行腹部手术的107例患者为研究对象,根据患者术后至出院期间是否发生肺部感染分为感染组(19例)和对照组(88例).对可能影响患者术后发生肺部感染的围手术期危险因素进行单因素和多因素Logistic回归分析.结果 107例患者中,发生肺部感染的患者19例(17.76％),未发生肺部感染的患者88例(82.24％).单因素分析提示:感染组患者麻醉时间、手术时间、术中补液量、术中失血量、术后留置鼻胃管时间和上腹部手术比例均大于对照组,差异有统计学意义(P＜0.05).组间急诊手术、术中气管置管、术后静脉置管分布无差异(P＞0.05).多因素Logistic回归分析提示:上腹部手术(OR=5.26,95％CI:1.18～23.48)、手术时间长(OR=10.259,95％CI:2.56～41.04)和置胃管时间长(OR=4.00,95％CI:1.68～9.49)是影响老年腹部肿瘤手术术后肺部感染的独立危险因素;并且均会增加术后肺部感染的风险(P＜0.05).结论 上腹部手术、手术时间长和置胃管时间长可能增加老年腹部手术患者术后肺部感染的风险;采用综合护理措施可降低术后发生肺部感染的风险.     

重症患者导管相关性尿路感染的影响因素及差异性分析

目的 探讨重症患者导管相关性尿路感染(catheter-associated urinary tract infections,CAUTI)的影响因素及差异性.方法 采用自行设计的经过信度和效度检验的留置尿管评估观察表,前瞻性监测某院13个病区留置尿管的重症住院患者654例,包括本科室置管和带管入院2组患者CAUTI 的影响因素并分析其差异性.结果 本科室置管的重症患者417例,发生CAUTI 56例,CAUTI影响因素的多因素分析结果显示:女性,OR=5.937,95％ CI(1.474 ～ 23.909);ICU置管,OR=60.499,95％ CI (1.455～2515.992);置管前未预先连接尿管与集尿袋,OR =5.585,95％CI(1.278～24.411);置管时手触摸尿管前端,OR =9.802,95％CI(2.413 ～39.816);尿管留置时间≥7 d,OR=47.652,95％ CI(9.733～233.297);尿管留置时间≥14 d,OR=334.843,95％CI(56.700～1977.434);乳胶尿管,OR=0.158,95％CI(0.037 ～0.671).带管入院237例,发生CAUTI 38例,Logistic回归分析结果显示:尿管留置时间≥7 d,OR=7.277,95％ CI(2.004～26.420);尿管留置时间≥14 d,OR=57.492,95％ CI(16.549～199.728);置管后未更换引流袋,OR=3.429,95％CI(1.245～9.443);乳胶尿管,OR=0.323,95％ CI (0.123 ～0.846).2组重症患者CAUTI影响因素差异性分析结果显示:心血管疾病、慢性呼吸道疾病、三腔尿管、更换引流袋及普通引流袋对本科室置管组重症患者CAUTI的影响稍大于带管入院组,而尿管留置时间及乳胶尿管对本科室置管组重症患者CAUTI的影响稍小于带管入院组,2组差异有统计学意义(P＜0.05).结论 女性、ICU置管、置管前未预先连接尿管与集尿袋、置管时手触摸尿管前端及尿管留置时间是本科室置管重症患者CAUTI的危险因素,乳胶尿管则是保护因素;尿管留置时间和置管后未更换引流袋是带管入院重症患者CAUTI的危险因素,乳胶尿管也是保护因素.针对相关因素进行预防性干预和规范护理,对降低CAUTI发生率具有重要意义.     

重症监护室患者中心静脉导管相关性血流感染现状及危险因素meta分析

  目的  分析ICU患者导管相关性感染的危险因素。  方法  检索PubMed、Web of Science、Cochrane Library、CNKI、万方、CBM、EBSCO等数据库中有关ICU患者中心静脉导管相关性血流感染独立危险因素的相关文章,合并结局指标并使用RevMan 5.3软件进行meta分析。  结果  纳入13篇文献,共12 283例患者,出现感染的人数为773例,感染发生率为6.29%。危险因素共9项,包括导管留置时间≥7 d(OR=5.30,95% CI:3.39~8.27)、合并糖尿病(OR=21.15,95% CI:11.45~39.08)、置管前使用抗生素(OR=6.63,95% CI:5.12~8.58)、高龄(OR=3.01,95% CI:2.74~3.31)、穿刺次数＞2次(OR=60.10,95% CI:30.63~117.94)、APACHEⅡ评分较高(OR=16.07,95% CI:8.97~28.77)、股静脉置管(OR=12.41,95% CI:3.82~40.30)、男性(OR=7.93,95% CI:3.69~17.04)、经历过急诊手术(OR=8.12,95% CI:3.43~19.19), 均P＜0.05。  结论  导管留置时间≥7 d、患者合并糖尿病、置管前使用抗生素、患者年龄＞55岁、置管次数＞2次、APACHEⅡ评分较高、选择股静脉为留置部位、男性、经历过急诊手术是ICU患者发生中心导管相关性血流感染的主要危险因素。临床上应重视高危人群和相关危险因素,采取有效的干预措施,减少中心静脉导管相关性血流感染的发生。      

重症监护病房行连续性肾脏替代疗法治疗患者医院感染的危险因素及预防措施

目的 分析重症监护病房行连续性肾脏替代疗法治疗患者医院感染的危险因素,据此制定相关预防措施.方法 回顾性调查分析我ICU 2011年1月至2013年12月行连续性肾脏替代疗法治疗的96例患者的临床资料,记录患者的性别、年龄、侵入性操作情况、静脉置管时间及住院时间.分析影响因素,并计算出相对风险比（OR）和95％的可信区间（CI）.结果 96例中发生医院感染18例,感染率为18.75％;年龄、侵入性操作情况及静脉置管时间是重症监护病房行连续性肾脏替代疗法医院感染的主要因素（P＜0.05）.结论 年龄、侵入性操作及静脉置管时间是重症监护病房行连续性肾脏替代疗法医院感染的主要因素,应根据引发原因制定相对应的预防措施,以降低医院感染率的发生.     

经皮穿刺环甲膜置管在上呼吸道阻塞的应用及气管狭窄危险因素分析

目的 探究经皮穿刺环甲膜置管在上呼吸道阻塞的临床应用,分析气管狭窄的危险因素.方法 回顾2006-05/2018-05月在作者医院急诊科抢救的227例上呼吸道阻塞患者的临床资料,以采用经皮穿刺环甲膜置管进行通气的121例患者为观察组,以经皮气管插管/气管切开通气的106例患者为对照组.比较两组患者各临床指标和术后并发症,并统计术后发生气管狭窄人数,分别采用单因素分析和多元Logistic回归分析气管狭窄的危险因素.结果 所有患者均抢救成功,观察组一次成功率100％,显著高于对照组的90.56％(P=0.002);完成操作时间、建立人工气道时间显著短于对照组(P<0.05);出血、感染、喉水肿、声音嘶哑、气管损伤等并发症发生率显著低于对照组(P<0.05).单因素和多元Logistic回归分析表明:插管型号≥8 mmID(OR=2.472,95％CI:1.279～4.776)、反复呼吸道感染(OR=2.147,95％CI:1.209～3.812)、插管时间>7天(OR=2.054,95％CI:1.112～3.794)、经口气管插管/气管切开(OR=3.248,95％CI:2.086～5.058)、糖尿病(OR=2.138,95％CI:1.181～3.872)为影响上呼吸道阻塞患者发生气管狭窄的独立危险因素,环甲膜穿刺置管是保护因素(P<0.05).结论 环甲膜穿刺置管能迅速建立人工气道,改善呼吸功能,满足保留气管需求,操作简单、耗时少,并发症低,是气管狭窄的保护因素.     

高血压脑出血患者微创钻孔引流术后肺部感染危险因素分析

目的:分析高血压脑出血患者微创钻孔引流术后肺部感染危险因素分析,为术后肺部感染的防治提供理论依据.方法:选取2014年9月至2016年9月130例高血压脑出血患者,所有患者均按标准微创钻孔引流术治疗,参照《医院感染诊断标准(试行)》进行肺部感染诊断.将所有患者分为感染组与非感染组,分别调查两组患者年龄、性别、住院情况以及合并疾病情况,并记录各患者用药情况,采用单因素分析分析肺部感染的危险因素,然后采用logistic回归线分析进行多因素分析,探究其独立危险因素.结果:130例行微创钻孔引流术高血压脑出血患者中出现肺部感染40例,感染率为30.77％;其中年龄、神志清醒程度、合并糖尿病、肺部疾病、留置胃管、使用糖皮质激素、使用抗菌药物、H2受体阻滞剂、住院时间、引流管污染、脑脊液漏等均为肺部感染的危险因素,有统计学意义(P<0.05);影响脑出血患者微创钻孔引流术后肺部感染独立危险因素有昏迷(OR=3.343,95％CI为2.342～8.546)、鼻饲胃管(OR=4.417,95％CI为2.436～10.432)、应用抗菌药物(OR=5.765,95％CI为1.653～11.825)、使用H2受体阻滞剂(OR=4.421,95％CI为1.165～8.784)、住院时间(OR=5.324,95％CI为2.335～9.786)、合并糖尿病OR=3.342,95％CI为2.212～9.876).结论:高血压脑出血患者微创钻孔引流术后肺部感染危险因素众多,临床上需要根据患者自身情况,结合相关危险因素调查结果进行感染预防.     

PICC与VPA在肿瘤化疗患者中应用效果的系统评价

目的 系统评价植入式静脉输液港(VPA)与经外周静脉穿刺中心静脉置管(PICC)在恶性肿瘤患者化疗中的应用效果.方法 收集2008年10月至2016年12月在中国学术期刊全文数据库(CNKI)、万方数据库和Pubmed数据库发表的研究资料.根据纳入标准筛选相关研究,采用Revman Manager 5.3软件进行Meta分析.结果 最终纳入63篇文献进行Meta分析,共计病例11 296例.其中30篇文献调查了VPA与PICC一次性置管成功率的情况,合并效应显示差异无统计学意义(OR=0.96,95％CI:0.75～1.23,P＞0.05).16篇文献分析结果显示采用VAP的患者导管留置时间大于或等于1年的比例要高于采用PICC的患者(OR=27.17,95％CI:18.08～40.83,P＜0.05).采用VAP患者的并发症发生率低于采用PICC的患者(OR=0.19,95％CI:0.16～0.22,P＜0.01).11篇文献调查了VPA与PICC的生活质量,VAP组患者生活质明显高于PICC组(OR=8.53,95％CI:5.88～12.38,P＜0.05).结论 在恶性肿瘤患者的化疗中VPA留置时间更长,并发症发生率更低,患者生活质量更高.     

ICU创伤后感染患者并发脓毒症的危险因素分析

目的 分析重症监护病房(intensive care unit,ICU)创伤后感染患者并发脓毒症的危险因素.方法 收集2012-2015年重庆市某三级甲等教学医院综合ICU因创伤入院且发生感染的患者227例,其中男性174例,女性53例.根据患者是否并发脓毒症将其分为脓毒症组(n=168)和非脓毒症组(n=59),记录两组患者的一般资料、损伤情况、感染情况、病理生理特征等,采用SPSS 17.0统计软件分析可能导致脓毒症的相关因素.结果 创伤后感染患者脓毒症发生率为74.01％.与非脓毒症组比较,脓毒症组患者入ICU后24 h内液入量、中心置管、有创机械通气、有创机械通气持续时间、输血、血液感染、外伤创面或外科手术部位感染等较多,入院时序贯性器官功能衰竭评分(sequential organ failure score,SOFA)、损伤严重度评分(injury severity score,ISS)、新损伤严重度评分(new injury severity score,NISS)等较高(P＜0.05).经Logistic单因素和多因素逐步回归分析筛选出7个危险因素:入院时SOFA较大(OR =2.64,95％CI:1.27～5.46,P=0.009)、入ICU时功能障碍系统的个数增加(OR=2.10,95％ CI:1.35 ～ 3.27,P=0.001)、入ICU 24 h内血pH值异常(OR =3.16,95％ CI:1.43 ～ 6.99,P=0.005)、入ICU 24 h内脉压差平均值增大(OR=1.52,95％ CI:1.09 ～2.11,P=0.014)、存在葡萄球菌属感染(OR =4.32,95％CI:1.54 ～ 12.07,P=0.005)、存在外伤创面或外科手术部位感染(OR=3.73,95％CI:1.12 ～ 12.46,P=0.032)、有创机械通气持续时间增加(OR=1.94,95％CI:1.36 ～2.77,P＜0.01).结论 严密监测创伤患者入ICU 24 h内pH值及脉压差变化,预防创面及外科手术部位感染,避免葡萄球菌属感染,减少有创机械通气持续时间等,有望降低其脓毒症发生率及致死率.     

ICU中心静脉置管感染因素分析及护理对策

目的分析ICU中心静脉置管相关性感染危险因素,采取有效护理预防对策。方法采用目标性监测方法,对2008年1月—2009年12月我院ICU中心静脉置管患者导管相关性感染情况进行监测,分析常见致病菌及感染危险因素。结果共监测符合条件的ICU住院患者381例,发生导管相关性感染26例,34例次,患病率为6.82%.经单因素分析,导管相关性感染的危险因素与患者置管时间、病情严重程度、插管时机相关。结论严格中心静脉置管护理,提高患者机体免疫力,缩短置管时间,加强护士手卫生的管理和穿刺部位消毒,对控制中心静脉置管相关性感染至关重要。     

Meta-analysis of risk factors in recurrence of hepatocellular carcinoma after operation

目的:探讨影响肝细胞性肝癌(HCC)复发的危险因素,为预测和预防HCC的复发提供依据.方法:通过相关检索策略查找已经发表的针对我国HCC复发危险因素的相关文献,整理并制作成数据库进行Meta分析.结果:HCC患者术后1年复发率为38.7％、2年复发率为57.9％.各因素与HCC术后复发关系的Meta分析结果分别为:乙肝病毒感染(OR=1.53,95％CI:1.12～2.10)、肿瘤直径(＞5 cm)(OR=2.39,95％CI:1.64～3.49)、肿瘤数目(≥2个)(OR=3.57,95％CI:2.15～5.93)、肿瘤包膜不完整(OR=2.61,95％CI:1.17～5.80)、血管侵犯(OR=4.03,95％CI:1.92～8.43)、TNM 3～4期(OR=4.88,95％CI:1.36～17.57).结论:乙肝病毒感染、肿瘤直径、肿瘤数目、肿瘤包膜、血管侵犯、TNM分期均与HCC术后复发相关.可能是引起HCC复发的危险因素.     

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.