替格瑞洛对大鼠脑组织缺血再灌注损伤程度的影响及分子机制探究

目的:研究替格瑞洛对大鼠脑组织缺血再灌注损伤程度的影响及分子机制。方法:选择SD大鼠作为实验动物并分为对照组、模型组、替格瑞洛组、氯吡格雷组,制作脑组织缺血再灌注损伤模型后,替格瑞洛组给予150mg/kg的替格瑞洛灌胃,氯吡格雷组给予90mg/kg的氯吡格雷灌胃。干预后1周时,测定脑组织含水量及氧化应激分子、炎症因子的含量。结果:模型组大鼠的脑组织含水量以及脑组织中MDA、Ox-LDL、NF-kB、TNF-α、IL-1β、IL-6的含量以及血清中TNF-α、IL-1β、IL-6的含量显著高于对照组,脑组织中SOD、GSH-Px、Prdx6的含量则较对照组降低;替格瑞洛组、氯吡格雷组大鼠的脑组织含水量以及脑组织中MDA、Ox-LDL、NF-kB、TNF-α、IL-1β、IL-6的含量以及血清中TNF-α、IL-1β、IL-6的含量显著低于模型组,脑组织中SOD、GSH-Px、Prdx6的含量显著高于模型组;替格瑞洛组大鼠的脑组织含水量以及脑组织中MDA、Ox-LDL、NF-kB、TNF-α、IL-1β、IL-6的含量以及血清中TNF-α、IL-1β、IL-6的含量显著低于氯吡格雷组,脑组织中SOD、GSH-Px、Prdx6的含量显著高于氯吡格雷组。结论:替格瑞洛能够较氯吡格雷更为有效抑制氧化应激反应和炎症反应并减轻脑组织缺血再灌注损伤。     

氯吡格雷联合阿司匹林对大鼠胃黏膜的影响及TNF-α、VEGF表达研究

目的探讨氯吡格雷及氯吡格雷联合阿司匹林对实验大鼠胃黏膜的影响及可能机制。方法雄性SD大鼠随机分为4组,每组48只,分别予氯吡格雷、阿司匹林、氯吡格雷联合阿司匹林和生理盐水灌胃。给药前及给药后3、7、14、21和28 d处死大鼠,取胃观察。Guth法测定溃疡指数;免疫组织化学法测定胃黏膜TNF-α、VEGF表达。结果氯吡格雷灌胃后大鼠胃黏膜损伤指数与对照组及用药前相比存在差异(P<0.05)。氯吡格雷联合阿司匹林灌胃后大鼠胃黏膜损伤指数与对照组及用药前相比,损伤存在差异(P<0.01),与阿司匹林组及氯吡格雷组亦有差异(P<0.01)。TNF-α定量结果显示,各实验组用药后不同时间点与对照组或用药前比较,呈高水平表达,差异有统计学意义(P<0.05)。氯吡格雷组TNF-α表达与损伤指数呈正相关(P<0.01)。VEGF定量结果显示,各实验组用药后不同时间点与对照组或用药前比较,VEGF表达差异有统计学意义(P<0.05)。结论常规剂量氯吡格雷可导致大鼠胃黏膜损害,胃黏膜VEGF表达减少,TNF-α表达增强。氯吡格雷联合阿司匹林对大鼠胃黏膜的损伤较单用氯吡格雷或阿司匹林明显加重。     

替格瑞洛对经PCI治疗急性非ST段抬高型心肌梗死患者炎性因子和不良心脏事件的影响研究

目的:探讨替格瑞洛对经皮冠状动脉介入(PCI)治疗急性非ST段抬高型心肌梗死(NSTEMI)患者炎性因子和不良心脏事件(MACE)的影响。方法:采用随机数表法将200例NSTEMI患者分为氯吡格雷组和替格瑞洛组,每组各100例。两组均给予NSTEMI常规标准治疗,氯吡格雷组PCI术前口服阿司匹林300 mg和氯吡格雷300 mg负荷量,术后口服阿司匹林100 mg/d和氯吡格雷75 mg/d;替格瑞洛组PCI术前口服阿司匹林300 mg和替格瑞洛180 mg,术后口服阿司匹林100 mg/d和替格瑞洛90 mg(2次/d)。检测两组PCI术前后C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平变化;结合术后3个月随访观察两组MACE发生情况。结果:术后7 d、30 d,两组患者PCI血清CRP、TNF-α、IL-6水平与术后1 d比较均有明显下降(P<0.01),替格瑞洛组PCI术后1 d、7 d、30 d血清CRP、TNF-α、IL-6水平显著低于氯吡格雷组,差异有统计学意义(均P<0.01);PCI术后均成功随访3个月,替格瑞洛组MACE发生率(10.00%)低于氯吡格雷组(21.00%),差异有统计学意义(χ~2=4.619,P<0.05)。结论:替格瑞洛能有效降低NSTEMI患者PCI术后炎性因子浓度,减少MACE发生,效果优于氯吡格雷。     

负荷量氯吡格雷对脓毒症血小板聚集和急性肺损伤影响的实验研究

目的：观察负荷量氯吡格雷对脂多糖诱导的脓毒症大鼠血小板聚集和肺组织炎症损伤的影响。方法36只雄性Wistar大鼠随机分为对照组、脓毒症组、氯吡格雷组,每组12只。对照组大鼠腹腔注射生理盐水10 mg/kg;脓毒症组大鼠予腹腔注射脂多糖建立脓毒症/急性肺损伤（ALI）模型;氯吡格雷组大鼠在腹腔注射脂多糖后立即给予氯吡格雷800 mg/kg灌胃,建模后3 h,取血测量动脉血氧分压（PaO2）,计算氧合指数（PaO2/FiO2）,运用全血电阻法测定血小板聚集率,用酶联免疫分析法测量血及肺组织中肿瘤坏死因子-α（ TNF-α）浓度,取肺组织HE染色观察肺组织病理,并计算肺湿/干重比值（ W/D比值）。结果脓毒症组、氯吡格雷组PaO2、PaO2/FiO2均低于对照组（P＜0．05）;但氯吡格雷组PaO2、PaO2/FiO2均明显高于脓毒症组（P＜0．05）。脓毒症组、氯吡格雷组大鼠肺湿/干重比值、血清及肺组织TNF-α均高于对照组（P均＜0．05）,但氯吡格雷组上述指标均明显低于脓毒症组（P均＜0．05）。氯吡格雷组血小板聚集率明显低于另外两组（P＜0．05）。脓毒症组大鼠肺组织可见明显炎症损伤,氯吡格雷组肺组织炎性损伤程度明显减少。结论负荷量氯吡格雷可迅速抑制脓毒症大鼠急性肺损伤血小板的活化和聚集,并减轻肺组织炎症损伤。     

阿司匹林通过调节CTRP6抑制糖尿病大鼠心肌纤维化和炎症反应

目的探究阿司匹林对糖尿病大鼠心肌纤维化和炎症反应的影响及其分子作用机制。方法选取SPF级,雄性,SD大鼠,随机分为三组:对照组(Control组)、糖尿病组(DM组)和阿司匹林药物干预组(Aspirin组)。Control组:腹腔注射生理盐水; DM组:腹腔注射链脲佐菌素(streptozotocin,STZ)(60 mg/kg)构造糖尿病大鼠模型;Aspirin组:先腹腔注射STZ 60 mg/kg,再以1 mg/(kg·d)阿司匹林大鼠灌胃处理。10周后超声心动图检测大鼠心脏结构与功能变化; Masson染色观察大鼠心肌纤维化状况; ELSIA检测心肌炎症因子(IL-β、IL-6、TNF-α)含量; RTPCR和Western blot检测心肌组织CTRP6 mRNA和蛋白表达变化。结果与Control组相比,DM组大鼠心脏功能异常和结构损伤,心肌纤维化状况显著,心肌IL-1β、IL-6、TNF-α含量显著增加(P0.01),RT-PCR和Western blot检测显示心肌组织CTRP6表达显著降低(P0.01);与DM组相比,Aspirin组大鼠心脏功能恢复和结构改善,心肌纤维化程度显著降低,心肌IL-1β、IL-6、TNF-α含量下降(P0.05,P0.01),心肌组织CTRP6 mRNA和蛋白表达升高(P0.05,P0.01)。结论阿司匹林可以抑制糖尿病大鼠心肌纤维化和炎症反应其机制涉及促进CTRP6表达。     

冠心宁治疗急性心肌梗死后心力衰竭大鼠的作用机制研究

目的 观察冠心宁治疗急性心肌梗死后心力衰竭大鼠的作用机制。方法 通过结扎左冠状动脉前降支的方法建立大鼠急性心肌梗死后心力衰竭模型,将造模成功的45只大鼠采用随机数字表法分为空白对照组、氯吡格雷组及冠心宁组,每组各15只。灌胃4周后,观察各组大鼠心肌超微结构变化,检测心肌组织中磷脂酰肌醇3-激酶(PI3K)、蛋白激酶B(AKT)表达、心肌组织中氧化应激因子[活性氧(ROS)、细胞总抗氧化能力(T-AOC)]、血清肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)、心脏彩超指数[左室室间隔收缩期厚度(IVSs)、左室室间隔舒张期厚度(IVSd)、左室短轴缩短率(LVFS)]。结果 相较空白对照组,氯吡格雷组及冠心宁组大鼠的心肌超微结构变化更显著,且冠心宁组对大鼠心肌超微结构的炎性损伤明显减轻。氯吡格雷组、冠心宁组心肌组织中PI3K、AKT表达均高于空白对照组,且冠心宁组高于氯吡格雷组(P＜0.05)。氯吡格雷组、冠心宁组心肌组织中PI3K、AKT表达均低于空白对照组,冠心宁组低于氯吡格雷组(P＜0.05)。氯吡格雷组、冠心宁组心肌组织中ROS低于空白对照组,T-AOC水平高于空白对照组,冠心宁组心肌组织中ROS低于氯吡格雷组,T-AOC水平高于氯吡格雷组(P＜0.05)。氯吡格雷组、冠心宁组血清TNF-α水平低于空白对照组,TGF-β1水平高于空白对照组,冠心宁组血清TNF-α水平低于氯吡格雷组,TGF-β1水平高于氯吡格雷组(P＜0.05)。氯吡格雷组、冠心宁组IVSs低于空白对照组,LVFS高于空白对照组,冠心宁组IVSs低于氯吡格雷组,LVFS高于氯吡格雷组(P＜0.05)。结论 冠心宁可改善急性心肌梗死后心力衰竭大鼠心肌超微结构与心功能,降低氧化应激水平及炎症反应,其作用机制可能与激活P13K/AKT信号通路、增强线粒体功能有关。     

芹菜素对肝缺血-再灌注大鼠IL-1β、IL-6及TNF-α表达的影响

目的 探讨芹菜素对肝缺血-再灌注大鼠血IL-1β、IL-6、TNF-α表达的影响。 方法 将40只雄性Wistar大鼠随机分为A(假手术)组、B(肝缺血-再灌注损伤)组、C(芹菜素10 mg/kg)组、D(芹菜素20 mg/kg)组。Pringle法建立肝缺血(1 h)-再灌注(6 h)损伤大鼠模型。C、D组在再灌注的同时腹腔内分别给芹菜素10、20 mg/kg。HE染色观察肝组织病理变化。测定血ALT、AST。酶联免疫吸附实验(ELISA)法测定白介素(IL)-1β、IL-6、肿瘤坏死因子(TNF)-α浓度。 结果 C、D组肝组织病理改变明显轻于B组。C组血IL-1β、IL-6、TNF-α、ALT、AST均高于D组，且均低于B组(均P＜0.01)。IL-1β、IL-6、TNF-α与ALT正相关(r=0.56、0.64、0.57，均P＜0.01)；与AST正相关(r=0.61、0.58、0.63，均P＜0.01)。 结论 芹菜素对缺血-再灌注损伤大鼠肝损伤的保护机制之一为下调血IL-1β、IL-6、TNF-α表达，呈现剂量效应关系。      

氯吡格雷联合阿司匹林对不稳定型心绞痛患者血清炎症因子的影响及疗效

目的探讨氯吡格雷联合阿司匹林对不稳定型心绞痛(UAP)患者血清炎症因子的影响及疗效。方法选择2014年1月～2017年6月在该院心内科门诊治疗UAP患者80例,随机分为联合组和对照组,各40例。两组均按照UAP治疗方案进行治疗,对照组加用阿司匹林100 mg/次,1次/d,口服;联合组再加氯吡格雷75 mg/次,1次/d。两组连用8周,分别于治疗前后比较血清超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平,并评估临床效果及不良反应。结果治疗8周后,两组血清hs-CRP、TNF-α和IL-6水平均较治疗前显著下降(P0.05或P0.01),且观察组治疗后下降幅度更显著(P0.05);同时联合组临床总有效率高于对照组(χ2=4.11,P0.05)。对照组和观察组分别发生不良反应发生率5.0%(2/40)和10.0%(4/40),症状相对较轻,两组比较差异无统计学意义(χ2=0.18,P0.05)。结论氯吡格雷联合阿司匹林治疗UAP患者的效果明显优于单用阿司匹林治疗,安全性较好,机制可能与其显著降低血清hs-CRP、TNF-α和IL-指标,控制血管斑块炎症反应起抗炎作用密切相关。     

赤雹根总皂苷对AA大鼠脾脏TNF-α、IL-1β、IL-6表达的影响

目的：观察赤雹根总皂苷（TSTDR）对佐剂性关节炎（AA）大鼠脾脏指数和脾脏肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）表达的影响。方法：雄性SD大鼠60只随机分为正常对照组,模型组,TSTDR低（40mg/kg/d）、中（80mg/kg/d）、高（160mg/kg/d）剂量组和雷公藤多苷组（12mg/kg/d）。大鼠右后足跖部皮下注射弗氏完全佐剂0.1ml建立AA大鼠模型,成模后各用药组大鼠分别灌胃给予相应药物21d。计算大鼠的脾脏指数,免疫组织化学染色法检测各组大鼠脾脏TNF-α、IL-1β、IL-6的表达。结果：TSTDR中、高剂量组大鼠的脾脏指数显著低于模型组（P＜0.01,P＜0.05）。TSTDR各剂量组大鼠脾脏TNF-α、IL-1β、IL-6的表达水平明显低于模型组（P＜0.01,P＜0.05）;并且,TSTDR中剂量组、TSTDR高剂量组大鼠脾脏TNF-α、IL-1β、IL-6的表达水平明显低于TSTDR低剂量组（P＜0.01,P＜0.05）。结论：抑制脾脏TNF-α、IL-1β、IL-6的表达可能是TSTDR治疗AA的机制之一。     

阿司匹林和氯吡格雷对体外血小板黏附内皮细胞基质活性的影响及其机制研究

目的 体外研究阿司匹林和氯吡格雷对血小板黏附内皮细胞基质活性的影响及其机制,从理论上寻找两种药物联合效果优于单药的原因。方法 于2013年在第三军医大学动物中心购买健康雌性SD大鼠42只,采用随机数字表法,将SD大鼠分为阿司匹林组（8只）、氯吡格雷组（8只）、阿司匹林联合氯吡格雷组（联合组,8只）、对照组（8只）以及用于原代细胞分离培养10只。分离培养原代大鼠血管内皮细胞,利用50 μg/ml氧化修饰低密度脂蛋白（ox-LDL）建立受损血管内皮细胞模型并采用100 mg/kg阿司匹林、10 mg/kg氯吡格雷、100 mg/kg阿司匹林联合10 mg/kg氯吡格雷以及200 μl蓖麻油制作内皮细胞基质板|血浆血小板分离制备前3 d,阿司匹林组喂养阿司匹林100 mg·kg-1·d-1,氯吡格雷组喂养氯吡格雷10 mg·kg-1·d-1,联合组喂养阿司匹林100 mg·kg-1·d-1,氯吡格雷10 mg·kg-1·d-1,对照组喂养蓖麻油200 μl/d。采用ELISA法检测黏附内皮细胞基质上的血小板数量|采用蛋白质免疫印迹法检测阿司匹林和氯吡格雷对血管内皮细胞蛋白血栓调节蛋白（TM）、氧化型低密度脂蛋白受体1（LOX-1）、CD40表达的影响。结果 经阿司匹林和氯吡格雷处理的血小板对内皮细胞黏附活性的影响：4组50、100、150、200 μl血小板黏附内皮细胞基质活性比较,差异均有统计学意义（P＜0.05）,其中氯吡格雷组和联合组50、100、150、200 μl血小板黏附内皮细胞基质活性均低于对照组和阿司匹林组,阿司匹林组150 μl血小板黏附内皮细胞基质活性低于对照组（P＜0.05）。血小板黏附经阿司匹林和氯吡格雷处理的内皮细胞基质活性的影响：4组50、100、150、200 μl血小板黏附内皮细胞基质活性比较,差异均有统计学意义（P＜0.05）,其中联合组50、100、150、200 μl血小板黏附内皮细胞基质活性分别低于对照组、阿司匹林组和氯吡格雷组（P＜0.05）。蛋白质免疫印迹法显示,阿司匹林和氯吡格雷均能抑制由ox-LDL引起的TM表达的减少。ox-LDL能明显诱导血管内皮细胞LOX-1表达,阿司匹林能明显抑制由ox-LDL引起的LOX-1和IL-6的表达|而氯吡格雷则能明显抑制内皮细胞CD40的表达。结论 阿司匹林和氯吡格雷均能从上调TM和抑制炎性因子两方面降低血小板对内皮细胞基质的黏附作用。但两者联合更能抑制由ox-LDL引起的炎性因子的表达,降低血小板对内皮细胞基质的黏附。     

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.