不稳定性心绞痛及急性心肌梗塞病人血浆PAI—1活性的观察

对ＵＡ和ＡＭＩ病人血浆ＰＡＩ－１活性水平及其动态变化进行了观察研究。结果显示：血浆ＰＡＩ－１活性ＵＡ组（９３２±２.６０ＡＵ／ｍｌ）及ＡＭＩ组（1０.２±１.５９ＡＵ／ｍｌ）均高于对照组（６.７５±２.６０ＡＵ／ｍｌ）（Ｐ＜０.０５）；ＡＭＩ病人血浆ＰＡＩ－ｌ活性在治疗早期有一过性下降，以后均高于正常水平。     

急性心肌梗塞与血管紧张素转化酶活性关系的临床研究

以马尿酸定量法测定符合ＷＨＯ规定的诊断标准的急性心肌梗塞（ＡＭＩ）患者７８例和正常对照组３４例的血清血管紧张素转化酶（ＡＣＥ）活性。结果：（１）ＡＭＩ患者的血清ＡＣＥ活性显著高于对照组（Ｐ〈０．００１）,（２）ＡＭＩ亚急性期或恢复期的ＡＣＥ活性均显著低于ＡＭＩ急性期者（Ｐ〈０．０５,Ｐ〈０．０１）,恢复期ＡＭＩ患者的ＡＣＥ活性则显著低于亚急性期者（Ｐ〈０．０５）;（３）ＡＭＩ患者并发心衰或并发休克     

脑梗死患者血浆PAP水平与单核细胞组织因子、t-PA和PAI活性的测定及其意义

目的观察脑梗死（ＣＩ）患者血浆纤溶酶－α２－抗纤溶酶复合物（ＰＡＰ）、凝血酶－抗凝血酶Ⅲ复合物（ＴＡＴ）测定和外周血单核细胞（ＰＢＭＣ）组织因子（ＴＦ）及ｔ－ＰＡ：ａ和ＰＡＩ：ａ的变化及其意义。方法分别应用ＥＬＩＳＡ法、凝血酶和反应法发色底物法测定５０例脑梗死患者、２０例健康对照及２０例非血栓疾病病例对照的血浆ＰＡＰ、ＴＡＴ、Ｆｇｎ含量、ＰＢＭＣＰＣＡ、ＰＢＭＣＴＰＡ和ＰＡＩ活性。结果①脑梗死患者血浆ＰＡＰ、ＴＡＴ及Ｆｇｎ水平明显增高,与病例对照组及正常对照组比较均有显著差异;②脑梗死患者ＰＢＭＣＴＦ活性明显高于健康对照组（Ｐ＜０．０１）及病例对照组（Ｐ＜０．０１）。ＰＢＭＣｔ－ＰＡ活性表达明显低于健康对照组（Ｐ＜０．０５）及病例对照组（Ｐ＜０．０１）。ＰＢＭＣＰＡＩ活性明显高于健康对照组（Ｐ＜０．０５）及病例对照组（Ｐ＜０．０１）。结论血浆ＴＡＴ及ＰＡＰ水平检测可较好的评价脑梗死患者凝血及纤溶系统激活状态。脑梗死患者在细胞水平已处于高凝状态。并在细胞水平存在凝血与纤溶系统失衡。     

肺癌患者血液抗凝和纤溶状态的变化及其意义

检测原发性肺癌４８例的抗凝血酶Ⅲ活性（ＡＴ－Ⅲ：Ａ）、抗凝血酶Ⅲ抗原（ＡＴ－Ⅲ：Ａｇ）、ａ＿２巨球蛋白（α＿２－ＭＧ）、血浆纤溶酶原活性（Ｐｌｇ：Ａ）、血浆纤溶激活活性（ＦＡＡ）．血浆纤溶激活抑制活性（ＦＩＡ）、组织型纤溶酶原激活物（ｔ－ＰＡ）及其抑制物（ＰＡＩ）。结果表明，肺癌患者抗凝活性较正常人显著降低而纤溶活性增强，血液抗凝与纤溶状态异常与肿瘤期别有关，α＿２－巨球蛋白有突出的变化。     

老年高血压病患者血浆纤溶活性与胰岛素敏感性分析

采用发色底物法及放免法检测了３０例老年期高血压病（ＥＨ）患者和３０例健康老年人血浆组织型纤溶酶原激活物（ｔ－ＰＡ）、纤溶酶原激活物抑制因子（ＰＡＩ）。空腹血浆胰岛素（Ｉｎ）、血糖（Ｇ）水平，分析了纤溶活性与胰岛素敏感性（ＩＳ）的相关性。结果发现：ＥＨ患者血浆ＰＡＩ活性明显高于对照组，血浆ｔ－ＰＡ活性及ＩＳ明显低于对照组；ＩＳ与ＰＡＩ显著负相关，与ｔ－ＰＡ显著正相关。提示：纤溶活性异常与胰岛素抵抗共同在高血压的发生发展中起重要作用。     

脑梗死患者血浆PAP水平与单核细胞组织因子,t—PA和PAI活？…

观察脑梗死患者血浆纤溶酶－α２－抗纤溶酶复合物，凝血酶－抗凝血酶Ⅲ复合物测定和外周血单核细胞组织因子及ｔ－ＰＡ；ａ和ＰＡＩ：ａ的变化及其意义。方法分别应用ＥＬＩＳＡ法，凝血酶和反应法发色底物法测定５０例脑梗死患者、２０例健康对照组及２０例非血栓疾病病例对照的血浆ＰＡＰ、ＴＡＴ、Ｆｇｎ含量、ＰＢＭＣＰＣＡ、ＰＢＭＣＴＰＡ和ＰＡＩ活性。结果（１）脑梗死虱血浆ＰＡＰ、ＴＡＴ及Ｆｇｎ水平明显增高，与病例对     

NIDDM患者无症状性心或脑缺血时血中TNF-α、t-PA及PAI的改变

为了解无症状性心或脑缺血的非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者的血中肿瘤坏死因子－α（ＴＮＦ－α）及纤溶活性的变化，我们观察了２０例正常人、２５例ＮＩＤＤＭ伴无症状性心或脑缺血患者、１８例ＮＴＤＤＭ不伴无症状性心或脑缺血患者血中ＴＮＦ－α水平，组织型纤溶酶原激活剂（ｔ－ＰＡ）活性和ＰＡ抑制物（ＰＡＩ）活性的改变。结果显示：ＴＮＦ－α、ＰＡＩ在ＮＩＤＤＭ伴无症状缺血患者最高，而ｔ－ＰＡ最低。表明ＴＮＦ－α水平升高及纤溶活性降低参与了ＮＩＤＤＭ无症状性心或脑缺血的发生。     

风心病患者血浆tPA及PAI－1水平的变化

测定４０例风心病患者和２４例正常人血浆组织型纤溶酶原激活物（ｔＰＡ）及其抑制物（ＰＡＩ－１）活性。结果表明：风心病患者ｔＰＡ活性较对照组明显降低，ＰＡＩ－１则明显升高；且风心病合并房颤者ｔＰＡ活性明显低于无房颤者，ＰＡＩ－１则明显高于无房颤者。提示风心病患者存在纤溶功能的障碍，合并房颤者尤为严重。     

前列腺素E1对肺心病前列环素,血栓素的影响

对３０例肺心病急性发作期病人，观察前列腺素Ｅ１（ＰＧＥ１）对前列环素－血栓素Ａ２（ＰＧＩ２－ＴＸＡ２）、平均肺动脉压（ＭＰＡＰ）及血气的影响。结果发现：①ＰＧＥ１治疗后血浆ＴＸＢ２降低（Ｐ〈０．０５），６－Ｋｅｔｏ－ＰＧＦ１α／ＴＸＢ２增高（Ｐ〈０．０５），而６－Ｋｅｔｏ－ＰＧＦ１α无变化（Ｐ〉０．０５）；②ＰＧＥ１治疗后ＭＰＡＰ下降明显，ＰａＯ２略有改善。认为ＰＧＥ１能纠正ＰＧＩ２－ＴＸＡ２平衡     

加压素和β─—内啡肽在透析病人无症状心肌缺血中的作用

用动态心电图监测血液透析患者无症状心肌缺血（ＳＭＩ）发生情况，并同步观察其血浆精氨酸加压素（ＡＶＰ）及β－内啡肽（β－ＥＰ）含量。结果显示：血透病人缺血性ＳＴ段检出率为５２．３８％其中ｓＭＩ占７２．７２％；透析前血浆ＡＶＰ浓度明显高于正常，透析后ＡＶＰ水平下降，但血浆β－ＥＰ在透析后则显著升高；并发现心绞痛发作病人透析前后其血浆β－ＥＰ浓度均低于ＳＭＩ患者。提示透析ＳＭＩ患者存在的“心绞痛报警系统”缺陷与透析中内源性阿片肽系统激活有关，血浆β—ＥＰ可能在ＳＭＩ发生中有一定作用。     

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.