α－2b干扰素治疗慢性乙型肝炎的前瞻性对照研究

在６２例慢性乙型肝炎（乙肝）患者中，３８例（治疗组）接受重组α－２ｂ干扰素治疗，２４例（对照组）接受抗乙肝免疫核糖核醚治疗。结果表明，治疗组ＨＢｅＡｇ和ＨＢＶＤＮＡ清除率明显高于对照组（Ｐ＜０．０５），血清ＡＬＴ水平明显升高的患者（ＡＬＴ＞７０Ｕ）及慢性活动型肝炎患者对干扰素的治疗反应明显优于ＡＬＴ正常及慢性迁延型肝炎病人（Ｐ＜０．０５）。     

乙型肝炎患者血清中CRP的测定及其临床意义

通过９６例乙型肝炎病人和５０例正常人血清进行ＣＲＰ的测定，以及乙肝患者ＡＬＴ正常及异常作ＣＲＰ的比较，了解它们之间的关系。分两组将乙肝与健康人及乙肝中ＡＬＴ正常与异常，用半定量胶乳凝集法，对两组作ＣＲＰ的比较。结果乙肝患者的ＣＲＰ明显高于正常人（Ｐ〈０．０１），在乙肝患者血清中ＡＬＴ增高的ＣＲＰ也明显高于ＡＬＴ正常的（Ｐ〈０．０１），说明了ＣＲＰ与乙肝感染及肝功能正常或不正常有着一定的关系。     

a—2b干扰素治疗慢性乙型肝炎的前瞻性对照研究

在６２例慢性乙型肝炎（乙肝）患者中，３８例（治疗组）接受重组ａ－２ｂ干扰素治疗，２４例（对照组）接受抗乙肝免疫抗乙肝免疫核糖核酸治疗。结果表明，治疗组ＨＢｅＡｇ和ＨＢＶ ＤＮＡ清除率明显高于对照组（Ｐ〈０．０５），血清ＡＬＴ水平明显升高的患者（ＡＬＴ〉７０Ｕ）及慢性活动型肝炎患者对干扰素的治疗反应明显优于ＡＬＴ正常及慢性迁延型肝炎病人（Ｐ〈０．０５）。     

某高校99级新生HBsAg携带和ALT异常状况调查

目的：了解大学生ＨＢｓＡｇ携带情况,为乙肝疫苗的预防接种提供资料。方法：ＨＢｓＡｇ用ＥＬＩＳＡ法检测,ＡＬＴ活性检测用赖氏法。结果：ＨＢｓＡｇ阳性检出率１３．０６％（５５／４２１）。男生ＨＢｓＡｇ阳性率为１７．０３％（４６／２７０）,女生阳性率５．９６％（９／１５１）。性别间有极显差异性（ｘ＾２＝１０．４６,Ｐ〈０．０１）。单纯ＡＬＴ异常占１．１８％（５／４２１）,ＡＬＴ异常并ＨＢｓＡｇ阳性     

慢性乙型肝炎患者外周血T淋巴细胞亚群检测

采用Ｗｕ单克隆抗体致敏的红细胞花环法和ＥＬＩＳＡ方法，对６８例慢性乙型肝炎患者的外周血Ｔ淋巴细胞亚群和血清乙肝病毒标志物（ＨＢＶＭ）进行了检测，选择３０例正常人做对照，同时常规检测ＡＬＴ、ＡＳＴ，对照分析ＨＢＶＭ或ＡＬＴ、ＡＳＴ与Ｔ淋巴细胞亚群的关系。结果：慢性乙肝患者ＷｕＴ８高于正常人，ＷｕＴ４、ＷｕＴ４／ＷｕＴ８比值低于正常人（Ｐ＜０．０５～０．０１）；ＨＢｅＡｇ（＋）患者ＷｕＴ８高于ＨＢｅＡｇ（－）者，而ＷｕＴ４／ＷｕＴ８比值低于ＨＢｅＡｇ（－）者（Ｐ＜０．０５～０．０１）；血清ＡＬＴ和ＡＳＴ升高者ＷｕＴ３、ＷｕＴ８高于ＡＬＴ和ＡＳＴ正常者，而ＷｕＴ４／ＷｕＴ８比值低于正常者（Ｐ＜０．０１～０．００１）。提示：外周血Ｔ淋巴细胞亚群的检测对评估病毒复制、肝细胞损伤有一定参考价值，亦可用作慢性乙肝患者细胞免疫机能的初步监测。     

病毒性肝炎患者血清镁的含量及意义

检测４６例病毒性肝炎患者血清镁含量，并观察了患者的血清镁与ＡＬＴ、ＡＦＰ变化的关系。结果：慢活型病毒性肝炎组的病人血清镁含量降低，与正常人群比较有差异（Ｐ＜０．０５）；肝炎后肝硬化、慢重型病毒性肝炎组的病人血清镁含量明显降低，与正常人群比较有显著性差异（Ｐ＜０．０１）。患者ＡＬＴ、ＡＦＰ升高时血清镁含量显著降低（Ｐ＜０．０１），当患者的ＡＬＴ、ＡＦＰ恢复正常时，血清镁含量上升（Ｐ＞０．０５）。结果表明：病毒性肝炎患者血清镁含量的高低可视为判断病情轻重，肝功能损伤的程度，同时也提供了慢活型、慢重型病毒性肝炎、肝炎后肝硬化的病人治疗时应注意补充镁盐。     

6535名幼儿、中小学生乙肝病毒感染情况调查分析

采用间接血球凝集法对靖西县６５３５名幼儿、中小学生进行乙肝病毒（ＨＢＶ）感染情况调查，结果发现ＨＢｓＡｇ阳性率为１１．２５％，男女生之间差异有高度显著性（χ２＝７．２，Ｐ＜０．０１），城乡学生之间差异也有高度显著性（χ２＝２０．４９，Ｐ＜０．０１），用赖氏法测定血清ＡＬＴ，发现ＨＢｓＡｇ阳性者比阴性者肝脏损害严重（χ２＝２４．７７，Ｐ＜０．０１）。同时采用ＥＬＩＳＡ法对ＨＢｓＡｇ阳性的学生进一步做“两对半”检查，就调查结果进行了讨论，并提出相应的建议。     

HCV感染者6项免疫指标与ALT检测的临床意义

为了进一步观察ＣＩＣ，ＩｇＧ，ＩｇＡ，ＩｇＭ，Ｃ３，Ｃ４６项免疫指标与ＡＬＴ在丙型肝炎病毒（ＨＣＶ）感染者血清中的变化，对６５例ＨＣＶ感染者进行检测。结果：６５例ＨＣＶ感染者中，ＣＩＣ：（２３．１８±４．５０）ｍｇ／Ｌ，ＩｇＧ：（２４．９１±１１．２０）ｇ／Ｌ，ＩｇＡ：（２．８０±０．７１）ｇ／Ｌ，显著高于正常对照组（Ｐ＜０．０１）；ＩｇＭ：（１．５８±０．７１）ｇ／Ｌ，Ｃ３：（１．４４±０．２２）ｇ／Ｌ，Ｃ４：（０．４１±０．０８）ｇ／Ｌ，略高于正常对照组，但无显著性差异（Ｐ＞０．０５）。ＡＬＴ：５７／６５例异常。结果提示，在ＨＣＶ感染者中，患者肝细胞受损过程中ＡＬＴ与ＣＩＣ的增高成正比例关系；免疫球蛋白及补体的检测，对综合判断ＨＣＶ感染者及其疾病的活动状况，也有较大价值。     

7518名从业人员ALT改良赖氏法正常值的调查

７５１８名从业人员ＡＬＴ改良赖氏法正常值的调查刘忠民袁浩简小珊（赣州市卫生防疫站３４１０００）血清谷丙转氨酶（ＡＬＴ）增高能反映肝细胞损害情况，检测ＡＬＴ对预防病毒性肝炎有着重要意义。从业人员健康体检采用改良赖氏法对基层防疫站较实用，而正常值又无国家...     

Graves病患者四种血清酶测定结果分析

目的：探讨Ｇｒａｖｅｓ病患者血清酶的变化及意义。方法：对１１６例Ｇｒａｖｅｓ病患者进行血清丙氨酸转氨酶（ＡＬＴ）,天冬氨酸转氨酶（ＡＳＴ）,碱性磷酸酶（ＡＬＰ）,γ－谷氨酰转肽酶（ＧＧＴ）测定。结果：甲亢未控制组ＡＬＴ、ＡＳＴ、ＡＬＰ、ＧＴ明显高于正常对照组及甲亢控制组（Ｐ〈０．０１）;但甲亢控制组ＡＬＰ、ＧＧＴ仍较正常对照组高（Ｐ〈０．０１）,且甲亢患者ＡＬＴ、ＡＳＴ、ＡＬＰ、ＧＧＴ与ＦＴ３、     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.