心源性晕厥患者126例心电图检查分析

目的 探讨动态心电图在心源性晕厥诊断中的应用价值.方法 对126例疑为心源性晕厥患者行动态心电图检查,嘱患者尽量以诱因促使晕厥发作.准确记录晕厥发生的时间.结果 126例患者中29例(23.02%)晕厥发作时间与检出心律失常时间一致;且晕厥与心室停搏>3.0s有关.而心室停搏<3.0s,无1例发生晕厥(P<0.01).结论 动态心电图对心律失常引起的心源性晕厥的诊断.具有重要的临床应用价值.     

应用动态心电图诊断心源性晕厥的临床意义

目的:分析动态心电图诊断心源性晕厥的临床意义。方法:选取我院于2012年5月~2013年5月收治的60例疑似心源性晕厥患者进行动态心电图检查,观察晕厥时间、频率及临床症状等指标,分析其检查结果。结果:60例患者中有30例有晕厥症状,47例有心律失常的发生,两者的发展时间基本一致,在发生晕厥的患者中心室停搏小于3秒无晕厥的发生,有33次呼吸率间期大于3秒,发生晕厥9次,晕厥患者与无晕厥患者的呼吸率间期及中心室停搏比较差异有统计学意义(P0.05)。结论:动态心电图易操作、可重复,对于提高心源性晕厥的诊断准确率有着重要意义,可以作为心源性晕厥的首选诊断方法。     

12导联动态心电图对心源性晕厥病因诊断的分析

目的应用12导联动态心电图对心源性晕厥进行诊断与分析。方法对51例疑为心源性晕厥患者行动态心电图检查,嘱其尽量以诱因促使晕厥发作,并记录发作时间。结果51例患者中12例(23.5%)晕厥发作时间与检出心律失常时间一致;且晕厥与心室停搏>3.0s有关,而心室停搏<3.0s,无1例发生晕厥(P<0.01)。结论12导联动态心电图可为心源性晕厥患者获得可靠的病因诊断,为临床提供恰当的治疗方案。     

动态心电图对心源性晕厥病因诊断的分析

目的 应用12导联动态心电图对心源性晕厥进行诊断与分析.方法 对36例疑为心源性晕厥患者行动态心电图检查,嘱其尽量以诱因促使晕厥发作,并记录发作时间.结果 36例患者中8例(22.2%)晕厥发作时间与检出心律失常时间一致;且晕厥与心室停搏＞3.0s有关,而心室停搏＜3.0s,无一例发生晕厥( P＜0.01).结论 12导联动态心电图可为心源性晕厥患者获得可靠的病因诊断,为临床提供恰当的治疗方案.     

12导联动态心电图对心源性晕厥病因诊断的分析

目的:应用12导联动态心电图对心源性晕厥进行诊断与分析。方法:对51例疑为心源性晕厥患者行动态心电图检查,嘱其尽量以诱因促使晕厥发作,并记录发作时间。结果:51例患者中12例(23.5%)晕厥发作时间与检出心律失常时间一致;且晕厥与心室停搏>3.0s有关,而心室停搏<3.0s,无一例发生晕厥(P<0.01)。结论:12导联动态心电图可为心源性晕厥患者获得可靠的病因诊断,为临床提供恰当的治疗方案。     

疑心源性晕厥64例动态心电图分析

目的应用24h动态心电图对心源性晕厥进行诊断与分析。方法对64例疑为心源性晕厥患者行动态心电图检查。结果缓慢心律失常与快速型心律失常是心源性晕厥主要病因,晕厥发作与检出心律失常时间一致,且晕厥与心室停搏（〉3.0s）及室上性或室性心动过速持续时间长短有关。结论 24h动态心电图对心源性晕厥患者作出可靠的病因诊断有重要意义。     

动态心电图对142例晕厥患者的检查分析

目的:通过动态心电图对晕厥患者检查,探讨晕厥病因诊断及动态心电图检查的应用价值。方法:对142例晕厥患者行动态心电图监测,并嘱其在检查中尽可能的诱发晕厥发作并同时记录其发作时间,从而记录发作时心电图变化。结果:142例患者中,晕厥41例(28.87%),其中晕厥发作38例检出与严重心律失常发作时间一致,检查出窦性心动过缓伴窦性停搏16例,房室传导阻滞11例,室性心动过速4例,室上性心动过速7例。另有3例未有心律失常发作时而出现晕厥。心室停搏(R-R间期)>3s有晕厥发作,心室停搏(R-R间期)<3s无晕厥发作。结论:晕厥与心室长时间停搏有显著相关性,临床上对发作性晕厥患者必须进行动态心电图检查,以利明确病因诊断。     

68例晕厥患者动态心电图监测分析

目的：探讨动态心电图对晕厥患者病因诊断的价值。方法：对68例临床诊断为晕厥的门诊或住院患者行24小时十二导动态心电图监测。结果：68例晕厥患者中,32例动态心电图无明显异常,36例动态心电图异常。10例在监测期间发生晕厥,而晕厥时动态心电图捕捉到心律失常7例,心电图无明显异常3例。36例动态心电图异常患者,窦性心动过缓18例,心房纤颤2例,二度二型房室传导阻滞1例,并伴有阻滞型心室停搏（ R－R间期＞2．0秒）;室性心律失常6例。结论：动态心电图监测对部分因心律失常所致的心源性晕厥有重要的临床价值,但检查阴性时也不能完全排除心源性晕厥,有必要时多次行动态心电图检查。     

58例心源性晕厥患者的动态心电图表现

目的：为进一步了解心源性晕厥患者发生心律失常的性质及高危心电图表现特征。方法：结合患者生活日志,回顾性分析了58例心源性晕厥患者的动态心电图资料。结果：58例患者,均发生严重心律失常。33例（56.9%）晕厥发作与心律失常有关,其中快速性心律失常23例（39.7%）,发生晕厥13例（22.4%）;缓慢性心律失常35例（60.3%）,发生晕厥20例（34.5%）。快速性心律失常致晕厥由〉200 bpm的极快心室率诱发,缓慢性心律失常致晕厥主要为〉3.0 s的心室停搏所引发。结论：心律失常尤其是缓慢性心律失常是导致心源性晕厥的重要原因,多见于器质性心脏病患者,易致猝死。动态心电图可为心源性晕厥患者获得可靠的病因诊断,为临床选择恰当的治疗方案提供有效依据。     

24小时动态心电图对诊断心源性晕厥的临床意义

目的评价24小时动态心电图在心律失常引起的心源性晕厥临床诊断中的应用价值。方法对120例不明原因黑朦、晕厥的患者进行24小时动态心电图检查,并嘱其尽量以诱因促使晕厥发作,并记录下患者黑朦、晕厥等症状发作时的心电图情况。结果 120例中发生黑朦、晕厥49例,其中有39例晕厥发作与严重心律失常发作的时间一致,主要为心室停搏,且与长R-R间期〉3.0秒及快速性室性心律失常有关,另有10例未记录到晕厥时有心律失常。结论动态心电图检查对心源性晕厥可作出可靠的病因诊断;检查阴性者尚不能排除心源性晕厥,应给予多次检查,以提高诊断阳性率。     

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.