孕中、晚期多囊卵巢综合征患者发生妊娠期糖尿病的危险因素分析

目的：探讨多囊卵巢综合征（polycystic ovary syndrome,PCOS）妇女妊娠后不同孕期中发生妊娠期糖尿病（gestational diabetes mellitus,GDM）的危险因素,以深入认识PCOS合并GDM的临床特点。方法：选取孕妇在孕前于重庆市沙坪坝区妇幼保健计划生育服务中心妇产科诊断为PCOS并接受规范治疗,并在2013年3月至2015年3月在该科接受产前检查。根据孕中期（孕24周）、孕晚期（孕32周）口服糖耐量试验结果,分为妊娠期糖尿病组（GDM组）和正常组（非GDM组）,其中GDM组孕妇在孕中期和孕晚期分别有20和28例,非GDM组孕妇在孕中期和孕晚期分别有77和69例,比较不同组别间孕妇的基本情况及雄激素、胰岛素水平的差异,并分析其中GDM发生的危险因素。结果：在孕中期,GDM组与非GDM组的孕期增加体质量、胰岛素水平有统计学差异[GDM组孕期增加体质量（5.54±1.32） kg,非GDM组孕期增加体质量（4.08±0.91） kg,t=2.487,P=0.015;GDM组胰岛素为（30.35±8.70） pmol/L,非GDM组胰岛素为（25.47±7.56） pmol/L,t=3.289,P=0.001];在孕晚期,GDM组与非GDM组的孕期增加体质量、糖尿病家族史、睾酮及胰岛素水平有明显差异[GDM组孕期增加体质量（9.83±0.91） kg,非GDM组孕期增加体质量（8.61±1.23） kg,t=2.283,P=0.025;GDM组有糖尿病家族史10例,非GDM组胰岛素有糖尿病家族史9例, ?字2=3.939,P=0.0４７;GDM组睾酮为（3.49±1.65） nmol/L,非GDM组睾酮为（2.46±1.17） nmol/L,t=2.542,P=0.013;GDM组胰岛素为（33.78±7.01） pmol/L,非GDM组胰岛素为（27.12±6.39） pmol/L,t=4.108,P=0.000]。logistics分析提示,较高的孕期增加体质量、胰岛素水平是PCOS孕妇在孕中期发生GDM的独立危险因素（OR=2.467,95%CI=1.912~3.355,P=0.029;OR=1.565,95%CI=1.287~1.921,P=0.007）;较高的孕周增加体质量、睾酮和胰岛素水平是PCOS孕妇在孕晚期发生GDM的独立危险因素（OR=2.640,95%CI=2.392~3.588,P=0.033;OR=1.587,95%CI=1.103~3.307,P=0.045;OR=2.735,95%CI=1.182~4.803,P=0.001）。结论：在孕中、晚期,较高的孕期增加体质量和胰岛素水平都是PCOS孕妇发生GDM的危险因素;较高的睾酮水平仅在孕晚期是PCOS孕妇发生GDM的危险因素。     

脂肪因子nesfatin-1与妊娠期糖尿病患者AFABP、瘦素、GLP 1的相关性

【摘要】 目的 探讨脂肪因子nesfatin 1与妊娠期糖尿病（Gestational diabetes mellitus,GDM）患者脂肪细胞型脂肪酸结合蛋白（Adipocyte Fatty Acid BindingProtein ,AFABP）、瘦素、胰高血糖素样肽 1（Glucagon like peptide 1,GLP 1）的相关性。 方法 选取2015年3月～2017年6月我院妇产科收治的68例妊娠期糖尿病患者作为GDM组,选取同期50例正常糖耐量（Normal Glucose Tolerance,NGT）妊娠妇女作为NGT组。对两组患者行回顾性分析,采用SPSS对脂肪因子nesfatin 1和糖尿病患者相关指标进行pearson相关性及多元回归分析。 结果 GDM 组产前体重指数（BMI）、△BMI（产前BMI 孕前BMI）、空腹血糖、空腹胰岛素、nesfatin 1、瘦素、AFABP均显著高于NGT 组,差异有统计学意义（P＜0.05）;两组产妇孕前BMI及GLP 1差异无统计学意义（P＞0.05）;pearson相关性分析提示nesfatin 1与孕前 BMI、产前BMI 、孕期增加体重、△BMI、空腹胰岛素、AFABP相关（P＜0.05）;多元回归分析提示,产前 BMI及空腹胰岛素是nesfatin 1的独立危险因素。校正空腹胰岛素和产前 BMI 后logistic回归分析nesfatin 1、瘦素、AFABP为GDM的独立危险因素（P＜0.05）。结论 GDM患者nesfatin 1与AFABP呈正相关,nesfatin 1、AFABP、瘦素为GDM患者的独立危险因素,血清GLP 1与GDM无关。     

2 748例住院孕妇妊娠期糖尿病发病率及危险因素的研究

目的:分析孕妇妊娠期糖尿病(gestational diabetes mellitus,GDM)发病情况及危险因素?方法:收集2012年1月1日~2013年12月31日本院产科门诊随诊并住院分娩的孕妇资料2 748例,通过口服75 g葡萄糖耐量试验(OGTT)筛查GDM,评估发病率?相关危险因素?结果:①2 748例孕妇中GDM 540例,非GDM 2 208例,GDM发病率19.65%;②GDM组年龄?孕前BMI?产前BMI?孕期体重增加值?新生儿体重较非GDM组均有升高(P < 0.05);③单因素分析显示年龄(≥30岁)(OR=1.868,P < 0.001)?自然流产史(OR=1.673,P < 0.001)?高血压病史(OR=2.509,P=0.017)?糖尿病家族史(OR=5.776,P < 0.001)?孕前BMI≥24(OR=2.981,P < 0.001)?孕期体重增长情况(OR=1.923,P < 0.001)均是GDM发生的相关危险因素?进一步行多因素Logistic回归显示年龄≥30岁(OR=1.406,P=0.006)?自然流产史(OR=1.462,P=0.003)?糖尿病家族史(OR=4.969,P < 0.001)?孕前BMI≥24(OR=1.475,P=0.035)?孕期体重增长幅度≥16.0 kg(OR=1.846,P < 0.001)与GDM发生有关;而妊娠期贫血孕妇GDM的发生率为无贫血孕妇的0.518倍(OR=0.518,P < 0.001);④无高危因素组GDM发病率11.95%,当高危因素≥4个,GDM发病率达65.00%(χ2=144.182,P < 0.001)?结论:孕前BMI≥24?年龄≥30岁?自然流产病史?DM家族史?孕期体重增加≥16 kg等因素为GDM发生的独立危险因素,妊娠期贫血可降低GDM发生?加强孕前?孕期高危因素筛查?干预,有利于减少GDM发生?     

PCOS合并妊娠期糖尿病患者母婴结局分析

目的 探讨多囊卵巢综合征合并妊娠期糖尿病孕妇的一般情况、糖脂代谢水平以及母婴结局,以期为疾病的个性化治疗及远期并发症预防提供理论依据。方法 收集2014年5月~2018年4月黑龙江中医药大学附属第一医院产科门诊诊断为GDM的患者205例,根据PCOS诊断标准将205例GDM患者分为两组,即PCOS+GDM组84例、非PCOS+GDM组121例;选取同期就诊于笔者医院产科门诊进行产检的75g糖耐量实验正常的孕妇158例作为对照组,比较3组孕妇的一般情况、糖脂代谢水平及母婴结局。结果 PCOS组孕妇的产前BMI、T、AND、不良孕史、自然流产、胚胎停育、糖尿病家族史以及胰岛素使用比例显著大于非PCOS组及对照组;GDM孕妇的产次显著低于对照组、孕妇出生体重显著高于对照组;非PCOS+GDM组孕妇的孕前BMI及糖尿病家族史显著高于对照组(P<0.05)。PCOS组孕妇的FINS、HOMA-IR、TC及LDL值显著大于非PCOS组及对照组,HbA1c检测孕周小于非PCOS组及对照组;GDM孕妇的FPG及HbA1c显著高于对照组;非PCOS+GDM组孕妇的FPG、FINS HOMA-IR、HbA1c、HbA1c检测孕周及LDL显著高于对照组(P<0.05)。PCOS组孕妇的子痫前期、早产及羊水过多的发生率显著高于非PCOS组及对照组;GDM孕妇的胎膜早破、羊水过多及产后出血的发生率显著高于对照组(P<0.05)。PCOS组的新生儿体重及大于胎龄儿发生率显著高于非PCOS组及对照组;GDM组的新生儿黄疸发生率显著高于对照组;PCOS组的新生儿低血糖发生率显著高于对照组(P<0.05)。结论 PCOS合并GDM孕妇的一般情况较重,且PCOS加重了GDM孕妇不良妊娠结局。PCOS合并GDM孕妇糖脂代谢异常程度较重,PCOS合并GDM新生儿结局不良,并发症发生率较高。     

胰岛素治疗与妊娠期糖尿病患者孕期体重及体重指数增加的相关性

目的研究胰岛素治疗与妊娠期糖尿病（GDM）患者孕期体重及BMI增加的相关性。方法回顾性分析诊断为GDM的孕妇556例,其中23例接受胰岛素治疗（胰岛素治疗组）,533例未予胰岛素治疗（非胰岛素治疗组）。对比两组妊娠结局,分析胰岛素治疗与孕期体重增加及孕期BMI增加的相关性。结果胰岛素治疗组子痫前期、大于胎龄儿（LGA）、小于胎龄儿（SGA）、新生儿低血糖、巨大儿等不良妊娠结局发生率低于非胰岛素治疗组,但差异均无统计学意义（均P＞0.05）;556例患者孕期体重增加与GDM不良结局均呈正相关（r=0.0919,P＜0.05）;胰岛素治疗组孕期体重及BMI增加明显低于非胰岛素治疗组,差异均有统计学意义（均P＜0.01）;胰岛素治疗与孕期体重增加及孕期BMI增加呈负相关（r=-0.1452、-0.1339,均P＜0.01）。结论胰岛素治疗可使GDM妇女孕期体重及BMI增加幅度降低,可能是改善GDM妊娠不良结局的机制之一。     

妊娠期糖尿病孕妇产后糖代谢异常的影响因素

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)患者产后糖代谢转归情况及产后糖代谢异常的相关因素。方法收集并分析2008年1月至2010年12月在北京妇产医院进行产前检查、分娩及产后随访的624例妊娠期糖尿病孕妇的临床资料,根据产后6～8周糖代谢恢复情况分为糖代谢正常组(444例)和糖代谢异常组(180例),了解两组转归的相关因素。结果 1)444例孕妇产后6～8周糖代谢恢复正常,占71.2%,180例孕妇产后6～8周糖代谢仍然异常,占28.8%,其中糖尿病(diabetes mellitus,DM)18例,空腹血糖受损(impaired fasting glucose,IFG)32例,糖耐量受损(impaired glucose tolerance,IGT)130例;2)产后糖代谢异常组孕期GDM诊断的孕周较糖代谢正常组早,空腹血糖、孕前及产后体质量指数(body mass index,BMI)、血脂均较正常组高,孕期应用胰岛素控制血糖、合并相关合并症、DM家族史的比例较正常组高,差异有统计学意义(P<0.05),而两组母乳喂养比例差异无统计学意义(P>0.05);3)两组孕妇的年龄、孕产次以及孕期体质量增长相比较,差异无统计学意义(P>0.05)。结论 1)大部分GDM孕妇产后6～8周糖代谢可恢复正常,28.8%(180例)的孕妇产后仍然存在糖代谢异常;2)孕妇GDM诊断孕周早、孕期空腹血糖高、DM家族史、孕期应用胰岛素控制血糖、孕期合并相关合并症、孕前及产后高BMI、高脂血症等均为产后糖代谢异常的高危因素。     

孕妇孕期血糖与体重及C反应蛋白的关系探讨

[目的]探讨孕妇孕期血糖与体重及C反应蛋白的关系。[方法]分组整理分析1356例足月单胎分娩孕妇,按体重指数(BMI)、孕期体重增加及C反应蛋白不同分组,运用统计学方法分析整理孕期血糖升高与不同分组间的关系。[结果]超重组与肥胖组孕早期空腹血糖、糖筛查(GCT)、葡萄糖耐量异常(IGT)、妊娠期糖尿病(GDM)比例均明显高于正常组(P<0.05)。按孕期体重绝对值增加幅度分组,B组的GCT、C组的GCT、IGT、GDM比例均明显高于A组,有统计学意义(P<0.05)。而B组的孕早期空腹血糖、IGT、GDM以及C组的孕早期空腹血糖与A组相比无明显差异(P>0.05)。按孕期C反应蛋白浓度分组,E组与F组孕早期空腹血糖、GCT、IGT、GDM比例均明显高于D组(P<0.05)。[结论]孕妇孕前体重指数、孕期体重增加及CRP与孕期血糖有重要关系,对孕前高BMI的孕妇应加强监护。     

妊娠期糖尿病危险因素探讨

目的探讨妊娠期糖尿病（GDM）危险因素,患者背景特点。方法选取我院2008年间住院病例96例GDM患者及200例糖筛查正常病例对照。从年龄、身高、体重指数、糖尿病家族史、自然流产史、及孕期罹惠假丝酵母菌情况进行统计分析。结果GDM组于年龄增加、孕前体重BMI、糖尿病家族史、自然流产史等因素中与糖筛查正常组比较有明显差异。     

妊娠期糖尿病发病的危险因素分析*

目的：探讨妊娠期糖尿病(gestational diabetes mellitus, GDM)发病的危险因素,为预防GDM的发生提供临床依据。方法：回顾性分析2016年1—12月妇女保健科收治的GDM患者162例(观察组),按1∶1比例收集同期在我院妇女保健科产检的162例正常孕妇作为对照组。自制调查问卷调查受试者的年龄、孕前体质量指数(body mass index, BMI)、月收入、文化程度、胎次、糖尿病家族史、膳食模式等相关影响因素,分析GDM的危险因素。结果：单因素分析发现年龄、孕前BMI、文化程度、胎次、糖尿病家族史、孕期并发症、膳食、负性情绪与GDM发病相关,进一步行多因素非条件Logistic回归分析,结果显示孕前BMI、多胎次、糖尿病家族史、高能量摄食、高碳水化合物比例摄食是GDM的危险因素,OR值分别为4.25(2.98~4.53)、4.06(2.77~4.28)、2.01(1.98~3.04)、3.21(2.25~3.96)、5.01(4.06~5.95),差异均有统计学意义(均P＜0.05)。结论：妊娠期肥胖、多胎次、糖尿病家族史、高能量摄食、高碳水化合物比例摄食是GDM的危险因素,单纯高蛋白质比例膳食与其发病无关。     

妊娠糖尿病患者负性情绪及危险因素分析

目的 调查妊娠糖尿病（GDM）患者负性情况的发生状况,并分析其危险因素。方法 选取2014 年 6 月—2016 年6 月海南省人民医内分泌科就诊的GDM 患者189 例,根据医院用焦虑抑郁量表（HADS）评分 结果,分为GDM 合并负性情绪组（GDM+ 负性情绪组,HADS>15 分）Ⅲ例和GDM 不合并负性情绪组（GDM 组,HADS ≤ 15 分）88 例。另根据HADS 评分将GDM+ 负性情绪组分为轻度负性情绪亚组（16 ≤ HADS ≤ 20） 39 例、中度负性情绪亚组（21 ≤ HADS ≤ 30）37 例及重度负性情绪亚组（31 ≤ HADS ≤ 42）35 例。采 用Pearson 相关分析HADS 评分水平的相关因素。采用Logistic 回归分析GDM 患者合并负性情绪的影响因 素。结果 ① GDM 患者合并负性情绪的发生率为58.73%（111/189）。GDM+ 负性情绪组孕前BMI、FPG、 HbA1c、TC、TG、HDL-C、HOMA-IR 及糖尿病家族史患者比例均高于GDM 组（P <0.05）;②重度负性 情绪亚组FPG、HbA1c、TC、TG、HDL-C 及HOMA-IR 水平均高于轻度负性情绪亚组和中度负性情绪亚组, 且中度负性情绪亚组FPG、HbA1c、TC 及HOMA-IR 水平高于轻度负性亚组（P <0.05）;③ Pearson 相关分 析显示,孕前BMI、孕期体重增加、FPG、HbA1c、TC、TG、HDL-C、HOMA-IR 及有糖尿病家族史均与 HADS 评分相关（P <0.05）;④孕前BMI、孕期体重增加、HbA1c 及糖尿病家族史是GDM 合并负性情绪的 危险因素（P <0.01）。结论 GDM 患者合并负性情绪的发生率仍较高,尤其是孕前BMI 高、孕期体重增加、 HbA1c 水平高及有糖尿病家族史的患者。因此,对该类孕妇应及早的进行心理干预,提供更多的心理辅导, 预防负性情绪的发生。     

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.