下呼吸道感染患者支气管肺泡灌洗液定量培养及临床分析

目的：探讨下呼吸道感染患者支气管肺泡灌洗液病原菌分布及对常用抗菌药物的耐药性,为临床用药提供合理依据。方法：回顾性分析南京医科大学第一附属医院2018年下呼吸道感染患者支气管肺泡灌洗液定量分离培养结果及临床资料。结果：178例患者共分离病原菌197株,其中社区获得性肺炎（community acquired pneumonia,CAP）101 例（56.7%）,医院获得性肺炎（hospital acquired pneumonia,HAP）77 例（43.3%）,主要来源于重症监护病房（30.5%）、老年医学科（29.5%）、呼吸与危重症医学科（26.4%）。HAP病原菌以革兰阴性菌为主,占89.5%,CAP病原菌也以革兰阴性菌为主,但比例低于HAP病原菌,占77.5%。分离到的病原菌中,革兰阴性菌163株,占82.7%,排在前3位的是鲍曼不动杆菌（71株,36.0%）、铜绿假单胞菌（34株,17.3%）和肺炎克雷伯菌（28株,14.2%）;真菌21株,占10.7%,其中念珠菌属16株,曲霉菌4株,糠皮马拉色菌1株;革兰阳性菌13株,占6.6%,主要为金黄色葡萄球菌（10株,5.1%）。鲍曼不动杆菌对亚胺培南、美罗培南耐药率均为98.6%,铜绿假单胞菌对亚胺培南、美罗培南耐药率分别为29.4%、23.5%,肺炎克雷伯菌对亚胺培南、美罗培南耐药率均达57.1%。10株金黄色葡萄球共检出6株甲氧西林耐药金黄色葡萄球菌,检出率为60.0%,未检出对万古霉素、利奈唑胺耐药的金黄色葡萄球菌。结论：支气管肺泡灌洗液常见致病菌为革兰阴性杆菌,各病原菌耐药情况严重。临床应严格按照药敏结果合理用药,降低多重耐药菌肺部感染的发生率。     

2018—2020年宁夏地区临床分离革兰阴性菌耐药性分析

目的 监测宁夏地区临床分离的革兰阴性菌对抗菌药物的耐药性。方法 应用WHONET 5.6软件,参考2020年美国临床和实验室标准协会（CLSI）标准对2018—2020年宁夏30家医院革兰阴性菌耐药监测数据进行总结和分析。结果 分离出的103 188株非重复病原菌中,革兰阴性菌占71.45%(73 731株),革兰阳性菌占28.55%(29 457株)。排名前5位的细菌为克雷伯菌属、大肠埃希菌、铜绿假单胞菌、不动杆菌属和肠杆菌属。克雷伯菌属对头孢曲松耐药率为11.9%～14.0%,对亚胺培南和美罗培南的耐药率分别为0.9%～2.3%和1.1%～2.8%;大肠埃希菌对头孢曲松的耐药率为48.3%～49.9%,对亚胺培南的耐药率为0.6%～1.0%;铜绿假单胞菌对亚胺培南的耐药率为5.8%～7.7%,对美罗培南的耐药率为4.1%～4.8%;不动杆菌属对亚胺培南的耐药率为39.2%～43.8%;肠杆菌属、变形杆菌属、摩根菌属和沙雷菌属对碳青霉烯类的耐药率为0～4.2%。结论宁夏地区革兰阴性菌对抗菌药物的耐药率低于全国水平,但多重耐药和碳青霉烯类耐药菌株的增加,对临床抗感染治疗造成威胁,应加强...     

烧伤患者院内感染病原菌分布及耐药性分析

目的 分析烧伤患者院内感染病原菌的分布及耐药性,为烧伤患者院内病原菌感染的治疗提供依据。方法 收集2015年1月至2017年12月海军军医大学（第二军医大学）长海医院534例烧伤患者的各类临床标本,分离培养病原菌。使用VITEK 2 Compact全自动微生物分析仪或Microflex基质辅助激光解析飞行时间质谱仪进行细菌鉴定,使用VITEK 2 Compact全自动微生物分析仪进行细菌药物敏感性试验。结果 共分离出1 219株病原菌。其中革兰阴性菌877株（71.9%）,位列前4位的菌株分别为肺炎克雷伯菌（203株,16.7%）、铜绿假单胞菌（183株,15.0%）、鲍曼不动杆菌（176株,14.4%）和大肠埃希菌（101株,8.3%）;革兰阳性菌342株（28.1%）,位列前3位的菌株分别为金黄色葡萄球菌（136株,11.2%）、屎肠球菌（72株,5.9%）和粪肠球菌（60株,4.9%）。病原菌主要来源于创面分泌物（577株,47.3%）、痰/支气管肺泡灌洗液（341株,28.0%）和尿液（147株,12.1%）,93.5%（319/341）的痰/支气管肺泡灌洗液病原菌为革兰阴性菌。534例患者中有311例（58.2%）患者分离出2株及以上细菌。革兰阴性菌中肺炎克雷伯菌对常见抗菌药物的耐药率普遍偏高,呈现多重耐药趋势;铜绿假单胞菌耐药情况不容忽视,对碳青霉烯类抗菌药物的耐药率最高为35.5%;鲍曼不动杆菌对碳青霉烯类药物的耐药率最高达93.2%,对其他大部分抗菌药物耐药率>80.0%。革兰阳性菌中耐甲氧西林金黄色葡萄球菌检出率为69.1%（94/136）,肠球菌属对常见抗菌药物的耐药率为38.9%~66.3%,但尚未发现对万古霉素、替加环素和利奈唑胺耐药的革兰阳性菌。结论 烧伤患者院内感染病原菌分布较为复杂,超过一半的患者呈多重细菌感染。最常见的致病菌为肺炎克雷伯菌,呈现多重耐药趋势。革兰阳性菌对万古霉素、替加环素和利奈唑胺敏感。     

2010年海南省人民医院细菌耐药性监测

目的 了解2010年我院全年临床分离常见细菌对常用抗菌药物的耐药性现状.方法 采用纸片扩散法进行抗菌药物敏感试验,采用WHONET 5.4软件进行数据分析.结果 临床分离的1 634株细菌中,革兰阳性菌占25.5％,革兰阴性菌占74.5％.耐甲氧西林金黄色葡萄球菌检出率为34.2％,未发现耐万古霉素及利奈唑胺的葡萄球菌,大肠埃希菌和肺炎克雷伯菌中产超广谱β内酰胺酶(ESBLs)检出率各为39.5％和25.8％,肠杆菌科细菌均对碳青霉烯类敏感;其中铜绿假单胞菌对哌拉西林/他唑巴坦、美罗培南及左氧氟沙星的耐药率分别为22.8％、24.4％和27.7％.鲍曼不动杆菌对美罗培南、亚胺培南的耐药率为22.7％、54.5％.洋葱伯克霍尔德菌对左氧氟沙星、美罗培南和磺胺甲唑/甲氧苄啶的耐药率为2.3％、9.1％、9.1％.结论 我院2010年临床分离菌以革兰阴性菌为主,铜绿假单胞菌仍居第1位,肠杆菌科细菌对碳青霉烯类抗菌药物耐药率最低.定期进行细菌耐药性监测有助于了解医院细菌耐药性变迁,为临床经验用药提供依据.     

基于MALDI-TOF MS检测肺泡灌洗液病原菌分布和耐药性分析

目的 了解呼吸危重症医学科和重症监护病房(Intensive care unit,ICU)肺部疾病患者支气管肺泡灌洗液(Bronchoalveolar lavage fluid,BALF)病原菌种类及其耐药性。方法 回顾性分析2017年1月～2018年12月我院呼吸危重症医学科和ICU肺部疾病患者BALF分离的病原菌种类及耐药性情况。采用基质辅助激光解吸电离飞行时间质谱(Matrix-assisted laser desorption/ionization time of flight mass spectrometry,MALDI-TOF MS)对病原菌进行鉴定。结果 BALF阳性检出率为17.80%(162/910),共分离培养出病原菌191株,其中真菌98株(51.31%),以念珠菌、曲霉菌和新生隐球菌为主;革兰阴性杆菌共90株(47.12%),以鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯菌为主,多药耐药鲍曼不动杆菌对亚胺培南和美罗培南的耐药率均为58.33%,对头孢哌酮/舒巴坦和替加环素的耐药率分别为45.83%、16.67%,对哌拉西林/他唑巴坦及头孢类药物的耐药率均大于54.0%。其他革兰阴性杆菌对常用抗菌药物的耐药率不高。结论 基于MALDI-TOF MS鉴定的BALF病原菌种类多样,以真菌和革兰阴性杆菌为主,其中鲍曼不动杆菌多药耐药现象严重。病原菌的准确鉴定和敏感药物使用为临床提供治疗依据。     

ICU病房病原菌分布及耐药性分析

目的总结我院近2年ICU病房病原菌菌群分布及常见致病菌的耐药情况。方法对ICU分离出2720株病原菌的分类、药敏试验结果进行回顾性分析。结果2720株病原菌中革兰阴性菌1686株占62.0%,革兰阳性菌628株占23.1%,真菌406株占14.9%。革兰阴性菌构成比明显高于革兰阳性菌,最常见的革兰阴性菌分别是铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌、产酸克雷伯菌、肺炎克雷伯菌;在革兰阳性菌中居主导地位的是葡萄球菌和肠球菌。主要致病革兰阴性杆菌对头孢哌酮/舒巴坦、亚胺培南和美洛培南稍敏感,而对替卡西林、头孢噻吩、哌拉西林与阿莫西林均耐药;革兰阳性菌对万古霉素、替考拉宁、奎奴普丁/达福普汀、呋喃妥因、米诺四环素及呋西地酸敏感,而对青霉素耐药率高达100%。结论ICU病原菌以革兰阴性菌为主,检出菌均存在严重耐药问题,及时监测病原菌变化及耐药趋势以指导临床用药至关重要。     

ICU病房病原菌分布及耐药性分析

目的 总结我院近2年ICU病房病原菌菌群分布及常见致病菌的耐药情况.方法 对ICU分离出2720株病原菌的分类、药敏试验结果进行回顾性分析.结果 2720株病原菌中革兰阴性菌1686株占62.0%,革兰阳性菌628株占23.1%,真菌406株占14.9%.革兰阴性菌构成比明显高于革兰阳性菌,最常见的革兰阴性菌分别是铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌、产酸克雷伯菌、肺炎克雷伯菌;在革兰阳性菌中居主导地位的是葡萄球菌和肠球菌.主要致病革兰阴性杆菌对头孢哌酮/舒巴坦、亚胺培南和美洛培南稍敏感,而对替卡西林、头孢噻吩、哌拉西林与阿莫西林均耐药;革兰阳性菌对万古霉素、替考拉宁、奎奴普丁/达福普汀、呋喃妥因、米诺四环素及呋西地酸敏感,而对青霉素耐药率高达100%.结论 ICU病原菌以革兰阴性菌为主,检出菌均存在严重耐药问题,及时监测病原菌变化及耐药趋势以指导临床用药至关重要.     

支气管肺泡灌洗液细菌培养分布及耐药性分析

目的 :分析临床分离支气管肺泡灌洗液细菌培养分布及耐药状况。方法 :回顾性分析1 081例支气管肺泡灌洗液病原菌分布及耐药情况。结果: 共分离出病原菌506株,革兰阴性菌472株,占93.2%;革兰阳性菌34株,占6.8%。主要病原菌为铜绿假单胞菌、嗜麦芽窄食单胞菌、鲍曼不动杆菌、琼氏不动杆菌、鲁氏不动杆菌及金黄色葡萄球菌。铜绿假单胞菌、鲍曼不动杆菌对阿米卡星敏感性在80%以上,嗜麦芽窄食单胞菌对复方新诺明敏感性高（80.6%）;未发现耐万古霉素的金葡菌。结论: 肺泡灌洗液的主要病原菌为革兰阴性杆菌,细菌多药耐药现象严重,合理用药是控制感染的关键。     

近3年我院常见革兰阴性杆菌耐药性分析

目的:监测我院近3年临床分离的常见革兰阴性细菌的耐药变迁,指导临床合理使用抗菌药物.方法:2005～2007年从我院住院患者临床非重复分离的革兰阴性菌株8237株,采用CLSI推荐的纸片扩散法测定其抗菌药物敏感性,数据分析采用WHONET5.3软件.结果:所有分离的细菌中,最常见的革兰阴性病原菌是铜绿假单胞菌(45.4%,3 740株),其次为鲍曼不动杆菌(15.5%,1276株)、大肠埃希氏菌(13.2%,1087株),肺炎克雷伯(11.8%,972株),嗜麦芽窄食单胞菌(7.7%,634株),其他不动杆菌(5.1%,420株),阴沟肠杆菌(4.8%,395株),流感嗜血杆菌(3.7%,305株).大肠埃希氏菌和肺炎克雷伯菌ESBLs的检出率显著升高.对革兰阴性菌敏感性较高的抗菌药物是亚胺培南、美洛培南、阿米卡星、派拉西林/他唑巴坦、头孢他啶.铜绿假单胞菌对这些药物的敏感率基本保持在50%以上;亚胺培南和美洛培南对所分离的鲍曼不动杆菌的体外抗菌活性最强,但也呈逐年下降的趋势;对嗜麦芽窄食单孢菌抗菌活性较高的是米诺环素、左氧氟沙星和复方新诺明;大肠埃希氏菌和肺炎克雷伯菌对碳青霉烯类药物最敏感,敏感率为99.1%～100%.结论:3年来我院临床分离的革兰阴性细菌耐药率有较快增长.加强耐药监测,合理应用抗菌药物非常重要.     

潮州地区下呼吸道感染病原菌分布、耐药性监测及临床用药分析

目的：研究潮州地区下呼吸道感染病原菌的分布及进行耐药监测,同时了解抗菌药物使用情况。方法：选择2012年1月~2014年6月2 368例我院呼吸内科下呼吸道感染患者痰液进行细菌培养、菌种鉴定及药敏试验,统计分析病原菌耐药性,分析抗菌药物使用情况。结果：2368例患者检出1108株病原菌,分离率46.8%（1108/2368）。其中检出细菌1001例（占90.3%）,真菌107例（占9.7%）。病原菌主要以革兰阴性菌为主,前五位依次为肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、流感嗜血杆菌、大肠埃希菌;分离的革兰阳性菌主要以金黄色葡萄球菌为主,其次肺炎链球菌;分离出的真菌主要以白色假丝酵母菌为主,占真菌82.2%（88/107）。本研究分离的肺炎克雷伯菌和大肠埃希菌产ESBLs株分离率分别为43.0%（83/193）及72.8%（43/59）,非产ESBLS株对常用抗生素的耐药率均低于产ESBLS株,未发现对亚胺培南、美罗培南耐药的菌株。铜绿假单胞菌对哌拉西林/他唑巴坦、阿米卡星、妥布霉素、左氧氟沙星的耐药率均低于20%,对亚胺培南和美罗培南的耐药率分别为17.3%和16.8%;鲍曼不动杆菌对亚胺培南和美罗培南的耐药率均为68.1%（94/138）,多重耐药的鲍曼不动杆菌对常用抗菌药物的耐药率除多黏菌素外均大于90%。检出1108株病原菌中病例有756例,其中528例根据药敏结果调整用药,有效例数493例,有效率93.37%（493/528）。结论：下呼吸道感染细菌以革兰阴性菌为主,多种细菌对临床常用抗菌药物存在不同程度的耐药,有条件的医院应及早进行痰培养、药敏试验,及早调整抗菌药物,提高了临床治疗有效率。     

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.