恶性血液病患者感染病原菌分布及耐药性分析

目的探讨和分析恶性血液病患者发生病原菌感染时细菌的分布特点及耐药情况,为临床合理应用抗菌药物提供一定的科学依据。方法选取我院2000年1月至2014年1月收治的血液病发生细菌感染并由标本培养出病原菌株的患者130例为研究对象,对病原菌分布和用药情况进行系统性回顾分析,观察和统计细菌的分布情况和耐药特点。结果恶性血液病患者病原菌感染部位以血流感染为主(85例,占64.5%),所有病原菌中以革兰阴性菌为主(90株,占69.2%),其次为革兰阳性菌(68株,占21.6%);耐药性统计中,各类细菌耐药性明显,大肠埃希菌对ESBLs检出率为90.3%,肺炎克雷伯菌对ESBLs检出率为62.9%,葡萄球菌中检出MRSA 4株和MRCNS 5株。革兰阴性杆菌对亚胺培南、阿米卡星、美罗培南较敏感,耐药率较低;革兰阳性菌对万古霉素、利福平、莫西沙星和替加西林较敏感,耐药率低。头孢类抗生素已不适合一线用药。结论恶性血液病患者病原菌分布以血流感染为主,主要为革兰阴性菌,病原菌对各类抗菌药物耐药性严重,应根据细菌分布和耐药特点合理应用抗菌药物。     

神经内科住院患者感染病原菌分布及耐药性分析

目的分析神经内科住院患者感染病原菌分布及耐药性,为抗菌药物的合理应用提供依据。方法对2016年1～12月医院神经内科住院的253例感染患者的细菌分离及鉴定,并对感染患者的病原菌分布及药敏试验结果进行回顾性分析。结果神经内科住院的感染患者的感染部位,以下呼吸道感染为主,其次为上呼吸道感染、泌尿道等,分别占66.81%、13.36%和7.51%。标本来源以痰液、尿液、血液为主,分别占61.26%、17.39%和12.25%;共分离病原菌125株,其中革兰阴性菌96株占76.80%,革兰阳性菌15株占12.00%。真菌14株占11.20%;革兰阴性菌主要为肺炎克雷伯菌和大肠埃希菌,革兰阳性菌中屎肠球菌和葡萄球菌属检出率较高,真菌中以白色假丝酵母菌为主。革兰阴性菌对喹诺酮类、青霉素类、头孢菌素类等抗菌药物耐药率较高,部分可达100.0%,而对氨基糖苷类、美罗培南、亚胺培南、阿米卡星及头孢哌酮/舒巴坦等仍较敏感,革兰阳性菌对青霉素、克林霉素等普遍耐药,但对万古霉素、替考拉宁、利福平等仍较敏感。结论神经内科住院患者发生感染以呼吸道感染最为常见,泌尿系感染次之,在分离菌株中仍以革兰阴性菌为主,对常用的抗菌药物耐药率较高,应加强细菌学送检,根据感染病原菌体外药敏结果及抗菌药物使用原则有针对性选用抗菌药物,减少细菌耐药的产生。     

新生儿肺炎病原学检测及药敏分析

目的探讨新生儿重症监护病房（NICU）新生儿肺炎的主要病原菌及其药敏情况,为临床合理使用抗菌药物提供参考依据。方法回顾性分析东莞市大朗医院2009年9月～2012年5月NICU207例新生儿肺炎患儿痰液标本分离出的病原菌及药敏情况。结果207份痰液标本中134份培养阳性,阳性率为64．73％,革兰阴性菌83株,占61．94％,革兰阳性菌47株,占35．07％,真菌4株,占2．98％。革兰阴性菌以肺炎克雷伯菌、大肠埃希菌和肠杆菌为主,耐药性高,较敏感的抗生素为哌拉西林／他唑巴坦、阿莫西林／棒酸、头孢西丁,未见对亚胺培南、美罗培南、丁胺卡那霉素耐药的菌株。革兰阳性菌中以金黄色葡萄球菌和表皮葡萄球菌为主,金黄色葡萄球菌和表皮葡萄球菌对青霉素、苯唑西林、红霉素的耐药率达到100％,对夫西地酸、万古霉素、诺氟沙星、左旋氧氟沙星、利福平和复方磺胺甲恶唑敏感。结论新生儿肺炎以革兰阴性菌为主,应加强病原菌及药敏监测,合理使用抗菌药物。     

2016-2017年单中心血液肿瘤患儿感染病原菌分布的临床特点分析

目的 探讨北京儿童医院血液肿瘤中心血液系统疾病患儿病原菌的流行病学特点,为临床合理使用抗菌药物提供参考依据.方法 回顾性分析2016年1月至2017年6月在北京儿童医院血液肿瘤中心住院,送检标本细菌培养阳性的血液病患儿资料.去除污染及定植标本后,共获病原菌2 188株,分析其临床资料及药敏试验结果.结果 全部病原菌中革兰阴性菌占48.1％、革兰阳性菌占38.3％、真菌占13.6％.革兰阴性菌中以肺炎克雷白杆菌、铜绿假单胞菌、阴沟肠杆菌、大肠埃希菌为主要致病菌;革兰阳性菌则以凝固酶阳性表皮葡萄球菌及人葡萄球菌为首.其中89例次标本同一部位分离出2种细菌,2例次标本同一部位分离出3种细菌.感染部位以血流(62.5％)、呼吸道(17.4％)、泌尿系统(7.2％)、皮肤软组织(6.4％)为主.1 383株血培养阳性菌株中革兰阴性菌678株(49％),革兰阳性菌631株(45.6％),真菌74株(5.4％).呼吸道、泌尿系感染病原以革兰阴性菌为主,而皮肤软组织的感染病原以革兰阳性菌为主.革兰阳性菌中,共检出耐甲氧西林葡萄球菌(methicillin-resistant staphylococcus,MRS)348株(占革兰阳性菌的41.6％),以表皮葡萄球菌及人葡萄球菌为主;革兰阴性菌中检测到超广谱β内酰胺酶(extended-spectmmbeta-lactamase,ESBL)阳性的细菌336株(占革兰阴性菌的31.9％),以肺炎克雷伯杆菌及大肠埃希菌为主.结论 血液肿瘤患儿合并感染以革兰阴性菌为主,血流及呼吸道为最常见的感染部位,耐药菌及条件致病菌发生率有增长趋势.     

呼吸科普通病房和呼吸重症加强治疗病房下呼吸道感染病原体的分布及药敏差异

目的分析呼吸科普通病房和呼吸重症加强治疗病房（RICU）住院患者下呼吸道感染病原菌分布和药敏的差异。方法对呼吸科普通病房和RICU下呼吸道感染住院患者痰菌（或纤支镜吸取分泌物）培养阳性结果进行回顾性统计分析。结果共分离出菌株3202株。其中普通病房1254株,革兰阳性菌2．63％,革兰阴性菌42．42％,真菌54．95％。革兰阳性菌中,以肺炎链球菌为主,占51．52％;革兰阴性菌中,以副流感嗜血杆菌居首位,占21．99％,二者均对大多数常用抗菌药物敏感。RICU分离的1948株病原菌中,革兰阳性球菌4．52％,革兰阴性杆菌37．73％,真菌57．75％。革兰阳性菌中,以金黄色葡萄球菌居为主,占52．27％,革兰阴性菌中,以鲍曼不动杆菌居首位,占27．35％,二者均对大多数常用抗菌药物耐药。铜绿假单胞菌无论是在普通病房还是RICU均有较高感染率,且对大多数常用抗菌药物耐药。结论呼吸科普通病房革兰阳性菌感染中以肺炎链球菌为主,革兰阴性菌感染以副流感嗜血杆菌为主,二者均对大多数常用抗菌药物敏感;RICU革兰阳性菌感染中以金黄色葡萄球菌为主,革兰阴性菌感染以鲍曼不动杆菌为主,二者均对大多数常用抗菌药物耐药。     

2019年至2021年血液病住院患者血流感染病原菌分布及耐药性分析

目的 分析解放军总医院血液病住院患者血流感染病原菌的分布特点和耐药性,为临床合理选用抗菌药物提供参考依据。方法 对2019年至2021年血液病和非血液病住院患者送检的血培养及药敏结果进行回顾性分析,用VITEK-2微生物分析仪进行微生物鉴定和药敏试验。结果 血液病患者血培养阳性标本病原菌以革兰阴性杆菌为主（71.2%）,其次是革兰阳性菌（26.8%）、真菌（2.0%）;主要病原菌有大肠埃希菌、肺炎克雷伯菌、凝固酶阴性葡萄球菌、铜绿假单胞菌等;主要革兰阴性菌对阿米卡星、亚胺培南、美罗培南敏感率较高;主要革兰阳性菌对万古霉素、利奈唑胺敏感率较高;葡萄球菌属未发现万古霉素、替加环素和利奈唑胺耐药株;分离的真菌对二性霉素B和伏立康唑的敏感率高。对血液病和非血液病患者血流感染的病原菌进行比较,发现血液病患者铜绿假单胞菌和嗜麦芽窄食单胞菌构成比高于非血液病患者,凝固酶阴性葡萄球菌和白色假丝酵母菌明显低于非血液病患者（P<0.05）。血液病患者大肠埃希菌对碳青霉烯类药物、喹诺酮类药物等的耐药率高于非血液病患者,差异有统计学意义（P<0.05）;肺炎克雷伯菌和铜绿假单胞菌对碳青霉烯类、喹诺酮类等抗菌药物的耐药率均低于非血液病患者,差异有统计学意义（P<0.05）。结论 革兰阴性菌是引起本院血液病住院患者血流感染最主要的病原菌,以大肠埃希菌最为常见,与本院非血液病患者病原菌分布结果大致相同。革兰阴性菌对阿米卡星、亚胺培南、美罗培南、哌拉西林/他唑巴坦敏感率高,革兰阳性菌对万古霉素、利奈唑胺敏感率高。本研究发现血液病患者大肠埃希菌对碳青霉烯类药物、喹诺酮类药物等的耐药率高于非血液病患者,在临床诊治中应加强对碳青霉烯类药物和喹诺酮类药物的关注和监控,及时进行病原菌和耐药性监测、正确选用抗菌药物、及早控制血流感染,对预后非常重要。     

肺结核合并呼吸道感染的288株病原菌分布及耐药性分析

目的通过对288株肺结核合并呼吸道感染的病原菌分布及其耐药性情况进行统计分析,以指导临床合理用药。方法对2012年7—12月肺结核合并呼吸道感染患者送检痰标本中分离鉴定的致病菌288株及药敏试验结果进行归纳分析。结果肺结核继发呼吸道感染的患者痰标本中共培养出288株菌株,革兰阴性菌226株,占78．47％,革兰阳性菌株18株,占6．25％,真菌44株,占15．28％。革兰阴性菌中肺炎克雷伯杆菌、阴沟肠杆菌、铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌为主;革兰阳性菌主要为肺炎链球菌、金黄色葡萄球菌、表皮葡萄球菌;真菌主要为白色念珠菌。药敏结果细菌种类情况各不相同,用药应根据细菌种类来确定。结论肺结核合并呼吸道感染的病原菌以革兰染色阴性菌为主。检出病原菌对抗菌药物的耐药性较强,临床医生应根据细菌培养和药敏结果采取合理抗生素治疗。     

我院肛瘘合并感染患者脓液病原菌培养和药敏结果分析

目的:探讨我院肛瘘合并感染患者脓液病原菌培养和药敏结果，旨在为肛瘘临床合理用药提供理论参考。方法:回顾性分析2019年5月至2021年5月我院收治的174例肛瘘合并感染患者的临床资料，采集所有患者脓液标本进行病原菌培养，分析病原菌分布情况及主要病原菌药敏结果。结果:174例肛瘘合并感染患者共检出234株病原菌株，其中革兰阳性菌40株(占17.09%)、革兰阴性菌194株(占82.91%)。革兰阳性菌中以金黄色葡萄球菌为主(20株，占8.56%),革兰阴性菌中以大肠埃希菌为主(118株，占50.43%),其次为肺炎克雷伯菌(22株，占9.41%)。药敏结果显示，金黄色葡萄球菌对哌拉西林、万古霉素、利奈唑胺极为敏感(敏感率均为100%),而对青霉素、红霉素、利福平较为耐药(耐药率均>80%)。大肠埃希菌对大多数抗菌药物耐药，仅对阿米卡星、亚胺培南、美罗培南极为敏感(敏感率均为100%)。肺炎克雷伯菌亦对大多数抗菌药物耐药，仅对头孢他啶、哌拉西林、氨曲南、亚胺培南、美罗培南极为敏感(敏感率均为100%)。结论:我院肛瘘合并感染患者脓液病原菌主要以革兰阴性菌为主，检出率前3位的病原菌分别...     

骨科感染患者病原菌分布及耐药性分析

目的明确骨科感染患者常见病原菌的分布及耐药情况,指导临床合理应用抗菌药物。方法选取我院骨科病房患者225例,采集病灶伤口分泌物等标本进行细菌培养鉴定,并对检出的病原菌按照K-B琼脂扩散法进行药敏试验。结果除6例患者伤口分泌物中未分离出病原菌外,共分离出病原菌219株,其中革兰阳性菌90株(占41.10%),主要包括金黄色葡萄球菌、表皮葡萄球菌、肠球菌等;革兰阴性菌129株(占58.90%),主要包括铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌等。药敏结果显示耐药菌菌种分布较为广泛,革兰阳性菌和革兰阴性菌均对青霉素类抗菌药物耐药率较高。万古霉素和亚胺培南分别是革兰阳性菌、革兰阴性菌敏感性较高的抗菌药物。结论骨科患者感染多见,感染的病原菌种类多,耐药情况复杂,应动态观察骨科患者细菌分布及耐药性的变化,合理应用抗菌药物,从而降低骨科患者感染的发生。     

某医院下呼吸道感染病原菌及耐药性

目的探讨小儿下呼吸道感染病原菌的分布及其对常用抗菌药物的耐药性,为临床应用抗菌药物提供参考。方法针对2016年1月至2018年5月中国人民解放军武汉总医院儿科下呼吸道感染患儿送检的标本情况进行分析,统计病原菌的分布情况,并总结其耐药性。结果共计检出病原菌341株,其中革兰阴性菌185株,占54.2%;革兰阳性菌151株,占44.3%;真菌5株,占1.5%。药敏结果显示:主要革兰阴性菌对美罗培南、亚胺培南、阿米卡星均敏感,对氨苄西林、头孢呋辛的耐药率较高;主要革兰阳性菌对利奈唑胺、万古霉素均敏感,对红霉素、克林霉素、苯唑西林、青霉素G的耐药率较高。结论小儿下呼吸道感染的病原菌前5位为金黄葡萄球菌、大肠埃希菌、流感嗜血杆菌、肺炎克雷伯菌和肺炎链球菌,临床应根据病原菌药敏结果,合理应用抗菌药物。     

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.