支气管哮喘和慢性阻塞性肺疾病患者吸入高渗盐水诱导痰的安全性和有效性观察

目的:观察缓解期哮喘和稳定期中、重度慢性阻塞性肺疾病(COPD)患者吸入高渗盐水诱导痰的安全性和有效性。方法:吸入沙丁胺醇200μg后10m in吸入3%的高渗盐水诱导痰。观察16例哮喘患者、14例COPD患者和11例健康对照者诱导痰前、后肺功能、心率(HR)、呼吸频率(RR)、血氧饱和度(SaO2)和不良反应,做诱导痰炎性细胞分类计数。夹心法酶联免疫吸附实验(ELISA)测定诱导痰上清液中白细胞介素-5(IL-5)的含量。结果:哮喘和COPD患者诱导痰前后肺功能、HR、RR和SaO2均无显著变化(P>0.05)。哮喘组患者诱导痰中嗜酸性粒细胞数(16.3±7.2)%显著高于对照组(0.7±0.6)%和COPD组(6.5±5.4)%(P<0.05),而COPD组患者诱导痰中中性粒细胞数(59.4±10.6)%显著高于对照组(25.1±6.1)%和哮喘组(28.7±7.3)%(P<0.05)。哮喘组诱导痰中IL-5水平(53.3±24.2)ng/L显著高于对照组(20.2±4.1)ng/L和COPD组(29.8±4.7)ng/L(P<0.05)。COPD组患者中性粒细胞数的百分比与基础第1秒用力肺活量(FEV1)间呈负相关(r=-0.58,P<0.05)。哮喘组和COPD组不良反应发生率分别为31.25%和42.86%,但轻微且均能耐受。结论:缓解期哮喘和稳定期中、重度COPD患者吸入高渗盐水进行痰的诱导是安全的。诱导痰的分析能反映哮喘和COPD的气道炎症特征。     

慢性鼻窦炎伴鼻息肉合并哮喘患者FeNO与IL-17表达和肺功能的相关性

目的 探讨慢性鼻窦炎伴鼻息肉合并哮喘患者Fe NO值与IL-17表达和肺功能的关系。方法 选取慢性鼻窦炎伴鼻息肉合并哮喘患者32例(A组)、慢性鼻窦炎伴鼻息肉患者30例(B组)、正常对照组30例(C组),分别测定三组血液中IL-17,Fe NO和FEV1%并进行统计学分析。结果 A组IL-17及Fe NO值高于B组和C组(P<0.05),FEV1%低于B组和C组(P<0.05);B组IL-17、Fe NO值高于C组(P<0.05),B组FEV1%值与C组差异无统计学意义(P>0.05)。慢性鼻窦炎伴鼻息肉合并哮喘患者Fe NO与IL-17表达正相关(r=0.442,P<0.05)),与FEV1%呈负相关(r=-0.342,P<0.05)。结论慢性鼻窦炎伴鼻息肉合并哮喘患者Fe NO和外周血中IL-17水平均显著升高而FEV1%显著降低,Fe NO与外周血中IL-17及FEV1%具有相关性。     

重度支气管哮喘患者诱导痰中白细胞介素-17水平及其与气道炎症和气流受限的关系

目的:探讨重度支气管哮喘(简称哮喘)患者诱导痰中白细胞介素-17(IL-17)的水平及其与炎症细胞和肺功能的关系. 方法:分别选择16例慢性持续期重度哮喘患者(哮喘组)、14例稳定期中度慢性阻塞性肺疾病(COPD)患者(COPD组)和12例健康对照(健康对照组),对其进行肺功能的测定和用诱导痰检查方法对痰炎性细胞进行分类计数,并用酶联免疫吸附实验(ELISA)测定诱导痰上清液中IL-17、IL-6和IL-8的水平 .结果:哮喘组患者诱导痰中IL-17水平与COPD组和健康对照组比较差异有统计学意义(P<0.05),但COPD组和健康对照组比较无显著性差异(P>0.05).哮喘组患者诱导痰中IL-17水平与中性粒细胞数和IL-8呈正相关(r值分别为0.62和0.71,P<0.05),与第一秒用力呼气容积占预计值的百分比(FEV1%)呈负相关(r=-0.65,P<0.05).哮喘组和COPD组患者诱导痰中IL-8水平与健康对照组比较差异有统计学意义(P<0.05),但两组间无显著性差异(P>0.05).哮喘组和COPD组患者诱导痰中IL-8水平与中性粒细胞数呈正相关(r值分别为0.58、0.64,P<0.05),与FEV1%呈负相关(r值分别为-0.63、-0.58,P<0.05).哮喘组患者诱导痰中IL-6水平与COPD组和健康对照组比较差异有统计学意义(P<0.05),但COPD组和健康对照组比较无显著性差异(P>0.05).结论:慢性持续期重度哮喘患者诱导痰中增高的IL-17水平与其气道炎症和气流受限有关,且可能是通过IL-8途径实现的.     

重症溃疡性结肠炎患者外周血中髓样树突状细胞和IL-17A表达及预后研究

目的 探讨重症活动期溃疡性结肠炎(ulcerative colitis,UC)患者外周血单个核细胞(PBMC)中髓样树突状细胞(myeloid dendritic cell,MDC)比例和IL-17A水平及与预后关系。 方法 选取2016年1月—2019年3月温州市中西医结合医院收治的重症活动期UC患者90例作为研究对象,根据其预后情况分为预后良好组(49例)、预后不良组(41例)。利用流式细胞术检测PBMC中MDC,酶联免疫吸附试验(ELISA)检测血浆IL-17A水平。 结果 治疗后2组PBMC中MDC比例和血浆IL-17A水平低于治疗前(均P<0.001);治疗前后预后良好组PBMC中MDC比例分别为(0.48±0.15)%、(0.29±0.09)%,低于预后不良组的(0.56±0.17)%、(0.44±0.13)%(均P<0.05);血浆IL-17A水平分别为(12.97±4.24)ng/L、(9.05±2.96)ng/L,低于预后不良组的(16.02±5.13)ng/L、(11.88±3.90)ng/L(均P<0.05)。重症活动期UC患者PBMC中MDC比例与血浆IL-17A水平呈正相关(r=0.692,P<0.001)。入院时腹泻≥10次/d、MDC及IL-17A是影响重症活动期UC患者不良预后的独立危险因素(均P<0.05)。PBMC中MDC比例联合血浆IL-17A水平预测重症活动期UC患者不良预后的AUC为0.943,预测效果优于单独检测。 结论 PBMC中MDC比例和血浆IL-17A水平升高可作为评估重症活动期UC患者不良预后的潜在标记物。      

COPD急性发作期患者外周血IL-35、hs-CRP检测及临床意义

目的 观察慢性阻塞性肺疾病急性发作期(acute exacerbation of chronic obstructive pulmonary disease, AECOPD)患者外周血IL-35、hs-CRP水平,并探讨其临床意义。 方法 80例COPD患者分为急性发作期组(A组,n=49)和稳定期组(B组,n=31),同期健康体检者25名为对照者(C组,n=25)。ELISA法检测3组外周血清IL-35表达;检测3组外周血清hs-CRP。 结果COPD患者B组、A组外周血清IL-35表达水平分别为(4.171±1.339)ng/ml、(3.480±1.790)ng/ml,与对照组[(5.194±1.595)ng/ml]相比,差异有统计学意义(P<0.05);B组与A组相比,差异无统计学意义(P>0.05)。A组患者血清hs-CRP水平[(61.143±30.024)mg/L]明显高于B组和C组[(12.161±4.495mg/L、(1.075±0.855)mg/L],差异有统计学意义(P<0.05)。A组外周血清IL-35与hs-CRP呈负相关性(r=-0.349,P=0.014),B组无负相关(r=-0.237,P=0.199)。 结论 AECOPD患者外周血清IL-35低表达及hs-CRP高表达,两者联合检测可作为临床诊断AECOPD的辅助指标。     

IL-17A抑制Th2细胞分化减轻哮喘小鼠气道嗜酸性粒细胞炎症

目的 研究IL-17A对哮喘小鼠Th2细胞分化及其相关炎症的作用.方法 24只C57BL/6J小鼠按随机数字表法分为对照组、哮喘组和IL-17A处理组(n=8).哮喘组和IL-17A处理组予以卵清蛋白(ovalbumin,OVA)致敏及激发.每次雾化激发前1h,IL-17A处理组给予重组小鼠IL-17A气道滴入.各步对照均予以生理盐水.末次激发后24h处死小鼠,收集支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)行细胞总数及分类计数.ELISA检测BALF中IL-4、IL-5、IFN-γ、IL-17A的浓度.HE和PAS染色及半定量评分评估小鼠肺部病理变化.流式细胞术检测脾脏和支气管淋巴结Th细胞分化.免疫磁珠分选健康小鼠幼稚CD4+T细胞,用Th2极化培养基体外培养,并给予IL-17A或等量PBS干预,检测Th2细胞的增殖、凋亡和分化.结果 哮喘组较对照组,BALF中细胞总数、嗜酸性粒细胞数及其比例(P＜0.05)、IL-4、IL-5、IL-17A浓度均显著增高(P＜0.05),IFN-γ浓度显著下降(P＜0.05);支气管、血管周围炎症细胞浸润和杯状细胞化生明显加重(P＜0.01);脾脏和淋巴结Th2细胞分化比例显著增高(P＜0.05).IL-17A处理组较哮喘组,BALF中的细胞总数[(26.00±5.43)×104/mLvs(58.40 ±26.93)×104/mL,P＜0.05]、嗜酸性粒细胞数[(8.04±1.98)×104/mL vs(31.95±12.28)×104/mL,P＜0.05]及其比例[(29.93 ±3.03)％ vs(53.47 ±6.62)％,P＜0.01]显著降低,而中性粒细胞数及其比例无明显变化;BALF中Th2相关因子IL-4浓度[(9.86 ±2.77) pg/mL vs(28.13 ±4.62) pg/mL,P＜0.01]、IL-5浓度[(7.30 ±0.50) pg/mL vs(10.50±1.10) pg/mL,P＜0.01]均显著降低;支气管、血管周围炎症细胞浸润减轻,HE染色半定量评分降低[(2.00 ±0.51)vs(3.12 ±0.64),P＜0.05],杯状细胞化生减少[(0.80 ±0.45)vs(2.40 ±0.55),P＜0.01];脾脏[(2.24±0.44)％vs(4.82±1.83)％,P＜0.01]和淋巴结[(7.05±0.58)％vs(10.57±1.35)％,P＜0.05]中Th2细胞分化比例显著减少.极化培养的幼稚CD4+T细胞,予IL-17A干预后,诱导分化的Th2细胞比例显著减少(P＜0.05),而增殖和凋亡无显著变化.结论 IL-17A有抑制Th2细胞分化,减轻哮喘小鼠气道嗜酸性粒细胞炎症的作用.     

白细胞介素18对豚鼠哮喘模型气道炎症作用的实验观察

目的观察白细胞介素18(IL-18)对豚鼠哮喘模型气道炎症的作用。方法采用卵蛋白(OVA)腹腔注射致敏加雾化吸入激发的方法复制豚鼠哮喘模型。30只豚鼠按随机数字法分成3组(每组10只)进行处理,分别为哮喘模型组(A组)、模型对照组(B组)和IL-18干预组(C组)。光镜下检测各组豚鼠支气管肺泡灌洗液(BALF)中炎症细胞计数及分类,用酶联免疫吸附法测定BALF中Th1细胞因子IFN-γ、IL-2和Th2细胞因子IL-4、IL-5浓度,并进行3组之间的比较。结果豚鼠BALF中嗜酸粒细胞(EOS)个数A组、B组、C组分别为(98±58)×106/L、(12±10)×106/L、(29±10)×106/L,A组与B组、C组比较差异有统计学意义(P<0.01);中性粒细胞个数A组与B组、C组比较差异有统计学意义(P均<0.05)。IFN-γ和IL-2浓度A组与B组比较差异有统计学意义(P<0.05),与C组比较差异亦有统计学意义(P均<0.01)。IL-4浓度A组与B组、C组比较差异有统计学意义(P均<0.05);IL-5浓度A组与B组、C组比较差异有统计学意义(P<0.01)。结论IL-18可通过调节Th1/Th2细胞因子的平衡而达到控制哮喘气道炎症的作用。     

HMGB1在支气管哮喘和慢性阻塞性肺疾病患者中的表达及其意义

目的 探讨支气管哮喘及慢性阻塞性肺疾病(COPD)患者诱导痰中高迁移率组蛋白B1( HMGB1)的表达及其与气道炎症的关系.方法 按标准纳入慢性持续期哮喘患者57例,稳定期的COPD患者30例,对照组(健康体检者)20例;完成哮喘控制问卷后,分别进行肺功能检测和诱导痰检查,记录第1秒用力呼气容积( FEV1)占预计值的百分比(FEV1％预计值),行诱导痰中性粒细胞分类计数,酶联免疫吸附法检测诱导痰HMGB1水平.结果 哮喘组、COPD组诱导痰HMGB1水平分别为(291±55)、(511±39) ng/L,显著高于对照组的(61±5)ng/L(均P＜0.01);在107例研究对象中,HMGB1的表达与FEV1％预计值呈反比;COPD组诱导痰HMGB1水平显著高于哮喘组(P＜0.01).嗜酸粒细胞哮喘组与非嗜酸粒细胞哮喘组HMGB1水平分别为(290 +55)、(292±54) ng/L,差异无统计学意义(P＞0.05).Ⅱ、Ⅲ级COPD患者HMGB1水平分别为(526±29)、(541±29 )ng/L,显著高于Ⅰ级的(471±18)ng/L(均P＜0.01).轻、中、重度持续期哮喘患者诱导痰中性粒细胞比例分别为(27±2)％、(36±4)％、(49±4)％,HMGB1水平分别为(227±16)、(312±14)、(347±11) ng/L,差异均有统计学意义(均P＜0.01).哮喘及COPD患者诱导痰中HMGB1与中性粒细胞比例均呈正相关(r值分别为0.880和0.132,均P＜0.01).年龄、性别、嗜酸粒细胞比例均不是影响HMGB1表达的显著性因素,诱导痰中性粒细胞比例和FEV1％预计值与HMGB1表达水平关系显著(t=-3.059,P =0.005).结论 HMGB1在支气管哮喘及COPD患者诱导痰中呈高表达,对气道炎症有增强作用.     

肿瘤坏死因子α和内皮素1对支气管哮喘发病的影响

目的观察支气管哮喘患者急性发作期与缓解期血浆肿瘤坏死因子α(TNF-α)和内皮素1(ET-1)的变化,探讨其与哮喘发病的关系.方法对哮喘急性发作组(A组)、缓解组(B组)、健康对照组(C组),采用放射免疫法测定血浆TNF-α、ET-1,同时检测血氧分压(PaO2).结果 A、B、C3组TNF-α分别为52.6±12.2pmol/L、31.8±9.0pmol/L、20.2±7.5pmol/L;ET-1分别为75.8±27.0ng/L、45.6±6.8ng/L、25.5±8.5ng/L.A组、B组TNF-α、ET-1较C组均有显著性差异(t=0.267和0.296,均P＜0.01).另外,TNF-α与ET-1呈正相关(r=0.36,P＜0.05);TNF-α与PaO2呈负相关(r=-0.82,P＜0.01);ET-1与PaO2亦呈负相关(r=-0.90,P＜0.01).结论 TNF-α、ET-1在哮喘发病中起重要作用,TNF-α可促进ET-1分泌,且TNF-α、ET-1的增加均与缺氧有关.     

孟鲁司特联合舒利迭治疗哮喘的临床疗效及对 炎症因子表达的影响

目的 探讨孟鲁司特联合舒利迭治疗哮喘的疗效和临床应用价值.方法 选择哮喘130例采取随机数字表法分为观察组和对照组,对照组给予舒利迭治疗,观察组联合孟鲁司特治疗,记录两组疗效.结果 观察组治疗后Th17(0.33±0.02)%,Treg(2.53±0.62)ng/L;对照组治疗后Th17(0.64±0.06)%,Treg(1.89±0.38)ng/L,组间对比差异有统计学意义(P<0.05).观察组治疗后IL-4(22.74±3.46)ng/L,IFN-γ(165.28±16.77)ng/L;对照组治疗后IL-4(32.85±5.72)ng/L,IFN-γ(122.85±10.68)ng/L,组间对比差异有统计学意义(P<0.05).结论 孟鲁司特联合舒利迭治疗支气管哮喘效果显著,能够有效降低体内炎症因子浓度,值得在临床大力推广使用.     

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.