老年高血压病人24小时动态血压昼夜节律的改变

应用无创性动态血压监测仪对115例老年高血压病人及对照组进行24小时动态血压监测，发现在对照组中有24例（61．9％）血压昼夜节律性消失；老年高血压Ⅰ、Ⅱ期组分别与对照组比较，血压昼夜节律性消失的发生率均无显著性差异；而老年高血压Ⅲ期组与对照组比较，其发生率显著增高（P＜0．01）。提示血压昼夜节律性消失较多见于高血压有并发症者。     

老年人蛛网膜下腔出血特点分析

目的通过二个年龄组分析探讨老年蛛网膜下腔出血的特点。方法对老年组３８例（５４．３％），非老年组３２例（４５．７％）进行临床分析、比较。结果７０例患者中年龄多布于６０～６９岁，３０～４９岁。老年组２０例（５２．６％）有高血压史，非老年组７例（２１．９％）。病程中出现头痛老年组２５例（６５．８％）非老年组３０例（９３．８％）。昏迷起病老年组１１例（２８．９％），非老年组６例（１８．８％），前者其中死亡７例（６３．６％），后者１例（１６．７％）。老年组并发症多达３５例次，非老年组１４例次。前者死亡１９例（５０％），后组７例（２１．９％）。复发率老年组３例（７．９％），低于非老年组６例（１８．８％），但复发后的死亡率高于非老年组，预后差。结论老年蛛网膜下腔出血发生率高于中青年，头痛症状发生少，意识障碍多见，并发病多，死亡率高，复发低，一旦发生，死亡率高，预后差。     

中老年高血压病高危患者24小时动态血压特征

目的了解中老年高血压病高危患者24小时动态血压特征及脉压情况。方法选用2002年以来住院的中老年高血压病高危患者132例，老年组（年龄≥60岁）63例，中年组69例（40岁≤年龄≤59岁）。所有患者均作24小时动态血压监测。结果老年组的收缩压日间与夜间均大于中年组（P〈0．05）；老年组的脉压日间与夜间均大于中年组（P〈0．05）；老年组的昼夜血压无差异（P〉0．05），中年组的昼夜血压存在差异（P〈0．05）。结论随着年龄的增长，同是高危险分层的高血压患者，老年组以收缩压增高为主，脉压增大，昼夜节律消失；中年组患者昼夜节律减弱。     

老年期、老年前期糖尿病的流行特征

对柳州市１５岁以上人群１２３０２人进行糖尿病调查，结果：老年组、老年前期组和成年组中的糖尿病患病率分别为１１８．３‰、４７．３‰和７．５‰。各组间女性明显高于男性。影响老年组和老年前期组患病率的主要因素为体重指数和职业。文化程度对患病率没有影响。老年前期和老年组糖尿病（ＤＭ）患者典型的多饮、多食、多尿及消瘦症状少见，但１／３以上的患者伴视力下降，肢体麻痛和高血压。     

老年单纯收缩期高血压与原发性高血压24小时动态血压监测

应用２４小时非创伤性动态血压仪（ＡＢＰＭ）对１０２例老年受试者进行监测，结果发现：单纯收缩期高血压（ＩＳＨ）与原发性高血压组同正常血压组昼夜节律基本相似，前二者收缩压（ＳＢＰ）昼夜节律无显著变化，ＩＳＨ组舒张压（ＤＢＰ）昼夜节律显著减弱（Ｐ＜０．００１），而２４小时平均ＳＢＰ高于原发性高血压和正常组（Ｐ＜０．００１），２４小时平均ＤＢＰ前二者相差不显著（Ｐ＞０．０５），而与正常比较差异很显著（Ｐ＜０．０１）。提示治疗中应注意血压昼夜节律变化，恰当选择治疗方案     

老年单纯收缩期高血压与原发性高血压24小时动态血…

应用２４小时非创伤性动态血压仪（ＡＢＰＭ）对１０２例老年受试者进行监测，结果发现：单纯收缩期高血压（ＩＳＨ）与原发性高血压组同正常血压组昼夜节律基本相似，前二者收缩压（ＳＢＰ）昼夜节律无显著变化，ＩＳＨ组舒张压（ＤＢＰ）昼夜节律显著减弱（Ｐ〈０．００１），而２４小时平均ＳＢＰ高于原发性高血压和正常组（Ｐ〈０．００１），２４小时平均ＤＢＰ前二者相差不显著（Ｐ〉０．０５），而与正常比较差异很显著（Ｐ〈     

非洛地平对原发性高血压的临床疗效观察

目的：评价非洛地平的降压疗效与毒副反应。方法：对４１例入选的原发性高血压患者按２∶１比例随机分为治疗组２７例（男１３例，女１４例，年龄为５３．９±１０岁）和对照组１４例（男１１例，女３例，年龄为４８．１±１２岁），分别给予非洛地平与尼群地平各治疗８周。结果：治疗组血压下降４．１±２．１／２．３±１．０ｋＰａ（Ｐ＜０．００１），显效率８８．９％（２４／２７例），有效率７．４％（２／２７），总有效率９６．３％，达靶率８１．４８％；对照组血压下降３．０±２．３／２．１±１．７ｋＰａ（Ｐ＜０．００１）。显效率５７．１％（８／１４），有效率２８．６％（４／１４），总有效率８５．７％，达靶率６４．２９％。总有效率与达靶率前者均高于后者，但无显著性差异。治疗组不良反应主要有踝关节浮肿（１１．１％）、头痛（７．４％）、面部潮红（７．４％）、心悸（３．７％）等，而对肝肾功能、糖脂质代谢等无明显不良影响。结论：非洛地平可十分有效地降低血压，其不良反应与其他钙拮抗剂的主要表现形式相似，多可耐受。     

高血压病血压昼夜节律与左室肥厚关系的初步探讨

目的 观察高血压病血压昼夜节律与左室肥厚（LVH）的关系。方法 52例高血压病患均经24h动态血压监测（ABPM）来观察血压昼夜节律，并经心电图检查诊断为左室肥厚。根据血压昼夜节律变化而分组。结果 血压昼夜节律消失15例，LVH 7例，占46．6％；血压昼夜节律正常37例，LVH8例，占21．6％。结论 血压昼夜节律消失组左室肥厚检出率显高于血压节律正常组。而夜间收缩压（SBP）和舒张压（DBP)经与（LVH）呈显负关系。     

老年人动态血压昼夜节律分析

目的 了解老年人动态血压昼夜节律改变的特征。方法 使用美国ＡｃｃｕｔｒａｃｋｅｒⅡ型无创全自动血压记录仪,对２６８例老年人（其中高血压１６０例,正常血压１０８例）和２９０例中青年（其中高血压１６６例,正常血压者１２４例）,进行２４小时动态血压监测。结果 ①血压昼夜节律改变老年高血压组与老年对照组有差异（Ｐ〈０．０５）;中青组高血压组与中青年对照差异有显著性（Ｐ〈０．０１）;老年高血压与中青年高血压     

高血压性左心室肥厚与血压昼夜节律的关系

目的：探讨高血压性左心室肥厚与血压昼夜节律的关系。方法：选择原发性高血压病伴左心室肥厚患者40例（Ⅰ组），不伴左心室肥厚患者25例（Ⅱ组），血压正常者42例（Ⅲ组），进行动态血压监测，并对结果进行统计学分析。结果：除Ⅰ组与Ⅱ组24h平均血压的差别无统计学意义（P〉0．05），其他指标（睡眠血压下降率及血压昼夜节律消失百分率）的组间两两比较差异均有统计学意义（P≤0．001）。结论：血压昼夜节律消失可作为高血压性左心室肥厚的预测指标，高血压治疗中应注意恢复血压昼夜节律，以预防左心室肥厚。     

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.