糖尿病对非体外循环下冠状动脉旁路移植术患者生存质量的影响

目的 探讨糖尿病对接受非体外循环下冠状动脉旁路移植术(OPCAB)患者的生存质量的影响.方法 选取2008年11月至2010年11月在我院接受OPCAB的患者共233例,其中糖尿病组78例,非糖尿病组155例,分别于术前和术后6个月向患者发放SF-36生存质量调查简表,对患者生存质量予以评估.分别比较糖尿病组与非糖尿病组在术前生存质量、术后生存质量以及生存质量增加值的差异.结果 术前生存质量比较,糖尿病组在躯体疼痛(BP) (48.1±26.3 vs.58.0±25.7)、总体健康(GH)亚组(37.7±17.9 vs.44.3±19.5)以及躯体健康总评(PCS) (39.5±19.6 vs.46.8±19.9)得分低于非糖尿病组(P＜0.05).术后生存质量比较,PF(66.2±20.3 vs.73.7±20.8)、VT(61.4±19.3 vs.68.3±19.6)、GH亚组(50.8±18.3 vs.58.3±21.9)以及精神健康总评(MCS:61.0±20.4 vs.67.5±21.2)得分低于非糖尿病组(P＜0.05).对生存质量增加值做组间比较,糖尿病在躯体疼痛(BP)亚组的增加值高于非糖尿病组(25.3±28.7 vs.16.1±27.7;P=0.021),在其余亚组的生存质量增加值差异均无统计学意义.结论 对于接受OPCAB的患者,糖尿病患者的生存质量普遍低于非糖尿病患者,在术前主要表现在躯体健康方面,在术后主要表现在精神健康方面.糖尿病患者接受OPCAB对于躯体疼痛的改善程度要多于非糖尿病患者.     

肝胆手术后持续静脉自控镇痛患者的护理与效果分析

目的 评价术后持续静脉自控镇痛(PCIA)的护理效果.方法 选择108例肝胆手术患者为研究对象.观察组56例患者,使用PCIA,辅以综合护理;对照组52例患者,术后使用传统肌内注射止痛剂,辅以常规护理.比较二组镇痛效果、并发症及满意度.结果 观察组镇痛有效率高于对照组,差异有统计学意义(96.42 ％vs82.69％,P＜0.05).观察组术后各个时间点的VAS评分明显低于术前(P＜0.001),也显著低于同期对照组评分(P＜0.001).观察组并发症发生率低于对照组,差异有统计学意义(5.36％vs21.15％,x2=5.9634,P=0.0146).观察组满意度明显高于对照组,差异有统计学意义(98.21％ vs 84.62％,P＜0.05).结论 在PCIA过程中进行综合护理,可有效缓解患者术后疼痛感,减少并发症,并提高满意度.     

经皮穴位电刺激用于老年患者全髋关节置换术后早期疼痛治疗的临床研究

目的 本研究选择全髋关节置换术的老年患者,应用经皮穴位电刺激(TEAS),观察术后早期疼痛治疗效果.方法 选择60例行全髋关节置换术的老年患者(＞65岁),随机分为两组:TEAS组30例:患者于切皮前30 min、术后2、4、20和48 h接受30 min经皮穴位电刺激(双侧内关、合谷穴;手术侧风市穴及足三里穴)治疗;对照组30例:假刺激组(选择相同穴位相同刺激时间,但刺激电流强度为零).所有患者术后接受病人自控静脉镇痛48 h.通过观察患者术后各时段芬太尼的用量及镇痛效果评分(VAS),记录镇痛相关不良反应发生率及补救药物使用频率.结果 两组患者一般临床资料差异无统计学意义.两组术后8、24和48 h静息和活动状态下疼痛评分比较,差异无统计学意义(P＞0.05).在术后24 h和48 h,对照组患者芬太尼的消耗量显著高于TEAS组(P＜ 0.001).TEAS组术后镇痛相关不良反应发生率及应用补救药物频率显著低于对照组(恶心16.7％ vs.46.7％;呕吐10.0％vs.32.3％;眩晕6.7％ vs.26.7％;补救药物频率13.3％ vs.36.7％,P＜0.05).结论 经皮穴位电刺激用于老年患者全髋关节置换术后早期镇痛,可以有效缓解术后疼痛,明显减少术后镇痛药物的用量,不良反应发生率低.     

区域神经阻滞技术在创伤胫腓骨骨折患者麻醉中的应用

目的 探讨区域神经阻滞技术在未来下肢战伤麻醉救护中的价值.方法 模拟下肢战伤麻醉处理方式,为58例下肢开放性胫腓骨骨折患者外固定支架固定及清创实施麻醉.经抗休克稳定后,将拟接受手术救治的患者随机分入P组和S组,各29例.P组患者采用神经阻滞技术,在超声引导下实施髂筋膜和坐骨神经联合阻滞后行清创和骨折固定手术;S组则采用传统的椎管内麻醉(蛛网膜下隙阻滞复合硬膜外麻醉)方法,麻醉后接受相同的手术救治.分析比较两组患者的一般情况、术中麻醉意外发生情况、麻醉效率、麻醉后持续镇痛时间和患者整体感受(视觉模拟评分).结果 术前两组患者一般情况的差异无统计学意义.实施麻醉后,S组有20例(71％)患者循环不稳定、2例(7％)患者呼吸困难,经麻醉医师处理后稳定(1例因插管改全麻退出研究),而P组患者无一例发生麻醉并发症;P组患者从入手术室到手术前的麻醉时间短于S组(P＜0.01),同时P组患者输液量低于S组(P＜0.01);术后P组麻醉镇痛时间长于S组(P＜0.01);患者整体感受提示P组患者从麻醉开始直至术后的舒适度优于S组(P＜0.01).结论 从安全性和整体舒适度方面比较创伤胫腓骨骨折患者的麻醉处理方式,区域神经阻滞技术优于传统的椎管内麻醉方式.     

近期上呼吸道感染史对儿童围术期呼吸系统不良事件的影响:前瞻性队列研究

目的:观察近期上呼吸道感染史对接受全身麻醉的儿童围术期呼吸系统不良事件风险的影响.方法:选择2015年1 1月至2016年5月期间在北京大学第一医院接受全身麻醉下眼科择期手术的232例儿童,术前通过儿童父母填写问卷的形式采集并记录儿童的术前基础资料及相关疾病史,包括性别、年龄、身高、体重、术前2周内有无上呼吸道感染史、有无早产史、长期被动吸烟史、经常性夜间打鼾史和哮喘病史.同时记录围术期相关信息(喉罩成功置入所需的次数、麻醉时间等),观察围术期出现的呼吸不良事件,包括氧饱和度下降、气道分泌物增加、咳嗽、喉痉挛、支气管痉挛的发生情况.应用多因素Logistic回归模型筛选儿童全身麻醉围术期呼吸系统不良事件的危险因素.结果:入选的232例儿童中,术前2周内有上呼吸道感染史的占28.0％(65/232),其全身麻醉苏醒期发生氧饱和度降低(23.1％vs.12.0％,P=0.034)、气道分泌物增加(15.4％vs.6.6％,P=0.036)或一种及以上呼吸系统不良事件(32.3％vs.18.6％,P=0.024)的风险增加.多因素Logistic回归分析显示,术前2周内的上呼吸道感染史(OR =2.021,95％ CI:1.023 ～3.994,P=0.043)和经常性夜间打鼾史(OR=3.660,95％ CI:1.517～8.832,P=0.004)是儿童围术期呼吸系统不良事件的独立危险因素.结论:术前2周内的上呼吸道感染史伴随儿童围术期呼吸系统不良事件的风险增加.     

丙泊酚复合小剂量芬太尼用于无痛人工流产的麻醉疗效

目的 观察小剂量芬太尼复合丙泊酚用于无痛人工流产麻醉的临床疗效.方法 选择自愿接受无痛人工流产手术的患者 90例,随机分为芬太尼复合丙泊酚组( PF组) 和丙泊酚( P组).观察两组的麻醉效果、术中生命体征变化、手术时间、苏醒时间、不良反应等.结果 两组患者的麻醉效果差异无统计学意义(P＞0.05),手术后两组心率、平均动脉压均较术前明显增快、升高,但PS组升幅明显低于P组(P<0.05).结论 丙泊酚复合小剂量芬太尼可安全用于无痛人工流产术的麻醉,值得临床推广应用.     

双腔起搏器植入后不同右心室心尖部起搏比例对心脏结构功能的远期影响

目的:评价双腔起搏器植入后不同右心室心尖部起搏比例对心脏结构和功能的远期影响.方法:入选北京大学第三医院心内科植入双腔起搏器且心室电极置于右心室心尖部的患者,随访并记录末次超声心动图和起搏器程控结果,剔除起搏比例10％ ～ 40％的患者.结果:共入选83例患者,随访(38±23)个月.术后中、重度二尖瓣返流(mitral valve regurgitation,MR)和三尖瓣返流(tricuspid valve regurgitation,TR)的发生率均高于术前(6.2％ vs.2.6％,11.1％ vs.4.9％,均P＜0.01).术后中、重度TR患者9例,肺动脉收缩压(pulmonary artery systolic pres-sure,PASP)高于无或轻度三尖瓣返流患者[(49.6±10.5) mmHg vs.(33.8±12.0) mmHg,1 mmHg =0.133 kPa,P＜0.01],二尖瓣口舒张早期血流速度/二尖瓣外侧环舒张早期速度比值(E/Em)大于其他患者(11±5vs.9±3,P＜0.05).心室起搏比例＜10％的患者52例(A组),心室起搏比例＞40％的患者31例(B组),术后两组中、重度MR和TR的发生率均高于术前.B组术后右心房较术前增大[(17.7±4.0) cm2vs.(15.6±3.2) cm2,P＜0.05],右心室较术前增大[(21.5±4.4) mmvs.(19.9±3.4) mm,P＜0.05],PASP≥50 mmHg的发生率高于术前(9.7％vs.3.2％,P＜0.05).术后B组左心房、右心房面积均大于A组[(21.8±5.5) cm2vs.(20.2±4.6) cm2,(17.7±4.0) cm2vs.(16.1±3.8) cm2,均P＜0.05],左心室射血分数低于A组(68％±6％ vs.70％±6％,P＜0.05).结论:双腔起搏器植入后过多右心室心尖部起搏远期可导致左心房、右心房和右心室增大,肺动脉高压以及左心室射血分数减低.     

枣庄市无偿献血者献血反应调查分析

目的 调查和分析枣庄市无偿献血者的献血反应,以期为探求更为全面的预防措施提供重要依据.方法 选择2011年3月至2011年9月期间枣庄市中心血站无偿献血者1680例为调查对象,并依据献血地点、献血次数、献血方式、献血量等变化的特点,对诱发献血反应的原因进行调查和分析.结果 与在流动献血车上献血者相比,在血站内献血者发生献血反应的比率显著降低(1.23％％2.02％,P＜0.05).与首次献血者相比,2次及以上献血者发生献血反应的比率显著降低(0.61％vs2.11％,P＜0.05).与集体献血者相比,个体献血者发生献血反应的比率显著降低(1.50％vs 1.94％.P＜0.05).与献血量为400ml献血者相比,献血量为200 ml献血者发生献血反应的比率显著降低(1.05％vs1.94％,P＜0.05).同时,精神紧张以及饥饿和疲劳等因素是导致献血反应发生的主要原因.结论 应进一步加强对无偿献血知识的宣传和讲解,积极改善献血者焦虑和紧张的负性心理,在对献血者进行献血征询和信息采集时,应重点筛查相关信息,以便在献血过程中积极采取相应干预措施,最大限度减少献血反应的发生.     

气管导管表面涂抹复方利多卡因乳膏预防经鼻蝶窦垂体瘤手术全麻苏醒期呛咳的有效性研究

目的 评价复方利多卡因乳膏涂抹气管导管用于气管黏膜表面麻醉对提高经鼻蝶窦垂体瘤苏醒期拔除气管导管平稳性的有效性.方法 本研究为前瞻随机对照研究,连续纳入北京协和医院60例经鼻蝶窦垂体瘤手术的患者,随机分为试验组(L组)和对照组(C组).将L组气管导管前二分之一和套囊表面均匀涂布复方利多卡因乳膏,C组导管表面涂抹石蜡油.研究终点为苏醒期的呛咳事件.记录围术期血流动力学指标、患者在麻醉恢复室(PACU)的拔管时间,随访住院期间并发症.结果 拔管期的自发呛咳率L组低于C组(7％ vs.40％,P＜0.01);诱发的呛咳率L组显著低于C组(20％ vs.60％,P＜0.01).术毕至拔管时间L组小于C组[(18±6)min vs.(27±6)min,P＜0.05].需要追加芬太尼的患者比例L组低于C组(17％ vs.70％,P＜ 0.01).L组的收缩压与心率乘积在拔管时和拔管后1 min均低于C组(P＜0.05).结论 对于全麻经鼻蝶窦垂体瘤手术,气管导管表面涂抹复方利多卡因乳膏进行气管黏膜表面麻醉能有效减少苏醒期患者的呛咳事件、减少芬太尼补救用药量、缩短术毕至拔管时间并降低拔管时血流动力学波动.     

半月板手术患者围手术期曲马多使用情况分析

目的 分析半月板手术患者围手术期曲马多使用情况,为后续合理用药提供参考.方法 回顾性分析2018年12月至2019年10月在我院接受关节镜下半月板手术的126例患者资料.根据术前1个月内是否服用曲马多将患者分为曲马多使用组(33例)与曲马多未使用组(93例),统计分析两组患者一般资料、围手术期曲马多的使用情况及随访期间药物相关不良反应的发生情况.结果 两组患者年龄、性别、BMI、第一临床诊断、麻醉方式、手术时间、手术类型、围手术期非甾体抗炎药(NSAID)使用情况差异均无统计学意义(P均>0.05).与曲马多未使用组患者相比,曲马多使用组患者有术后3、6个月继续服用该药的风险(OR=3.294,95％CI 1.383～7.846;OR=2.795,95％CI 1.037～7.534).术后1个月,29例单纯接受半月板手术者中,曲马多使用组继续使用率为100.0％(8/8),曲马多未使用组为76.2％(16/21),差异无统计学意义(P=0.129);74例接受膝关节手术操作<3项的患者曲马多使用率为90.5％(67/74),52例手术操作≥3项者的曲马多使用率为100.0％(52/52),差异有统计学意义(P=0.022).曲马多使用组患者术后1个月内曲马多的处方量高于曲马多未使用组(P=0.004),但两组术后3、6个月内曲马多的处方量差异均无统计学意义(P均>0.05).随访期间所有患者的总体不良反应发生率为11.9％(15/126),曲马多使用组胃肠道不适的发生率较曲马多未使用组高[21.2％(7/33)vs 2.2％(2/93)],差异有统计学意义(P=0.001).同时服用曲马多和NSAID的患者胃肠道不适、消化道溃疡、过敏反应和其他不良反应的发生率均稍高于单纯服用NSAID者,但差异均无统计学意义(P均>0.05).结论 术前服用曲马多患者术后1个月内再次服用该药的风险较术前未服用者高.膝关节镜术中接受操作项目越多的患者术后镇痛可能会依赖更多曲马多,但长期服用曲马多存在胃肠道不适等风险.     

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.