儿童青少年糖尿病临床特征及初步分型探讨

目的探讨儿童青少年糖尿病患者的临床特征和初步分型。方法根据空腹C肽水平将36例儿童青少年糖尿病患者分为C肽降低组(空腹C肽<0.60μg/L,24例)和C肽正常组(空腹C肽≥0.60μg/L,12例),比较两组患者的临床资料。结果 C肽正常组黑棘皮症、2型糖尿病家族史、代谢综合征及超重/肥胖者的比例明显高于C肽降低组(P<0.01或P<0.05),体质指数、腰围、空腹C肽、餐后2hC肽及餐后C肽增加值水平明显高于C肽降低组(均P<0.01),谷氨酸脱羧酶抗体/蛋白酪氨酸磷酸酶抗体阳性率、并发酮症/酮症酸中毒及低体重者的比例明显低于C肽降低组(P<0.01或P<0.05),随机血糖及血β羟丁酸水平明显低于C肽降低组(P<0.01或P<0.05)。结论根据空腹C肽水平可对儿童青少年糖尿病患者初步分型,C肽降低组更倾向于1型糖尿病,C肽正常组更倾向于2型糖尿病。     

抗体阴性的酮症起病糖尿病患者临床特征分析

目的探讨抗体阴性的酮症起病糖尿病患者临床特征。方法选取2014年10月至2017年10月在合肥市第二人民医院内分泌科住院的新诊断成人糖尿病患者为研究对象,其中抗体阴性的酮症起病糖尿病患者根据体质指数(BMI)分为正常体重酮症组(34例)和超重酮症组(31例),同期非酮症起病的普通初发2型糖尿病患者为非酮症初发组(88例),比较三组患者的BMI、空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(Hb A1c)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)以及脂肪肝的情况。经治疗酮体转阴、血糖控制达标后行馒头餐试验,测定空腹及餐后2 h血浆C肽的水平,应用稳态模型评估胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)。结果正常体重酮症组和超重酮症组FPG和Hb A1c水平均显著高于非酮症初发组[(11. 4±2. 5) mmol/L、(11. 2±2. 1) mmol/L比(9. 4±3. 0) mmol/L,(11. 4±2. 3)%、(11. 7±2. 9)%比(10. 1±2. 0)%](P <0. 05)。正常体重酮症组2 h PBG水平显著高于超重酮症组和非酮症初发组[(18. 1±2. 1) mmol/L比(16. 3±4. 4) mmol/L、(16. 3±3. 5) mmol/L](P <0. 05)。超重酮症组脂肪肝发生率高于正常体重酮症组和非酮症初发组[58.%(18/31)比32. 4%(11/34)、33. 0%(29/88)](P <0. 05)。超重酮症组空腹C肽、C肽-2 h以及HOMA-β均高于正常体重酮症组[499(260,713) pmol/L比282(193,375) pmol/L、975(806,1 895) pmol/L比938(860,1 031) pmol/L、19(10,27)比11(8,13)](P <0. 05),超重酮症组HOMA-IR高于正常体重酮症组和非酮症初发组[3. 3(2. 5,4. 4)比2. 6(2. 2,3. 3)、2. 9(2. 4,3. 5)](P <0. 05)。结论酮症起病的糖尿病患者男性更多见,与普通2型糖尿病患者相比,酮症起病的超重及肥胖患者脂肪肝的发生率、空腹血糖、三酰甘油以及空腹C肽的水平更高,胰岛功能较好,但胰岛素抵抗较明显,考虑糖脂毒性可能在该类患者的疾病发展中起重要作用。     

以酮症起病的糖尿病临床特征分析

目的 了解以酮症起病的糖尿病患者的自身抗体检出情况,并分析其临床特征.方法 测定133例以酮症起病的糖尿病患者的血脂谱、随机血糖、糖化血红蛋白、胰岛功能、谷氨酸脱羧酶抗体(GAD-Ab)和蛋白酪氨酸磷酸酶抗体(IA_2-Ab),记录血压、体重、糖尿病家族史等.任一自身免疫抗体阳性为A+,两种抗体阴性为A-;空腹C肽≥0.333 nmol/L定为B+,反之为B-.根据检测结果将研究队列分为3组,组1为A+,包括A+B+和A+B-;组2为A-B+;组3为A-B-.结果 ①GAD-Ab阳性率为27.8%,IA_2-Ab阳性率为16.5%,任一阳性占29.3%.②组1的年龄和体质指数(BMI)显著小于组2和组3(P值均<0.01),而随机血糖和高密度脂蛋白胆固醇水平显著高于组2和组3(P值分别<0.05、0.01).组2的糖尿病家族史伴发率最高,占48.2%.组2的三酰甘油水平显著高于组1(P<0.05),而空腹C肽及餐后2 h C肽水平显著高于组1和组3(P值均<0.01).结论 以酮症起病的糖尿病患者的临床特点存在差异,结合自身免疫抗体和胰岛B细胞功能可提示其临床表型亚型的归类,采取不同的治疗策略.     

酮症起病抗体阴性的中青年糖尿病患者的临床特征及分型

目的探讨酮症起病抗体阴性的中青年糖尿病患者的临床特征及分型。方法酮症起病抗体阴性中青年糖尿病患者62例作为研究对象,将其根据体重指数(BMI)分为肥胖组与非肥胖组,根据胰岛β细胞功能保留与否分为β+组与β-组,比较不同组别在年龄、BMI、糖化血红蛋白(Hb A1c)、空腹C肽(FCP)、血脂、糖尿病家族史、高血压史等方面的差异,并对其随访观察,6个月后比较各组血糖、胰岛功能等情况。并选取非酮症起病2型糖尿病50例作为对照组。结果酮症起病抗体阴性中青年糖尿病患者起病时平均Hb A1c达12.39%,男性与女性之比为1.82∶1,超重和肥胖占67.7%,高甘油三酯血症(TG)占58%;与对照组相比,患者起病年龄较小,Hb A1c较高,FCP较差(P<0.05),BMI、血脂各项、高血压史、6个月后Hb A1c和FCP及临床缓解、非胰岛素依赖情况差异无统计学意义。抗体阴性中肥胖组较之非肥胖组,起病时BMI、TG、糖尿病家族史、高血压史较高,6个月后胰岛功能恢复明显好于后者,血糖控制效果更好,临床缓解和停用胰岛素比例高(P<0.05)。抗体阴性中β+组较之β-组,起病时BMI、FCP较高,6个月后胰岛功能恢复明显好于后者,血糖控制效果更好,临床缓解和停用胰岛素比例明显高(P<0.05)。结论酮症起病抗体阴性的中青年糖尿病患者具有许多2型糖尿病类似的临床特点,大多数经短期胰岛素治疗后胰岛功能恢复较好,分类上考虑归为酮症倾向的2型糖尿病,尤其肥胖者和胰岛β细胞功能保留者。     

2型糖尿病并脂肪肝的临床分析

目的 :探讨 2型糖尿病并脂肪肝与肥胖、血糖、血脂紊乱、胰岛素水平的关系。方法 :测定 2型糖尿病并脂肪肝患者体重指数 (BMI)、空腹血糖 (FBG)、餐后 2 h血糖 (PBG)、血脂、空腹胰岛素和 C肽、餐后 2 h胰岛素和 C肽等 ,以 2型糖尿病无脂肪肝患者作对照。结果 :2型糖尿病并脂肪肝组与无脂肪肝组比较 ,BMI、甘油三酯、载脂蛋白 B、胰岛素和 C肽均明显升高 (P <0 .0 5 ) ,高密度脂蛋白胆固醇、载脂蛋白 - A1 明显降低 (P <0 .0 5 )。结论 :2型糖尿病并脂肪肝患者存在超重、脂代谢紊乱和高胰岛素血症     

二甲双胍/维格列汀和利拉鲁肽对肥胖合并2型糖尿病患者的临床疗效比较

目的 评价基于二甲双胍/维格列汀和利拉鲁肽的两种治疗方案对肥胖合并2型糖尿病患者(BMI>25 kg/m²)的临床疗效。方法 回顾性分析2019～2022年皖南地区107例肥胖合并2型糖尿病患者,根据所选患者初发肥胖合并2型糖尿病,将患者分为二甲双胍/维格列汀治疗组(n=53)和利拉鲁肽治疗组(n=54),持续治疗3个月。比较两组患者治疗前后的BMI、腹围、空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹C肽、餐后2 h C肽、空腹胰岛素及餐后2 h胰岛素,观察治疗前后各项指标的变化。结果 107例皖南地区肥胖合并2型糖尿病患者中,二甲双胍/维格列汀组和利拉鲁肽组患者治疗前后的BMI(P<0.05)、腹围(P<0.05)、空腹血糖(P<0.05)、餐后2 h血糖(P<0.05)以及糖化血红蛋白(P<0.05)均较前下降,空腹C肽及餐后2 hC肽较前恢复(P<0.05)。对比两组治疗结果,血糖下降水平疗效相当,但利拉鲁肽组的腹围减少疗效更优(P<0.01),两组治疗方案对患者的胰岛素水平影响并不显著(P>0.0...     

儿童1型糖尿病与甲状腺功能降低的相关性研究

目的探索儿童1型糖尿病(T1DM)甲状腺功能变化及其临床意义。方法收集85例T1DM例为研究对象进行回顾性分析。结果合并游离甲状腺素(FT4)、合并游离三碘甲状腺原氨酸(FT3)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)与糖化血红蛋白(HbA1c)均呈负相关(均P<0.01),FT4、FT3、TT3、TT4与入院随机血糖均呈负相关(均P<0.01),T1DM患儿甲状腺激素各指标与起病年龄、BMI值以及空腹C肽水平均无相关性(均P<0.05)。观察组中合并有糖尿病酮症酸中毒(DKA)的比例高于对照组(P<0.05),观察组入院即刻随机血糖高于对照组(P<0.05),观察组HbA1c明显高于对照组(P<0.05),观察组空腹C肽明显低于对照组(P<0.05)。两组性别、起病年龄、BMI值、有/无糖尿病家族史所占比例、糖尿病抗体阳性所占比例差异均无统计学意义(均P>0.05)。结论合并甲状腺功能降低的T1DM儿童,疾病程度更为严重,胰岛功能也更差。     

自发性酮症起病肥胖糖尿病临床分析

目的 探讨自发酮症起病的肥胖糖尿病患者的临床特征.方法 收集自发性酮症起病糖尿病患者40例,根据体质量指数（BMI）分为肥胖组（BMI≥25kg/m2,A组17例）和非肥胖组（BMI＜25kg/m2,B组23例）.入院测定两组血糖、血脂、β细胞功能及胰岛素抵抗等.入院后予胰岛素强化控制血糖,2周及3个月后复查血糖、胰岛功能,同时观察患者胰岛素停用情况.结果 与B组相比,A组合并脂肪肝比例、总胆固醇、三酰甘油、低密度脂蛋白、C肽、胰岛素、Homa-IS及Homa-IR更高（均P＜ 0.05）.两组胰岛素治疗2周后,胰岛素抵抗减轻,但胰岛素分泌指数没有改变,A组的Homa-IS及Homa-IR更高.治疗3个月后,胰岛素抵抗进一步减轻,胰岛素分泌指数上升,A组的Homa-IR仍更高.随访3个月,A组停用胰岛素比率明显高于B组.结论 自发酮症起病的肥胖糖尿病患者具有不同于l型糖尿病的临床特征,其发生酮症时胰岛素缺乏程度较轻,胰岛储备功能尚好,胰岛素抵抗较严重,常合并高脂血症.在酮症纠正、血糖血脂控制后,大部分可以停用胰岛素.     

利拉鲁肽联合西格列汀对肥胖的2型糖尿病患者胰岛功能及代谢指标的影响

目的 探讨利拉鲁肽联合西格列汀对肥胖的2型糖尿病患者胰岛功能及代谢指标的影响。方法 选择2020年1月—2021年12月于本院治疗的肥胖合并2型糖尿病患者80例作为研究对象,随机分为研究组与对照组两组,每组各40例。研究组采用利拉鲁肽联合西格列汀治疗;对照组选用西格列汀联合二甲双胍。两组均持续治疗3个月,观察治疗前后两组患者的血糖、血脂、体重指数(BMI)、胰岛功能及脂肪因子等水平的变化。结果 治疗前,两组空腹血糖水平与餐后2小时血糖水平比较并无明显差异(P>0.05);治疗后,两组空腹和餐后2小时血糖均较治疗前有显著改善(P<0.01);治疗后,对照组空腹血糖水平、餐后2小时水平较高于研究组(P<0.01)。治疗前,两组BMI指标与体重比较无明显差异(P>0.05);治疗后,两组体重、BMI指标教治疗前均明显改善(P<0.01);治疗后,对照组BMI指标与体重均高于研究组(P<0.01)。治疗前,两组胰岛β细胞指数、胰岛素抵抗指数均无明显差异(P>0.05);治疗后,两组胰岛β细胞指数、胰岛素抵抗指数均较治疗前有明显改善(P<0.01)...     

二甲双胍联合比格列酮治疗肥胖新诊断2型糖尿病患者的疗效观察

目的:探讨二甲双胍与吡咯列酮联合治疗对肥胖的新诊断2型糖尿病患者的疗效。方法:选择2009年3月-2011年1月在内分泌科就诊的初诊肥胖的2型糖尿病患者128例,随机分为治疗组和对照组两组各64例。两组患者均予以饮食干预、运动疗法;对照组加用二甲双胍;观察组在对照组治疗基础上加用盐酸吡格列酮。两组患者均治疗3个月。结果:两组患者治疗前后FPG、2hPG、空腹C肽、餐后2hC肽、FINS、2hINS比较,均明显降低,组内治疗前后比较差异均有统计学意义(P<0.01,或P<0.05);治疗后,观察组FPG、2hPG、空腹C肽、餐后2hC肽、FINS、2hINS与对照组比较,降低更为明显,差异有统计学意义(P<0.05)。两组患者治疗前后BMI、HbAIc、hc-CRP比较,均明显改善,组内治疗前后比较差异均有统计学意义(P<0.01,或P<0.05);治疗后,观察组BMI、HbAIc、hc-CRP与对照组比较,改善更为明显,差异有统计学意义(P<0.05);两组血脂水平比较差异无统计学意义(P>0.05)。结论:二甲双胍联合吡格列酮治疗肥胖2型糖尿病时存在协同治疗效应,是治疗初诊2型糖尿病肥胖患者理想的方法。     

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.