网织红细胞参数在肝硬化患者中的变化及意义

目的探讨网织红细胞各参数在肝硬化（HC）患者的变化及临床意义。方法采用五分类全自动血液细胞分析仪（MEACKMAN COULTER LH750）检测57例肝硬化病人和33例正常人的网织红细胞参数（网织红细胞百分数RET％、高散射光网织红细胞百分数HLR％和未成熟网织红细胞指数IRF），并对结果进行对比分析。结果与正常人比较肝硬化RET％、HLR％和IRF显著地升高，差异有统计学意义（P〈0．05和P〈0．01）。结论网织红细胞参数测定有助于早期判断红细胞的活动度，作为反映肝硬化患者骨髓造血功能的新型指标，而IRF和HLR％为更灵敏、更早的指标，有助于肝硬化的早期诊断和对贫血的早期治疗。     

贝克曼-库尔特LH750血液分析仪网织红细胞及相关参数的调查及应用

目的:对贝克曼库尔特LH75 0血液分析仪网织红细胞等相关参数的调查,了解仪器分析的精密度、健康成人的参考范围和贫血情况下的变化。方法:选取3份新鲜的正常人标本做重复性试验;调查12 0份健康成人的各个参数的平均值;调查85份贫血标本,观察不同病因时HLR和IRF的改变。结果:RET的重复性试验CV为3.2 %。正常成人的RET范围在0 .5 6 % 1.86 %之间。HLR的均值为0 .30 % ;溶血性贫血、急性失血、慢性贫血、白血病和再生障碍性贫血等不同病因的贫血,各自的HLR均值依次为4 .11%、1.70 %、0 .73%、0 .31%和0 .2 8%。MSCV值的异常改变,在贫血标本约占2 0 % ,正常标本约为7%。结论:仪器分析的精密度比MAXM型号明显提高。应用参数(RET、IRF、MRV)的调查结果与有关资料基本接近。研究参数HLR与流式细胞仪的HFR有相同的临床应用价值。MSCV的临床应用有待进一步探讨。     

应用HLR参数对不同类型贫血的观察探讨

目的了解Beckman--Coulter750血液分析仪HLR（High Laser Reticulocyte，强光散射网织红细胞）参数在不同类型贫血的上的反映。方法分别做200例非贫血和110例贫血的的Ret．HLR等参数的调查，同时连取5个不同的贫血病例观察其变化的差异。结果各组的HLR平均值：非贫血组为0．25％（S：0．09），溶贫为3．66％，急性失血为1．59%，慢性失血为0．72％，白血病为0．30％。再障为0．30％。结论贫血时HLR增高。随着贫血的改善，HLR可下降至正常水平。骨髓造血机能受抑制的贫血，Ret减低但HLR仍占一点的高比例。不同类型的贫血在治疗过程HLR的变化有差异。将HLR与Ret、IRF等参数结合起来综合分析，对贫血疾病诊治的观察有一定的意义．     

外周血干细胞移植中网织红细胞参数指标的应用价值

目的探讨网织红细胞（RET）参数在外周血干细胞移植病人造血功能恢复的临床应用价值。方法采用五分类全自动血液细胞分析仪（BEACKMAN COULTER LH750）检测7例外周血干细胞移植病人的网织红细胞参数（网织红细胞百分数RET％、强光散射网织红细胞百分数HLR和未成熟网织红细胞指数IRF）,并对结果进行对比分析。结果外周血干细胞移植后造血功能恢复天数（d）的中位数分别为：Ret％13．4d、HLR7．2d、IRF7．9d。结论IRF和HLR是较敏感的指标,在评价外周血干细胞移植后造血功能恢复方面有较大的临床应用价值。     

全自动血液分析仪测定网织红细胞新型参数的临床应用

目的 :探讨全自动血液分析仪测定网织红细胞新型参数的临床应用。方法 :应用GENS全自动血液分析仪 ,检测 4 2例贫血患者抗凝全血标本的网织红细胞百分比 (RET % )、网织红细胞计数绝对值 (RET # )、未成熟网织红细胞组分 (IRF)、网织红细胞平均体积 (MRV)和高散射光强度网织红细胞百分比 (HLR % )五项网织红细胞参数。 31名健康人作为正常对照组。结果 :溶血性贫血 (HA)组RET % ,RET # ,HLR % ,IRF和MRV同对照组比较均显著增高。再生障碍性贫血 (AA)组除IRF外 ,RET % ,RET #和HLR %三项参数同对照组比较呈显著下降 ,但MRV显著高于对照组。慢性肾功能不全 (CRF)组RET % ,MRV和HLR %显著高于对照组 ,但RET #与对照组无显著差异。HA组各项网红参数均显著高于CRF组 ,两组存在显著性差异。结论 :全自动血液分析仪测定的网织红细胞及其分类参数有助于判断红细胞的活动度 ,作为一些贫血类型的初筛鉴别诊断和疗效监测的新型指标 ,具有一定的实用价值。     

XE-5000全自动血液分析仪测定网织红细胞的临床价值的分析

目的探讨XE-5000全自动血液分析仪测定网织红细胞的临床价值。方法用XE-5000全自动血液分析仪测定网织红细胞的几项指标：网织红细胞百分比（RET％），网织红细胞绝对值（RET#），未成熟网织红细胞指数（IRF），低荧光强度网织红细胞（LFR％），中荧光强度网织红细胞（MFR％），高荧光强度网织红细胞（HFR％）。结果正常健康人网织红细胞参数参考范围：RET#为（57±36）×10^9／L，RET％为（1．23±0．71），LFR％为（94±5），MFR％为（11±6），HFR％为（1．36±1．05），IRF％为（12±7）。缺铁性贫血（IDA）：IRF（16±3），RET#（68±41），RET％（1．61±0．56），LFR％（72±6），MFR％（14±4），HFR％（3．82±1．33）。IDA患者除LFR指标外，其他结果均明显高于正常健康人。结论XE-5000血液分析仪测定网织红细胞可以用于临床贫血性疾病的诊断。     

网织红细胞参数在各类贫血患者中的应用及意义

目的 :探讨网织红细胞参数在各类贫血患者中的应用及意义。方法 :采取患者静脉血 2 ml EDTA- K2 抗凝 ,充分混匀 ,于 L H75 0型全自动血液分析仪分别检测血红蛋白 (Hb)、网织红细胞参数 (RET、IRF、HFR)。结果 :RET%成人 0 .5 %～ 1.5 % ,新生儿 2 %～ 6 % ,IRF0 .2～ 0 .4 ,HFR0 .0 7%～ 0 .71%。结论 :观察网织红细胞参数对于贫血病人的诊断 ,判断病情发展和预后 ,指导临床用药及药物疗效有一定参考价值。比 Hb降低敏感。其中 IRF和HFR比 RET更敏感且全自动仪器操作更准确。     

缺铁性贫血患者网织红细胞及分群检测的临床应用

目的：探讨网织红细胞及分群的检测对缺铁性贫血患者铁剂治疗后疗效观察的临床应用。方法：用血液分析仪检测40例正常对照组及78例缺铁性贫血患者网织红细胞及分群参数。结果：缺铁性贫血患者铁剂治疗前网织红细胞及分群与对照组无显著性差异（p〉0．05），经铁剂治疗后Ret、Ret^#、IRF、MFR、HMR高于治疗前（P〈0．01），LFR低于治疗前（P〈0．01）。结论：网织红细胞及分群的检测，可用于缺铁性贫血铁剂治疗后的疗效观察及与慢性病贫血的鉴别诊断。     

未成熟网织红细胞在小儿贫血中的应用价值

目的探讨未成熟网织红细胞在小儿贫血中的临床应用价值。方法应用Syrsmex XE-2100全自动血细胞分析仪检测578例儿童血液病患儿的网织红细胞计数（RET）、网织红细胞百分比（RET）、未成熟网织红细胞比率（IRF）、低荧光强度网织红细胞比值（LFR）、中荧光强度网织红细胞比值（MFR）、高荧光强度网织红细胞比值（HFR）等参数。结果营养性缺铁性贫血、溶血性贫血、ABO溶血组和血小板减少性紫癜患儿RET，IRF等指标显著增高（P〈O．05），再生障碍性贫血、白血病患儿RET显著降低（P〈0．05），IRF显著增高（P〈0．05）。结论测定网织红细胞及未成熟网织红细胞比率有助于判断骨髓生成红细胞的活动度，对贫血类型的鉴别诊断有一定价值。     

标本保存条件对血液病患者网织红细胞参数测定的影响

目的探讨不同保存条件对血液病患者网织红细胞参数测定的影响。方法观察不同温度、不同时间、不同容器保存的血液标本网织红细胞计数和"分群"的变化。结果 2~8℃保存标本,网织红细胞计数值72 h内无明显变化,未成熟网织红细胞指数(IRF)48 h后逐渐降低;室温保存标本,网织红细胞计数值48 h后逐渐降低,增生性贫血患者IRF 48 h后逐渐降低,白血病患者IRF 24 h后逐渐降低。两种EDTA-K2抗凝管采集的血液标本网织红细胞各参数均无明显变化。结论标本保存的温度及时间对血液病患者网织红细胞计数及IRF均存在影响;两种采血容器对网织红细胞各参数测定无明显影响。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.