不同年龄妇女胫骨定量超声检测与骨代谢生化指标关系

目的 探讨胫骨定量超声测量与血生化骨代谢指标在不同年龄组妇女中的变化趋势。方法 共457例绝经前、后妇女，其中绝经前组89例，按年龄分为3个亚组：绝经前第1组(25～35岁)23例，绝经前第2组(36～45岁)31例；绝经前第3组(46～55岁)35例。368例为绝经后组，按绝经年限分为：绝经后第1组(绝经1～5年)88例，绝经后第2组(绝经6～25年)280例。采用酶联免疫吸附法(ELISA)测定各组骨吸收指标尿胶原吡啶交联与肌酐比值(Pyd／Cr)、骨形成指标血骨碱性磷酸酶(BALP)、血骨钙素(BGP)、血I型胶原羧基末端前肽(CICP)，同时测定胫骨超声速率(SOS)。结果 所有骨代谢生化指标在绝经后早期均有明显升高。绝经前第3组的骨吸收指标：Pyd／Cr已较绝经前其他两组明显升高。绝经后妇女的SOS值均较绝经前显著降低。结论 骨形成指标的改变落后于骨吸收指标，Pyd／Cr能较早反映围绝经期骨代谢的变化，SOS可简便、准确地反映绝经后妇女骨量的改变。     

纺织女工绝经期后骨质疏松症的流行病学研究

本调查从流行病学的角度研究了436名纺织女工绝经后期骨丢失的现状及多种因素对前臂骨密度的影响。结果表明,妇女在50岁后或绝经后骨丢失明显增快。在影响骨密度的诸因素中,年龄和绝经因素较重要,体重的影响程度较小。骨密度低的人发生骨折的机会明显增多。本组绝经后妇女非外伤性骨折的发生率为11.45％,最常见的骨折部位是桡骨。绝经对骨折的发生起重要作用。     

前臂骨矿含量与年龄及绝经的关系：中国妇女与意大利妇女的比较

用单光子吸收法测定中国及意大利妇女非优势侧前臂骨矿含量(BMC)。46岁前,两组BMC保持稳定,此后中国妇女BMC下降,逐年加重;意大利妇女于46岁下降后,61岁开始下降速度减慢,81岁又加速。绝经1年后,两组妇女BMC均下降。绝经较年龄对BMC的影响大:中国妇女BMC降至低限的年龄较意大利妇女早。     

绝经后骨质疏松与雌激素的关系

检测110例绝经后妇女及40例绝经前妇女的空腹尿钙与尿肌酐的比值及雌二醇的水平,并分析两者的关系。检测结果表明绝经后空腹尿钙与尿肌酐的比值明显高于绝经前相应的比值。绝经前妇女的雌激素值明显高于绝经后妇女的雌激素值,两者数据呈显著的负相关。空腹尿钙与尿肌酐比值高说明骨吸收速度加快,容易发生骨质疏松。雌激素水平低影响骨的合成,是造成骨质疏松的直接原因。绝经后妇女E_2水平低,尿Ca:Cr比值高,有发生骨质疏松的趋势,对23例有骨质疏松趋势的患者进行雌激素替代疗法,得到了一定的疗效。     

北京地区健康志愿者胫骨超声速率的测定及其分析

目的：初步建立北京健康人群的胫骨骨超声速率（Tibia speed of sound,Tibia SOS)的正常参考值。方法：用以色列Myriad公司生产的Sound Scan2000型胫骨超声测定仪,对951名北京地区的健康志愿者（男性461名,女性490名）进行胫骨SOS的测定,按不同性别,以十岁为界,80岁以上合并为1组,男女各分7组。结果：男女胫骨SOS在30－39岁年龄组达到峰值,之后男女均开始下降,50岁以后女性下降速度比男性快。妇女绝经前后的胫骨SOS差异显著;胫骨SOS随绝经年限的增加而下降,但下降速度是非线性的,可分为：快速下降期、稳定期和再下降期。结论：胫骨SOS的测定是诊断骨眩松症的一种可行的方法。     

不同激素治疗方案对绝经后骨质疏松妇女骨代谢的影响

目的探讨绝经后骨质疏松症不同激素治疗方案对骨代谢的影响。方法选取绝经后骨质疏松妇女120例,随机分为A组和B组。A组服用倍美安,B组服用醋酸甲羟孕酮。用药半年后观察骨密度（BMD）、尿钙/尿肌酐（Ca/Cr）和骨钙素（BGP）。结果治疗后,两组骨密度未见明显变化（P〉0.05）,A组尿Ca/Cr水平明显下降而B组骨钙素（BGP）水平上升（P〈0.05）。结论单纯补充孕激素也可预防绝经后骨质疏松妇女的骨的流失;服用雌激素可以有效抑制骨的吸收。     

绝经后妇女血清AKP、BGP和尿Ca、Cr测定及意义

<正> 绝经后妇女由于雌激素水平下降,骨吸收加快导致骨量减少,易引起骨质疏松症。我们检测了40例约经后妇女血清碱性磷酸酶(AKP)、骨钙素(BGP)及尿钙(U—Ca)、尿肌酐(U—Cr)的含量,分析绝经后妇女骨代谢的变化,对临床绝经后妇女骨质疏松症的诊断及治疗有一定意义。     

绝经妇女骨质丧失与雌激素水平的关系

对76例绝境前后妇女进行了血清性激素水平、血清碱性磷酸酶(ALP)、空腹尿钙/肌酐(Ca/Cr)、羟脯氨酸/肌酐(Hyp/ Cr)比值及桡骨骨矿含量(BMC)测定.结果 绝经妇女血清ALP、空腹Ca/Cr比值显著高于为绝经妇女,及绝经后骨质生成及吸收增强,其中以骨吸收为主.从绝经妇女中随机选出14例,给予口服觉雌醇每日5ug,观察1个月,血清ALP、空腹尿/Ca/Cr及Hyp/Cr比值显著降低,其中以骨吸收抑制为主.     

阿仑膦酸钠防治绝经后骨质疏松的疗效

目的观察国产阿仑膦酸钠防治绝经后骨质疏松症的疗效。方法56例50～74岁骨量减少或骨质疏松的绝经后妇女随机分为两组(每组28人),每日给予阿仑膦酸钠10mg/d或安慰剂,两组均加服碳酸钙片和维生素D,治疗6个月。试验前后用双能X线吸收法检测腰椎和髋部的骨矿密度(bonemineraldensity,BMD),同时检测骨转换的生化指标。结果与治疗前相比,治疗组腰椎BMD平均增加5%(P<0.01),对照组各部位的BMD均下降(P<0.05);治疗组骨吸收指标和骨形成指标均降低,其中NTx下降最明显,近75.7%(P<0.001),而对照组却无显著性变化。结论国产阿仑膦酸钠能降低绝经后妇女的骨转换,增加骨量。     

IL-6及其受体和绝经后女性骨丢失的关

目的探讨IL-6及其受体、雌激素(E2)和骨丢失的关系,研究绝经后骨质疏松的病理机制。方法以131名健康妇女作为研究对象,年龄31～72岁,其中64名未绝经者按年龄分组,67名绝经者按绝经年限分组。分别抽取静脉血分离血清检测E2、FSH、IL-6、sIL-6R、sgp130、BGP、AKP、Ca、P等指标,同时测定腰椎及股骨颈骨密度(BMD)。结果E2水平及BMD随年龄及绝经年限增加逐年下降,BMD和E2呈正相关。IL-6在绝经前含量较低,IL-6、sIL-6R和sgp130均有随年龄和绝经年限增加而上升的趋势,和E2、BMD呈明显负相关。BGP和AKP绝经后各组明显高于绝经前各组,血钙水平于绝经早期有一过性增加,以后略有下降,并保持在一相对稳定水平。血磷各组变化不大。结论妇女随着年龄增加,BMD逐年下降,特别是进入绝经期后,BMD下降速度加快。E2水平下降可促进IL-6及其受体的分泌,并进一步促使原始的破骨细胞(osteoclast,OC)发育、成熟和活化,促进骨吸收增加,最终导致骨质疏松。     

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.