HSV-TK/GCV系统对卵巢癌细胞OVCAR3杀伤作用的研究

目的评价HSV—TK／GCV系统对卵巢癌细胞OVCAR3的杀伤作用及旁观者效应。方法用含HSV—TK重组腺病毒载体转染人卵巢上皮性癌细胞OVCAR3,用四甲基偶氮唑蓝（MTT）法计算细胞存活率以评价杀伤作用;转染的OVCAR3细胞（TK^＋）与未转染的OVCAR3细胞（TK^-）以不同比例混合,再加入GCV,MTT法计算细胞存活率以评价旁观者效应。结果HSV—TK／GCV系统可明显杀伤OVCAR3细胞,在感染复数（MOI）为100时,平均细胞存活率为26％;HSV—TK／GCV系统对该细胞的杀伤作用有明显的“旁观者效应”,当TK^＋细胞占10％、20％、30％、40％、50％时,细胞平均存活率分别为82％、52％、41％、35％、32％。免疫细胞化学检测OVCAR3细胞的细胞膜上有Cx43的表达。结论HSV—TK／GCV系统对人卵巢上皮性癌细胞OVCAR3有明确的杀伤作用及旁观者效应。     

阳离子脂质体介导HSV-TK基因对人脑胶质瘤细胞的杀伤作用

目的 观察阳离子脂质体介导的HSV－TK／ACV系统对人脑胶质瘤细胞的杀伤作用。方法 将新近克隆的含HSV－TK基因的真核表达载体pCR3-5K,用阳离子脂质体Lipofectamine转染至人脑胶质瘤细胞株TJ905中，筛选出阳性克隆，给予不同浓度的ACV，观察不同时间对细胞的杀伤情况，并用MTT方法检测不同细胞对ACV的反应情况。结果 转染TK基因的胶质瘤细胞对ACV的杀伤敏感性明显提高（P＜0．01），ACV对转染TK基因的胶质瘤细胞有特异性抑制和杀伤作用。结论 阳离子脂质体Lipofectamine是一种简便、安全、有效的基因转移方法。可用阳离子脂质体介导pCR3-TK转移，进行胶质瘤HSV－TK／GCV基因治疗的研究，为胶质瘤的治疗提供一种新方法。     

骨髓增生异常综合征患者骨髓CD4~+T细胞共刺激分子CD28/CTLA-4的变化

目的通过检测骨髓增生异常综合征（MDS）患者CD3^＋CD4^＋T细胞表面CD28^＋和CTLA-4^＋分子水平,探讨两者在MDS发病机制中的作用。方法用流式细胞技术检测38例初治MDS患者和11例正常对照组外周血CD3^＋CD4^＋T细胞表面CD28^＋和CTLA-4^＋表达率。结果（1）MDS组CD3^＋CD4^＋CD28^＋表达率为（79.82±8.99）%[难治性贫血（RA）（78.65±10.4）%、伴原始细胞增多性难治性贫血（RAEB）/转变中的原始细胞增多性难治性贫血（RAEB-t）（80.10±7.28%）],低于正常对照组的（89.56±3.06）%,差异有高度统计学意义（P﹤0.01）;（2）MDS组CD3^＋CD4^＋CTLA-4^＋表达率为（2.14±1.25）%[RA（1.51±0.80）%、RAEB/RAEB-t为（2.65±1.33）%],显著高于正常组的（0.11±0.12）%,差异有高度统计学意义（P﹤0.01）;随MDS疾病的进展,RAEB/RAEB-t组CD3^＋CD4^＋CTLA-4^＋的表达率与RA组比较,差异有统计学意义（P〈0.05）;（3）CTLA-4/CD28免疫应答中相互拮抗的共刺激分子对比值在MDS-RA组中为2.14±0.97,RAEB/RAEB-t组为3.58±1.55,高于正常对照组的0.11±0.11,差异有高度统计学意义（P﹤0.01）;并且RA组和RAEB/RAEB-t组之间的差异亦有高度统计学意义（P﹤0.01）。结论（1）MDS患者骨髓的CD3^＋CD4^＋T细胞表面的共刺激分子表达异常,CD28下调,CTLA-4上调,T细胞处于抑制状态;（2）随着MDS骨髓中原始细胞的增多,CD28/CTLA-4比值增高,进一步说明CD28/CTLA-4异常与MDS疾病的发生及进展相关。     

携HSV1-TK自杀基因超声微泡造影剂联合前药更昔洛韦对前列腺癌细胞的抑制

目的观察超声微泡造影剂携单纯疱疹病毒Ⅰ型胸昔激酶(HSV1-TK)基因体外转染及联合前药更昔洛韦(GCV)对前列腺癌细胞株PC-3的抑制效应。方法超声辐照PC-3细胞,MTT筛选出最适辐照时间;将含有HSV1-TK基因的质粒通过静电吸附在脂质微泡表面,采用最适超声辐照转染,并用荧光显微镜及Western blot观察TK基因的转入及表达;MTT法观察使用不同浓度的前药更昔洛韦(GCV)后细胞增殖抑制率;流式细胞仪检测最适浓度的前药GCV对转染后的前列腺癌细胞PC-3的周期的影响;MTT法观察HSV1-TK/GCV自杀基因系统对前列腺癌PC-3细胞杀伤效应。结果 MTT检测显示超声强度为1.0 W/cm2,频率为1 MHz,辐照时间30 s时超声辐照对细胞无明显的抑制作用;通过超声辐照后HSV1-TK基因可以顺利转入PC-3细胞中并有稳定的表达。与对照组相比,当前药GCV浓度在100μg/ml时,超声+微泡+TK组细胞杀伤率明显高于其他各组,细胞存活率约32%,低于其他各组(P<0.05);流式细胞术检测显示大多数细胞被阻断在S期,细胞生长受到明显抑制。结论以超声辐照微泡造影剂为载体转染自杀基因联合前药GCV,对人前列腺癌细胞有明显杀伤作用。     

HSV-TK/ACV治疗小鼠肺腺癌LA795及其与机体免疫系统的关系

目的 :探讨HSV -TK/ACV(GCV)系统对小鼠肺腺癌细胞LA795治疗作用及其与机体免疫系统的关系。方法 :用重组逆转录病毒载体上清感染体外培养的小鼠肺腺癌细胞LA795 ,然后用新霉素类似物G41 8进行筛选 ,得到转染HSV -TK基因的LAtk细胞 ,分别将LA795细胞和LAtk细胞接种于小鼠皮下 ,观察ACV治疗后肿瘤生长情况、抗免疫功能以及对动物生存期的影响。结果 :体外转染HSV -TK基因的LAtk细胞获得了对ACV的敏感性 ,接种LAtk细胞的治疗组动物在ACV治疗后出现了肿瘤体积缩小 ,而对照组接种LA795细胞的动物在ACV治疗后肿瘤体积逐渐增大 ,两者具有显著差异 (P<0 .0 1 )。治疗组动物生存期为 5 1 .8d ,对照组动物生存期平均为 1 5 .9d ,两者具有显著差异 (P <0 .0 1 )。光镜下观察治疗组肿瘤组织及血管周围有大量的淋巴细胞浸润 ,计数 75个高倍视野中的淋巴细胞为 1 1 6.0 3± 5 2 .95 ,而对照组为 1 0 .41± 5 .5 2 ,二者具有显著差异 (P <0 .0 1 )。超微结构观察显示淋巴细胞群攻击癌细胞现象 ,癌细胞出现凋亡征象。结论 :①HSV -TK/ACV系统可以显著杀伤小鼠肺腺癌细胞LA795 ,使肿瘤消退 ,动物生存期延长 ,提示该系统有良好的治疗效果和应用前景。②HSV -TK/ACV系统治疗肿瘤除了其直接杀伤作用外 ,尚有机体免疫系统的     

腹腔镜脾切除术治疗不同类型的免疫性血小板减少性紫癜

【目的】探讨腹腔镜脾切除术（LS）治疗皮质激素治疗无效型（SR）和激素依赖治疗型（SD）的免疫性血小板减少性紫癜（ITP）的结果。【方法】回顾性分析1999年9月至2008年2月期间129例成功完成LS的ITP患者的临床资料,并分为SR组（82例）与SD组（47例）,比较两组的治疗结果。统计方法中率的比较采用χ2检验,均数比较采用Studentt检验。【结果】129例患者并发症发生率为9.3%,1例SR型患者因术后腹腔感染、败血症而死亡。血液学疗效：79.1%患者完全显效（CR）,10.1%部分显效（PR）,10.8%无效（NR）。SR组与SD组患者术前1d血小板计数分别为（90&#177;66）&#215;10^9/L和（124&#177;69）&#215;10^9/L（P〈0.05）,手术时间分别为（120&#177;46）min和（121&#177;45）min（P〉0.05）,术中出血量分别为（83&#177;145）mL和（95&#177;288）mL（P〉0.05）,术后48h总引流量分别为（106&#177;148）mL和（65&#177;67）mL（P〈0.05）,并发症发生率分别为9.7%和8.5%（P〉0.05）,术后7d血小板计数分别为（340&#177;215）&#215;10^9/L和（426&#177;264）&#215;10^9/L（P〈0.05）。血液学疗效：SR组CR70.7%,PR12.2%,NR17.1%,而SD组CR93.6%,PR6.4%,两组间差异有统计学意义（P〈0.05）。【结论】LS治疗ITP具有良好的疗效。在术前准备妥当的情况下,SR型患者手术安全性与SD型相近,但其总体血液学疗效明显差于后者。     

HSV-tk/GCV系统对人宫颈癌细胞株ME180旁观者效应的研究

目的：研究以逆转录病毒载体介导的HSV－tk/GCV系统对宫颈癌ME180细胞株的旁观者效应。方法：应用脂质体及ploybrene转染技术，将重组逆转录病毒载体PLXSN－HSV－tk，导入PA317包装细胞，以其分泌的逆转录病毒感染宫颈癌ME180细胞（ME），建立ME／TK转化细胞株。观察GCV对ME、ME／TK细胞的存活率及旁观者效应。结果：从病毒滴度、电镜及PCR检查，证实tk基因随病毒的感染已成功地导入PA317及ME180细胞。ME／TK细胞对GCV的敏感性显著高于亲代ME细胞。ME／TK及ME＋ME／TK混合细胞还随GCV浓度的增加受到明显的抑制。ME＋ME／TK混合细胞的存活率，随ME／TK细胞比例的增加而降低，说明TK／GCV系统不但能杀伤tk^ 细胞，也能杀伤未导入tk的细胞，存在明显的旁观者效应。结论：HSV－tk/GCV系统对宫颈癌ME180细胞具有明显的杀伤及旁观者效应。     

rhG-CSF动员正常供者与恶性血液病患者外周血造血干细胞质量的比较

目的探讨正常供者与恶性血液病患者使用重组人粒细胞集落刺激因子（rhG—CSF）动员后,用血细胞分离机采集的外周血造血干细胞,通过形态学观察PBSC中淋巴细胞比例及单个核细胞活力。方法分别对15例正常供者和14例恶性血液病患者使用rhG—CSF动员剂,用血细胞分离机采集外周血中单核细胞（MNC）,观察有核细胞数、有核细胞分类、MNC计数及细胞活力。结果（1）正常供者组采集的PBSC有核细胞总数为（4．31&#177;1．41）&#215;10^8／kg,恶性血液病患者组有核细胞总数MNC数为（6．21&#177;4．37）&#215;10^8／kg。（2）恶性血液病组采集的PBSC有核细胞数高于供者组（P〈0．01）。（3）用淋巴细胞比值乘以有核细胞总数计算单个核细胞,正常供者组（2．82&#177;1．03）&#215;10^8／kg、恶性血液病患者组（2．58&#177;1．79）&#215;10^8／kg,正常供者组与恶性血液病组单个核细胞数比较差异无统计学意义（P〉0．05）。（4）正常供者组MNC计数为（96．7&#177;5．1）％,其中淋巴细胞占（65．9&#177;9．4）％、粒细胞占（16．3&#177;8．7）％、单核细胞占（16．5&#177;4．0）％;恶性血液病组MNC计数为（92．7&#177;15．6）％,其中淋巴细胞占（55．3&#177;16．7）％、粒细胞占（24．3&#177;16．5）％、单核细胞占（14．9&#177;9．1）％。（5）正常供者组冻存前后细胞活力分别为（91．5&#177;4．3）％、（67．4&#177;9．1）％,恶性血液病组冻存前后细胞活力分别为（82．9&#177;11．1）％、（56．5&#177;20．1）％;两组冻存前后细胞活力差异均有显著性（P〈0．01）。（6）rhG—CSF动员前后正常供者组及恶性血液病组T细胞在CD3单克隆抗体＋rhIL-2刺激下,外周血T淋巴细胞的增生能力在应用rhG—CSF后下降[（68．5&#177;15．1）％vs（52．3&#177;12．5）％（P〈0．05）。结论单用rhG—CSF或化疗联合rhG—CSF动员均可采集到足够数量的外周血造血干细胞,应用淋巴细胞乘以有核细胞数作为外周血造血于细胞移植时计算输入外周血造血干细胞数量的指标时简便、快捷,不失为一良好的临床检测方法。     

Inhibitory effect of ultrasound microbubbles carrying HSV1-TK gene combined with ganciclovir on prostate cancer cells

目的 观察超声微泡造影剂携单纯疱疹病毒Ⅰ型胸昔激酶(HSV1-TK)基因体外转染及联合前药更昔洛韦(GCV)对前列腺癌细胞株PC-3的抑制效应.方法 超声辐照PC-3细胞,MTT筛选出最适辐照时间;将含有HSV1 -TK基因的质粒通过静电吸附在脂质微泡表面,采用最适超声辐照转染,并用荧光显微镜及Western blot观察TK基因的转入及表达;MTT法观察使用不同浓度的前药更昔洛韦(GCV)后细胞增殖抑制率;流式细胞仪检测最适浓度的前药GCV对转染后的前列腺癌细胞PC-3的周期的影响;MTT法观察HSV1-TK/GCV自杀基因系统对前列腺癌PC-3细胞杀伤效应.结果 MTT检测显示超声强度为1.0 W/cm2,频率为1 MHz,辐照时间30 s时超声辐照对细胞无明显的抑制作用;通过超声辐照后HSV1-TK基因可以顺利转入PC-3细胞中并有稳定的表达.与对照组相比,当前药GCV浓度在100μg/ml时,超声+微泡+TK组细胞杀伤率明显高于其他各组,细胞存活率约32％,低于其他各组(P＜0.05);流式细胞术检测显示大多数细胞被阻断在S期,细胞生长受到明显抑制.结论 以超声辐照微泡造影剂为载体转染自杀基因联合前约GCV,对人前列腺癌细胞有明显杀伤作用.     

腺病毒介导的HSV—tk／GCV自杀基因系统靶向性治疗前列腺癌的实验研究

目的：观察腺病毒介导单纯疱疹病毒胸苷激酶基因,丙氧鸟苷（HSV—tk／GCV）自杀基因系统在人端粒酶逆转录酶（hTERT）启动子调控下对人前列腺癌细胞的靶向性体外杀伤效应。方法：利用不同感染复数（MOI）的重组腺病毒携带增强型绿色荧光蛋白（EGFP）基因感染前列腺癌细胞LNCaP和人成纤维细胞MRC-5,荧光显微镜下观察其感染效率：利用携带不同启动子的重组腺病毒Ad—hTERT-HSV／TK以及Ad—CMV—HSV／TK感染LNCaP和MRC-5细胞,加入不同浓度GCV,MTY法观察受转染细胞的存活率。结果：重组腺病毒Ad—hTERT—EGFP能特异地转染LNCaP,其转染效率随重组病毒的MOI增加而升高（P〈0．01）,MOI为1时转染率为8．3％,MOI为1000时转染率达100％;应用GCV处理后,Ad—CMV—HSV／TK对LNCaP和MRC-5细胞均有杀伤作用,而Ad—hTERTp—HSV／TK只杀伤LNCaP（P〈0．001）,随着MOI和GCV浓度的增加,LNCaP细胞存活率明显降低（P〈0．01）,MOI为1和GCV浓度为1μmol/L时存活率为95．4％。MOI为100和GCV浓度为1000μmol／L时存活率仅为6．1％,并有旁观者效应。结论：重组腺病毒携带EGFP报告基因可准确、简便地确定转染效率;hTERT启动子调控的重组腺病毒介导的HSV—tk／GCV自杀基因系统对人前列腺癌细胞有靶向杀伤作用。     

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.