中国西部地区脱髓鞘性视神经炎患者AQP4-IgG表达及其临床特征关系分析

目的 比较142例脱髓鞘性视神经炎（demyelinated optic neuritis,DON）患者血清或脑脊液中AQP4-IgG表达与其临床特征的关系。方法 回顾性收集2016年1月至2020年10月于陆军军医大学第一附属医院眼科收治的142例DON患者AQP4-IgG检验结果,对AQP4-IgG阳性及阴性患者的临床资料进行分析。结果 ①检测到AQP4-IgG阳性者48例（33.8%）,女性与男性比为5.9∶1,双眼同时发病者31例（64.6%）,发病时LogMAR视力为0.48±0.64,随访结束时LogMAR视力为0.55±0.65。②检测到AQP4-IgG阴性者94例（66.2%）,女性与男性比为1.7∶1,双眼同时发病者53例（56.4%）,发病时LogMAR视力为0.54±0.61,随访结束时LogMAR视力为0.39±0.49。③AQP4-IgG阳性女性患者比例明显高于AQP4-IgG阴性患者（χ2=7.827,P<0.01）;二者双眼患病率不具有统计学差异（χ2=0.884,P>0.05）;二者在发病时LogMAR视力并无统计学差异（t=-0.721,P>0.05）,但AQP4-IgG阳性患者视力预后更差（t =2.058,P<0.05）。AQP4-IgG阳性患者血沉升高（χ2=5.403,P<0.05）,以及合并自身抗体结果阳性的比例比AQP4-IgG阴性患者更高（χ2=5.231,P<0.05）,二者均具有统计学差异。结论 AQP4-IgG阳性的视神经脊髓炎谱系疾病患者女性发病率更高,视力预后更差,且可能合并自身抗体结果异常或者自身免疫性疾病。根据AQP4-IgG检测结果,准确地进行临床分型对治疗方案选择及预后分析具有重要指导意义。     

高原地区部队眼外伤临床分析

目的 探索和分析西藏驻军眼外伤的临床特点、诊治过程和预后,提出救治改进建议。方法 收集2011年1月1日至2017年12月31日保障西藏地区军人的6家医院收治的眼外伤军人的病例资料,包括人口统计学信息、致伤原因、就医时间、入院和出院时视力等,并与全军其他医院收治的军人眼外伤资料进行比较。结果 共纳入112例（116眼）眼外伤患者,男110例、女2例;机械性眼外伤111例（114眼）,占99.11%（98.28%）;55例（49.11%）在训练场所受伤,35例（31.25%）在休闲场所受伤,22例（19.64%）在工作场所受伤。39例（34.82%）受伤3 d后才到达西藏军区各中心医院或总医院就诊,24 h内就诊率（41.07%,46/112）低于济南军区总医院（82.37%,271/329）和全军全训部队（89.73%,131/146）的数据（P均<0.01）。70眼出院视力较入院视力提高,占有视力记录（92眼）的76.09%,其中低视力和单眼盲共33眼（35.87%,33/92）。与济南军区总医院和全军全训部队收治的军人眼外伤比较,低视力[29.35%（27/92）vs 8.03%（31/386）、6.16%（9/146）]和单眼盲[6.52%（6/92）vs 2.07%（8/386）、0.68%（1/146）]占比均较高（P均<0.05）;而与15家军队三甲医院数据[10.23%（79/772）、15.28%（118/772）]相比,低视力占比较高,单眼盲占比较低,差异均有统计学意义（P均<0.05）。结论 西藏地区军人眼外伤以机械性眼外伤为主;在训练场所眼外伤发生最多,可能与高原缺氧有关;低视力和单眼盲的伤眼较多。有必要进一步提高西藏军队医院眼外伤救治能力和西藏地区伤员后送能力。     

维生素D受体基因多态性与青藏高原藏族儿童结核病的对照研究

目的 探讨维生素D受体基因两种多态现象与青藏高原藏族儿童结核发病间的关系。方法 聚合酶链式反应-限制性片段长度多态性（PCR-RFLP）分析的方法分别对162例藏族儿童活动性肺结核患者及167例有分枝杆菌接触史的同民族健康者进行维生素D受体基因ApaⅠ、BsmⅠ多态性的基因型,根据不同基因型对样本分组进行统计学分析以研究两种多态性与青藏高原藏族儿童肺结核易感性的关系。结果 病例组中,AA、Aa与aa 3种基因型别为10例（6.2%）、72例（44.5%）、80例（49.4%）,健康对照组的相应基因型则为22例（13.2%）、79例（47.3%）、66例（39.5%）,病例组aa基因型频率高于对照组（OR=1.493,95% CI：0.964~2.312,P<0.05）。病例组中,BB、Bb、bb 3种基因型分别为2例（1.2%）、24例（14.8%）、136例（83.9%）,健康对照组的相应基因型则为1例（0.6%）、20例（11.9%）、146例（87.4%）,χ²检验表明两组的基因型频率差异无统计学意义（OR=1.009,95% CI：0.560~1.816,P>0.05）。结论 维生素D受体的ApaⅠ的多态性与高原藏族儿童肺结核易感性相关,其aa基因型可能是发病风险因素,而BsmⅠ的多态性则无关。     

大动脉炎397例临床特征分析：性别和年龄差异分布

目的 探讨不同性别和年龄大动脉炎患者临床特征的差异。方法 回顾性分析2001年1月至2017年12月海军军医大学（第二军医大学）长海医院收治的397例大动脉炎患者的病历资料,比较男女患者及不同性别中≤ 40岁和>40岁患者的临床表现、并发症、实验室检查和影像学检查结果的差异。结果 397例大动脉炎患者中男64例、女333例（男女比例为1：5.2）,发病年龄为2~67岁。>40岁男性大动脉炎患者多于女性[17例（26.6%）vs 53例（15.9%）,χ²=4.190,P=0.041]。相比女性患者,男性患者首发症状以高血压最多见[31.2%（20/64）vs 16.5%（55/333）,χ²=7.605,P<0.01],而以头晕、头痛或晕厥起病者较少[28.1%（18/64）vs 46.5%（155/333）,χ²=7.409,P<0.01]。病程中,男性患者较女性患者更常出现高血压[70.3%（45/64）vs 56.8%（189/333）,χ²=4.076,P<0.05],较少发生脉搏减弱或消失[51.6%（33/64）vs 76.0%（253/333）,χ²=15.885,P<0.01];男性发病年龄≤ 40岁的患者较>40岁者高血压的发生率更高[78.7%（37/47）vs 47.1%（8/17）,χ²=5.997,P<0.05],而脉搏减弱或消失的发生率较低[40.4%（19/47）vs 82.4%（14/17）,χ²=8.787,P<0.01]。男性患者并发动脉瘤形成、主动脉瓣反流的比例较女性患者更高[39.1%（25/64）vs 17.4%（58/333）、23.4%（15/64）vs 10.8%（36/333）,χ²=15.210、7.644,P均< 0.01]。男女患者及各年龄亚组之间红细胞沉降率升高和C-反应蛋白升高的患者比例差异均无统计学意义（P均> 0.05）。在血管受累及临床分型方面,相比女性患者,男性患者常见肾动脉受累和Ⅳ型[54.7%（35/64）vs 32.7%（109/333）、32.8%（21/64）vs 18.9%（63/333）,χ²=11.194、6.212,P均< 0.05],颈总动脉受累、锁骨下动脉受累和Ⅰ型较少见[37.5%（24/64）vs 64.3%（214/333）、37.5%（24/64）vs 56.5%（188/333）、21.9%（14/64）vs 42.3%（141/333）,χ²=16.016、8.416、9.449,P均<0.01];男性发病年龄≤ 40岁的患者较> 40岁者更常见Ⅳ型[44.7%（21/47）vs 0（0/17）,χ²=11.305,P<0.01],颈总动脉受累、锁骨下动脉受累和Ⅰ型较少见[29.8%（14/47）vs 58.8%（10/17）,25.5%（12/47）vs 70.6%（12/17）,14.9%（7/47）vs 41.2%（7/17）,χ²=4.491、10.814、5.046,P均<0.05]。结论 男性大动脉炎患者发病晚于女性,男性患者尤其发病年龄≤ 40岁的患者以高血压和肾动脉受累（Ⅳ型）多见,女性和发病年龄>40岁的男性患者常见脉搏减弱或消失和颈总动脉、锁骨下动脉受累（Ⅰ型）,并发高血压、动脉瘤形成和主动脉瓣反流的男性患者多于女性患者。     

儿童过敏性紫癜91例临床分析

目的 探讨儿童过敏性紫癜（HSP）的发病情况及临床特点。方法 对我院在2012年6月至2014年7月收治的91例HSP患儿的临床表现、实验室指标进行分析,并与我国湖南省、西藏高原地区、武汉市以及印度尼西亚的研究结果进行对比。纳入同期来我院进行健康检查的87名健康儿童作为健康对照组,比较HSP患儿与健康对照儿童以及单纯皮肤、非肾脏混合和肾脏受累HSP患儿的免疫功能。结果 纳入研究的91例患儿男女比例为1.07∶1,平均年龄为（8.3±2.4）岁,>5岁且≤ 10岁年龄段是发病高峰,发病季节集中于10～12月;发病原因以呼吸道感染为主,34例（37.36%）的HSP患儿发病前2周内有明确呼吸道感染史。在临床表现方面,首发症状有皮疹损害者80例（88.89%）,随后的整个病程中91例（100.00%）患儿均先后出现皮疹。首发症状有肾脏损害者12例（13.19%）,随着病程发展增加到34例（37.36%）,低于湖南省的发生率（χ²=19.194,P<0.01）,但高于西藏高原地区和武汉市（χ²=3.591、12.319,P均<0.05）。>10岁且≤15岁患儿肾脏受累比例高于 > 5岁且≤10岁和 > 1岁且≤5岁两个年龄段[57.14%（16/28）vs 30.19%（16/53）、20.00%（2/10）,χ²=5.570、4.077,P均<0.05]。出现各类伴随症状的时间平均约为7 d,肾功能异常出现最晚,平均约10 d。在免疫功能方面,HSP患儿CD4⁺T淋巴细胞比例及其与CD8⁺T淋巴细胞的比值均低于健康对照组（t=8.460、9.460,P均<0.01）,但在HSP患儿单纯皮肤组、非肾脏混合组和肾脏受累组之间差异无统计学意义。HSP患儿IgG、IgA、IgE水平均高于健康对照组（t=7.841、13.933、6.870,P均<0.01）,其中肾脏受累组的IgG和IgA水平均高于单纯皮肤组（t=4.941、5.111,P均<0.01）。结论 隐匿性感染对HSP发病的影响不容忽视。相比其他临床症状肾脏受累较为隐匿,疾病早期肾功能正常的患儿仍有必要较长时间动态监测尿常规。大多HSP患儿的免疫功能紊乱,主要表现为CD4⁺与CD8⁺T淋巴细胞比值下降,但与疾病的严重程度无明显相关性。     

CCR7loPD-1hi滤泡辅助性T细胞在系统性红斑狼疮患者外周血中的比例及临床意义

目的 检测系统性红斑狼疮（SLE）患者外周血中CCR7^loPD-1^hi滤泡辅助性T细胞（Tfh）的比例,并探讨其临床意义。方法 收集31例SLE患者、29例类风湿关节炎（RA）患者、12例干燥综合征（SS）患者和37名健康对照的外周血样本。采用流式细胞术检测Tfh表面C-X-C趋化因子受体3（CXCR3）、诱导型共刺激分子（ICOS）和信号淋巴细胞激活分子家族成员5（SLAMF5）的表达水平,以及外周血中CCR7^loPD-1^hi Tfh和CCR7hiPD-1lo Tfh的比例。分析SLE患者外周血中CCR7^loPD-1^hi Tfh的比例与临床指标、成浆细胞比例的相关性。结果 相比CCR7hiPD-1lo Tfh,CCR7^loPD-1^hi表面CXCR3、ICOS和SLAMF5的表达水平较高（t=3.73、5.06、8.27,P均<0.01）。SLE和RA患者外周血中CCR7^loPD-1^hi Tfh的比例分别为5.79%（2.97%,8.95%）和4.57%（2.51%,7.60%）,均高于健康对照组[2.93%（1.63%,5.21%）,U=314.5、332.5,P均<0.01],而SS患者外周血中CCR7^loPD-1^hi Tfh的比例与健康对照相比差异无统计学意义（U=183.0,P>0.05）。SLE患者外周血中CCR7^loPD-1^hi Tfh的比例与系统性红斑狼疮疾病活动指数（SLEDAI）、抗双链DNA抗体滴度、成浆细胞比例均呈正相关（r=0.447 1、0.517 4、0.466 9,P均<0.05）。结论 SLE患者外周血中CCR7^loPD-1^hi Tfh比例增加与SLEDAI升高和成浆细胞比例的增加相关,检测患者外周血Tfh亚群可间接反映生发中心及B淋巴细胞的功能状态,对SLE的诊断、监测和预后有重要意义。     

针刺对青光眼患者视功能影响的临床观察

[目的]探讨针刺治疗对眼压稳定的青光眼患者视功能影响。[方法]选取青光眼患者68例,采用前瞻性随机对照研究,将68例青光眼性视神经病变者随机治疗组及对照组。对照组继续接受原来的降眼压基础治疗;治疗组在基础治疗外予以针刺治疗,取穴如下：主穴风池、太阳、睛明、合谷,配穴：球后、四白、承泣、童子髎、丝竹空,百会等,每日1次,每周治疗6 d,4周为1个疗程,连续治疗3个疗程（12周）,观察患眼视力、眼压、视野、视觉诱发电位的变化。[结果]1）治疗后,治疗组视力均数较治疗前提高（P<0.05）;2）两组患者治疗前后眼压未见明显改变及差异（P<0.05）;3）治疗后,与治疗前比较,治疗组视野平均敏感度（MS）值提高（P<0.05）,视野平均缺损值（MD）降低（P<0.05）;4）治疗12周后两组的P100波峰均提高,潜伏期时间缩短。[结论]针刺治疗青光眼虽不能明显提高患者视力、降低眼压,但可以改善视野光敏度、降低平均缺损值,值得临床作为青光眼的辅助治疗以保护视神经、改善视功能。     

不同发病孕周的妊娠期肝内胆汁淤积症围产儿结局分析

目的 探讨不同发病孕周的妊娠期肝内胆汁淤积症（ICP）患者的围产儿结局。方法 选取2015年11月至2017年11月黄山市人民医院诊治并分娩的ICP患者167例,按ICP不同发病孕周分为4组,1组为妊娠≤27⁺⁶周（15例）,2组为妊娠28周~31⁺⁶周（29例）,3组为妊娠32~33⁺⁶周（26例）,4组为妊娠≥34周（97例）。比较4组患者早产、剖宫产、羊水污染、胎儿窘迫、新生儿窒息及死胎的发生率。以孕32周为界,比较妊娠<32周组（44例）及妊娠≥32周组（123例）患者早产、剖宫产、羊水污染、胎儿窘迫、新生儿窒息、死胎的发生率以及其血清总胆汁酸（TBA）及重度ICP发生率的情况。结果 4组患者早产、剖宫产、羊水污染、新生儿窒息及死胎的发生率差异均有统计学意义（χ²=46.587,P<0.001;χ²=7.990,P=0.046;χ²=24.557,P<0.001;χ²=9.045,P=0.019;χ²=11.777,P=0.003）。妊娠<32周组患者早产、剖宫产、羊水污染、胎儿窘迫、新生儿窒息、死胎的发生率高于妊娠≥32周组,差异有统计学意义（χ²=42.626,P<0.001;χ²=7.838,P=0.005;χ²=24.204,P<0.001;χ²=4.751,P=0.029;χ²=9.612,P=0.002;χ²=7.592,P=0.006）。妊娠<32周组患者的血清TBA水平高于妊娠≥32周组,差异有统计学意义（t=3.435,P=0.001）;妊娠<32周组患者重度ICP发生率高于妊娠≥32周组,差异有统计学意义（χ²=4.042,P=0.044）。结论 妊娠<32周ICP患者血清TBA水平高,围产儿不良结局发生率高,临床应重视并积极诊治孕32周之前发病的ICP患者。     

锥型束CT在双颌前突患者尖牙唇侧牙槽骨缺损中的应用

目的 探讨锥型束CT （CBCT）在双颌前突患者尖牙唇侧牙槽骨缺损中的应用价值。方法 选取2016年1~12月于安徽省立医院就诊的未经正畸治疗的双颌前突成人患者65例,按照垂直骨面型将患者分为低角组（20例）,均角组（31例）以及高角组（14例）,在相同参数下拍摄CBCT,比较各组中尖牙唇侧牙槽骨缺损及骨开窗,骨开裂的检出率情况,并分析其分布特征。结果 65例患者中尖牙唇侧牙槽骨缺损检出率为67.31%,其中骨开窗检出率为40.77%,牙槽骨开裂检出率为26.54%。牙槽骨骨开窗主要发生在上颌（χ²=69.380,P<0.05）,而骨开裂主要发生在下颌（χ²=18.959,P<0.05）。低角组骨开窗的检出率7.68%低于均角组21.92%和高角组11.15%,差异均有统计学意义（P<0.05）。3组间骨开裂检出率差异无统计学意义（χ²=0.346,P>0.05）。结论 CBCT可反映双颌前突患者尖牙唇侧牙槽骨缺损中骨开窗,骨开裂的易发部位,。     

超声乳化白内障吸除术中晶状体后囊膜破裂的危险因素分析

目的 探讨超声乳化白内障吸除术中发生晶状体后囊膜破裂（PCR）的危险因素。方法 回顾性分析2011年1月至2017年12月在上海市奉贤区中医医院行超声乳化白内障吸除联合人工晶状体植入术的5 415例患者（5 743只眼）资料,将术中发生晶状体PCR的120眼（105例患者）纳入观察组,按照1 ∶ 4的比例随机选取未发生PCR的480眼（452例患者）纳入对照组。对两组患者的基本信息（性别、年龄）、全身危险因素（高血压病史、糖尿病史、心血管疾病史、糖皮质激素服用史、吸烟史、饮酒史）、眼科基本信息及眼科危险因素（视力、眼压、青光眼史、高度近视史、角膜病变史、葡萄膜炎病变史、白内障类型、玻璃体积血、玻璃体手术史）和白内障晶状体核硬度进行比较,分析超声乳化白内障吸除术中发生PCR的危险因素。结果 观察组患眼术前视力<20/200 [89.2%（107/120）vs 58.1%（279/480）]、玻璃体积血[10.8%（13/120）vs 2.3%（11/480）]、玻璃体手术史[20.8%（25/120）vs 4.8%（23/480）]占比均高于对照组,差异有统计学意义（P<0.05）。观察组和对照组分别有111眼和459眼进行了晶状体核硬度分级,观察组Ⅰ～Ⅴ级者分别为9眼（8.1%）、11眼（9.9%）、10眼（9.0%）、46眼（41.4%）和35眼（31.5%）,对照组Ⅰ～Ⅴ者分别为88眼（19.2%）、82眼（17.9%）、109眼（23.7%）、97眼（21.1%）和83眼（18.1%）,两组比较差异有统计学意义（P<0.05）。观察组logMAR视力由术前2.11±0.98恢复到术后1.07±0.44（P<0.05）,对照组由术前1.37±0.90恢复到术后0.72±0.37（P<0.05）;观察组术前和术后的logMAR视力均较对照组差（P<0.05）。结论 术前视力<20/200、玻璃体积血、玻璃体手术史和晶状体核硬度分级是超声乳化白内障吸除术中发生PCR的危险因素。     

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.