颈动脉粥样硬化程度与血小板活化的相关性分析

目的：研究血小板活化指标CD62p，CD63与颈动脉粥样硬化的关系，以评价血小板活化在颈动脉粥样硬化形成中的作用。方法：以B超检测颈动脉，按动脉粥样硬化程度将患者分为：颈动脉正常组（正常组）、颈动脉内中膜增厚组（增厚组）、稳定性斑块组、不稳定性斑块组共4组，且同时测定CD62p、CD63，并进行颈动脉弱样硬化评分与危险因素相关性分析。结果：CD62p：不稳定性斑块组较其余三组均增高，P＜0．05－0．01，稳定性斑块组较正常组增高（P＜0．01）。CD63：不稳定性斑块组较正常组、内中膜增厚组增高（P＜0．05），稳定性斑块组较正常组增高（P＜0．05）。经多元逐步回归分析显示颈动脉粥样硬化程度与CD62p呈显著正相关。结论：血小权活化是颈动脉粥样硬化的危险因素之一。     

通心络对颈动脉粥样硬化炎性机制作用的临床研究

目的 探讨通心络对动脉粥样硬化炎性机制的作用，并观察其对颈动脉粥样硬化斑的影响。方法 经体外血管超声检查有颈动脉粥样硬化斑块患者100例，均在降纤、抗凝、脑细胞活化剂等常规治疗基础上加服通心络胶囊（每次4粒，每日3次）3个月，每位患者均检测治疗前后血清CRP、sICAM-1、P-选择素、MCP-1、MMP-9、血脂等的变化，同时经颈动脉彩超观察其硬化斑的变化。结果 经过3个月的治疗后，患者血清CRP、sICAM—1、P-选择素、MCP-1、MMP-9水平较治疗前显著降低（P〈0．05）；而治疗前后血脂水平差异无统计学意义（P〉0．05）；颈动脉彩超观察显示，治疗后动脉硬化斑块较治疗前有不同程度减轻。结论 颈动脉粥样硬化患者在常规治疗基础上加用通心络胶囊能明显降低血清炎症因子的浓度，从而减轻对血管内皮的炎症损害作用，进一步恢复内度功能。减少动脉粥样硬化的发生发展。并能稳定斑块。提高临康疗效．     

辛伐他汀治疗动脉粥样硬化疗效观察

目的：观察辛伐他汀对动脉粥样硬化的临床疗效。方法：选择92例伴有颈动脉粥样硬化的患者，随机分为两组。治疗组46例，服用辛伐他汀40mg／d，每晚1次；对照组46例，服用安慰剂，每日1次，疗程6个月。治疗前后经彩色多普勒超声检测颈动脉内膜-中层的厚度及斑块大小。结果：治疗组颈动脉内膜-中层厚度及斑块大小治疗后明显减小（P〈0．05）。对照组治疗前后差异无统计学意义（P〉0．05）。结论：辛伐他汀可以明显减轻颈动脉硬化病变，可作为治疗颈动脉粥样硬化的常规用药。     

麝香保心丸与阿司匹林配伍辛伐他汀对老年高血压患者颈动脉斑块的疗效比较

目的：探讨麝香保心丸与阿司匹林分别配伍辛伐他汀对老年高血压患者颈动脉粥样硬化斑块的疗效。方法：选择颈动脉彩色多普勒检查明确有颈动脉粥样斑块的患者186例,其中96例（观察组）给予常规剂量麝香保心丸加辛伐他汀,90例（对照组）给予常规量阿司匹林加辛伐他汀治疗,两组疗程均为6个月。记录治疗前后的颈动脉IMT、斑块数量和颈动脉粥样硬化斑块总面积（CPA）,同时观察血压、心电图、凝血功能,血黏度及生化检查。结果：治疗后观察组患者粥样班块数量较对照组明显减少;CPA明显缩小（P〈0．05）,血黏度得到明显改善（P〈0．05）。结论：麝香保心丸与辛伐他汀对颈动脉斑块的治疗效果优于阿司匹林配伍辛伐他汀。     

普伐他汀对颈动脉粥样硬化斑块稳定性的临床研究

目的：观察应用普伐他汀后脑梗死患者颈动脉粥样硬化斑块的变化。方法：112例确诊颈动脉粥样硬化斑块的患者，随机分成药物干预组（n=56）和低脂饮食干预组（n=56），开设健康对照组56例，为同期健康查体者。药物干预组在饮食控制的基础上给予普伐他汀10mg口服，1次／d，疗程为6个月。低脂饮食干预组采用饮食控制，加强体育运动，减轻体质量等方法。干预6个月后观察斑块声学密度变化。结果：治疗后6个月，药物干预组血清TC，TG，LDL—C较治疗前明显降低（P〈0．05），也显著低于低脂饮食干预组（P〈0．05）。HDL—C值较治疗前显著增加，也显著高于低脂饮食干预组（P〈0．05）。试验组低回声斑块声学密度的背向散射积分值（IBS）较治疗前显著升高，也显著高于对照组（P〈0．05）。结论：对合并颈动脉粥样硬化斑块的脑梗死患者，长期服用普伐他汀可以降低血脂，改善低回声斑块组织学构成，增加斑块密度，从而稳定斑块，并降低其C-反应蛋白水平，从而可减少脑卒中的发生及再发。     

不同剂量辛伐他汀治疗脑梗塞颈动脉粥样硬化斑块的临床研究

目的研究不同辛伐他汀剂量对脑梗塞患者颈动脉粥样硬化斑块的治疗效果。方法将本院脑梗塞住院治疗的144例有颈动脉粥样硬化斑块的患者随机分成辛伐他汀20mg组及辛伐他汀40mg组进行为期24个月的观察对比。结果辛伐他汀20mg组与40mg组在治疗前颈动脉粥样硬化斑块积分比较,差异无统计学意义（P〉0.05）;辛伐他汀20mg组与40mg组在治疗24个月后颈动脉粥样硬化斑块积分比较,差异无统计学意义（P〉0.05）;辛伐他汀20mg组与40mg组在治疗24个月前后颈动脉粥样硬化斑块积分比较,差异有统计学意义（P〈0.05）。结论 24个月每晚服用20mg、40mg辛伐他汀对脑梗塞患者颈动脉粥样硬化斑块稳定和逆转均有较好作用。     

颈动脉粥样硬化与冠心病的关系

目的：探讨颈动脉粥样硬化与冠心病的关系。方法：将非脑血管患者60例分为对照组（20例）、心绞痛组（20例）和心肌梗死组（20例）。冠心病依据心电图、肌钙蛋白、运动试验诊断；颈动脉粥样硬化用彩色多普勒超声观测。结果：对照组颈动脉多普勒超声未见狭窄及粥样斑块，颈动脉内膜厚度／腔内径〈0．1；心绞痛和心肌梗死组90％（36／40）发现颈动脉粥样硬化斑块，颈动脉内膜厚度／腔内径〉0．1，收缩期颈内动脉血流速／颈动脉血流速〉0．8，与对照组比较，有显著性差异（P＜0．05），但心绞痛组和心肌梗死组上述指标未见显著差异（P＞0．05）。结论：颈动脉样硬化与冠心病有密切关系，颈动脉粥样硬化可作为冠状动脉病变的信号。     

阿托伐他汀钙对冠心病患者颈动脉粥样硬化斑块的影响

目的：研究阿托伐他汀钙对冠心病合并颈动脉粥样硬化斑块患者的临床疗效。方法：选取我院收治的冠心病合并颈动脉粥样硬化斑块患者82例,随机均分为实验组与对照组,对照组维持原冠心病常规治疗,实验组在对照组的基础上服用阿托伐他汀钙20 mg/d ,持续1年,观察对比两组患者治疗后的临床疗效。结果：两组治疗1年后,实验组患者在TC、TG、LDL-C、HCY等指标上显著低于对照组,而HDL-C水平显著高于对照组（P＜0．05）;实验组患者的IMT平均为（1．02±0．13） mm,斑块积分平均为（3．35±0．32）,对照组患者的IMT平均为（1．33±0．24）mm,斑块积分平均为（3．84±0．38）,两组在IMT、斑块积分上存在显著性差异（ P＜0．05）。结论：阿托伐他汀钙治疗颈动脉粥样硬化斑块疗效显著,但一定要在治疗过程中加强预防患者血清中HDL-C的升高。     

缺血性脑血管病患者血小板CD62P的变化及其临床意义

目的：探讨血小板表面P选择素（CD62P）与缺血性脑血管病发生及其与动态硬化关系。方法：应用流式细胞仪测定262例急性脑血管病患者发病48小时以内CD62P的改变，其中109例脑梗塞患者于恢复期进行复查。结果：（1）脑梗塞急性期CD62P较对照组显著升高（P＜0．01）；（2）初发脑梗塞组恢复组CD62P较急性期明显下降（P＜0．01），而复发脑梗塞组恢复期CD62P较急性期无明显下降（P＞0．05）；（3）脑梗塞伴颈动脉粥样硬化斑块组恢复期CD62P较无颈动脉粥样硬化斑块组高（P＜0．05）；（4）脑出血伴脑梗塞者CD62P明显升高。结论：活化血小板参与了缺血性脑损伤的病理过程。动脉粥样硬化对血小板活化发生起一定作用。     

阿托伐他汀治疗颈动脉粥样硬化斑块的临床疗效观察

目的：分析阿托伐他汀治疗颈动脉粥样硬化斑块的临床疗效。方法：回顾性分析我院2012年6月-2013年6月期间收治的58例颈动脉粥样硬化斑块患者的临床资料,将其平均分成对照组和观察组,其中给予对照组患者采用非诺贝特胶囊治疗,给予观察组患者采用阿托伐他汀治疗,比较分析两组患者治疗前、后血脂、颈动脉内膜-中层厚度以及斑块面积的变化。结果：和治疗前相比,观察组血脂的四项指标TG、TC、HDL以及LDL均有明显改善,血脂水平得到有效控制,具有统计学意义（ P＜0．05）;同时观察组在治疗后颈动脉粥样硬化斑块面积与IM T有明显下降,具有统计学意义（P＜0．05）。结论：采用阿托伐他汀治疗颈动脉粥样硬化斑块,临床治疗效果显著,不但能够降低患者的血脂水平,同时还能缩小斑块面积,值得临床推广应用。     

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.     

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.