血清CA19—9测定对胰腺癌和胆管癌的诊断价值

采用ＲＩＡ法测定１５８例胰腺和胆道良、恶性疾病和２０例正常人血清ＣＡ１９－９含量，部分病例同时测定血清ＰＯＡ、ＣＥＡ含量。结果：正常人血清ＣＡ１９－９含量较低（１３．４±１０．１Ｕ／ｍｌ），无一例阳性（＞３７Ｕ／ｍｌ）。胰腺癌和胆管癌ＣＡ１９－９阳性率分别为８４．４％、７３．８％，显著高于良性胰腺疾病组（２０．０％）和良性胆道疾病组（３０．４％）（Ｐ＜０．００５或Ｐ＜０．０１）。上段胆管癌ＣＡ１９－９阳性率也显著高于中、下段胆管癌（Ｐ＜０．０５）。血清ＣＡ１９－９测定对胰腺癌和胆管癌诊断敏感性７９．３％，特异性７９．１％，正确率８４．８％。ＣＡ１９－９、ＰＯＡ、ＣＥＡ联合检测可提高诊断胰腺癌的可用度。     

血清α－L－岩藻糖苷酶活力测定对原发性肝癌的诊断意义

测定了原发性肝癌７７例（ＰＨＣ组），肝硬化３５例（ＤＣ组），消化系统其他恶性肿瘤患者３３例（ＤＳＣ组）及健康人１００例（ＮＣ组）血清α－Ｌ－岩藻糖苷酶（ＡＦＵ）活力。结果表明：ＰＨＣ组ＡＦＵ（６６９．６±１９１．５ｎｍｏｌ·ｍｌ￣（－１）·ｈ￣（－１））显著高于ＮＣ组（３１４．３±６７．０ｎｍｏｌ·ｍｌ￣（－１）·ｈ￣（－１），Ｐ＜０．０１），ＤＳＣ组（３９０．６±１０２．３ｎｍｏｌ·ｍｌ￣（－１）·ｈ￣（－１），Ｐ＜０．０１）和ＤＣ组（４５８．３±１５０．１ｎｍｏｌ·ｍｌ￣（－１）·ｈ￣（－１），Ｐ＜０．０５）。其诊断敏感性和特异性分别为７１．４％和８９．３％，与ＡＦＰ联合检测时ＰＨＣ组总的阳性检出率达８８．２％。     

高血压病患者胰岛素抵抗与血浆纤溶酶原激活物抑制物-1的关系

目的：研究高血压病（ｅｓｅｎｔｉａｌｈｙｐｅｒｔｅｎｓｉｏｎ,ＥＨ）病人胰岛素抵抗（ｉｎｓｕｌｉｎｒｅｓｉｓｔａｎｃｅ,ＩＳＲ）与纤溶酶原激活物抑制物１（ＰＡＩ１）的关系。方法：ＥＨ病人５９例,正常对照４６例。测定血浆ＰＡＩ１、ｔＰＡ（组织型纤溶酶原激活物）、空腹血糖（ＧＬＵ）、胰岛素（ＩＮＳ）、低密度脂蛋白胆固醇（ＬＤＬＣ）、高密度脂蛋白胆固醇（ＨＤＬＣ）、甘油三酯（ＴＧ）、胰岛素敏感指数（ＩＳＩ）、血尿酸（ＵＡ）、体重指数（ＢＭＩ）、腹围／臀围比（ＷＨＲ）等指标。结果：ＥＨ病人ＩＳＩ（用空腹血糖与胰岛素乘积的倒数表示）较正常对照组下降（－５．４±０．５ｖｓ－３９±０．８,Ｐ＜０．０１）。血浆ＰＡＩ１较对照组升高［（２９±８）ｍｇ·Ｌ－１ｖｓ（２４±５）ｍｇ·Ｌ－１,Ｐ＜０．０１］。在高血压组中单相关分析表明ＰＡＩ１与ＷＨＲ（ｒ＝０．３６９,Ｐ＜０．０１）、ＧＬＵ（ｒ＝０．５６３,Ｐ＜０．００１）正相关,与ＩＳＩ（ｒ＝－０．３０１,Ｐ＜０．０５）,ＨＤＬＣ（ｒ＝－０．４１７,Ｐ＜０．０１）、ｔＰＡ（ｒ＝－０．４９９,Ｐ＜０．００１）负相关。以ＢＭＩ、ＷＨＲ、ＩＳＩ、ＨＤＬＣ、ＬＤＬ     

低分子肝素治疗不稳定型心绞痛临床分析

目的：现察低分子肝素（ＬＭＷＨ）治疗不稳定型心绞痛（ＵＡＰ）的临床疗效。方法：对经常规治疗症状缀解不理想的 ３６例 ＵＡＰ 患者加用 ＬＭＷＨ５０００单位腹壁皮下注射,２次／日,用 ７～１０日,现察用药前后心绞痛发作次数和持续时间、心电图改善情况。结果：心绞痛控制总有效率９１．７％。用药前后心绞痛发作次数分别为１８．９± １２．１（次·周－１）、１．３８±２．２（次·周－１）,Ｐ＜０．００１;心绞痛持续时间分别为８０．５±１６．５（ｍｉｎ·周－１）、１．２５±０．８（ｍｉｎ·周－１）,Ｐ＜０．００１。心电图改善总有效率６４．０％。结论：在常规治疗基础上加用ＬＭＡＨ治疗ＵＡＰ方便、安全、有效。     

分枝杆菌多糖对小鼠造血功能的影响

观察了分枝杆菌多糖（ＭＰＳ）对环磷酰胺抑制ＢＡＬＢ／ｃ小鼠骨髓作用的影响。结果表明：给予ＣＰＡ使小鼠骨髓ＧＭ－ＣＦＵ抑制约３０％左右。１．０ｍｇ／ｋｇ的ＭＰＳ对ＧＭ－ＣＦＵ有促进作用（第１批实验ＣＰＡ对照组３１６．５±３４．６，实验１组４５４．５±１９．１，Ｐ＜０．０５；第２批实验ＣＰＡ对照组２０８．７±４３．７，实验２组４３７．８±５４．１，Ｐ＜０．０２）；而０．１５ｍｇ／ｋｇＭＰＳ无促进作用。在０．１５和１．０ｍｇ／ｋｇ剂量下，小鼠血清ＧＭ－ＣＳＦ活性水平明显提高；０．１５和１．０ｍｇ／ｋｇＭＰＳ可分别刺激小鼠每０．１ｍＬ血清产生５００Ｕ和８５０ＵＧＭ－ＣＳＦ。分析认为ＭＰＳ与日本的Ｚ－１００活性水平相当，这些作用可能通过激活单核或Ｔ细胞而间接产生。     

石楠藤提取物对急性出血坏死性胰腺炎大鼠治疗作用的实验研究

作者报道中药石楠藤提取物对急性出血坏死性胰腺炎（ＡＨＮＰ）大鼠治疗作用的实验研究。将１００只ＳＤ大鼠随机分为三组：①假手术组（ＳＯ组）；②ＡＨＮＰ组（ＡＰ组），该组动物在ＡＨＮＰ诱发后，不做特殊治疗；③石楠藤提取物治疗组（ＳＮ组）。该组动物在ＡＨＮＰ诱发后１０分钟经腹腔内注射石楠藤提取物（１％石楠藤提取物５ｍｌ／ｋｇ体重）。结果表明：ＳＮ组血清淀粉酶值明显下降（ＳＮ组１６１３０±５０３０Ｕ／Ｌ６ｈ、１９２９０±５３８０Ｕ／Ｌ１２ｈｖｓＡＰ组２３７８０±３９６０Ｕ／Ｌ、２８４７０±４１５０Ｕ／Ｌ，Ｐ＜０．０１）。血中ＰＡＦ含量明显降低（ＳＮ组１．３±０．３０ｎｇ／ｍｌ１ｈ、２．０±０．３４ｎｇ／ｍｌ６ｈ、２．１±０．３２ｎｇ／ｍｌ１２ｈｖｓＡＰ组２．２±０．２５ｎｇ／ｍｌ、６．１±０．４２ｎｇ／ｍｌ、１０．１±０．５３ｎｇ／ｍｌ，ｐ＜０．０１）。血浆内毒素含量明显下降（ＳＮ组６９．９±７．２ＥＵ／Ｌ、６ｈ、９１．１±８．４ＥＵ／Ｌ、１２ｈｖｓＡＰ组９８．４±６．９ＥＵ／Ｌ、１５１．７±９．１ＥＵ／Ｌ，Ｐ＜０．０１）。石楠藤提取物治疗组术后平均存活时间明显长于ＡＰ组（ＳＮ组：４３．５ｈ，ＡＰ组１１．５ｈ，ｐ＜０     

不饱和脂肪酸对肺癌细胞的抑制作用

不饱和脂肪酸（ＬＡ）浓度为２５μｇ／ｍｌ，对人肺腺癌细胞系（ＳＰＣ－Ａ１）细胞和二倍体人胚肺细胞系（ＨＬＦ）细胞抑制率分别为：９８．４±２．２％，１８．０±２．１％（Ｐ＜０．００１）。表现为对恶性细胞的选择性抑制作用。ＳＰＣ－Ａ１对５μｇ／ｍｌ ＬＡ无反应，１μＭ丝裂霉素Ｃ（ＭＭＣ）对ＳＰＣ－Ａ１细胞抑制率为４３．４±２．９％而当用１μｍ ＭＭＣ处理这种对５μｇ／ｍｌ ＬＡ无反应的ＳＰＣ－Ａ１时，     

血清CA19-9微粒子酶免疫法测定及其临床应用

目的探讨血清中ＣＡ１９－９的测定在消化道恶性肿瘤的诊断及动态观察中的价值。方法用微粒子酶免疫法对５０例胰腺癌、３４例肝癌、２７例肠癌及一些消化道良性肿瘤患者血清ＣＡ１９－９进行测定,并对胰腺癌、肝癌、肠癌转移组和未转移组及治疗前后血清ＣＡ１９－９的水平进行比较。结果胰腺癌、肝癌、肠癌患者血清中ＣＡ１９－９的水平分别为１７５．３±９７．５４、１５４．３±８９．２５、１１６．４±１０１．３２Ｕ／ｍｌ,明显高于正常对照组的１５．４±９．７１Ｕ／ｍｌ（Ｐ＜０．０１）,且转移组的水平明显高于未转移组（Ｐ＜０．０５）。施行根治术后,病人血清ＣＡ１９－９的水平显著下降（Ｐ＜０．０５）,而采用姑息术、化疗或放疗的患者血清ＣＡ１９－９水平虽有所下降,但仍显著高于正常。结论血清ＣＡ１９－９测定对消化道恶性肿瘤,尤其是胰腺癌、肝癌和肠癌的诊断有重要价值,且对这些疾病的疗效监测和预后评估起到积极作用。     

狼疮性肾炎患者尿内白细胞介素2受体和免疫球蛋白自由轻链的…

对３０例狼疮性肾炎（ＬＮ）病人尿中可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）和免疫球蛋白自由轻链（ＦＬＣＩ）进行检测。发现ＬＮ活动组的ｓＩＬ－２Ｒ平均值为１６０±１８０Ｕ／ｍｌ，明显高于ＬＮ非活动组（９２±２３Ｕ／ｍｌ，Ｐ＜０．０５）和正常对照组（８５±１９Ｕ／ｍｌ，Ｐ＜０．００１）；ＬＮ活动组尿ＦＬＣＩ的阳性率（７７％）亦明显ＬＮ非活动组１５％，Ｐ＜０．０１）。提示尿液中ｓＩＬ－２Ｒ和ＦＬＣＩ的增多     

柯萨奇B组病毒性心肌炎患儿血清可溶性白细胞介素—2受体水平测定

本文作者对５６例病毒性心肌炎患儿，进行了柯萨奇病毒Ｂ组（ＣｏｘＢ）抗体的检测。其中３２例抗ＣｏｘＢＩｇＭ阳性，阳性率为５７．１％，明显高于对照组（Ｐ＜０．００１）。采用ＥＬＩＳＡ法，对抗ＣｏｘＢＩｇＭ阳性的３２例心肌炎患儿血清中可溶性白细胞介素—２受体（ｓＩＬ－２Ｒ）水平进行了检测。结果表明，ＣｏｘＢ病毒感染的心肌炎患儿ｓＩＬ－２Ｒ水平为６７９．００±３５５．０７Ｕ／ｍｌ，健康同龄组为１５７．８７±１５７．２４Ｕ／ｍｌ，二者相比差异显著（Ｐ＜０．００１）。提示ＣｏｘＢ病毒心肌炎存在细胞免疫紊乱。     

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.