米非司酮治疗子宫肌瘤的临床疗效观察

目的:探讨米非司酮治疗子宫肌瘤的临床效果和安全性。方法:对78例被确诊为子宫肌瘤患者给予米非司酮口服治疗,连用3个月。在治疗前后B超测量子宫及肌瘤的体积,检测雌孕激素水平、血常规、肝肾功能,观察药物不良反应。结果:治疗后子宫及肌瘤体积明显缩小,雌、孕激素水平明显下降,血红蛋白升高,临床症状明显改善。未见明显不良反应。结论:米非司酮治疗子宫肌瘤安全有效,值得临床推广应用。     

米非司酮治疗子宫肌瘤96例疗效观察

目的:探讨米非司酮治疗子宫肌瘤的临床效果及副作用。方法:对96例被确诊的子宫肌瘤患者从月经周期的第1天起每晚睡前口服米非司酮25mg,共3个月。在治疗前后B超测量子宫体积、肌瘤体积,检测雌孕激素水平,血红蛋白、肝肾功能、不良反应。结果:治疗后临床症状明显改善。治疗期间所有病人雌孕激素水平明显下降,血红蛋白升高,子宫及肌瘤明显缩小,肌瘤平均体积缩小42.3%,子宫平均体积缩小35.1%。停药后月经恢复,不良反应小。结论:米非司酮治疗子宫肌瘤安全有效,不良反应小。     

小剂量米非司酮治疗围绝经期子宫肌瘤临床观察

目的：探讨米非司酮治疗围绝经期子宫肌瘤的临床效果。方法：对45例围绝经期妇女确诊子宫肌瘤患者,口服米非司酮6．25mg／d,3个月1疗程,治疗前后行B超监测子宫及肌瘤大小,实验室观察血常规、尿常规、肝功能、肾功能。结果：45例患者用药过程中均闭经,腰腹酸痛症状消失,贫血纠正。子宫及肌瘤缩小,缩小率分别为33．18％及40．25％。结论：米非司酮治疗围绝经期子宫肌瘤疗效确切,副作用小,是一种理想的药物治疗方法。     

米非司酮治疗子宫肌瘤70例临床分析

目的：探讨米非司酮治疗子宫肌瘤的临床效果。方法：70例确诊子宫肌瘤的患者，口服米非司酮12．5mg／天，3个月。结果：用药过程中均闭经，贫血得以纠正．困绝经期可致绝经。因用药后肌瘤缩小，界限清楚，可作为子宫切除术和肌瘤剔除术术前用药．减少术中出血。子宫及肌瘤体积平均缩小36．71％及55．58％，血红蛋白恢复正常。结论：米非司酮对子宫肌瘤有一定效果，丰富了保守治疗方法，是一种更为经济，更有前途的药物方法。     

米非司酮治疗子宫肌瘤73例临床观察

目的观察米非司酮治疗子宫肌瘤的效果。方法73例子宫肌瘤患者,口服米非司酮25 mg,睡前顿服,每日1次,连续3个月,为1疗程,观察子宫及肌瘤体积的变化,实验室观察血尿常规、肝功能、雌激素、孕酮。结果子宫体积及肌瘤体积缩小率分别为38.29%和41.87%(P<0.01),尤以肌瘤体积缩小明显,贫血得以纠正,雌、孕激素水平变化不明显(P>0.05)。结论米非司酮治疗子宫肌瘤效果肯定,但应严格掌握指证,加强随访。     

小剂量米非司酮对子宫肌瘤雌、孕激素受体的影响

目的：探讨小剂量米非司酮对子宫肌瘤及其雌、孕激素受体（ＥＲ和ＰＲ）的影响。方法：服用米非司酮每日１０ｍｇ，治疗有症状的子宫肌瘤患者２７例，连续３个月后，其中７例行子宫切除，测其血清Ｅ２、Ｐ、ＦＳＨ、ＬＨ水平，并分别对子宫肌瘤及肌层组织用免疫组化方法测ＥＲ和ＰＲ；同时与未用药而行子宫切除的肌瘤进行比较。结果：每日服用１０ｍｇ米非司酮３个月后，使子宫肌瘤体积缩小４１．６％。体内的Ｅ２和Ｐ水平均下降，Ｅ２维持在滤泡早期水平；肌瘤的ＰＲ和ＥＲ含量均减少，ＰＲ减少更明显，接近绝经后水平。结论：小剂量米非司酮缩小子宫肌瘤的机理可能与其降低体内Ｅ２和Ｐ水平及肌瘤的ＰＲ和ＥＲ含量有关。     

阴式全子宫切除术前米非司酮的应用

子宫肌瘤是妇科常见的良性肿瘤,近年研究表明[1]高雌孕激素是子宫肌瘤发病的一个主要原因,尤其是肌瘤局部雌孕激素受体含量增高,增强了激素的生物学效应,促使了肌瘤生长,米非司酮作为孕激素受体拮抗剂,可取代体内孕激素与孕激素受体结合而使肌瘤体积明显缩小.阴式子宫切除具有微创,腹部不留疤痕的优点,深受患者青睐,但对瘤体大于3个月的患者手术有一定困难.我们利用米非司酮可使肌瘤缩小的原理,对30例子宫肌瘤患者先行12周米非司酮治疗后行阴式子宫切除,取得了良好的效果.     

米非司酮治疗绝经期子宫肌瘤16例临床分析

目的：探讨米非司酮治疗绝经期子宫肌瘤的临床效果。方法：对1999年11月至2000年11月在我院门诊妇科检查后确诊为“子宫肌瘤”而无手术禁忌者，用米非司酮治疗子宫肌瘤时在用药前后子宫体积与肌瘤体积的比较。结果：用药前后子宫体积缩小58．5％（P＜0．01）；肌瘤体积缩小46．9％（P＜0．05）。结论：米非司酮是一种副作用小，减少手术率、减轻患者痛苦，对围绝经期子宫肌瘤患者是一种较好的保守治疗方法。     

米非司酮治疗子宫肌瘤152例疗效观察

目的 探讨米非司酮治疗子宫肌瘤的临床效果。方法 随机选择152例确诊子宫肌瘤的患者，每日口服米非司酮12．5mg，连服3个月，用药前及用药后分别测定子宫及子宫肌瘤体积。结果 用药后子宫及子宫肌瘤体积明显缩小。用药过程均闭经，贫血得以纠正，围绝经期可致绝经。因用药后肌瘤缩小，界限清楚，可作为子宫切除术和肌瘤剔除术术前用药，减少术中出血。子宫及肌瘤体积平均缩小35．5％及65．5％，血红蛋白恢复正常。结论 米非司酮治疗子宫肌瘤安全有效，是一种可行的保守治疗方法。也可作为开展微创手术的术前准备用药。     

米非司酮治疗子宫肌瘤临床疗效观察

目的：观察米非司酮治疗子宫肌瘤的临床效果。方法：将42例确诊为子宫肌瘤的患者进行药物治疗。口服米非司酮12．5mg,每日一次,连服3个月为一个疗程。治疗前后应用B超监测子宫及子宫肌瘤的大小,实验室观察雌激素（E2）、孕酮（P）、肝肾功能、血常规等。观察服药后的副反应。结果：42例患者在服药期间均出现闭经,血红蛋白上升,子宫及子宫肌瘤的平均体积均出现明显缩小,治疗后有35例病人肌瘤缩小20％以上,有效率达83．33％。结论：米非司酮治疗子宫肌瘤效果好,副反应小．是一种理想的可供选择的治疗方法。     

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.