急性早幼粒细胞白血病患者FG、SFC、FDP及D-二聚体的检测

测定40例正常人和50例急性早幼粒细胞白血病患者血浆纤维蛋白原（Fg）、血清纤维蛋白降解产物（FDP），血浆可溶性纤维蛋白复合物（SF）及血浆D-二聚体的含量．结果：Fg为1．8±0．72g／L，FDP为464±94μg／L，SFC为482．5±167mg／L，D-二聚体为5524.94±4247．03μg／L．正常对照组Fg为3．2±0．87g／L．FDP为215±63μg／L，SFC为49．7±16．4mg／L，D-二聚体为177．1±43．9ug／L．两组差异显著．提示上述指标可作为显示体内出凝血像异常及纤溶亢进的有效证据．作为DIC的确诊可确切地反应疾病病变过程．     

血浆纤维蛋白原与冠状动脉粥样硬化性心脏病的相关性研究

目的 探讨冠状动脉粥样硬化性心脏病（简称冠心病，Coronary heart disease，CHD）患者血浆纤维蛋白原（Fi-bfinogen，Fg）水平变化与冠状动脉病变程度和不同类型冠心病的关系。方法 101例CHD患者[其中单支血管病变组46例，双支血管病变组30例，多支血管病变组25例；不稳定性心绞痛（UAP）62例，急性心肌梗死（AMI）28例，稳定性心绞痛（SAP）11例]与37例对照组，采集静脉血，检测血浆Fg等水平，然后进行统计学处理。结果 CHD组血浆Fg[（3．75640±1．15034）g／L]均较对照组Fg[（2．85140±0．64145）g／L]显著升高（P〈0．001）；并且按冠状动脉病变支数分组后，多支病变组血纤维蛋白原高于单支病变组（P〈0．05），按疾病类型分组后AMI组血纤维蛋白原均高于UAP组和SAP组（P〈0．05）。结论 血纤维蛋白原在冠心病的发病机制中可能起一定作用，可以作为预测急性心肌梗死和判断冠脉病变严重程度的参考指标。     

选择适合的新鲜血浆建立纤维蛋白原测定的标准曲线

目的 选择适合的新鲜血浆,建立纤维蛋白原测定的标准曲线,以确保检测结果的准确性。方法 以校正合格的ACL-Advance血凝分析仪为参考仪器,以其测定纤维蛋白原浓度分别为1．5g／L、2．0g／L、2．5g／L、3．0g／L、3．5g／L、4．0g／L的新鲜血浆为定标血浆,分别对SysmexCA-50血凝分析仪建立标准曲线,并比较两台仪器测定纤维蛋白原的结果。结果 纤维蛋白原浓度为2．5g／L、3．0g/L的定标血浆,建立SysmexCA-50血凝分析仪测定纤维蛋白原的标准曲线,两台仪器检测纤维蛋白原的结果差别无统计学意义（P〉0．05）,并且相关性良好。结论 纤维蛋白原浓度为2．5～3．0g／L的新鲜血浆为定标血浆,建立纤维蛋白原测定的标准曲线,可以确保检测结果的准确性。     

ACL-7000血凝仪测定纤维蛋白原的方法学比较及临床应用

目的比较ACL-7000血凝仪测定纤维蛋白原的2种方法和探讨其临床应用。方法ACL-7000血凝仪的Von Clauss法和PT—der法分别检测不同纤维蛋白原含量的病人血浆。结果纤维蛋白原小于2．00g／L或在2．00～4．00g／L之间，2种方法没有差异显著性（P〉0．05），纤维蛋白原大于4．00g／L时，PT—der法所得结果明显高于Von Clauss法（P〈0．02）。结论纤雏蛋白原小于2．00g／L或在2．00～4．00g／L之间时，可以使用PT—der法替代Von Clauss法检测纤维蛋白原；纤维蛋白原大于4．00g／L时，不能用PT—der法替代Von Clauss法。因此，在临床工作中，应根据疾病的需要及纤雏蛋白原的含量，选择不同的检测方法。     

正常妊娠与妊高征蛋白C和组织纤溶酶原激活物的改变

测定25例正常孕妇，22例中度或重度妊高征病人的血浆蛋白C活性（Pc：C）和蛋白e抗原（Pc：Ag）及组织纤溶酶原激活物抗原（t－PA：Ag）的水平，以20例非孕妇作对照。结果表明：正常孕妇血浆Pc：C为1570％±38．1％，Pc：Ag为7．22±2．3μg／L；妇高征病人Pc：C为193.5％±66％，Pc：Ag为6.96±2.27μg／L；两组呈同步升高（P＞0．05），与非孕组（Pc：c为100.9％±25.3％，Pc：Ag为4.66±1．6μg／L）比较，差异显著（P＜0．001）．t－PA：Ag妇高征组为15.6±11.08μg／L，正常孕妇为8±5.8μg／L，与非孕组（2．02±1．013μg／L）比较，差异显著（P＜0.001）．表明在妊娠后期，特别是妇高征时，孕妇的抗凝与纤溶系统有明显改变。     

脓毒症致DIC和多器官功能衰竭患者炎性因子和凝血及纤溶系统相关指标的变化

目的探讨脓毒症致DIC以及多器官功能衰竭（MODS）患者炎性因子、凝血及纤维蛋白溶解相关指标的变化。方法97例脓毒症患者根据是否合并DIC及MODS分组，血浆组织因子（TF）和组织因子途径抑制物（TFPT）、组织型纤维蛋白酶原活化剂（t-PA）及其抑制物1（PAI-1）和肿瘤坏死因子-α（TNF-α）、IL-6浓度。发色底物法检测血浆蛋白C活性。结果血浆TNF-α、IL-6浓度在脓毒症合并DIC组为（38±12）ng／L、（77±9）ng／L，合并MODS组为（63±25）ng／L、（103±28）ng／L，分别高于非DIC组的（17±6）ng／L、（45±6）ng／L和非MODS组（29±7）ng／L、（48±9）ng／L，均P〈0．05；死亡组高于存活组（P〈0．05）。合并DIC组蛋白C活性为（32±10）％，合并MODS者为（24±12）％，分别低于非DIC组的（57±28）％及非MODS者的（55±17）％，均P〈0．05；死亡组低于存活组（P〈0．05）；合并DIC组t—PA浓度为（48±17）μg/L，PAI-1浓度为（103±38）μg／L，均高于非DIC组，P〈0．05。结论在脓毒症、DIC、MODS一系列的发生发展过程中，炎性介质发挥了重要作用，蛋白C活性减低和PAI-1的增高使纤维蛋白易于沉积造成微血栓形成，并且为DIC预后不良指标。     

循环酶法测定血浆同型半胱氨酸的方法学评价

目的：评价测定血浆同型半胱氨酸（HCY）的循环酶方法。方法：血浆氧化型同型半胱氨酸经三-乙-羧乙基膦（TCEP）还原成游离型HCY，基于HCY甲基转移酶（HMTase），S-腺苷同型半胱氨酸水解酶（SAHase）构成的循环酶体系以及脱氢酶-辅酶体系的原理，用自动生化分析仪测定血浆HCY。结果：测定线性范围达1．5μmol／L～50．0μmol／L：批内CV分别为2．1％、1．7％；日间CV分别为3．7％、4．1％，总CV分别为4．9％、5．2％；回收率96．8％-101．3％；本法和高效液相色谱法比较：R^2=0．9737，Y=0．972X＋1．595。t=2．01，P〉0．05，差异无显著性；血氨〈50．0μmol／L，三酰甘油〈11．0mmol／L，抗坏血酸〈10．0mmol／L，胆红素〈500．0μmol／L，血红蛋白〈2．0g／L，谷胱甘肽〈0．05mmol／L时，对结果无明显干扰。结论：本方法具有简便、灵敏等特点，适合血浆HCY的常规和自动化分析。     

C-反应蛋白的临床意义

C-反应蛋白（CRP）是人体血浆中一种正常蛋白组分．含量甚微。当组织损伤或炎症发生时，CRP在肝脏的合成和分解率增加，血清中的CRP浓度含量显著上升，是一种急性相的反应物。在临床上，CRP浓度测定非常有助于炎症和感染的检测．是敏感的炎症指标之一。由于健康人体内的CRP水平较低．表现健康人：90％〈3mg／L，99％〈10mg／L，由细菌感染或创伤引起的急性炎症〉10mg／L。     

老年外周血慢性炎症因子与5年全因死亡率的相关性研究

目的：探索无症状老年人外周血慢性非特异性炎症因子与5年全因死亡率的相关性。方法：入组来院体检的〉80岁无症状老年个体，检测外周血慢性非特异性炎症因子C反应蛋白和纤维蛋白原的水平，用流式细胞术检测外周血淋巴细胞CD3、CD4和CD8的百分比后，进行5年全因死亡率的纵向随访。结果入组的169例无症状老年个体，5年后随访到155人，其中20人死亡。比较生存组和死亡组的基线数据显示，死亡组C反应蛋白显著高于生存组（4．7mg／Lvs2．4mg／L，P〈0．01）；生存组的CD3＋CD4＋／CD3＋CD8＋显著高于死亡组（1．12vs0．79，P〈0．05）；生存组的纤维蛋白原略低（2．98g／Lvs3．51g／L，P〉0．05）。结论无症状老年男性外周血慢性非特异性炎症因子的表达增高与5年全因死亡率相关。     

金色链霉菌培养条件优化研究

金色链霉菌摇瓶培养适宜的接种量为3．2％、接种时间为25h、温度在28℃左右。4g／L的硫酸铵和0．043g／L无机磷有利于产物金霉素(CTC)合成。酵母膏的加入对CTC的合成有一定促进作用，以3g／L的效果较好。在50L发酵罐中，较低浓度的无机磷对CTC发酵有利；酵母膏的加入量以4．2g／L最佳，产物效价比酵母膏加入量为2．8g／L和5．6g／L时高3．1％和9．79／5，优化发酵过程的CTC产率提高了18％。     

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.