DTI成像参数与脑微出血者认知功能障碍的关系

目的 探究脑微出血（CMBs）患者弥散张量成像（DTI）检测参数与认知功能障碍间的相关性。方法 收集笔者医院神经内科98例脑微出血患者作为观察组,另选择在笔者医院检测未发现脑部微出血80例作为对照组,采用日常生活能力评定表（ADL）对日常生活进行评定,蒙特利尔认知评分表（MoCA）对受试者认知功能进行评估,所有受试者均能进行DTI成像检测,观察CMBs病灶数目以及分布情况,对比两组MoCA、ADL评分,DTI参数FA、MD值与MoCA评分进行Pearson相关性分析。结果 共检测出325例CMBs病灶,基底核区占44.31%,大脑皮质以及皮质占26.46%,丘脑占8.31%、脑白质占8.00%、小脑占6.77%、脑干占6.15%。观察组脑白质、丘脑、小脑FA值低于对照组,MD值高于对照组,差异有统计学意义（P<0.05）。观察组空间执行能力、命名能力、记忆力、注意力、抽象能力、语言、定向能力、总分均低于对照组,差异有统计学意义（P<0.05）。观察组ADL步行、转移、上下楼梯等各项评分以及总分均低于对照组,差异有统计学意义（P<0.05）。Pearson相关性分析显示,MoCA评分中空间执行能力、命名能力、记忆力、注意力、抽象能力、语言、定向能力、总分与基底核、脑皮质、脑白质、丘脑、小脑、脑干FA值呈正相关,与MD值呈负相关。结论 DTI检测FA值、MD值与CMBs患者MoCA评分存在一定的相关性,对患者认知功能障碍恢复具有一定的指导作用。     

基于体素分析的磁共振弥散张量成像在多系统萎缩的应用研究

目的 利用磁共振弥散张量成像（diffusion tensor imaging,DTI）技术,联合基于体素分析方法（voxel-based analysis,VBA）,探讨多系统萎缩（multiple system atrophy,MSA）患者白质的改变。方法 选取15例小脑型多系统萎缩（MSA-C）患者（病例组）及11例志愿者（对照组）,分别行全脑常规MRI及DTI扫描,采用SPM8（http：//www.fil.ion.ucl.ac.uk/spm/software/spm8/）生成部分各向异性（fractional anisotropy,FA）图和平均弥散率（mean diffusivity,MD）图。结果 与对照组比较,病例组FA减少累及双侧脑干、脑桥、小脑（小脑后叶、山坡）、额叶（额上回）、扣带回、边缘叶及白质,差异有统计学意义（P=0.000）,MD升高累及双侧小脑（小脑后叶、小脑蚓）、额叶（额上、中回、中央前回）、颞叶（颞上、中回、颞横回）、岛叶、顶叶（缘上回、角回）,差异有统计学意义（P=0.000）。结论 基于体素分析的磁共振弥散张量成像可以用于显示全脑微结构改变,对MSA有一定诊断意义。     

肿瘤并发病原菌感染患者NLR的临床意义

目的 探讨肿瘤患者外周血象中性粒细胞与淋巴细胞数比值（NLR）对肿瘤并发病原菌感染的诊断价值。方法 回顾分析中科院合肥物质研究院肿瘤医院2014年4月至2016年1月收治的43例伴病原菌感染肿瘤患者（感染组）和43例无病原菌感染患者（非感染组）资料,统计学分析两组与健康对照组患者白细胞数（WBC）、中性粒细胞数（NEUT）、淋巴细胞数（LYMPH）、NLR、血红蛋白（Hb）及血清白蛋白（ALB）指标差异及其相关性;采用logistic二分类回归分析肿瘤并发病原菌感染危险因素;ROC曲线分析NLR对肿瘤并发病原菌感染诊断价值。结果 感染组患者的NLR高于非感染组及对照组且非感染组高于对照组,差异均有统计学意义（P=0.000）;感染组WBC及NEUT数均高于非感染组及对照组（P=0.000、P=0.001）但非感染组与对照组比较,差异无统计学意义（P=0.240、P=0.666）;感染组LYMPH、ALB及Hb均低于非感染组及对照组（P=0.000、P=0.000、P=0.003）且非感染组低于对照组（P=0.000、P=0.000、P=0.000）;肿瘤组NLR与其ALB、Hb、淋巴细胞呈负相关（r=-0.530、r=-0.216、r=-0.740,P=0.000、P=0.046、P=0.000）,与中性粒细胞正相关（r=0.604,P=0.000）;logistic回归显示,NLR升高及ALB降低是肿瘤患者合并病原菌感染独立危险因素（P=0.001、P=0.023）。ROC曲线显示,NLR的曲线下面积（AUC）为0.864（P=0.000）,当NLR取值为4.19、4.62时,NLR诊断感染敏感性为88.39%,83.7%,特异性为69.77%、74.4%,诊断价值最大;NEUT的AUC为0.647（P=0.018）;WBC对感染无诊断价值（P=0.237）。结论 NLR对肿瘤患者发生病原菌感染具有较好诊断效能;NLR与ALB、Hb有相关性。     

急性阑尾炎病理分型与血小板参数的相关性

目的 探讨血小板参数PLT、PDW、MPV与急性阑尾炎（AA）病情进展程度的相关性。方法 选取2017年1月至2019年7月在蚌埠市第三人民医院接受阑尾切除术的116例AA患者作为研究对象,所有患者术前均行PLT、PDW、MPV检查,术后均将切除的标本送病理检查。根据病理检查结果,将患者分为单纯性阑尾炎组（41例）与复杂性阑尾炎组（75例）,评估PLT、PDW、MPV与AA病情进展的相关性。结果 单纯性阑尾炎组患者PDW为（13.37±3.00）%、MPV为（11.42±1.27）fL、PLT为（220.96±58.79）×10⁹/L,与复杂性阑尾炎组相比,差异均有统计学意义（P<0.05）。PLT和MPV、PDW均呈负相关（r=-0.499,P=0.000;r=-0.464,P=0.000）,MPV和PDW则呈正相关（r=0.933,P=0.000）。结论 PLT、PDW、MPV与AA病理类型及病情严重程度有一定关联,可作为AA临床诊断参考。     

多烯磷脂酰胆碱联合还原型谷胱甘肽治疗非酒精性脂肪性肝炎疗效和安全性的Meta分析

目的 系统评价多烯磷脂酰胆碱联合还原型谷胱甘肽治疗非酒精性脂肪性肝炎（NASH）的治疗效果及安全性。方法 计算机检索PubMed、EMbase、Cochrane Library、中国知网、万方、维普及中国生物医学文献数据库（CBM）从建库到2017年10月前发表的有关多烯磷脂酰胆碱联合还原型谷胱甘肽治疗非酒精性脂肪性肝炎的随机对照试验。两名研究者独立,严格按照纳入和排除标准进行文献筛选。评价纳入文献的方法学质量,提取符合纳入标准的数据,采用RevMan 5.1软件进行Meta分析。结果 共有7项试验纳入研究,共计649例NASH患者。Meta分析结果显示：与单用多烯磷脂酰胆碱或还原型谷胱甘肽相比,多烯磷脂酰胆碱联合还原型谷胱甘肽可明显改善肝功能指标：AST（MD=-17.04, 95% CI：-26.24~-7.83, P=0.000）、ALT（MD=-15.47, 95% CI：-23.34~-7.59, P=0.000）、TG（MD=-0.76, 95% CI：-1.03~-0.49, P=0.000）、TC（MD=-0.68, 95% CI：-1.04~-0.33, P=0.000）、TBiL（MD=-6.58, 95% CI：-12.95~-0.21, P=0.040）;降低患者BMI（MD=-1.67, 95% CI：-2.40~-0.95, P=0.000）和肝脏B超评分（MD=-0.35, 95% CI：-0.47~-0.23, P=0.000）;提高临床总有效率（RR=1.27, 95% CI：1.17~1.37, P=0.000）,但并不能降低LDL水平（MD=-0.06, 95% CI：-0.32~0.19, P=0.620）,且不良反应少,安全性好。结论 多烯磷脂酰胆碱联合还原型谷胱甘肽能够明显改善NASH患者的肝脏生化指标,如AST、ALT、TG、TC、TBiL以及降低BMI和肝脏B超评分,提高临床总有效率。个别报道存在不良反应,但发生率相对较低。故多烯磷脂酰胆碱联合还原型谷胱甘肽治疗NASH疗效好,安全性高。     

ACLF相关AKI患者的血清persepsin水平及其诊断价值研究

目的 探讨并发急性肾损伤（acute kidney injury,AKI）的慢加急性肝衰竭（acute-on-chronic liver failure,ACLF）患者血清可溶性CD14亚型（persepsin）蛋白水平改变及其用于AKI诊断的价值。方法 纳入2011年2月~2015年6月在笔者医院治疗的HBV相关ACLF患者300例,根据是否并发AKI分为AKI组（n=141）及无AKI（non-AKI）组（n=159）。患者住院时记录一般及实验室指标,检测血清persepsin及胱抑素C（cystatin C,Cys-C）水平。分析persepsin与各项指标的相关性,ROC曲线分析persepsin诊断ACLF患者AKI的效能。结果 AKI组persepsin水平（670.74±459.41pg/ml）显著高于non-AKI组（238.42±191.70pg/ml）,差异有统计学意义（P=0.000）。不同AKI分期persepsin由高至低依次为：AKI-3期 >AKI-2期 >AKI-1期。AKI组患者血清persepsin与eGFR（r=-0.621,P=0.000）呈显著负相关,与TBIL（r=0.192,P=0.022）、WBC（r=0.260,P=0.002）、sCr（r=0.568,P=0.000）、Cys-C（r=0.575,P=0.000）及MELD评分（r=0.272,P=0.000）呈正相关。persepsin用于诊断ACLF并发AKI的AUC为0.836（95%CI：0.787~0.885）,persepsin联合Cys-C的AUC为0.858（95%CI：0.813~0.903）。结论 persepsin水平可反映ACLF患者并发AKI时的肾功能损害严重程度,与Cys-C联合时具有良好的AKI诊断效能。     

常规弥散加权成像和弥散张量成像在肝纤维化和炎症中的诊断效能

目的 探讨MR传统弥散加权成像（DWI）与弥散张量成像（DTI）对慢性病毒性肝炎患者的肝纤维化程度和炎症程度定量分析的能力,评估DWI与DTI在诊断肝纤维化和炎症中的诊断效能。方法 选取笔者医院收治的58例经病理组织学诊断为慢性病毒性肝炎的患者和8例健康志愿者作为研究对象。所有研究对象都进行DWI和DTI检查,采用弥散敏感度（b值）为0、800s/mm²的单次激发快速自旋回波进行DWI和DTI检查。计算表观弥散系数（ADC）及平均弥散率（MD）,分析两种方法定量肝纤维化分期的能力。对慢性肝炎患者肝穿刺病理组织检查,按照肝活检评分系统Metavir评分表对肝实质纤维化和肝炎症程度进行分级。运用Spearman相关分析探讨ADC值MD值变化和纤维化分期、炎症分级之间的相关性。结果 ADC与纤维化分期呈显著负相关（r分别为-0.939、-0.682,P<0.01）;ADC、MD值与炎症分级之间有负相关性（r分别为-0.721、-0.486,P<0.01）。结论 DWI在肝纤维化分期和肝炎炎症分级方面的诊断效能均优于DTI,ADC值可定量评价肝纤维化的分期及肝炎活动的分级。     

复方阿胶浆防治癌症化疗后骨髓抑制疗效和安全性的系统评价

[目的]系统评价复方阿胶浆联合化疗防治癌症化疗后骨髓抑制的有效性和安全性。[方法]计算机检索CNKI、WanFang、SinoMed、PubMed、EMbase、The Cochrane Library,搜集关于复方阿胶浆联合常规化疗治疗癌症/肿瘤患者的随机对照试验,检索时限从建库至2017年3月。由2位作者独立筛选文献、提取资料,采用RevMan 5.3软件进行Meta分析。[结果]共纳入17个RCT,包含7个结局指标,1 139例患者。Meta分析结果显示,与单纯化疗组相比,联用复方阿胶浆组在改善外周血象白细胞[MD=-0.71,95% CI（-1.14,-0.28）,P=0.001;OR=0.24,95% CI（0.13,0.48）,P<0.0001]、血红蛋白[MD=-10.34,95% CI（-15.10,-5.58）,P<0.001;OR=0.28,95% CI（0.14,0.54）,P=0.000 2]、血小板[MD=-20.94,95% CI（-35.63,-6.25）,P=0.005]、红细胞[MD=-0.46,95% CI（-0.69,-0.23）,P<0.000 1]及生活质量[OR=3.84,95% CI（2.07,7.11）,P<0.000 1]方面差异有统计学意义;对降低血小板所致骨髓毒性[OR=0.58,95% CI（0.27,1.21）,P=0.15]、保护中性粒细胞[MD=-0.10,95% CI（-0.66,0.47）,P=0.73]及不良反应等方面差异均无统计学意义。[结论]当前证据提示复方阿胶浆联合化疗能够改善癌症化疗后外周血象和生活质量,且安全性较好。但由于纳入文献质量不高,尚需严格设计的高质量临床研究进一步验证。     

磁共振弥散张量成像在早产和足月脑性瘫痪患儿中的应用价值

目的 探讨磁共振弥散张量成像（DTI）在早产脑瘫和足月脑瘫患儿中的应用价值。方法 选取2013年9月至2016年12月安徽省儿童医院确诊的64例脑瘫患儿,依据孕周大小分为早产组32例与足月组32例,运用粗大运动功能量表88项（GMFM-88）评价患儿的运动障碍程度;选取内囊前肢（ICAL）、内囊膝部（ICGL）、内囊后肢（ICPL）、胼胝体膝部（GCC）、胼胝体体部（BCC）、胼胝体压部（SCC）和大脑脚部位作为感兴趣区（ROI）,测量弥散各向异性（FA）,比较两组不同ROI的FA值;运用Pearson相关分析分析两组各ROI的FA值与GMFM-88分值的相关性。结果 早产组的FA值在各部位均小于足月组,右侧ICPL、SCC和双侧大脑脚部位两组差异有统计学意义（P<0.05）;早产组DTI内囊前肢、膝部和后肢的FA值和GMFM-88分值之间呈现正相关（P<0.05）,其中内囊后肢的相关系数最高（r=0.572,P=0.001）;足月组各部位FA值和GMFM-88分值均无显著相关性（P>0.05）。结论 早产脑瘫的整体白质发育较足月脑瘫明显延迟;在评价运动功能方面DTI在早产脑瘫中的应用价值高于足月脑瘫患儿。     

急性脑梗死患者外周血平均血小板体积与颈动脉粥样硬化的相关性研究

目的 探讨急性脑梗死患者外周血平均血小板体积（mean platelet volume,MPV）水平与颈动脉粥样硬化的相关性。方法 纳入99例发病1周内的急性脑梗死患者为观察组,30例同期无心脑血管疾病,并经多普勒彩色超声检查无颈动脉内膜增厚的健康体检者为对照组。检测所有纳入者的外周血MPV水平,采用多普勒彩色超声检查颈动脉内膜中层厚度（intima media thickness,IMT）,按病变程度将观察组分为IMT正常组、IMT轻度狭窄组、IMT中重度狭窄组;根据头颅CT或MRI提示的梗死面积大小将观察组分为小面积、中等面积、大面积脑梗死组。分析比较观察组与对照组以及观察组各亚组间MPV水平的差异,并分析MPV与IMT及梗死面积的相关性。结果 脑梗死组外周血MPV水平较对照组升高,差异有统计学意义（P<0.05）;观察组不同颈动脉狭窄程度组外周血MPV比较差异有统计学意义（P=0.000）;Pearson相关性分析表明,MPV与IMT值呈正相关（r=0.331,P=0.000）,MPV与脑梗死面积呈正相关（r=0.386,P=0.000）;ROC曲线显示MPV对急性脑梗死的预测曲线下面积为0.682,最佳界值是11.45,敏感度为41.4%,特异性为86.7%。结论 急性脑梗死患者外周血MPV水平与颈动脉粥样硬化狭窄程度密切相关,且对急性脑梗死有一定的预测价值。     

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.