颅内深部中线及中线旁病变的X－刀分次治疗的临床研究

采用Ｘ－刀分次治疗方法治疗颅内深部中线及中线旁病变４３例。经治疗后４～１２月随访，疗效令人满意，病变缩小率３９％；症状改善率７２．１％；病变控制率（不再增大）４４．２％。无１例患者出现与本治疗有关的并发症。     

颅内深部中线及中线旁病变的X－刀分次治疗的临床研究

颅内深部中线及中线旁病变的Ｘ－刀分次治疗的临床研究首都医学院附属天坛医院神经外科赵奇煌，陈炳桓，杨炯达阎润民，梁继军，王俊岭，肖泽久，陈亚林，钱渡江，陈滨采用Ｘ－刀分次治疗方法治疗颅内深部中线及中线旁病变４３例。经治疗后４～１２月随访，疗效令人满意，...     

中线恶性淋巴瘤临床病理和免疫组化特征研究

目的：探讨头面中线非何杰金淋巴瘤（中线ＮＨＬ）的临床病理特点及免疫表型。方法：采用免疫组化ＬＳＡＢ法,选用单克隆抗体ＣＫ、ＬＣＡ、ＵＣＨＬ１、Ｌ２６检测２８例中线ＮＨＬ,４例鼻咽癌（ＮＰＣ）和２例坏死性鼻腔炎的组织表型抗原。结果：２８例中线ＮＨＬ中,２７例阳性表达ＬＣＡ（白细胞共同抗原）;２０例（７１．４％）ＵＣＨＬ１阳性,为Ｔ细胞淋巴列（２８．６％）Ｌ２６阳性,为Ｂ细胞淋巴瘤。无１例表达ＣＫ（Ｃ     

中线T细胞淋巴瘤的TCR—γ基因重排研究

目的 对中线Ｔ细胞淋巴瘤的克隆性进行研究。方法：用一组针对Ｔ细胞受体γ链基因Ｖ区片段的家族特异性引物和ＰＣＲ方法，对１１例（２２个标本）中线Ｔ细胞淋巴瘤病例进行了Ｔ细胞受体γ基因重排的检测，结果：２２个标本中的２１个有Ｔ细胞受体γ链基因的克隆性重排（９４．４５％），在９例原发灶的连续活检和１例原发灶及其转移灶的标本中未发现曾生的克隆家族的改变。结论：中线Ｔ细胞淋巴瘤的病变组织中存在Ｔ细胞的单克隆性     

糖化血红蛋白和糖尿病视网膜病变关系的研究

为了控制糖尿病视网膜病变的发生和发展，探讨糖化血红蛋白（ＨｂＡ１Ｃ）与糖尿病视网膜病变的关系，对２１６例糖尿病患者进行了８年跟踪观察，将２１６例糖尿病患者ＨｂＡ１Ｃ８年间平均值进行统计学处理，以分析ＨｂＡ１Ｃ与视网膜病变发生、发展的关系。结果：８年间糖化血红蛋白平均值在６．０％以下者，视网膜病变进展率为０％；ＨｂＡ１Ｃ平均值在６．０％～６．９％之间者，视网膜病变进展率为１３．３％；ＨｂＡ１Ｃ平均值在７．０％～７．９％之间者，视网膜病变进展率为１３．５％；ＨｂＡ１Ｃ平均值在８．０％～８．９％之间者，视网膜病变进展率为４３．４％；ＨｂＡ１Ｃ平均值在９．０％以上者，视网膜病变进展率为４２．０％。因此将糖化血红蛋白控制在６．０％以下，对预防糖尿病视网膜病变的发生、发展极为重要。     

尖锐湿疣与女阴假性湿疣的临床病理分析

本文对３３９例尖锐湿疣及３０７例假性湿疣的活检资料进行了统计分析．尖锐湿疣有２１％的病变累及两个或两个以上部位；夫妻（性侣）同患者占１．２％，伴轻度非典型增生的３．５％；９１．６％的表皮层内见挖空细胞．假性湿疣病变以双侧小阴唇内侧多见；不伴非典型增生；上皮浅层细胞水肿空泡化似蓝球网状结构占３０．１％；细胞核呈退行性固缩占２６．９％．文章对两者的病因、临床病理及诊断治疗进行了初步探讨．     

先天性鼻背中线瘘管5例临床分析

目的：探讨先天性鼻背中线瘘管的临床特点及治疗原则。方法：总结5例先天性鼻背中线瘘管患者的临床资料。5例患者均于全麻或局麻下行瘘管切除术，4例完整切除瘘管组织，1例因瘘管穿过鼻骨至鼻中隔上方，盲端扩大形成囊肿，为完整切除病变组织，凿除部分鼻骨，取自体髂骨修复。结果：3例愈合良好。1例鼻翼处瘢痕形成致轻微凹陷，1例轻度外鼻畸形，5例患者术后瘘管均无复发。结论：先天性鼻背中线瘘管患者应尽早手术治疗，彻底切除是避免复发的关键。     

中线外周T细胞淋巴瘤32例临床病理分析

探讨中线外周Ｔ细胞淋巴瘤的临床病理特征。方法对１９８０年以来诊治的坏死性肉芽肿和线恶性网状细胞增生症２６例进行免疫组化标记，并和已行免疫标确诊为中线性外周Ｔ细胞淋巴瘤的６例进行回顾性分批结果３２例均表现为中线部位的进行性坏死，溃汤，免疫组化标记显示ＵＣＨＵ１阳性占９３．７５％。结论及多部位深外活检及免疫组化标记和电镜检查可明显提高该病早期准确的诊断率。     

纤维喉镜下电离子手术治疗声带良性病变53例

总结分析在纤维喉镜引导下应用电离子治疗仪＾「１」手术治疗喉部良性病变５３例，结果治愈４５例（８４．９％），有效５２例（９８．１％），无效１例（１．９％）。该治疗方法具有痛苦小，安全可靠，操作简便，无出血等优点，为耳鼻喉科医师治疗喉部良性病变提供了一种新的有效方法。     

眼底荧光血管造影检查在眼科疾病诊断中的应用 (附987例临床分析)

目的：通过运用眼底荧光血管造影技术对临床不同年龄和不同眼科疾病诊断的应用，了解该检查技术对临床诊断和指导治疗的作用，以及应用注意点．方法：９８７例门诊和住院病人临床资料回顾性总结．具体方法如下：９８７只眼，按≤２０岁，２１岁～４０岁，４１岁～６０岁，６１～８０岁，＞８０岁五个年龄组进行分析．病种按黄斑病变，视网膜血管病变，视神经乳头病变，色素上皮病变，脉络膜病变，外伤６组病变分析．结果：９８７例中男性眼４５４例，如性眼５３３例，男女之比女性稍多，其中年龄最小４岁最大８６岁，平均５７．６岁·不同年龄疾病诊断阳性率：≤２０岁为１００％，２１～岁～４０岁为８７．２％，４１岁～６０岁为８５．９％，６１岁～８０岁为８６％，＞８０岁为９０％．不同疾病检出率：视网膜血管病变为６２．３％，黄斑病变为２３．８％，色素上皮病变为８．５％，视神经乳头病变为３．４％，脉络膜病变为 １．８％，外伤为０．２％．６类中恶心感３１例，占 ３．１％，呕吐 ６例．占 ０．６％，皮疹 ２例，占 ０．２％；晕厥 １例；占 ０．１４％．无喉水肿，气管痉挛，心血管反应及死亡等重症反应．结论：眼底荧光血管造影技术在不同年龄和不同眼科疾病诊断中不失为一种安全有效     

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.