广州市134例新型冠状病毒肺炎确诊患者出院1年随访研究

目的 收集广州市134例新型冠状病毒肺炎（COVID-19）确诊患者出院1年随访资料,并分析总结其特点,为进一步评价COVID-19患者的远期疗效提供依据。方法 收集在广州医科大学附属市八医院治愈出院1年并在该院康复门诊随访的134例COVID-19确诊患者为研究对象,按COVID-19患者住院时确定的轻型、普通型、重型为分组,分别进行新型冠状病毒抗体、T淋巴细胞亚群、肺功能、胸部CT等结果进行分析。结果 134例随访患者新型冠状病毒IgG阳性105例（占78.4%）;CD4⁺及CD8⁺T淋巴细胞绝对值下降分别有34例（占25.4%）及20例（占14.9%）;肺通气功能障碍者34例（25.4%）,弥散功能障碍37例（27.6%）。三组患者对比,抗体IgG阳性比例、CD4⁺及CD8⁺淋巴细胞下降比例、肺功能异常比例等差异均无统计学意义。胸部CT基本正常89例（占66.4%）,以慢性炎症为主10例（占7.5%）,以纤维病灶为主31例（占23.1%）,出现间质性改变4例（3.0%）;相较而言,重型组患者更容易出现慢性炎症及间质性改变。结论 对出院随访满1年的COVID-19康复期患者,大部分IgG抗体呈阳性,绝大多数患者T淋巴细胞亚群、肺功能及胸部CT均可恢复正常,但有部分患者存在T淋巴细胞亚群异常、肺通气功能受损和弥散功能障碍,胸部CT可见慢性炎症、纤维病灶及间质性改变等。     

化学发光免疫分析技术在新型冠状病毒肺炎辅助诊断中的应用价值

目的评估化学发光免疫分析技术（CLIA）检测新型冠状病毒（SARS-CoV-2）的IgM和IgG抗体在新型冠状病毒肺炎（COVID-19）辅助诊断中的应用价值。方法选取2020年1月31日至3月16日温州市中心医院收治的COVID-19住院患者66例（阳性组）,均根据临床诊断和SARS-CoV-2核酸检测结果阳性确诊为COVID-19。选取同期根据临床诊断和SARS-CoV-2核酸检测排除COVID-19的发热患者50例（对照组）。采用CLIA对116例研究对象的229份血清进行SARS-CoV-2IgM和IgG抗体检测。结果CLIA检测SARS-CoV-2IgM抗体的灵敏度、特异度、阳性预测值、阴性预测值分别为57.54%（103/179）、92.00%（46/50）、92.26%（103/107）、37.70%（46/122）;检测IgG抗体的灵敏度、特异度、阳性预测值、阴性预测值分别为88.27%（158/179）、96.00%（48/50）、98.75%（158/160）、69.57%（48/69）;联合检测IgM和IgG抗体的灵敏度、特异度、阳性预测值、阴性预测值分别为88.83%（159/179）、88.00%（44/50）、96.36%（159/165）、68.75%（44/64）。IgM抗体与IgG抗体可在0～7d检出,随着病程进展阳性率逐步升高,在22～28d阳性率均到达顶峰,此后IgM抗体阳性率逐渐降低,而IgG抗体阳性率依旧维持较高水平。结论CLIA检测SARS-CoV-2抗体具有良好的灵敏度和特异度,在病程的22～28d检测阳性率最高,该方法简便、快捷,在COVID-19的辅助诊断中有重要的应用价值。     

2019冠状病毒病康复者特异性IgG 抗体效价的影响因素及变化趋势

目的： 探讨2019 冠状病毒病(coronavirus disease 2019,COVID-19)康复者严重急性呼吸综合征冠状病毒 2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)特异性IgG 抗体的影响因素及效价变化趋势,为康复 者恢复期血浆临床治疗的可行性提供理论依据。方法： 采用胶体金免疫层析法检测2020 年2 月19 日至4 月6 日期间 随诊的113 例COVID-19 康复者SARS-CoV-2 特异性IgG 抗体及其效价,分析高效价组(抗体效价≥1?160)与低效价组 (抗体效价<1?160)病例的基本特征及治疗因素差异;连续监测高效价组特异性IgG 抗体效价,分析效价变化趋势。 结果： 高效价组与低效价组患者年龄、ABO血型分布、COVID-19 临床分型、发病时间、入院后首次C-反应蛋白、 淋巴细胞绝对值、CD19+CD3-淋巴细胞绝对值及病程中是否接受糖皮质激素治疗差异均无统计学意义(均P>0.05),高 效价组男性占比高于低效价组(P<0.05);高效价组SARS-CoV-2 特异性IgG 抗体效价在患者出院28 d 后全部下降至1? 160 以下。结论： 男性COVID-19 患者较女性患者可能更容易产生高效价SARS-CoV-2 特异性IgG 抗体。康复者 SARS-CoV-2特异性IgG抗体效价峰值维持时间较短,用于临床治疗的康复者血浆应在患者康复出院后28 d内采集。     

新型冠状病毒肺炎康复患者与疫苗接种者抗体水平研究

目的分析新型冠状病毒肺炎(COVID-19)康复患者与健康人群新型冠状病毒疫苗接种者血清抗体水平差异。方法收集2020年1月—2020年10月四川省治愈出院并于四川省人民医院随访的COVID-19康复者12例作为康复组,43例接种2剂新冠疫苗满6个月的健康人群作为免疫组,51例接种新冠疫苗加强针(第三针)28~35 d的健康人群作为加强组,3组人群定量检测免疫指标、SARS-CoV-2特异性IgG抗体和中和抗体。结果康复组与免疫组特异性IgG抗体阳性率均为100%,康复者特异性IgG抗体均值为43.44 AU/mL,明显高于免疫组特异性IgG抗体均值25.02 AU/mL(t=-3.077,P<0.05);康复组、免疫组、加强组中和抗体阳性率分别为83.33%、32.56%、100.00%,中和抗体均值分别为29.03、4.63、32.03 AU/mL,康复组出院8~14个月后体内平均中和抗体水平是免疫组的6.3倍,加强组平均中和抗体水平是免疫组6.9倍。加强组中男性中和抗体均值为61.68 AU/mL,明显高于女性中和抗体均值26.13 AU/mL(P<0.05),而BMI分组、年龄分组在各组内比较差异无统计学意义(P>0.05)。在免疫功能方面,康复组中CD4+T淋巴细胞计数均值为415.00 cells/μL,明显低于免疫组CD4+T淋巴细胞计数均值590.00 cells/μL(P<0.05),而免疫球蛋白A、G、M及补体3、补体4在康复组及免疫组中比较差异无统计学意义(P>0.05)。结论COVID-19患者在疾病发展过程中可产生IgG抗体和中和抗体,且高于接种2剂新冠疫苗者;新冠疫苗加强针能诱发更高的抗体水平,且男性中和抗体水平高于女性。     

接种新型冠状病毒灭活疫苗（Vero细胞）后感染COVID-19病例的临床特征及抗体情况

目的 通过分析22例接种新型冠状病毒灭活疫苗（Vero细胞）后感染新型冠状病毒肺炎（COVID-19）患者的临床特征及抗体情况,方便临床预判和治疗。方法 选取2020年12月—2021年3月在我院收治的22例接种灭活疫苗后的COVID-19患者为研究对象,通过分析其人口学特征、临床症状、血检结果、核酸及抗体、胸部影像学及治疗方法等,以了解接种灭活疫苗后COVID-19患者的临床特征及抗体变化情况。结果 22例COVID-19患者中位年龄34.5岁,临床症状主要有咳嗽（8例）、咳痰（3例）、纳差（3例）、发热（1例）、胸闷（1例）、咽喉不适（1例）、鼻塞流涕（1例）等;胸部影像学有单侧肺炎（2例）及双侧肺炎（7例）,表现为磨玻璃影（5例）或磨玻璃合并斑片影（4例）。入院时1例患者查新冠病毒抗体IgM（+）IgG（-）,3例IgM（-）IgG（-）,4例IgM（-）IgG（+）,14例IgM（+）IgG（+）。结论 本次我院诊治的接种灭活新冠疫苗（Vero细胞）后COVID-19患者,以青中年男性居多,临床分型以普通型患者为主,临床症状主要有咳嗽、咳痰、发热、咽喉不适等,胸部影像学可出现单侧或双侧磨玻璃影或斑片影渗出病灶,经氧疗、中药等常规治疗后所有患者均预后良好。接种灭活新冠疫苗（Vero细胞）后再感染新冠病毒患者,可在短期内迅速产生大量IgG抗体。     

ELISA和金标法在新型冠状病毒肺炎诊断中的临床价值

目的：探讨酶联免疫吸附试验（ELISA）和金标法检测新型冠状病毒抗体的临床应用价值。方法：新型冠状病毒肺炎确诊患者17例在入院时分别采用ELISA和金标法检测新型冠状病毒IgG抗体和IgM抗体,同时选取30例健康体检者作为正常对照组。结果：ELISA法检测COVID-19患者单独IgG抗体阳性3例,单独IgM抗体阳性3例,二者同时阳性8例,同时阴性3例,健康对照组IgG和IgM抗体均有１例阳性,IgG抗体灵敏度和特异度分别为64.7%和90.2%;IgM抗体灵敏度和特异度分别为64.7%和96.7%。金标法检测IgG和IgM抗体同时阳性10例,同时阴性7例,其灵敏度、特异度分别为58.8%和100%,健康对照组均为阴性。两种方法检测IgG抗体的符合率为82.3%,Kappa系数为0.627,检测IgM抗体的符合率为58.8%,Kappa系数为0.131。结论：ELISA和金标法检测新型冠状病毒IgG抗体和IgM抗体的特异度高,可用于疑似人群快速筛查,但二者符合率一般,建议联合检测     

广州市47例新型冠状病毒肺炎恢复期患者肺功能研究

目的 了解47例新型冠状病毒肺炎(COVID-19)患者恢复期肺功能状况,分析新型冠状病毒对肺的损伤程度,为COVID-19致肺损伤恢复提供实验依据。方法 选取2020年1月—2月在广州市第八人民医院治愈出院,隔离14 d后的47例COVID-19恢复期患者为研究对象,对检测肺功能、胸部CT、新型冠状病毒抗体结果进行回顾性分析。结果 47例恢复期COVID-19患者新型冠状病毒IgM阴性40例(占85.1%),IgG阳性44例(占93.6%),其中IgM、IgG均阳性7例,IgM、IgG均阴性3例。肺功能损障碍29例(占61.7%),其中轻度、中度障碍分别19例、10例。限制性通气功能障碍3例,阻塞性通气功能障碍1例,通气功能障碍2例,混合通气功能障碍1例,弥散功能障碍26例,弥散并限制性通气功能障碍2例,弥散并阻塞性通气功能障碍1例,弥散并通气功能障碍2例,小气道功能障碍共5例。11例重型COVID-19患者肺功能障碍10例(占90.9%),其中轻度4例,中度6例,36例普通型患者肺功能障碍19例(占52.8%),其中轻度15例,中度4例,两组对比重型COVID-19患者中度肺功能障碍较普通型多。恢复期患者胸部CT异常35例,多表现为弥漫大片状磨玻璃样影、散在斑片影、纤维条索影;其中表现为弥漫大片磨玻璃影和纤维条索影者共8例,中度肺功能障碍患者(7例)较轻度肺功能障碍患者多(1例),重型患者(6例)较普通型患者(2例)多。结论 COVID-19患者恢复期绝大部分患者有肺功能障碍,多表现为弥散功能障碍,对指导康复治疗有一定临床意义。     

3例新型冠状病毒肺炎患者不同标本检测分析

目的 分析新型冠状病毒肺炎（COVID-19）患者临床表现及治疗后咽拭子、粪便、尿液的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）核酸检测阴转情况,探讨新型冠状病毒肺炎（COVID-19）病人的出院标准。方法 回顾性分析3例海南省人民医院收治的COVID-19病例,对其临床表现及治疗后咽拭子、粪便、尿液的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）核酸检测结果进行描述。结果 3例COVID-19病例治疗后咽拭子核酸转阴性,粪便核酸检测仍呈阳性,合并尿液核酸阳性1例,1例患者病程3周后出现SARS-CoV-2抗体lgM、lgG均阳性(滴度分别为4.416和18.485)。结论 建议严格把握出院标准,推荐增加粪便、尿液核酸检测,出院后仍需集中医学观察14 d以最大限度降低消化道传播风险的可能。     

新型冠状病毒疫苗接种对维持性血液透析合并COVID-19患者的价值

目的 探讨接种新型冠状病毒疫苗（新冠疫苗）对维持性血液透析（MHD）患者新型冠状病毒感染（COVID-19）严重程度的影响。方法 回顾性分析2022年12月至2023年1月安徽医科大学附属阜阳人民医院肾内科收治的166例终末期肾脏病行MHD合并COVID-19患者的临床资料。依据疫苗接种情况分为未接种组（接种0针）及接种组（接种≥2针）。比较两组患者临床特征及短期预后，并应用logistic回归模型分析患者住院及重症风险增加的独立危险因素。结果 166例MHD合并COVID-19患者中，未接种组91例（54.8%），接种组75例（45.2%）。未接种组年龄与吸烟比例高于接种组（P<0.05）。感染新型冠状病毒肺炎后，患者临床表现多样，发热（73.1%）、乏力（65.6%）、食欲减退（57.5%）最常见。接种组使用激素、中心吸氧、住院、重症比例明显减少，治愈患者比例显著增加（P<0.05）。接种新冠疫苗可减少MHD患者住院（OR=0.364，95% CI：0.147~0.901）及重症（OR=0.182，95% CI：0.037~0.901）发生风险。合并糖尿病、冠状动脉粥样硬化性心脏病（冠心病）是MHD合并COVID-19患者住院及重症风险增加的独立危险因素，年龄是其重症风险增加的独立危险因素。结论 终末期肾脏病接受MHD合并COVID-19患者临床表现多样，合并糖尿病、冠心病患者住院及重症风险均增加，年龄增加患者重症风险增加，接种新冠疫苗可减少住院及重症风险。     

真实世界中新型冠状病毒抗体检测结果的探究

背景　新型冠状病毒肺炎（COVID-19）疫情早期,胶体金法检测新型冠状病毒（SARS-CoV-2）抗体首先获国家药品监督管理局批准用于临床,但SARS-CoV-2抗体检测结果假阳性的干扰因素尚不明确。目的　探讨临床如何分析解读SARS-CoV-2抗体检测阳性结果。方法　收集2020年3-6月北京大学国际医院同时送检SARS-CoV-2 IgM/IgG抗体和核酸的8 678例受检者的临床资料进行回顾性分析,收集受检者流行病学史、临床表现及实验室指标（包括SARS-CoV-2抗体和核酸检测结果、类风湿因子、补体、免疫球蛋白）。采用胶体金法检测SARS-CoV-2 IgM/IgG抗体,抗体阳性复核采用磁微粒化学发光法。SARS-CoV-2核酸检测采用RT-PCR方法。使用嗜异性抗体阻断试管（HBT）处理胶体金法检测阳性的标本,然后再次进行检测。结果　（1）8 678例受检者标本中,8 677例SARS-CoV-2核酸检测阴性,胶体金法检测SARS-CoV-2 IgM抗体阳性者25例（0.288%）,SARS-CoV-2 IgG抗体阳性者5例（0.058%）,SARS-CoV-2 IgM和SARS-CoV-2 IgG抗体同时阳性者0例。使用化学发光法复核后,仅3例受检者SARS-CoV-2抗体阳性,27例抗体均为阴性。1例受检者SARS-CoV-2核酸检测阳性,同时抗体IgM和IgG均为阴性。（2）30例胶体金法检测SARS-CoV-2抗体阳性者均无流行病学史,且同时SARS-CoV-2核酸检测结果均为阴性,排除感染SARS-CoV-2或既往感染SARS-CoV-2的可能,其中有10例SARS-CoV-2 IgM抗体阳性者进行2次以上动态监测结果仍为阳性,其余20例受检者未进行动态监测。（3）胶体金法检测SARS-CoV-2 IgM抗体假阳性率为0.288%,SARS-CoV-2 IgG抗体假阳性率为0.058%。采用HBT对胶体金法检测SARS-CoV-2抗体阳性的标本进行处理后,25例SARS-CoV-2 IgM抗体阳性的标本中,除1例结果仍为阳性外,其余结果均转为阴性;而5例SARS-CoV-2 IgG抗体阳性的标本结果依然为阳性。（4）30例SARS-CoV-2抗体阳性者的类风湿因子、补体、免疫球蛋白水平均在参考范围内。结论　SARS-CoV-2抗体检测结果可出现假阳性,SARS-CoV-2 IgM抗体阳性绝大多数是嗜异性抗体干扰所致,SARS-CoV-2 IgG抗体阳性者可能还存在其他潜在未知的干扰因素。嗜异性抗体对胶体金法的干扰大于化学发光法。因此,非疑似COVID-19患者或确诊COVID-19患者不宜进行SARS-CoV-2抗体检测指导临床,一定要考虑实验的干扰因素。     

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.