类风湿关节炎患者外周血滤泡辅助性T淋巴细胞百分率的变化及意义

目的 探讨滤泡辅助性T淋巴细胞(Tfh)百分率在类风湿关节炎(RA)患者外周血中的变化及意义.方法 选取该院2016年9-11月收治的RA患者,分为RA活动组与RA稳定组,各35例.另选取同期行健康体检者35例作为健康对照组.用流式细胞术检测受试者外周血CD4+ CXCR5+ ICOS+ Tfh细胞的百分率,分析RA患者外周血Tfh细胞百分率与28个关节疾病活动度评分(DAS28)、抗环瓜氨酸肽(CCP)抗体及类风湿因子(RF)水平的相关性.结果 RA活动组外周血Tfh细胞百分率[(0.84±0.16)％]明显高于RA稳定组[(0.64±0.15)％]及健康对照组[(0.56±0.14)％],差异均有统计学意义(P＜0.01);且RA稳定组亦高于健康对照组(P＜0.05).RA患者外周血Tfh细胞百分率与DAS28及抗CCP抗体水平均呈明显正相关(r=0.355、0.324,P＜0.01),与RF水平无明显相关性(r=0.205,P＞0.05).结论 外周血中Tfh细胞百分率的增加可能与RA的发生、发展有关.     

γ干扰素诱导蛋白30基因在系统性红斑狼疮CD4+T细胞中的表达分析

目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)患者CD4 T细胞mRNA中干扰素诱导蛋白30基因(IP-30)的表达水平与SLE疾病活动度的相关性.方法收集23例SLE患者和10例正常对照人群的临床资料.取外周血用免疫磁珠法分离出CD4 T细胞,抽提RNA并逆转录合成cDNA,运用GLGI方法从LongSAGE标签库中筛选出IP-30,比较该基因在系统性红斑狼疮疾病活动指数(SLEDAI)不同的SLE患者中表达的差异.结果①SLE患者组IP-30的表达量显著高于正常对照(P=0.01,P＜0.05).SLEDAI≥10组和SLEDAI＜10组其IP-30的表达量显著高于正常对照(P分别为0.01和0.047),但两组间比较无显著差别(P=0.149).②SLE有狼疮肾炎组和SLE无狼疮肾炎组相比IP-30表达量有差异(P＜0.05).③IP-30的表达量随SLE的活动水平升高而明显增加,与SLEDAI具有显著的正相关(r=0.830,P＜0.01),与补体C3和外周血白细胞数成负相关(r=-0.517,r=-0.424,P＜0.05).结论CD4 T细胞IP-30水平表达升高提示IP-30可能参与SLE的发病,并对SLE活动度的判断和狼疮肾炎的诊断有一定的意义.     

Th17/Treg在系统性红斑狼疮患者中的探讨

目的 探讨系统性红斑狼疮(SLE)患者外周血辅助性T细胞17(Th17)与调节性T细胞(Treg)及血浆中相关细胞因子白细胞介素(IL)-17、IL-6、IL-23的变化.方法 收集SLE患者70例和健康对照组30例,采用SLE疾病活动指数(SLEDAI)评分方法将SLE患者分为活动组(≥5分,38例)和稳定组(0～4分,32例).采用流式细胞术(FCM)检测外周血Th17、Treg百分数,用酶联免疫吸附测定法(ELISA)检测血浆中IL-17、IL-6、IL-23水平.结果 SLE患者外周血Th17占CD4+T细胞比例高于对照组(P＜0.05),SLE活动组Th17占CD4+T细胞比例较SLE稳定组及对照组高(均P＜0.05);SLE患者外周血Treg占CD4+T细胞比例低于对照组(P＜0.05),SLE活动组Treg占CD4+T细胞比例较SLE稳定组及对照组低(均P＜0.05);SLE患者外周血Th 17/Treg高于对照组(P＜0.05),SLE活动组Th 17/Treg高于SLE稳定组及对照组(均P＜0.05).Th17、Th 17/Treg、IL-6与SLEDAI评分均呈正相关(r=0.923、0.567、0.397,均P＜0.05),Treg与SLEDAI评分均呈负相关(r=-0.458,均P＜0.05).结论 SLE患者中Th17细胞、调节性T细胞百分数存在异常,且与疾病活动性密切相,提示两种共同变化或失衡可能在SLE的发生、发展过程中起重要作用.     

ZBTB20在SLE患者外周血B细胞中的表达和临床意义

目的 研究锌指和BTB结构域蛋白20 (ZBTB20)在系统性红斑狼疮(SLE)患者外周血B细胞中的表达,并探讨ZBTB20在SLE中的临床意义.方法 采用RT-PCR技术检测36例SLE患者(SLE组)和30例健康对照者(对照组)外周血CD19+B细胞中ZBTB20 mRNA的表达水平;Western blot检测分析外周血ZBTB20蛋白水平;流式细胞术检测B细胞亚群所占比例.分析SLE患者B细胞中ZBTB20 mRNA的表达与B细胞亚群比例变化的关系及与临床指标(抗ds-DNA抗体、抗核抗体、免疫球蛋白IgG、抗ENA抗体)的相关性.结果 SLE组外周血CD19+B细胞中ZBTB20 mRNA的表达明显高于对照组(P＜0.05);SLE组患者外周血ZBTB20蛋白水平高于对照组(P＜0.05).与对照组相比,SLE患者外周血B细胞亚群,CD19+B细胞比例降低(P＜0.05),CD19-CD138+浆细胞/CD19+B细胞之间的比值及CD19-CD138+浆细胞比例明显增高(P＜0.05);SLE患者B细胞中ZBTB20 mRNA的表达水平与CD19-CD138+浆细胞/CD19+B细胞的比值呈正相关(P＜0.05);ZBTB20 mRNA与抗ds-DNA抗体、免疫球蛋白IgG、抗核抗体、抗ENA抗体均呈正相关(P＜0.05).结论 ZBTB20可能通过促进B细胞分化从而参与SLE发病.     

MPO-ANCA相关性血管炎患者中性粒细胞外捕网与滤泡辅助T细胞间关系的探讨

目的 探讨抗中性粒细胞胞质髓过氧化物酶抗体相关性血管炎(MPO-AAV)患者中性粒细胞外捕网(NET)与滤泡辅助T细胞(Tfh)间关系及意义.方法 选择初诊未治疗的MPO-AAV患者和健康对照者各35例,流式细胞术(FCM)检测所有受试者外周血Tfh占CD4+T细胞分数(Tfh％)、表达 ICOS 的 Tfh 占 CD4+T 细胞分数(ICOS+Tfh％)及Tfh表达ICOS的平均强度(MFI);酶联免疫吸附试验(ELISA)法检测外周血MPO-ANCA、NET及IL-23水平,收集每例受试者的临床资料,评估每例患者病情活动度(BVAS-V3).结果 与健康对照组比较,MPO-AAV组外周血 Tfh％、ICOS+Tfh％、Tfh 的 MFI、NET 及 IL-23水平均高于对照组[分别为(25.7±3.9)％vs(20.7±5.3)％,P＜0.001;(1.9±1.0)％vs(0.8±0.4)％,P＜0.001;(59.5±10.3)vs(48.7±6.4)(MFI),P＜0.001;(0.6±0.2)vs(0.2±0.1)(吸光度),P＜0.001;(0.753 5±0.201 9)vs(0.237 5±0.087 0)(pg/L),P＜0.001].双变量相关性分析提示MPO-ANCA水平分别与Tfh％及Tfh的MFI呈正相关(分别为r= 0.737,P＜0.001;r = 0.628,P＜0.001),但在多变量线性回归分析显示MPO-ANCA仅与Tfh％相关(P＜0.001).IL-23分别与Tfh％、Tfh的MFI及NET水平呈正相关(分别为:r = 0.475,P = 0.004;r=0.359,P = 0.034;r =0.806,P＜0.001).虽然双变量相关性分析提示Tfh％分别与外周血中NET及IL-23水平呈正相关(分别为:r= 0.714,P＜0.001;r=0.480,P =0.004),但多变量线性回归分析显示Tfh％仅与NET水平呈正相关(P＜0.001),即NET是影响Tfh％的独立因素.同时,结果显示NET与肾损害间存在相关性(r = 0.390,P= 0.021).结论 NET可能通过激活髓样树突状细胞提升Tfh％,以辅助B细胞产生特异性自身抗体 MPO-ANCA 参与 MPO-AAV 发病.     

CD4+ CD25+ CD127low/-T细胞在系统性红斑狼疮活动期患者中的表达

目的 检测调节性T细胞(Treg)的新旧标志,进一步探讨Treg细胞在系统性红斑狼疮(SLE)发病中的作用.方法 采用三色直接荧光素标记法和多参数流式细胞术检测29例SLE患者及24例正常对照组外周血CD4+ CD25+ CD127low/-T细胞、CD4+ CD25highT细胞及CD4+ CD25+FOXP3+T细胞的比例,同时检测外周血抗dsDNA等抗体及免疫球蛋白、补体等水平并进行相关分析.结果 SLE患者外周血CD4+ CD25+ CD127low/-T细胞与正常对照组差异无统计学意义(P＞0.05),CD4+ CD25+ FOXP3+T细胞[(2.1±1.2)%]及CD4+ CD25highT细胞[(0.8 ±0.4)%]与正常对照组[(1.8±0.8)%及(4.0±1.4)%]比较差异有统计学意义(P＜0.01);SLE组3种细胞占CD4+ CD25+T细胞的比例均明显低于正常对照组(均P＜0.01),CD4+ CD25+ CD127low/-T细胞、CD4+CD25+ FOXP3+T细胞及CD4+ CD25highT细胞分别占CD4+ CD25+T细胞的比例及与年龄、性别和病程,IgG、IgA、IgM、尿蛋白,24 h蛋白尿,抗dsDNA、抗Clq、抗核小体抗体水平均无相关性(均P＞0.05);但其与SLEDAI评分均存在负相关(P＜0.05).仅CD+ CD25+ GD127low/-T细胞/CD+ CD25+T细胞与补体C4存在明显的负相关(P＜0.01).结论 Treg细胞与活化的CD4+T细胞的相对比例可能在SLE的发病中起到重要作用.     

单核细胞趋化蛋白-1表达与狼疮肾炎

目的探讨单核细胞趋化蛋白-1(MCP-1)在狼疮肾损伤中的作用.方法应用ELISA方法测定112例系统性红斑狼疮(SLE)患者、30例类风湿性关节炎患者、11例非SLE肾损伤患者及40例正常健康者血清MCP-1水平;应用RT-PCR方法,测定以上各组外周血单个核细胞(PBMCs)MCP-1 mRNA表达.结果狼疮处于疾病活动时PBMCs MCP-1 mRNA表达上调,尤其是狼疮肾炎活动组患者PBMCs MCP-1 mRNA表达增加最为显著(P＜0.001),PBMCs MCP-1 mRNA表达不仅与总狼疮疾病活动指数评分呈正相关(r=0.6245,P＜0.001),而且与狼疮疾病活动指数肾评分呈正相关(r=0.6808,P＜0.001),而在类风湿性关节炎组和非狼疮肾脏疾病组仅低水平表达,与正常对照组水平相近似(P＞0.05).狼疮活动组血清MCP-1水平较非活动组及正常对照组均明显升高(P＜0.001),但活动性狼疮肾炎组与无肾损伤组之间血清MCP-1水平的差异无显著性(P＞0.05).结论狼疮处于疾病活动时PBMCs MCP-1 mRNA表达上调,并与狼疮肾炎的疾病活动情况密切相关.     

滤泡辅助性T细胞在免疫性血小板减少症发病机制中的作用

目的 探讨免疫性血小板减少症(immune thrombocytopenia,ITP)患者外周血B细胞、成熟B细胞、滤泡辅助性T细胞及树突状细胞亚群的变化,及其相互关系及Tfh细胞在ITP发病中的作用.方法 采用流式细胞术检测35例初治ITP患者及30例正常人外周血B细胞及成熟B细胞比例、Tfh细胞数量及树突细胞亚群.结果 ITP患者外周血CD19+B细胞及成熟B细胞比例分别为(13.49±9.05)％和(81.96±11.99)％,均高于对照组[(9.12±4.60)％和(75.42±12.86)％,P＜0.05].ITP患者Tfh细胞(CD4+CXCR5+ICOS+PD-1+)比例为(4.27±3.88)％,明显高于对照组(1.02±0.54)％,差异有统计学意义(P＜0.01).ITP患者浆细胞树突细胞比例为(2.06±1.65)％,明显低于对照组(5.07±3.48)％,差异有统计学意义(P＜0.01).结论 ITP患者存在Tfh细胞数量异常,可能导致B细胞比例升高,在ITP的发病机制中起重要作用.     

Th17及相关细胞因子在系统性红斑狼疮中的变化

目的 研究系统性红斑狼疮(SLE)患者外周血辅助性T细胞17 (Th17)及血浆中相关细胞因子白细胞介素(IL)-17、IL-6、IL-23的变化.方法 收集SLE患者62例和健康对照组30例,采用SLE疾病活动指数(SLEDAI)评分方法将SLE患者分为活动组(≥5分,34例)和稳定组(0～4分,28例).采用流式细胞术(FCM)检测外周血Th17细胞百分数,用酶联免疫吸附测定法(ELISA)检测血浆中IL-17、IL-6、IL-23水平.结果 SLE患者外周血Th17占CD4+T细胞比例高于健康对照组(P＜0.05),SLE活动组Th17占CD4+T细胞比例较SLE稳定组高(P＜0.05).SLE患者组血浆中IL-6、IL-17、IL-23均较健康对照组高(P＜0.05).Th17、IL-6、IL-17、IL-23与SLEDAI评分均呈正相关(r=0.923、0.393、0.689、0.501,均P＜0.05).结论 Th17细胞在SLE的发病及发展过程中起重要作用.     

系统性红斑狼疮患者妊娠期外周血中滤泡辅助性T淋巴细胞的变化及其意义

目的 探讨系统性红斑狼疮（SLE）患者妊娠期外周血中滤泡辅助性T淋巴细胞（Tfh）的变化,并阐明Tfh细胞在妊娠期SLE患者中的免疫作用。 方法 选取来自山东省青岛市市立医院和青岛市妇女儿童医院就诊的SLE患者,分为SLE妊娠组32例和SLE未妊娠组30例,以健康妊娠组（健康妊娠妇女）30例和健康未妊娠组（健康未妊娠妇女）25例为对照,SLE妊娠组32例患者（随访丢失2例）根据妊娠期间和终止妊娠后3个月内病情变化分为SLE妊娠预后不良组（8例）和SLE妊娠临床稳定组（22例）,收集各组受试者临床资料和实验室检查指标。采用流式细胞术检测各组受试者外周血中CD4+诱导性T细胞共刺激因子（ICOS）+趋化因子C-X-C-基元受体5（CXCR5）+Tfh细胞占CD4+T淋巴细胞百分率（Tfh细胞百分率）,采用Spearman相关分析检验SLE妊娠组患者外周血中Tfh细胞百分率与患者实验室检查指标的相关性,采用酶联免疫吸附试验（ELISA）法检测各组受试者外周血中白细胞介素6（IL-6）、白细胞介素21（IL-21）和干扰素γ（IFN-γ）水平。 结果 与健康妊娠组比较,SLE妊娠组患者外周血中Tfh细胞百分率明显升高（P<0.01）,健康未妊娠组受试者外周血中Tfh细胞百分率明显降低（P<0.05）;与SLE未妊娠组比较,SLE妊娠组患者外周血中Tfh细胞百分率明显升高（P<0.05）。随访中,与SLE妊娠临床稳定组比较,SLE妊娠预后不良组患者外周血中Tfh细胞百分率明显升高（P<0.05）。SLE妊娠组患者外周血中Tfh细胞百分率与抗心磷脂抗体（ACA）-IgG和抗β2糖蛋白Ⅰ（β2GPⅠ）抗体滴度均呈正相关关系（r=0.743 1,P<0.05;r=0.830 7,P<0.01）。与健康妊娠组比较,SLE妊娠组患者外周血中IL-6和IL-21水平明显升高（P<0.05）;与SLE未妊娠组比较,SLE妊娠组患者外周血中IL-21水平明显升高（P<0.05）。 结论 SLE患者妊娠早期外周血中Tfh细胞百分率升高可能与SLE患者妊娠预后不良有关。     

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.