内毒素对肝硬化患者可溶性CD14的影响

目的　研究肝硬化时外周血单个核细胞 (PBMC)在内毒素刺激后可溶性CD14 (sCD14 )的变化。方法　选择肝炎后肝硬化患者 5 9例 ,分为伴有内毒素血症 (IETM ,A组 ) 2 9例和不伴有IETM (B组 ) 30例 ,19名健康人作为对照组。采用梯度离心法得到PBMC ,按每 2× 10 6个细胞给予内毒素 1ng的比例刺激 ,于 0、3、6h抽取培养液 ,分别检测sCD14和肿瘤坏死因子 (TNF) α。结果　肝功能分级 :Child PughC级者血浆sCD14水平为 (4 .79± 1.91) μg/ml,明显高于Child pughA级者的 (2 .91± 0 .14 ) μg/ml和Child PughB级者的 (3.6 8± 0 .91) μg/ml。A组血浆sCD14水平为 (4 .85± 1.11) μg/ml,其PBMC在内毒素刺激 6h后所释放的sCD14及TNF α的浓度分别为 (10 1.5 4± 7.6 3)和 (4 33.2 5± 12 3.4 5 )ng/ml;而B组分别为 (3.6 8± 0 .91)、(73.84± 6 .94 )和 (2 10 .18± 81.0 1)ng/ml;对照组分别为 (2 .31± 0 .2 1)、(70 .82± 5 .16 )和 (12 2 .2 1± 0 .34)ng/ml。在培养后第3、6小时 ,A组sCD14、TNF α水平与对照组相比 ,差异有显著性 (P <0 .0 5 )。结论　肝硬化伴IETM的PBMC对内毒素的敏感性增加 ,提示PBMC处于预致敏状态     

sCD14与TNF-α在胃肠道创伤感染中的表达

目的:探讨sCD14与TNF-α在胃肠道创伤感染中的表达。方法:采用ELISA(酶联免疫吸附法)于不同时相测定37例胃肠道创伤合并感染患者血清中sCD14(可溶性CD14)、TNF-α(肿瘤坏死因子α)血清浓度变化情况。结果:sCD14与TNF-α在术后感染加重组中其血清水平分别于第1d出现病理性增高(1.61±0.47μg/ml)与(28.63±8.29pg/ml);在感染缓解组中其血清水平分别于术后第1d开始增高分别为1.52±0.38μg/ml与26.70±7.41pg/ml;至第14d降至对照组分别为sCD14为0.94±0.25μg/ml、TNF-α为17.02±9.27 pg/ml水平。结论:sCD14、TNF-α血清浓度的变化在反映感染发生发展及严重程度方面具有一定的价值。sCD14与TNF-α分别是患者感染发生、加重或缓解的预测和预后指标之一。     

慢性乙型肝炎患者血清sCD14的水平与肠源性内毒素血症？…

目的 探讨慢性乙型肝炎（慢乙肝）患者血清中ｓＣＤ１４的水平与继发肠源性内毒素血症的关系．以ＥＬＩＳ法检测６０例慢乙肝患者血清ｓＣＤ１４和ＴＮＦ－α水平,同时,应用基质显色法定量检测了患者血浆内毒素水平并将三者与对照组进行比较。结果 轻度慢乙肝（Ａ组）患者血清ｓＣＤ１４水平与对照组无显著差异（Ｐ〉０．０５）,中度慢乙肝（Ｂ组）和重度慢乙肝（Ｃ组）ｓＣＤ１４水平均显著高于对照组（Ｐ〈０．０１）;慢乙肝     

sCD14在内毒素诱导巨噬细胞活化中的调节机制

目的 观察不同浓度的sCD14和脂多糖（LPS）经过孵育和不孵育同时刺激佛波醇酯（PMA）诱导分化的THP-1细胞分泌肿瘤坏死因子-α（TNF-α）,以研究sCD14在LPS转运和活化过程中的重要调节作用.方法 通过细胞培养,实验细胞为PMA诱导分化的THP-1细胞;同时将实验分为sCD14组（终浓度分别为1、0.5、0.1、0.01μg/ml）、sCD14～LPS混合物预孵育组（LPS终浓度分别为10、1ng/ml;sCD14终浓度为分别1、0.5、0.1、0.01μg/m1）、sCD14-LPS不孵育组（LPS终浓度分别为10、1ng/ml;sCD14终浓度为1、0.5、0.1、0.01μg/ml）,并分别培养4h后,吸出上清液至1.5ml的离心管中,于-70℃内保存并采用化学发光法检测TNF-α.结果 sCD14本身不能刺激单核细胞分泌TNF-α;LPS浓度为1ng/ml、sCD14浓度为0.01μg/ml和0.1μg/ml时,与LPS单独刺激TNF-α分泌量的差异均无统计学意义（均P＞0.05）;sCD14浓度为0.5μg/ml和1μg/ml时,TNF-α分泌量的差异均有统计学意义（P＜0.05或0.01）.在LPS浓度为10ng/ml、sCD14浓度为0.5μg/ml和1μg/ml时,与LPS单独作用TNF-α分泌量均有显著性差异（均P＜0.01）.sCD14/LPS混合物预孵育组曲线低平,无明显分泌高峰.结论 适当浓度的sCD14可明显增强LPS对单核巨噬细胞的活化作用,且在LPS高浓度时尤为明显,而将sCD14和LPS混合孵育可使上述效应减少甚至消失.     

理气化痰祛瘀方对高脂血症金黄地鼠炎症的干预作用及机制研究

目的 观察理气化痰祛瘀方对高脂血症金黄地鼠炎症的表达水平,初步研究TLR4/ TRAF-6信号通路在其中所起的作用。方法 采用高脂饲料喂养诱导高脂血症金黄地鼠模型,按数字表随机分配法将48只7周龄雄性LVG叙利亚金黄地鼠随机分为正常对照组（等量0.9%生理盐水）,理气化痰祛瘀方低、中、高剂量组（剂量依次为6.3,12.6,25.2 g·kg-1·d-1）和非诺贝特组（150mg·kg-1·d-1）进行治疗,给药后6周（饲喂第8周）测定血生化指标。采用酶联免疫吸附（ELISA）法分别检测血清白细胞介素-6（IL-6）、肿瘤坏死因子α（TNF-α）含量、肝脏组织胆固醇7α羟化酶（CYP7A1）含量。 Western Blot检测给药处理后金黄地鼠肝脏组织Toll样受体4（TLR4）和肿瘤坏死因子受体相关蛋白6（TRAF-6）水平表达情况, qRT-PCR检测金黄地鼠肝脏组织中TLR4、TRAF-6 mRNA水平表达情况。 结果 理气化痰祛瘀方能显著降低金黄地鼠血清TC、TG、LDL-c水平,与模型组比较,对照组中理气化痰祛瘀方中、高剂量组金黄地鼠血清IL-6显著下调[（128.65±16.73）pg/mL比（145.96±11.62）pg/mL;（124.48±20.48）pg/mL比（145.96±11.62)pg/mL P均<0.05];理气化痰祛瘀方中、高剂量组金黄地鼠血清TNF-α含量显著下调[（447.73±65.28）ng/L比（508.92±20.13）ng/L;（442.01±53.19）ng/L比（508.92±20.13)ng/L ,P均<0.05];理气化痰祛瘀方中、高剂量组肝脏 CYP7A1含量则显著上升[（32.43±6.08）ng/mL比（25.85±2.49）ng/mL,P<0.01;（33.70±5.74）ng/mL比（25.85±2.49)ng/mL, P<0.05];与模型组比较,理气化痰祛瘀方低、中、高剂量组金黄地鼠肝脏组织TLR4蛋白表达水平[（1.651±0.188）比（2.158±0.124）,P<0.05;（1.411±0.134）比（2.158±0.124),P<0.01;（1.346±0.188）比（2.158±0.124),P<0.01]和TRAF-6蛋白表达水平[（1.785±0.048）比（2.283±0.216）,P<0.05;（1.605±0.138）比（2.283±0.216),P<0.01; （1.442±0.209）比（2.283±0.216),P<0.01]均显著下调,且呈现剂量依赖性;与模型组比较,理气化痰祛瘀方低、中、高剂量组金黄地鼠肝脏中TLR4 mRNA水平[（56.32±15.56）g/kg比（122.90±27.94）g/kg,P<0.05;（20.83±4.34）g/kg比（122.90±27.94）g/kg,P<0.01;（9.88±2.50）g/kg比（122.90±27.94）g/kg ,P<0.01]均显著下调,TRAF-6 mRNA水平[（23.62±3.85）g/kg比（55.79±4.56）g/kg;（11.23±2.46）g/kg比（55.79±4.56）g/kg;（6.29±2.15）g/kg比（55.79±4.56）g/kg ,P均<0.01]均显著下调,且呈现剂量依赖性。结论 理气化痰祛瘀方参与高脂饲料诱导的金黄地鼠高脂血症中炎症的发生,显著抑制IL-6、 TNF-α、 CYP7A1在高脂血症金黄地鼠血清及肝脏中的表达,其机制可能与TLR4/ TRAF-6 信号通路传导途径相关。     

瘦素与肿瘤坏死因子在妊娠高血压综合征发病中的关系

目的探讨瘦素和肿瘤坏死因子(TNF-α)在妊娠高血压综合征(妊高征)发病中相互关系。方法采用放射免疫法测定34例妊高征患者(妊高征组)的外周血清瘦素及TNF-α水平,并以20例正常晚期妊娠妇女(正常妊娠组)为对照。将血清瘦素水平与TNF-α、肌酐、尿酸水平进行相关分析。结果(1)妊高征组血清瘦素水平为32.85±11.46ng/ml,明显高于正常妊娠组(18.92±3.03ng/ml,P<0.05);轻度妊高征组血清瘦素水平为21.98±4.83ng/ml,与正常妊娠组比较,差异无显著性(P>0.05);中、重度妊高征患者血清瘦素水平分别31.13±5.18ng/ml,41.84±10.90ng/ml,与轻度妊高征及妊娠正常组比较,差异显著(P均<0.05);轻、中、重度妊高征患者之间血清瘦素水平差异明显(P均<0.05)。妊高征患者的血清瘦素水平与肌酐、尿酸正相关(r分别为0.46、0.59,P均<0.01)。(2)妊高征组血清TNF-α水平为22.65±11.48fmol/ml,明显高于正常妊娠组(9.21±2.14fmol/ml,P<0.05);轻度妊高征患者血清TNF-α水平为11.51±4.12fmol/ml,与正常妊娠组比较,差异无显著性(P>0.05);中、重度妊高征患者血清TNF-α水平分别为19.46±7.41fmol/ml和32.89±8.31fmol/ml,与轻度妊高征及正常妊娠组比较,差异均有显著性(P均<0.05);轻、中、重度妊高征患者之间血清TNF-α水平差异明显(P均<0.05)。(3)妊高征组血清瘦素水平与TNF-α水平呈正相关(r=0.56,P<0.01)。结论妊高征患者血清TNF-α水平增高可能是导致血清瘦素水平升高的原因之一。     

HER2在乙肝肝硬化患者血清中的表达及临床意义

目的：检测乙肝后肝硬化患者血清人类表皮生长因子受体2（HER2）浓度,并探讨其临床意义。方法：采集江阴市人民医院60例慢性乙肝、149例乙肝后肝硬化患者及60例健康体检人群血清标本,采用时间分辨荧光免疫分析法检测血清HER2水平,比较不同组间、不同肝硬化严重程度患者间血清HER2水平,分析乙肝肝硬化患者血清HER2水平与临床参数及终末期肝病模型（MELD）评分的相关性。结果：血清HER2浓度在健康对照组、慢性乙肝组、乙肝后肝硬化组分别为9.21±2.59 ng/mL、11.59±4.43 ng/mL和17.60±6.03 ng/mL,与健康对照组相比,慢性乙肝、乙肝后肝硬化患者血清HER2水平均显著升高（P<0.01）,乙肝肝硬化组表达水平显著高于慢性乙型肝炎组（P<0.001）,差异均有统计学意义。肝硬化Child C级患者血清HER2（16.57±4.67 ng/mL）高于Child A级（12.11±3.65 ng/mL,P=0.000）及B级（14.48±4.53 ng/mL,P=0.02）患者,差异均有统计学意义。失代偿期肝硬化患者HER2水平与BIL、AST、ALT、PT呈正相关（P均<0.05）,与Alb水平呈负相关（P<0.05）,但与MELD评分无相关性。结论：乙肝肝硬化患者血清HER2水平高表达,且与其严重程度呈正相关,提示HER2可能参与乙肝后肝硬化的进程。     

梗阻性黄疸患者血清sCD40L水平的变化及其临床意义

目的 观察梗阻性黄疸(OJ)患者血清可溶性CD40配体(sCD40L)水平的变化,并探讨其临床意义.方法 选择2015年4~12月在我院消化二科住院治疗的OJ患者35例作为观察组,另选同期在我院进行健康检查的志愿者35例作为对照组,检测对照组在入院时及观察组治疗前、治疗后3 d的血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、结合胆红素(DBIL)、血清sCD40L、肿瘤坏死因子-α(TNF-α)和白细胞介素-8(IL-8)的水平,分析OJ患者的sCD40L与其他指标的相关性.结果 观察组患者治疗前的血清ALT、AST、TBIL、DBIL、sCD40L、TNF-α和IL-8水平分别为(55.34±10.35)IU/L、(62.19±11.25)IU/L、(35.43±5.22)μmol/L、(8.94±2.58)μmol/L、(3.25±0.27)μg/L、(58.24±10.38)ng/L、(60.23±10.37)ng/L,均高于对照组的(32.17±5.32)IU/L、(36.27±6.78)IU/L、(10.19±4.58)μmol/L、(4.39±1.37)μmol/L、(2.84±0.32)μg/L、(34.52±9.26)ng/L、(43.69±11.26)ng/L,差异均有统计学意义(P<0.05),且观察组治疗后上述指标分别为(43.27±9.89)IU/L、(47.25±10.14)IU/L、(13.32±4.19)μmol/L、(6.18±2.97)μmol/L、(2.92±0.25)μg/L、(42.37±8.79)ng/L、(50.14±11.32)ng/L,均明显低于治疗前,差异均有统计学意义(P<0.05).OJ患者的血清sCD40L与血清TNF-α、IL-8、ALT、AST、TBIL及DBIL之间均呈正相关(均P<0.05).结论 OJ患者血清sCD40L水平明显上升,且其与炎症反应及肝功能指标联系紧密,临床可通过监测血清sCD40L变化了解患者病情,评估预后.     

自身免疫性疾病患者血清可溶性CD4、CD8的测定及临床意义

目的 探讨血清可溶性CD4、CD8抗原 (sCD4、sCD8)在自身免疫性疾病中测定的临床意义。 方法采用ELISA法测定78例Graves病 (GD)、系统性红斑狼疮 (SLE)和类风湿关节炎(RA)患者和38名健康者 (对照组 )的血清sCD4、sCD8水平 ,并对28例GD患者血清sCD4、sCD8水平作治疗前后的动态观察。 结果 3组患者治疗前血清sCD4、sCD8水平均高于对照组[sCD4对照组 (4.16±2.7)u/ml,GD和SLE患者为 (8.05±4.19)u/ml和(7.93±4.12)u/ml,与对照组比P<0.01 ,RA患者 (6.27±3.24)u/ml ,与对照组比P<0.05 ;sCD8对照组 (4.27±2.17)u/ml,GD、SLE、RA患者分别为 (11.37±4.34)u/ml、(15.38±5.65)u/ml、(12.25±4.48)u/ml,与对照组比均P<0.01)。经丙基硫氧嘧啶治疗后 ,GD患者sCD8下降。血清sCD4、sCD8与TT3、TT4、TSH、ANA、C3、ESR、RF无相关性。 结论 GD、SLE、RA患者的血清sCD4、sCD8水平升高 ,可能是独立的免疫学监测指标。     

乙肝肝硬化合并自发性细菌性腹膜炎患者血清和腹水中糖链抗原125及降钙素原的变化情况

目的 探讨乙肝肝硬化合并自发性细菌性腹膜炎患者血清和腹水中糖链抗原125(sugar chain antigen 125,CA125)及降钙素原(procalcitonin,PCT)的变化情况。 方法 选择2013年1月—2016年6月杭州市西溪医院乙肝肝硬化腹水合并自发性细菌性腹膜炎患者60例作为观察组、乙肝肝硬化腹水未合并自发性细菌性腹膜炎患者60例作为对照组。测定2组患者血清和腹水中CA125、PCT水平。 结果 观察组血清CA125和PCT水平[(425.76±157.43) U/L、(1.326±0.434) ng/ml]均高于对照组[(314.27±132.95) U/L、(0.587±0.276) ng/ml],P<0.05。观察组腹水CA125和PCT水平[(567.34±213.75) U/L、(0.983±0.316) ng/ml]均高于对照组[(378.52±167.53) U/L、(0.214±0.105) ng/ml],P<0.05。抗生素治疗有效患者47例中,治疗后血清和腹水CA125、PCT水平[(411.53±152.13) U/L、(1.279±0.424) ng/ml;(558.76±202.14) U/L、(0.946±0.307) ng/ml)]均低于治疗前[(331.86±143.25) U/L、(0.635±0.265) ng/ml;(385.42±197.47) U/L、(0.546±0.324) ng/ml],P<0.05。血清CA125和腹水CA125呈正相关(r=0.882,P<0.001),血清PCT和腹水PCT呈正相关(r=0.856,P<0.001)。血清CA125水平和血清PCT水平无显著相关性(P>0.05)。 结论 乙肝肝硬化合并自发性细菌性腹膜炎患者血清和腹水中CA125、PCT水平升高,经抗生素治疗有效患者血清和腹水中CA125、PCT水平下降。      

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.