倍他乐克对原发性高血压左室肥厚的逆转作用

观察２３例原发性高血压左室肥厚患者，应用倍他乐克治疗１０￣１２周后，血压、心率明显下降（Ｐ〈０．０１及０．０５），舒张期室间隔厚度（ＩＶＳＴ）、左室重量指数（ＬＶＭＩ）明显下降（Ｐ〈０．０５），Ｅ／Ａ比值明显升高（Ｐ〈０．０１）。提示倍他乐克既可降压又可使高血压性左室肥厚逆转，左室舒张功能明显改善。     

羟乙基淀粉及动脉灌注法结合持续低流量灌注对兔心肺联合保存的作用

目的研究胶体物质羟乙基淀粉（ＨＥＳ）及低流量灌注技术（ＬＦＰ）对兔心肺联合保存的作用。方法选用健康家兔５０只，２只用于正常心肺组织的超微结构观察，４８只随机均分为晶体液（ＣＳ）组、ＨＥＳ组及ＬＦＰ组，每组８对供、受体。用Ｓｔ．Ｔｈｏｍａｓ液及改良Ｅｕｒｏ－Ｃｏｌｌｉｎｓ液灌注ＣＳ组心、肺，含５％ＨＥＳ的Ｓｔ．Ｔｈｏｍａｓ液及改良Ｅｕｒｏ－Ｃｏｌｌｉｎｓ液灌注ＨＥＳ组及ＬＦＰ组心、肺，取心与左肺整体４℃保存７ｈ，保存期间ＬＦＰ组经主、肺动脉持续低流量（０．２５ｍｌ／ｇ心肺重量／ｈ）灌注４℃相应保存液。移植后每３０ｍｉｎ测定供体心左室收缩压（ＬＶｓｐ）、左室舒张末压（ＬＶｅｄｐ）、右房压（ＲＡＰ）及供体肺气道峰压（Ｐａｗ），取动脉血测氧分压（ＰａＯ２），实验结束时记录异丙肾上腺素用量，计算心肺重量增值，测定心肺组织丙二醛（ＭＤＡ）含量，取心肺组织观察超微结构。结果ＣＳ组心肺重量增值高于ＨＥＳ组（Ｐ＜０．０１），ＨＥＳ组与ＬＦＰ组无明显差异。ＣＳ组ＬＶｓｐ均低于ＨＥＳ组（Ｐ＜０．０５或＜０．０１），３０，６０ｍｉｎ时ＬＦＰ组高于ＨＥＳ组（Ｐ＜０．０５）。ＣＳ组ＬＶｅｄｐ均高于ＨＥＳ组（Ｐ＜０．０５或Ｐ＜０．０１）     

鹿角方对充血性心力衰竭大鼠血浆心钠素的影响

目的：为了观察鹿角方对充血性心力衰竭（ＣＨＦ）大鼠血浆心钠素（ＡＮＦ）的影响。方法：采用实验性腹主动脉银夹狭窄大鼠模型,观察左室重量指数（ＬＶＭＩ）,放免测定血浆ＡＮＦ。结果：模型组血浆ＡＮＦ水平较假手术组明显升高（Ｐ＜０．０１）,鹿角方大剂量组和鹿角方小剂量组血浆ＡＮＦ水平较模型组显著下降（Ｐ＜０．０１,Ｐ＜０．０５）;模型组ＬＶＭＩ较假手术组显著升高（Ｐ＜０．０１）,鹿角方大剂量组和鹿角方小剂量组ＬＶＭＩ较模型组明显下降（Ｐ＜０．０１,Ｐ＜０．０５）。结论：鹿角方具有逆转ＣＨＦ大鼠左室肥厚及降低血浆ＡＮＦ水平的作用     

高血压病患者左室肥厚与QT离散度的关系

目的：探讨高血压病患者左室肥厚与ＱＴ离散度的关系。方法：７０例高血压病患者,分为左室肥厚组（ｎ＝ ３１）及无左室肥厚组（ｎ＝ ３９）,用超声心动图测量左室重量（ＬＶＭ）及左室重量指数（ＬＶＭＩ）。从１２ 导联心电图同步测量ＱＴ离散度（ＱＴｄ）、ＱＴｃｄ 并分析两者间相互关系。结果：高血压伴左室肥厚者ＱＴｄ 及ＱＴｃｄ 较无左室肥厚者明显增大（Ｐ均＜ ０．０１）;高血压Ⅰ期、Ⅱ期、Ⅲ期之间比较,显示：Ⅱ、Ⅲ期与Ⅰ期相比,Ｐ 均＜ ０．０１;Ⅱ期与Ⅰ期相比,Ｐ＞ ０．０５。左室肥厚伴室性心律失常者ＱＴｄ 及ＱＴｃｄ 与无心律失常者两组相比,Ｐ均＜ ０．０１。结论：高血压病患者伴左室肥厚组ＱＴｄ 及ＱＴｃｄ 比无左室肥厚组明显增大。左室肥厚组伴室性心律失常比无室性心律失常组明显增大。高血压Ⅲ期与Ⅰ、Ⅱ期患者ＱＴｄ 及ＱＴｃｄ 相比,差别有显著性,Ｐ均＜ ０．０１;ＱＴｄ 与ＬＶＭＩ两者呈正相关（ｒ＝ ０．４,Ｐ＜ ０．０５）     

高血压病患者左心房内径、左心室重量指数与心脏功能关系探讨

对１４２例高血压病（ＥＨ）患者按左心房内径（ＬＡＤ）、左心室重量指数（ＬＶＭＩ）分组研究其与心机械图检测排血前时间与左室排血时间的比值（Ｐ／Ｌ）、心导纳向量环心房收缩相与心室射血相比值（Ｖ／Ｔ－Ⅱ）的关系。结果ＬＡＤ≥３５ｍｍ组左室舒张功能明显异常，与ＬＡＤ正常组比较Ｖ／Ｔ－Ⅱ值差异有高度显著性（Ｐ＜０．０１）；ＬＶＭＩ增高组与ＬＶ－ＭＩ正常组比较Ｐ／Ｌ、Ｖ／Ｔ－Ⅱ差异有高度显著性（Ｐ＜０．０１）；ＥＨ＿ＬＡＤ扩大发生率较ＬＶＭＩ增加发生率为高（Ｐ＜０．０１）；ＬＡＤ扩大者增高比ＬＡＤ不大者明显（Ｐ＜０．０１）。提示：应重视ＥＨ的ＬＡＤ扩大，ＬＶＭＩ增高患者，且宜早期改善心脏舒张功能，逆转心脏结构异常。     

卡托普利对高血压性左心室肥厚的影响

采用多普勒超声心动图观察了连续口服１２个月卡托普利（ＣＰ）对４２例高血压病患者左室肥厚的影响，结果ＣＰ在降低血压的同时，使心室舒张期室间隔厚度（ＩＶＳＴ），左室后壁厚度（ＰＷＴ）和左室重量指数（ＬＶＭＩ）显著减少（Ｐ＜０．０５～０．００１），而３１例对照组使用降压灵未发现类似效应。提示ＣＰ具有较好的逆转高血压性左室肥厚（ＨＬＶＨ）的作用。     

比索洛尔对高血压病患者左室肥厚减退作用的观察

２０例经超声心动图证实有左室肥厚的高血压病患者服用比索洛尔３个月后，其收缩压和舒张压均明显下降（Ｐ值均＜０．０１），空间隔、左室后壁厚度、左室重量及左室心肌重量指数均明显减少（Ｐ值均＜０．０１）。提示比索洛尔为一种能够逆转左室肥厚的有效降压药物。     

杞菊地黄口服液合用苯那普利对高血压和左室肥厚的影响

４０例Ⅱ、Ⅲ期高血压患者分别用杞菊地黄口服液合用苯那普利（观察组，２２例）及单用苯那普利（对照组，１８例）治疗，疗程３个月。结果发现：两组患者治疗后血压均明显下降（Ｐ〈０．０１）；两组患者左室肥厚（ＬＶＨ）治疗后均明显消退。观察组ＬＶＨ消退较对照组更为明显。前者左室心肌重量（ＬＶＭＷ）消退率为２５．５％，左室心肌重量指数（ＬＶＭＩ）消退率为２５．３％，后者分别为１９．５、１９．７％。３、加用杞菊地     

高血压病患者心脏结构与功能的超声研究

探讨高血压病患者心脏结构与功能及血流动力学的关系。方法用超声心动图（ＵＣＧ）对１０５例高血压病患者与４５例健康人对比分析。结果高血压病患者舒张末室间隔厚度（ＩＶＳＴ）、舒张末左室后壁厚度（ＬＶＰＷＴ）、左室重量指数（ＬＶＭＩ）均较对照组显著增加（Ｐ＜０．００１），ＬＶＭＩ增加占７４．２％，对称性左室肥厚占６６．６％，非对称性室间肥厚（ＡＳＴ）占７．６％，外周血管阻力（ＰＶＲ），左室作功指数（ＬＶＷＩ）较对照组显著增高（Ｐ＜０．００１），平均动脉压与ＩＶＳＴ、ＬＶＰＷＴ、ＬＶＭ、ＬＶＷＩ呈低度相关，与ＰＶＲ呈高度相关（ｒ＝０．７６５Ｐ＜０．００１）。结论提示高血压病患者心脏结构改变主要表现为ＩＶＳ或／和ＬＶＰＷ肥厚，ＬＶＭ增加，不同的心脏结构改变对心功能及血流动力学变化有着不同的影响。     

美托洛尔对高血压病人左室肥厚和心功能的影响

对３０例原发性高血压病合并左室肥厚患者用美托洛尔降压治疗２月，应用超声心动图观察左心结构和心功能的变化．结果：１）服药２月后血压明显降低（Ｐ＜０００１），显效率８０％，６９％的病人血压完全降至正常；２）服药后ＩＶＳＴ和ＰＷＴ均显著降低，各平均降低１２４％（Ｐ＜０００１）和４１％（Ｐ＜００５）．ＬＶＭＩ降低１０６％（Ｐ＜０００１）．ＡＯＤ，ＬＡＤ，ＬＶＥＳＤ及ＬＶＥＤＤ无显著改变．多因素相关分析显示ＬＶＭＩ下降值与血压下降无关．３）服药后左室舒张功能指标Ｅｐ，Ｅｐ／Ａｐ及Ｅａｆ显著增加，而Ａａｆ和Ａａ／Ｅａ显著降低（Ｐ＜００１）．多元逐步回归分析显示左室舒张功能指标改善主要受血压下降，室壁减薄及ＬＶＭＩ降低影响，ＨＲ下降也起一定作用．左室收缩功能指标ＥＦ，ＦＳ及ＰＥＰ／ＥＴ无显著改变，ＣＯ下降１０８％（Ｐ＜００２）．表明：美托洛尔是一种安全有效的抗高血压药，降压时对ＬＶＨ有消退作用，同时对异常的舒张功能有改善作用，对收缩功能没有明显的损害作用     

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.