压电石英晶体活化部分凝血酶时间检测传感器的构建及初步应用

目的 建立一种检测血浆活化部分凝血酶时间(APTT)的压电石英晶体传感器。方法 采用AT切向、基频10MHz的银膜石英晶体作为压电元件；观察血浆凝集过程中晶体振荡顿率的变化，确定血浆凝集反应的起点和终点。结果 (1)血浆标本加入反应体系后，晶体振荡频率呈阶梯状快速下降，接着频率瞬时上升，然后再缓慢降低达到平稳，频率阶梯下降的起点为血浆凝集反应的起点，频率从快速上升变为下降的转折点为血浆凝集的终点，计算两点之间的时间即为血浆活化部分凝血酶时间。(2)该方法检测结果与STAGO磁珠检测法的相关性好(γ=0．972)，批内CV=2．54％，批间CV=7．14％。结论 压电石英晶体传感器检测血浆活化部分凝血酶时间，血浆凝集反应起点和终点确定方便、可靠。且操作简单、快速、成本低廉，检测结果准确，是一种敏感性高、重复性好的血浆活化部分凝血酶时间检测新方法，可用于临床常规检测。     

压电石英晶体传感器检测血浆凝血酶原时间及其初步应用

目的：建立一种压电石英晶体传感器检测血浆凝血酶原时间（PT）的方法。方法：采用AT切向，基频10MHz的银膜石英晶体作为压电元件；观察血浆凝集过程中晶体振荡频率的变化，确定血浆凝集反应的起点和终点。结果：（1）血浆标本加入反应体系后, 晶体振荡频率呈阶梯状快速下降，接着频率瞬时上升，然后再缓慢降低达到平稳，频率阶梯下降的起点为血浆凝集反应的起点，频率从快速上升变为下降的转折点为血浆凝集的终点，计算两点之间的时间即为血浆凝血酶原时间。（2）该方法的检测结果与STAGO磁珠检测法的相关性好（γ＝0．97），批内CV＝0．78％，批间CV＝2．38％。结论：压电石英晶体传感器检测血浆凝血酶原时间，血浆凝集反应起点和终点确定方便，可靠，且操作简单，快速，成本低廉，检测结果准确，是一种敏感性高，重复性好的血浆凝血酶原时间检测新方法，可用于常规检测。     

压电石英晶体传感器检测血浆纤维蛋白原方法的研究及应用

目的建立一种压电石英晶体传感器检测血浆纤维蛋白原(Fib)的方法.方法采用AT切向、基频10MHz的银膜石英晶体作为压电元件;观察血浆凝集过程中晶体振荡频率的变化,确定血浆凝集反应的起点和终点.结果 (1)检测池加入凝血酶原待频率稳定后,血浆标本加入反应体系后,晶体振荡快速下降,由于反应中形成的纤维蛋白原凝块的质量、体积与晶体接触的面积以及血清产生的量不同,造成频率瞬时的上升、下降,或频率稳定,直至反应结束频率平稳,加样后频率下降的起点为血浆凝集反应的起点,频率上升、下降,稳定的起始点为反应的终点,计算两点的时间即为反应时间,查标准曲线得纤维蛋白原的含量.(2)该方法的检测结果与STAGO磁珠检测法的相关性好(r＝0.957).结论压电石英晶体传感器检测血浆纤维蛋白原是一种实时在线检测的方法,在线观测凝集反应的终点,反应的起点和终点的判别方便、可靠、准确.且操作简单,快速,成本低廉,是一种敏感性高、重复性好的方法,并可用于临床检测.     

压电石英晶体生物传感器的血浆凝血因子检测系统的效能研究

目的研究用压电石英晶体传感器进行凝血因子检测的系统,介绍血浆凝血因子检测系统的工作原理.方法利用压电石英晶体的逆压电反应,基于模糊和解耦控制技术,采用单片机进行恒温恒湿控制和频率计数,测得血浆凝集时间,来确定凝血因子的活性和含量.结果本检测系统提高了凝血因子检测的方便性、精度和一致性.结论压电石英晶体传感器用于凝血因子检测具有精度高和成本低等优点,有广阔的临床应用和推广前景.     

压电石英晶体传感器液相检测的影响因素

目的　探讨压电石英晶体传感器液相检测的影响因素。方法　采用AT切向镀金膜的石英晶体制成 2× 5型石英晶体微阵列 ,观察晶体振荡频率在不同粘度和密度的甘油PBS( 0 .15mol LpH 7.0 )溶液、不同浓度的NaCl溶液、不同pH的PB溶液( 0 .0 6 7mol L)及不同体积的PBS溶液 ( 0 .15mol LpH 7.0 )中的变化规律以及机械冲击和重新加样对晶体振荡频率的影响。结果　石英晶体振荡频率随溶液粘度和密度、离子浓度、pH的增大而降低。溶液体积、机械冲击和重新加样对晶体频率基本无影响。结论　石英晶体传感器所处溶液体系的性状如粘度、密度、离子浓度、pH等因素对其振荡频率有较大的影响 ,石英晶体传感器用于生物反应检测时应减少和避免上述因素的干扰     

压电石英晶体传感器金膜表面亲和素固定研究

目的 研究压电石英晶体传感器金膜表面亲和素固定的反应趋势及最佳条件。方法 用3,3＇-二巯基丙酸自组装方法将亲和素固定在压电石英晶体传感器金膜表面,比较不同浓度、不同pH值条件下亲和素固定引起的频率变化。结果 经单因素方差分析,磷酸盐缓冲液pH值为6．2时亲和素固定引起的频率变化与pH5．8、6．6时差异无统计学意义（P〉0．05）,但pH值为6．2时频率下降有最大均值．应用pH7．0、7．4溶液进行亲和素固定时频率改变显著减小（P〈0．01）。浓度为0．2mg／ml时亲和素固定已达饱和。结论 选用pH6．2的0．2mg／ml时亲和素进行压电石英晶体传感器金膜修饰。     

压电石英晶体振荡频率检测平台的建立及应用

目的　构建一种 2× 5型压电石英微阵列振荡频率检测平台。方法　利用基频 1 0MHz的 2× 5型石英晶体微阵列作为传感换能器件 ,自行设计自激式振荡频率检测仪、频率分析软件PESA2 .0 ,与计算机连接组成压电石英晶体传感器检测平台 ,并应用于气、液相检测。结果　石英晶体微阵列在气、液相起振能力强 ,并获得稳定振荡 ,气相稳定度可达± 1Hz ,液相≤ 2Hz。消除了温度、电离辐射、机械震动等因素的干扰 ;实现了频率信号检测的自动化、微机化和自能化。结论　该检测平台具有检测频率稳定、自动化和智能化程度较高、能实时检测等优点 ,是一种新型压电晶体振荡频率检测共用平台 ,可广泛用于压电传感器振荡频率的检测     

压电凝血反应频率指数衰减规律及最大曲率终点法的研究

目的建立压电凝血反应曲线拟合模型及最大曲率终点法判断反应终点。方法用压电石英传感器检测血浆凝血酶原时间,比较指数衰减、幂函数及多项式3种拟合模型的6种曲线的拟合效果,并采用最大曲率终点法判断反应终点。结果6条拟合曲线的非线性回归效果均有显著意义(P<0.05);同类模型内的两条曲线残差平方和(SSE)比较没有显著性差别(P>0.05),而非同类模型之间则差异显著(P<0.01),且多项式SSE最小,指数衰减模型次之,但多项式模型因其曲率存在多个峰值而不能用最大曲率法判断终点;最大曲率终点法比传统的终点频率峰法重复性更好(P<0.05)。结论指数衰减模型Y=A B×EXP(-X/C)能很好地拟合压电凝血反应曲线;最大曲率终点法能显著提高检测重复性。     

压电石英晶体微阵列免疫传感器检测IgG的实验研究

目的 构建一种新型压电石英晶体人免疫球蛋白(IgG)的免疫微阵列传感器。方法 抗IgG单克隆抗体采用蛋白A(SPA)法固定在AT切向、基频10MHz的石英晶体微阵列金膜电极表面制成抗体敏感膜，构成压电石英晶体IgG免疫微阵列传感器。结果 构建的IgG压电石英晶体免疫微阵列传感器对IgG的响应特性良好，其检测下线为0．5mIU／ml。结论 研制的压电石英晶体IgG免疫微阵列传感器具有灵敏度高、特异性好、成本低廉、操作简单、快速，能在线实时检测等优点，可用于临床实验诊断。     

链置换扩增(SDA)压电DNA传感器

目的：构建链置换扩增（SDA）压电DNA传感器，研究其响应特性，方法：（1）将SDA与压电DNA传感器结合，建SDA压电DNA传感器结合技术。（2）以结构菌IS6110片段为检测对象，研究SDA压电DNA传感器的响应特性，结果：（1）SDA压电DNA传感器的响应信号达到500Hz左右；（2）SDA压电DNA传感器出现频率下降的时间长度（响应时间）与加入的检测核酸的浓度相关；（3）不同浓度检测核酸（靶核酸）导致的频率下降绝对值差别不大。结论：SDA压电DNA传感器能直接检测基因组DNA；其响应时间与检测物（靶核酸）的加入量相关，可以用作定量依据。     

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.