软骨MRI敏感序列比较及与关节镜、病理结果对照研究

目的评价人体软骨的MRI序列,寻找其敏感序列并探讨其在关节软骨急性创伤及软骨类肿瘤病变中的应用价值。方法76例急性膝关节软骨损伤患者,7例软骨类肿瘤的患者,采用抑制脂肪的快速自旋双回波质子和T2加权像（FS-FSE-T2WI/PD）、抑制脂肪的三维快速扰相梯度回波（FS-3D-T1＊-FSPGR）、反相位T1加权三维快速扰相梯度回波（Unilateral-T1-Special-3D-FSPGR）,对软骨类肿瘤病变,加用快速自旋回波T1加权像（FSE-T1WI）、快速自旋回波T2加权像（FSE-T2WI）、T2＊梯度回波（GR）和弥散加权成像（DWI,b=300）进行扫描。前瞻性分析456个关节软骨面及7个肿瘤实体,进行病变分级诊断和肿瘤信号特点分析,分别与关节镜及病理检查结果对照分析,采用双盲法计算各序列信噪比（signalnoiseratio,SNR）,对比噪声比（contrastnoiseratio,CNR）以及诊断软骨病变的敏感度、特异度、准确度、阴性预测值、阳性预测值和Kappa值。结果76例膝关节中MRI诊断软骨损伤45例,其中31人做了关节镜检查,7例软骨类肿瘤均经病理证实。FS-FSE-T2WI、FS-FSE-PD、FS-3D-T1＊-FSPGR及Unilateral-T1-Special-3D-FSPGR序列的SNR分别为5.75±0.47、51.57±2.28、43.96±5.23和45.00±10.18。将矢状面和横断面的FS-FSE-T2WI/PD结合分析,其诊断的敏感度为91%、特异度为99%、准确度为97%、阳性预测值为98%、阴性预测值为94%,Kappa值为0.80;FS-3D-T1＊-FSPGR和Unilateral-T1-Special-3D-FSPGR诊断的敏感度为81%、特异度为97%、准确度为95%、阳性预测值为96%、阴性预测值为87%,Kappa值为0.71。结论FS-FSE-T2WI/PD是诊断关节软骨病变的最敏感序列;Unilateral-T1-Special-3D-FSPGR和FS-3D-T1＊-FSPGR序列对关节软骨病变具有相同病变检出力,但是前者SNR优于后者,且扫描时间明显缩短,完全可以替代前者用于临床;首次将软骨敏感的FS-FSE-T2WI/PD,FS-3D-T1＊-FSPGR,Unilateral-T1-Special-3D-FSPGR和T2＊GR序列应用于软骨类肿瘤的诊断,其中T2＊GR是显示软骨类肿瘤的最有价值序列。DWI是诊断软骨类肿瘤的一种很有价值的成像方法。     

膝关节软骨多种MR成像序列对比

目的探讨多种MR扫描序列对关节软骨的诊断价值并筛选最佳成像序列。方法应用12种MR序列组合对9只新鲜牛膝关节模型行矢状位扫描。MR序列为：T1加权、T2加权及质子密度加权快速涡流自旋回波序列（TSE—T1WI、TSE-T2WI、TSE—PDWI）,附加脂肪饱和的T1加权、T2加权及质子密度加权快速涡流自旋回波序列（TSE-T1WI-SPIR、TSE-T2WI-SPIR、TSE-PDWI-SPIR）,T1加权三维快速梯度回波序列（3D—FFE-T1WI）,分别附加脂肪饱和、水激励、磁化传递的三维快速梯度回波序列（3D—FFE—SPIR、3D—FFE—WATS、3D—FFE—MTC）,三维平衡快速梯度回波序列（3D-BFFE）,附加水激励的三维平衡快速梯度回波序列（3D—BFFE-WATS）。测量并比较各序列中关节软骨信号噪声比（SNR）,软骨与周围组织的对比噪声比（CNR）。从中优选出最佳MR序列对15位健康志愿者进行单膝关节检查,计算关节软骨SNR、CNR及其效率值,统计分析试验结果。结果牛膝关节软骨SNR值在附加SPIR、WATS、MTC技术的序列组合中高于未附加这些技术的序列组合,各序列间差异有统计学意义（均P〈0．01）。健康志愿者软骨SNR较高者为3D-FFE-SPIR、3D-FFE-WATS、3D-BFFE-WATS。CNR较高者为软骨对骨皮质、骨髓、肌肉和脂肪：3D-FFE-SPIR、3D-FFE-WATS、3D-BFFE-WATS;对液体：3D-FFE—WATS、TSE—T2WI—SPIR、3D—FFE—SPIR;对半月板和韧带：3D—FFE—SPIR、3D-BFFE-WATS、TSE—PDWI—SPIR。SNR、CNR效率值较高者为3D—FFE—WATS、3D-BFFE-WATS、3D-FFE—SPIR。与其他序列相比差异有统计学意义（P〈0．01）。3D-FFE-SPIR与3D-FFE-WATS比较中,软骨SNR、CNR（软骨对骨皮质、肌肉）差异无统计学意义（均P〉0．05）;CNR（软骨对液体、骨髓、脂肪）在3D-FFE-WATS序列中高且两者差异有统计学意义（均P〈0．01）。结论SPIR或WATS技术使软骨SNR及软骨与周围组织的CNR增高,当进行软骨检查时应常规使用脂肪抑制技术。WATS扫描速度快,脂肪抑制均匀,可以替代SPIR-3D-FFE-WATS可清晰显示关节软骨,为检查软骨病变最敏感序列之一。3D-BFFE-WATS序列的SNR、CNR高且扫描速度快,效率值高,可以应用于临床。     

3.0TMR腕关节软骨多序列成像实验研究

目的〓〖HTK〗观察不同扫描序列及参数对腕关节软骨成像质量的影响，优化获取3D-FSPGR 序列最佳扫描参数。〖HTW〗方法〓〖HTK〗选择成人尸体腕关节3个，用GE SIGNA EXITE II 3.0T磁共振扫描仪检查,MRI序列包括自旋回波T1加权像（SE T1WI）、自旋回波T2加权像（SE T2WI）、质子密度加权像（PDWI）、脂肪抑制质子加权像（FS PDWI）及三维脂肪抑制扰像梯度回波像（3D-FSPGR），其中后者采用不同的TE时间［minimum(2.2ms)、minfull(6.6ms)、outphase(3.2ms)］结合不同翻转角（Flip，5°、10°、20°、30°、60°）进行扫描，分别得到每一序列的相同层面图像并计算不同参数成像关节软骨的信噪比（SNR）,软骨与骨髓、软骨与肌腱的对比噪声比（CNR）。〖HTW〗结果〓〖HTK〗① FS PD 序列、3D-FSPGR序列软骨信号-噪声比较高; 3D-FSPGR序列在TE/Flip (6.6ms/30°) 时具有最好的软骨与骨髓、软骨与肌腱的对比噪声比； ② PDWI、FS PDWI、及3D-FSPGR 序列间关节软骨的SNR对比，差异无统计学意义(P＞0.05)；3D-FSPGR 序列软骨与骨髓、软骨与肌腱的CNR较PDWI、FS PDWI序列软骨与骨髓、软骨与肌腱的CNR差异有统计学意义（P＜0.01)；③ SE T1WI、SE T2WI序列关节软骨SNR、软骨与骨髓、软骨与肌腱的CNR均较低，差异无统计学意义（P＞0.05）；与PDWI、FS PDWI、3D-FSPGR序列比较，差异有统计学意义(P＜0.01)。〖HTW〗结论〓〖HTK〗3D-FSPGR 在TE/Flip (6.6ms/30°)时关节软骨显示最清晰，为关节软骨检查的最佳扫描序列；FS PDWI序列关节软骨显示较清晰，可作为关节软骨检查的常规扫描序列。     

磁敏感加权成像对脊髓急性外伤性出血的应用价值探讨

目的:探讨磁敏感加权成像在脊髓急性外伤性出血中的应用价值.方法:21例脊髓急性外伤出血的患者行3.0T磁敏感加权成像(SWI)、二维扰相梯度回波(T2*加权2D-MERGE T2* WI)及常规快速自旋回波T1加权FSE-T1WI、快速自旋回波T2加权FSE-T2 WI序列扫描,病变组所有病例经临床随访及病理证实,包括颈段脊髓挫裂伤12例、胸段脊髓挫裂伤6例、胸腰段脊髓挫裂伤3例.比较分析SWI及T2* WI、T2WI对脊髓出血性病变检出的敏感性和特异性.11例正常志愿者作为对照组.结果:21例脊髓挫裂伤常规FSE-T2WI均显示水肿征象,其中6例在SWI、2D-MERGE T2* WI及FSE-T1 WI、FSE-T2WI均未见出血征象;7例仅在SWI显示出血征象;8例在SWI显示低信号出血征象较2D-MERGE T2* WI及常规FSE-T2WI更敏感.结论:磁敏感加权成像检出脊髓急性外伤性出血比常规MRI更敏感,可作为脊髓出血性病变MRI检查重要的补充序列.     

脂肪抑制三维稳态旋进快速成像FS-3D-FISP序列在诊断踝关节软骨损伤中的应用价值

目的 对照不同序列踝关节软骨病损的MRI特点与关节镜表现,评价特殊序列,即脂肪抑制三维稳态旋进快速成像FS-3D-FISP对软骨病变的诊断价值.方法 对因踝关节疼痛拟行踝关节镜检查的40例(41踝)患者,术前常规行T2加权快速自旋回波FSE-T2WI、质子密度加权快速自旋回波FSE-PDWI和FS-3D-FISP 3种MRI序列扫描,分别得到MRI分级结果,并与关节镜分级诊断结果进行比较.结果 以关节镜诊断为标准,FS-3D-FISP序列敏感度最高,可达92.9%.在敏感度上FS-3D-1 ISP>FSE-FDWI>FSE-T2WI,与关节镜诊断的一致性上:FS-3D-FISP的Kappa值达到0.7590,一致性高,也明显优于FSE-PDWI和FSE-T2WI (P<0.01).结论 FS-3D-FISP序列能够准确地反映软骨病变,并且能较真实体现早期的软骨病变,与关节镜诊断结果具有良好的一致性,而且通过三维重建对软骨病变进行立体定位诊断,能更准确地显示病变的部位及程度,并对其进行合理 分级,更好地指导临床决策.     

磁共振成像在肝血色素沉着症诊断中的应用价值

目的：分析肝血色素沉着症磁共振（ MR） T2加权图像（ T2 WI）及梯度双回波T1加权图像（ T1 WI）的影像表现,评价MRI在肝血色素沉着症中的应用价值。方法回顾性分析确诊27例肝血色素沉着症患者MR图像,观察其T2 WI及梯度双回波T1 WI的肝脏信号改变。结果所有病例T2 WI均表现为肝脏实质信号不同程度减低,接近或低于同层面竖脊肌,肝脏在梯度双回波T1 WI同反相位均见信号减低,同相位图像上信号减低更明显,因此反相位信号高于同相位为其特异性征象,其中9例合并脾脏信号减低,脾脏信号反相位高于同相位。结论 T2 WI结合梯度双回波T1 WI对诊断肝血色素沉着症具有较高敏感性和特异性,MRI检查对肝血色素沉着症早期诊断和监测治疗具有重要临床价值。     

新生儿头颅磁共振成像序列优化临床价值的探讨

目的探讨不同扫描序列及参数在新生儿头颅MRI中的价值。方法行头颅MRI检查的新生儿85例,扫描序列为磁共振扩散加权成像（DWI）b值800,快速反转恢复T1加权成像（IR/TSE-T1 WI）轴位,快速自旋回波T2加权成像（TSE-T2 WI）轴位,自旋回波T1加权成像（SE-T1 WI）矢位。扫描前给予患儿镇静、棉塞及耳机保护听力。结果85例MRI图像质量满意。 MRI检查显示室管膜下出血20例,脑白质损伤21例,皮层出血3例,额顶叶细胞毒性水肿2例,两侧额叶软化灶2例,胼胝发育不良1例,内囊后肢髓鞘化延迟2例,脑回畸形2例,其余32例头颅MRI检查未见异常。结论DWI对新生儿早期脑白质损伤、早期细胞毒性水肿具有较高敏感性;IR/TSE-T1 WI能反应新生儿脑髓鞘化进程;SE-T1 WI对皮层出血、室管膜下出血较IR/TSE-T1 WI略有优势。成像优化组合为DWI、IR/TSE-T1 WI、TSE-T2 WI（轴位）,SE-T1 WI（矢位）,必要时加用SE-T1 WI（轴位）。     

血液病骨髓MRI表现

目的：探讨血液和造血系统疾病的MRI表现。方法：选择经骨髓穿刺或活检证实的血液和造血系统疾病13例,其中急性白血病（acute leukemia,AL）7例,慢性淋巴细胞白血病（chronic lymphocytic leukemia,CLL）1例,非霍奇金淋巴瘤（non—Hodgkin lymphoma,NHL）2例,巨幼细胞性贫血2例,原发性血小板增多症（essential thrombocytosis,ET）1例。12例行胸腰椎骨髓MRI,1例行左胫腓骨MRI。4例先行MRI示信号异常,提示血液疾病,后经骨髓穿刺及活检确诊。MRI检查使用0．5T超导型磁共振成像系统,进行自旋回波（spin echo,SE）序列T1加权像（T1WI）、快速自旋回波（furbo spin echo,TSE）序列T2加权像（T2WI）、梯度回波（gradient echo,GRE）序列T2加权像（T2＊WI）,3例行短时反转恢复（short time inversion,STIR）序列。结果：13例患者受检骨髓MRI均表现为T1WI均匀低信号,T2WI 10例呈高信号,3例呈等信号,GRE序列T2＊WI均表现为高信号,2例AL和1例NHL行STIR序列表现为高信号。1例AML—M2化疗达完全缓解后受检骨髓信号恢复正常。且髓外软组织浸润病灶消失。结论：MRI能为血液和造血系统疾病提供影像学依据,并有助于临床诊断和疗效的评价。     

正常青少年膝关节软骨的MRI表现

目的探讨正常青少年膝关节软骨的MRI表现。方法使用GE 0.2T低场磁共振成像机,采用膝关节线圈,对膝关节行矢状面扫描,应用序列为梯度回波序列T2WI*、自旋回波T1WI、自旋回波T2WI、脂肪抑制序列。翻转角20°,扫描野16 cm;层厚4 mm,间隔1 mm。结果膝关节矢状位MRI梯度回波序列T2WI*序列中,股骨髁与胫骨平台的骺软骨MRI能显示出3层不同的信号强度。结论MRI能准确地显示正常青少年膝关节软骨的层次结构,为临床诊断膝关节疾病提供参考依据。     

磁共振多序列扫描在脑内原发性淋巴瘤的应用价值

目的：探讨磁共振多种扫描序列联合应用在脑内原发性淋巴瘤的应用价值。方法对8例脑内原发性淋巴瘤患者的磁共振资料进行回顾性研究,分析肿瘤的位置、形态及T1加权成像（T1WI）、T2加权成像（T2WI）、液体衰减反转回复（FLAIR）、磁共振扩散加权成像（DWI）及增强T1WI图像的信号变化特征。结果肿瘤呈类圆形或不规则团块状,T1WI呈等或稍低信号,T2WI及FLAIR呈等或稍低信号,DWI呈高信号,表现扩散系数（ADC）值减低。肿瘤信号多数均匀,增强扫描肿瘤呈均匀或不均匀明显强化。结论磁共振多种扫描序列联合应用能提供更多的诊断信息,有助于提高脑内淋巴瘤诊断与鉴别诊断的正确率,为临床治疗提供更多有价值的信息。     

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.