右美托咪定经海马CA1区PPARγ磷酸化在大鼠体外循环脑保护中的作用

目的 探讨PPARγ磷酸化在右美托咪定对大鼠体外循环脑保护中的作用。方法 成年健康雄性SPF级SD大鼠36只,体重350～450 g,随机分为3组,每组12只。假手术组（S组）：在戊巴比妥钠麻醉下行气管插管,右颈内静脉及双侧股动脉穿刺置管,不进行体外循环。体外循环组（C组）：同S组麻醉穿刺置管,复制大鼠体外循环模型,进行体外循环2 h。右美托咪定组（D组）：在体外循环前15 min至体外循环2 h期间经右颈内静脉以5μg/（kg·h）的速度泵注右美托咪定注射液,其余同C组。S组置管期间及C组在转流期间均恒速泵注等容积的生理盐水。置管或转流2 h后采集标本,采用苏木精-伊红染色观察海马组织病理变化,酶联免疫吸附试验测定大鼠血浆中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及中枢神经特异蛋白（S100β）水平,Western blotting检测海马组织中Bcl-2、Bax、Cleaved Caspase-3、PPARγ、p-PPARγ蛋白表达,免疫组织化学染色检测海马组织p-PPAR γ蛋白的阳性细胞数。结果 S组海马CA1区细胞形态完整;C组海马CA1区细胞受损情况较重,...     

右美托咪定预处理通过抑制NLRP3炎性小体激活减轻大鼠肠缺血再灌注诱导的急性肺损伤

目的 探讨右美托咪定（Dex）对大鼠肠缺血再灌注（II/R）所致急性肺损伤（ALI）的保护作用以及核苷酸结合域样受体蛋白3（NLRP3）炎性小体活性的影响。方法 将32只健康雄性SD大鼠,随机分为4组（8只/组）。假手术组（Sham组）仅暴露肠系膜上动脉（SMA）,肠缺血再灌注组（II/R组）阻断SMA 1 h后再灌注2 h,II/R+右美托咪定处理组（Dex+II/R组）右美托咪定干预后行再灌注,Dex假手术组（Dex组）右美托咪定预处理假手术组。Sham组和II/R组腹腔注射等量生理盐水。采取夹闭SMA 1 h再灌注2 h的方法建立肠缺血再灌注损伤模型。测定各组大鼠肺部组织湿/干质量比值（W/D）、髓过氧化物酶（MPO）活性,HE染色评估肺组织病理学变化以及行肺损伤评分;ELISA检测肺部组织中炎性因子TNF-α、IL-18、IL-1β水平;Western blot检测肺部组织中NLRP3、凋亡相关斑点样蛋白（ASC）、Caspase-1及磷酸化腺苷酸活化蛋白激酶（p-AMPK）蛋白的表达水平。结果 相较于Sham组,II/R组肺组织病理损伤明显,W/D值、MPO活性及肺组织中的TNF-α、IL-18、IL-1β表达显著升高（P<0.05）,肺组织中NLRP3、ASC、Caspase-1蛋白表达增加（P<0.05）,p-AMPK蛋白表达减少（P<0.05）;相较于II/R组,Dex+II/R组肺组织病理损伤轻微,W/D值、MPO活性及肺组织中的TNF-α、IL-18、IL-1β表达明显下降（P<0.05）,肺组织NLRP3、ASC、Caspase-1蛋白表达明显下降（P<0.05）,p-AMPK蛋白表达明显增加（P<0.05）。结论 右托美咪定通过对NLRP3炎性小体激活的抑制,减轻炎性反应,进而改善大鼠II/R所致的ALI。     

右美托咪定对犬体外循环后肺血管通透性的影响

目的探讨右美托咪定对犬体外循环（CPB）后肺血管通透性的影响。方法成年健康杂种犬54只,按随机数字表法分为对照组（C组）、CPB组（CPB组）和右美托咪定组（Dex组）,每组18只。制备CPB诱发肺损伤模型,Dex组于CPB前即刻静脉泵注右美托眯啶1ug／（kg·min）,随即予以1lag／（kg·h）持续泵注至实验结束;CPB组给予等量09％氯化钠溶液;C组不进行CPB,其余操作与CPB组相同。分别于CPB前（Tc）、CPB结束后30min（T1）、60min（T2）时采集动脉血样,测定呼吸指数（RI）、支气管肺泡灌洗液（BALF）中白细胞计数、总蛋白含量及TNF—a、IL-6浓度;测定肺组织伊文思蓝（EB）含量和肺湿／干质量比：光镜下观察肺组织病理学变化。结果与C组比较,CPB组和Dex组RI升高,BALF白细胞计数、总蛋白含量及TNF—a、IL-6浓度、EB含量和肺湿／干质量比升高（P〈0．05）;与CPB组比较,Dex组上述指标均降低（P〈0．05）;C组肺组织结构清晰,未见明显肺损伤;CPB组显示明显的肺部炎症反应,肺泡壁明显充血,肺泡隔增宽,Dex组病理学损伤程度较CPB组明显减轻。结论右美托咪定可明显降低CPB后肺血管通透性,其机制与减轻CPB后肺组织炎性反应有关。     

右美托咪定预处理抑制脑缺血再灌注时谷氨酸的释放及其受体机制研究

目的  评价右美托咪定预处理对大鼠全脑缺血再灌注损伤时海马谷氨酸（Glu）及其受体NMDAR1（NR1）表达的影响。方法  雄性Wistar大鼠90只,体重250~300 g,采用随机数字表法,将其分为3组（n =30）：假手术组（S组）、全脑缺血再灌注组（I/R组）和右美托咪定组（D组）,采用四血管阻断法制备全脑缺血再灌注损伤模型。D组于全脑缺血前2 h经尾静脉注射右美托咪定3μg/kg,随后以3μg/（kg·h）速率输注120 min,I/R组给予等容量生理盐水。应用Combs评分系统评价大鼠神经运动功能的缺损情况;采用脑微透析技术结合高效液相色谱（HPLC）检测大鼠海马细胞外Glu水平的变化;采用免疫组织化学方法检测海马CA1区NR1蛋白表达。结果  与S组比较,I/R组和D组大鼠平衡木和引绳肌力试验评分下降（P <0.05）,海马细胞外Glu的水平增高（P <0.05）,海马CA1区NR1表达上调（P <0.05）;与I/R组比较,D组大鼠平衡木和引绳肌力试验评分升高（P <0.05）,海马细胞外Glu的水平降低（P <0.05）,海马CA1区NR1表达下调（P <0.05）。 结论 右美托咪定可减轻大鼠全脑缺血再灌注损伤,改善神经运动功能的缺损,其机制与抑制Glu释放和下调NR1表达有关。

     

右美托咪定对体外循环手术患儿Th1/Th2平衡的影响

目的 探讨右美托咪定对体外循环(cardiopulmonary bypass,CPB)手术患儿辅助性T细胞（helper T cell,Th）1/Th2平衡的影响。 方法 选择择期CPB下行室间隔缺损修补术患儿80例,年龄4~8岁,美国麻醉医师协会（American Society of Anesthesiologists,ASA）分级Ⅱ或Ⅲ级,采用随机数字表法分为2组：对照组和右美托咪定组,每组40例。所有患儿静脉注射咪唑安定0.15 mg/kg,舒芬太尼1 μg/kg,依托咪酯0.3 mg/kg,罗库溴铵0.6 mg/kg麻醉诱导,右美托咪定组给予初始剂量1 μg/kg右美托咪定泵注（给药时间＞10 min）,然后以0.5 μg·kg-1·h-1的速率维持至术毕,对照组同样的方法给予等容量生理盐水。分别于CPB开始前（T1）、CPB开始后30 min（T2）、CPB停止即刻（T3）、CPB停止后24 h（T4）和CPB停止后72 h（T5）采集动脉血样,流式细胞术检测血浆肿瘤坏死因子α（tumor necrosis factor-α,TNF-α）、白细胞介素 (interleukin,IL) -6、干扰素γ（interferon-γ,IFN-γ）和IL-4的水平。 结果 2组患儿血浆IL-4水平呈先升高后降低趋势,右美托咪定组IL-4水平在T2~4时低于对照组,组间、时点间、组间·时点间交互作用差异有统计学意义（P＜0.05）。2组患儿血浆IFN-γ、IFN-γ/IL-4水平呈先降低后升高趋势,右美托咪定组IFN-γ、IFN-γ/IL-4水平在T2~4时高于对照组,组间、时点间、组间·时点间交互作用差异有统计学意义（P＜0.05）。2组患儿血清TNF-α、IL-6水平呈先升高后降低趋势,右美托咪定组TNF-α、IL-6水平在T2~4时低于对照组,组间、时点间、组间·时点间交互作用差异均有统计学意义（P＜0.05）。 结论 右美托咪定能够减轻CPB引起的Th1/Th2向Th2漂移,缓解机体免疫抑制状态,减轻围术期炎症反应。     

右美托咪定对奥沙利铂致神经性疼痛的镇痛作用及机制

目的探讨右美托咪定（Dex）对奥沙利铂（Oxa）致神经性疼痛的镇痛作用及其机制。方法采用单剂量Oxa腹腔注射诱发 大鼠神经性疼痛模型。SD大鼠随机分为4组:空白对照组（control组）、神经性疼痛组（model组）、右美托咪定处理组（Dex组）、 右美托咪定+阿替美唑组（Ati组）。在行为学上检测各组大鼠机械痛阈值(PWT)和冷热痛阈值（TWL）;应用免疫印记法和免疫 荧光法检测大鼠脊髓p-STAT3的蛋白表达。结果与control组比较,model组和Ati组PWT和TWL（冷）显著性缩短（P<0.05）; 脊髓p-STAT3 的表达水平显著性增加（P<0.01)。与model 组比较,Dex 处理后60~120 min PWT和TWL（冷）显著性延长（P< 0.05）;脊髓p-STAT3的表达显著性减少（P<0.01)。与Dex组比较,Ati组在Dex处理后60~120 min PWT和TWL（冷）显著性缩 短（P<0.05）,而脊髓p-STAT3的表达显著性增加（P<0.05）。结论Dex可通过抑制大鼠脊髓p-STAT3的增长,缓解Oxa所致的神 经性疼痛。     

右美托咪定对老年小鼠海马和杏仁核半胱氨酸蛋白酶-3基因表达影响的实验研究

目的:探讨右美托咪定对老年小鼠海马和杏仁核半胱氨酸蛋白酶-3(Caspase-3)基因表达的影响。方法:48只老年(18月龄)小鼠随机平分为三组:对照组、舒芬太尼组与右美托咪定组。舒芬太尼组与右美托咪定组分别给予5μg/kg舒芬太尼与5μg/kg右美托咪定进行腹腔注射,对照组给予等容量0.9%氯化钠溶液腹腔注射,每周1次,持续8周,检测Caspase-3表达变化情况。结果:舒芬太尼组与右美托咪定组干预第4周与第8周的逃避潜伏期低于对照组(均P<0.05),穿越平台次数与处于平台所在象限时间高于对照组(P<0.05),舒芬太尼组与右美托咪定组对比差异有统计学意义(P<0.05)。舒芬太尼组与右美托咪定组干预第4周与第8周的血清去甲肾上腺素含量高于对照组(均P<0.05),TNF-α含量低于对照组(P<0.05),舒芬太尼组与右美托咪定组对比差异有统计学意义(P<0.05)。舒芬太尼组与右美托咪定组干预第8周的海马和杏仁核Caspase-3基因、蛋白表达水平低于对照组(均P<0.05),舒芬太尼组低于右美托咪定组(P<0.05)。结论:右美托...     

右美托咪定对脓毒血症大鼠肾功能及紧密连接蛋白表达的影响

目的探讨右美托咪定对脓毒血症大鼠肾功能及紧密连接蛋白表达的影响。方法 SD大鼠30只,随机分为右美托咪定处理组(Dex组)、脓毒血症模型组(M组)、生理盐水对照组(C组),每组10只。Dex组大鼠静脉注射脂多糖(LPS)5 mg/kg,之后泵注Dex 7μg/kg,15 min后调整剂量为5μg/kg·h,持续泵注30 min;模型组按同样方法给予LPS后泵注生理盐水;C组始终采用上述方法给予生理盐水。24 h后取血液分离血浆,多功能生化仪检测肌酐(Scr)和尿素氮(BUN)含量;ELISA检测IL-1β和TNF-α含量;Western blot检测肾组织中紧密连接蛋白ZO-1和occludin的表达变化。结果与C组相比,模型组损伤较重,可见大量炎性细胞浸润,有肾小球肾炎表现,而Dex组未见明显的炎症细胞,细胞异常较少,与模型组相比,损伤减轻。肾功能及炎性因子检测结果显示,与C组比较,各组血浆中Scr、BUN、IL-1β和TNF-α含量均显著升高(P0.05),ZO-1和occludin蛋白表达水平均下降(P0.05);与模型组比较,Dex组各项指标均明显降低(P0.05),ZO-1和occludin蛋白表达水平均升高(P0.05)。结论右美托咪定可改善脓毒血症所致的急性肾损伤的肾功能,抑制炎症反应,提升紧密连接蛋白,对肾脏有一定的保护作用。     

右美托咪定对体外循环缺血再灌注损伤肺组织保护作用的相关信号通路

目的探讨右美托咪定对体外循环缺血再灌注损伤肺组织保护作用可能的信号通路。方法将40只SD成年大鼠随机分 为5组,分别为缺血再灌组（A组）、右美托咪定组（B组）、空白对照组（即假手术组,C组）、渥曼青霉素组（D组）、渥曼青霉素＋右 美托咪定组（E组）。比较5组大鼠的动脉血气指标、肺组织细胞凋亡率、蛋白激酶B（Akt）、磷酸化Akt（p-AKT）、半胱氨酸天冬 氨酸特异性蛋白酶-3（Caspase-3）与caspase-9蛋白表达等情况的差异。结果随着实验时间的延长,A组、B组、D组与E组大鼠 在体外循环前、开放左肺门、实验结束3 个时间点心率、平均动脉压、氧合指数均呈显著的下降趋势,呼吸指数逐渐升高。在 实验结束时,B组大鼠的心率、平均动脉压、氧合指数明显高于其他A组、D组与E组（P<0.05）,呼吸指数显著较低（P<0.05）; A~E组大鼠在实验结束时,肺组织病理评分分别为4.89、1.89、0、6.01、5.76;肺组织细胞凋亡率分别为6.25%、3.69%、1.06%、 8.06%、7.79%（P<0.001）;Western blot 检测结果显示,与其他4 组相比,B组大鼠的Akt、p-AKT蛋白表达量显著较高（P<0.05）, caspase-3、caspase-9蛋白相对表达量明显更低（P<0.05）。结论右美托咪定可有效减轻体外循环大鼠的肺损伤,PI3K/Akt信号 通路相关的caspase-3、caspase-9蛋白可能是其作用靶点。     

右美托咪定对阻塞性睡眠呼吸暂停综合征大鼠海马神经元凋亡的影响及其机制研究

目的 探究右美托咪定（Dex）对阻塞性睡眠呼吸暂停综合征（OSAS）大鼠海马神经元凋亡的影响，并分析其作用机制。方法 45只SD雄鼠随机选取10只作为对照组，其余大鼠复制OSAS模型，5只大鼠窒息死亡，剩余30只大鼠成功复制OSAS模型并随机分为OSAS组及Dex高、低剂量组，每组10只。Dex高、低剂量组分别腹腔注射Dex 2.5、0.5μg/（kg·d），对照组与OSAS组给予等剂量的生理盐水。连续干预4周后，采用神经监测仪监测大鼠呼吸暂停情况、平均及最低血氧饱和度，苏木精-伊红染色观察海马组织CA1区病理学改变，流式细胞术检测大鼠海马组织神经元凋亡，Western blotting检测核因子E2相关因子2(Nrf2)/血红素氧合酶1(HO-1)通路相关蛋白的表达。结果 与对照组比较，OSAS组呼吸暂停次数增多（P <0.05），平均及最低血氧饱和度降低（P <0.05），细胞凋亡率升高（P <0.05）,Nrf2、缺氧诱导因子1α(HIF-1α)及HO-1蛋白相对表达量升高（P <0.05）；与OSAS组比较，Dex高、低剂量组呼吸暂停次数减少（P <...     

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.