南通地区不同人群血清胃蛋白酶原含量检测分析

目的:检测江苏省南通地区不同人群中血清胃蛋白酶原(PG)的含量水平,研究其在不同性别、不同年龄段人群中的变化规律,以探讨血清PG测定对胃部疾病和胃癌早期筛查的诊断价值。方法:采用时间分辨荧光免疫分析法对2360例进行血清胃蛋白酶原Ⅰ、Ⅱ(PGⅠ、PGⅡ)含量测定并计算PGⅠ/PGⅡ比值(PGR),对结果进行统计学分析。结果:(1)经检测2360例血清PGⅠ含量为156.6±55.6ng/mL、PGⅡ含量为10.7±4.4ng/mL、PGR结果为15.5±4.5。(2)≥45岁人群血清PGⅠ、PGⅡ水平均高于<45岁人群及整体人群血清PGⅠ、PGⅡ水平。(3)男性血清PGⅠ含量高于女性,而PGⅡ含量两者比较差异无统计学意义;<45岁人群血清PG异常率低于≥45岁以上人群,男性血清PG异常率高于女性,且以PGⅠ异常率为高。结论:南通地区不同人群血清PG含量总体处于正常水平;随着年龄的增长,PGⅠ含量增高,异常率也升高;且男性PG异常率明显高于女性。     

肝纤维化时血清胆碱酯酶的诊断及意义

目的评价血清胆碱酯酶的检测对慢性肝炎导致肝纤维化的诊断意义。方法对35例健康成人及130例慢性活动性肝炎病人(包括乙肝、丙肝)及病理学上有肝纤维化和肝硬化的病人的血清胆碱酯酶进行测定,同时测定了谷丙转氨酶、谷草转氨酶和白蛋白等其他血清学指标。结果正常健康成人血清胆碱酯酶活性为8120±2620 u/L,慢性活动性肝炎病人血清胆碱酯酶活性(Ⅰ)为7234±2108 u/L,肝纤维化病人血清胆碱酯酶活性(Ⅱ)为3526±1174 u/L,肝硬化病人血清胆碱酯酶活性(Ⅲ)为2291±1053 u/L。结论在所检测的血清酶中,胆碱酯酶是唯一一个在肝纤维化时活性明显改变的酶。胆碱酯酶活性高低与病理分级程度有一定相关性。因此,胆碱酯酶是诊断早期肝纤维化及肝组织损伤程度的特异性指标。     

血清胃蛋白酶原及其亚群对胃癌早期诊断的应用价值

目的：通过时胃癌患者血清胃蛋白酶原PG及其亚群PGⅠ、PGⅡ的测定,探讨血清PGⅠ、PGⅡ及PGⅠ／PGⅡ（PGR）比值对胃癌早期诊断的关系。方法：运用乳胶增强免疫比浊法测定30例胃癌患者和20例正常对照空腹血清PGⅠ、PGⅡ的含量及PGR值,并进行比较统计学分析。结果：胃癌患者组血清PGⅠ含量及PGⅠ／PGⅡ（PGR）比值（36．65±12．79ng／ml;3．16±0．76）明显低于正常对照组（50．16±13．24ng／ml;5．26±0．88）,有显著性差异。结论：监测血清PGⅠ及PGⅠ／PGⅡ（PGR）比值变化对胃癌的早期诊断有重要的临床意义,可望作为胃癌早期筛选的指标。     

分娩方式对肝功能的影响

【目的】探讨阴道分娩和剖宫产对肝功能的影响。【方法】随机选取2006年我院住院分娩的产妇共100例,其中阴道分娩和剖宫产各50例,均无明显内科合并症和产科并发症,分娩前及分娩后24h检测肝功能和凝血功能,观察不同分娩方式前后谷丙转氨酶、谷草转氨酶、总胆红素、血清白蛋白、凝血酶原活动度的变化情况,以及对比两组间分娩前后各指标的差值,统计方法采用t检验。【结果】阴道分娩前后谷丙转氨酶、谷草转氨酶、总胆红素、凝血酶原活动度的变化有显著性差异,血清白蛋白变化无显著性差异,剖宫产分娩前后各指标变化无显著性差异。谷丙转氨酶、谷草转氨酶、总胆红素、凝血酶原活动度阴道分娩前后的差值大于剖宫产前后的差值。分娩前后血清白蛋白的差值在不同分娩方式间差别无显著性。【结论】阴道分娩对肝功能有一定影响,剖宫产对肝功能影响不明显;阴道分娩对肝功能的影响大于剖宫产对肝功能的影响。     

病毒性肝炎病情严重程度的计算机判别诊断-常用肝功能指标逐步判别分析

目的：常用肝功能指标模型诊断探索。方法：肝功能指标在临床现病情诊断中是非常重要的。以往人们多是从临床医学角度来判断,本文用统计学方法,对１０个常用肝功能指标ＴＰ（总蛋白）ＡＬＴ（总蛋白）ＡＬＧ（白蛋白）ＧＬＢ（球蛋白）Ａ／Ｇ（白／球）ＴＢＩＬ（总胆红素）ＤＢＩＬ（直接胆红素）ＩＢＩＬ（间接胆红素）ＡＳＴ（谷草转氨酶）ＡＬＴ（谷丙转氨酶）ＡＳＴ／ＡＬＴ（谷草／谷丙）进行了判别分析研究。结果：发现由Ｔ     

脾切断流术对肝硬化门静脉高压患者肝功能及血清HGF、TGF-β的影响

目的 探讨脾切断流术对肝硬化门静脉高压患者肝功能及血清HGF、TGF-β水平的影响.方法 方便选取2013年3月—2015年12月该院收治的肝硬化门静脉高压患者98例,随机分为对照组与观察组,各49例.对照组给予保守治疗,观察组行脾切断流术治疗.检测2组血清总胆红素(T-Bil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)及前白蛋白(PA)等肝功能指标水平及HGF、TGF-β水平,评价治疗前后患者肝功能状态及血清HGF、TGF-β水平的变化.结果 治疗前2组各项肝功能指标及血清HGF、TGF-β水平比较差异无统计学意义(P>0.05);与治疗前比较,治疗后观察组T-Bil(27.59±7.22)μmol/L,AST(46.19±7.66)IU/L,ALT(38.79±8.27)IU/L,ALP(56.25±13.25)U/L等肝功能指标及TGF-β水平(92.28±12.63)μg/L降低,而PA(107.26±10.33)mg/L,HGF(7.55±1.86)μg/L水平升高,且组间差异有统计学意义(P<0.01).结论 脾切断流术可显著提高肝硬化门静脉高压患者血清HGF水平,降低血清TGF-β水平,改善患者肝功能.     

TIPS治疗前后肝硬化门静脉高压患者血清CXCL9、 TXA2 和PGI2 水平及其与预后的相关性研究

目的 研究经颈静脉肝内门体分流术（TIPS）治疗肝硬化门静脉高压前后血清CXCL9、血栓 素A2（TXA2）、前列腺素I2（PGI2）水平变化及其与预后的相关性。方法 选取2013 年1 月—2014 年12 月 青海大学附属医院行TIPS 治疗的75 例乙肝肝硬化门静脉高压患者作为研究对象。中位生存时间910 d,其 中≥ 910 d 35 例,<910 d 40 例。记录患者手术前后肝功能指标、门静脉压力、门静脉血流指数及血清CXCL9、 TXA2、PGI2 水平;并以中位生存时间分组,比较生存时间≥ 910 d 与<910 d 患者血清CXCL9、TXA2、PGI2 水平,Spearman 相关性分析上述指标与预后的相关性。结果 术后2 周患者谷丙转氨酶（ALT）、谷草转氨 酶（AST）较术前下降,白蛋白（ALB）上升（P <0.05）;术后1 周患者门静脉压力、门静脉血流指数、血清 CXCL9、TXA2、PGI2 水平比术前下降（P <0.05）;生存时间≥ 910 d 患者术前血清CXCL9、TXA2、PGI2 水 平分别为（290.95±83.51）pg/ml、（89.12±16.35）ng/L、（121.93±29.56）ng/L,均低于生存时间<910 d 患 者的（340.12±96.59）pg/ml、（121.26±23.08）ng/L、（159.83±32.65）ng/L（P <0.05）;Spearman 相关性分 析显示术前血清CXCL9、TXA2、PGI2 水平与患者预后呈负相关（P <0.05）。结论 TIPS 治疗能改善肝硬化 门静脉高压患者肝功能,降低门静脉压力,术后血清CXCL9、TXA2 及PGI2 水平下降;术前血清CXCL9、 TXA2 及PGI2 水平与患者预后密切相关。     

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。     

e抗原阴性的慢性肝病患者血清HBV-DNA含量与血清转氨酶的关系

目的探讨e抗原阴性的慢性肝病(包括慢性肝炎、肝硬化、肝癌)患者血清HBV-DNA含量与血清谷丙转氨酶(ALT)及谷草转氨酶/谷丙转氨酶(AST/ALT)比值的相关性。方法应用聚合酶链反应(PCR)技术检测91例e抗原阴性的慢性肝病患者血清HBV-DNA含量,全自动生化分析仪测定ALT、AST/ALT指标。结果91例e抗原阴性的慢性肝病患者血清HBV-DNA含量平均为1.24×105copies/ml;血清ALT水平平均为326IU/L;血清AST/ALT平均为1.15;血清HBV-DNA含量与ALT之间无相关性(r=-0.43、P>0.05);与血清AST/ALT成明显负相关(r=-0.314、P<0.01)。结论血清HBV-DNA含量由高到低变化与肝细胞损伤及损伤程度无关,但在一定程度上可以较好地评价e抗原阴性的慢性肝病患者的病情进展。提示疾病会向不良方向转归。     

GP73在HBV相关性肝病中的水平及意义

目的:探讨高尔基体蛋白73（GP73）在乙型肝炎病毒（HBV）相关性肝病中的检测及意义。方法:选取2016年5月-2018年5月在我院治疗的HBV相关性肝病患者160例,其中慢性乙肝患者78例,乙肝肝硬化患者52例,肝癌患者30例,采用GP73检测试剂盒检测血清GP73水平。结果:肝癌组、乙肝肝硬化组和慢性乙肝组血清GP73分别为（101.11±35.60）ng/mL、（81.87±30.54）ng/mL和（60.45±12.24）ng/mL,肝癌组＞乙肝肝硬化组＞慢性乙肝组＞对照组（P＜0.05）;丙氨酸氨基转移酶（ALT）、天门冬氨酸转氨酶（AST）和总胆红素（TBIL）水平,肝癌组＞乙肝肝硬化组＞慢性乙肝组＞对照组（P＜0.05）,而ALB水平,肝癌组＜乙肝肝硬化组＜慢性乙肝组＜对照组（P＜0.05）;血清GP73与ALT、AST、TBIL成正相关（r=0.451、0.406和0.357,P＜0.05）,与ALB成负相关（r=-0.380,P＜0.05）。结论: GP73在HBV相关性肝病中明显升高,与疾病严重程度和肝功能有一定关系。     

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.