冠心病病人sICAM-1与肺炎衣原体抗体的变化

目的 观察冠心病（CHD）可溶性细胞间黏附分子-1（sICAM-1）、肺炎衣原体（Cpn）抗体的变化与CHD之间的关系。方法 用酶联免疫吸附（ELISA）法对60例CHD病人,其中包括急性心肌梗死（AMI）、不稳定型心绞痛（UAP）、陈旧性心肌梗死（OMI）、稳定型心绞痛（SAP）各15例,进行sICAM-1、Cpn-IgG、Cpn-IgM检测,并以40例正常体检者作为对照。结果 CHD组sICAM-1水平高于对照组（F=20.339,q=4.033～12．612,P〈0.01）,AMI组sICAM-1水平高于UAP、OMI、SAP组（q=4.555～7.114,P〈0.01）;CHD组Cpn—IgG阳性率和浓度均高于对照组（Х^2=4．250-8．887,F=11．529,q=3.018～9.673,P〈0.01、0．05）;冠心病各组Cpn-IgG阳性率之间差异无显著性（P〉0．05）;AMI组Cpn-IgG浓度高于OMI、UAP、SAP组（q=3．794～5.518,P〈0．01、0．05）;Cpn-IgM阳性率在冠心病各组之间差异无显著性（P〉0．05）;Cpn—IgG浓度与sICAM-1之间有显著相关性（r=0．544,P〈0．01）。结论 Cpn感染可能通过引起或加重局部冠状动脉炎症反应,共同导致CHD的发生。     

冠心病患者脂蛋白(α)与D-二聚体的变化及其相关性研究

目的　观察冠心病 (CHD)患者血清脂蛋白α[Lp(α) ]与血浆D -二聚体 (DD)水平的变化特点 ,并探讨它们之间的关系。方法　对 12 4例CHD患者和 2 6例正常人采用双抗体ELISA法测定Lp(α)浓度和DD水平。结果　CHD患者中 ,急性心肌梗死 (AMI)和不稳定性心绞痛 (UAP)组患者Lp(α)浓度显著高于对照组 (P <0 .0 1) ;陈旧性心肌梗死 (OMI)和稳定性心绞痛 (SAP)组患者Lp(α)浓度亦有一定程度的升高 (P <0 .0 5 )。与对照组相比 ,AMI组患者DD水平显著升高 (P <0 .0 1) ,UAP组患者DD水平亦有所升高 (P <0 .0 5 )。组间比较发现 ,Lp(α)水平在OMI与SAP、UAP与AMI组间差异无显著性 (P >0 .0 5 ) ;DD水平在OMI与SAP组间差异无显著性 (P >0 .0 5 ) ;UAP与AMI组比较有显著差异性 (P <0 .0 5 ) ,后者高于前者 ;UAP、AMI组与SAP、OMI组比较 ,前两组患者DD水平高于后两组 (P <0 .0 5 )。12 4例CHD患者相关分析显示 :Lp(α)与DD水平呈显著正相关 (r=0 .5 79,P <0 .0 0 1)。结论　冠心病患者Lp(α)显著升高且与反映继发性纤溶增强的指标DD有密切相关关系。     

冠心病患者血清白细胞介素-18与幽门螺杆菌感染的临床意义

目的探讨冠心病(CHD)患者血清中白细胞介素-18(IL-18)水平的变化与幽门螺杆菌(Hp)感染及其临床意义。方法将经临床确诊的CHD患者60例分为稳定型心绞痛(SAP)组、不稳定型心绞痛(UAP)组、急性心肌梗死(AMI)组、陈旧性心肌梗死(OMI)组,每组15例,以20例健康查体者作为对照组。应用酶联免疫吸附法分别检测各组血清IL-18水平与幽门螺杆菌IgG抗体(Hp-IgG)阳性率。结果OMI组、UAP组和AMI组血清IL-18水平显著高于对照组(P<0.05),但SAP组与对照组比较,差别无统计学意义(P>0.05)。血清IL-18水平在SAP组、OMI组、UAP组、AMI组中依次升高,差别均有统计学意义(P<0.05);CHD组Hp-IgG阳性率显著高于对照组(P<0.05)。结论CHD患者血清IL-18水平与Hp-IgG阳性率显著升高,而且IL-18水平在一定程度上反映了病情变化,对预测冠心病的病变程度、判断预后有价值。     

冠心病病人血清VEGF水平与幽门螺杆菌感染关系

目的 探讨冠心病(CHD)病人血清中血管内皮细胞生长因子(VEGF)水平与幽门螺杆菌(Hp)感染情况的变化及其临床意义.方法 将经临床确诊的CHD病人60例分为稳定型心绞痛(SAP)组、不稳定型心绞痛(UAP)组、急性心肌梗死(AMI)组、陈旧性心肌梗死(OMI)组,每组各15例,以20例健康查体者作为对照组.应用ELISA法分别检测其血清VEGF水平和Hp-IgG表达.结果 CHD病人血清VEGF水平与Hp-IgG阳性率显著高于对照组(t＝8.030,P＜0.01;χ2＝4.310,P＜0.05),SAP、UAP、AMI与OMI组病人血清VEGF水平之间两两比较,差异有显著性(F＝65.01,q＝3.11～18.11,P＜0.05、0.01).Hp-IgG阳性者血清VEGF水平显著高于阴性者(t=9.208,P＜0.01).结论 CHD病人血清VEGF与Hp-IgG水平显著升高,且在一定程度上反映了病情的变化,联合检测VEGF和Hp-IgG对预测冠心病的病变程度、判断预后有一定的价值.     

冠心病病人血清脂联素和补体激活产物浓度的变化

目的探讨冠心病(CHD)病人血清脂联素(APN)与补体激活产物浓度的变化和意义。方法采用ELISA法检测96例CHD病人血清APN和可溶性补体激活产物(sC5b-9)的变化,其中急性心肌梗死(AMI)20例,陈旧性心肌梗死(OMI)24例,不稳定型心绞痛(UAP)28例,稳定型心绞痛(SAP)24例,并以36例健康人检测结果作为对照。结果 CHD病人血清APN浓度显著低于对照组,sC5b-9浓度明显高于对照组(t′=5.624、6.448,P<0.01);不同类型CHD病人APN和sC5b-9浓度差异有显著性(F=56.258、69.724,q=5.665～11.259,P<0.01)。有并发症的CHD病人血清APN浓度明显低于无并发症病人,sC5b-9浓度明显高于无并发症病人,差异有显著性(t′=6.934、6.455,P<0.01)。CHD病人血清APN与sC5b-9浓度呈负相关(r=-0.548,P<0.01);SAP组、UAP组和AMI组血清APN与sC5b-9浓度呈负相关(r=-0.513～-0.625,P<0.05、0.01)。结论 APN和sC5b-9参与了冠心病的发生与发展,且与病情严重程度有关。     

C反应蛋白、心肌肌钙蛋白Ⅰ、肌酸激酶及其同工酶检测在冠心病诊断中的应用

目的　探索冠心病急性心肌梗死和不稳定型心绞痛的早期实验室诊断方法。方法　分别采用免疫浊度法、酶速率法测定 60例冠心病 ( CHD)患者及 2 0例正常对照组 ( CP)的 C反应蛋白 ( CRP)、心肌肌钙蛋白 ( c Tn )、肌酸激酶 ( CK)及其同工酶 ( CK- MB)的阳性率。结果　 CHD组患者的 CRP、 c Tn 、CK- MB和 CK的阳性率均明显高于 CP组 (均为 P<0 .0 5 )。CHD组又分为 3组 ,急性心肌梗死组 ( AMI) 2 0例、不稳定型心绞痛组 ( U A) 2 0例、稳定型心绞痛组 ( SA) 2 0例。AMI组患者的 CRP、c Tn 、CK- MB和 CK阳性率明显高于 SA组 (均为 P<0 .0 1) ;UA组 CRP和 c Tn 的阳性率明显高于 SA组 (均为 P<0 .0 1) ,但两组间 CK- MB和 CK的阳性率相比无明显差异 (均为P>0 .0 5 )。结论　 CRP和 c Tn 的增高与冠心病的发生密切相关     

同型半胱氨酸与冠心病相关性的临床研究

目的:探讨血清同型半胱氨酸( HCY)水平与冠心病( CHD)的关系。方法:采用荧光偏振免疫分析法( FPIA)对1 5 3例行冠状动脉造影患者测定HCY水平。冠脉造影显示3支冠脉中至少1支血管病变狭窄≥5 0 %者为CHD组( 1 0 5例) ,3支血管中任一血管狭窄程度均<5 0 %者为对照组( 4 8例)。CHD患者进一步分为1支病变组( 2 5例) ,2支病变组( 31例)及3支病变组( 4 9例)。结果:1 CHD组血清HCY水平明显高于对照组( P<0 .0 0 1 ) ,且CHD组中高HCY血症发生率明显高于对照组( P<0 .0 0 1 ) ;2 0、1、2、3支血管病变者血清HCY浓度呈逐级增高趋势,0支病变组与其它各病变组间比较均相差非常显著( P<0 .0 0 1 ) ,1支、2支、3支病变组间差异无统计学意义;3不同临床类型患者,HCY水平急性心肌梗死( AMI) >陈旧性心肌梗死( OMI) >不稳定型心绞痛( UAP) >稳定型心绞痛( SAP)>其它( Other) ,其中AMI组与UAP组相比较差异显著( P<0 .0 1 )、AMI与SAP组、AMI与Other组间比较均有显著性显著( P<0 .0 0 1 )。结论:CHD患者血清HCY水平明显增高,高HCY血症所占比例较大,且血清HCY浓度随冠脉病变程度加重呈上升趋势,CHD活动性病变较稳定性病变HCY浓度增高,提示HCY与冠状动脉病变的发生发展可能有直接关系,是CHD可能的危险因素     

冠心病病人血清VEGF与IL-18变化及临床意义

目的 探讨冠心病（CHD）病人血清中血管内皮细胞生长因子（VEGF）和白细胞介素-18（IL-18）水平的变化及其临床意义。方法 将经临床确诊的CHD病人60例分为稳定型心绞痛（SAP）组、不稳定型心绞痛（UAP）组、急性心肌梗死（AMI）组、陈旧性心肌梗死（OMI）组,每组各15例,以20例健康查体者作为对照组。应用ELISA法分别检测其血清VEGF和IL-18水平。结果 CHD病人血清VEGF与IL-18水平显著高于对照组（t=9．094、6．638,P〈0．01）;SAP、UAP、AMI与OMI四组病人之间两两比较,差异有显著意义（F=65．01、30．17,q=3．11～18．11,P〈0．05、0．01）;SAP与OMI两组病人血清IL-18水平比较,差异无显著意义（q=1．43,P〉0．05）。CHD病人血清VEGF与IL-18水平具有相关性（r=0．53,P〈0．01）。结论 CHD病人血清VEGF与IL-18水平显著升高且两者具有相关性,提示两者在冠心病的病程进展中可能存在一定的相互作用。     

常用急性心肌梗死诊断标志物临床应用价值比较

①目的　比较几种常用的急性心肌梗死 (AMI)诊断标志物的临床应用价值。②方法　检测 46例AMI病人及 62例心绞痛 (AP)病人血清中的心肌肌钙蛋白Ⅰ (cTnⅠ )、肌红蛋白 (Mb)、肌酸激酶 (CK)、肌酸激酶同工酶 (CK MB)含量 ,并进行对比分析。③结果　AMI组cTnⅠ、Mb、CK、CK MB各指标阳性率分别为 93 .48%、97.83 %、65 .2 2 %、76 .0 9% ;AP组各指标阳性率分别为 1 .68%、48.39%、32 .2 6 %、1 4 .52 %。Mb与cTnⅠ对AMI诊断灵敏度差异无显著性 (χ2 =0 .345 ,P >0 .0 5) ;两者高于CK、CK MB对AMI诊断灵敏度 (χ2 =4.1 2 8～ 9.552 ,P <0 .0 1、0 .0 5)。cTnⅠ与CK MB对AMI诊断特异度分别为 90 .32 %、85 .48% ,两者比较差异无显著意义 (χ2 =0 .683 ,P >0 .0 5) ;两者高于Mb与CK对AMI诊断特异度 (χ2 =9.538～ 2 2 .545 ,P <0 .0 1 )。④结论　cTnⅠ是诊断AMI较好指标     

冠心病病人血浆细胞黏附分子-1水平的变化

目的观察冠心病（CHD）病人血浆细胞间黏附分子1水平的变化，并探讨其与冠心病活动性之间的关系。方法采用酶联免疫吸附（ELISA）法，检测了60例CHI）病人血浆可溶性细胞间黏附分子-1（sICAM-1）的水平，并与健康对照组进行比较。结果CHD病人血浆sICAM-1水平高于对照组（t=7．136，P〈0．01）；且急性心肌梗死（AMI）病人显著高于陈旧性心肌梗死病人及稳定型心绞痛（SA）病人（t=4．329、5．635，P〈0．01），不稳定型心绞痛（UAP）病人高于SA病人（t=3．666，P〈0．01）。结论CHD病人sICAM-1水平明显高于正常对照组，且在一定程度上反映了病情的严重程度。     

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.