右美托咪定与艾司洛尔对鼻内镜手术患者控制性降压的对比研究

目的比较右美托咪定与艾司洛尔在鼻内镜手术患者控制性降压中的应用效果。方法选择择期全麻下行鼻内镜手术患者60例,随机均分为两组,采用右美托咪定（D组）、艾司洛尔（E组）行控制性降压。桡动脉穿刺置管监测有创动脉压,维持平均动脉压（MAP）在55~65 mmHg。记录入室麻醉前（t0）、麻醉后5 min（t1）、术中30 min（t2）、术中60 min（t3）、停止降压后5 min（t4）、恢复室拔管后5 min（t5）6个时点的HR、MAP。记录降压达标时间、降压持续时间、丙泊酚诱导用量、芬太尼用量、出血量、手术时间、拔管时间,对术野质量和苏醒期清醒镇静程度进行评定,观察有无副作用,并于术前、降压后45 min和手术结束即刻抽桡动脉血行血气分析。结果在手术时间、降压达标时间、降压持续时间、出血量、术野质量、血气分析中,两组比较差异无统计学意义（P〉0.05）,两组患者术中MAP均能维持在目标范围。与E组比较,D组HR、MAP在t0、t1、t2、t3的差异无统计学意义,t4、t5时点降低（P〈0.05）。与E组比较,D组患者丙泊酚诱导用量、芬太尼用量减少（P〈0.05）,拔管时间、疼痛耐受时间延长（P〈0.05）,苏醒期清醒镇静程度评分更高（P〈0.05）。结论右美托咪定和艾司洛尔均可安全用于鼻内镜手术患者控制性降压,但右美托咪定在镇痛、镇静和节省麻醉药方面更有优势。     

右美托咪定在老年合并高血压患者行白内障超声乳化术中的应用

目的 观察右美托咪定在老年合并高血压患者行白内障超声乳化术中镇静、镇痛及稳定循环的效果.方法 择期行白内障超声乳化术合并高血压老年患者68例（68眼）,按照随机数字表法分为右美托咪定组（D组）,生理盐水组（C组）,每组34例.D组于手术开始前15 min持续泵注右美托咪定负荷剂量0.6～0.8μg/kg,10 min泵完,后以0.3～0.4.μg/（kg·h）维持至手术结束.C组泵注等量生理盐水.观察并记录两组患者术前（T0）、术始（T1）、术中10 min（T2）、术中20 min（T3）、术毕（T4）的平均动脉压（MAP）、心率（HR）、疼痛（VAS）和镇静（Ramsay）评分及血管活性药物使用情况.结果 与C组比较,D组T1～T4时MAP明显降低（P＜0.05）,HR明显减慢（P＜0.05）.与To时比较,D组T1～T4时MAP降低,HR减慢（P＜0.05）,但均在正常范围内,不需作特殊处理;而C组MAP明显升高（P＜0.05）,HR明显增快（P＜0.05）,6例使用降压药物进行降压,8例使用药物控制心率.与C组比较,D组在T1～T3时点镇静评分高于C组（P＜0.05）,T1～T4疼痛评分则低于C组（P＜0.05）.结论 在老年合并高血压患者行白内障超声乳化术中应用右美托咪定,能够较好的优化血流动力学参数而稳定循环,并能较好的满足术中的镇静、镇痛要求,值得推广应用.     

右美托咪定对脑肿瘤手术患者的麻醉效果分析*

目的?比较右美托咪定与丙泊酚复合麻醉对脑肿瘤手术患者的麻醉效果、血流动力学及脑保护作用。方法?选取2018年2月—2020年2月在新疆医科大学附属肿瘤医院择期行脑肿瘤手术的62例患者。其中,神经胶质瘤37例,脑膜瘤25例。采用随机数字表法分为右美托咪定组和丙泊酚组,每组31例。监测患者麻醉诱导开始前（T0）、术中切开硬脑膜时（T1）、完全去除肿瘤时（T2）、手术结束时（T3）及手术结束后24?h（T4）的心率（HR）、平均动脉压（MAP）、中心静脉氧饱和度（ScVO2）、颈内静脉氧饱和度（SjVO2）及神经元特异性烯醇化酶（NSE）、S100β蛋白水平,记录患者苏醒时间、拔管时间、拔管后警觉/镇静（OAA/S）评分及术后不良反应发生情况。结果?HR、MAP在不同时间、不同组间及变化趋势上有差异（P?<0.05）。ScVO2、SjVO2和NSE、S100β蛋白水平在不同时间、不同组间及变化趋势上有差异（P?<0.05）。右美托咪定组苏醒时间、拔管时间低于丙泊酚复合麻醉组（P?<0.05）,而OAA/S评分高于丙泊酚复合麻醉组（P?<0.05）。两组不良反应发生率比较,差异无统计学意义（P?>0.05）。结论?右美托咪定较丙泊酚复合麻醉对脑肿瘤手术患者具有更好的麻醉镇静效果,有利于血流动力学稳定和脑代谢,有效保护患者脑组织,安全性较高,具有重要的临床应用价值。     

右美托咪定在妇科腹腔镜手术中对术中知晓的影响

目的观察右美托咪定在妇科腹腔镜手术中对患者术中知晓发生率的影响。方法选择600例择期全麻下行腹腔镜手术患者,随机分为右美托咪定组(D组)和对照组(C组)。D组诱导前静脉泵注右美托咪定0.8μg/kg;C组给予等量生理盐水。记录给药前(T1)、麻醉诱导前(T2)、拔管后即刻(T3)的BIS值、OAA/S评分、MAP、HR变化,记录丙泊酚和瑞芬太尼用量、麻醉恢复情况,随访术中知晓情况。结果 D组T2时间点的BIS值、MAP、HR、OAA/S评分显著低于T1时和C组(P<0.05);T3时间点C组MAP明显升高,HR明显增快,D组无明显变化。D组丙泊酚和瑞芬太尼用量少于C组。D组术中知晓发生率低于C组。各组呼吸恢复时间、睁眼时间、拔管时间差异无统计学意义(P>0.05)。结论右美托咪定能提供较为稳定的镇静状态,减少术中知晓的发生,降低全麻药物用量,且不延长麻醉恢复时间。     

不同剂量右美托咪定对鼻窦手术患者应激反应和苏醒质量的影响

目的 探讨不同剂量右美托咪定复合丙泊酚-瑞芬太尼持续静脉泵注对功能性鼻内镜鼻窦手术(FESS)患者围手术期的血流动力学、应激反应及苏醒质量的影响.方法 选择行择期FESS患者80例,随机分为4组(n=20):生理盐水组(C组)、右美托咪定0.3μg/(kg·h)组(D1组)、右美托咪定0.5μg/(kg·h)组(D2组)、右美托咪定0.7μg/(kg·h)组(D3组).D1、D2、D3组分别在麻醉诱导前10 min静脉输注负荷量右美托咪定0.6μg/kg(以生理盐水稀释成4μg/mL,10 min完成),术中给予维持剂量右美托咪定分别为0.3μg/(kg·h)、0.5μg/(kg·h)及0.7μg/(kg·h)至手术结束前10 min,C组以同样方式静脉输注生理盐水.记录麻醉诱导前(T0)、气管插管后1 min(T1)、手术开始(T2)、拔管前(T3)、拔管后10 min(T4)各时点的HR、MAP.检测术中T0、T1、T4时点血浆皮质醇(COR)、肾上腺素(ADR)水平.观察并记录患者呼叫睁眼时间、自主呼吸恢复时间、拔管时间以及术后发生心动过缓、高血压等不良反应情况,并进行镇静-躁动SAS评分和Ramsay镇静评分.结果(1)与T0比较,T1、T2时C组HR、MAP明显升高(P<0.05).D1、D2、D3组HR、MAP明显低于C组(P<0.05).T4时C组HR、MAP较T0时明显升高(P<0.05),D1、D2、D3组均低于C组(P<0.05),D3组HR低于D1、D2组(P<0.05).(2)T1、T4时,C组COR、ADR较T0时明显升高(P<0.05),且D1、D2和D3组COR、ADR低于C组(P<0.05),T4时点,C和D1组COR浓度高于D2组和D3组(P<0.05).(3)D1、D2、D3组患者呼叫睁眼、自主呼吸恢复及拔管时间与C组比较差异无统计学意义(P>0.05).在T4时点,C组SAS评分明显高于D1、D2、D3组(P<0.05).D1、D2、D3组患者Ramsay镇静评分显著高于C组(P<0.05).结论 右美托咪定复合丙泊酚-瑞芬太尼持续输注用于FESS,患者围手术期的血流动力学更稳定,能降低围术期的应激反应,提高麻醉苏醒质量, 0.5 μg/( kg· h)右美托咪定是FESS患者较合适的临床应用剂量.     

不同剂量右美托咪定在鼻内镜手术中实施监护麻醉的效果观察

目的 观察不同剂量右美托咪定在局部麻醉鼻内镜手术中实施麻醉监护的效果.方法 择期拟在局部麻醉下行鼻内镜手术的患者60例,按照不同剂量的右美托咪定分为A组及B组,各30例.A组于手术开始前10min以负荷量1 μg/kg静脉泵注右美托咪定10min,之后以维持量0.3μg·kg-1·h-1恒速输注,手术结束停止输注.B组手术开始前10 min以0.6 μg·kg-1·h-1恒速输注右美托咪定,手术结束停止输注.观察入室后（T0）、手术开始时（T1）、开始后10 min（T2）、开始后30min（T3）、开始后50min（T4）的平均动脉压（MAP）和心率（HR）.记录手术时间.由同一手术医生于T1、T2、T3、T4时点按Fromme评分法（SSFQ评分）进行术野质量评分.结果 A组T1时点的MAP高于T0时点及B组（均P＜0.05）,A组T2、T3、T4时点的MAP均较T0、T1时点低（均P＜0.05）,且明显低于B组（均P＜ 0.05）,B组仅T4时点的MAP较T0时点低（均P＜0.05）;A组T2、T3、T4时点的HR均低于T0、T1时点（均P＜0.05）,B组T3、T4时点的HR低于T0时点（均P＜0.05）,A组HR术中均明显低于B组（均P＜ 0.05）.A组患者T2、T3、T4时点的SSFQ均明显低于T1时点及B组（均P＜0.05）;B组患者T3、T4时点的SSFQ低于T1、T2时点（均P＜0.05）.A组手术时间明显短于B组（P＜0.05）.结论 负荷剂量右美托咪定在局部麻醉鼻内镜手术中实施麻醉监护可降低血压,为手术创造良好的手术视野,减少手术时间,安全可行.     

盐酸右美托咪定在鼻内镜手术局麻中的辅助作用

目的：研究盐酸右美托咪定在局麻鼻内镜手术的辅助作用。方法：60例择期鼻内镜手术患者,美国麻醉医师协会Ⅰ、Ⅱ级,随机分为右美托咪定组（D组,n=30）和对照组（C组,n=30）,D组患者术前先经输液泵缓慢静脉注射右美托咪定0.5 μg/kg 负荷剂量,10 min泵完,然后以0.5 μg/（kg·h）速率持续泵注至术毕。C组持续泵注相同容量的生理盐水至术毕。2组患者均在局麻下完成鼻内窥镜手术。记录2组患者麻醉前（T0）、手术开始（T1）、手术30 min（T2） 及术毕（T3）平均动脉压（mean arte－rial pressure,MAP）、心率（heart rate,HR）、脉搏血氧饱和度（saturation of pulse oxygen,SPO2）、呼吸频率（respiratory rate,RR）、镇痛镇静评分及不良反应。结果：在T1、T2、T3时点,D组HR、MAP、RR、疼痛视觉模拟评分均低于C组,而镇静Ramsay评分高于C组,具有统计学差异（P＜0.01）,各个时点D组与C组SPO2均未见统计学差异（P ＞0.05）。与C组相比,D组患者麻醉手术中恶心、呕吐、呼吸抑制等不良反应发生率未见统计学差异（P ＞0.05）。结论：静脉应用小剂量右美托咪定可以减轻局麻鼻内镜手术患者术中疼痛,有效减少血流动力学波动,并提供一定的镇静效果,且对呼吸不产生抑制,值得临床推广应用。     

小剂量右美托咪定静脉泵注联合丙泊酚在宫腔镜手术麻醉中的应用效果分析

目的：探讨小剂量右美托咪定静脉泵注联合丙泊酚在宫腔镜手术麻醉中的应用效果。方法：选取2020年1月—2021年12月于广饶县人民医院行宫腔镜手术治疗的406例患者作为研究对象，根据随机数字表法分为观察组与对照组，各203例。对照组采用常规剂量右美托咪定静脉泵注联合丙泊酚麻醉，观察组采用小剂量右美托咪定静脉泵注联合丙泊酚麻醉。比较两组患者血流动力学、疼痛程度、镇静评分、清醒时间、不良反应发生情况。结果：麻醉15 min后，两组平均动脉压（MAP）、心率（HR）低于麻醉前，差异有统计学意义（P<0.05）；观察组MAP、HR高于对照组，差异有统计学意义（P<0.05）。观察组术后疼痛评分、镇静评分低于对照组，清醒时间短于对照组，差异有统计学意义（P=0.000）。观察组不良反应发生率低于对照组，差异有统计学意义（P=0.001）。结论：小剂量右美托咪定静脉泵注联合丙泊酚应用于宫腔镜手术麻醉中，能够缓解患者术后疼痛感，缩短清醒时间，减轻对患者MAP、HR的影响，促进患者术后意识恢复，降低不良反应发生率。     

右美托咪定在腹腔镜下保胆手术中的应用

目的 观察右美托咪定在腹腔镜下保胆手术中控制性降压作用的应用效果和安全。方法选取90例行择期腹腔镜下保胆取石术患者，随机分为右美托咪定1组(E1组)、右美托咪定2组（E2组）、和对照组（生理盐水组），每组30例。以丙泊酚、瑞芬太尼靶控输注和罗库溴铵静注行麻醉诱导，以丙泊酚、瑞芬太尼靶控输注麻醉中维持。3组患者麻醉诱导前10min分别给予右美托咪定1.0、0.5μg/kg和同等剂量的生理盐水，维持MAP为（65±5）mmHg，如不能达到此目标，予硝酸甘油0.25mg单次静脉注射。记录患者在安静状态下（T0）、药物负荷量后(T1)、气管插管即刻(T2)、手术开始即刻(T3)、手术开始后5min(T4)、手术开始后10min(T5)、手术开始后15min(T6)、停止用药时(T7)、停药后5min（T8）、停药后10min(T9)、拔除气管导管即刻(T10)、拔除气管导管后5min（T11)时MAP、HR、BIS，记录丙泊酚、盐酸瑞芬太尼、血管活性药物用量及手术时间、麻醉苏醒时间，观察进入PACU时Ramsay镇静评分、术后VAS疼痛评分及术后恶心、呕吐等不良反应的发生情况。结果E1、E2组MAP均能维持在目标范围，对照组需静注硝酸甘油。E1、E2组麻醉药物诱导剂量明显低于对照组（P<0.05），E1、E2组差异无统计学意义（P>0.05）。3组患者麻醉清醒时间、Ramsay评分、术后VAS疼痛评分差异无统计学意义（P>0.05），对照组术后PONV发生率高于E1、E2组，但差异无统计学意义（P>0.05）。结论右美托咪定在腹腔镜下保胆手术中应用时，控制性降压作用效果确切，血液动力学稳定，临床应用安全     

右美托咪定-丙泊酚-舒芬太尼麻醉用于脊柱侧弯矫形术的临床观察

目的 观察右美托咪定辅助靶控丙泊酚-舒芬太尼麻醉用于脊柱侧弯矫形术的安全性和有效性.方法 择期行脊柱侧弯矫形术患者40例,按随机数字表法分为右美托咪定组（D组）和生理盐水组（C组）,每组20例,分别在麻醉诱导前给予0.8 μg/kg右美托咪定和等量生理盐水,10 min输完.术中D组持续泵入右美托咪定0.2μg/（kg·h）,C组输注等容量生理盐水.观察麻醉诱导前10 min（T1）、麻醉诱导后3 min（T2）、气管插管后1 min（T3）、停药（T4）、唤醒即刻（T5）、加深麻醉后6 min（T6）的收缩压（SBP）、舒张压（DBP）、心率（HR）.记录两组血液动力学、唤醒时间、唤醒成功率、唤醒期间的躁动情况及唤醒期间的出血量,记录有无术中知晓.结果 两组唤醒成功率比较差异无统计学意义（P＞0.05）,D组较C组血液动力学稳定（P＜0.05）,D组躁动的发生率及唤醒期间的出血量显著少于C组（P＜0.05）.结论 右美托咪定辅助靶控丙泊酚-舒芬太尼麻醉能有效实施术中唤醒,有助于减少唤醒期间的出血量及躁动的发生,使术中血流动力学更平稳.     

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.