不同海拔地区正常人群血清氧化应激反应相关指标含量变化

目的探讨不同海拔地区正常人群血清氧化应激反应相关指标含量变化。方法采用比色法检测不同海拔地区(高海拔组、中度海拔组、平原组)血清丙二醛、羟自由基、总抗氧化能力、超氧化物歧化酶、还原型谷胱甘肽、氧化型谷胱甘肽的含量。结果高海拔组和中度海拔组血清MDA含量都明显高于平原组;高海拔组血清OH含量明显高于中度海拔组及平原组;平原组血清AOC含量明显高于中度海拔组及高海拔组;平原组血清SOD含量明显高于中度海拔组及高海拔组,中度海拔组血清SOD含量明显高于高海拔组;平原组血清GSH/GSSG明显高于中度海拔组及高海拔组。结论随着海拔的升高,正常人群氧化应激反应升高,抗氧化能力下降。     

高海拔地区健康青年官兵心电图ST-T段改变的分析

目的了解驻守高海拔地区健康青年官兵心电图ST-T段的改变。方法根据受检人员驻守地海拔,将其分为高原组(n=202,海拔3 750～5 380m)及平原组(n=98,海拔1 400m)。对其进行心电图检测,受检者接受12个导联(Ⅰ、Ⅱ、Ⅲ、aVR、aVL、aVF、V1、V2、V3、V4、V5、V6)心电图描记及分析测量。结果驻守高海拔地区健康青年官兵的心电图改变与驻守平原地区官兵的心电图比较,差异有统计学意义(P<0.01)。aVR波中以主波向上且R波为主波的占21.78%,R波最高达0.81mV,Q波最深达0.89mV。结论对ST-T段改变的诊断应持慎重态度,应结合临床综合判断。     

高原低氧对大鼠血液HIF-1α含量和组织器官COX表达的影响

目的 探讨慢性低氧对大鼠血清中HIF-1α含量和组织器官COX表达的影响.方法 Wistar大鼠110只由兰州运至西宁市(海拔2200m)后随机分为:对照组(n=50,立即采集外周血分离血清,收集各脏器标本,深低温冻存);高原组[n=60,将大鼠运至青海果洛州花石峡镇(海拔4300m)饲养30天造模,采集外周血并分离血...     

兰州MODS评分诊断标准对高海拔地区MODS结局的预测分析

目的:比较高海拔地区3个诊断评分标准对多器官功能障碍综合征(MODS)结局预测的准确性.方法:分别用平原地区评分诊断标准(庐山会议评分分级标准和Marshall评分系统)以及高原MODS评分系统(兰州标准),对海拔1600～3200 m的40例MODS的相关参数值绘制受试者工作特征曲线(ROC曲线),验证3个标准在不同海拔高度预测ARDS/MODS结局的准确性.结果:兰州标准检验高海拔MODS总分的ROC曲线下面积、预测结局的灵敏度、特异度,明显优于庐山和Marshall评分系统.结论:兰州标准适合于对高海拔地区MODS的病情评估.     

平原移居者与高原世居者低氧适应的差异及平原移居者习服现象的分析

目的:探讨不同海拔地区居民在低氧适应的生理与生化方面的差异,以及平原移居高原的习服现象。方法:选取高原世居大学生40名(男、女各20名)作为对照组,平原大学生40名(男、女各20名)作为实验组进行参数指标对比,分析两组大学生之间低氧适应的差异性;选取平原大学生移居两年前后对比分析平原移居大学生的习服现象。结果:初入高原的平原大学生的红细胞(RBC)、血红蛋白(Hb)、红细胞比容(Hct)、血小板(PLT)、血氧饱和度(SaO2)明显低于高原组(P<0.05),心肌肌酸激酶(CK)明显高于高原组(P<0.05);2013年组大学生的RBC、Hb、Hct和SaO2明显高于2011年组(P<0.05);CK明显低于2011年组(P<0.05)。结论:两年后平原大学生获得了良好的习服。     

高海拔地区健康军人唾液指标测定

目的探讨高海拔地区健康军人唾液指标正常参考范围。方法受试者按海拔高度分为3 700m组（n=49）、4 300m组（n=57）、4 500m组（n=36）、5 300m组（n=21）及平原对照组（1 400m组,n=20）,采集其唾液标本,应用高效液相色谱分析法测定唾液多项生化指标。结果随海拔高度增加,各项指标水平有不同程度增高;与平原对照组比较,除Mg2＋、K＋以外,5 300m组各项指标均显著增高,差异有统计学意义（P〈0.01或P〈0.05）。结论初步确定了不同海拔地区唾液指标正常参考范围,为高原地区兵员作训标准的制定提供了参考。     

异叶青兰对高原低氧肝损伤的保护作用

本文选用西安出生（海拔397米）纯种日本大耳白兔随机分为平原组、高原组和高原服药组，移居高原（海拔3900米）同时服用异叶青兰后，应用体视学方法测算出动物肝细胞线粒体各密度参数。结果发现：高原服药组肝细胞线粒体数密度明显增加高于高原组，差异显著（P＜0．01），线粒体体积密度明显下降低于高原组（P＜0．05），线粒体平均体积也小于高原组。因此，认为异叶青兰对低氧肝损伤具有一定的保护作用。     

高原和平原原发性肾病综合征患者凝血功能指标的对比分析

目的 探讨高原和平原原发性肾病综合征(nephrotie syndrome,NS)患者凝血功能指标的差异,为高原NS患者的诊治提供参考依据.方法 以健康体检者为正常对照组(n=30),同期检测两藏军区总医院(高原组,n=30)和第三军医大学新桥医院肾内科(平原组,n=30) Ns患者凝血酶原(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、D-二聚体(D-Dimer)和血浆抗凝血酶Ⅲ(AT-Ⅲ)活性等指标,并对各组凝血抗凝指标的检验结果进行对比分析.结果 与对照组相比,两组NS患者的PT、APTT均无显著差异(P>0.05),但Fib和D-D显著增高(P<0.01),AT-Ⅲ活性显著降低(P<0.01).两组Ns患者问相比,高原Ns患者的Fib和D-D均显著高于平原Ns组(P<0.01),而AT-Ⅲ活性明显低于平原NS组(P<0.01).结论 高原NS患者凝血活性较平原NS患者强,提示高原NS患者更需抗凝治疗.     

武警新兵腺病毒肺炎在不同海拔地区的临床特征

[目的]总结描述腺病毒在不同海拔地区的致病特点.[方法]本研究搜集武警新兵在不同海拔地区患腺病毒肺炎后的临床资料,按照海拔不同分为平原组(n=221)和高原组(n=109),从两组患者的一般临床情况、症状和体征、实验室检查、影像学特征、临床结局等方面进行总结和回顾性分析研究.[结果]两组患者腺病毒分型均为B55型,平原...     

高海拔地区内毒素致绵羊多脏器功能障碍综合征的病理学改变

目的研究高海拔地区内毒素致绵羊多脏器功能障碍综合征(MODS)的病理学变化特征。方法将16只绵羊随机分为2组,中度海拔组和高海拔组,按相同的剂量静脉给予内毒素(6μg/kg)制作MODS模型,24h后麻醉处死绵羊,观察主要脏器的病理学变化。结果中度海拔和高海拔MODS组绵羊肺脏、肝脏、脾脏、肠粘膜均出现明显炎性改变,高海拔MODS组绵羊肺脏、肝脏病理学评分明显高于中度海拔MODS组。结论高海拔地区MODS的病理损伤较中度海拔明显加重。     

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.