妊娠早期膳食铁营养指导对妊娠中晚期孕妇血红蛋白含量的影响

目的 分析妊娠早期实施膳食铁营养指导对妊娠中晚期孕妇血红蛋白含量的影响.方法 选取来我院治疗的妊娠早期孕妇162例,随机均分为对照组(常规教育)和观察组(膳食铁营养指导),2组均包含81例孕妇,在干预前(妊娠早期)和妊娠中、晚期(孕24,34周)分别测定2组孕妇的血红蛋白含量.结果 ①观察组孕妇妊娠中、晚期膳食铁摄入量依次为(25.04±0.81)mg/d、(34.97±0.54)mg/d,对照组依次为(21.09±1.23)mg/d、(28.95±2.55)mg/d,2组对比差异均显著(P<0.05).②观察组孕妇妊娠中、 晚期血红蛋白含量依次为(114.27±9.75)g/L、(112.71±9.11)g/L,对照组依次为(102.91±10.21)g/L、(99.05±8.29)g/L,2组对比差异均显著(P<0.05).结论 对妊娠早期孕妇给予膳食铁营养指导,可以提高妊娠中晚期膳食铁的摄入量,进而提高体内的血红蛋白含量,有助于保障母婴的健康水平.     

283例孕产妇血清碱性磷酸酶结果分析

目的 :观察妊娠期血清碱性磷酸酶 (AKP)值的变化情况。方法 :用日立 70 2 0型全自动生化分析仪采用AKP试剂盒检测 2 83例妊娠妇女血清AKP值 (实验组 )及 76名育龄非孕健康妇女血清AKP值 (对照组 )。结果 :对照组血清AKP值为 (6 5 .13± 2 1.2 8)U/L ,早期妊娠时血清AKP值为 (4 3.82± 13.13)U/L ,较对照组明显降低P <0 .0 0 1,中期妊娠时血清AKP值为 (6 4 .18± 2 0 .2 4 )U/L ,与对照组相比差异无显著性P >0 .0 5。晚期妊娠时血清AKP值为 (12 3± 6 5 .78)U/L。与对照组相比显著升高P <0 .0 0 1。妊高征患者血清AKP值 :(2 4 7.87± 4 5 .2 3)U/L ,较晚孕组显著升高P <0 .0 0 1。过期妊娠患者血清AKP值 :(4 2± 6 .38)U/L ,较晚孕组显著降低P <0 .0 0 1。结论 :正常妊娠时 ,孕妇体内AKP值在早孕时轻度降低 ;中孕时变化不明显 ;晚孕时明显升高。妊高征时AKP值显著升高 ,过期妊娠时明显下降     

孕妇与新生儿脐血SF、RDW测定结果分析

目的 :探讨妊娠晚期及分娩时孕妇、新生儿脐血血清铁蛋白 (SF)含量、红细胞体积分布宽度 (RDW ) ,以了解母体内铁的贮存量 ,并与新生儿脐血的两项测定值进行比较。方法 :使用全自动酶标分析仪、SF— 3 0 0 0型血液分析仪测定 10 5例晚期妊娠孕妇静脉血和脐血的SF含量、RDW值。结果 :正常对照组SF为 12 5 8± 66.7μg/L ,孕妇分娩时SF为 15 9± 5 .5 μg/L ,脐血SF为 162 4± 75 .6μg/L ;前两者比较有显著差异 (P <0 .0 0 1) ,后两者比较亦有显著差异 (P <0 .0 0 1) ,对照组与脐血SF含量比较有差异 (P <0 .0 5 ) ;孕妇分娩时RDW值为 2 9 8± 5 .9( % ) ,脐血RDW值为 14 2± 3 9( % ) ,两者比较有显著差异 (P <0 .0 0 1)。结论 :SF、RDW测定简便易行 ,可早期了解孕妇体内铁的贮存情况 ,为了保证孕妇和新生儿铁的贮备 ,孕妇在妊娠早期应多食用含铁丰富的食物或适当补充铁剂 ,以纠正妊娠晚期孕妇出现的缺铁。     

胸腹水中唾液酸含量在鉴别良恶性疾病上的价值

本文测定恶性、炎性和肝硬化3组胸腹水中的总唾液酸(TotalSialic Acid TSA)和脂质结合唾液酸(Lipid-bound Sialic Acid LSA)含量,结果表明恶性组和炎性组的 TSA 和 LSA 明显高于肝硬化组,但恶性组和炎性组的 TSA 和 LSA 则无明显差异。恶性、炎性和肝硬化组的 TSA 值分别为499.52±183.98mg/L、508.68±208.79mg/L 和117.71±70.46mg/L;LSA则分别为146.28±103.62mg/L、115.26±72.13mg/L 和58.90±35.46mg/L。以肝硬化组的 TSA+2SD 作为恶性组和肝硬化组的鉴别值,其敏感性为88%,特异性为90.47%,有效性为89.13%。LSA 则无鉴别价值。     

肿瘤患者血清中总唾液酸、脂质结合唾液酸和前清蛋白的水平

测定了106例健康成人,222例各种原发部位不同的肿瘤患者和83例非肿瘤患者血清脂质结合唾液酸(LBSA)、总唾液酸(TSA)和前清蛋白(PA)的含量。LBSA、TSA和PA的正常值分别为158.6±29.8mg/L、574.4±77.4mg/L和321.8±42.6mg/L。各种肿瘤患者的含量与正常值相比均有明显差异,但阳性率不同,白血病最高,卵巢癌次之,其他依次为肺癌、结直肠癌、乳腺癌、食道癌和胃癌。与治疗前相比,治疗后LBSA和TSA均见降低,PA升高。LBSA和TSA在鉴别良恶性疾病和监护治疗效果方面有一定价值。     

妊娠高血压综合征患者血清及尿β_2—微球蛋白测定的意义

研究目的探讨β_2—微球蛋白与妊娠高血压综合征临床意义研究设计病例对照研究研究对象 36例妊娠高血压综合征患者,孕周28～40周,年龄22～30岁;对照组为40例正常晚期妊娠孕妇。处理方法妊娠高血压综合征患者及正常孕妇血清和尿,用放射免疫分析法测定β_2—微球蛋白水平。同时测血尿素氮(BUN)以对照,测定结果进行t检验。测定结果 36例妊娠高血压综合征患者及40例正常晚期妊娠孕妇血清β_2—微球蛋白测定值分别为4.98±1.50mg/L和2.57±1.43mg/L(p<0.01,t检验)。29例妊娠高血压综合征患者及23例正常孕妇尿β_2—微球蛋白水平分别为1.03±0.91mg/L和0.55±0.40mg/L(P<0.05)。33例妊娠高血压综合征患者及25例正常孕妇,血尿素氮(BUN)测定值分别为6.16±4.17mmol/L和6.173±3.84mmol/L(P>0.05)。结论妊娠高血压综合征患者血清及尿β_2—微球蛋白水平均明显高于正常晚期妊娠孕妇,血清及尿β_2—微球蛋白测定是监测妊娠高血压综合征患者肾功能受损较敏感的方法。     

妊娠肝内胆汁淤积症对产妇肝功能和围产儿的影响

目的　探讨妊娠肝内胆汁淤积症 (ICP)患者高水平胆汁酸对肝功能及围产儿的影响。　方法　 ICP患者 2 1例 (ICP组 ) ,随机选择正常住院孕妇 2 4例 (对照组 ) ,分别测定肝功能并对相关临床资料进行比较分析。　结果　 ICP组血清总胆汁酸 (72 .3± 5 8.5 ) μm ol/ L,血清总胆红素 (32 .0± 4 5 .9) μm ol/ L,血清直接胆红素 (1 8.1±31 .5 ) μm ol/ L,丙氨酸氨基转移酶 (AL T) (1 5 8.5± 1 4 1 .4 ) IU/ L 和天门冬氨酸氨基转移酶 (1 2 9.2± 1 0 3.7) IU/ L,对照组分别为 1 0 .8± 4 .0 ,8.3± 3.1 ,1 .8± 1 .8,1 3.8± 5 .6和 2 2 .8± 6 .3(P<0 .0 0 1或 P<0 .0 5 ) ,而血清碱性磷酸酶在两组间差异无显著性 (P>0 .0 5 ) ;ICP组患者早产、异常产、羊水粪染、胎儿窘迫及新生儿不良结局发生率均明显高于对照组 (P<0 .0 0 1、P<0 .0 1或 P<0 .0 5 )。　结论　 ICP患者血清中高水平胆汁酸对围产儿造成严重不良影响并引起孕妇肝功能损害     

正常妊娠中胆固醇酯转运蛋白水平的研究

目的 :研究正常妊娠者血清胆固醇酯转运蛋白 (CETP)水平特征。　方法 :采用”Sandwich”酶免疫法测定 2 96例正常妊娠者血清CETP ,同时测定血脂和雌激素水平 ,并以年龄匹配的 92例正常非孕女性为对照。　结果 :早孕组 (孕 7～ 2 0周 )CETP浓度为 (3.79± 1.33)mg/L ,明显高于对照组 (2 .6 4± 1.2 5 )mg/L ,P <0 .0 0 0 1,同时也高于孕中期 (孕 2 1～ 2 8周 ) [(2 .84± 1.5 0 )mg/L ,P <0 .0 0 0 5 ]和孕晚期组 (孕 2 9- 4 0周 ) [(2 .79± 1.6 4 )mg/L ,P <0 .0 0 0 1];孕中、晚期组CETP水平与对照组相比有增加 ,但无明显差异。另外 ,三酰甘油、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B随着妊娠周期的增加而逐渐增高 ,高密度脂蛋白胆固醇和载脂蛋白AI则在孕中期达到最大值。　结论 :妊娠期间激素 /血脂水平的变化以及与卵巢中一些因子协同作用而影响CETP水平     

妊娠妇女血清总胆汁酸检测的临床意义

目的探讨孕妇血清总胆汁酸(TBA)在妊娠过程中的变化。方法用酶法定量检测正常孕妇200例(研究组)与健康非妊娠妇女30例(对照组)血清中TBA浓度。结果对照组和妊娠早期组、后期组血清TBA值分别为1.1±0.8μmol/L和2.4±1.4μmol/L、5.6±4.4μmol/L;妊娠早期和晚期孕妇血清中TBA水平都比非妊娠组升高(P<0.01),而且妊娠晚期组比早期组孕妇血清中TBA水平也有明显升高(P<0.01)。结论血清TBA在妊娠过程中持续升高,孕妇在妊娠时就有潜在发生妊娠性肝内胆汁瘀积症(ICP)的危险。     

妊娠高血压综合征患者血清β绒毛膜促性腺激素与胎盘催乳素水平测定及其临床意义

用放射免疫分析法(RIA)测定156例妊高征患者(其中轻度71例,中度33例,重度52例)及220名同期正常晚期单胎妊娠孕妇的血清β-hCG、HPL.结果(1)轻、中、重度妊高征患者血清β-hCG分别为14.29±6.25μg/L、18.07±12.44μg/L、21.59±13.67μg/L;正常晚期妊娠组为12.89±5.97μg/L,妊高征组与正常晚期妊娠组比较,差异有高度显著性(P＜0.01);轻、中、重度妊高征妇女血清HPL分别为4.58±1.01μg/L、4.33±1.21μg/L、4 29±0.93μg/L;正常晚期妊娠组为4.29±0.84μg/L,妊高征组与正常晚期妊娠组比较,差异无显著性(P＞0.05).结果表明,妊高征患者血清β-hCG水平显著升高,且随妊高征病情程度加重而升高;β-hCG可作为妊高征病情的监测指标之一,HPL水平的变化不能作为妊高征的检测指标.     

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.