上海市温度和大气污染对居民心血管疾病门急诊人数的影响

目的 探讨上海市日均温度和大气污染物对居民心血管疾病门急诊人数的影响。方法 采用广义相加Possion回归模型,在控制时间的长期趋势、节假日效应、星期效应和医保政策等混杂因素后,分析上海市2013年1月至2014年12月温度、主要大气污染物与心血管疾病门急诊人数之间的关系。结果 上海市2013年1月至2014年12月,上海市主要大气污染物PM_2.5、PM₁₀、SO₂、NO₂的日均浓度分别为56.3、76、20.6、46.7μg/m³。当平均温度低于18℃时,心血管疾病的就诊风险是平均温度高于18℃时的1.016倍(95% CI:1.013～1.018)。春夏季,PM_2.5、PM₁₀、SO₂、NO₂浓度每升高10μg/m³,居民心血管疾病门急诊人数分别增加0.502%(95% CI:0.464%～0.545%)、0.251%(95% CI:0.221%～0.282%)、2.716%(95% CI:2.558%～2.874%)、1.496%(95% CI:1.421%～1.571%);秋冬季,PM_2.5、PM₁₀、SO₂、NO₂浓度每升高10μg/m³,居民心血管疾病门急诊人数分别增加0.543%(95% CI:0.521%～0.570%)、0.568%(95% CI:0.548%～0.587%)、1.607%(95% CI:1.528%～1.685%)、1.923%(95% CI:1.868%～1.978%)。结论 上海市居民心血管内科门急诊人数与日平均温度呈非线性负相关,在控制温度等混杂因素后,与大气污染物浓度呈正相关。     

PM2.5对人皮肤成纤维细胞分泌IL-6、TGF-β1的影响

目的 探讨大气颗粒物PM_2.5对人皮肤成纤维细胞(human skin fibroblast, HSF)分泌IL-6和TGF-β1的影响及胶原多肽(collagen polypeptide, CP)的干预作用。方法 将HSF分为PM_2.5组和CP干预组。PM_2.5组用0、25、50、100、200μg/ml的PM_2.5与HSF培养48h;CP干预组用100μg/ml PM_2.5和0、15、30、60μg/ml CP与HSF共培养48h。采用ELISA方法测定细胞上清液中IL-6、TGF-β1含量。结果 随着PM_2.5浓度升高(0、25、50、100、200μg/ml),PM_2.5组细胞上清液中的IL-6含量也逐渐升高,TGF-β1含量则逐渐下降,两者都存在一定的剂量-效应关系,各炎性因子浓度差异有统计学意义(P<0.05);在PM_2.5浓度为100μg/ml时,随着CP浓度升高(0、15、30、60μg/ml),PM_2.5+CP组IL-6浓度逐渐下降,TGF-β1含量逐渐增加,两者都存在一定的剂量-效应关系,各炎性因子浓度差异有统计学意义(P<0.05)。结论 PM_2.5能促进皮肤炎症,可能与上调IL-6、下调TGF-β1有关;而CP能通过抑制上述作用,缓解PM_2.5对皮肤致炎作用。     

长沙市某区域大气PM2.5中多环芳烃的污染特征分析

目的了解长沙市某区域大气PM2.5中多环芳烃的污染特征和危害。方法采集大气PM2.5样品共84个。用高效液相色谱法测定样品中多环芳烃质量浓度,分析不同时期多环芳烃污染特征,利用特征比值法识别其主要来源。结果研究区域多环芳烃(PAHs)污染物以6环化合物为主,16种PAHs总质量浓度(∑₁₆PAHs)年均值为(9.47±9.68) ng/m³,中位数为5.13 ng/m³,其中冬季∑₁₆PAHs中位数最高,夏季最低。苯并[a]芘(BaP)年均质量浓度低于GB3095—2012环境空气质量标准(年平均1 ng/m³),BaP 24 h平均质量浓度超过标准质量浓度限值(2.5 ng/m³)仅2天,超标2.38%。特征比值法判断出PAHs的主要来源为机动车尾气。结论长沙市某区域大气PM2.5中PAHs污染水平冬季高于其他季节,提倡绿色低碳出行。     

辣椒素对背根神经节神经元钙离子浓度和线粒体膜电位的影响

目的探讨辣椒素对体外原代培养的胎鼠背根神经节（dorsal root ganglion，DRG）神经元钙离子浓度（［Ca²⁺］_i）和线粒体膜电位（mitochondiral membrane potential，MMP）的影响作用。方法分散培养的胎鼠DRG神经元用不同浓度的辣椒素（0.001μmol/L, 0.01μmol/L, 0.1μmol/L, 1μmol/L, 10μmol/L）孵育1min，用共聚焦激光扫描显微镜检测神经元［［Ca²⁺］_i的改变。对于能引起［Ca²⁺］_i升高的浓度组，在辣椒素孵育1min时，用流式细胞术检测神经元MMP的变化；并且在移去辣椒素后10min，重新检测神经元［Ca²⁺］_i的变化。结果0.001μmol/L、0.01μmol/L辣椒素孵育1min，神经元胞内［［Ca²⁺］_i没有变化；0.1μmol/L、1μmol/L和10μmol/L辣椒素孵育1min，神经元胞内［Ca²⁺］_i升高，移去辣椒素后10min，0.1μmol/L、1μmol/L辣椒素孵育的DRG神经元胞内［Ca²⁺］_i恢复到基础水平，10μmol/L辣椒素孵育的标本升高的［Ca²⁺］_i没有明显改变。辣椒素孵育时用无钙溶液，则神经元胞内［Ca²⁺］_i不升高。10?μmol/L辣椒素孵育1min的DRG神经元MMP降低，0.1μmol/L和1μmol/L辣椒素孵育的标本MMP无明显变化。结论一定浓度的辣椒素可使原代培养的DRG神经元胞内［Ca²⁺］_i升高，MMP降低。低浓度辣椒素引起的［Ca²⁺］_i的升高在10min内可以恢复到基础水平，而高浓度辣椒素引起的［Ca²⁺］_i的升高在10min内则不能恢复。辣椒素所致的胞内［Ca²⁺］_i升高可能是由于胞外钙离子内流引起的。     

99mTcO4-甲状腺显像对甲状腺摄碘-131 率测定的影响

目的 观察Na^99mTcO^-₄甲状腺显像对甲状腺¹³¹I放射性计数的影响及其随时间变化的规律。方法 以2013年3月至5月在北京协和医院核医学科就诊并已行甲状腺摄碘率(RAIU)测定的40例Graves病甲状腺功能亢进患者为研究对象,静脉注射Na^99mTcO^-₄(185MBq)行甲状腺显像以测定甲状腺面积,采用甲状腺功能仪分别测定患者注射Na^99mTcO^-₄后1、25、49、73、169 h甲状腺内放射性计数,并利用半衰期公式推算25、49、73 h时甲状腺内来自于¹³¹I及^99mTc的放射性计数,以^99mTc/室本底计数(1200)相对值为参考,观察^99mTc放射性计数随时间的变化规律及其对RAIU的影响,同时计算出⁹⁹Tc^m在甲状腺内的有效半衰期(Teff ^99mTc),观察其与游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、¹³¹I有效半衰期(Teff ¹³¹I)间的相关性。结果 静脉注射Na^99mTcO^-₄后第1、25、49、73h,通过甲状腺功能仪测定出来自^99mTc的放射性计数分别为(440.16±247.35)×10⁴、(11.37±10.67)×10⁴、(0.13±0.36)×10⁴、(-0.10±0.19)×10⁴,其与室本底比值分别为3668.00、94.75、1.08、NA。Teff ^99mTc为(4.41±0.49)h,与FT3、FT4和Teff ¹³¹I均无明显相关;Teff ¹³¹I与FT3(r=-0.503,P=0.003)、FT4(r=-0.516,P=0.002)则呈负相关。结论 甲状腺功能亢进患者甲状腺内Teff ^99mTc为4.41 h。注射Na^99mTcO^-₄ 3 d后,Na^99mTcO^-₄甲状腺显像对RAIU测定已无影响。^99mTc的有效半衰期与患者甲状腺激素水平和摄碘功能无明显相关性。     

中空纤维膜反应器结合芬顿试剂脱除燃煤烟气中的Hg0

将中空纤维膜反应器和芬顿试剂结合脱除烟气中的Hg⁰。研究了不同参数以及SO₂、NO和O₂等杂质气体对Hg⁰脱除的影响。结果表明：随着H₂O₂浓度、Fe²⁺浓度、溶液初始pH和温度的增加,Hg⁰脱除率先增加后降低,其最佳工作条件是H₂O₂浓度为6 mmol/L,Fe²⁺浓度为9 mmol/L,溶液初始pH为2.5,温度为20℃;增大液气比和通过减小气相流量增大停留时间均对Hg⁰脱除有增强作用,当液气比超过0.11时,Hg⁰的脱除率不再增加;当气相流量为0.6 L/min时,Hg⁰脱除率超过85%;SO₂、NO对Hg⁰的脱除有抑制作用,O₂对Hg⁰的脱除几乎没有影响;还测定出温度20℃下中空纤维膜反应器的比相界面积a=270.29 m^-1和传质动力学参数k_L=8.13×10^-4 m/s,k_G=0.786×10^-6 mol/（m²·s·Pa）。     

大气颗粒物(PM10/PM2.5)与人群循环系统疾病死亡系的病例交叉研究

目的:探讨北京市大气颗粒物(PM10及PM2.5)污染对居民循环系统疾病死亡的影响。方法:连续监测2007年至2008年北京市大气中PM2.5日均浓度,并收集同时期海淀区居民循环系统疾病死亡数据、北京市大气污染物和气象条件资料,应用双向对称性病例交叉研究和条件Logistic回归对数据进行分析,同时调整了性别、年龄及季节等潜在混杂因素的影响。结果:在控制当日气温、相对湿度、平均气压、风速的影响后,PM2.5每升高10μg/m3,所关联的总循环系统疾病、心血管疾病、脑血管疾病死亡的超额危险度分别为0.78%(95%CI:0.07%-1.49%)、0.85%(95%CI:-0.28%1.99%)和0.75%(95%CI:-0.17%1.68%);PM10每升高10μg/m3,所关联的总循环系统疾病、心血管疾病、脑血管疾病死亡的超额危险度分别为0.36%(95%CI:-0.07%0.78%)、0.63%(95%CI:-0.02%1.28%)和0.33%(95%CI:-0.26%0.92%),其中PM2.5与循环系统疾病死亡的关联有统计学意义(P<0.05)。颗粒物在温暖季节(4月至9月)与循环系统疾病死亡的关联比寒冷季节时更强,差异有统计学意义。结论:北京市海淀区循环系统疾病死亡人数的增加可能与颗粒物污染浓度的升高有关,该效应在温暖季节更强,大气PM2.5对健康的影响比PM10更大。     

我国四城市2013年1月雾霾天气事件中PM2.5与人群健康风险评估

目的 以过早死亡风险为指标评估北京、上海、广州和西安2013年1月雾霾天气事件的健康风险.方法 收集2013年1月我国4个区域代表性城市:北京、上海、广州和西安环境空气中粒径≤2.5μm的颗粒物(PM2.5)日均浓度,分析4个城市的PM2.5的污染水平和浓度特征;收集2010年为标准年的这4个城市人口学资料及死亡率,参考环境保护部科技标准司的《我国五城市大气细颗粒物(PM2.5)污染与居民死亡关系研究报告》的暴露-反应关系系数,并基于Possion回归的比例风险模型计算过早死亡人数.结果 2013年1月,北京、上海、广州和西安PM2.5 24 h平均浓度分别为(240±165)、(83±27)、(94±49)和(210±98) μg/m3,均超过我国《环境空气质量标准》(GB 3095-2012)二级标准(75μg/m3),北京和西安整体高于上海和广州,北京、上海、广州和西安超标率分别为86.4％(19/22),58.1％(18/31),54.8％(17/31)和93.5％(29/31);计算得出2013年1月雾霾天气事件过早死亡人数:北京为725 (95％ CI:457～977)人,上海为296(95％ CI:96～502)人,广州为310(95％ CI:189 ～434)人,西安为85(95％CI:21 ～ 141)人.结论 2013年1月雾霾天气事件PM2.5污染严重,增加了人群健康风险.     

血清Tg、TgAb对甲状腺癌根治术联合131I治疗后随访期间复发/转移的评估价值

目的 研究血清甲状腺球蛋白（Tg）、甲状腺球蛋白抗体（TgAb）对甲状腺癌根治术联合¹³¹I治疗后随访期间复发/转移的评估价值。方法 回顾性分析2018年6月—2020年6月中国贵航集团三〇二医院收治的106例分化型甲状腺癌患者的临床资料,患者均接受甲状腺癌根治术治疗,术后均采用¹³¹I进行清除残留的甲状腺组织（清甲）治疗。随访24个月,将患者分为复发转移组（21例）和未复发转移组（85例）。比较两组临床资料、¹³¹I治疗情况及血清促甲状腺激素（TSH）、Tg、TgAb。绘制受试者工作特征（ROC）曲线分析血清Tg、TgAb检测对甲状腺癌根治术联合¹³¹I治疗后复发/转移的预测价值。采取非条件一般Logistic回归模型进行多因素分析。结果 与未复发转移组比较,复发转移组原位肿瘤T₄分期、手术方式为腺叶切除或近全切、残余甲状腺质量≥1 g、手术至¹³¹I治疗时间> 3个月、24 h摄¹³¹I率≤ 20%患者的占比均较高（P <0.05）;复发转移组血清Tg和TgAb水平均较高（P <0.05）;ROC曲线分析结果显示：血清Tg预测甲状腺癌根治术联合¹³¹I治疗后复发或转移的最佳截断值为1.674 μg/L,AUC为0.803（95% CI：0.721,0.884）,敏感性为81.1%（95% CI：0.724,0.898）,特异性为63.8%（95% CI：0.585,0.691）;血清TgAb预测的最佳截断值为44.19 3 IU/mL,AUC为0.911（95% CI：0.859,0.963）,敏感性为89.2%（95% CI：0.813,0.971）,特异性为72.5%（95% CI：0.674,0.774）。非条件Logistic一般回归分析结果显示：原位肿瘤T₄分期［O^R=2.916（95% CI：1.325,6.417）］、腺叶切除或近全切［O^R=3.243（95% CI：2.174,4.838）］、残余甲状腺质量≥ 10 g［O^R=1.835（95% CI：1.514,2.224）］、手术至¹³¹I治疗时间> 3个月［O^R=1.962（95% CI：1.371,2.808）］、24 h摄¹³¹I率≤ 20%［O^R=2.638（95% CI：1.219,5.709）］、血清Tg ≥ 1.674 μg/L［O^R=2.503（95% CI：1.430,4.360）］、血清TgAb≥ 44.193 IU/mL［O^R=2.944（95% CI：2.016,4.299）］可能是甲状腺癌根治术联合¹³¹I治疗后复发或转移的危险因素（P <0.05）;风险因素预测模型预测甲状腺癌根治术联合¹³¹I治疗后复发/转移的ROC曲线下面积为0.961（95% CI：0.935,0.987）,标准误为0.010,临界值为73.162,敏感性为91.9%（95% CI：0.863,0.957）,特异性为88.2%（95% CI：0.845,0.922）。结论 甲状腺癌根治术联合¹³¹I治疗后出现复发/转移的患者血清Tg、TgAb水平明显升高,Tg、TgAb对预测复发/转移具有较好的价值,联合其他危险因素建立风险因素预测模型可进一步提高预测价值。     

姜黄素固体脂质纳米粒的制备及表征

目的：制备姜黄素（Cur）固体脂质纳米粒（SLN）。方法：用薄膜超声法制备Cur-SLN,以m_cur︰m_{单硬脂酸甘油酯}、m_{单硬脂酸甘油酯}︰m_卵磷脂、聚山梨酯-80质量浓度、超声时间为考察因素,以包封率为指标,用正交试验优选处方,并考察其粒径分布、Zeta电位。结果：当m_cur︰m_{单硬脂酸甘油酯}=1︰3、m_{单硬脂酸甘油酯}︰m_卵磷脂=1︰2.5、聚山梨酯-80质量浓度2.5%、超声时间12 min时,所制得的Cur-SLN平均粒径为（145.6±5）nm,Zeta电位为（－31.9±1.5）mV,包封率为（97.42±0.39）%,载药量为(7.92 ± 0.05)%。结论：采用薄膜-超声法制备Cur-SLN可行,为开发姜黄素新型给药系统提供试验依据。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.