桂枝芍药知母汤对Ⅱ型胶原诱导性关节炎大鼠IFN-γ及IL-4水平的影响

目的研究桂枝芍药知母汤对Ⅱ型胶原诱导性关节炎大鼠的治疗作用,并探讨其作用机制。方法采用牛Ⅱ型胶原诱导的关节炎模型(Collagen-induced arthritis,CIA),灌胃给药21 d后观察大鼠体重变化、足肿胀度;采用ELISA法测定大鼠滑膜和血清中的白细胞介素4(IL-4)水平,小鼠巨噬细胞NO2-释放法测定大鼠滑膜和血清中干扰素γ(IFN-γ)活性。结果桂枝芍药知母汤能改善CIA大鼠体重变化,降低原发性和继发性足肿胀度,下调CIA大鼠滑膜和血清IFN-γ、IL-4水平。结论CIA大鼠滑膜中IFN-γ、IL-4水平均升高,血清中以IFN-γ升高为主。桂枝芍药知母汤抗风湿作用,可能通过下调CIA大鼠滑膜和血清IFN-γ、IL-4水平,从而调节Th1/Th2平衡。     

CTLA-4抗体诱导原因不明复发性流产患者Th1/Th2转换的体外研究

目的:观察CTLA-4抗体在诱导原因不明复发性流产患者Th1/Th2转换中的作用.方法:用人绒毛膜癌细胞株JEG-3制备的滋养细胞抗原刺激30例复发性流产患者外周血单核细胞,实验组加CTLA-4抗体(10μg/ml组和1μg/ml组),对照组加IgG(10μg/ml组和1μg/ml组)培养,分别取24h、72h上清液,ELISIA法测其IL-2、IFN-γ和IL-4的水平.结果:①与同浓度对照组相比,实验组产生的IL-4均显著降低(P＜0.01),而产生的IFN-γ、IL-2均明显升高(P＜0.05).②与CTLA-4抗体1μg/ml组相比,CTLA-4抗体10μg/ml组产生的IL-4稍低,而IFN-γ和IL-2稍高,但无统计学差异(P＞0.05).结论:CTLA-4抗体可以上调Th1型细胞因子,下调Th2型细胞因子,提示CTLA-4抗体体外阻断CTLA-4可诱导原因不明复发性流产的Th1/Th2失衡更向Th1极化,不利于妊娠.     

CTLA-4Ig与ICAM-1单抗促进供者来源的未成熟树突状细胞诱导移植受体免疫耐受

目的:研究细胞毒性T淋巴细胞相关抗原4融合蛋白(CTLA-4Ig)和细胞间黏附分子1(ICAM-1)单抗体内注射促进供者未成熟树突状细胞(imDC)诱导受者免疫耐受的可能机制.方法:实验分对照组(仅输注imDC)、CTLA-4Ig组、ICAM-1单抗组和CTLA-4Ig ICAM-1单抗联合组,每组均以2×106 C57BL/6供者imDC经尾静脉输注受鼠(雄性),自imDC输注之日起连续2周向受鼠腹腔内注射CTLA-4Ig或(和)ICAM-1单抗(0.1 mg/d),DC输注1周后4组均行异位心脏移植,于心脏移植后7 d和21 d,进行免疫学分析.结果:CTLA-4Ig或联合ICAM-1单抗治疗后均明显抑制同种imDC免疫的移植受体脾脏T细胞对同种抗原刺激的增殖反应,降低淋巴细胞毒活性,明显抑制血清和MLR反应中Th1细胞因子IL-2、IFN-γ的产生,显著提高Th2细胞因子IL-10的水平;明显降低心脏移植受体同种抗体IgG的产生.ICAM-1单抗治疗组的受体T细胞对同种抗原刺激的增殖反应虽有减弱,但与对照组相比没有显著的差异;对MLR反应上清和血清中IL-2的产生有明显的抑制,而对其他细胞因子的产生没有明显的作用.结论:CTLA-4Ig联合ICAM-1单抗治疗可通过诱导受体T细胞对同种抗原特异性的低反应性,抑制淋巴细胞毒活性和B细胞的体液免疫反应,并促进Th2细胞的极化来促进imDC诱导的同种抗原特异性的免疫耐受.     

Ⅱ型胶原变构肽鼻黏膜给药治疗胶原诱导性关节炎的实验研究

目的:研究以丙氨酸替换Ⅱ型胶原(collagen Ⅱ,CⅡ)263-272序列中的267、270、271位氨基酸的变构肽鼻黏膜给药对胶原诱导性关节炎(collagen induced arthritis,CIA)的抑制作用及其作用机制.方法:以牛CⅡ免疫Lewis大鼠诱发CIA.于发病的当天开始给予CⅡ变构肽和原型肽鼻滴入治疗,连续每天给药,5 d后,改为隔天给药,空白对照组给予磷酸盐缓冲液(phosphate buffered solution,PBS).观察关节肿胀情况,记录关节炎评分以及体重的改变.治疗结束后处死大鼠,行后踝关节病理切片,观察关节病理改变.ELISA方法检测血清巾抗C Ⅱ抗体亚型以及细胞因子的变化,流式细胞仪检测外周血 CD4+CD25+T细胞的变化,荧光定量PCR检测脾和淋巴结中Foxp3和TGF-β mRNA的表达水平.结果:(1)CⅡ变构肽可以抑制CIA的发展.实验结束时CⅡ变构肽、原型肽以及PBS组大鼠关节炎评分分别为2.50±2.43、4.50±2.23和6.33±2.73(变构肽治疗组与PBS对照组比较,P<0.05),各组大鼠后踝关节病理学评分分别为1.33±1.07、2.17±0.94和2.83±0.58,与PBS对照组相比,CⅡ变构肽可以明显抑制CIA关节病变的发展(P<0.05).(2)与PBS对照组相比,CⅡ变构肽可以降低CIA大鼠体内抗CⅡ抗体IgG2a亚型的滴度(0.56±0.19和0.95±0.29,P<0.05).C Ⅱ变构肽、原型肽及PBS对照组大鼠血清中γ干扰素(interferon-γ,IFN-γ)水平分别为(185.33±29.77)、(231.62±41.82)和(220.64±83.61)ng/L,与原型肽组相比,CⅡ变构肽可以降低大鼠血清中IFN-γ水平.(3)CⅡ变构肽治疗对调节性T细胞的影响:3组大鼠外周血CIM+CD25+T细胞占CD4+T细胞比例差异无统计学意义,CⅡ变构肽治疗组大鼠脾和淋巴结中Foxp3和转化生长因子B(transforming growth factors β,TGF-β)mRNA的表达水平较对照组有升高趋势,但差异无统计学意义.结论:C Ⅱ变构肽鼻黏膜给药治疗可以抑制CIA的发展,CⅡ变构肽可能主要通过抑制CIA大鼠体内IgG2a型抗CⅡ抗体的产生,并降低血清中IFN-Ⅱ,从而抑制Th1型免疫反应而发挥治疗作用.     

仿生髓核组织工程细胞支架的免疫原性研究

目的探讨自行设计构建髓核组织工程支架材料的免疫原性.方法将75只SD大鼠随机分为3组:正常组、对照组及移植组.将自行设计构建的支架材料植入移植组大鼠皮下,以未植入支架组作为对照.分别于术后1、3、7、14、28、56、84 d取支架及周围组织,并分离血清.行组织学观察及RT-PCR检测IFN-γ、IL-2、IL-4、IL-10 mRNA表达,ELISA检测血清中抗Ⅱ型胶原抗体水平.结果支架材料在大鼠体内表现为轻度的炎性反应,逐步为纤维肉芽组织取代.RT-PCR未检测到IFN-γ、IL-2 mRNA表达,IL-4、IL-10 mRNA表达增高,反映支架材料移植后促进T辅助细胞向Th2方向转化,抑制机体炎症发生.同时血清中未检测到抗Ⅱ型胶原抗体表达增高.结论自行设计的髓核组织工程支架材料无明显免疫原性,可进行深入研究.     

联合阻断CD28和ICOS对移植胰岛功能影响的实验研究

目的:探讨CTLA-4Ig及可溶性B7RP-1融合蛋白联合阻断CD28和ICOS对移植胰岛功能的影响。方法:在异种胰岛移植模型的基础上48只实验动物随机分成4组,每组12只,供体为SD大鼠,受体为近交系昆明小鼠。联合处理组(A组):分别于移植后0、2、4d和1、3、5d腹腔内注射CTLA-4Ig和可溶性B7RP-1融合蛋白组;可溶性B7RP-1融合蛋白处理组(B组):移植后1、3、5d腹腔内注射可溶性B7RP-1融合蛋白组;CTLA-4Ig处理组(C组):移植后0、2、4d腹腔内注射CTLA-4Ig组;对照组(D组):单纯胰岛移植,不做CTLA-4Ig和可溶性B7RP-1融合蛋白处理组。通过观察大鼠胰岛移植后移植物存活时间和移植胰岛病理改变,并用RT-PCR方法检测IL-2和IL-10在移植组织中的表达情况。结果:联合处理组大鼠移植胰岛存活时间较对照组及CTLA-4Ig处理组和可溶性B7RP-1融合蛋白组明显延长,移植胰岛光镜检查接近正常,IL-2mRNA表达差异有显著性[(42.55±6.34)%VS(112.55±15.34)%,P<0.01],IL-10mRNA表达差异无显著性[(105.35±15.16)%VS(102.23±16.02)%,P>0.05]。结论:应用CTLA-4Ig+可溶性B7RP-1融合蛋白联合阻断CD28和ICOS,可以明显的抑制排斥反应,提高移植物的存活率。     

Ⅱ型胶原多肽263～272序列中多个氨基酸替换的意义及其在胶原性关节炎治疗中的作用

目的:研究Ⅱ型胶原变构肽(APL)中氨基酸替换对胶原性关节炎(CIA)的抑制作用,为类风湿关节炎(RA)的多肽免疫治疗提供试验依据.方法:以丙氨酸替换Ⅱ型胶原(CⅡ)263～272多肽中与T细胞受体(TCR)结合的氨基酸,3H掺入法检测变构肽对RA患者外周血T细胞活化的竞争抑制作用,筛选用于CIA治疗的变构肽.以牛CⅡ诱导大鼠CIA模型,应用不同剂量(1, 10, 100 μg)的CⅡ变构肽每周2次皮下注射,观察大鼠关节肿胀的变化情况.治疗3周后(初次免疫后第35天)处死大鼠,进行X线及病理评分.ELISA法检测血清IFN-γ水平.结果:3条CⅡ263～272变构肽均不同程度抑制CⅡ原型肽对RA患者T 细胞的活化.其中,同时替换267位谷氨酰胺(Q)、270位赖氨酸(K)和271位甘氨酸(G)为丙氨酸(A)的APL3效果最好.应用APL3对CIA进行治疗的结果发现,100 μg治疗组CIA大鼠的关节炎指数、X线及病理评分均显著低于PBS对照组.血清IFN-γ水平也较PBS对照组明显下降.而无关肽组与PBS对照组相比,关节炎指数、X线和病理评分以及血清IFN-γ水平均无明显差别.结论:TCR结合氨基酸位点替换后的CⅡ263～272多肽具有T细胞低反应性和对原型肽的竞争抑制作用,并可抑制大鼠胶原性关节炎的发展,提示其抑制RA免疫异常的可能性.     

奇壬醇对牛Ⅱ型胶原特异性淋巴细胞的体内和体外作用(英文)

目的观察奇壬醇对牛II型胶原特异性淋巴细胞体内和体外的免疫调节作用,探讨奇壬醇对抗原特异性淋巴细胞的免疫抑制作用机制。方法将Wistar大鼠随机分为对照组、模型组、奇壬醇组和泼尼松龙组。除对照组外,均复制胶原诱导关节炎大鼠模型,造模当天开始给药。造模30 d后取脾脏和引流淋巴结,制备单细胞悬液,经体外培养48 h后,ELISA法检测培养上清中干扰素-γ(IFN-γ)、白介素-10(IL-10)、IL-4、肿瘤坏死因子-α(TNF-α)含量;在II型胶原诱导下,取正常大鼠淋巴结细胞、脾细胞与不同浓度的奇壬醇共同培养,检测胶原诱导的淋巴细胞增殖及凋亡。结果与模型组相比,奇壬醇组脾细胞培养上清中IFN-γ和TNF-α含量降低(P<0.05,P<0.01),IL-10和IL-4水平升高(P<0.05,P<0.01);淋巴结细胞培养上清中IFN-γ和TNF-α含量降低(P<0.05,P<0.001),IL-10和IL-4水平升高(P<0.05,P<0.001);体外实验中,奇壬醇抑制II型胶原特异性淋巴结细胞增殖,促进II型胶原特异性淋巴结细胞和脾细胞凋亡,均呈剂量依赖关系。结论奇壬醇可通过抑制II型胶原特异性淋巴细胞分泌促炎因子,促进胶原特异性淋巴细胞分泌抗炎因子,抑制胶原特异性淋巴细胞增殖和促进其凋亡,以多条途径发挥免疫抑制作用。     

雷公藤单体T4对胰岛β细胞免疫保护作用的机制探讨

目的 探讨雷公藤单体T4对胰岛β细胞的免疫保护作用,为胰岛β细胞的免疫保护治疗提供实验依据.方法 培养胰岛β细胞株NIT细胞及正常对照外周血单个核细胞,分别与以下6组作用:①IL-1β+IFN-γ组;②IL-1β+IFN-β+DXM组;③IL-1β+IFN-γ+T4组;④T4组;⑤DXM组;⑥对照组(DMEM).ELISA法检测培养上清IL-4、IFN-γ水平,硝酸还原酶法检测上清一氧化氮水平,化学发光法检测上清胰岛素水平.结果 ①IL-1β+IFN-γ刺激的NIT-1细胞分泌IL-4水平较其他各组减少(P<0.01),IFN-γ分泌比其他各组增多(P<0.01),IL-4/IFN-γ比其他各组降低(P<0.01).②T4+IL-1β+IFN-γ刺激的NIT-1细胞与IL-1β+IFN-γ刺激组相比,分泌IL-47k平增高(P<0.01),IFN-γ减少(P<0.01),IL-4/IFN-γ增高(P<0.01).③IL-1β+IFN-γ刺激的NIT-1细胞分泌NO较其他各组增高(P<0.01),胰岛素分泌减少(vs IL-1β+IFN-γ+T4 组、IL-1β+IFN-γ+DXM组,P<0.05;vs T4组、DXM组、对照组,P<0.01).④T4+IL-1β+IFN-γ刺激的NIT-1细胞与IL-1β+IFN-γ组相比,分泌NO水平减少(P<0.01),Ins增加(P<0.05);与IL-1β+IFN-γ+DXM组相比,NO分泌减少(P<0.05).结论 T4可减轻IL-1β+IFN-γ对NIT细胞的损伤作用,保护NIT细胞的胰岛素分泌功能.     

NGF参与支气管哮喘大鼠气道炎症的发生及作用机制

目的 探讨神经生长因子(nerve growth factor, NGF)对支气管哮喘大鼠气道炎症的影响及作用机制.方法 24只雄性SD大鼠分为正常对照组(A组)、哮喘组(B组)和抗NGF组(C组),每组8只.测定各组支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)总细胞及细胞分类计数;HE染色观察气道病理改变;RT-PCR和ELISA法检测各组大鼠白细胞介素-4(interleukin-4,IL-4)、干扰素-γ(interferon-γ,IFN-γ)、NGF mRNA和蛋白表达水平.结果 B组与A组比较,BALF中细胞总数及细胞分类计数增多(P＜0.05);IL-4、NGF mRNA和蛋白表达增加(P＜0.01);而IFN-γ mRNA和蛋白表达减少(P＜0.01).C组与B组比较,BALF中细胞总数及细胞分类计数减少(P＜0.05);IL-4、NGF mRNA和蛋白表达减弱(P＜0.01);而IFN-γ mRNA和蛋白表达水平无显著差异.B组BALF中NGF含量与细胞总数、嗜酸性粒细胞、淋巴细胞呈正相关(r=0.833、0.944、0.949,P＜0.05);与IL-4含量呈正相关(r=0.944,P＜0.01),与IFN-γ含量不相关(r=0.122,P＞0.05);与肺组织中IL-4 mRNA表达水平呈正相关(r=0.848,P＜0.05),与IFN-γ mRNA表达不相关(r=0.611,P＞0.05).结论 NGF与哮喘大鼠气道炎症密切相关,它可以通过使Th2型细胞因子分泌亢进参与哮喘的发生.     

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.