慢性肺心病心力衰竭患者的甲状腺功能

目的：探讨慢性肺心病心力衰竭患者甲状腺素的变化。方法：对52例慢性肺心病心力衰竭患者血清TT3、TT4和TSH进行检测，观察其变化，并分析慢性肺心病心衰患者与TT3、TT4和TSH的关系。结果：慢性肺心病心力衰竭患者其TT3、TT4均值低于对照组。TSH无明显变化。结论：慢性肺心病心力衰竭患者甲状腺功能有一定程度的下降，且非原发性甲状腺功能低下。     

冠心病、糖尿病、脑梗死患者甲状腺激素水平测定的临床意义

目的 探讨冠心病、糖尿病、脑梗死患者血清甲状腺激素水平测定的临床意义.方法 选择老年冠心病56例、糖尿病52例、脑梗死31例,以同期老年健康者50例为对照组,用化学发光免疫分析法分别测定4组血清总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平.结果 4组TT3、FT3、TSH水平比较,差异有统计学意义(P均＜0.05),冠心病组、糖尿病组、脑梗死组患者血清TT3、FT3水平均较对照组低,TSH水平较对照组高(P均＜0.05),TT4、FT4水平与对照组比较,差异无统计学意义(P＞0.05).结论 老年冠心病、糖尿病、脑梗死患者血清中甲状腺激素水平的检测对客观评价老年性疾病患者的甲状腺功能有一定的临床意义.     

不同手术方式治疗甲状腺结节的效果比较

目的 探究不同手术方式治疗甲状腺结节的临床效果.方法 选取2017年1月至2020年7月本院收治的80例甲状腺结节患者作为研究对象,随机分为对照组与观察组,每组40例.对照组行传统甲状腺切除术治疗,观察组行改良小切口甲状腺切除术治疗.比较两组手术指标、治疗前后甲状腺功能指标[血清促甲状腺激素(TSH)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)]、生活质量综合评估问卷(GQOL-74)评分及并发症发生率.结果 观察组术中出血量少于对照组,手术时间、切口长度、术后肛门排气时间及住院时间均短于对照组,差异有统计学意义(P<0.05).术后3个月,两组血清TSH水平均高于术前,血清TT3、TT4、FT3及FT4水平均低于术前,差异有统计学意义(P<0.05);两组血清TSH、TT3、TT4、FT3及FT4水平比较差异无统计学意义.术后3个月,两组社会功能、躯体功能、心理功能及物质功能评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05).观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05).结论 改良小切口甲状腺切除术治疗甲状腺结节效果显著,可明显缩短患者手术时间与住院时间,减少术中出血量,降低并发症发生率,提高患者生活质量,值得临床推广应用.     

慢性心衰与正常甲状腺功能病态综合征的关系(附47例分析)

目的探讨慢性心衰与正常甲状腺功能病态综合征(ESS)的关系。方法采用时间分辨荧光免疫分析法检测47例慢性心衰患者(心衰组)与30例健康者(对照组)TT3、TT4、FT3、FT4及TSH水平。结果心衰组较健康组血清TT3、FT3明显降低(P<0.05),不同心功能患者差异亦具统计学意义(P<0.05),各组血清TT4、FT4、TSH差异无统计学意义;心衰纠正前后TT3、FT3值比较具有统计学差异(P<0.05),而血清TT4、FT4、TSH差异无统计学意义。结论慢性充血性心衰患者常合并ESS,它与心衰的严重程度相关;ESS应是慢性心衰的伴随症状,为机体的适应性反应。     

重症肝炎患者血清甲状腺激素的变化及其临床意义

目的探讨重症肝炎患者血清甲状腺激素的变化情况及其临床意义.方法采用放射免疫法检测32例重症肝炎患者、15例慢性肝炎患者及14例正常对照的血清总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)及促甲状腺激素(TSH)水平,比较各组之间的差异.结果重症肝炎患者血清TT3、TT4水平均明显低于正常对照组(P<0.05),其中死亡组的TT3及TT4水平明显低于存活组(P<0.05),而存活组患者危重期的TT3水平明显低于恢复期(P<0.01),各组血清TSH值无明显差异.重症肝炎患者血清总胆红素(TB)与TT3水平呈负相关.结论重症肝炎患者存在血清甲状腺激素的异常代谢,其严重程度对判断患者的预后可能有一定的作用.     

慢性心力衰竭患者血清甲状腺激素和皮质醇改变与心功能的相关性

目的观察慢性心力衰竭（CHF）患者血清甲状腺激素（TH）及皮质醇（F）的水平改变及其与心功能的相关性。方法采用化学发光免疫法,测定51例CHF患者血清TH及F水平,并测定其左室射血分数（LVEF）,与20例健康者对照分析。结果CHF组血清TT3、TT4较对照组（NC）下降（P〈0.05）,rT3较NC组升高（P〈0.05）,且CHF组随着心力衰竭的加重,TT3、TT4水平逐渐减低,rT3水平逐渐升高;FT3、FT4、TSH及F水平在CHF各组与NC组比较无统计学意义（P〉0.05）。结论CHF患者常伴有正常甲状腺病态综合征。血清TT3、TT4及rT水平的变化可作为评价CHF患者病情严重程度的客观指标。     

COPD急性加重期患者甲状腺激素水平测定及临床意义

目的:观察慢性阻塞性肺疾病(COPD)急性加重期患者甲状腺激素水平的变化,探讨其临床意义。方法:44例COPD急性加重期患者,采用放射免疫法测定其治疗前后血清总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)水平,并与44例健康体检者进行对照。结果:COPD急性加重期血清TT3、FT3、TSH与对照组比较差异有统计学意义;COPD急性加重期治疗前后血清TT3、FT3比较差异有统计学意义;好转组与死亡组COPD急性加重期患者血清TT3、TT4、FT3、FT4比较差异有统计学意义。结论:血清甲状腺激素水平的变化反映了COPD急性加重期患者病情严重程度,可用于COPD急性加重期患者病情的评估。     

心衰患者甲状腺激素变化分析

目的探讨慢性心力衰竭(CHF)患者血清甲状腺激素(TH)的变化及其临床意义。方法采用放免法测定89例慢性心力衰竭患者及40例门诊健康体检者血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺素(TSH)的水平并比较。结果慢性心力衰竭患者与对照组比较,血清T3、FT3、T4均降低(P<0.05或P<0.01),FT4、TSH无明显变化(P>0.05);T3、FT3、T4随心衰程度加重逐渐降低(P<0.05或P<0.01);TSH在心衰各亚组间比较差异无统计学意义(P>0.05)。结论慢性心力衰竭患者常伴有正常甲状腺功能病态综合征,其甲状腺衰竭激素水平的变化程度与心衰严重程度相关。     

非小细胞肺癌患者化疗前后血清甲状腺激素水平变化及临床意义

目的 探讨非小细胞肺癌(NSCLC)患者血清甲状腺激素水平在化疗前后的变化及其临床意义.方法 采用放射免疫分析法测定78例NSCLC患者化疗前后血清总三碘甲状腺原氨酸(TT3)、总甲状腺素(TF4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺激素(TSH)水平,并与35例正常人血清甲状腺激素水平比较.结果 NSCLC患者血清TT3[(1.27±0.36) nmol/L比(2.62 ±0.46) nmol/L]、FT3[(2.65±0.76) pmol/L比(3.79 ±0.63) pmol/L]水平低于正常对照组(P＜0.05),TT4、FT4及TSH水平与正常对照组接近(P＞0.05).血清TT3和FT3水平与临床分期有关(P＜0.05),与分化程度和病理类型无关(P均＞0.05);化疗后有效者(完全缓解和部分缓解)血清TT3、FT3水平明显高于化疗前(P＜0.05).结论 血清甲状腺激素水平检测对肺癌的病情判断及疗效监测有一定的临床意义.     

呼吸衰竭患者甲状腺激素水平的变化及临床意义

目的探讨呼吸衰竭患者甲状腺激素水平的变化情况及临床意义。方法选取在我院就诊的96例呼吸衰竭患者作为研究对象,按病情分为急性呼吸衰竭组（45例）和慢性呼吸衰竭组（51例）,同时选取健康体检的正常人（48例）作为对照组,分析比较三组对象的总三碘甲状腺原氨酸（n）、总甲状腺激素（n）、游离三碘甲状腺原氨酸（n）、游离甲状腺素（n）、促甲状腺激素（TSH）水平。结果与对照组相比,急性呼吸衰竭组患者,TT3、TT4、FTT3、FT4水平均低于对照组（P〈0．01）,TSH水平高于对照组（P〈0．01）;慢性呼吸衰竭组患者TT3、TT4、FT3均低于对照组（P〈0．01）,而FT4和TSH水平无明显差异（P〉0．05）;急性呼吸衰竭组患者TSH水平高于慢性呼吸衰竭组（P〈0．01）。结论对呼吸衰竭患者进行甲状腺激素水平的测定,有助于对疾病的评估治疗。     

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.