胎儿胸腺组织植入治疗小儿早期I型糖尿病

无菌取妊娠１６～３２周水囊引产胚胎胸腺，剪成约１ｍｍ＾３的组织块，于３７℃５％ＣＯ２条件下培养４～７天，收集并洗涤后植入糖尿病患儿三角肌内。植入后１５天～６个月，血糖，尿糖，糖化血红蛋白及胰岛素用量均较植入前明显降低（Ｐ〈０．０１～０．０５），ＣＤ４与ＣＤ８较植入前后增加（Ｐ〈０．０５～０．０１），按统一疗效标准评定，显效３０％（６／２０），有效５０％（１０／２０），总有效率８０％。     

小肝细胞癌的影象学评价

以１１８例经手术后病理证实的小肝细胞癌（ＳＨＣＣ）作计算机Ｘ线体层摄影（ＣＴ）分析。增强前（ＮＣ）的敏感性（６２．２％）低于增强后（＋Ｃ）（７８．１％），低于进床式动态团注增强ＣＴ（ＤＩＢ－ＣＴ）（８４．６％），Ｐ＜０．０１、Ｐ＜０．０５，但与４ｈ延迟ＣＴ（Ｄ－ＣＴ）（７８．５％）相比Ｐ＞０．０５。动脉造影ＣＴ（ＣＴＡ）、经动脉门脉造影ＣＴ（ＣＴＡＰ）的敏感性显著高于ＮＣ（Ｐ＜０．０５）。Ｂ超（ＵＳ）的敏感性显著低于＋Ｃ、ＣＴＡ和ＣＴＡＰ（Ｐ＜０．０５）。同位素（ＰＭＴ）检查的敏感性均低于其他各种影象学方法（Ｐ＜０．０１）。对≤１ｃｍ的ＳＨＣＣ，以ＣＴＡ（７１．４％）和ＣＴＡＰ（１００％）的敏感性为最高，与ＵＳ（３．０％）和＋Ｃ（１５．２％）相比Ｐ＜０．０１。对ＳＨＣＣ的定性诊断，以ＣＴＡ和ＤＩＢ－ＣＴ最佳。以ＣＴＡ和ＣＴＡＰ敏感性最高，ＤＩＢ－ＣＴ和Ｄ－ＣＴ次之，常规ＣＴ优于ＵＳ。     

持续性不卧床腹膜透析腹膜炎治疗新方案

为了比较两种不同治疗方案对持续性不卧床腹膜透析（ＣＡＰＤ）腹膜炎的疗效，我们研究４１例ＣＡＰＤ腹膜炎，其中２０例（Ａ组）用新方案治疗，２１例（Ｂ组）用以往常规方案治疗。两组的疗效明显不同，表现为Ａ组治愈率较Ｂ组高（９４．０％比７８．６％，Ｐ＜０．０５）；腹膜炎持续时间较Ｂ组短（２．８±１．６天比４．０±２．０天，Ｐ＜０．０５）；腹膜炎复发率较Ｂ组低（１５９±９８．８天比９８±９９．６天，Ｐ＜０．０５）；治疗失败率较Ｂ组低（６．０％比２１．４％，Ｐ＜０．０５）。研究证明：新方案治疗ＣＡＰＤ腹膜炎疗效优于以往的常规治疗方案。     

大柴胡加味对梗阻性黄疸T细胞亚群免疫调节观察

用单克隆抗体致敏的红细胞花环法测定梗阻性黄疸患者全血Ｔ细胞亚群，并进一步观察梗阻性黄疸单纯手术组（Ａ组）和手术加服大柴胡加味围手术期治疗组（Ｂ组）术前Ｔ细胞亚群与术后动态变化情况。结果表明梗阻性黄疸患者ＣＤ３、ＣＤ４明显低于正常对照阻（Ｐ＜０．０５），ＣＤ４／ＣＤ８显著下降（Ｐ＜０．０１）。梗阻性黄疸术后第２天ＣＤ３、ＣＤ４及ＣＤ４／ＣＤ８进一步下降，低于术前水平（Ｐ＜０．０５）。Ｂ组术后第１０天ＣＤ３、ＣＤ４比Ａ组明显增高（Ｐ＜０．０５）。梗阻性黄疸术后第２０天ＣＤ３、ＣＤ４及ＣＤ４／ＣＤ８比术前明显增高（Ｐ＜０．０５）。研究提示梗阻性黄疸手术有利于Ｔ细胞免疫功能的恢复，围手术期中药治疗能促进Ｔ细胞功能尽快恢复，动态观察Ｔ细胞亚群变化对判断预后有一定的临床价值。     

41例乙型病毒性肝炎患者19项免疫指标分析

用间接免疫荧光、免疫透射比浊法检测各型乙肝患者的１９项免疫指标，结果ＣＤ％，ＣＤ／ＣＤ　比值与正常对照相比有显著差异（Ｐ＜０．００１，Ｐ＜０．０１，Ｐ＜０．０５）。ＡＨ组ＣＤ＋ＣＤ一ＣＤ结果与ＣＡＨ，ＣＰＨ组相比均有显著差异（Ｐ＜０．０１，Ｐ＜０．０５）。Ｂ细胞无组间差异。３组患者ＰＢＬ绝对数＞１２００／ｍｍ３；组间比较，仅ＡＨ与ＣＰＨ组差异显著（Ｐ＜０．０５）。Ｉｇ，Ｃ３，Ｃ４与正常组比较，ＩｇＧ升高（Ｐ＜０．０５），Ｃ４降低（Ｐ＜０．０ｌ）．ＣＡＨ，ＣＰＨ组ＩｇＭ较ＡＨ组高，Ｃ４较ＡＨ组低，ＣＡＨ较ＣＰＨ组更低，均具统计学意义。结果表明，ＣＤ细胞降低是引起乙肝患者肝细胞损伤首要的免疫因素。     

高聚金葡素治疗糖尿病的临床观察

采用超抗原生物制剂高聚金葡素的两种剂型（ＢＭ口服液和ＢＭ胶囊），分别协同治疗２０例糖尿病。结果：ＢＭ口服液组治后的血糖比治前下降３０．８９％，Ｐ＜０．００１；ＨｂＡ１Ｃ比治前下降３７．３３％，Ｐ＜０．００１。ＢＭ胶囊组治后的血糖比治前下降１３．７３％，Ｐ＜０．０５；ＨｂＡ１Ｃ比治前下降２９．３７％，Ｐ＜０．００１。胰岛素（３６例）治后增加５１．３％，Ｐ＜０．０１；４０例患者中Ｃ肽治后增加１９．３４％，Ｐ＜０．０５；４０例的Ｔ细胞亚群ＣＤ３治后增加１３．２％，Ｐ＜０．０１；ＣＤ４增加１７．４％，Ｐ＜０．００１；ＣＤ８减少１９．４％，Ｐ＜０．００１；ＣＤ４／ＣＤ８比值由１．０４转为１．５０，达到正常水平。表明高聚金葡素与降血糖药物合用对治疗糖尿病有明显的协同作用。其机理可能是通过超抗原的生物调节因子，调节机体内环境和细胞免疫功能所致。值得进一步深入研究。     

流式细胞仪检测胃癌中CD44s及CD44v6表达

目的　探讨黏附因子ＣＤ４４ｓ和ＣＤ４４ｖ６的表达与胃癌生物学行为的关系。方法　应用流式细胞术对５８例胃癌及４０例胃良性病变的新鲜标本检测ＣＤ４４ｓ和ＣＤ４４ｖ６,并应用免疫组化测定ＰＣＮＡＬ１。结果　胃癌组ＣＤ４４ｓ的阳性率（６２．１％,３６／５８）明显高于良性病变组（２７．５％,１１／４０,Ｐ＜０．０１）,且与ＰＣＮＡＬＩ（Ｐ＜０．０５）有关。胃癌组ＣＤ４４ｖ６的阳性率（５８．６％,３４／５８）高于良性病变组（３２．５％,１３／４０,Ｐ＜０．０５）,且与肿瘤部位（Ｐ＜０．０５）、淋巴结转移（Ｐ＜０．０５）及ＰＣＮＡＬＩ（Ｐ＜０．０５）有关。ＣＤ４４ｓ与ＣＤ４４ｖ６表达在胃良性病变组（Ｒｓ＝０．５９,Ｐ＜０．０１）及胃癌组中（Ｒｓ＝０．２９,Ｐ＜０．０５）存在相关性。结论　ＣＤ４４ｓ和ＣＤ４４ｖ６之间存在相关性并在胃癌中表达增强并和增殖活性有关,ＣＤ４４ｖ６与肿瘤部位及淋巴结转移有关。     

单用达那唑治疗慢性再生障碍性贫血19例临床观察

单用达那唑（ＤＮＺ）治疗１９例慢性再生障碍性贫血（ＣＡＡ）病人。结果表明，基本治愈１例，缓解５例，明显进步７例，有效者共１３例，总有效率为６８．４％，初治者５／７例有效，有效率为７１．４％；复治者８／１２例有效，有效率为６６．７％。治疗后与治疗前比较，血红蛋白、白细胞、血小板和网织红细胞均明显升高（Ｐ＜０．００１）；骨髓红系、粒系及巨核细胞明显增高（Ｐ＜０．０５）；Ｔ辅助细胞（ＣＤ４）明显增加、Ｔ抑制细胞（ＣＤ８）明显降低，ＣＤ４／ＣＤ８比值明显升高（Ｐ＜０．０５）。并结合文献对ＤＮＺ的作用原理进行讨论。     

胸腺移植和654－2治疗难治性癫痫的研究

采用胸腺移植和６５４－２治疗小儿难治性癫痫４５例，总有效率达９１．１％，明显高于对照组４５．２％（Ｐ＜０．０１）。癫痫患儿Ｔ细胞亚群测定与对照组比较显示ＣＤ_３、ＣＤ_４、ＣＤ_４／ＣＤ_８明显降低（Ｐ＜０．０１），表明癫痫患儿存在细胞免疫功能异常。胸腺移植和６５４－２治疗后与治疗前比较ＣＤ_３、ＣＤ_４、ＣＤ_４／ＣＤ_８明显升高（Ｐ＜０．０１），表明其能明显改善癫痫患儿的免疫功能。抗癫痫药物治疗前后各免疫学指标比较无显著性差异（Ｐ＞０．０５），表明抗癫痫药物对患儿Ｔ细胞亚群变化无明显影响。     

慢性乙型肝炎患者外周血淋巴细胞亚群及膜白细胞介素2受体表达的研究

目的：探讨乙型病毒性肝炎（乙肝）患者外周血淋巴细胞亚群及膜表面白细胞介素２受体（ｍＩＬ－２Ｒ）与乙肝发病机制的关系．方法：采用ＡＰＡＡＰ技术检测９２例慢性乙肝患者外周血淋巴细胞亚群及ｍＩＬ－２Ｒ．结果：慢性乙肝患者ＣＤ＋４细胞数明显降低（Ｐ＜０．０５），ＣＤ＋８细胞数显著上升（Ｐ＜０．０５或Ｐ＜０．０１），以致ＣＤ＋４／ＣＤ＋８比值下降；ｍＩＬ－２Ｒ显著低于正常对照组（Ｐ＜０．０５），在ＰＨＡ激活后与正常接近，但均较ＰＨＡ激活前显著增高（Ｐ＜０．０１）．２０例慢活肝恢复期ｍＩＬ－２Ｒ已趋于正常．结论：慢性乙肝患者存在着免疫调节功能异常，可能与乙型肝炎病毒的持续存在互为因果关系．     

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.