剖宫产降低产后血清泌乳素水平

目的探讨剖宫产对产后泌乳的影响。方法采用放射免疫方法检测４０例经阴道分娩产妇（阴道分娩组）及４０例剖宫产产妇（剖宫产组）产前及产后２４ｈ血清垂体泌乳素（ＰＲＬ）水平，并观察产后乳母泌乳始动时间。结果阴道分娩组产前血清ＰＲＬ水平为（２７６．６８±２１．５３）μｇ／Ｌ，剖宫产组产前血清ＰＲＬ水平为（２４７．２６±２７．０９）μｇ／Ｌ，２组比较，无显著性差异（Ｐ＞０．０５）；产后２４ｈ阴道分娩组与剖宫产组血清ＰＲＬ水平分别为（３１５．９４±３１．３９）μｇ／Ｌ和（２３４．５０±２４．６９）μｇ／Ｌ，２组比较，差异有显著性（Ｐ＜０．０５）；产后２组泌乳始动时间比较，差异有显著性（Ｐ＜０．０５）。结论剖宫产血清垂体泌乳素的分泌，并使泌乳始动时间延迟血清ＰＲＬ对泌乳始动时间是必不可少的     

碳酸酐酶放射免疫分析法的建立

建立了碳酸酐酶的放射免疫分析法。该法具有较高的灵敏度，操作简便。标准曲线及标本的定量测定重复性好，批内ＣＶ＝７．０６％（ｎ＝１７）；批间ＣＶ＝８．５７％（ｎ＝７），回收率高、中、低浓度平均为１００．３４％，可测范围为１５．６～５００μｇ／Ｌ．测得结果满意，正常男性血清含量为３１４．８９±９２．２２μｇ／Ｌ（ｎ＝５４，Ｘ±ＳＤ），女性为２５４．１７±７５．３　ｇ／Ｌ（ｎ＝５４），男女差异非常显著（Ｐ＜０．００１）。     

不孕症妇女血清催乳素含量的测定

采用放射免疫法（ＲＩＡ）测定１８６例不孕症妇女血清催乳素（ＰＲＬ）浓度。结果表明，高催乳素血症１１５例，占６１．８２％。其中月经周期正常６１例，ＰＲＬ均值２８．３７±１６．７８μｇ／Ｌ；月经周期不规则６３例，ＰＲＬ均值５４．００±４７．５５μｇ／Ｌ；闭经６２例，ＰＲＬ均值为１７１．０３±１３３．３４μｇ／Ｌ．经统计学处理，３组血清ＰＲＬ值差异有极显著性（Ｐ＜０．００１），且ＰＲＬ＞２００μｇ／Ｌ者２７例，全部出现闭经，１７例确诊为垂体瘤。提示血清ＰＲＬ含量与女性生殖内分泌有密切关系。ＰＲＬ增高影响月经周期变化，导致排卵障碍、黄体功能不全并不孕。     

肺癌患者血清3种生长因子测定的临床意义及化疗后的变化

用放射免疫分析法测定 ４０ 例肺癌患者血清 Ｉ Ｇ ＦⅡ、 Ｔ Ｇ Ｆα、 Ｇ Ｍ  Ｃ Ｓ Ｆ水平,并与 ２０ 例正常对照比较。２１ 例患者化疗后再次测定,观察化疗后的变化。结果表明,肺癌患者血清 Ｔ Ｇ Ｆα为 ７．８５±１．６１ｎｇ／ Ｌ,明显高于对照组的 ５２９±１．３１ｎｇ／ Ｌ（ Ｐ＜ ０．０１）; Ｇ Ｍ  Ｃ Ｓ Ｆ 为 １２７±０．３３μｇ／ Ｌ,明显高于对照组 ０４１±０．１２,（ Ｐ＜ ０．０１）;血清 Ｉ Ｇ ＦⅡ水平为 ０４８±０．１４μｇ／ Ｌ,与正常对照的 ０４６±０．１３μｇ／ Ｌ 无差异（ Ｐ＞００５）。化疗后患者血清 Ｇ Ｍ  Ｃ Ｓ Ｆ明显升高（ Ｐ＜ ００１）, Ｉ Ｇ ＦⅡ、 Ｔ Ｇ Ｆα无明显变化。     

淮南市1 993

目的：了解淮南市居民的血清甲胎蛋白（ＡＦＰ）及癌胚抗原（ＣＥＡ）水平，以供临床检验参考和原发性肝癌的普查。方法：采用放射免疫法进行测定。结果：正常成人血清ＡＦＰ男性为１０．６４±８．９８μｇ／Ｌ，女性为９．１０±５．５３μｇ／Ｌ，差异有显著性（Ｐ＜０．０１）。血清ＣＥＡ男性为７．２３±４．１３μｇ／Ｌ，女性为７．５２±５．６３μｇ／Ｌ，差异无显著性（Ｐ＞０．０５），故正常参考范围为７．２８±４．４６μｇ／Ｌ；并发现１名女性肝癌患者，其血清ＡＦＰ异常升高，＞４０００μｇ／Ｌ。ＣＥＡ检测中未发现异常升高者。结论：该市人群血清ＡＦＰ及ＣＥＡ水平无异常变化，而放免法测定血清ＡＦＰ可作为肝癌普查的有效指标。     

肝硬化患者血清髓鞘碱性蛋白的测定及意义

目的 探讨血清髓鞘碱性蛋白（ＭＢＰ）测定在肝硬化患者脑部损害中的诊断意义。方法 采用酶联免疫吸附法定量测定肝硬化患者血清ＭＢＰ水平。结果 ６２例肝硬化患者血清ＭＢＰ为１．１７（０．４６～１３．０９）μｇ／Ｌ,高于正常对照组１．００（０．５０～１．３２）μｇ／Ｌ（Ｐ〈０．０１）。其中亚临床型和临床型肝性脑病组为１３．６０（１０．５４～２０．２８）μｇ／Ｌ,高于无肝性脑病组「１．００（０．４４～７．９８）μｇ／Ｌ」;按肝功能Ｃｈｉｌｄ分级,Ａ级「０．４４（０．７０～１．０２）μｇ／Ｌ」、Ｂ级「１．１７（０．７４～４．３９）μｇ／Ｌ」、Ｃ级「１５．１７（１３．００～２８．１１）μｇ／Ｌ」之间ＭＢＰ水平有差异。结论 血清ＭＢＰ测定对临床上诊断亚临床型或早期肝性脑病有一定价值。     

食管癌患者血清 P53 蛋白免疫酶联测定

采用免疫酶联法（Ｅｌｉｓａ）测定河南省食管癌高发区林州市居民食管癌患者（ｎ＝２０）和正常人（ｎ＝１１）血清中Ｐ５３蛋白（突变型加野生型）的水平。结果：正常人血清Ｐ５３蛋白水平为（０．１５±０．０９）μｇ／Ｌ，癌患者为（０．２３±０．０４）μｇ／Ｌ。癌患者血清Ｐ５３蛋白水平明显高于正常人（Ｐ＜０．０５）。结果提示：血清Ｐ５３蛋白水平可能是食管癌的一种重要的检测指标。     

糖尿病患者血清生长激素水平与微血管病变的关系

目的了解糖尿病患者血清生长激素（ＧＨ）水平与微血管病变之间的关系，探讨糖尿病患者微血管的病变机理。方法非胰岛素依赖型糖尿病（ＮＩＤＤＭ）１４１例，胰岛素依赖型糖尿病（ＩＤＤＭ）２７例。生长激素水平和胰岛素（ＩＮＳ）均采用放射免疫法测定，血糖用氧化酶法测定。结果ＮＩＤＤＭ患者的ＧＨ无合并微血管病变患者（３．３±１．２μｇ／Ｌ）明显高于正常人（１．０±１．２μｇ／Ｌ），合并微血管病变者（５．７±１．９μｇ／Ｌ）明显高于无微血管病变者，，差异都有非常显著意义（Ｐ＜０．０１）。随病程延长，ＧＨ水平越高，微血管病变发病比例也就越高。血清ＧＨ水平与血糖呈平行关系（ｒ＝０．１７３），与ＩＮＳ间无显著相关。ＩＤＤＭ患者ＧＨ水平（６．６±３．４μｇ／Ｌ）较ＮＩＤＤＭ患者（４．６±１．８μｇ／Ｌ）还高，且均为有微血管病变者。结论ＧＨ升高可能是糖尿病患者微血管病变的重要因素之一。     

部宫产降低产后血清泌乳素水平

目的 探讨剖宫产对产后泌乳的影响。方法 采用放射免疫方法检测４０例经阴道分娩产妇（阴道分娩组）及４０例剖宫产产妇（剖宫产组）产前及产后２４ｈ血清垂体泌乳素（ＰＲＬ）水平，并观察产后乳母泌乳始动时间。结果 阴道分娩组产前血清ＰＲＬ水平为（２７６．６８±２１．５３）μｇ／Ｌ，剖宫产组产前血清ＰＲＬ水平为（２４７．２６±２８７．０９）μｇ／Ｌ，２组比较，无显性差异（Ｐ〉０．０５），产后２４ｈ阴道分娩组     

急性心肌梗塞肌红蛋白检测的诊断价值

测定７８例血清肌蛋红蛋白（Ｍｂ）浓度，其中３３例急性心肌梗塞（ＡＭＩ）急性期入院，最早在起病后１．５小时升高，２１例在冠脉再通治疗后（４６．７±１７．３）分钟出现升高的峰值，平均为（８８９．９±４７．３）μｇ／Ｌ比再灌注前升高６５．５％，Ｍｂ异常升高持续（３７．３±６．８）小时，另观察２０例不稳定性心绞痛（ＵＡＰ）患者，疼痛发作期和间歇期Ｍｂ分别为（５６．３±２１．６）μｇ／Ｌ和（４１．６±２．３     

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.