代谢综合征患者血清白介素10与胰岛素抵抗的关系

目的探讨代谢综合征(MS)患者胰岛素抵抗(IR)与血清白介素10(IL-10)水平的关系。方法 MS患者及年龄相匹配的正常对照组各18例。以高胰岛素-正常血糖钳夹技术检测葡萄糖代谢率(M值),评价IR程度:采用酶联免疫吸附法检测血清IL-10水平,用Pearson相关分析法分析血清IL-10水平与M值的相关性。结果 MS组M值显著低于对照组[(5．76±1．81)mg／kg·min vs (8．39±1．25)mg／kg·mim,P<0．05];MS组血清IL-10水平显著低于对照组[1．3(0．8／3．1) pg／ml vs 2．4(1．1／4．5)pg/ml,P<0．05];Pearson相关分析法显示血清IL-10水平与M值正相关(P<0．05)。结论 MS患者血清IL-10水平降低,可能与IR的发生有关。     

远端缺血后适应处理对急性脑梗死患者血清促炎因子和抗炎因子的影响及其临床意义

目的探讨远端缺血后适应处理(RIPC)对急性脑梗死患者血清促炎因子和抗炎因子的影响及其临床意义。方法连续纳入2012年1月—2015年6月江汉大学附属医院/武汉市第六医院神经内科急性脑梗死患者100例,采用随机数字表法分为对照组和观察组,每组各50例,对照组给予常规治疗,观察组加用RIPC。分析治疗前、治疗后2周血清促炎因子(INFγ、TNF-α、IL-18以及IL-8)和抗炎因子(IL-13、TGFβ以及IL-4)水平变化。结果对照组血清促炎因子与抗炎因子治疗前后差异均无统计学意义(P>0.05)。观察组患者治疗后血清TNF-α[(102.7±22.8)pg/ml vs.(61.3±12.1)pg/ml,t=2.335,P=0.013]和IL-18[(37.7±5.4)pg/ml vs.(14.3±3.7)pg/ml,t=2.247,P=0.016]水平明显下降(P<0.05),血清IL-13水平[(15.9±3.6)pg/ml vs.(52.2±4.1)pg/ml,t=2.300,P=0.014]上升,且改善情况优于对照组(P<0.05)。RIPC与△TNF-α(r=0.641,P<0.05)、△IL-18(r=0.687,P<0.05)以及△IL-13(r=0.732,P<0.05)呈正相关。结论 RIPC治疗有助于改善急性脑梗死患者抗炎/促炎系统,可能是潜在的急性脑梗死治疗方法。     

雷帕霉素逆转胰岛素抵抗的动物实验

目的探讨新型免疫抑制剂雷帕霉素对胰岛素抵抗的作用及可能机制。方法利用肥胖胰岛素抵抗动物模型(obob小鼠),观察雷帕霉素对小鼠空腹血糖和胰岛素水平的影响,研究雷帕霉素对小鼠胰岛素抵抗的治疗作用及对循环细胞因子IL-1β,IL-6和TNF-α水平的影响,探讨雷帕霉素的可能作用机制。结果雷帕霉素治疗后小鼠的空腹血糖水平明显下降,与对照组比较有统计学意义,空腹胰岛素水平也下降,曲线下面积的比较差异有显著(8.90±0.95vs5.27±0.73,P<0.05);循环中TNF-α[(31.7±3.4)vs(37.7±1.1)pg/ml]和IL-1β[(18.0±3.2)vs(29.5±1.1)pg/ml]水平虽也下降,但差异无显著性,与之对应,IL-6[(46.2±9.8)vs(85.6±5.3)pg/ml]的水平明显降低(P<0.05)。结论雷帕霉素能提高obob小鼠胰岛素敏感性,有治疗改善肥胖诱导的胰岛素抵抗的作用。     

肺结核患者血清骨桥蛋白和白介素18的检测及意义

目的探讨肺结核患者血清骨桥蛋白(OPN)、白介素18(IL-18)、干扰素-γ(IFN-γ)和超敏C-反应蛋白(hs-CRP)水平的变化及其临床意义。方法选择初治的肺结核患者42例作为肺结核组,健康体检者36例作为对照组,应用酶联免疫吸附法(ELISA)测定血清OPN、IL-18、IFN-γ水平,免疫比浊法测定血清hs-CRP水平。比较肺结核组与对照组、伴有高热者和非高热者、痰菌阳性患者与阴性患者、病变程度严重患者与病情较轻患者OPN、IL-18、IFN-γ和hs-CRP水平。结果肺结核患者组血清OPN、IL-18、IFN-γ和hs-CRP水平明显高于对照组〔分别为(683.21±321.76)ng/ml vs.(168.46±117.31)ng/ml、(428.36±178.54)pg/ml vs.(157.32±83.45)pg/ml、(4.26±2.39)pg/ml vs.(0.17±0.36)pg/ml和(39.67±21.48)μg/ml vs.(3.23±1.34)μg/ml〕,差异均有统计学意义(P<0.05)。伴有高热(体温>39.0℃)患者血清OPN、IL-18、IFN-γ和hs-CRP水平明显高于非高热者〔分别为(743.66±364.23)ng/ml vs.(389.47±164.50)ng/ml、(456.32±261.41)pg/mlvs.(316.35±126.04)pg/ml、(4.67±3.21)pg/ml vs.(2.59±1.98)pg/ml和(51.24±21.62)μg/ml vs.(38.87±14.37)μg/ml〕,差异均有统计学意义(P<0.05);痰菌阳性的患者血清OPN、IL-18和IFN-γ水平明显高于痰菌阴性者〔分别为(612.48±340.33)ng/ml vs.(426.24±154.31)ng/ml、(436.76±211.78)pg/ml vs.(302.34±114.67)pg/ml和(3.81±2.01)pg/ml vs.(2.32±1.61)pg/ml〕,差异均有统计学意义(P<0.05)。病变程度严重的粟粒性肺结核、空洞性肺结核患者血清OPN〔(983.48±431.24)ng/ml、(778.65±214.69)ng/ml〕、IL-18〔(576.26±217.63)pg/ml、(414.57±194.35)pg/ml〕、IFN-γ〔(6.18±2.93)pg/ml、(5.07±2.34)pg/ml〕水平明显高于浸润性肺结核和结核性胸膜炎患者,差异均有统计学意义(P<0.05)。结论肺结核患者血清OPN、IL-18、IFN-γ和hs-CRP水平明显升高,OPN和IL-18可作为判断肺结核病变活动性和病情严重性的敏感指标。     

肺癌伴发感染患者降钙素原和炎性因子的检测及临床意义

目的:检测肺癌伴发感染患者降钙素原(PCT)和炎性因子含量并探讨其临床意义。方法:以临床确诊肺癌伴发全身感染患者为试验组,以单纯肺癌患者为对照组,采血测定外周血白细胞计数(WBC)、PCT、C-反应蛋白(CRP)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)等含量。结果:感染患者WBC与对照组相比显著升高[(8.31±1.42)×109/L vs.(5.85±1.08)×109/L,,差异有统计学意义(P<0.01)];PCT显著升高[(1.74±0.22)ng/ml vs.(0.65±0.10)],差异有统计学意义(P<0.01);CRP各组差异无统计学意义(P>0.05),但远高于正常值范围;IL-1含量显著升高[(15.38±2.56)pg/ml vs.(6.43±2.07)pg/ml],差异有统计学意义(P<0.01);IL-6含量显著升高[(164.27±21.79)pg/ml vs.(95.30±19.17)pg/ml],差异有统计学意义(P<0.01);TNF-α含量显著也升高[(1.22±0.15)ng/ml vs.(0.89±0.15)ng/ml],差异有统计学意义(P<0.01)。使用抗感染药物控制感染后,感染患者上述指标均降至对照水平。结论:PCT是判定肺癌患者伴发感染的良好指标。     

代谢综合征患者血清hs-CRP、IL-18水平与胰岛素抵抗的关系

目的 探讨代谢综合征(MS)患者血清C反应蛋白(hs-CRP)、白细胞介素-18(IL-18)水平与胰岛素抵抗(IR)的关系.方法 选择MS患者(MS组)40例和健康(C)对照组30例,测定受试者空腹血清hs-CRP、IL-18、体质量、腰围、血压、血糖、血脂及胰岛素等参数,计算稳态模型胰岛素抵抗指数(HOMA-IR). 结果 MS组hs-CRP、IL-18、BMI、SBP、DBP、FPG、2hPG、FINS、TG、HOMA-IR均明显高于对照组,且差异有统计学意义(P<0.05),MS组HDL-C明显低于对照组,差异也有统计学意义(P<0.05);hs-CRP与IL-18呈显著正相关(r＝0.536,P<0.05),hs-CRP、IL-18水平与HOMA-IR呈显著正相关,差异有统计学意义(P<0.05).结论 MS患者血清hs-CRP、IL-18水平均明显升高,且与IR程度明显相关,代谢综合征、胰岛素抵抗与体内炎症反应有关.     

双歧杆菌四联活菌片辅助治疗小儿非感染性腹泻疗效及其对血清IL-6、IL-17水平的影响

目的观察双歧杆菌四联活菌片(思连康)辅助治疗小儿非感染性腹泻的效果及其对血清IL-6、IL-17水平的影响。方法选取2014年3月—2015年2月陕西省榆林市中医医院儿科治疗的非感染性腹泻患儿68例,按照抽签法随机分为观察组和对照组各34例。对照组给予常规治疗,观察组在此基础上加用思连康。比较2组总有效率,治疗前和治疗7 d后IL-6、IL-17水平,并对2组患儿治疗后的病情改善情况进行比较。结果观察组总有效率为91.18%(31/34),明显高于对照组的70.59%(24/34),差异有统计学意义(P<0.05);治疗后,观察组血清IL-6、IL-17水平明显低于对照组[(9.47±1.01)pg/ml vs.(16.08±3.11)pg/ml,(10.47±1.14)pg/ml vs.(17.85±3.44)pg/ml,P<0.05];患儿体温恢复至正常时间、腹泻停止时间、住院时间均明显短于对照组[(3.11±0.63)d vs.(6.04±1.02)d,(2.21±0.31)d vs.(4.24±0.63)d,(4.22±0.54)d vs.(7.32±1.02)d,P<0.05]。结论小儿非感染性腹泻采取思连康进行治疗,可提高临床疗效,能明显降低患儿血清IL-6、IL-17水平,缩短止泻时间和治疗时间,明显改善病情。     

抑郁症患者帕罗西汀治疗前后血清细胞因子C-反应蛋白和锌水平变化的研究

目的探讨IL-6、IL-1β、TNF-α、CRP、锌在抑郁症病理生理机制中的作用。方法抑郁症患者33例,符合CCMD-3和ICD-10诊断标准;正常对照组23例。采用酶联免疫吸附法(ELISA)测定两组血清IL-6、IL-1β、TNF-α的水平,同时采用散射比浊法测定CRP,化学比色法测定锌水平。于治疗前后评定HAMD,分析抑郁症病情严重程度、病程、发病起始年龄、性别、HAMD总分及其因子分与血清IL-6、IL-1β、TNF-α、CRP、锌水平的关系。结果1.抑郁症组治疗前血清IL-6[(8.90±5.63)pg/ml]、TNF-α[(13.57±7.63)pg/ml]、CRP[(6.18±5.68)mg/L]水平显著高于正常对照组[(IL-6:(5.95±3.66)pg/ml,TNF-α:[12.87±5.34)pg/ml],CRP:[(2.50±1.44)mg/L],血清锌水平[(11.88±2.37)mmol/L]显著低于正常对照组[(13.60±1.90)mmol/L];抑郁症组血清锌水平[(11.19±2.21)mmol/L]女性患者显著低于男性患者(14.04±1.48)μmol/L;2.抑郁症组治疗前血清锌与HAMD中迟缓因子分有显著的正相关关系(r=0.351,P<0.05);3.帕罗西汀治疗后血清IL-6、TNF-α、CRP水平较治疗前显著下降(P<0.05),血清锌水平较治疗前显著升高(P<0.01)。结论1.血清IL-6、TNF-α、CRP水平升高可能是抑郁症的免疫学标志之一;2.锌可能对抑郁症的发病有一定作用;3.帕罗西汀可能对IL-6、TNF-α、CRP、锌有一定影响。     

吸烟对大鼠骨骼肌细胞葡萄糖转运子4基因表达及蛋白含量的影响

目的:探讨吸烟对胰岛素抵抗(IR)大鼠骨骼肌细胞葡萄糖转运子4mRNA基因表达及蛋白含量的影响。方法:正常6周龄Wistar大鼠48只,随机分为3组,分别为正常饲养组、高脂饲养组及糖尿病组,每组再随机分为吸烟组与对照组,吸烟组进行12周熏烟实验,应用高胰岛素-正葡萄糖钳夹技术进行IR的评价。应用RT-PCR及免疫组化技术检测被动吸烟大鼠及各自对照组大鼠骨骼肌细胞葡萄糖转运子4mRNA基因表达及蛋白含量的影响。结果:正常吸烟组、高脂饲养及糖尿病吸烟组葡萄糖输注率(GIR)明显低于各自对照组[(27.21±4.71)比(34.93±4.91)mg/(kg·min);(12.78±2.34)比(21.68±2.27)mg/(kg·min);(13.81±2.34)比(17.22±1.90)mg/(kg·min);P<0.01]。正常饲养吸烟组、高脂饲养吸烟组及糖尿病吸烟组大鼠骨骼肌细胞葡萄糖转运子4mRNA基因的表达量及蛋白含量与各自对照组相比无明显差异[(0.53±0.04)比(0.58±0.06)mg/(kg·min);(0.40±0.09)比(0.42±0.04)mg/(kg·min);(0.35±0.10)比(0.37±0.06)mg/(kg·min);P>0.05及(7.84±0.44)比(8.21±0.42)mg/(kg·min);(6.48±0.47)比(6.81±0.24)mg/(kg·min);(4.96±0.39)比(5.10±0.57)mg/(kg·min);P>0.05]。结论:吸烟能导致大鼠IR,吸烟对大鼠骨骼肌细胞葡萄糖转运子4mRNA基因表达及蛋白含量无明显影响,葡萄糖转运子4mRNA基因表达及蛋白含量可能不参与吸烟致IR的发生机制。     

N-乙酰半胱氨酸对慢性阻塞性肺疾病合并肺气肿患者血清炎性因子及肺功能的影响分析

目的分析N-乙酰半胱氨酸对慢性阻塞性肺疾病(COPD)合并肺气肿患者血清炎性因子及肺功能的影响。方法回顾性分析2015年1月—2017年1月扬州大学附属医院急诊科与呼吸科收治的COPD合并肺气肿患者80例临床资料,依据治疗方法不同分为对照组(n=40)和常规治疗联合N-乙酰半胱氨酸治疗组(观察组,n=40),治疗12周后对2组患者的肺功能指标、血清C反应蛋白(CRP)、白介素-18(IL-18)、IL-12水平进行统计分析。结果治疗后观察组患者的血清CRP、IL-18、IL-12水平低于对照组[(1.97±0.51)mg/L vs.(3.22±1.25)mg/L、(101.86±16.64)mg/L vs.(113.47±20.17)mg/L、(109.35±10.24)pg/L vs.(89.78±10.20)pg/L,t=3.355、3.250、3.169,P=0.025、0.021、0.035];2组患者治疗0 h、1 h血气分析各项指标的差异无统计学意义(P>0.05);观察组患者治疗后6 h、24 h血气分析Pa O2、Sp O2均明显高于对照组(P<0.05),Pa CO2明显低于对照组(P<0.05),但p H值之间的差异均不显著(P>0.05);观察组患者的FEV1、FVC、FEV1/FVC均高于对照组[(1.98±0.35)L vs.(2.64±0.41)L、(3.00±0.34)L vs.(4.01±0.24)L、(69.63±5.24)%vs.(78.84±4.64)%,t=6.965、4.541、3.747,P=0.020、0.034、0.021]。结论 N-乙酰半胱氨酸能够有效降低COPD合并肺气肿患者血清炎性因子水平,进而减轻患者肺部炎性反应,从而改善患者肺功能。     

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.