微生物感染与不良妊娠关系的探讨

目的：分析不同妊娠情况微生物检测结果，探讨微生物感染与不良妊娠之间的关系。方法：对各种不良妊娠患、妊娠正常的人工流产妇女、正常分娩的产妇应用聚合酶链反应（PCR）方法检测各种微生物，所检测的微生物包括腺病毒（ADV）、人类微小病毒B19（B19V）、巨细胞病毒（CMV）、爱泼思坦－巴尔病毒（EBV）、单纯疱疹病毒（HSV）、风疹病毒（RV）、柯萨奇病毒（COX）、弓形虫（TOX）、沙眼衣原体（CT）、解脲支原体（UU）。结果：各种微生物感染在不良妊娠患均有阳性发现，微生物的分布情况呈B19V（23．6％）＞CMV（16．0％）＞TOX（15．1％）＞RV（10．4％）＞UU（9．4％）＞COX（7．5％）＞HSV（6．6％）＞ADV、EBV（3．8％）＞CT（2．8％）顺序排列。2个政党组亦有少数阳性发现。不良妊娠患与正常人流妇女、正常分娩产妇的各结果比较，B19V、CMV、RV、HSV、TOX检测结果之间的差别均具有显性（P＝0．000－0．031），其余各微生物检测结果之间的判别无统计学意义（P＝0．121－0．724）。正常人流妇女与正常分娩产妇组间各结果的差别均无统计学意义（P＝0．339－1．0）。结论：微生物感染对妊娠健康有很大影响，其中B19V、CMV、RV、HSV可能是造成不良妊娠的主要微生物，其余微生物感染对妊娠也有一定的不良影响。诊治这些微生物感染应作为妊娠期预防保健常规项目。     

微生物感染与不良妊娠的关系

目的:探讨微生物感染与不良妊娠之间的关系。方法:应用聚合酶链反应检测多种微生物(包括腺病毒,ADV;人类微小病毒B19V,巨细胞病毒,CMV;爱泼思坦-巴尔病毒,EBV;单纯疱疹病毒,HSV;风疹病毒,RV;柯萨奇病毒,COX;弓形虫,TOX;沙眼衣原体,CT;解脲支原体,UU)。结果:在不良妊娠组,微生物的阳性率呈B19V(23.6%)>CMV(16.0%)>TOX(15.1%)>RV(10.4%)>UU(9.4%)>COX(7.5%)>HSV(6.6%)>ADV和EBV(均3.8%)>CT(2.8%)排列;与正常人流者、正常分娩产妇比较,B19V、CMV、RV、HSV、TOX检测结果之间的差别均具有显著性(P=0.000~0.031),其余结果之间的差别无统计学意义(P=0.121~0.724)。正常人流妇女与正常分娩产妇组间各结果的差别均无统计学意义(P=0.339~1.0)。结论:微生物感染对妊娠健康有很大影响,其中B19V、CMV、TOX、RV可能是本地造成不良妊娠的最主要微生物。     

应用荧光杂交定量PCR和ELISA法进行产前TORCH筛查比较及临床意义的研究

目的：比较荧光杂交定量PCR和ELISA法进行产前TORCH筛查的差异，探讨病原微生物拷贝数在临床诊治中的作用；方法：分别用荧光杂交定量PCR和ELISA IgM法筛查孕期血标本272例，其中包括妊娠早期102例，晚期170例；采集121例分娩孕妇及新生儿脐带血标本；222例不明原因流产标本，其中66例采集了新鲜自然流产脱膜和绒毛；结果：孕期筛查血CMV DNA和TOX DNA的阳性率分别为1．8％（5／272）和0．36％（1／272），其中妊娠早期CMV DNA的阳性率为2．9％（3／102），晚期为1．2％（2／170），不明原因流产，查出血清CMV感染22例，TOX4例，CMV DNA和TOX DNA的阳性率分别为9．9％（22／222）和1．8％（4／222）。脱膜和绒毛均感染3例，1例血清，脱膜感染但未采到绒毛标本。有2例是母血清中查到CMV，流产组织中未查到。查出血清，脱膜和绒毛均感染TOX1例，妊娠妇女外周血CMVDAN≥10^3有88％的发生流产；结论：荧光杂交定量PCR法不但具有较高的灵敏度和特异性而且可检测病毒负载量－拷贝数／ml，拷贝数越高发生流产的可能性愈高，应推荐作为妊娠初期筛查的首选方法。     

先天性心脏病心脏组织中TORCH病原基因的检测

目的　探讨先天性心脏病 (CHD)心肌组织中 TORCH各病原体 (弓形体 / TOX;风疹病毒 / RV;单纯疱疹病毒 / HSV2 ;巨细胞病毒 / CMV)的感染状况 .方法　通过收集 42例先天性心脏病及 38例对照组的心脏组织石蜡标本 ,用聚合酶链反应 (PCR)或逆转录 -聚合酶链反应 (RT- PCR)技术进行病毒基因的检测 .结果　在 42例先天性心脏病心肌组织中检测到 CMV,HSV2 ,TOX的阳性率分别为 2 6.2 % ,4.7%和 16.7% ,而 38例对照组中 CMV,HSV2 ,TOX的阳性率分别为 2 1.1% ,2 .6%和 2 .6% ,两组比较 TOX在两组中的检测差异有显著性 (P=0 .0 37…     

1416例围产期妇女TORCH感染血清学调查

TORCH是在围产期引起宫内感染的一组常见病毒,为了解围产期妇女 TORCH感染情况,本文将在山西省妇幼保健院产科门诊1416 例围产期妇女用ELISA法检测了弓形虫(TOX),风疹病毒(RV),巨细胞病毒(CMV),单纯疱疹病毒(HSV)的 IgM,结果如下:TOX0.21％、RV0.28％、CMV0.98％、HSV4.8％.总阳性率为6.2％。     

新余地区TORCH感染与不良妊娠关系的调查分析

目的探讨本地区不良妊娠与弓形体(TOX)、风疹病毒(RV)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV)(TORCH)系列病原体感染的相关性及找出相应的处理方法.方法应用酶联免疫吸附试验(ELISA),检测2009年1月~2011年12月之间86例有不良妊娠史的妇女(试验组)及1823例正常孕妇(对照组)TORCH感染情况,探讨两者之间的关系.结果(1)试验组TORCH感染率为,TOX 13.95%;RV 10.46%;CMV 17.44%;HSV 3.49%.(2)而同时段正常育龄孕妇相应的TORCH活动性感染率为:TOX 0.16%,RV0.33%,CMV 0.44%;HSV 0.05%.试验组均显著高于对照组(P<0.01).结论 TORCH系列病原体感染是导致妇女不良妊娠结局的重要原因之一,对有不良妊娠史的妇女,行TORCH筛查对防止出生缺陷和围产儿合并症及并发症完全必要.     

先天性心脏病与弓形虫、风疹病毒、巨细胞病毒及单纯疱疹病毒感染的关系

目的 探讨先天性心脏病(先心病)与弓形虫(TOX)、风疹病毒(RV)、巨细胞病毒(CMV)及单纯疱疹病毒(HSV)感染的关系.方法 选取80例先心病患者(先心病组)和32例非先心病者(对照组).采用聚合酶链反应(PCR)荧光定量方法 检测两组受检者心肌组织、血清和白细胞中的TOX、RV、CMV及HSV 4种基因并进行比较.结果 先心病组心肌组织中TOX、RV、CMV、HSV的基因检出率分别为16.2%、18.8%、28.8%和7.5%,对照组分别为0、0、18.8%和6.2%,两组TOX、RV基因检出率间差异有统计学意义(P＜0.05),CMV、HSV基因检出率间差异无统计学意义(P＞0.05).先心病组与对照组心肌组织中CMV、HSV阳性者的CMV[(5.50±1.30)copies/ml和(5.30±0.33)copies/ml]、HSV[(4.51±0.87)copies/ml和(4.32±0.17)copies/ml]基因定量比较,差异均无统计学意义(P＞0.05);先心病组与对照组白细胞中CMV阳性者的CMV[(5.23±1.20)copies/ml和(5.02±0.79)copies/ml]基因定量比较,差异亦无统计学意义(P＞0.05).结论 先心病的发生与TOX、RV、CMV、HSV感染有关,但与病原体感染的数量无关.     

先天性心脏病心肌组织中HPVB19,RV基因的检测

目的：探讨HPVB19和RV等病原感染与先心病的发病关系。方法：采用PCR，RT－PCR及ISH等分子生物技术，对79例先心病和46例非先心病的先心病心肌组织中HSVB19，RV，TOX等病原基因进行检测及B19病毒在心肌细胞内定位研究。结果：①在先心病心肌组织中B19，TOX，RV，HSV病原基因的检测阳性率分别为18％（12／66），13％（10／79），23％（7／30）和4％（3／79），前三与对照组间比较有显性差异（P＜0．05），而HSV在两组间无统计学意义（P＞0．05），提示B19，TOX，RV为先心病发病的重要危险因子。②对活检心肌组检测上述病原基因的阳性病例，同时作血清中B19，TOX，RV的特异性IgM检测均阴性。③通过原位杂交显示B19病毒DNA主要分布在心肌细胞核内，光学显微镜下心肌细胞无炎性浸润。结论：先心病心肌组织中可检测到HPVB19，TOX，RV基因，并有较高的阳性率，提示它们可能是先心病发病的重要感染病原。     

绵阳地区1358例孕妇TORCH感染的血清学筛查

目的了解绵阳地区妊娠妇女TORCH感染的情况。方法采用酶联免疫吸附试验(ELISA)对1358例孕妇血清同时进行TORCH的IgM和IgG检测。结果孕妇TORCH(TOX、RV、CMV、HSVⅠ和HSVⅡ)IgM抗体感染的阳性率分别为0.15%、1.18%、0.37%、0.44%、0.22%;TORCH-IgG抗体感染的阳性率分别为6.12%、63.99%、94.70%、92.49%、17.82%。TORCH相关抗体检查4种筛查结果:lgG(+)IgM(-):TOX83例,RV869例,CMV1286例,HSVⅠ1256例,HSVⅡ242例;IgG(-)IgM(+):TOX1例,RV7例,CMV3例,HSVⅠ5例,HSVⅡ3例;IgG(+)IgM(+):TOX1例,RV9例,CMV2例,HSVⅠ1例,HSVⅡ0例;IgG(-)IgM(-):TOX1273例,RV473例,CMV67例,HSVⅠ96例,HSVⅡ1113例。结论孕前或孕期妇女同时进行TORCH-IgM/IgG检测,可及时了解孕妇TORCH感染阶段,尽早采取方法和措施,对提高人口素质具有重要意义。     

钦州市异常孕产史妇女常见病原体检测分析

目的 探讨异常孕产(自然流产、死胎和胎儿畸形)与妇女常见病原体[梅毒(TP)、弓形体(TOX)、单纯疱疹病毒(HSVⅡ)和巨细胞病毒(CMV)]的相关性.方法 用酶联免疫(ELLSA)法检测异常孕产史妇女(497例)血中TP-IgM、TOX-IgM、HSVⅡ-IgM和CMV-IgM,并与正常孕产妇女(125例)比较,探讨异常孕产与4种病原体的关系.结果 异常孕产史妇女中TP-IgM、TOX-IgM、HSVⅡ-IgM和CMV-IgM感染阳性率分别为1.81%、9.86%、1.61%和9.26%;正常孕产妇女仅TOX和CMV阳性病例各1例,其感染阳性率均为0.80%.在自然流产和胎儿畸形组,TOX感染阳性率分别为10.74%和7.41%;CMV感染阳性率分别为10.02%和7.41%.结论 TOX和CMV感染是引起异常孕产的重要因素之一;在异常孕产中,以自然流产比率最高,胎儿畸形次之.因此,建议把TOX和CMV作为妊娠前或妊娠早期妇女常规检测项目,以便及早发现,及时防治,减少异常孕产的发生.     

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.     

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.