小儿肺炎支原体肺炎121例临床及X线分析

目的：探讨小儿肺炎以原体肺炎临床及Ｘ线特点。方法：采用日本富士明胶颗粒法测定小儿血清抗肺炎支原体抗体ＩｇＭ及胸部Ｘ线摄片。结果：确诊为支原体肺炎１２１例，临床表现主要有发热（４６．３％）、咳嗽（１００％）肺部体征少，胸片表现多种多样，包括：肺门阴影增大，间质浸润，支气管肺炎及叶／段实变。红霉素为治疗首选药物，有肺外合并症者加用糖皮质激素治疗有效。治疗：小儿支原体肺炎咳嗽症状多，肺部体征少，胸片表现     

小儿与儿童支原体肺炎的X线表现特点分析

分析５０例小儿支原体肺炎的Ｘ线表现特点，学龄期獐以节段性肺实质浸润为主，学龄前期以间质和肺站周围浸润改变为主。     

婴幼儿支原体肺炎37例对比性分析

本文将近年来所收治的３７例婴幼儿肺炎支原体肺炎与同期的年长儿肺炎支原体肺炎及婴幼儿其他病原所致的肺炎做了对比性分析报道。婴幼儿肺炎支原体肺炎发病率近年有所提高，与同龄其他病原所致肺炎比较，除平均发病年龄偏大外，症状及Ｘ线改变无明显差异。而与年长儿肺炎支原体肺炎比较，具有呼吸道症状体征明显，肺部Ｘ线改变多为双侧，肺外损害较多等特点。通过对比性分析为婴幼儿肺炎支原体肺炎的诊断提供了临床经验。     

肺炎支原体肺炎的临床表现和X线变化的再认识(附56例报告)

对56例肺炎支原体肺炎临床表现和X线变化进行了分析。结果表明,高热,刺激性干咳为主要症状;肺外表现相当多见;X线变化主要有支气管肺炎,肺门增大,间质改变和大片融合病灶等;19例肺部听诊未出现罗音。     

小儿支原体肺炎108例临床X线分析

目的提高对小儿支原体肺炎的认识和诊断水平。方法对我院收治的108例小儿支原体肺炎的临床X线资料进行回顾分析。结果小儿支原体肺炎以学龄儿童多见(56.1%),临床表现:发热、咳嗽、肺部体征多不明显;X线表现间质浸润型81例(75.1%),腺泡实变型19型(17.8%),混合型8例(7.1%)。其中,肺门淋巴结肿大或肺门结构不清23例(21.5%)。结论支原体肺炎临床表现不典型,X线表现呈多样性改变,诊断需要认真分析X线征象,密切结合临床和实验室检查。     

支原体肺炎53例肺外表现分析

支原体肺炎（ＭＰＰ）常合并肺外多系统器官的损害，现将本院１９９５年９月～１９９６年１２月确诊的ＭＰＰ合并肺外表现的５３例报告如下。１临床资料诊断标准①持续剧烈咳嗽伴发热；②肺部体征或有或无；③Ｘ线表现呈现不同程度的肺炎表现、肺门阴影增重或肺不张表现；...     

小儿支原体肺炎的X线表现及其鉴别

目的：通过分析小儿支原体肺炎的X线表现，以提高对本病的认识水平。方法：搜集80例经过临床和实验室检查证实为小儿支原体肺炎的X线胸片进行分析。结果：X线呈间质性肺炎表现、支气管肺炎样改变、肺叶或肺段实变以及肺门呈扇形阴影增大。结论：小儿支原体肺炎X线表现各异，无明显特征性，必须紧密结合临床与实验室检查，才能做出正确的诊断。     

小儿支原体肺炎25例临床分析

目的 提高对支原体肺炎的认识和诊断水平.方法 回顾性分析25例支原体肺炎患儿的临床及X线表现等资料. 结果 25例中8例表现为小斑、片状阴影或班片阴影互相融合或密度不均片状影,6例表现为节段或大叶颁布的致密影,11例表现为下肺野及肺门周围局部透亮度减低、结构模糊,3例表现为胸膜增厚或胸腔少量积液.X线表现与胸部体征不同步. 结论 X线征象结合临床及实验室检查对确诊支原体肺炎有重要价值.     

小儿肺炎支原体肺炎的X线诊断分析

目的探讨小儿支原体肺炎的胸部X线表现及临床特征,提高诊断水平。方法对63例支原体肺炎患儿的临床及X线资料进行回顾性分析。结果本组病例63例,间质浸润性病变21例,小叶性实质浸润型23例,肺段或大叶实质浸润14例,表现为单纯肺门淋巴结肿大肺门阴影增浓5例。结论小儿支原体肺炎肺部X线表现各异,通过X线检查,并与临床和实验室检查相辅助,对其早期诊断治疗具有重要作用。X线征象差异性和动态观察能够提高早期诊断和鉴别诊断准确性,为临床早期诊断、早期治疗提供重要依据。     

383例支原体肺炎住院患儿临床分析

目的：分析支原体肺炎的临床表现、相关辅助检查、治疗用药和疗效。方法：采用回顾性研究方法对本院2005年1月-12月收治的383例支原体肺炎住院患儿进行临床分析。结果：①年龄分布：最小3个月又10d，最大16周岁，其中男172例，女211例；②本组病例均有发热及咳嗽，部分患儿有呼吸困难；③肺外表现89例；④血MP-IgM阳性302例，咽MP-PCR阳性375例，二者同时阳性297例；⑤胸部X线表现：肺纹理增强为主102例，肺门影增浓为主76例，支气管肺炎改变为主132例，大片状影改变为主62例；⑥373例患儿应用红霉素后1周内热退。结论：支原体肺炎病程长，临床表现多样，首选药物为红霉素，规范治疗对预防复发及减少肺外并发症均有一定的意义。     

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.