异氟醚对体外循环炎性细胞因子的影响

目的:观察异氟醚吸入麻醉药对体外循环(CPB)早期炎性反应和晚期炎性反应的影响。方法:选取40例先天性心脏病房-室间隔缺损患者按麻醉维持不同随机分为两组异氟醚组(Iso组)和异丙酚组(Pro组),每组20例,Iso组以吸入体积分数为1.0%~1.5%异氟醚为主;Pro组主要用异丙酚维持。分别于以下6个时点采集动脉血,麻醉诱导后(T1)、切皮前(T2)、升主动脉开放后(T3)、CPB术后2h(T4)、CPB术后24h(T5)、CPB术后48h(T6)用放射免疫法测定肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6);采用免疫印迹法(Westerblot)检测HMGB1。结果:Iso组切皮前(T2)TNF-α明显下降,差异有显著性(P<0.05);T2~T4的值明显低于Pro组(P<0.05)。各组TNF-A、IL-6在CPB中及术后均较切皮前(T2)升高(P<0.05);两组间各时间点IL-6的差异无显著性(P>0.05);两组高迁移率族蛋白B1(HMGB1)在T1~T4时间点差异无显著性(P>0.05);在T5~T6时两组均显著增高,但Iso组均明显低于Pro组,差异具有显著性(P<0.05)。结论:异氟醚不仅可以抑制早期炎症细胞因子TNF-α、IL-6等的释放,同时也可以抑制晚期炎性介质HMGB1的释放,对CPB术中及术后炎性表达具有明显的抑制作用。     

1,6-二磷酸果糖对促炎性细胞因子释放的影响

目的　通过观察体外循环 (CPB)中预充 1,6—二磷酸果糖 (FDP)对CPB术后促炎性细胞因子释放的影响 ,探讨它减轻CPB术后全身炎症反应的作用和机理。方法　选择 3 8例主动脉阻断时间在 2 0min以上的心脏直视手术患者 ,随机分为实验组 2 0例 ,对照组 18例。实验组在常规CPB预充液中加入FDP2 0 0mg/kg ,对照组不用FDP。分别在手术开始前、CPB结束后即刻、CPB结束后 3h、6h及 2 4h抽取桡动脉血 ,采用ELISA法测定血浆肿瘤坏死因子 (TNF -α)、白介素 - 6(IL - 6)、白介素 - 8(IL - 8)的浓度。结果　两组患者术前血浆TNF -α、IL- 6、IL - 8的浓度无差异 ,在CPB结束后均已明显升高 ( p <0 .0 1) ,CPB后 3h达高峰 ,6h已开始下降 ,2 4hTNF-α恢复到接近术前水平 ( p>0 .0 5 ) ,IL - 6、IL - 8仍高于术前 ( p <0 .0 5 )。实验组患者TNF -α、IL - 6、IL - 8在CPB结束后即刻、3h、6h血浆浓度均明显低于对照组 ( p<0 .0 1) ,IL - 6、IL - 8在CPB结束后 2 4h也低于对照组 ( p<0 .0 5 )。结论　CPB术后血浆促炎性细胞因子TNF -α、IL - 6、IL - 8的浓度明显升高 ,在CPB预充液中加入FDP可明显减少CPB术后TNF -α、IL - 6、IL - 8的释放 ,表明此药可减轻CPB术后全身炎症反应。     

不同静脉麻醉药物对心瓣膜置换术患者IL-6、IL-8、IL-10的影响

目的 :观察咪唑安定和异丙酚对体外循环 (CPB)心瓣膜置换术围术期 IL - 6、IL- 8、IL - 10的影响。方法 :将2 0例择期行 CPB心瓣膜置换术的风湿性心脏病患者随机分为咪唑安定组 (M组 )和异丙酚组 (P组 ) ,每组 10例。麻醉诱导 M组用咪唑安定 0 .0 6～ 0 .10 mg/kg,P组用异丙酚 1.0 0～ 1.5 0 mg/kg静注 ,其余均用东莨菪碱、芬太尼、维库溴铵、利多卡因诱导 ,麻醉维持除用芬太尼、维库溴铵间断静注外 ,M组分次追加咪唑安定 0 .0 4～ 0 .1mg/kg,P组静注异丙酚 3～ 5 mg/kg· h-1。分别在麻醉前 (T1)、腔静脉插管时 (T2 )、主动脉阻断后 30 min(T3)、主动脉开放后10 min(T4 )、1h(T5 )、2 h(T6 )、4 h(T7)、2 4 h(T8)从桡动脉采血 ,测定 hct、IL- 6、IL - 8、IL - 10。结果 :与 T1相比 ,3组患者 T4～T7外周血 IL- 6、IL- 8、IL- 10明显升高 (P<0 .0 1) ,分别于 T5、T6、T5达峰值 ;P组 T7时 IL- 8值明显低于同时点的 M组 (P<0 .0 5 ) ;而 T4～T6时 IL- 10则显著高于同时点的 M组 (P<0 .0 5或 P<0 .0 1)。结论 :与咪唑安定麻醉相比 ,异丙酚麻醉能减轻 CPB心瓣膜置换术患者围术期 IL- 8反应和增加 IL- 10释放。     

脑瘤手术中吸入异氟醚或异丙酚麻醉对血流动力学及应激反应的影响

目的　研究两种麻醉方法对血流动力学和应激反应的影响。方法　行脑瘤手术的 38例病人随机分为两组 ,醚组和酚组 ,醚组 (2 0例 ,咪唑安定、芬太尼、万可松诱导 ;维持麻醉为吸入异氟醚 1MAC ,30min后 1.5MAC ,30min。间断静注芬太尼、万可松 ) ;酚组 (18例 ,诱导同醚组 ,维持麻醉为全凭异丙酚静脉泵入 6mg·kg 1 ·h 1 ,30min后 12mg·kg 1 ·h 1 ,30min。间断静注芬太尼、万可松 )。快速补液。两组分别于诱导前 (T1 )、插管后即刻 (T2 )、麻醉维持 30min(T3)和 6 0min(T4 ) 4个时动脉血测定血糖浓度。同时监测血流动力学。结果　 (1)血流动力学变化　醚组 :MAP值在T3、T4 时点非常显著降低 (P <0 .0 1) ,且显著低于酚组同时点值 (P<0 .0 5 )。HR值各时点无统计学差异 (P <0 .0 5 ) ;酚组 :MAP值在T4 时点显著降低 (P <0 .0 5 )。HR值在T3、T4 时点显著降低 (P<0 .0 5 ) ,并低于醚组同时点值 (P <0 .0 5 )。 (2 )动脉血血糖浓度的变化　异丙酚组各时点血糖无变化 ;异氟醚组血糖浓度在麻醉后 30及 6 0min显著升高 (P <0 .0 5 ,P <0 .0 1)。结论　酚组的麻醉方式可适当控制应激反应 ,术中平稳 ,更利于脑瘤手术     

异丙酚和异氟醚麻醉对老年患者术后认知功能的影响

目的:探讨异丙酚和异氟醚麻醉对老年患者术后认知功能的影响。方法:选择骨科全麻手术患者40例,术前无神经精神系统疾病史,近1个月未服用脑血管扩张药,ASAI～Ⅱ级。随机分为2组:I组为异丙酚组(n=20),Ⅱ组为异氟醚组(n=20),术中分别以异丙酚和异氟醚维持麻醉。用简易智能量表(MMS)的方法评估两者对认知功能的影响。结果:2组麻醉时间及术中各时点MAP、HR、SPO2比较差异均无统计学意义(P0.05)。MMS评分:Ⅱ组在麻醉结束后6h(T5)、12H(T6)、24h(T7)时,I组在T5、T6时较麻醉诱导前(T6)明显降低,Ⅱ组T7时点与I组同时点比较差异有统计学意义(P0.05)。结论:异氟醚和异丙酚用于老年患者麻醉均能引起术后认知功能障碍,但异丙酚麻醉术后认知功能障碍恢复明显快于异氟醚麻醉患者。     

异氟醚对人肺泡巨噬细胞趋化因子和细胞因子mRNA表达的影响

目的　研究异氟醚麻醉中人肺泡巨噬细胞IL 8、IL 1β、TNF α、IFN γ、IL 4和IL 10mRNA的表达 ,探讨异氟醚对肺炎性反应的影响。方法　 2 4例肝脏部分切除手术病人随机分为异氟醚组 (n =12 )和对照组 (n =12 ) ,在麻醉诱导后即刻和 4h分别用纤维支气管镜行支气管肺泡灌洗 ,从灌洗液中收获肺泡巨噬细胞提取RNA ,逆转录合成cDNA以 β actin为内对照作PCR后电泳扫描求积 ,检测肺泡巨噬细胞上述细胞因子、趋化因子mRNA的表达。结果　异氟醚组麻醉诱导后 4h比麻醉诱导后即刻IL 8、IL 1βmRNA的表达显著增加 (P <0 .0 5 ) ,对照组麻醉诱导后 4h比麻醉诱导后即刻IL 8、IL 1βmRNA的表达轻度增加 (P <0 .0 5 ) ;在麻醉诱导后4h ,异氟醚组和对照组之间IL 8、IL 1βmRNA的表达水平差异有显著意义 (P <0 .0 5 )。TNF α、IFN γ、IL 4和IL 10mRNA的表达在麻醉前后无明显变化。结论　异氟醚能增强病人肺泡巨噬细胞促炎性细胞因子、趋化因子mRNA的表达 ,提示异氟醚可能加重肺部的炎性反应     

异丙酚对颅内肿瘤患者围术期血浆中一氧化氮和内皮素水平的影响及临床意义

目的:观察异丙酚对颅内肿瘤患者围手术期血浆中一氧化氮（NO）和内皮素(ET)水平的影响,探讨异丙酚的脑保护作用机制。方法：将40例 ASAⅠ～Ⅱ级颅内肿瘤择期手术患者进行编号,用随机数字表法分为异丙酚组和异氟醚组,每组20例。麻醉维持分别为异丙酚组：生理盐水500 mL加异丙酚;异氟醚组：1%～2%的异氟醚持续吸入,两组均间断给予芬太尼、维库溴铵维持麻醉。分别于麻醉诱导前（T1）、气管插管后1 h(T2)、2 h(T3)、术后4 h(T4)和24 h(T5),抽取静脉血,测定血浆NO及ET含量。结果：T1和T2时,两组患者血浆NO和ET水平比较差异无显著性; T3和T4时,异丙酚组血浆NO和ET水平低于异氟醚组（P<0.05）;T5时,异氟醚组和异丙酚组血浆NO水平均升高,两组比较差异无显著性;异氟醚组和异丙酚组血浆ET水平虽均降低,两组比较差异有显著性（P<0.05）。结论：临床麻醉剂量的异丙酚能显著降低颅内肿瘤患者围术期血浆中NO及ET水平,提示异丙酚具有非选择性抑制一氧化氮合酶(NOS)及体内ET生成的作用,从而具有多途径、多位点的脑保护特性。     

氯胺酮异丙酚静脉全麻与异氟醚吸入全麻苏醒对比观察

目的 :评价氯胺酮 -异丙酚完全静脉麻醉的苏醒情况。方法 :选择 6 0例ASAⅠ -Ⅱ级乳腺癌根治术的病人 ,随机分为异氟醚吸入全麻组 (A组n =30 )和氯胺酮 -异丙酚静脉全麻组 (B组n =30 )。A组吸入异氟醚维持麻醉 ,B组持续静脉泵入氯胺酮 1 .5mg/kg/h ,异丙酚 8～ 6mg/kg/h维持麻醉。记录病人的术后行为评分 ,以及意识恢复、拔管、完全清醒时间和2 4h术后随访情况。结果 :A组术后意识恢复、拔管、完全清醒时间均明显长于B组 (P <0 0 1 )。A组遗忘、定向力、合作评分均不同程度高于B组 (P <0 0 5 )。B组个别病例术后居复期存在精神症状 ,但无统计学意义。结论 :氯胺酮 -异丙酚TIVA与异氟醚吸入全麻相比苏醒快捷、完全 ,无后遗作用     

盐酸戊乙奎醚对体外循环机体炎症反应的影响

目的研究盐酸戊乙奎醚对体外循环(CPB)机体炎症反应的影响。方法选择40例择期行体外循环瓣膜置换术的风湿性心脏病患者,按随机数字表分为盐酸戊乙奎醚组(P组)和生理盐水对照组(C组),每组20例。P组诱导和预充液中使用盐酸戊乙奎醚,对照组则使用生理盐水,分别于麻醉诱导前(T0),CPB开始后30min(T1),主动脉开放10min(T2),CPB结束后2h(T3),抽取动脉血,测定血浆白介素(IL)-6、肿瘤坏死因子(TNF)-α的浓度,并观察术后肺炎发生率、全身炎症反应综合征(SIRS)发生率、有无谵妄等临床指标。结果组内比较,P组和C组在T2、T3时,IL-6浓度均高于T0、T1(P<0.05);P组TNF-α浓度在T3时低于T1和T2(P<0.05)。组间比较,在T2、T3时,P组IL-6浓度低于C组(P<0.05);TNF-α浓度各时间点差异无统计学意义(P>0.05)。肺炎发生率和SIRS发生率P组均低于C组(P<0.05)。结论应用盐酸戊乙奎醚能一定程度上抑制细胞因子的释放,对CPB术后SIRS和肺部并发症有一定的防治作用。     

异丙酚加小剂量芬太尼对体外循环手术心肌核因子-κB的影响

目的 :观察异丙酚加小剂量芬太尼对小儿体外循环心脏手术心肌核因子 κB(NF κB)和细胞间粘附分子1(ICAM 1)的影响 ,探讨其减轻心肌缺血再灌注损伤的可能机制。方法 :2 0例体外循环 (CPB)下手术治疗的先天性心脏病 (ASD、VSD)病人 ,随机等分为异丙酚加小剂量芬太尼联合组 (PF组 ,异丙酚 2mg·kg- 1 ·h- 1 加芬太尼 2 0～ 30μg·kg- 1 )和大剂量芬太尼组 (HF组 ,芬太尼 6 0～ 70 μg·kg- 1 )。检测上、下腔静脉置管时和开放主动脉 30min时右心耳心肌NF κB和ICAM 1的表达 ,在切皮前 (T0 )、CPB前 (T1 )、主动脉阻断 2 5min(T2 )、主动脉开放 30min(T3)、CPB后12 0min(T4 )和术后 2 4h(T5)的血清过氧化物歧化酶 (SOD)活性 ,并记录术后气管拔管时间及恢复情况。结果 :在主动脉开放 30min时 ,两组心肌NF κB和ICAM 1的灰度值比CPB前显著降低 (P <0 .0 5 ) ,但PF组心肌NF κB及ICAM 1的灰度值显著高于HF组 (P <0 .0 5 )。在T2 、T3和T4 时 ,PF组SOD活性值显著高于HF组 (P <0 .0 5 )。术后两组病人均顺利康复 ,但PF组病人术后气管导管拔出时间较HF组早 (P <0 .0 5 )。结论 :异丙酚加小剂量芬太尼复合麻醉可能通过抑制心肌NF κB、ICAM 1的表达与活性 ,对缺血再灌注心肌产生保护作用     

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.