超声观测胎儿胸腺的临床意义

目的超声观察胎儿胸腺并应用改良Simpson法公式计算其体积,建立正常值参考范围,旨在发现胸腺发育异常及其临床意义。方法检查胎龄20～39+孕周无明显异常胎儿,选取在三血管或三血管气管切面,应用改良Simpson法测量胸腺的容积(体积),计算正常值范围,采用回归分析各测量项与孕龄的关系。并依此进行胸腺筛查。取不同孕期胎儿,分析其体积正常值范围。结果胎龄20～23+周时胸腺体积平均值(0.91±0.29)cm3;24～27+周时为(2.65±0.62)cm3;28～31+周时为(4.78±1.25)cm3;32～35+周时为(6.43±1.39)cm3;36～39+周时为(10.65±1.92)cm3。共检出了7例胎儿胸腺减少。结论胎儿胸腺体积随胎龄的增长而增长,高分辨力超声能清楚地显示胸腺。改良Simpson法测量胎儿胸腺体积是评估其大小的可行方法之一。     

胸膜恶性间皮瘤和转移性肺腺癌的微绒毛,桥粒超微结构形态测量研究

本文研究结果表明,应用超微结构形态测量其微绒毛、桥粒有助于胸膜恶性间皮瘤和转移性肺腺癌的鉴别。16例胸膜恶性间皮瘤平均微绒毛长宽比值(L/W)为11.76。相反,10例转移性肺腺癌平均微绒毛L/W为5.22,两者之间具有显著差异(P<0.001)。本文测量了16例恶性间皮瘤和10例转移性肺腺癌的桥粒长度,两组平均桥粒长度差异不十分显著,但是,所有16恶性间皮瘤的桥粒长度均有大于1.5μm,相反,10例转移性肺腺癌无1例桥粒长度超过1.5μm,表明恶性间皮瘤具有长的桥粒,而转移性肺腺癌则缺乏长的桥粒。     

胎龄为26～41周的新生儿骨生长发育的放射学测量的横断面研究

对胎龄为26～41周的347名新生儿(男228例,女119例)拍仰卧位X线片,测量其上肢骨(肱骨)、下肢骨(股骨)等长骨骨化部分的长度和L1椎体的中轴长度(即高度)。所有儿童都在重症监护室治疗。入院治疗原因有肺透明膜病、胎粪吸入综合征、新生儿窒息或短暂的呼吸急促。异常生长、巨观畸形或多胞胎产儿不在研究之列。胎龄在26～41周男婴的L1长度平均每周增加0.23m m,肱骨增长1.82m m,股骨增长2.35m m。而女婴的相应指标分别为0.20m m,1.54m m和2.30m m。在胎龄26～41周内L1长度与身长的比值逐渐增加。两性在胎龄34周时L1都有一个生长突增现象。胎龄<…     

对腹腔内脏器表面间皮细胞的扫描电镜观察

本文应用扫描电镜对小鼠、大鼠与家兔的肝、脾、胃、磅胱与卵巢等器官外表面的间皮细胞进行了观察。发现这些器官的间皮细胞都具有微绒毛,但其长短、粗细和分布的疏密程度有所不同。其共同特征是在细胞中央有核处向外突出,其顶部微绒毛较少,四周两相邻细胞相接处稍下陷形成浅沟,该部微绒毛较多本文对不同器官间皮之间的差异进行了描述,并联系其机能意义进行了讨论。     

屈光性角膜切除术对兔角膜内皮细胞的影响

目的探讨ArF准分子激光对角膜内皮细胞的影响.方法运用ArF准分子激光对15只新西兰白兔(30眼)行不同深度(100、200、300μm)屈光性角膜切除术(PRK),通过扫描和透射电镜观察急性期角膜内皮细胞的形态和结构变化.结果消融深度为100μm和200μm的标本中,角膜内皮细胞的形态和结构没有变化.切削深度为300μm组中扫描电镜示术后30min可见角膜内皮细胞明显水肿,面积增大(195μm2),形态不清,内皮细胞表面微绒毛减少,其细胞间的连接也不紧密.术后3d内皮细胞水肿较前减轻(169μm2),微绒毛增多.术后7d时内皮细胞恢复至正常状态(128μm2).结论一定深度的准分子激光才会对角膜内皮细胞造成影响,且随着时间的推移这种损伤会得到修复.     

对胎儿肝血管内皮的扫描电镜观察

对12例不同胎龄之胎儿肝脏进行扫描电镜观察,发现胎儿肝各血管内皮游离面结构随胎儿的发育及所在部位不同而有差异。血窦内皮上有窗孔,小叶间静脉之内皮有小孔样结构;中央静脉者无窗孔而有微绒毛样结构,小叶间动脉者无上述结构而有微褶等。并对观察所见结构之功能意义进行了分析讨论。     

人胎膈胸膜孔超微结构的研究

本文应用扫描电镜和透射电镜对人胎膈胸膜孔作了研究.膈胸膜间皮细胞表面有长而密集的微绒毛,其外观呈疏网状.胸膜孔位于2~3个间皮细胞之间,直径约6.2μm.在胸膜孔内,间皮细胞伸出瓣膜状胞质突起,使孔内通道蜿蜒曲折.胸膜孔可能是胸膜腔内物质吸收的主要通道之一.     

对胎儿晶状体发育的扫描电镜观察

对人胚胎晶状体的发育进行了扫描电镜观察。结果表明,晶状体囊表面光滑,前上皮与囊的相邻面有许多微绒毛。晶状体纤维表面随着胎龄增长出现差异。二个月胎儿纤维表面光滑。三个月胎儿纤维表面出现球形突起。四个月以后的胎儿晶状体纤维表面除球形突起外,还可见指状、舌状突起。在无突起形成的部位有微嵴及斑块状结构。随着胎龄的增长,突起的体积和数量均增加。纤维表面的突起不仅可以加强纤维间的连接,而且与晶状体的代谢密切相关。     

屈光性角膜切除术对兔角膜内皮细胞的影响

目的：探讨ArF准分子激光对角膜内皮细胞的影响。方法：运用ArF准分子激光对15只新西兰白兔（30眼）行冰同深度（100、200、300μm）屈光性角膜切除术（PRK），通过扫描和透射电镜观察急性期角膜内皮细胞的形态和结构变化。结果：消融深度为100μm和200μm的标本中，角膜内皮细胞的形态和结构没有变化。切削深度为300μm组中扫描电镜示术后30min可见角膜内皮细胞明显水肿，面积增大（195μm^2),形态不清，内皮细胞表面微绒毛减少其细胞间的连接也不肾密。术后3d内皮细胞水肿较前减轻（169μm^2)，微绒毛增多。术后7d时内皮细胞恢复至正常状态（128μm^2)。结论：一定深度的准分子激光才会对角膜内皮细胞造成影响，且随着时间的推移这种损伤会得到修复。     

人卵黄囊的超微结构研究

作者对不同孕周的人卵黄囊２０例进行了电观察，结果显示卵黄囊壁由内胚层，间充质和间皮组成，内胚层细胞表面有丰富的微绒毛，胞质内有许多粗面内质网，高尔基复合体及小管状结构。间皮细胞表面的微绒毛细长并呈分枝状，表面质膜下有胞饮小泡。间充质及其血管腔内有不同成熟程度的红细胞。     

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.