微柱凝胶技术检测孕妇血型抗体效价的研究

目的探讨运用微柱凝胶法技术检测孕妇血清中IgG抗A（B）血型抗体水平的效果，以预防新生儿溶血病的发生。方法采用微柱凝胶技术检测IgG抗A（B）血型抗体效价，并对阳性者予以相应的治疗。结果1539例孕妇中IgG抗A（B）效价≤1：64的1002例，≥1：128的537例，其中231例经中药治疗后复查，180例IgG A（B）效价降至1：64以下，51例无变化，总有效率为78％。结论用微柱凝胶技术检测孕妇血清中1如抗体水平具有操作快速、简便、准确、灵敏度及特异性大大高于试管法，具有重复性好，结果客观、实验样本量少、生物污染少以及结果可以长期保存等优点。     

微柱凝胶手工法在ABO HDN病中的应用

目的探讨微柱凝胶手工法检测围产期孕妇IgG抗A、B抗体效价的临床意义。方法采用微柱凝胶手工法：西班牙DianaFuge离心机、Diana孵育器及微柱凝胶Coombs卡。取围产期夫妻血型不合，O型孕妇2533例全血2ml进行检测，预测新生儿ABO HDN的发病情况。结果IgG抗A、B抗体效价≥1：64者有703例，占27.75％，则提示有27．75％的胎儿有ABO HDN发生的可能。结论微柱凝胶手工法检测围产期孕妇产前抗体效价具有重要临床意义，值得推广应用。     

92例孕妇产前IgG抗体效价的微柱凝胶法检测

目的探讨微柱凝胶法检测对孕妇产前IgG抗体效价的意义。方法取92例夫妻血型不合的O型孕妇血清进行微柱凝胶法检测,并观察新生儿ABO新生儿溶血病(HDN)的发病情况。结果IgG抗A抗体效价≥64者17例,占39.53%;抗B抗体效价≥64者20例,占40.82%。IgG抗A抗体者的总发病率为12.20%,IgG抗B抗体者的总发病率为14.29%。2者的发病均出现在抗体效价≥64。结论产前检测IgG抗体水平具有重要的临床意义。     

孕妇IgG抗A（B）效价与ABO新生儿溶血病的关系

目的探讨孕妇IgG抗A（B）效价与ABO新生儿溶血病（ABO-HDN）的关系。方法对491例与丈夫血型不合的O型RhD（＋）孕妇IgG抗A（B）抗体水平进行检测。以抗体效价≥64为阳性,对IgG抗体阳性的孕妇分娩的新生儿做血型鉴定、胆红素测定和溶血三项试验,从而分析孕妇IgG抗A（B）效价与ABO新生儿溶血病的关系。结果491例O型RhD（＋）孕妇IgG抗A（B）效价≥64者200例,占40.7%;200例IgG抗体阳性孕妇分娩的新生儿中有108例母婴血型不同,其中49.1%为第一胎;发生ABO-HDN的28例,占25.9%。孕妇IgG抗A（B）效价为64、128、256、≥512的ABO-HDN的发病率分别为10.2%、34.3%、66.7%和80.0%（〈0.01）。结论孕妇IgG抗A（B）的效价高,ABO-HDN发病可能性大。产前进行IgG抗A（B）效价的检测对预防和治疗母婴血型不同的新生儿溶血病有积极作用。     

1539例孕妇血清ABO抗体水平检测及分析

目的探讨产前检测ABO抗体的重要性。方法用微柱凝胶法对1 539例孕妇进行血型鉴定及产前ABO血型IgG抗A（B）抗体水平检测。结果 IgG抗A（B）抗体效价阳性检出率（效价大于1：64）O-A〉O-B〉O-AB,差异有统计学意义（P〈0.05）。1 539例孕妇中抗体效价≥1：64的检出率为56.6%,并且随着抗体效价增高,患者例数越来越少,检出率亦越低。随着不良孕产次数的逐渐增加,中、高滴度的IgG抗A（B）效价滴度的孕妇所占比例也逐渐升高,差异有统计学意义（P〈0.05）。结论产前孕妇要及时进行ABO血型IgG抗A（B）抗体水平检测,特别是有不良孕产史的孕妇要及时进行检测,以及早发现,及早采取干预措施。     

500例孕妇ABO血型抗体效价的检测及分析

目的了解血清中IgG抗A（B）血型抗体效价异常在“O”型孕妇中所占比率及临床意义,及早发现、及早治疗新生儿溶血病。方法用BIOVUE微柱凝胶法检测孕妇产前抗体效价。结果500例孕妇中血清效价≥1：64的占16例,异常检出率为3．20％。结论积极开展产前保健孕妇ABO血型抗体效价检测,及早发现异常,及时治疗,减少由于母婴血型不合引起的溶血疾病发生,这对提高我国出生人口素质至关重要。     

母体抗体效价检测在新生儿溶血病诊断中的应用

目的探讨O型血孕妇产前IgG抗（A）B抗体效价与新生儿ABO溶血病的关系。方法采用微柱凝胶法动态监测745例O型血孕妇血清IgG抗（A）B抗体,并对高风险新生儿做溶血病血清学检测。结果孕妇血清抗体效价为1∶64、1∶128和≥1∶256时,新生儿ABO溶血病的发病率分别为10.32%、50.94%和85.71%,不同抗体效价组别间差异有统计意义（P〈0.01）。结论 ABO溶血病的发病率随着孕妇血清抗体效价升高而升高,产前IgG抗体效价的动态监测对预防新生儿溶血病有重要意义。     

微柱凝胶技术检测513例孕妇IgG抗体效价

目的:运用微柱凝胶法技术检测孕妇血清中的IgG抗A(B)血型抗体水平,以预防新生儿溶血病的发生。方法:采用微柱凝胶技术检测IgG抗A(B)血型抗体效价。结果:513例孕妇中IgG抗A(B)效价≤64的334例,128的179例,其中77例经中药治疗后复查,46例IgG抗A(B)效价降至64以下,另31例经继续服药后复查,14例IgG抗A(B)效价降至64以下,17例IgG抗A(B)效价无变化,总有效率为78％。结论:用微柱凝胶技术检测孕妇血清中IgG抗体水平具有操作快速、简便、准确,灵敏度及特异性大大高于试管法,重复性好、实验样本量少,减少生物污染,能最大限度减少由于操作人员主观因素带来的影响,结果可以长期保存等优点,对结果异常者及时服用中药治疗,可有效预防新生儿溶血病。     

孕妇血清IgG抗体两种检测方法的一致性检验

目的观察微柱凝胶法和试管法检测孕妇血清IgG抗体结果的一致性,为临床提供准确、方便的检测方法。方法100例ABO血型均为O型孕妇,丈夫血型分别为A型,B型或AB型,分别采用微柱凝胶法和试管法检测其血清IgG抗体效价。结果微柱凝胶法比试管法检测凝集强度高1＋或2＋,两种检测方法结果一致性较好（χ2=184.640,P=0.000,Kappa指数=0.526）。结论微柱凝胶法检测孕妇血清IgG抗体,操作简单,重复性好,结果客观易判断,标准一致,值得临床推广。     

微柱凝胶卡检测O型血孕母血清中IgG抗体效价参考值范围探讨

目的:探讨应用微柱凝胶抗人球蛋白卡(微柱卡)测定的O型血孕妇血清中的IgG抗A,抗B效价的参考值范围.方法:筛选300例O型RH阳性夫非O型孕妇用凝胶微柱卡进行IgG抗A、抗B效价测定,并对产后新生儿进行HDN血型血清学检查,即ABO血型、COOmb实验,游离和释放试验,以及血清胆红素测定,以了解孕妇血清中的IgG抗A、抗B效价高低与ABO新生儿溶血病发生率之间的关系.结果:300例O型血孕妇血清中的IgG抗A,抗B效价＜64、64、128、256、512、1024各组分别占44.7、19.3、18.7、13.3、3.3、0.7,确诊为HDN的新生儿有67例,孕妇IgG抗A,抗B效价＜64、64、128、256、512、1024各组HDN例数分别为12,5,8,31,9,2,孕妇抗体效价≤64新生儿HDN实验仅释放试验1项阳性100%,且黄疸指数100%轻度黄疸,孕妇抗体效价为128的新生儿仅有8例发生HDN,仅释放试验一项阳性92.7%,且黄疸指数轻度黄疸92.7%仅有1例中度黄疸.结论:母亲的抗体效价用微柱法检测在效价128发生HDN的几率仅有14%,发生的8例症状程度也很轻,血清胆红素测定仅有1例中度黄疸,微柱卡检测抗体效价灵敏度要高于传统的间接抗人球蛋白法,微柱卡法的参考值可定为＜128IgG.     

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.