成年男性2型糖尿病患者血清游离睾酮水平及其相关因素研究

目的：　探讨男性2型糖尿病（type 2 diabetes mellitus,T2DM）患者血清游离睾酮（free testosterone,FT）水平及其相关影响因素。方法：　回顾性分析2018年2月至2019年2月郑州大学第一附属医院收治的18~70岁男性2型糖尿病患者303例,并以年龄1∶1匹配于本院体检的非糖尿病健康男性303例作为对照,比较2组间不同年龄段血清FT水平的差异。根据血清FT水平将T2DM组患者按四分位法分为Q1组、Q2组、Q3组和Q4组,采用Spearman秩相关分析FT水平的相关因素并采用logistic回归分析探讨男性T2DM患者低血清FT水平的影响因素。结果：　男性T2DM患者血清FT水平明显低于同年龄组的健康男性对照,且随年龄增长而降低;Spearman秩相关分析显示,FT与年龄（r=-0.402,P<0.001）、体质指数（body mass index,BMI）（r=0.215,P=0.001）、糖尿病病程（r=-0.121,P=0.035）呈负相关,与总胆固醇（total cholesterol,TC）（r=0.115,P=0.049）、25-羟维生素D₃[25-hydroxyl vitamin D₃,25-（OH）D₃]（r=0.340,P<0.001）、促甲状腺激素（thyroid-stimulating hormone,TSH）（r=0.231,P=0.025）呈正相关;多元logistic回归分析显示,在校正年龄、城乡分布、糖尿病病程、吸烟史、饮酒史后,高BMI（OR=1.101,95%CI=1.023~1.183,P=0.009）、高糖化血红蛋白（glycosylated hemoglobin,HbA1c）（OR=1.175,95%CI=1.060~1.302,P=0.002）、低25-（OH）D₃（OR=0.937,95%CI=0.900~0.975,P=0.001）及低TSH（OR=0.838,95%CI=0.710~0.989,P=0.037）是低FT水平的影响因素。结论：　成年男性T2DM患者血清FT水平低于同年龄组健康男性,低FT水平与高BMI、高HbA1c、低25-（OH）D₃及低TSH密切相关。     

25-羟维生素D水平与肾癌发病的相关性分析

目的 探讨25-羟维生素D水平与肾癌发病的关系。方法 选取2015年3月至2017年8月安徽医科大学第二附属医院收治的初治肾癌患者100例设为肾癌组,同期选择本院体检者采用倾向性评分法匹配200例非肿瘤人群为对照组,检测两组人群25-羟维生素D水平,比较两组患者的一般临床资料、实验室检查（如血钠、血磷、血钙及血肌酐）及25-羟维生素D水平等资料。采用单因素分析与因变量相关的变量,将有统计学意义的变量纳入多因素二分类logistic回归中再次分析。结果 25-羟维生素D （B=-0.067,OR=0.935,P=0.001）及高血压（B=0.064,OR=1.896,P=0.001）是影响肾癌发病的独立危险因素。结论 高水平的25-羟维生素D是肾癌的保护因素。     

精神分裂症患者25-羟维生素D水平与代谢综合征相关指标的关联研究

目的 探讨精神分裂症患者25-羟维生素D[25-（OH）D]水平与代谢综合征相关指标的关系。方法 选择2016年5月至2017年4月合肥市第四人民医院住院的精神分裂症患者229例,采用单因素、多元线性回归分析探索精神分裂症患者25-（OH）D水平与代谢综合征相关指标（空腹血糖、腰围、收缩压、舒张压）的关联。结果 单因素分析显示,25-（OH）D水平与空腹血糖存在显著负相关（β=-0.007,P=0.018）。多元线性回归结果显示,25-（OH）D水平仍与空腹血糖呈显著负相关（β=-0.008,P=0.006）。结论 精神分裂症患者25-（OH）D水平与空腹血糖存在负相关。     

2型糖尿病患者亚临床甲状腺功能亢进与血糖血脂的相关性研究

目的 分析2型糖尿病(T2DM)患者出现亚临床甲状腺功能亢进的影响因素并探讨其相互作用机制。方法 回顾性分析2020年4月至2022年9月在安徽省第二人民医院全科医学科住院确诊T2DM患者263例的临床资料,根据其是否合并亚临床甲状腺功能亢进分为试验组(n=124)和对照组(n=139)。记录并比较两组患者一般资料(年龄、性别等)、血常规、生化常规、甲状腺功能等指标。采用单因素及多因素logistic回归分析2型糖尿病患者出现亚临床甲状腺功能亢进的危险因素。结果 两组患者的清蛋白、空腹血糖、糖化血清蛋白、血脂等因素,差异存在统计学意义(P<0.05)。logistic回归模型多因素分析提示空腹血糖(OR=0.883,95%CI:0.788~0.990,P=0.032)、糖化血清蛋白(OR=1.008,95%CI:1.004~1.013,P<0.001)为患者发生亚临床甲状腺功能亢进的独立危险因素。结论 空腹血糖水平升高,糖化血清蛋白水平降低是T2DM患者出现亚临床甲状腺功能亢进的独立危险因素。     

探讨慢性阻塞性肺疾病患者血清中1α, 25-二羟维生素D水平及其影响因素

目的 1α, 25-二羟维生素D [1α,25(OH)₂D₃]是维生素D信号生物学功能的主要执行者,其血清水平不仅受其前体25-羟维生素D[25(OH)D]水平的调控,还受体内炎性状态的影响。本研究旨在分析慢性阻塞性肺疾病(COPD)患者中血清1α,25(OH)₂D₃水平及其影响因素。 方法 收集124例COPD患者和188名健康对照者,采用酶联免疫吸附法检测血清1α,25(OH)₂D₃及25(OH)D水平,同期收集COPD患者血清C反应蛋白(CRP)、白细胞计数(WBC)、血红蛋白量(Hb)及白蛋白(Alb)等实验室资料。 结果 经两独立样本t检验,与对照组相比,COPD组中血清1α,25(OH)₂D₃和25(OH)D平均水平明显降低,分别为:28.33±5.87 vs 30.58±6.48pg/ml, t=3.108, P=0.002; 25.73±5.44 vs 27.14±5.89ng/ml, t=2.128, P=0.034。根据患者病程分层分析,与稳定期COPD相比,急性加重期患者中血清1α,25(OH)₂D₃和25(OH)D平均水平亦显著降低,分别为:27.04±4.67 vs 29.17±5.01pg/ml, t=2.377, P=0.019; 24.31±4.22 vs 26.66±4.56ng/ml, t=2.888, P=0.005。采用Spearman相关分析法检验COPD组中血清1α,25(OH)₂D₃水平的相关影响因素,纳入的变量包括血清25(OH)D水平及CRP、WBC、Hb、Alb等血清学指标。结果显示COPD组中血清1α,25(OH)₂D₃水平与25(OH)D和CRP呈正相关(r=0.291, P=0.002; r=0.352, P=0.004),与Alb呈负相关(r=-0.346, P=0.001),而与WBC和Hb无关(P>0.05)。 结论 COPD患者中血清1α,25(OH)₂D₃水平与血清25(OH)D、CRP和Alb水平密切相关,并可能影响患者的病程。     

复杂性肛瘘术后肛门失禁风险预测模型的建立及评价

目的 构建复杂性肛瘘术后并发肛门失禁的风险预测模型并进行效果评价。方法 回顾性分析2020年1月至2021年5月福建中医药大学附属人民医院肛肠科收治的195例复杂性肛瘘患者资料。根据术后肛门失禁症状,将CCFIS评分≥2分划为肛门失禁组（42例）,CCFIS评分<2分划为功能正常组（153例）。结合患者一般情况、瘘管性质、肛门直肠压力测定结果、手术方式等变量进行单因素及logistic回归分析。结果 术后肛门失禁发生率为21.54%,CCFIS平均分为（3.40±1.170）分。logistic回归分析结果显示,瘘管类型为括约肌上瘘（OR=1.024,95%CI=0.405~2.585,P=0.025）、既往有1次以上的瘘管手术（OR=16.224,95%CI=3.291~29.977,P=0.001）、低静息压（OR=0.909,95%CI=0.869~0.952,P=0.000）、手术方式为切割挂线术（OR=1.389,95%CI=1.044~1.848,P=0.024）是复杂性肛瘘术后并发肛门失禁的独立危险因素（P<0.05）。根据筛选出的独立危险因素构建预测模型,绘制受试者工作特征（receiver operating characteristic,ROC）曲线,曲线下面积（area under the curve,AUC）为0.879（95%CI=0.818~0.939,P<0.001）,提示该模型有较好的预测价值。结论 通过独立危险因素建立的预测模型准确度较高,为临床复杂性肛瘘治疗方案的制订提供较好的参考依据。     

不同体质指数新诊断男性2型糖尿病患者25-羟维生素D水平及相关性分析

目的 分析新诊断男性2型糖尿病（T2DM）患者体内25-羟维生素D水平的变化,探讨其与体质指数（BMI）、胰岛素抵抗（IR）和胰岛β细胞功能的关系。方法 收集2018年1月至2019年12月中国科学技术大学附属第一医院（安徽省立医院）内分泌科住院新诊断男性T2DM患者84例作为T2DM组,选择同期在医院健康体检中心的男性体检者30例作为对照组。检测血清25（OH） D3、空腹血糖（FPG）、空腹胰岛素水平（FIns）等指标,并于75 g葡萄糖耐量试验（OGTT）或馒头餐试验后30、60和120 min采集静脉血检测血糖和胰岛素。结果 T2DM组血清25（OH） D₃水平低于对照组,差异有统计学意义（P<0.05）。随着BMI水平增高,25（OH） D₃水平降低,胰岛β细胞功能指数（HOMA-β）呈下降趋势（P<0.05）,胰岛素抵抗指数（HOMA-IR）呈上升趋势（P<0.05）。T2DM组行馒头餐或OGTT试验后不同时间的血糖、胰岛素、C肽水平差异有统计学意义（P<0.05）。随时间的推移各数值均有上升趋势,组别和时间因素对血糖、胰岛素、c肽水平变化有交互作用（P<0.05）。25（OH） D3与BMI、糖化血红蛋白（HbA1c）、HOMA-IR、HOMA-β呈负相关（P<0.05）。结论 低水平25（OH） D3可能与导致T2DM发病的IR及胰岛素敏感性下降有关。     

骨转换标志物PINP和β⁃CTX在帕金森病患者发生骨质疏松中的预测价值

目的：研究骨转换标志物Ⅰ型胶原氨基端前肽（procollagen type Ⅰ N-terminal propeptide,PINP）、Ⅰ型胶原羧基端前肽（β-cross-linked ctelopeptide of type I collagen,β-CTX）在帕金森病（Parkinson’s disease,PD）并发骨质疏松中的预测价值。方法：纳入PD患者105例,根据是否合并骨质疏松分为骨质疏松组和非骨质疏松组,对所有患者检测25（OH）D、甲状旁腺激素、骨钙素、β-CTX、PINP等骨代谢指标,分析各指标与骨质疏松发生之间的关系。结果：①骨质疏松组少动强直型比例、女性比例、PINP、骨钙素、β-CTX水平均高于非骨质疏松组,骨质疏松组25（OH）D水平低于非骨质疏松组,差异均具有统计学意义; ②相关分析结果显示PD患者骨质疏松发生与骨钙素（r=0.28,P=0.005）、β-CTX（r=0.36,P=0.001）、PINP（r=0.40,P＜0.001）均呈正相关,与25（OH）D（r=-0.30,P=0.002）、PINP/β-CTX（r=-0.56,P＜0.001）均呈负相关,差异具有统计学意义;③多因素二元Lo- gistic 回归分析显示,25（OH）D（OR=0.95,95%CI：0.84~0.98,P=0.041）、PINP/β-CTX（OR=0.90,95%CI：0.83~0.98,P=0.017）是 PD病合并骨质疏松的独立危险因素;④ROC曲线分析示25（OH）D联合PINP/β-CTX时ROC曲线下面积最大,AUC=0.82,灵敏性=0.80,特异性=0.84,P＜0.001。结论：血清25（OH）D水平及PINP/β-CTX比值与PD患者骨质疏松发生密切相关,在PD患者骨质疏松的发生中具有重要的预测价值,二者联合检测时诊断价值更高。     

基于SEER数据库异时双原发肺癌预后模型的构建和验证

目的：　运用回顾性研究的分析方法,探究异时双原发肺癌（metachronous dual primary lung cancer,mDPLC）的独立预后因素,并建立列线图预后模型。方法：　通过美国癌症监测、流行病学和结果（Surveillance,Epidemiology and End Results,SEER）数据库获得mDPLC患者的临床数据。将数据分为训练集和验证集进行建模和验证。采用单因素和多因素Cox回归分析确定训练集患者的独立预后因素,并纳入列线图对患者生存时间进行预测。通过C-指数、校准图、受试者工作特征（receiver operating characteristic,ROC）曲线、决策曲线分析（decision curve analyses,DCA）和综合鉴别改进（integrated discrimination improvement,IDI）评分对预后模型的准确性和可靠性进行评价。结果：　共有610例mDPLC患者纳入训练集,260例mDPLC患者纳入验证集。Cox回归分析表明,年龄（59~76岁：HR=1.453,95%CI=1.007~2.096,P=0.046;≥77岁：HR=1.953,95%CI=1.303~2.926,P<0.001）、性别（女性：HR=0.669,95%CI=0.529~0.845,P=0.001）、病理类型（腺癌+鳞癌：HR=2.251,95%CI=1.583~3.200,P<0.001）、TNM 分期（Ⅲ：HR=1.611,95%CI=1.126~2.305,P=0.009;Ⅳ：HR=2.443,95%CI=1.713~3.486,P<0.001）、淋巴结转移（是：HR=1.653,95%CI=1.199 ~2.280,P=0.002）、手术（1次：HR=1.431,95%CI=1.110~1.844,P=0.006;0次：HR=1.845,95%CI=1.183~2.878,P=0.007）和化疗（是+否：HR=0.603,95%CI=0.433~0.842,P=0.003）是独立预后因素。训练集和验证集的C-指数分别为0.711（95%CI=0.696~0.726,P<0.05）,0.677（95%CI=0.655~0.699,P<0.05）。训练集中ROC曲线的3年生存率和5年生存率AUC值分别为0.756（95%CI=0.713~0.800,P<0.05）和0.785（95%CI=0.732~0.838,P<0.05）,验证集中ROC曲线的3年生存率和5年生存率AUC值分别是0.695（95%CI=0.621~0.769,P<0.05）和0.711（95%CI=0.618~0.804,P<0.05）。训练集中3年和5年的IDI值分别为9.0%（P<0.001）和11.9%（P<0.001）,验证集中3年和5年的IDI值分别为6.6%（P<0.001）和7.8%（P<0.001）。根据独立预后因素建立的模型经验证可准确预测患者预后,并且效果优于TNM分期。结论：　本研究建立了一个mDPLC预后预测模型,内部验证表明该模型具有较好的效能,可为mDPLC患者提供准确和个性化的生存预测。     

磁共振氢谱定量评价2型糖尿病合并非酒精性脂肪肝病患者心肌三酰

目的应用磁共振氢谱（¹H-MRS）对2型糖尿病（T2DM）合并非酒精性脂肪肝病（NAFLD）患者心肌三酰甘油含量进行定量评价,探讨心肌三酰甘油含量与心功能参数、血清生物化学指标等的相关性。方法纳入2017年1月至2018年8月确诊的52例T2DM患者。测定患者血清生物化学指标,并应用¹H-MRS扫描评价患者左心室功能和心肌三酰甘油相对含量。采用Dixon技术行腹部磁共振成像扫描评价肝脏脂肪含量百分比。应用Pearson相关分析探讨心肌三酰甘油含量与心功能参数、血清生物化学指标等的相关性。结果腹部Dixon技术评价显示,合并NAFLD组T2DM患者肝脏脂肪含量百分比高于未合并NAFLD组患者[（14.99±5.21）% vs （3.51±1.75）%],差异有统计学意义（t=－7.209,P<0.01）。¹H-MRS分析结果显示,合并NAFLD组T2DM患者的心肌三酰甘油相对含量为（1.87±0.55）%,高于未合并NAFLD组患者的（1.19±0.48）%,差异有统计学意义（t=－4.105,P<0.01）。T2DM患者心肌三酰甘油相对含量与肝脏脂肪含量百分比、室间隔厚度（IVS）、空腹血糖及左心室重构指数（LVMVR）均呈正相关（r=0.582、0.293、0.318、0.282,P=0.001、0.035、0.021、0.042）。结论 ¹H-MRS可无创定量评价T2DM合并NAFLD患者的心肌三酰甘油代谢异常,且心肌三酰甘油相对含量与肝脏脂肪含量百分比、IVS、空腹血糖及LVMVR有关。     

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.