基于随机森林生存模型的AMI患者PCI术后的不良事件风险分析

目的：综合分析经皮冠状动脉介入术（percutaneous coronary intervention,PCI）后的急性心肌梗死（acute myocardial infarction,AMI）患者预后影响因素,并构建预测模型和预后评分体系,为临床血管个性化治疗提供参考。方法：本研究回顾性收集从2018年1月至2022年6月所有在江西省南昌大学第二附属医院行PCI术的AMI患者,随访结局是术后首次发生主要心血管不良事件（major adverse cardiovascular events,MACE）。采用十倍交叉验证的Lasso回归确定纳入模型的变量,构建随机生存森林（random survival forest,RSF）模型和Cox比例风险模型,采用受试者工作特征曲线（receiver operating characteristic,ROC）下面积（area under curve,AUC）和校准曲线评估模型性能。根据RSF模型拟合结果绘制风险计算器。结果：研究最终共纳入3 880例AMI患者,其中术后1年内发生主要心血管不良事件473例（12.2%）。Lasso回归筛选出性别、...     

大规模人群队列生活行为方式相关的肺癌风险预测模型的构建

目的 发现影响肺癌发病的生活行为相关危险因素,并构建肺癌风险预测模型,识别人群中的高风险个体,帮助肺癌早期筛查。方法 本研究数据来源于英国生物样本库（UK Biobank）2006年3月–2010年10月收集的502 389名参与者。参考国内外肺癌筛查指南和高质量肺癌危险因素研究文献,确定本研究高危人群识别标准。采用单因素Cox回归分析及逐步回归筛选出肺癌的危险因素,通过Cox比例风险回归构建多因素肺癌风险预测模型,根据比较赤池信息准则以及Schoenfeld残差检验结果,最终选择等比例假设的最优拟合模型。多因素Cox比例风险回归考虑生存时间,将人群按7∶3的比例随机分为训练集和验证集,使用训练集建立模型,并用验证集对模型性能进行内部验证。受试者工作特征曲线（ROC）曲线的曲线下面积（AUC）被用于评估模型的效能。将人群按照发病概率的0%～<25%、25%～<75%、75%～100%分为低风险、中风险及高风险人群,分别计算其中的发病人数占比。结果 本研究最终纳入453 558人,在累计随访5 505 402人年期间,共诊断出2 330例肺癌。Cox比例风险回归分析筛选出10...     

衰弱与急诊老年创伤患者不良预后关系的前瞻性队列研究

目的 探讨衰弱与急诊老年创伤患者不良结局预后的关系。方法 采用前瞻性队列研究设计,纳入2021年1–8月在成都市3所三甲医院急诊科收治的老年创伤患者,按照中文版创伤特异性衰弱指数（Trauma Specific Frailty Index,TSFI）评估结果分为衰弱组和非衰弱组,并记录6个月随访的终点事件（跌倒、再入院和死亡）。采用Cox风险回归模型分析衰弱与急诊老年创伤患者不良结局的关系。结果 共纳入375例急诊老年创伤患者,其中衰弱组131例,非衰弱组244例。随访6个月后,急诊老年创伤患者跌倒、再入院、死亡事件的发生率分别为18.93%、14.40%、7.73%。衰弱组急诊老年创伤患者跌倒（28.24%vs. 13.93%,P=0.001）、再入院（25.95%vs. 8.20%,P=0.000）、死亡（12.98%vs. 4.92%,P=0.005）的发生率均高于非衰弱组。应用Cox风险回归模型调整混杂因素以后,衰弱组发生跌倒[风险比（hazard ratio, HR）=1.859,95%置信区间（confidence interval, CI）:1.070～3.230,P=0...     

腹膜透析总水清除量下降速率快是患者死亡的独立危险因素

目的：腹膜透析患者的总水清除量（total fluid removal,TFR）与生存率密切相关,但TFR下降趋势与生存率的关系不详,本研究欲通过前瞻队列设计阐明两者之间的关系。方法：共纳入2002年7月至2007年2月新腹膜透析患者297例,随访观察至患者死亡、转为血液透析、肾移植或研究终点（2008年2月）。基线人口学、血生化及透析充分性指标等纳入研究分析。随访过程中,将患者每3个月内就诊前的TFR、尿量、超滤量作平均值,利用线性回归的方法计算TFR的变化斜率（k-TFR）。结果：患者中位年龄为62岁,42.4%为男性。中位随访时间为30个月。71例（23.9%）患者死亡。多元Cox回归模型提示,经年龄、是否存在基础糖尿病、基线血红蛋白及白蛋白校正后,k-TFR是全因死亡的独立危险因素。结论：腹膜透析过程中,TFR随时间下降快是患者全因死亡的独立危险因素。     

心功能对非瓣膜性心房颤动合并冠状动脉支架植入患者缺血性脑卒中及死亡风险的影响

背景　心房颤动（房颤）患者需评估出血/缺血风险进行抗凝治疗,接受冠状动脉支架植入术患者需抗血小板治疗,房颤合并冠状动脉支架植入术患者抗凝加抗血小板则会增加出血风险。心力衰竭（心衰）与房颤常共存且相互作用,在房颤患者中,心衰为脑卒中的公认危险因素。目的　探讨心功能对非瓣膜性房颤合并冠状动脉支架植入术后患者的缺血性脑卒中及死亡风险的影响。方法　收集2010年1月—2015年1月就诊于北京11家三级甲等医院的房颤合并冠状动脉支架植入患者2 471例进行多中心研究。排除失访及瓣膜性房颤患者后实际纳入分析1 987例,平均随访（3.5±1.5）年。根据美国纽约心脏病学会（NYHA）心功能分级进行研究,比较其缺血性脑卒中发生率及死亡率。分别以缺血性脑卒中及死亡为终点事件进行生存分析,绘制Kaplan-Meier生存曲线。同时对出血事件进行分析。最后采用Cox比例风险回归模型对卒中的危险因素进行分析。结果　心功能代偿组1 468例患者,63例发生缺血性脑卒中,占4.29%;心功能失代偿组519例患者,32例发生缺血性脑卒中,占6.17%;两组脑卒中发生率比较,差异无统计学意义（P=0.085）。心功能代偿组有152例死亡,占10.35%,心功能失代偿组有77例死亡,占14.84%,差异有统计学意义（P=0.006）。两组以缺血性脑卒中及死亡为终点事件绘制的生存曲线比较,差异均有统计学意义（P<0.05）。单因素Cox比例风险回归分析显示NYHA分级是缺血性脑卒中发生的影响因素（P=0.047）;进一步纳入传统的卒中危险因素及主要的超声心动图指标的多因素Cox比例风险回归分析结果显示：性别、脑卒中史、NYHA分级、左心室射血分数（LVEF）、左心房内径、左心室舒张末期内径是缺血性脑卒中发生的影响因素（P<0.05）。心功能失代偿组抗凝药物使用比例高于心功能代偿组,差异有统计学意义（P=0.001）。不同心功能分级患者卒中发生率比较,差异无统计学意义（P=0.086）,而死亡事件发生率比较差异有统计学意义（P=0.006）。心功能代偿组出血事件占12.74%（187/1 468）,心功能失代偿组占11.95%（62/519）,差异无统计学意义（P=0.639）。结论　心功能失代偿的冠心病伴非瓣膜性房颤患者有更高的死亡率,随着NYHA分级升高死亡风险亦呈增加趋势。     

血清γ-谷氨酰转肽酶对稳定性心绞痛患者远期预后影响的临床研究

目的:探讨血清γ-谷氨酰转肽酶（GGT）对稳定性心绞痛患者远期预后的影响。方法:使用2014-2018年在天津市胸科医院心内科登记住院的病例数据资料进行回顾性队列研究,共295例新发稳定性心绞痛患者纳入研究。以患者首次确诊冠心病的日期为观察起点,观察终点为出现终点事件或最后一次就诊日期。根据观察期间是否发生不良心血管事件（MACE）分为事件组和非事件组,并根据GGT四分位数将患者分为4组,使用Cox风险回归模型分析GGT对MACE的影响。结果:本次研究随访中位数为4.06年,共有86例（29.15%）冠心病患者发生MACE事件,事件组患者在入院时年龄、高血压比例、TC、LDL-C、ALT和GGT水平均高于无事件组,差异具有统计学意义（均P＜0.05）;不同冠状动脉病变程度的患者MACE发生率存在差异,且三支病变的患者GGT含量要高于双支病变和单支病变,差异具有统计学意义（P＜0.001）。多因素Cox回归分析显示,GGT（与≤25 U/L组相比,31 U/L＜GGT≤38 U/L和＞38 U/L组的HR分别为1.109、1.299）、年龄（与＜60岁相比,≥60岁的HR=1.683,95%CI:1.394~2.032）、高血压（HR=1.562,95%CI:1.201~2.032）、TC（HR=1.286,95%CI:1.079~1.533）对稳定性心绞痛患者远期发生MACE事件的影响均有统计学意义（P＜0.05）。结论:血清GGT水平升高与稳定性心绞痛患者MACE的发生有关,为进一步临床研究提供了理论依据。     

胃癌根治生理性吻合术后发生胆囊结石影响因素分析

目的 探讨胃癌根治生理性吻合术后胆囊结石的发病率及影响因素。方法 回顾性分析2014年1月—2020年12月胃癌根治术中采用生理性吻合患者临床资料,根据胃切除范围分为近端胃切除（PG）组和远端胃切除（DG）组;以术后胆囊结石形成为终点事件,截止随访日期为2022年12月;Kaplan-Meier法绘制累积事件发生率曲线,Log-Rank检验比较PG组和DG组胆囊结石发生率差异;倾向性评分匹配平衡两组基线资料后采用稳健估计法Cox回归分析胃癌根治生理性吻合术后胆囊结石形成的影响因素。结果 本研究共纳入355例患者,DG组92例,PG组263例;随访期间共有91例（25.63%）患者术后发生胆囊结石;术后2年内共有77例患者发生胆囊结石,占全部胆囊结石患者的84.61%;术后2年PG组胆囊结石的发生率（25.48%）高于DG组（10.87%）,差异有统计学意义（P <0.05）;倾向性评分匹配构建DG和PG组的平衡队列后对236例患者进行了评估,DG组84例,PG组152例。Cox回归分析显示近端胃切除、肝十二指肠韧带淋巴结清扫及辅助化疗是采用生理性吻合胃癌患者术后发生胆囊结石的独立...     

基于肺腺癌组织中可变剪接数据构建剪接因子-可变剪接调控网络的生物信息学分析

目的 利用生物信息学方法筛选与肺腺癌（LUAD）患者生存相关的可变剪接（AS）事件,构建剪接因子（SF）-AS调控网络,为LUAD患者的预后评价提供新思路。 方法 由癌症基因组图谱（TCGA）数据库中下载LUAD患者转录组数据和临床数据。从SF表达和RNA靶点（SpliceAid2）数据库中下载LUAD患者AS数据。对LUAD患者生存相关AS事件进行单因素Cox回归分析。采用LASSO回归分析和多因素Cox回归分析构建LUAD患者预后风险模型,基于该模型计算每种AS事件的风险评分,采用 Kaplan-Meier（K-M）生存分析和受试者工作特征曲线（ROC）评价模型的可靠性。通过Cox 回归分析风险模型、临床参数与LUAD患者独立预后的关系。采用Pearson检验对SF和与预后相关的AS事件进行相关性分析,并通过Cytoscape软件构建SF-AS互作网络。 结果 筛选获取与生存相关的AS事件43 948个,共7种类型,主要以外显子活跃（ES）事件和可变终止子（AT）事件为主。构建AS事件预后风险模型,基于该模型风险评分将LUAD患者分为高风险组和低风险组,K-M生存分析,高风险组LUAD患者总生存（OS）率较低风险组低（P<0.05）。ROC曲线分析,LUAD患者预后风险模型预测性良好,曲线下面积（AUC）为0.824。SF-AS调控网络,12个与预后相关SFs正向或负向调节AS事件,可预测LUAD患者的不良预后。 结论 筛选了与LUAD患者预后相关的AS事件和上游的调控因子SF,构建了SF-AS网络,为进一步研究AS事件与LUAD患者预后的相关性提供理论依据。     

CHA2DS2-VASc评分模型在中国肥厚型心肌病患者中的外部验证

目的:通过外部验证来评估CHA2 DS2-VASc评分模型在中国肥厚型心肌病(HCM)患者中的作用.方法:回顾性分析HCM患者病历资料,评估CHA2 DS2-VASc评分模型对于5年血栓栓塞(TE)事件的预测.结果:对于整体HCM人群,CHA2 DS2-VASc模型具有一定价值的TE事件区分能力,校准能力较好;在HCM非心房颤动人群中,CHA2 DS2-VASc模型具有一定价值的TE事件区分能力,在0～2分组中,TE事件的年发病率为0.66％ ～1.15％,而评分≥3分组,TE事件的年发病率升高,波动约2.60％;对于HCM合并心房颤动人群,无论患者的风险分层,TE事件的风险均较高,CHA2 DS2-VASc评分模型校准能力较差,低估实际观察到的TE事件.结论:HCM非心房颤动患者在CHA2 DS2-VASc评分≥3分时,TE事件发病率升高;但HCM患者合并心房颤动时,无论患者的风险分层,TE事件的发病率均较高,需要积极预防干预.     

容量负荷对腹膜透析患者残余肾功能的影响

目的 探讨容量状态及其他因素对腹膜透析患者残余肾功能（residual kidney function,RKF）下降的影响。方法 分析复旦大学附属华山医院腹膜透析中心自2010年6月至2017年8月期间进行腹膜透析（peritoneal dialysis,PD）并且规律随访患者的临床资料,筛除有腹膜炎病史、临床资料不全、中途由外院转入的患者。以患者开始规律PD第3个月的估算 肾小球滤过率（estimated glomerular filtration rate,eGFR）作为基础值,记录腹膜透析患者在≤36个月间内所有基本临床特征、透析相关变量和主要生化指标。终点事件定义为在开始PD 24个月内的eGFR下降为0。采用单因素及多因素线性回归和Cox回归模型法分析影响PD患者eGFR下降的影响因素。结果 本研究纳入96名患者,基线eGFR为（4.20±3.00） mL·min^-1·1.73 m^-2,单因素和多因素线性回归结果显示体重指数（body mass index,BMI）和时间平均后的终末段脑钠肽前体（NT-proB-type natriuretic peptide,BNP）为共同影响PD患者RKF下降的危险因素。单因素Cox回归分析结果显示BMI、标准化蛋白分解率（normalized protein catabolic rate,nPCR）、平均动脉压（mean arterial pressure,MAP）和时间平均后的BNP为影响PD患者进入终点事件的共同危险因素。多因素Cox回归分析结果显示时间平均后的BNP为影响PD患者进入终点事件的独立影响因素。结论 容量过剩与新开始PD患者RKF下降可能相关。     

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.     

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.