子宫内膜超声类型及厚度与妊娠的关系

目的　分析使用促性腺激素诱发排卵的病人子宫内膜的类型及厚度与妊娠关系。方法　回顾性分析 13 5个治疗周期具有均质征子宫内膜、三线征子宫内膜以及子宫内膜厚度≤ 9mm ,≥ 10mm的妊娠结果。结果　 13 5个治疗周期中 ,三线征子宫内膜为 10 7个周期 ( 79% ) ,均质征子宫内膜 2 8个周期 ( 2 1% ) ,在三线征子宫内膜妊娠率为 2 2 % ,均质征子宫内膜妊娠率为 7% ,二者妊娠率有明显差别 (P <0 0 1) ,子宫内膜厚度≥ 10mm时 ,妊娠率明显提高。结论　使用促性腺激素诱发排卵时 ,在hCG注射前 ,子宫内膜呈均质征以及内膜厚度≤ 9mm时 ,妊娠率明显降低     

195个周期宫腔内人工授精结局的影响因素探讨

目的：探讨影响夫精宫腔内人工授精妊娠率的因素。方法：回顾性分析2007年1月～2012年12月期间因不孕症行宫腔内人工授精（ IUI）治疗的104对夫妇的195个周期。分析年龄、不孕年限、IUI治疗周期数、不孕原因、促排卵、成熟卵泡数目、子宫内膜厚度等因素和妊娠之间的关系。结果：单因素和多因素Logistic回归分析均表明继发性不孕症患者妊娠率更高（OR＝3．494,P＝0．032,OR＝3．657,P＝0．048）。与自然周期相比,促排卵周期成熟卵泡数目更多（OR＝18．279,P＝0．000）,子宫内膜增厚（OR＝0．186,P＝     

超声诊断对不孕症自然周期卵泡发育和子宫内膜厚度的诊断价值

目的：研究超声诊断对不孕症自然周期卵泡发育和子宫内膜厚度的诊断价值。方法：选择2012年4月至2013年4月在我院接受诊治的已婚未孕患者106例作为研究对象。对所有患者进行经阴道超声监测,分析超声诊断结果和超声征象情况,分析患者的受孕情况。结果：排卵正常型的比例为63．81％（67／105）,显著高于排卵异常型的37．14％（39／105）,差异有统计学意义（P＜0．05）。最终排卵78例患者中,有25例怀孕。其中为三线征的子宫内膜计49例,为均质征的子宫内膜计29例,厚度＜9mm。排卵成功且妊娠者的卵泡直径及子宫内膜的厚度均显著大于排卵成功未妊娠者,差异有统计学意义（ P＜0．05）。结论：超声诊断对于不孕症患者自然周期内的卵泡发育以及子宫内膜的情况具有较好的显示和预测价值,对患者进行监测更利于成功妊娠,值得临床推广应用。     

B超检测子宫内膜厚度及分型对人工授精后妊娠结局的预测价值

为探讨人工授精周期影响妊娠率的因素,本文对56例人工授精妇女的卵泡发育及子宫内膜进行动态B超监测。子宫内膜小于7mm的11例无妊娠发生(0％),子宫内膜厚度大于8mm的45例有18例临床妊娠(40％),经X~2检验P值为0.008。在子宫内膜厚度大于8mm的45例中,子宫内膜呈Ⅰ型的39例,18例妊娠(46.2％),内膜呈Ⅱ型的无妊娠发生(0％),两组比较P=0.036。研究结果揭示,子宫内膜的厚度及B超分型对妊娠结局具有预测价值。     

夫精宫腔内人工授精152例临床分析

目的：探讨宫腔内人工授精（IUI）的临床妊娠率及其影响因素。方法：用阴道B超监测卵泡发育及子宫内膜厚度，结合尿黄体生成激素（LH）峰值判断排卵时间，用密度梯度离心法处理精液，对152例不孕症妇女实施IUI。结果：152例共接受308个周期的IUI治疗，共妊娠48例，周期妊娠率15．6％，临床累计妊娠率31．6％。接受促排卵治疗患者的妊娠率显著高于自然周期患者。结论：不孕原因不同是影响宫腔内人工授精妊娠率的重要因素。     

夫精宫腔内人工授精125周期疗效分析

目的：讨论宫腔内人工授精的妊娠率及其影响因素。方法：对2002年5月-2003年12月在我院生殖中心实施宫腔内人工授精（IUI）的不孕患者95例进行回顾性分析。结果：①宫腔内人工授精的妊娠率23．16％，周期妊娠率25．6％。②妊娠组主要分布在35岁以下的人群。③子宫内膜的厚度及卵泡直径大小对宫腔内人工授精有直接影响。结论：宫腔内人工授精是一种安全可靠、操作简便，且具有明显疗效的助孕技术，其中授精时机的选择直接影响妊娠率。     

夫精宫腔内人工授精治疗不孕症59例（110周期）回顾分析

目的：讨论夫精宫腔内人工授精（AIH）的临床妊娠率及其影响因素。方法：回顾性分析59例（110周期）接受夫精IUI治疗妇女的年龄、不孕年限、治疗方案、IUI时机、子宫内膜厚度与妊娠结局的关系。结果：我院夫精IUI的妊娠率为10％。女性年龄越轻，不孕年限越短，IUI妊娠率越高。IUI妊娠率与治疗方案、IUI的时机无关。IUI手术时子宫内膜8～14mm，妊娠率高。结论：夫精IUI促排卵方案和手术时机的选择是夫精IUI的关键，女方年龄、不孕年限以及子宫内膜的厚度影响IUI的妊娠率。     

三种不同超促排卵方案对宫腔内人工授精结局的影响

目的：探讨宫腔内人工授精（IUI）超促排卵的最佳方案。方法：对56例宫腔内人工授精使用不同超促排方案的结局进行比较。结果：克罗米芬（CC）周期7例，无妊娠，妊娠率0％。CC加入绝经促性腺激素（HMG）周期16例妊娠人数3人，妊娠率18．75％。HMG周期33例，妊娠人数11人，妊娠率33．33％。结论：HMG超促排卵方案在宫腔内人工授精中有较高的临床妊娠率。     

血清 Glycodelin-A 水平对宫腔内人工授精妊娠结局的作用

目的： Glycodelin-A是子宫内膜腺上皮细胞分泌的一种糖蛋白,其在胚胎着床以及植入期抑制母体对胚胎的免疫排斥反应、维持妊娠中发挥重要作用,并有望成为评价子宫内膜容受性、预测妊娠结局的一个重要指标。文中探讨宫腔内人工授精（ intrauterine insemination , IUI）周期中,HCG日检测血清Glycodelin-A水平与子宫内膜容受性之间的关系及其对妊娠结局的影响。方法选择2012年10月至2014年2月在南京军区南京总医院生殖医学中心门诊就诊的女性患者共107例。纳入研究条件为接受IUI治疗且须双侧输卵管检查证实通畅,排除子宫内膜病变、子宫内膜息肉以及宫腔粘连。根据妊娠结局分为妊娠组和非妊娠组。采用ELISA方法检测IUI患者HCG日血清Glycodelin-A水平,化学发光免疫法检测血清雌二醇、孕酮、黄体生成素水平,同时经阴道超声评价子宫内膜情况。结果 HCG日妊娠组血清Glycodelin-A[（1．47±0．38） ng／mL]较未妊娠组血清[（0．62±0．13）ng／mL]显著升高（P＜0．05）,子宫内膜厚度＜7 mm的患者较≥7 mm的患者HCG日血清Glycodelin-A水平显著降低[（0．51±0．17）ng／mL vs （1．53±0．49）ng／mL,P＜0．05]。结论 HCG日血清Glycodelin-A水平在一定程度上反映了子宫内膜的容受性,对IUI后妊娠结局的预测具有一定参考价值。     

经阴道超声监测卵泡及子宫内膜变化对治疗不孕症的指导价值

目的：探讨经阴道超声监测卵泡发育及子宫内膜变化在治疗不孕症中指导价值。方法：经阴道超声对160个促排卵周期的卵泡发育情况及内膜进行观察。结果：促排卵周期卵泡平均每天增长2．12mm，排卵前卵泡平均直径23．3mm，排卵前卵泡多数生长较快，成熟卵泡内多可见到金字塔样点状高回声。三线征子宫内膜为126例(78．8％)，均质征子宫内膜34例(21．2％)，均质征子宫内膜厚度多分布在≤9mm区域内。结论：经阴道超声是一种有价值的监测卵泡生长发育及子宫内膜变化的手段，对指导临床合理使用药物及穿刺取卵具有重要意义。     

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.