167例老年原发性高血压病血液流变学的分析

目的 对老年原发性高血压病血液流变学进行分析,探讨高血压患者血液流变学改变的主要特点及变化情况。方法 随机抽取167例来源为我院门诊及住院的老年原发性高血压患者作为观察组。健康对照组135例来自正常体检人员。抽血测定血液流变学参数。结果 老年原发性高血压病组与健康对照组比较,血沉和血沉方程k值间无显著性差异（P〉0．05）．全血粘度（高切、中切、低切）、血液粘度、血浆粘度、纤维蛋白原、红细胞压积、全血还原粘度、红细胞聚集指数、红细胞刚性指数均极显著升高（P〈0．01）,但红细胞变形指数显著下降（P〈0．01）。结论 老年原发性高血压病患者的血液流变学参数有非常明显的变化。     

高压氧与低分子肝素对改善脑梗死患者血液流变状态的实验研究

目的比较高压氧与低分子肝素对脑梗死患者血液流变状态的影响。方法随机选取经临床确诊的脑梗死患者66例作为治疗组,并将其按接受两种不同治疗方案分成两个不同的实验组,一组31例给予高压氧治疗,另一组35例给予低分子量肝素治疗,同时随机选取体检健康人群作为试验对照组。分别测量两治疗组治疗前和治疗后血液流变学的多项指标,并与对照组进行比较。结果治疗组血液流变学中全血高切粘度、全血低切粘度、血浆粘度和红细胞沉降率（ESR）较对照组有明显升高（P〈0．05）,治疗组治疗后较治疗前血液流变学多个指标（全血高切粘度、全血低切粘度、血浆粘度和ESR）均明显下降（P〈0．05）,但治疗组内两个实验组间各指标间无显著性差异。结论高压氧与低分子肝素治疗能明显改善脑梗死患者血液流变状态,增强抗凝聚和抗血栓作用。     

大连市血液流变学参考值范围的调查研究

目的了解中老年人的血液流变学各项指标的变化及其参考值确定。方法对大连地区35岁以上各年龄组，检测全血粘度（高、中、低切）、血浆粘度、血沉、红细胞压积、胆固醇、甘油三酯等八项项指标。结果各年龄组之间，全血粘度（高、中、低切）、血浆粘度差异无显著性（P〉0．05）；男女之间，血浆粘度差异无显著性（P〉0．05），胆固醇、红细胞压积差异有显著性（P〈0．05），全血粘度高切、中切、低切、甘油三酯、血沉差异有高度显著性（P〈0．01）。结论本组资料显示了大连地区正常人群血液流变学八项检测指标的正常参考范围，并反映出不同性别及年龄段的正常人的血液流变学特点，为临床诊断工作提供了可靠的实验依据。其中，男性甘油三酯正常参考范围与以前报导差异较大．这与人们饮食结构改变及男性社会活动中饮酒可能有很大关系。     

艾灸对30例健康人甲皱微循环及血液流变学的影响

目的：探讨艾灸对健康人甲皱微循环及血液流变学的影响。方法：选择健康学员及武警战士各30例，年龄20－22岁，应用江苏协达公司生产的XDM－1型微循环电脑检测仪及北京世帝科学仪器公司生产的LG－R－80血液粘度计，LG－B－190型红细胞变形／聚集测试仪。固定专人操作，分别于艾灸前及艾灸后，测试甲皱微循环及血液流变学各项指标的变化。结果：艾灸八邪及三阴交穴后，甲皱微循环各项指标均有明显变化，经统计学处理，红细胞聚集程度、血流速度、流态积分、管周积分均有显著性差异（P＜0．05），其余各项指标虽有不同程度的改变，但无统计学意义（P＞0．05）；血液流变学各项指标亦有明显变化，经统计学处理，全血低切相对粘度、全血低切还原粘度、红细胞刚性指数、红细胞聚集指数及血浆纤维蛋白原都有非常显著性差异（P＜0．01），全血高切相对粘度有显著性差异（P＜0．05），其余各项指标虽有不同程度的改变，但无统计学意义（P＞0．05）。结论：艾灸八邪及三阴交穴后可明显改善红细胞聚集程度，降低血液粘度，加快血流速度，降低外周血管阻力。     

骨关节炎患者血液流变学变化及其意义

检测骨关节炎（OA）患者血液流变学指标并探讨其临床意义。检测49例OA患者和20例正常对照的全血粘度,血小板聚集率、血浆粘度、全血还原粘度、红细胞压积、红细胞聚集指数、红细胞变形指数及血沉。OA患者的全血粘度（低切3/s）、血小板聚集率、血浆粘度较对照组显著升高（P＜0．01）,两组间全血粘度（高切200/s）、红细胞压积、红细胞聚集指数、红细胞变形指数及血沉无显著性差别（P＞0．05）．结论：骨关节炎患者血液粘滞度较正常增高、且主要由血浆因素所致。     

大连市血液流变学参考值范围的调查研究

目的了解中老年人的血液流变学各项指标的变化及其参考值确定。方法对大连地区35岁以上各年龄组,检测全血粘度（高、中、低切）、血浆粘度、血沉、红细胞压积、胆固醇、甘油三酯等八项项指标。结果各年龄组之间,全血粘度（高、中、低切）、血浆粘度差异无显著性（P〉0．05）;男女之间,血浆粘度差异无显著性（P〉0．05）,胆固醇、红细胞压积差异有显著性（P〈0．05）,全血粘度高切、中切、低切、甘油三酯、血沉差异有高度显著性（P〈0．01）。结论本组资料显示了大连地区正常人群血液流变学八项检测指标的正常参考范围,并反映出不同性别及年龄段的正常人的血液流变学特点,为临床诊断工作提供了可靠的实验依据。其中,男性甘油三酯正常参考范围与以前报导差异较大．这与人们饮食结构改变及男性社会活动中饮酒可能有很大关系。     

36例活动性肺结核患者的血液流变学改变

检查36例活动性肺结核患血液流变学参数，同时与32例健康相应的参数对照。结果表明：肺结核患的全血比粘度（低切速）、血浆比粘度，全血还原粘度（低切速）均明显增高（P＜0．01），血沉加快（P＜0．01），红细胞电泳时间减慢（P＜0．050；另活动性肺结核进展期患的血浆粘度显高于好转期患（P＜0．01）。说明活动性肺结核患存在高粘滞综合征，且在进展期血液流变学改变更明显。     

活血化瘀类方对动脉粥样硬化家兔血脂、血液流变学变化的影响

目的 探讨活血化瘀类方对动脉粥样硬化（AS）家兔血脂，血液流变学的影响，比较其作用的异同。方法 采用高脂喂饲复制家兔动脉粥样硬化模型，观察各组家兔血脂，血液流变学改变。结果 血府逐瘀汤能显著降低家兔血清TC，TG，LDL－C含量，亦能降低家兔全血粘度（低切，高切），血浆粘度，红细胞比容（P＜0．01）；活络效灵丹能明显降低血清TC，LDL－CW含量（P＜0．01），亦能降低家兔全血粘度（低切）（P＜0．01），红细胞比容（P＜0．05），失笑散能降低家兔血清TC，TG，LDL－C含量以及红细胞比容（P＜0．05）；桃红四物汤明显降低血清TG含量以及全血粘度（低切）（P＜0．01），亦能降低家兔全血粘度（高切）（P＜0．05）；丹参饮能明显降低全血粘度（低切，高切），红细胞比容（P＜0．01），亦能降低血清TC，LDL－C含量（P＜0．05）；结论 5首活血化瘀方均有不同程度地调节血脂代谢，改善血液流变学，抑制高脂喂饲家兔动脉粥样硬化形成的作用，其中以血府逐瘀汤，洛络效灵丹的作用较强。     

脑出血患者急性期血液流变学检测分析

目的 分析脑出血患者急性期血液流变学指标的变化及其临床意义。方法选88例符合标准的病人，检测其血液流变学指标，按出血量、有无合并脑梗塞、有无合并高血压、病情等分组分析。结果纤维蛋白原、全血还原粘度低切高于正常参考值，但红细胞压积明显低于正常值。纤维蛋白原指标在病程长、合并脑梗塞、病情轻时偏高，组间比较差异有统计学意义（P＜0．01～0．05）。全血还原粘度在出血量少组偏高，组间比较差异有统计学意义（P〈0．05）。全血粘度、血浆粘度在合并高血压病组偏高，组间比较差异有统计学意义（P〈0．05）。结论脑出血患者急性期的血液流变学指标与病程、病情、出血量相关。     

血液流变学检测指标对缺血性与出血性脑中风鉴别诊断的临床评价

目的：通过研究血液流变学检测指标变化的特点,评价对缺血性与出血性脑中风鉴别诊断的临床参考价值。方法：采用北京普利生公司LBY-N6C全自动血液流变学检测仪,对260例缺血性与出血性脑中风患者和200例健康体检者进行血液流变学指标检测并对结果进行分析比较。结果：男性与女性患者缺血性脑中风患者全血粘度高切、中切与低切值均高于对照组（P〈0．05）;出血性脑中风患者全血粘度高切、中切与低切值均低于对照组（P〈0．05）;缺血性脑中风患者全血粘度低切、中切与高切明显高于出血性脑中风患者（P〈0．01））。结论：血液流变学的检测作为人体生理功能和病理变化的指标,对缺血性与出血性脑中风的鉴别诊断、疗效观察、判断预后有重要的临床参考价值。     

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.