抗缪勒管激素检测在非梗阻性无精子症诊断中的临床应用

目的 通过测定非梗阻性无精子症患者精浆抗缪勒管激素(AMH),了解其对非梗阻性无精子症患者睾丸精子生成状况的预测作用,探讨其是否可以作为睾丸精子生成的精浆标志物.方法 使用酶联免疫法、固相化学发光免疫法测定正常生育组(n=20)、梗阻性无精子症组(OA组,n=12)、非梗阻性无精子症组(NOA组,n=24)3组年轻男性精浆中的AMH浓度和血清促卵泡激素(FSH)和睾酮(T)浓度,经阴囊B超测量睾丸体积(TV),并用睾丸组织病理活检或睾丸精子获取术(TESE)寻找此3组男性的精子生成证据.运用ROC曲线来确定各实验诊断指标对NOA患者TESE术成功与否的预测诊断价值,并运用ROC曲线决定图来确定各指标的最佳诊断阈值.结果 AMH在正常生育组人员精浆中的浓度范围为未检出(＜3.20 pmol/L)至556.00 pmol/L(几何平均值为118.73 pmol/L),高于血清水平(范围从＜3.20～84.82 pmol/L,几何平均值为28.72 pmol/L).OA组患者精浆AMH浓度均未检出,这就确认了其睾丸来源.NOA组患者精液AMH浓度比正常生育组显著降低(范围:＜3.20 ～ 68.60 pmol/L,几何平均值为17.70 pmol/L)(P＜0.01),但与血清FSH水平无关.NOA组患者精浆AMH浓度和睾丸活检的结果比较显示,13例检测不出精浆AMH的患者有11例与精子缺乏有关;而检出精浆AMH(浓度为7.60 ～ 68.60 pmol/L)的11例患者中有8例与存在持续性睾丸生精功能有关.精浆AMH、血清FSH、睾丸体积和联合参数用于区分NOA患者TESE术成功与否的最佳诊断阈值分别为≥8.60 pmol/L、≤11.3 IU/L、≥12.5 mL和≥18.6.结论 精液AMH在非梗阻性无精子症患者中可作为一种非侵入性持久性精子发生过少的标志物,这可在卵胞浆内单精子显微注射术(ICSI)前预示睾丸精子恢复成功与否的可能性.     

HIF-1α、VEGF及AMH在多囊卵巢综合征中的表达及其临床意义

  目的  研究缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)和抗苗勒管激素(AMH)在多囊卵巢综合征(PCOS)中的表达水平,探讨其临床意义。  方法  选择2018年6月—2020年6月湖州市中心医院收治的130例PCOS患者为观察组,同期100例健康女性为对照组,采用免疫化学发光法检测卵泡刺激素(FSH)、黄体生成素(LH)、泌乳素(PRL)、睾酮(T)、孕酮(P)和雌二醇(E2)水平,酶联免疫吸附法检测血清HIF-1α、VEGF和AMH水平,分析HIF-1α、VEGF和AMH的相关性及对PCOS的预测价值。  结果  观察组患者的FSH[(5.81±0.92)mU/mL]、LH[(10.54±0.72)mU/mL]、PRL[(398.55±80.47)ng/mL]、T[(7.76±2.27)nmol/L]、P[(5.29±0.92)nmol/L]、E2[(118.63±42.78)pmol/L]显著高于对照组(t值为3.179、12.150、4.284、11.223、43.724、3.955,均P＜0.05)。观察组患者HIF-1α[(163.12±25.17)pg/L]、VEGF[(257.03±30.45)pg/L]和AMH[(7.29±1.02)pg/L]显著高于对照组(t值为42.592、31.612、47.194,均P < 0.05)。HIF-1α与VEGF、AMH水平均呈正相关(r=0.811、0.848、0.762,均P < 0.05)。血清HIF-1α、VEGF及AMH曲线下面积分别为0.764、0.731、0.742,95%CI分别为0.681~0.852、0.634~0.819、0.649~0.827。  结论  PCOS患者HIF-1α、VEGF及AMH水平显著升高,对PCOS具有较高的预测价值,可作为临床诊断的指标。      

不育症患者精液中Caspase 3和Caspase 8检测的临床意义

目的 探讨不育症患者精子和精浆中Caspase 3和Caspase 8与精液常规参数的关系,并推测其可能的临床意义.方法 收集来该院门诊和海南医学院生殖中心就诊的患者标本76份,其中生育组20份,弱精组19份,少弱精组20份,无精组17份.所有标本均进行精子计算机辅助精子分析(CASA),然后分离精子精浆,采用双抗体一步夹心法酶联免疫吸附试验(ELISA)法检测精子和精浆中Caspase 3和Caspase 8的含量.结果 ①所有被检测样本的精子和精浆中都检测到了Caspase 3和Caspase 8.②精浆中Caspase 3的平均含量和Caspase 8的平均含量均高于精子,且有统计学意义[(Caspase 3:(9.00±9.20)pmol/L vs(6.36±5.81)pmol/L,P＜0.05;Caspase 8:(17.32±11.23)pmol/L vs(12.72±7.42)pmol/L,P＜0.05].③精子中Caspase 8的平均含量都分别与精子密度、活动性和A级呈负相关;精浆中Caspase 8的平均含量分别与精子的A级呈负相关;精浆中Caspase 8的平均含量与精子密度呈负相关,均有统计学意义.④与生育组相比,仅少弱精组精子中Caspase 8含量较高,且差异有统计学意义(P＜0.05).结论 精浆中也存在Caspase,精子和精浆中Caspase 8含量可以反映精子的质量,主要与精子活动性相关.     

彩色多普勒超声在无精子症患者睾丸穿刺活检中的应用价值

目的探讨彩色多普勒超声在无精子症患者睾丸穿刺活检中的应用价值。方法回顾性分析2012年11月—2015年2月在我科诊断为无精子症的53例患者的病例资料。所有患者进行常规阴囊超声检查,采用频谱多普勒检测睾丸动脉(TA)、睾丸内动脉(ITA)的收缩期最大速度(PSV)、舒张末期速度(EDV)和阻力指数(RI)。采用彩色多普勒超声观察睾丸内的血管分布及其数目,并进行半定量评分。所有患者进行睾丸穿刺活检并进行Johnsen评分。结果 47例患者诊断为梗阻性无精子症(OA),6例患者诊断为非梗阻性无精子症(NOA)。0A组睾丸的平均体积(15.3±3.6)m L,NOA组睾丸的平均体积(7.1±2.8)m L,差异有统计学意义(P<0.01);OA组与NOA组患者睾丸的血流参数(PSV、EDV、RI)结果有统计学意义(P<0.05);OA组与NOA组睾丸内血管半定量分级有的差异,其差异有统计学意义(P<0.01)。结论彩色多普勒超声检查对睾丸生精功能有很好的预测作用,可作为鉴别OA患者和NOA患者的指标。     

比索洛尔联合胰岛素增敏剂治疗对PCOS患者内分泌功能的影响

目的：探讨比索洛尔联合胰岛素增敏剂治疗对多囊卵巢综合征(PCOS)患者内分泌功能的影响。方法选择2011年8月至2014年8月我院内分泌科收治的60例PCOS患者,根据随机数表法将60例患者分为观察组(n=30)和对照组(n=30),对照组接受胰岛素增敏剂吡格列酮治疗,观察组患者接受比索洛尔联合吡格列酮治疗,比较两组患者治疗前后的空腹胰岛素(FIN)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、雌二醇(E2)、睾酮(T)、孕酮(PRGE)、垂体泌乳素(PRL)、性激素结合蛋白(SHBG)、皮质酮(Cor)、促肾上腺皮质激素(ACTH)、肾上腺皮质激素释放激素(CRH)、促性腺激素释放激素(CnRH)、环磷酸腺苷和环磷酸鸟苷的变化,并对疗效进行评价。结果治疗后,观察组患者的FIN [(18.5±3.9) mIU/L vs (26.3±4.7) mIU/L]、FPG [(7.13±1.4) mmol/L vs (4.72±1.7) mmol/L]、HOMA-IR [(0.65±0.13) vs (0.42±0.19)]、HOMA-β[(2.45±0.47) vs (1.69±0.14)]、E2[(56.9±8.7) pg/mL vs (46.9±10.5) pg/mL]、T [(58.5±4.2) ng/dL vs (39.6±6.7) ng/dL]、PRGE [(0.69±0.21) pg/mL vs (0.52±0.17) pg/mL]、PRL [(17.5±5.3) pg/mL vs (13.2±4.7) pg/mL]和环磷酸腺苷水平[(26.9±3.5) pmol/L vs (21.2±2.4) pmol/L]较治疗前均明显降低(P<0.05),SHBG [(18.5±3.9) nmol/L vs (26.3±4.7) nmol/L]、Cor [(18.5±3.9) ng/mL vs (26.3±4.7) ng/mL]、ACTH [(18.5±3.9) ng/mL vs (26.3±4.7) ng/mL]、CRH [(53.7±6.4) pg/mL vs (61.3±7.2) pg/mL]和环磷酸鸟苷的水平[(25.6±4.9) pmol/L vs (27.1±1.8) pmol/L]较治疗前均明显升高,差异均有统计学意义(P<0.05);治疗后,对照组患者的FIN [(25.9±3.7) mIU/L vs (18.5±3.9) mIU/L]、FPG [(7.09±0.93) mmol/L vs (5.52±1.86) mmol/L]、HOMA-IR [(0.67±0.14) vs (0.45±0.11)]、HOMA-β[(2.39±0.96) vs (2.08±0.33)]、E2[(57.8±6.4) pg/mL vs (46.9±10.5) pg/mL]、T [(59.6±5.5) ng/dL vs (45.8±9.1) ng/dL]、PRGE [(0.67±0.19) pg/mL vs (0.53±0.15) pg/mL]和PRL [(17.4±3.3) pg/mL vs (14.2±5.6) pg/mL]较治疗前均明显降低,SHBG [(84.3±15.8) nmol/L vs (131.9±30.1) nmol/L]水平较治疗前明显升高,差异均有统计学意义(P<0.05),而Cor、ACTH、CRH、环磷酸腺苷水平和环磷酸鸟苷水平较治疗前均无明显变化(P>0.05);观察组患者的治疗总有效率为93.33%,明显高于对照组的66.67%,差异有统计学意义(P<0.05)。结论比索洛尔联合胰岛素增敏剂吡格列酮治疗PCOS可明显改善患者机体的内分泌环境,提高患者的治疗效果。     

生殖激素水平和睾丸体积对非梗阻性无精症患者精子存在的预测价值

目的探讨非梗阻性无精症(non-obstructive azoospermia,NOA)患者生殖激素水平、睾丸体积等参数对睾丸内是否存在精子的预测价值,以及可用于预测经皮睾丸精子抽吸术(testicular sperm aspiration,TESA)结果的切点值。方法将我中心男科门诊就诊的133例NOA患者按TESA的结果分为有精子组(n=33)和无精子组(n=100),测定生殖激素水平、睾丸体积、精浆果糖、中性-ɑ糖苷酶、染色体、AZF等。结果有精子组和无精子组左侧睾丸体积分别为(9.12±2.25)、(6.25±2.63)m L,右侧睾丸体积分别为(9.23±2.02)、(6.47±2.48)m L,促卵泡生成素(follicle-stimulating hormone,FSH)分别为(9.82±2.09)、(22.62±15.00)m IU/m L,总睾酮(total testosterone,TT)分别为(5.19±0.68)、(4.15±1.82)ng/m L,总睾酮/黄体生成素(T/LH)分别为:0.61±0.19、0.57±0.35,总睾酮/雌激素(T/E2)分别为:162.40±16.66和141.40±93.40。无精子组血清FSH显著高于有精子组,优选的FSH水平切点值为13.31 m IU/m L时,其敏感度为74.1%,特异性为96.2%。FSH水平ROC曲线的AUC为0.850,表明其诊断准确性中等。结论就单一因素而言,FSH水平对于NOA患者预测睾丸内是否有精子发生具有相当重要的价值,并且明显优于睾丸体积;两者的联合应用对非梗阻性无精子症患者预测其睾丸内精子存在更有意义。     

精索静脉曲张不育患者精液质量、外周血生殖激素和精浆生化指标检测

目的:探索精索静脉曲张(VC)致不育的可能机制.方法:采用放免法和酶免法检测69例VC不育患者和36例正常男性精液质量、生殖激素六项和精浆生化指标.结果:VC组精液密度、a级精子、精子活率、活力均低于正常对照组(P<0.05);VC组FSH[(7.13±4.48)IU/L]比正常对照组[(4.77 ±1.61)IU/L]明显升高(P<0.05),LH、PRL、E2、T、P2组间差异均无统计学意义(P>0.05);精浆生化各项指标差异均无统计学意义(P>0.05).结论:VC能够降低精液的密度、精于活力和活率,以影响睾丸生精细胞为主.FSH能够反映睾丸生精功能的下降,对判断VC不育患者的预后和指导治疗有一定意义.     

老年期抑郁症患者血清褪黑激素浓度及临床意义

目的 探讨抑郁症患者与血清褪黑激素(MT)浓度的关系. 方法 采用放射免疫法对57例老年期抑郁症患者和35例正常老年人的血清褪黑激素浓度进行测定. 结果 老年期不伴Ⅱ型糖尿病抑郁症患者组的血清褪黑激素浓度[(0.20±0.08)nmol/L]和伴Ⅱ型糖尿病抑郁症患者组的血清褪黑激素浓度[(0.25±0.07)nmol/L]均显著高于正常老年人[(0.15±0.05)nmol/L](P＜0.05),18例老年期不伴Ⅱ型糖尿病抑郁症患者治疗前后血清褪黑激素浓度[(0.20±0.06)nmol/L和(0.22±0.07)nmoL/L]差异无显著性(P＞0.05);老年期抑郁症患者的HAMD评分与血清褪黑激素浓度无显著相关性(r=-0.133,P＞0.05). 结论 高褪黑激素分泌很可能是老年抑郁症的一个特征性生物学指标.     

白细胞精子症与畸形精子症患者精浆中过氧化氢及一氧化氮检测

目的 探讨精浆中过氧化氢和一氧化氮浓度与精液重要参数之间的关系.方法 接WHO方法对精液标本进行检测,标本分为正常对照组,白细胞精子症组和畸精症组,采用分光光度比色法检测精浆过氧化氢和一氧化氮浓度.结果 在白细胞精子症组精浆中过氧化氢及一氧化氮浓度分别为(71.65±13.55)mmol/L和(45.10±10.98)μmol/L,明显高于正常对照组(40.15±10.23)mmol/L和(20.04±5.06)μmol/L(P＜0.05).在畸形精子组过氧化氢的浓度(mmol/L)较正常组明显增高(85.36±18.5 vs 40.15±10.23,P＜0.05),但NO浓度(μmol/L)与对照组差异无显著性(26.58±9.23 vs 20.04±5.06,P＞0.05).结论 高白细胞浓度及高畸形率引起的精浆高氧自由基浓度可能是导致男性不育的重要因素之一.     

加味黄风汤对糖尿病肾病模型大鼠肾组织8-OHdG表达的影响

目的观察加味黄风汤对糖尿病肾病模型大鼠肾脏8-羟基脱氧鸟苷(8-OHdG)表达水平的影响。方法 40只雄性SD大鼠按照随机数字表法分为空白对照组、模型组、加味黄风汤低、高剂量组,各10只,除空白对照组外其余组大鼠均经腹腔注射链脲佐菌素(STZ)造模,8周后检测24h尿微量白蛋白,检测血清肌酐及血糖水平,肾组织病理切片光镜及电镜检查,酶联免疫吸附测定法(ELISA)检测大鼠肾组织8-OHdG表达水平,化学发光法(Luminescence)检测大鼠肾组织腺嘌呤核苷三磷酸(ATP)水平。结果模型组大鼠24h尿微量白蛋白较空白对照组增加[(1702.06±659.75)μg比(503.03±320.16)μg,P0.05],肾脏病理可见肾小球肥大,系膜基质增生,基底膜增厚及足细胞足突融合,模型组大鼠肾组织8-OHdG表达水平较空白对照组增加[(795.23±185.73)ng/mL比(600.79±159.54)ng/mL,P0.05)],肾组织ATP水平较空白对照组下降[(0.27±0.17)pmol/mg比(0.72±0.14)pmol/mg,P0.05)]。治疗8周后加味黄风汤低、高剂量组糖尿病肾病模型大鼠24h尿微量白蛋白水平明显下降[(783.34±326.11)μg比(1567.46±621.97)μg,(610.99±325.54)μg比(1610.34±695.64)μg,P0.05];血糖水平明显下降[(24.31±1.90)mmol/L比(29.19±1.88)mmol/L,(23.97±2.73)mmol/L比(30.56±1.88)mmol/L,P0.05];光镜下肾小球肥大、系膜基质增生减轻;电镜下足细胞足突融合、基底膜增厚情况都有所改善。加味黄风汤低、高剂量组较模型组肾组织8-OHdG表达水平均有所下降[(695.49±159.76)ng/mL、(610.61±71.43)ng/mL比(795.23±185.73)ng/mL,P0.05]。高剂量组肾组织8-OHdG表达水平低于低剂量组,但二者差异无统计学意义[(610.61±71.43)ng/mL比(695.49±159.76)ng/mL,P0.05]。加味黄风汤低、高剂量组较模型组肾组织ATP表达水平均有所上升[(0.39±0.15)pmol/mg、(0.52±0.14)pmol/mg比(0.27±0.17)pmol/mg,P0.05]。高剂量组ATP表达水平高于低剂量组,但二者差异无统计学意义[(0.52±0.14)pmol/mg比(0.39±0.15)pmol/mg,P0.05]。结论糖尿病肾病模型大鼠肾组织8-OHdG表达明显上升,ATP表达水平下降,出现蛋白尿,足细胞损伤。加味黄风汤可下调糖尿病肾病模型大鼠肾组织8-OHdG表达水平,提高肾组织ATP水平,减轻蛋白尿水平,改善血糖,保护肾功能。     

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.