青岛地区人体隐孢子虫感染调查

目的 探讨隐孢子虫在青岛地区的发病情况及其致病性。方法 抽样调查青岛市腹泻病人及散居人其粪便标本，用金胺－酚染色法及改良抗酸染色法检查隐孢子虫，对该虫一者随工查其家族成员。结果 共调查３６５５人，隐孢子虫检出率为２．４％，其中腹泻病 、散居人群、阳性者家庭成员检出率分别为２．２％，１．９％和８．６％，男女检出率分别为２．５％和２．２％，成人和儿童检出率分别为０．７％和３．３％，市区和郊区分别为２．     

卡氏肺孢子虫DNA的PCR检测

①目的探讨卡氏肺孢子虫的检测方法及感染状况。②方法收取病人痰液、肺组织及支气管灌洗液，常规方法提取ＤＮＡ，用聚合酶链反应（ＰＣＲ）技术检测卡氏肺孢子虫ＤＮＡ，并与吉氏染色结果进行比较。③结果８６例住院病人，卡氏肺孢子虫ＤＮＡ的ＰＣＲ检出率为４１．９％，卡氏肺孢子虫包囊吉氏染色法的检出率为１４．９％，两种方法的检出率比较，差异有显著性（ｕ＝６．６３８，Ｐ＜０．０５）。尿毒症、肺癌、血液病和肺部炎症病人卡氏肺孢子虫ＤＮＡ的ＰＣＲ检出率分别为３７．５％，６１．５％，５０．０％和２０．８％，差异有显著性（χ２＝９．０１，Ｐ＜０．０５）。痰液、肺组织和支气管灌洗液标本，卡氏肺孢子虫ＤＮＡＰＣＲ的检出率分别为２８．６％，６１．９％和７７．８％，差异有极显著意义（χ２＝１２．３０，Ｐ＜０．０１）。吉氏染色法检测出的１０份卡氏肺孢子虫包囊阳性标本，ＰＣＲ检测皆为阳性；５７份阴性标本，ＰＣＲ检测出１５份为阳性。４份结核标本ＰＣＲ检测皆为阴性。④结论ＰＣＲ技术检测肺组织和支气管灌洗液标本中的卡氏肺孢子虫ＤＮＡ，具有较高的敏感性和特异性     

重庆市乙型肝炎病毒血清标志物的动态分析

目的：对重庆市乙型肝炎病毒（ＨＢＶ）血清标志物进行动态分析。方法：采用ＥＬＩＳＡ法，对人群进行ＨＢＶ血清标志物调查检测。结果：均为常见的九种模式，本组与１９９４年比较变化较小，但单项抗—ＨＢｓ阳性模式的出现率由２１．９％升到２６．２％（χ２＝５．８３３、Ｐ＜０．０５）；本组ＨＢｓＡｇ的阳性率为８．３％，比１９８６年报道的低，男性为９．７％仍明显高于女性的６．５％（χ２＝９．３１０、Ｐ＜０．０５），１０岁～３０岁年龄组的ＨＢｓＡｇ阳性率均在平均阳性率８．３％之上，男女皆如此。流动职业人群感染率高于稳定职业人群（χ２＝６．１９０、Ｐ＜０．０５）。结论：ＨＢＶ感染模式的动态分析具有流行病学意义。     

喉鳞癌及乳头状瘤组织中人乳头瘤病毒DNA的PCR检测

①目的探讨人乳头瘤病毒１６型和１８型（ＨＰＶ１６和ＨＰＶ１８）与喉鳞癌、喉乳头状瘤的关系。②方法应用聚合酶链反应（ＰＣＲ）技术检测３４例喉乳头状瘤、８３例喉鳞状细胞癌石蜡包埋组织中ＨＰＶ１６及ＨＰＶ１８的ＤＮＡ．③结果喉乳头状瘤及喉鳞癌组织中ＨＰＶ１６的检出率为１４．７１％和３０．１２％，两组比较差异无显著性（χ２＝３．００６，Ｐ＞０．０５）；ＨＰＶ１８在喉乳头状瘤组织中未检出，而在喉鳞癌组织中为６．０２％，两组比较，差异无显著意义（χ２＝０．０８７，Ｐ＞０．０５）。高分化喉鳞癌组织中ＨＰＶ１６的检出率显著高于中分化鳞癌（χ２＝６．０３２，Ｐ＜０．０５），而高分化与低分化、中分化与低分化鳞癌之间的差异均无显著性（χ２＝０．３５１，１．５００，Ｐ均＞０．０５）；不同病理分化喉鳞癌组织中ＨＰＶ１８的检出率差异无显著性（χ２＝０．０６０，Ｐ＞０．０５）。④结论喉鳞癌的发生与ＨＰＶ感染密切相关，尤以ＨＰＶ１６明显     

6535名幼儿、中小学生乙肝病毒感染情况调查分析

采用间接血球凝集法对靖西县６５３５名幼儿、中小学生进行乙肝病毒（ＨＢＶ）感染情况调查，结果发现ＨＢｓＡｇ阳性率为１１．２５％，男女生之间差异有高度显著性（χ２＝７．２，Ｐ＜０．０１），城乡学生之间差异也有高度显著性（χ２＝２０．４９，Ｐ＜０．０１），用赖氏法测定血清ＡＬＴ，发现ＨＢｓＡｇ阳性者比阴性者肝脏损害严重（χ２＝２４．７７，Ｐ＜０．０１）。同时采用ＥＬＩＳＡ法对ＨＢｓＡｇ阳性的学生进一步做“两对半”检查，就调查结果进行了讨论，并提出相应的建议。     

饮食从业人员乙肝病毒感染的调查

采用酶联免疫吸附试验（ＥＬＩＳＡ）法，对田阳县参加健康体检的９９２０名饮食服务行业人员，进行乙型肝炎表面抗原（ＨＢｓＡｇ）、乙型肝炎ｅ抗原（ＨＢｅＡｇ）、血清谷丙转氨酶（ＡＬＴ）、麝香草酚（ＴＴＴ）的检测，结果表明ＨＢｓＡｇ和ＨＢｅＡｇ阳性率分别为１２．９８％和２．８４％；ＡＬＴ和ＴＴＴ异常率为２．６４％，ＨＢｓＡｇ检出率１９９２年最高，１９９５年最低（χ２＝５．８１，Ｐ＞０．０５）；ＨＢｅＡｇ阳性检出率１９９５年最高，１９９３年最低（χ２＝１１．２３，Ｐ＜０．０５），比较有显著性差异；ＴＴＴ、ＡＬＴ异常率１９９２年最低，１９９４年最高（χ２＝４．６２，Ｐ＞０．０５）；城乡ＨＢｓＡｇ、ＨＢｅＡｇ感染率无差异；１８～２７岁感染率最高，４６～６５岁最低；男性感染率比女性高（χ２＝５．４２，Ｐ＞０．０５）。     

生活事件,A型性格与青少年白发发病关系的病例对照研究

目的研究生活事件和Ａ型性格与青少年白发发病的关系。方法以有白发２０根以上为标准选择１０１名青少年病例，按１∶１比例选择相应对照，用“正常中国人生活事件量表”和“Ａ型性格问卷”进行询问调查。结果生活事件变化单位数即Ｌｃｕ≥１５０者发生青少年白发的危险比Ｌｃｕ＜１５０者高３．５６倍（ＯＲ＝３．５６，χ２＝１２．９Ｐ＜０．０１）；Ａ型性格者发生青少年白发的危险比非Ａ型性格者高２．３倍（ＯＲ＝２．３１，χ２＝６．７２Ｐ＜０．０１）；在有遗传史的对子中，Ｌｃｕ≥１５０者和Ａ型性格者发生青少年白发的危险分别是Ｌｃｕ＜１５０者和非Ａ型性格者的１１倍（ＯＲ＝１１，χ２＝１５．０４Ｐ＜０．０１）和３．２倍（ＯＲ＝３．２，χ２＝４．７６Ｐ＜０．０５）；在Ｌｃｕ＜１５０的对子中，Ａ型性格者发生青少年白发的危险是非Ａ型性格者的２．８３倍（ＯＲ＝２．８３，χ２＝４．３５Ｐ＜０．０５）。结论生活事件和Ａ型性格是青少年白发的重要病因，值得深入研究。     

子宫颈组织中人乳头状瘤病毒的PCR检测

①目的探讨人乳头状瘤病毒１６，１８型（ＨＰＶ－１６，ＨＰＶ－１８）感染与慢性宫颈炎、宫颈癌的关系。②方法聚合酶链反应（ＰＣＲ）技术检测２２例正常宫颈、５５例慢性宫颈炎、３０例宫颈癌的子宫颈组织。③结果正常宫颈组织中ＨＰＶ－１６，１８的检出率均为０．００％，慢性宫颈炎分别为１８．１８％和７．２７％，宫颈癌分别为５６．６７％和３．３３％．统计学处理表明，宫颈癌组织中ＨＰＶ－１６的检出率明显高于宫颈炎组织（χ２＝１３．６２４，Ｐ＜０．０１），而且Ⅲ度宫颈糜烂组织中ＨＰＶ－１６的检出率也较Ⅰ，Ⅱ度的检出率高，两者比较差异有显著意义（χ２＝１０．５５０，Ｐ＜０．０１），但不同宫颈疾患组织中ＨＰＶ－１８的检出率无统计学意义。④结论子宫颈癌的发生与ＨＰＶ感染密切相关，以ＨＰＶ－１６尤为明显，ＰＣＲ技术是检测组织中ＨＰＶ－ＤＮＡ的敏感、特异的方法     

虫草术酱汤治疗慢性乙型肝炎及肝炎后肝硬化疗效评价

目的对虫草术酱汤治疗慢性乙型肝炎（慢乙肝）及肝炎后肝硬化疗效进行评价。②方法２４０例慢乙肝和肝炎后肝硬化病人，随机分为治疗组与对照组，其中治疗组１２０例采用虫草术酱汤治疗，对照组给予西药保肝、对症、支持治疗。③结果治疗组的基本治愈及总有效率分别为６８．３％及８０．８％，对照组为１５．０％及２８．３％．治疗组ＡＴＬ与ＡＬＢ的疗效明显优于对照组（χ２＝９．０５，６．９８，Ｐ均＜０．０１）。治疗组ＨＢｅＡｇ与ＨＢＶ－ＤＮＡ阴转的疗效与对照组比较差异有极显著性（χ２＝４５．４５，３１．０５，Ｐ均＜０．０１）。随访１年，治疗组复发率为９．４％，对照组３８．６％，两组比较差异有极显著性（χ２＝１４．４７，Ｐ＜０．０１）。④结论虫草术酱汤对慢乙肝及肝炎后肝硬化有较好的治疗作用     

亚胺培南对粒细胞减少症合并感染病人的疗效

目的探讨亚胺培南／西司他丁（泰能组）单用及头孢三代并阿米卡星（联合组）对粒细胞减少症合并感染病人的治疗效果，指导对此类病人的临床用药。②方法回顾性分析１３４例粒细胞减少症病人应用两组药物的有效率及细菌清除率。③结果泰能组有效５９例（８９％），联合组为５０例（７３％），二者比较差异有显著性（χ２＝３１．９２，Ｐ＜０．００５）；泰能组和联合组对革兰阳性细菌清除率分别为８７％和７２％，两者比较差异有显著性（χ２＝１１５．５４，Ｐ＜０．００５）；对革兰阴性细菌清除率分别为８４％和７５％，两者比较差异无显著性（χ２＝２．９２，Ｐ＞０．０５）；两组总细菌清除率分别为８６％和７３％，两者比较差异有显著性（χ２＝６３．８９．Ｐ＜０．００５）。联合用药无效者换用泰能有效率为７８％（１４／１８），泰能无效组改用联合用药者均无效。④结论泰能疗效优于头孢三代并阿米卡星，联合用药无效者应用泰能仍有较好疗效。     

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.