血清与腹腔液CA125测定对子宫内膜异位症的诊断价值

目的 探讨血清及腹腔液CA125测定对子宫内膜异位症(endometriosis,EM)的诊断价值.方法 对212例行腹腔镜手术的患者,于术前抽取血清,术中抽取腹腔液测定CA125浓度;根据腹腔镜检查结果 分为子宫内膜异位症组(143例)和对照组(69例).回顾性分析两组的血清和腹腔液CA125值.结果 子宫内膜异位症组的血清CA125值为(36.48±10.52)U/mL,显著高于对照组(18.74±12.35)U/mL(P＜0.05);子宫内膜异位症组的腹腔液CA125值为(1 237.0±248.6)U/mL,显著高于对照组(521.0±98.2)U/mL(P＜0.05).以血清CA125≥35 U/mL为标准,子宫内膜异位症组诊断子宫内膜异住症的阳性率为71.33%(102/143),对照组为8.7%(6/69);子宫内膜异位症患者血清CA125的阳性率显著高于对照组(P＜0.001).子宫内膜异位症组血清CA125敏感性及特异性分别为71.33%及91.30%.以腹腔液CA125≥800 U/mL为标准,子宫内膜异位症组诊断子宫内膜异位症的阳性率为93.71%(134/143),对照组为0.00%(0/69);子宫内膜异位症患者腹腔液CA125的阳性率显著高于对照组(P＜0.001).子宫内膜异位症组腹腔液CA125敏感性及特异性分别为93.70%及100.00%.结论 腹腔液CA125可提高诊断EM的灵敏度,较血清CA125具有更高的敏感性.     

血清CA125检测在子宫内膜异位症中的表达与意义

目的探讨血清Cancer antigen125（CA125）的测定对术前子宫内膜异位症及其与子宫腺肌症，盆腔炎并存的诊断价值。方法回顾性分析91例术前检测血清CA125值，术后病理证实为子宫内膜异位症、子宫腺肌症、盆腔炎。结果子宫内膜异位症、子宫内膜异位症合并子宫腺肌症、盆腔炎血清CA125的测定值逐渐升高；但在统计学上差异均无显著性。结论测定血清CA125的值对诊断子宫内膜异位症及子宫内膜异位症合并子宫腺肌症、盆腔炎有一定的临床价值。     

血清和腹腔液IL-18、CA125测定与子宫内膜异位症的关系

目的 探讨血清和腹腔液IL-18、CA125水平的变化与子宫内膜异位症的关系.方法 收集45例子宫内膜异位症患者血清和腹腔液,分别测定IL-18及CA125水平.结果 子宫内膜异位症组腹腔液中IL-18水平明显高于对照组(P＜0.05),在子宫内膜异位症组中腹腔液IL-18水平显著高于血清中水平(P＜0.05),子宫内膜异位症Ⅰ～Ⅳ期之间血清和腹腔液中IL-18水平无明显差异(P＞0.05),子宫内膜异位症组患者血清CA125水平明显高于对照组,子宫内膜异位症Ⅰ～Ⅳ期中前3期术前血清CA125水平之间比较无显著性差异(P＞0.05).结论 IL-18在子宫内膜异位症的发病机制中有重要作用,综合分析血清和腹腔液CA125、IL-18水平,对子宫内膜异位症的诊断有重要参考价值.     

血清CA125测定在妇科疾病中的诊断价值

目的探讨血清CA125在妇科疾病中的应用价值.方法采用放射免疫分析法测定100例妇科疾病患者CA125抗原水平. 结果卵巢上皮癌组CA125水平为(641.47±199.49)μg/L,该组经手术和化疗后CA125水平比治疗前显著降低(P＜0.01);子宫内膜异位症组及子宫腺肌症组CA125水平明显高于卵巢良性肿瘤及子宫肌瘤. 结论血清CA125水平测定对卵巢上皮癌的诊断及预后评估具有重要意义,在子宫内膜异位症及子宫腺肌症诊断中有一定价值.     

血清CA19-9测定对子宫内膜异位症的诊断价值

目的:探讨血清CA19-9测定对子宫内膜异位症(内异症)的诊断价值。方法:应用放射免疫测定法,测定120例内异症患者血清CA19-9值,并将120例患者依术中所见按AFS[1]分期分成Ⅰ、Ⅱ、Ⅲ、Ⅳ四组,同时检测35例健康育龄妇女的血清CA19-9值作为对照组。结果:内异症组及对照组CA19-9检测值及阳性率分别为57.5±32.6,73.3%;13.7±9.4,8.6%,两组比较,差异有显著性意义(P<0.01),内异症血清中CA19-9敏感性及特异性分别73.3%及91.9%,内异症Ⅰ、Ⅱ和Ⅲ、Ⅳ期CA19-9阳性率差异有显著性意义(P<0.01),且AFS分期越高CA19-9水平越高。结论:血清CA19-9测定对子宫内膜异位症的诊断有参考价值,并可提示子宫内膜异位症的严重程度。     

血清CA125联合抗子宫内膜抗体测定诊断子宫内膜异位症的价值

目的探讨血清CA125联合EmAb测定诊断子宫内膜异位症的价值.方法对经病理证实的147例子宫内膜异位症(EM组)及30例非子宫内膜异位症(对照组)患者,术前采用放射免疫法测定血清CA125水平,用酶联免疫吸附法(ELISA)检测血清抗子宫内膜抗体(EmAb),并对75例EM患者术后1周的血清CA125水平进行测定.结果 EM组Ⅰ～Ⅳ期血清CA125水平(U*ml-1,±s)分别为45.08±24.87、63.48±19.32、109.43±60.24、126.52±86.74,对照组为21.42±8.31,EM组各期CA125水平明显高于对照组(P<0.01).将EM组各期CA125水平与AFS评分作相关分析,两者均呈直线正相关(P<0.01).EM组EmAb阳性率为64.63%,明显高于对照组的6.67%(P<0.05),且Ⅲ～Ⅳ期阳性率高于Ⅰ～Ⅱ期(P<0.005);EM组血清CA125的敏感性及特异性分别为89.41%、92.53%;EmAb的敏感性为64.63%,特异性为73.51%;以血清CA125和EmAb均阳性为标准,敏感性稍有下降为70.25%,特异性增加100%.75例术后1周的CA125水平低于术前(P<0.01).结论血清CA125联合EmAb测定对EM有较高的辅助诊断价值,并能提高诊断的准确性,且血清CA125测定有助于观察EM的疗效.     

血清CA125阳性在妇科疾病中的诊断价值

探讨血清CA125阳性在妇科疾病中的诊断价值。方法采用电化学对前来就诊的妇科患者血清标本进行检测,并将其中200例CA125阳性的患者进行跟踪。结果发现卵巢上皮癌78例,子宫内膜异位症38例,子宫腺肌症16例,卵巢良性瘤30例,宫外孕6例。结论血清CA125水平升高对卵巢上皮癌的诊断具有重要的意义,对子宫内膜异位症,子宫腺肌症的诊断有一定的价值。     

血清肿瘤标记物糖类抗原125对子宫腺肌病的诊断意义

目的 探讨血清肿瘤标记物对子宫腺肌病的诊断价值.方法 采用免疫放射法测定子宫腺肌病患者100例、子宫肌瘤患者96例、卵巢良性肿瘤98例的血清125(CA125)的水平,并与正常育龄女性100例血清CA125进行比较.结果 子宫腺肌病组、子宫肌瘤组和卵巢良性肿瘤组的血清中CA125值明显高于正常育龄女性组([ 108.23±59.52)KU/L,(19.64±9.13)KU/L,(21.07±10.38)KU/L比(1.01±0.08)KU/L,P＜0.01];CA125＞35KU/L子宫腺肌病组78例,阳性率78.0%(78/100),子宫肌瘤组阳性率19.8%(19/96),正常育龄女性组20.4%(20/98),子宫腺肌病组值显著高于子宫肌瘤组、卵巢良性肿瘤组及正常育龄女性组(P<0.01).结论 子宫腺肌病患者血清CA125升高,对子宫腺肌病有较好的诊断预测价值.     

子宫腺肌症病变范围与血清CA125的关系

目的探讨子宫腺肌症病变范围与血清CA125值的关系。方法采用放射免疫法(RIA)检测及比较69例子宫腺肌症患者(观察组)及30例子宫肌瘤患者(对照组)的血清标本CA125值,采用June Rosal描述方法测量观察组患者腺肌症病变范围。结果观察组患者血清CA125值(93.06±66.97 U/ml)明显高于对照组血清CA125值(17.33±6.80 U/ml),差异有显著性(<0.05)。随子宫腺肌症范围增大,血清CA125值升高。结论血清CA125检测有助于子宫腺肌症的诊断,根据血清CA125值可以粗略评估子宫腺肌症病变范围。     

血清及腹腔液CA125测定对子宫内膜异位症的诊断意义

目的探讨血清及腹腔液中CA125测定对子宫内膜异位症（EM）诊断的敏感性、特异性及相关性。方法经病理证实的EM组45例作为观察组,非子宫内膜异位症28例为对照组,应用电化学发光法分别测定两组血清及腹腔液中CA125水平。结果各期EM组血清CA125水平与对照组相比差异有统计学意义（P〈0.01）,EM组血清CA125水平随期别增加而升高;测定血清CA125水平诊断EM的敏感性为75.56%,特异性为89.29%。各期EM组腹腔液CA125水平与对照组相比差异有统计学意义（P〈0.01）;测定腹腔液CA125水平诊断EM的敏感性为93.33%,特异性为96.43%。结论血清及腹腔液中CA125值为子宫内膜异位症有价值的辅助检查手段,尤以腹腔液中CA125水平显著升高,两者呈正相关,可反映子宫内膜异位症的病变程度。     

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.