卵巢癌诊断指标研究

对５１例卵巢良,恶性肿瘤和２８例对照者的血清进行癌抗原１２５（ＣＡ１２５）癌抗原１５－３（ＣＡ１５－３）铁蛋白（ＳＦ）,乳酸脱氢酶（ＬＤＨ）和碱性磷酸酶（ＡＫＰ）５项指标检测。结果：（１）卵巢恶性肿瘤患者血清各项指标均值全部高于对照者和卵巢良性肿瘤患者（Ｐ〈０．０５或Ｐ〈０．０１）;（２）Ⅲ,Ⅳ期卵巢癌患者各项指标阳性率高于Ｉ,Ⅱ期患者（Ｐ〈０．０５或Ｐ〈０．０１）,除ＡＫＰ外,上皮性癌患者各项指     

血清CA125,CA15—3和SF联合测定在卵巢肿瘤诊断中的意义

对５１例卵巢良、恶性肿瘤和２８例对照者的血清进行癌抗原１２５（ＣＡ１２５），癌抗原１５－３（ＣＡ１５－３）和铁蛋白（ＳＦ）等指标检测。结果：（１）卵巢恶性肿瘤者血清三项指标均值全部高于对照者和卵巢良性肿瘤患者，差异有显著性（Ｐ〈０．０５￣０．０１）；（２）Ⅲ、Ⅳ期卵巢癌各项指标阳性率高于Ⅰ、Ⅱ期患者（Ｐ〈０．０５￣０．０１），上皮性癌患者各指标阳性率高于非上皮性癌患者（Ｐ〈０．０５）；（３）判断卵     

卵巢子宫内膜异位囊肿患者囊内液及血清CA—125的测定

经放射免疫测定，１７例卵巢子宫内膜异位囊肿（ＥＣＯ）囊内液ＣＡ－１２３均值Ｍ（Ｑ）为１１５．９×１０＾３（１２０．５×１０＾３）ＫＵ／Ｌ，明显高于患者血清ＣＡ－１２５水平「均值为４９．３（１９．２）ＫＵ／Ｌ〉Ｐ〈０．０１」，后者也明显高于无ＥＣＯ的异位症患者「ＣＡ－１２５为１７．５（９．８）ＫＵ／Ｉ」和正常妇女「血ＣＡ－１２５为１５．９（４．０）ＫＵ／Ｌ」，Ｐ值均〈０．０５。ＥＣＯ患者血清ＣＡ－１     

鼻咽癌外周血NK细胞活性的分析研究

作者测定了１１７例鼻咽癌患者外周血ＮＫ细胞活性水平，并与４０例健康者进行比较，结果发现鼻咽癌患者外周血ＮＫ细胞活性低于对照组（Ｐ＜０．０１），低分化鳞状细胞癌、未分化细胞癌患者ＮＫ细胞活性显著低于中分化鳞状细胞癌和对照组（Ｐ＜０．０５和Ｐ＜０．０１）；ＵＩＣＣ－ＴＮＭ分期Ⅱ、Ⅲ、Ⅳ期和复发病例的ＮＫ细胞活性均数各为２５．７５±１４．６３、２４．７０±１２．４２、１９．１５±８．２９、１５．６５±７．２５，Ⅳ期和复发者显著低于Ⅱ、Ⅲ期者（Ｐ＜０．０５）。血ＮＫ细胞活性与鼻咽癌患者血清ＥＢ病毒ＶＣＡ－ＩｇＡ抗体水平呈负相关（γｓ＝－０．８５，Ｐ＜０．０５）。结果表明鼻咽癌患者外周血ＮＫ细胞活性受抑制，并随病情进展而下降。作者认为检测外周血ＮＫ细胞活性可作为评估鼻咽癌预后的一项辅助指标。     

CA125、LDH在卵巢癌中的辅助诊断意义

选取卵巢上皮癌４０例、宫颈癌１３例、宫内膜癌１３例、良性肿瘤５０例和正常健康妇女５０例，以探讨卵巢上皮细胞癌膜抗原（ＣＡ１２５）、乳酸脱氢酶（ＬＤＨ）及同工酶、Ｃ－反应蛋白（ＣＲ）、唾液酸（ＳＡ）辅助诊断卵巢上皮癌的意义。结果：正常组血清ＣＡ１２５值（４×１０３±１．７６×１０３ｕ／Ｌ）及良性肿瘤组ＣＡ１２５值（１５×１０３±８．２４×１０３ｕ／Ｌ）明显低于卵巢癌组（２８０×１０３±７５×１０３ｕ／Ｌ）（Ｐ＜０．０５）；ＣＡ１２５辅助诊断卵巢上皮癌的敏感性（ＳＳ）为９５％、阳性拟然比（ＰＬＲ）为４．７５、准确性（ＡＣ）为８６％，明显高于宫颈癌的ＳＳ（８５％）、ＰＬＲ（４．２５）、ＡＣ（８０％）及宫内膜癌的ＳＳ（７７％）、ＰＬＲ（３．８５）、ＡＣ（７９％）。Ⅲ、Ⅳ期卵巢癌的ＣＡ１２５值（３９０×１０３±８２×１０３ｕ／Ｌ）明显高于Ⅰ、Ⅱ期卵巢癌的ＣＡ１２５值（２１０×１０３±７５×１０３ｕ／Ｌ）（Ｐ＜０．０５）；ＣＡ１２５的ＳＳ、ＮＰＶ、ＡＣ明显高于ＬＤＨ、ＣＲ、ＳＡ、ＣＲ的ＳＳ、ＮＰＶ、ＡＣ（Ｐ＜０．０５）；ＣＡ１２５的ＳＳ明显高于ＬＤＨ同功酶的ＳＳ７７％（Ｐ＜０．０５）。结论：ＣＡ１２５辅助诊断卵巢上     

卵巢上皮性肿瘤组织中CA125、Ki-67的表达及意义

目的 研究卵巢肿瘤标志物ＣＡ１２５和种瘤增殖抗原Ｋｉ－６７在卵巢在皮性肿瘤组织中的表达,二者的相关性及临床意义。方法 采用单克隆抗体ＣＡ１２５和Ｋｉ－６７对１１３例卵巢上皮性肿瘤病理标本进行免疫组化染色对比。结果 ＣＡ１２５的表达在粘液性肿瘤与非粘液性肿瘤间有极显著差异（Ｐ〈０．０１）,Ｋｉ－６７在不同组织学类型卵巢肿瘤间的表达无显著差异（Ｐ〉０．０５）;ＣＡ１２５与Ｋｉ－６７的表达强度恶性肿瘤显     

子宫内膜异位症患者免疫功能的变化与分析

对子宫内膜异位症（ 简称内异症） 患者的免疫指标进行测定, 探讨内异症患者体液与细胞免疫的状态, 并分析抗子宫内膜抗体（ＥＭＡｂ） 、卵巢肿瘤相关抗原（ＣＡ１２５） 在内异症诊断方面的意义。检测内异症患者的外周血免疫球蛋白（ＩｇＡ、ＩｇＭ、ＩｇＧ） , 补体Ｃ３ 、Ｃ４ 和Ｔ淋巴细胞亚群（ＣＤ３ 、ＣＤ４ 、ＣＤ８） 的含量及ＥＭＡｂ、ＣＡ１２５ , 并与盆腔炎组、对照组比较。结果表明内异症组与盆腔炎组外周血免疫球蛋白ＩｇＡ、ＩｇＭ、ＩｇＧ均升高, 与对照组相比, 有显著性差异（ Ｐ＜ ０ ．０１） ; 内异症组与盆腔炎组相比, 仅ＩｇＧ 含量降低（ Ｐ＜ ０．０１） ,ＩｇＭ、ＩｇＡ含量无显著性差异（ Ｐ＞ ０ ．０５）。内异症组与对照组相比, Ｃ３ 、Ｃ４ 有升高趋势, 但无显著性差异（ Ｐ＞０ ．０５） ; ＣＤ４／ＣＤ８ 较对照组升高（ Ｐ＜ ０．０５） , ＣＤ３ 、ＣＤ４ 均无明显变化。内异症患者ＥＭＡｂ 阳性率５９．１％ ,ＣＡ１２５ 升高者仅１４％ ; 盆腔炎患者ＥＭＡｂ 阳性率０ ％ , ＣＡ１２５ 升高者占５０％ 。认为内异症患者存在免疫功能的亢进, 尤以体液免疫亢进为主, 其程度与盆腔炎患者相近。ＥＭＡｂ 在内异症诊断方面具较高的特异性,ＣＡ１     

化学发光免疫分析联合检测四项肿瘤标记物及其临床应用

采用化学发光免疫（ＣＬＩＡ）分析方法对９０例健康人和２１６例恶性肿瘤患者进行ＣＥＡ、ＣＡ１９－９、ＣＡ１２５、ＣＡ１５－３等四项肿瘤标记检测，结果显示，绝大多数恶性肿瘤与健康人比较，其阳性率有显著性差异（Ｐ＜０．０１、Ｐ＜０．０５）。通过单项检测与联合检测比较，发现联合检测能显著提高恶性肿瘤的检出率，平均阳性率为８０．２％，具有临床诊断的价值。     

肺癌患者外周血T细胞亚群及免疫细胞活性的研究

采用ＡＰＡＡＰ法和流式细胞仪研究３２例肺癌患者及３０例健康人外周血Ｔ细胞亚群及免疫细胞活性（ＮＫ－Ａ）的变化。结果表明：肺癌患者外周血ＣＤ３＾＋、ＣＤ４＾＋、ＣＤ４＾＋／ＣＤ８＾＋及ＮＫ－Ａ与正常人比较呈显著性降低（Ｐ〈０．０５,Ｐ〈０．０１）;且肺癌伴癌转移者与未转移者上述各项指标亦有显著性差异（Ｐ〈０．０５）．说明肺癌患者存在细胞免疫降低;伴有癌转移的肺癌患者细胞免疫功能更低。提出积极调节肺癌     

癌患者的NK细胞和LAK细胞活性及MPS治疗对其的影响

观察了４７例癌患者和１３例健康人的ＮＫ细胞、内源性ＬＡＫ细胞对靶细胞的杀伤活性及ＮＫ细胞计数。结果表明，癌患者该３项指标均显著低于对照组（Ｐ＜０．００１），尤以晚期癌症和发生远处转移患者的降低为著。不同种类的癌和有无淋巴结转移的患者之间该３项指标无显著性差异。使用ＭＰＳ免疫治疗２周，可显著提高患者的上述３项指标（Ｐ＜０．００１、Ｐ＜０．００１、Ｐ＜０．０５）。     

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.