监测胎儿脑,脐血流阻力指标预测胎儿宫内缺氧

目的：预测胎儿宫内缺氧。方法：应用彩色多普勒超声对１４７例孕妇进行详细观察。结果：胎儿的大脑中动脉（ＭＣＡ）血流Ｓ／Ｄ值〈４、ＰＩ〈１．４、ＲＩ值〈０．６（Ｓ／Ｄ、ＰＩ、ＲＩ值简称阻力指标）;脐动脉（ＵＭＡ）血流Ｓ／Ｄ值〉３、ＰＩ值〉１．７、ＲＩ值〉０．８;ＰＩ、ＲＩＭＣＡ／ＰＩ、ＲＩＵＭＡ〈１时,提示胎儿宫内缺氧。妊高征组和伴ＩＵＧＲ的妊高征组缺氧发生率与正常组缺氧发生率比较差异有显著性（Ｐ〈０     

彩色多普勒超声技术测定正常中期妊娠血流的研究

采用多普勒超声技术（ＣＤＦＩ）测定３１２例正常中期妊娠孕妇脐动脉（ＵＡ）、胎儿大脑中动脉（ＭＣＡ）、胎儿腹主动脉（ＡＡ）及子宫动脉（ＵＴＡ）的收缩期峰值速度（Ｓ）、舒张末期速度（Ｄ）、Ｓ／Ｄ比值、阻力指数（ＲＤ）和搏动指数（ＰＩ）。结果显示ＭＣＡ的检出较其它血管困难，但随孕周而检出递增。多数动脉的速度参数随孕周而升高，阻力参数随孕周三。与孕周相关关系有显著意义（Ｐ〈０．０５），而ＭＣＡ中Ｄ随孕周变     

心房颤动对脑动脉血流的影响

目的：观察心房颤动（ＡＦ）对脑动脉血流的影响。方法：选择１４例心功能代偿期ＡＦ患者作观察组（ＡＦ组），１８例同龄健康体检者作对照组。采用经颅多普勒检测仪（ＴＣＤ）以脑动脉平均血流速度（Ｖｍ）及搏动指数（ＰＩ）为观察指标。结果：ＡＦ组脑动脉血流速度快慢不一，各动脉血管的Ｖｍ均较对照组降低，Ｐ〈０．０５或０．０１。ＡＦ组在脑中动脉（ＭＣＡ）、大脑前动脉（ＡＣＡ）的最大心搏平均血流速度（ＭａｘＶｍ）及心     

EFFECTS OF β－ENDORPHIN ON PHYTOHEMAGGLUTININ－INDUCED LYMPHOCYTE PROLIFERATION AND MOUSE PLAQUE－FORMING CELL RESPONSE VIA AN O

ＥＦＦＥＣＴＳＯＦβ－ＥＮＤＯＲＰＨＩＮＯＮＰＨＹＴＯＨＥＭＡＧＧＬＵＴＩＮＩＮ－ＩＮＤＵＣＥＤＬＹＭＰＨＯＣＹＴＥＰＲＯＬＩＦＥＲＡＴＩＯＮＡＮＤＭＯＵＳＥＰＬＡＱＵＥ－ＦＯＲＭＩＮＧＣＥＬＬＲＥＳＰＯＮＳＥＶＩＡＡＮＯＰＩＯＩＤＲＥＣＥＰＴＯＲＭ...     

门电路心血池显像结合超声心动图评估原发性高血压病人的左室…

应用＾９９ｍＴｃ－ＲＢＣ门电路心血池显像（ＧＢＰＩ）结合超声心动图（ＵＣＧ）对１００例单纯原发性高血压（Ⅱ期）病人和４２例正常人进行左室舒张功能测定，发现：（１）高血压组的ＧＢＰＩ的最大充盈率（ＭＦＲ）与正常组比较显著降低（Ｐ＜０．０１）；（２）ＵＣＧ的Ａ／Ｅ比值，两组比较无显著差异，Ａ／Ｅ与ＬＶＭＩ或其他指标均无相关；（３）高血压组的ＭＦＲ低于正常均值（２．４１ＥＤＶ／Ｓ）的占８６％，其中ＬＶＭ     

胎儿动脉 ＭＣＡ、ＭＣＡ 与 ＵＡ 的阻力指标 在高血压产妇母婴结局预测价值

目的：探讨胎儿大脑中动脉（ｍｉｄｄｌｅ ｃｅｒｅｂｒａｌ ａｒｔｅｒｙ，ＭＣＡ）与脐动脉（ｕｍｂｉｌｉｃａｌ ａｒｔｅｒｙ，ＵＡ）的阻力指标 在高血压产妇母婴结局的预测价值。方法：选取我院妇产科 １４７ 例妊娠期高血压产妇，按疾病轻重分为轻度组 ７８ 例，重度组 ６９ 例，选择正常孕妇 １７２ 例作为对照组。采取彩色多普勒超声检测胎儿 ＭＣＡ 与 ＵＡ 阻力指标并 计算其Ｓ ／ Ｄ、ＰＩ 及 ＲＩ 比值，用各阻力指标及比值与妊娠结局作 ＲＯＣ 曲线。结果：对照组与重度组 ＵＡ、ＭＣＡ 阻力 指标及比值组间差异显著（Ｐ＜０．０５），轻度组与重度组 ＵＡ、ＭＣＡ 阻力指标及比值组间差异显著（Ｐ＜０．０５）。三组 妊娠结局比较有显著差异（Ｐ＜０．０５）。经 ＲＯＣ 分析妊娠结局，ＭＣＡ 与 ＵＡ 阻力指标优于单一应用 ＭＣＡ 或 ＵＡ。 结论：疾病恶化后胎儿 ＵＡ 阻力指标上升，ＭＣＡ 及 ＭＣＡ 与 ＵＡ 阻力指标下降，ＲＩＭＣＡ／ ＵＡ 对妊娠期高血压疾病 预测价值佳。     

彩色多普勒超声检测妊高征患者肾内小动脉和脐动脉血流速度变化

目的：为了解妊高征（ＰＩＨ）时，肾内小动脉（ＩＮＲＡ）和胎儿脐动脉（ＦＵＡ）多普勒血流频普变化。方法：用彩超分别检测６３例第三期妊娠和１２例非妊娠妇女上述血管Ｓ／Ｄ（收缩期血流速度峰值／舒张末期血流速度值）、ＲＩ（阻力指数）和ＰＩ（搏动指数），用ｔ检验统计。结果：在重度ＰＩＨ时，ＦＵＡ的Ｓ／Ｄ和ＰＩ较其它组高（Ｐ＜０．０５），ＲＩ＿（ｉｎｒａ）／ＲＩ＿（ｆｕａ）≤１；该值与ＰＩＨ血压呈负相关。在ＰＩＨ组，ＩＮＲＡ的Ｓ／Ｄ、ＲＩ和ＰＩ与对照组分别相比，有显著性差异。结论：在ＰＩＨ时，肾循环与胎儿胎盘循环在出血动力学方面有区别，为预测ＰＩＨ预后提供了新方法。     

门电路心血池显像结合超声心动图评估原发性高血压病人的左室舒张功能

应用９９ｍＴｃ－ＲＢＣ门电路心血池显像（ＧＢＰＩ）结合超声心动图（ＵＣＧ）对１００例单纯原发性高血压（Ⅱ期）病人和４２例正常人进行左室舒张功能测定，发现：（１）高血压组的ＧＢＰＩ的最大充盈率（ＭＦＲ）与正常组比较显著降低（Ｐ＜０．０１）；（２）ＵＣＧ的Ａ／Ｅ比值，两组比较无显著差异，Ａ／Ｅ与ＬＶＭＩ或其他指标均无相关；（３）高血压组的ＭＦＲ低于正常均值（２．４１ＥＤＶ／Ｓ）的占８６％，其中ＬＶＭＩ高于正常值（男１００．２ｇ／ｍ２，女８６ｇ／ｍ２）的占８９．０％（７７／８６）；高血压组Ａ／Ｅ比值高于正常值（０．６９）的占６４％，其中ＬＶＭＩ高于正常值的占６２．５％。用ＧＢＰＩ的指标ＭＦＲ结合ＵＣＧ的指标Ａ／Ｅ比值来检测左室舒张功能，对原发性高血压的左室舒张功能的评估，有较大的实用价值，尤以ＭＦＲ指标更为可靠。     

CHANGES OF ENDOTHELIN-1 GENE EXPRESSION IN RAT BRAINS DURING ISCHEMIA AND ISCHEMIC REPERFUSION

ＣＨＡＮＧＥＳＯＦＥＮＤＯＴＨＥＬＩＮ－１ＧＥＮＥＥＸＰＲＥＳＳＩＯＮＩＮＲＡＴＢＲＡＩＮＳＤＵＲＩＮＧＩＳＣＨＥＭＩＡＡＮＤＩＳＣＨＥＭＩＣＲＥＰＥＲＦＵＳＩＯＮＷｕＷｅｉｐｉｎｇ（吴卫平）；ＫｕａｎｇＰｅｉｇｅｎ（匡培根）ａｎｄＬｉＺｈｅｎｚｈｏ...     

骨性关节炎血流动力学及代谢研究的现状和未来

骨性关节炎血流动力学及代谢研究的现状和未来ＰＡＳＴ，ＰＲＥＳＥＮＴＡＮＤＦＵＴＵＲＥＯＦＲＥＳＥＡＲＣＨＯＮＨＥＭＯＤＹＮＡＭＩＣＳＡＮＤＭＥＴＡＢＯＬＩＳＭＯＦＯＳＴＥＯＡＲＴＨＲＩＴＩＳ郑召民，陈清汉综述（河南医科大学第二附属医院骨科郑州４５００...     

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.