单孔腹腔镜阴道骶骨固定术治疗盆腔脏器脱垂的疗效观察

目的 探讨腹腔镜阴道骶骨固定术治疗盆腔脏器脱垂(POP)的临床治疗效果。方法 选取2016年12月至2020年6月于本院治疗盆腔器官脱垂和(或)伴随阴道前后壁脱垂的患者30例,于术前及术后分别根据POP-Q评分标准进行评分,对盆底功能障碍性疾病的症状进行问卷调查,应用问卷20(PFDI-20)、问卷7(PFIQ-7)及盆腔器官脱垂/尿失禁性生活质量问卷-12(PISQ-12)进行评分。结果 POP-Q评分、PFDI-20、PFIQ-7的比较差异有统计学意义(P<0.05);PISQ-12评分(P>0.05),差异无统计学意义,根据术后和术前分值相比,术后患者性生活满意度有所提高,同时随访患者术后脐部切口均愈合良好,无切口感染、脐疝、出血等相关并发症发生。结论 应用腹腔镜器械行经脐单切口三通道腹腔镜下阴道骶骨固定术(以下简称单孔腹腔镜阴道骶骨固定术),对治疗盆腔器官脱垂性疾病是安全、有效、美观微创的术式,可显著改善患者的生活质量。     

2种术式治疗重度子宫脱垂的疗效比较

目的 比较协和式改良全盆底重建术与Y形聚丙烯网片腹腔镜下阴道骶骨固定术治疗重度子宫脱垂的疗效.方法 回顾性分析2015年6月至2019年12月在安徽医科大学附属妇幼保健院(安徽省妇幼保健院)妇科收治的88例重度子宫脱垂患者的临床资料.根据手术方式不同,分为重建组(n=60)与腹腔镜组(n=28).于术前、术后12个月分别使用盆腔器官脱垂定量分度法(POP-Q)、盆底功能障碍问卷(PFDI-20)、盆腔器官脱垂尿失禁患者性功能调查问卷(PISQ-12)对手术疗效进行评价;比较两组患者围手术期情况以及术后并发症发生率情况.结果 重建组患者手术时间为(95.42±17.73)min,短于腹腔镜组,术中出血量为(81.92±29.76)mL,多于腹腔镜组,差异均有统计学意义(P<0.05);两组患者术前Aa、Ba、Ap、Bp、C/D指示点分值差异无统计学意义(P>0.05),TVL差异有统计学意义(P<0.05).重建组患者术后12个月的POP-Q各指示点数值及TVL均低于腹腔镜组,其中Aa、Ba、C/D、TVL差异有统计学意义(P<0.05),Ap、Bp差异无统计学意义(P>0.05).两组患者术前与术后12个月POP-Q各指示点的位移及TVL的差值进行比较,Aa、Ba、C/D差异有统计学意义(P<0.05),Ap、Bp、TVL差异无统计学意义(P>0.05).重建组患者术后12个月PFDI-20得分、PISQ-12得分均低于腹腔镜组,差异有统计学意义(P<0.05).两组患者术前与术后12个月PFDI-20得分、PISQ-12得分的差值进行比较,PISQ-12得分差异有统计学意义(P<0.05),PFDI-20得分差异无统计学意义(P>0.05).结论 2种术式均是治疗重度子宫脱垂的有效术式,协和式改良全盆底重建术解剖学恢复优于Y形聚丙烯网片腹腔镜下阴道骶骨固定术,但是患者术后性生活满意度略差.     

腹腔镜阴道/子宫骶骨固定术疗效及术后性功能的评价

目的:探讨腹腔镜阴道/子宫骶骨固定术对盆腔器官脱垂(POP)患者的疗效及术后性功能的评价。方法:分析2008年1月至2012年12月间武汉大学人民医院经盆腔器官脱垂定量分度法(POP-Q)分度证实为Ⅲ度及以上POP、且已完成生育的52例患者,23例行腹腔镜阴道骶骨固定术(HY+CSP子宫切除),29例行子宫骶骨固定术(HSP子宫保留),分别在术后1,6,12个月以及此后每年1次随诊,应用POP-Q评估、尿失禁影响问卷(ⅡQ-7)、泌尿生殖系影响量表(UDI-6)、视觉模拟满意度评分法(VAS)评估患者术后疗效。采用女性性功能指标量表(FSFI)问卷调查,评估患者术前、术后1年性生活质量。结果:腹腔镜阴道/子宫骶骨固定术后以POP-QⅡ度为复发的客观标准,患者术前、术后进行POP-Q分度评估、UDI-6、IIQ-7问卷、VAS满意度评分比较差异有统计学意义(P<0.05)。子宫骶骨固定术及阴道骶骨固定术患者术前FSFI中位数得分相似,而手术前后FSFI评分差异有统计学意义(P<0.05),且术后子宫骶骨固定组的性欲望、性兴奋和高潮程度中位数得分明显高于阴道骶骨固定组。结论:阴道/子宫骶骨固定术是治疗盆腔器官脱垂疗效良好的手术方式之一,子宫骶骨固定术的子宫保留与患者术后性生活质量密切相关。     

举宫杯辅助下腹腔镜骶骨阴道固定术对盆腔器官脱垂患者生活质量和性功能的影响

目的探讨举宫杯辅助下腹腔镜骶骨阴道固定术(curette assisted laparoscopic sacrocolpopexy,CALS)对盆腔器官脱垂患者症状、生活质量和性功能的影响。方法选取郑州大学第一附属医院2010年1月至2013年5月收治的盆腔器官脱垂患者,其中59例行CALS治疗,62例行阴式辅助下腹腔镜骶骨阴道固定术(vaginally assisted laparoscopic sacrocolpopexy,VALS)治疗。采用盆底功能障碍问卷(Pelvic Floor Distress Inventory-short form 20,PFDI-20)、盆底障碍影响问卷(Pelvic Floor Impact Questionnaire-short form 7,PFIQ-7)、盆腔器官脱垂尿失禁性功能问卷(Pelvic organ prolapse urinary Incontinence Sexual Questionnaire-short form 12,PISQ-12)分别对患者症状、生活质量和性功能进行评分。术后随访1 a。结果两组患者术后1 a的PFDI-20总评分、PFIQ-7评分和PISQ-12总评分较术前均有改善,差异有统计学意义(P<0.05),但组间差异无统计学意义(P>0.05)。结论举宫杯辅助下腹腔镜骶骨阴道固定术可改善盆腔器官脱垂患者的症状、生活质量和性功能,值得临床推广。     

经阴道网片盆底重建术的疗效中长期随访

目的 探讨盆腔脏器脱垂的经阴道网片盆底重建术是否保留子宫的疗效分析以及术后的中长期影响。方法 选择2010年1月至2016年12月期间因盆腔脏器脱垂而手术治疗的患者76例为研究对象。根据手术方式匹配分为保留子宫组(UC)和切除子宫组(CH)两组,各38例。比较两组围手术期指标及盆腔器官脱垂定量分期法(POP-Q)术前、术后6个月、术后1年、术后5年分度评价客观疗效。采用盆底障碍量表简表(PFDI-20)、盆底障碍影响简易问卷(PFIQ-7)及盆腔器官脱垂/尿失禁性生活质量问卷(PISQ-12)评分判定主观疗效。结果 UC与CH组比较,围手术期指标中住院天数(P<0.001)、术中出血(P<0.001)、手术时间(P<0.001)、术后排气时间(P=0.004)、留置尿管时间(P<0.001)均优于CH组。POP-Q分度：两组术后较术前均有所改善。PFDI-20、PFIQ-7、PISQ-12评分,UC、CH组各自不同时间(术前、术后6个月、术后1年、术后5年)比较,差异均有统计学意义(P<0.001),均有所改善;UC与CH组比较PISQ-12评分术后6个月...     

阴式辅助下腹腔镜骶骨阴道固定术治疗重度盆腔器官脱垂疗效和安全性

目的:观察阴式辅助下腹腔镜骶骨阴道固定术(VALS)治疗重度盆腔器官脱垂(POP)的临床疗效及安全性。方法:选取我院2014年1月-2015年12月收治的重度PFD患者共36例进行VALS治疗,并对患者进行6个月的随访,观察手术时间、术中出血量及并发症、POP-Q各指示点位置、术前及术后6个月的盆底障碍影响问卷-7(PFIQ-7)、盆底症状影响量表-20(PFDI-20)和盆腔器官脱垂/尿失禁性功能问卷-12(PISQ-12)。结果:本组36例患者均完成手术,未出现不良反应。术后患者的POP-Q指示点中Aa、Ba、C、AP、BP较术前均得到了明显的纠正(P<0.05),而术前及术后的阴道全长(TVL)对比差异无统计学意义(P>0.05)。术后6个月患者的PFIQ-7、PFDI-20、PISQ-12评分较术前均出现改善(P<0.05)。结论:VALS治疗重度POP能有效改善患者的临床症状、生活质量及心功能,具有较高的临床运用价值。     

全盆底重建术治疗227例女性盆腔脏器脱垂疗效分析

目的分析盆底重建术治疗盆腔脏器脱垂(POP)的临床疗效。方法选取2012年1月‐2015年12月于该院因POP II-IV接受经阴盆底重建手术(TVM)的患者227例,分析患者盆腔脏器脱垂定量分期法(POP-Q评分)、盆底功能障碍问卷-20(PFDI-20评分)、盆底障碍影响简易问卷-7(PFIQ-7评分)、盆腔器官脱垂/尿失禁性生活质量问卷-12(PISQ-12评分)以及术后复发率及手术并发症情况,共随访2年。结果术前与术后的POP-Q评分比较,客观治愈率100%,差异有统计学意义(P 0.05)。手术后POP-Q中的各位点值均上升,达到解剖学复位。术后的PFDI-20及PFIQ-7评分低于术前,差异有统计学意义(P 0.05)。术后PISQ-12评分高于术前,差异有统计学意义(P 0.05)。术后脱垂复发率为4.42%,疼痛发生率为8.81%,网片暴露率为4.85%,主观满意率为96.5%。结论经阴盆底重建术治疗II-IV度POP安全、疗效确切,对患者生活质量有明显地提高和改善,是POP的理想术式。     

两种保留子宫的高位骶韧带悬吊术治疗中盆腔脱垂患者的临床疗效观察

目的 探讨经腹腔镜及经阴道腹膜外两种高位骶韧带悬吊术对年轻中盆腔脱垂患者的疗效。方法 回顾性分析2018年1月至2022年1月北京市顺义区妇幼保健院采用保留子宫的高位骶韧带悬吊术并完成系统随访的42例中青年中重度子宫脱垂患者的临床资料,根据手术方式分为经腹腔镜高位骶韧带悬吊术组（腹腔镜组,n=22）和经阴道腹膜外高位骶韧带悬吊术组（阴式组,n=20）,两组均保留子宫,比较两组患者围手术期各项指标水平、评估术前及术后6个月时盆腔脏器脱垂情况,记录术后6个月盆底功能障碍性疾病症状问卷-20(pelvic floor dysfunction disease symptom questionnaire,PFDI-20)、盆腔器官脱垂/尿失禁性生活质量问卷-12(pelvic organ prolapse sexual quality questionnaire,PISQ-12)评价患者术后生活质量,以POP-Q评分评价客观疗效。结果 两组均未出现输尿管损伤,腹腔镜组较阴式组术中出血量少,恢复自主排尿、术后排气时间、术后住院时间短（P<0.05）。两组患者术后POP-Q各指标水平均优于术前...     

腹腔镜下子宫/阴道骶骨固定术与改良全盆底功能重建术治疗中盆腔缺陷的疗效比较

目的 分析腹腔镜下子宫/阴道骶骨固定术与改良全盆底功能重建术治疗中盆腔缺陷所致的盆腔器官脱垂(pelvic organ prolapse,POP)的疗效比较.方法 回顾性收集2008年1月至2012年12月在我院接受腹腔镜下子宫/阴道骶骨固定术(观察组,57例)和改良全盆底功能重建术(对照组,55例)的患者临床资料.随访利用盆腔器官脱垂定量(pelvic organ prolapse quantification POP-Q)评分法比较患者客观满意度;主观症状改善评分(patient global impression of change,PGI-C)比较主观满意度;比较手术时间和出血量等围手术期参数;术后比较并发症、再次手术率;利用盆底生活质量问卷(pelvic floor distress inventory-short form 20,PFDI-20;pelvic floor impact questionnaire 7,PFIQ-7)比较2组术前、术后生活质量评分.结果 所有患者手术都有较好的结局.观察组与对照组相比,减少了出血量、留置尿管时间、术后住院时间.在平均42个月的随访中,主观满意度在观察组为57/57(100％),在对照组为51/55(92.73％) (P＞0.05);客观满意度在观察组为45/57 (78.95％),在对照组为38/55(69.09％)(P＞0.05).PGI-C评分在观察组显著优于对照组;PFDI-20、PFIQ-7问卷2组评分均较术前显著改善,但2组间并无显著差异;性生活质量问卷(pelvic organ prolapse/urinary incontinence sexualquestionnaire-12,PISQ-12)评分在观察组术前及术后均优于对照组(P＜0.01).结论 与改良全盆底功能重建术比较,腹腔镜子宫/阴道骶骨固定术可显著减少手术出血量、留置尿管时间和术后住院时间,有较好的主观症状改善.     

达芬奇机器人系统辅助腹腔镜骶骨阴道固定术治疗盆腔器官脱垂的效果

目的探讨达芬奇机器人系统辅助腹腔镜骶骨阴道固定术治疗盆腔器官脱垂(POP)的效果。方法回顾性分析2016年1月至2018年12月郑州大学第一附属医院收治的98例POP(子宫及残端脱垂)患者的临床资料。按治疗方式分为腹腔镜组(65例)和机器人组(33例)。腹腔镜组患者接受传统腹腔镜骶骨阴道固定术治疗,机器人组患者接受达芬奇机器人辅助腹腔镜骶骨阴道固定术治疗。比较两组患者手术时间、术中出血量、术后留置尿管天数、腹腔引流量、肛门排气时间、术后住院天数、术中和术后并发症。比较两组患者手术前后盆腔器官脱垂量化系统(POP-Q)分度、盆底障碍影响问卷(PFIQ-7)及盆腔器官脱垂尿失禁性功能问卷(PISQ-12)评分。结果手术均顺利完成,未发生术中并发症及中转开腹。机器人组手术时间短于腹腔镜组,术中出血量少于腹腔镜组(均P<0.05)。两组术后留置尿管天数、腹腔引流量、肛门排气时间、术后住院天数比较,差异无统计学意义(均P>0.05)。机器人组短期并发症发生率、远期并发症发生率分别与腹腔镜组比较,差异无统计学意义(均P>0.05)。机器人组术后PFIQ-7评分、PISQ-12评分分别与腹腔镜组比较,差异无统计学意义(均P>0.05)。两组术后PFIQ-7评分均低于同组术前,两组术后PISQ-12评分均高于同组术前(均P<0.05)。两组术后3个月POP-Q评分比较,差异无统计学意义(均P>0.05)。术后3个月,机器人组Aa、Ba、C、pb、Ap、Bp较术前改善(均P<0.05)。机器人组术后3个月gh、Tvl分别与同组术前比较,差异无统计学意义(均P>0.05)。术后3个月,腹腔镜组Aa、Ba、C、Ap、Bp较术前改善(均P<0.05)。腹腔镜组术后3个月gh、pb、Tvl分别与同组术前比较,差异无统计学意义(均P>0.05)。结论采用达芬奇机器人系统辅助腹腔镜骶骨阴道固定术治疗POP的效果确切,有助于缩短手术时间,减少术中出血。     

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.