心肌梗塞病人心功能测定

用心尖搏动图（ＡＣＧ）对９５例心肌梗塞病人心功能结果与５２例正常健康者对照分析，结果发现：（１）急性心肌梗塞（ＡＭＩ）礤室收缩功能（ＳＴＩ）及舒张功能（ＤＴＩ）各项指标与正常对照组之间均有非常显著性差异（Ｐ〈０．０１）。（２）陈旧性心肌梗塞（ＯＭＩ）所测ＳＴＩ及ＤＴＩ各项指标与正常对照组之间均有非常显著性差异（Ｐ〈０．０１）。９３）ＡＭＩ与ＯＭＩ之间所测ＳＴＩ及ＤＴＩ除个别指标外，均无明显差异。     

冠心病患者纤溶指标及血栓弹力图变化意义的研究

目的：探讨纤溶指标及血栓弹力图改变对各类型冠心病的意义。方法：测定冠心病患者组织型纤溶酶原激活物（ｔ－ＰＡ），纤溶酶原激活物抑制物（ＰＡＩ），Ｄ－二聚体（Ｄ－ｄｍ）及血栓弹力图（ＴＥＧ）的变化。结果：纤溶改变在冠心病组与对照组有非常显著性差异（Ｐ＜０．０１），急性心肌梗塞（ＡＭＩ）、不稳定心绞痛组（ＵＡ）及隐匿型冠心病组（ＬＣＨ）组间有显著性差异（Ｐ＜０．０５）；而ＴＥＧ改变在对照组与各类型冠心病组间有显著性差异（Ｐ＜０．０１），各类型冠心病组间无显著性差异（Ｐ＞０．０５）。结论：ｔ－ＰＡ、ＰＡＩ活性、Ｄ－ｄｍ含量测定及ＴＥＧ的高凝图像改变可作为冠心病诊断及病程发展的指标。     

脑梗死患者血浆PAP水平与单核细胞组织因子、t-PA和PAI活性的测定及其意义

目的观察脑梗死（ＣＩ）患者血浆纤溶酶－α２－抗纤溶酶复合物（ＰＡＰ）、凝血酶－抗凝血酶Ⅲ复合物（ＴＡＴ）测定和外周血单核细胞（ＰＢＭＣ）组织因子（ＴＦ）及ｔ－ＰＡ：ａ和ＰＡＩ：ａ的变化及其意义。方法分别应用ＥＬＩＳＡ法、凝血酶和反应法发色底物法测定５０例脑梗死患者、２０例健康对照及２０例非血栓疾病病例对照的血浆ＰＡＰ、ＴＡＴ、Ｆｇｎ含量、ＰＢＭＣＰＣＡ、ＰＢＭＣＴＰＡ和ＰＡＩ活性。结果①脑梗死患者血浆ＰＡＰ、ＴＡＴ及Ｆｇｎ水平明显增高,与病例对照组及正常对照组比较均有显著差异;②脑梗死患者ＰＢＭＣＴＦ活性明显高于健康对照组（Ｐ＜０．０１）及病例对照组（Ｐ＜０．０１）。ＰＢＭＣｔ－ＰＡ活性表达明显低于健康对照组（Ｐ＜０．０５）及病例对照组（Ｐ＜０．０１）。ＰＢＭＣＰＡＩ活性明显高于健康对照组（Ｐ＜０．０５）及病例对照组（Ｐ＜０．０１）。结论血浆ＴＡＴ及ＰＡＰ水平检测可较好的评价脑梗死患者凝血及纤溶系统激活状态。脑梗死患者在细胞水平已处于高凝状态。并在细胞水平存在凝血与纤溶系统失衡。     

冠心病、高血压病人血浆氧自由基、一氧化氮及纤溶活性的变化

目的探讨冠心病、高血压病人血浆氧自由基、一氧化氮（ＮＯ）及纤溶活性的变化及相互关系。方法观察了３０例正常人及１８５例冠心病、高血压病人血浆丙二醛（ＭＤＡ）、超氧化物歧化酶（ＳＯＤ）、组织型血纤维蛋白溶酶原激活剂（ｔ-ＰＡ）。ｔ－ＰＡ抑制物（ＰＡＩ）及一氧化氮的变化。结果稳定性心绞痛组、不稳定心绞痛组、陈旧性心肌梗塞组、Ⅰ、Ⅱ期高血压病组、Ⅲ期高血压病组、冠心病并高血压病组病人,其血浆ＭＤＡ、ＰＡ均明显高于正常组（Ｐ＜０川）,而ＳＯＤ、ｔ－ＰＡ、ＮＯ则明显低于正常组（ｐ＜０．０１）。结论冠心病、高血压病人血浆中氧自由基增多,并可能引起血管内皮细胞损伤,ＮＯ合成释放减少,纤溶活性下降。     

吸烟对氧自由基和纤溶系统的影响

动态观察２０名健康男性急性吸烟前后超氧化物歧化酶（ＳＯＤ），丙二醛（ＭＤＡ），组织型行溶酶原激活剂（ｔ－ＰＡ）和纤溶酶原激活性剂抑制物（ＰＡＩ－Ｉ）活性的改变。结果表明：受试者急吸烟后ＳＯＤ增加（Ｐ〈０．０５），ＭＤＡ减少（Ｐ〈０．０５），纤溶系统有短暂激活。吸烟者ｔ－ＰＡ的释放不吸烟者减少（Ｐ〈０．０５），ｔ－ＰＡ的释放与ＳＯＤ呈正相关，与ＭＤＡ呈负相关。     

急性心肌梗塞与血管紧张素转化酶活性关系的临床研究

以马尿酸定量法测定符合ＷＨＯ规定的诊断标准的急性心肌梗塞（ＡＭＩ）患者７８例和正常对照组３４例的血清血管紧张素转化酶（ＡＣＥ）活性。结果：（１）ＡＭＩ患者的血清ＡＣＥ活性显著高于对照组（Ｐ〈０．００１）,（２）ＡＭＩ亚急性期或恢复期的ＡＣＥ活性均显著低于ＡＭＩ急性期者（Ｐ〈０．０５,Ｐ〈０．０１）,恢复期ＡＭＩ患者的ＡＣＥ活性则显著低于亚急性期者（Ｐ〈０．０５）;（３）ＡＭＩ患者并发心衰或并发休克     

单纯高血压及有缺血性脑卒中并发症患者纤溶系统的观察

目的 观察高血压伴或不伴缺血性脑卒中患者的纤溶系统的变化。方法 观察了４７例高血压伴缺血性脑卒中患者和２０例无缺血性脑卒中的高血压患者纤溶系统的变化,并与２４例健康对照组进行了比较。结果 高血压伴缺血性脑卒中患者ｔ－ＰＡ和纤溶酶原明显低于单纯高血压组（Ｐ〈０．０５）和健康对照组（Ｐ〈０．０１）;而ＰＡＩ和Ｄ－二聚体及纤维蛋白原明显高于高血压病患者（Ｐ〈０．０５）和健康对照组（Ｐ〈０．０１）,单纯高     

低分子肝素对不稳定型心绞痛患者纤溶活性及临床心性事件的影响

目的：观察低分子肝素对不稳定型心绞痛患者纤溶活性及临床心性事件的影响。方法：将６８例不稳定型心绞痛患者随机分成二组,其中治疗组３６例,对照组３２例,治疗组３６例在常规治疗基础上加用低分子肝素,治疗前后分别取血浆测定以下指标：组织型纤溶酶原激活物（ｔ－ＰＡ）活性,纤溶酶原激活物抑制物－１（ＰＡＩ－１）活性,纤溶酶原（ＰＩｇ）活性,Ｄ－二聚体（Ｄ一ｄｉｍｅｒ）含量。并观察住院 １５ ｄ内再发心绞痛,急性心肌梗死,心性死亡,ＰＴＣＡ或ＣＡＢＧ等临床心性事件发生率。结果：治疗组应用低分子肝素后血浆ｔ－ＰＡ及ＰＩｇ活性较治疗前显著增高,而ＰＡＩ—１活性在治疗后明显降低,总的临床心性事件发生率较对照组明显降低（ Ｐ＜ ０． ０５）。结论：低分子肝素能有效地增加不稳定型心绞痛患者体内纤溶系统活性,从而使临床心性事件发生率大大降低。     

心肌梗塞患者自然杀伤细胞活性检测

用１２５ＩＵｄＲ释放法测定１７例急性心肌梗塞（ＡＭＩ）后一周内的外周血自然杀伤（ＮＫ）细胞活性，并与１３例陈旧性心肌梗塞（ＯＭＩ）及５８例正常人对照。结果表明：ＡＭＩ组ＮＫ细胞活性明显低于正常组及ＯＭＩ组（Ｐ＜０．０１）。ＡＭＩ组中，梗塞面积广泛者ＮＫ细胞活性明显低于梗塞面积局限者（Ｐ＜０．０１）。提示ＮＫ细胞活性可作为ＡＭＩ诊断和预后判断的一个辅助参考指标。     

外科危重病患者凝血障碍的动态变化

目的 探讨外科危重病患者凝血功障碍与病情严重度和预后的关系，方法 ７１例外科危重症患者分为轻型组，重型组，死亡组，发病０，４，８ｄ分别检测抗凝血酶Ⅲ（ＡＴ－Ⅲ）组织型血浆溶酶原激活物（ｔ－ＰＡ）组织型血浆溶酶原激活物抑制剂（ＰＡＩ），血小板α颗粒膜蛋白（ＲＭＰ－１４０），结果 危重症患者凝血和纤溶系统被激活，并伴有纤溶受抑，死亡者与存活者差异有显著性（Ｐ〈０．０１），并与疾病严重度和预后有一定的相     

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.