慢性乙型肝炎患者血清HBsAg及HBV-DNA定量检测的意义

目的:探讨慢性乙型肝炎(CHB)患者血清HBsAg及HBV-DNA定量检测意义。方法:选取收治的160例CHB患者为研究对象,对治疗前、治疗中患者血清HBsAg及HBV-DNA水平进行定量检测;并对16例治疗后HBV-DNA转阴患者随访,监测HBsAg、HBV DNA水平变化,并对检测结果进行分析总结。结果:治疗前,HBeAg阳性组中,HBsAg水平与HBV-DNA水平呈明显正相关性(r=0.679,P<0.05),而在HBeAg阴性组中,HBsAg水平与HBV-DNA水平虽呈正相关性,但相关性较低(r=0.256,P<0.05)。治疗中,HBsAg、HBV-DNA显示正相关(r=0.423,P<0.05);160例中105例随着HBV-DNA水平降低而降低,比例为65.63%(105/160)。16例治疗后HBV-DNA转阴患者中,5例治疗过程中HBsAg水平持续降低,HBsAg水平低于250 IU/ml,停药24周后进行复查,HBV-DNA仍显阴性;11例治疗过程中HBsAg未降低或者升高,转阴后停药24周后进行复查,4例呈阳性。结论:CHB疾病与血清HBsAg、HBV-DNA水平存在一定相关性,检测CHB患者血清HBsAg、HBV-DNA水平对CHB发展转归具有预警意义。     

PCR与ELISA检测乙肝病毒的对比及临床意义

目的 探讨荧光PCR法检测HBV-DNA定量ELISA定性检测乙肝病毒标志物临床价值比较.方法 取受试者空腹血清标本同时以荧光定量PCR法检测HBV-DNA和酶联免疫法捡测乙肝病毒两对半.结果 HBV-DNA定量在9.99×10^8 IU/mL～1.00×10^6 IU/mL之间的404例,大三阳比例为85.89％;HBV-DNA定量在9.99×10^5 IU/mL～1.00×10^3 IU/mL之间的416例,小三阳比例为59.38％;HBV-DNA定量在1.00×10^3 IU/ml～1.00×10^2 IU/mL的140例中,HBsAg、HBcAb阳性患者比例为71.43％;HBV-DNA定量＜1.00×102 IU/mL的992例中,HBsAg、HBeAg阴性模式比例为95.67％.结论 荧光定量PCR法检测HBV-DNA和ELISA定性检测HBV表面标记物呈正相关,即HBV-DNA拷贝数多的以大三阳居多,HBV-DNA拷贝数少的以无传染性病毒携带者和阴性者居多.荧光定量PCR可以直接反映体内乙肝病毒感染状态及病毒载量情况,较ELISA更利于判断疾病的严重程度和传染性,更有利于指导临床药物选择和疗效观察.     

HBsAg < 1 500 IU/mL的慢性乙型肝炎病人联合聚乙二醇干扰素α-2b治疗的疗效观察

目的将核苷（酸）类似物（NAs）治疗后达到乙型肝炎表面抗原（HBsAg）<1 500 IU/mL的慢性乙型肝炎（CHB）病人,联合聚乙二醇干扰素α-2b（Peg-IFNα-2b）治疗,分析联合治疗与NAs单药治疗HBsAg清除的差异。方法将55例NAs治疗后达到HBsAg<1 500 IU/mL的病人分为联合治疗组（NAs+Peg-IFNα-2b）和NAs治疗组（继续原NAs治疗计划）,疗程48周,观察HBsAg清除率及影响HBsAg清除的相关因素。结果治疗48周末,联合组HBsAg清除率显著高于NAs组（P<0.01）;HBsAg水平随用药时间逐渐降低,联合组降低幅度高于NAs组（P<0.05）。基线HBsAg<327 IU/mL对48周疗程完成时HBsAg的清除有预测作用（P<0.05）,AUC为0.828,cut-off值为327 IU/mL,敏感度为75.0%,特异度为87.5%;基线丙氨酸氨基转移酶（ALT）异常病人HBsAg清除率明显高于ALT水平正常的病人（P<0.01）。结论对于接受NAs治疗达到血清HBsAg低水平的病人联合Peg-IFNα-2b治疗可以提高HBsAg清除率,基线HBsAg<327 IU/mL对48周疗程结束时HBsAg的清除有预测作用,基线ALT水平高于正常水平上限更容易实现HBsAg清除。     

HBsAg定量监测指导干扰素治疗HBeAg阴性慢性乙型肝炎研究

目的：探讨HBsAg定量监测对干扰素个体化治疗HBeAg阴性慢性乙型肝炎的指导作用。方法：2010年11月至2013年11月本院就诊的62例HBeAg阴性慢性乙型肝炎患者,采用α-2b干扰素500万IU,皮下注射,隔日1次治疗。抗病毒治疗至24周时根据HBsAg定量下降情况进行分组。 HBsAg定量下降≥1 lg IU/mL的患者纳入A组,HBsAg定量下降〈1 lg IU/mL的患者随机分成B1组和B2组。 A组和B1组继续给予α-2b干扰素治疗,B2组加用阿德福韦酯治疗,疗程共48周。所有患者随访24周。结果：A、B1和B2组的持续病毒学应答率分别为88.2％,22.7％和59.1％。 A组和B2组持续病毒学应答率比较,差异无统计学意义,且明显高于B1组。随访24周时A、B1和B2组HBV DNA较基线下降幅度分别为[（5.00±1.62）、（2.70±1.52）和（4.13±2.00）] lg copies/mL, B2组HBV DNA较基线下降幅度与A组接近,明显大于B1组。 A组患者HBsAg平均下降幅度高于B1组和B2组,最终A组有2例（11.8％）HBsAg消失,B1和B2组均为0。结论：HBsAg水平变化与HBeAg阴性慢性乙型肝炎患者抗病毒治疗持续应答相关。干扰素治疗24周时HBsAg下降≥1 lg IU/mL的患者持续病毒学应答率显著高于HBsAg下降〈1 lg IU/mL的患者,对干扰素治疗24周时HBsAg下降〈1 lg IU/mL患者可联合阿德福韦酯以提高持续病毒学应答率。     

HBV-DNA载量测定联合HBsAg定量分析在慢性HBV感染诊疗中的作用

目的分析乙型肝炎病毒脱氧核糖核酸(HBV-DNA)载量测定联合乙型肝炎表面抗原(HBsAg)定量分析在慢性乙型肝炎病毒(HBV)感染不同阶段及病程进展与转归预测中的作用。方法选取2016年2月至2017年3月间于本院就诊的HBV患者共268例。分析HBV-DNA载量低于2 000 IU/mL时,不同HBV-DNA水平组间和组内年龄、性别、乙型肝炎E抗原(HBeAg)和HBsAg定量结果等指标的作用和意义。结果 HBV-DNA载量测定结果发现,20 IU/mL者135人;HBV-DNA载量2 000 IU/mL患者共235例,其中HBeAg(-)占比75.32%(177/235);HBeAg(+)患者占比24.68%(58/235);HBV-DNA载量20 IU/mL时,其组内HBeAg(+)和HBeAg(-)间年龄分布对比,P=0.001,HBV-DNA载量为20~199 IU/mL时,两组对比,P=0.002,HBV-DNA载量为200~1 999 IU/mL时,两组对比P=0.001,差异均有统计学意义(P0.05);HBV-DNA载量20 IU/mL与20~199 IU/mL间,20 IU/mL与200~1 999 IU/mL间丙氨酸氨基转移酶(ALT)水平对比,P值分别为0.001和0.002,差异有统计学意义(P0.05);HBV-DNA载量20 IU/mL、20~199 IU/mL和200~1 999 IU/mL三组间HBsAg水平两两对比,差异均有统计学意义(P0.05),三组各组内HBeAg(+)组和HBeAg(-)组间HBsAg水平对比,差异均有统计学意义(P0.05)。结论 HBV-DNA载量测定联合HBsAg定量分析能够更好的预测HBV-DNA载量低于2 000 IU/mL的慢性乙肝患者的病情进展和转归。     

慢性乙型肝炎患者血清定量HBsAg与HBV-DNA及肝功能指标间相关性的分析

目的 探讨慢性乙型肝炎患者血清HBsAg定量检测结果分布状况及其与HBV-DNA和肝功能指标的相关性.方法 选取177例HBV-DNA阳性的慢性乙型肝炎患者,分为乙型肝炎病毒e抗原（HBeAg）阳性组115例、HBeAg阴性组62例,电化学发光免疫分析法（ECLIA）定量检测HBsAg含量,实时荧光定量PCR法（FQ-PCR）检测HBV-DNA,贝克曼AU6800全自动生化分析仪连续监测法检测肝功能指标（ALT、AST、ALP、γ-GT）.统计分析组间HBsAg与HBV-DNA含量的差异性,各组内血清HBsAg与HBV-DNA及肝功能指标间的相关性.结果 数据以中位数与四分位数表示,HBeAg阳性组与阴性组中HBsAg与HBV-DNA含量（对数转换后表示）分别为4678.5 IU/ml（2806,6128.7）、2770.0IU/ml（1228,5440）;5.56（3.86,7.54）、3.66（3.16,4.59）,存在统计学差异（P＜0.05）.HBeAg阳性组中HBsAg与HBV-DNA总体存在相关性（r=0.537,P＜0.01）,在HBV-DNA处于103 ～ 105、105～ 107、＞ 107IU/ml复制量时两者相关系数分别为0.205、0.443、0.712（P均＜0.05）.HBeAg阴性组HBsAg与HBV-DNA间相关系数为0.22,P=0.083;在HBV-DNA≤104IU/ml与＞104IU/ml复制量时两者相关系数分别为0.03和0.08;在ALT、AST升高与正常时两者相关系数分别为0.23和0.17.两组定量HBsAg与主要肝功能指标ALT、AST、ALP、γ-GT均不存在相关性.结论 HBeAg阳性慢性乙型肝炎患者血清HBsAg含量可反映HBV-DNA复制程度,可辅助衡量肝脏炎症状况.     

HBV感染相关性肝癌患者血清HBcrAg检测的临床价值分析

目的 分析乙肝（hepatitis B, HBV）感染相关性肝癌患者血清乙型肝炎核心相关抗原（hepatitis B core antigen, HBcrAg）检测的临床价值。方法 回顾性分析2021年1月—2022年6月就诊于广东医科大学附属医院的HBV相关性肝癌患者70例的临床资料,纳入肝癌组,同时选取70例同期HBV阳性的非肝癌患者,纳入非肝癌组。对比两组患者HBcrAg、HBV DNA、乙肝表面抗原水平（HBsAg）差异,采用ROC曲线分析上述指标的临床价值,采用Pearson相关性分析患者HBcrAg水平与HBV DNA、HBsAg水平的相关性,采用Logistic回归分析HBcrAg、HBV DNA、HBsAg水平与HBV感染相关性肝癌的相关性。结果 肝癌组患者HBcrAg、HBV DNA、HBsAg水平高于非肝癌组,差异有统计学意义（P<0.05）。其中HBcrAg灵敏性和特异性最高,当水平分别超过7.17 logU/mL、5.78 log10IU/mL、5.23 log10IU/mL提示患者发生肝癌风险较大（P<0.05）;肝癌组患者HBcrAg水平与其HB...     

两种HBV DNA定量试剂在慢性乙型肝炎医疗决策点的比较研究

目的比较两种实时荧光定量HBV-DNA检测试剂对慢性乙型肝炎（CHB）患者管理的一致性。方法选取某国产试剂H和Roche公司COBAS AmpliPrep/COBAS TaqMan（CAP/CTM）高灵敏核酸检测系统作为比较对象,分别检测133例CHB患者血清HBV-DNA。选择HBV-DNA〈500 IU/mL、500～2000 IU/mL、〉2000 IU/mL等三个浓度进行两检测系统的一致性监测。结果 （1）两系统检测结果比较,试剂H组HBV-DNA浓度为500～2000 IU/mL时,其结果的Log值为2.84±0.27,相应标本在CAP/CTM组的检测结果为3.48±0.54,两种系统检测结果差异有统计学意义（P=0.000）。试剂H组HBV-DNA浓度为〉2000 IU/mL时,其结果的Log值为4.74±1.06,相应标本在CAP/CTM组的检测结果为5.32±1.01,两种系统检测结果差异有统计学意义（P=0.000）。（2）以CAP/CTM为标准,试剂H在HBV-DNA〈500 IU/mL、500～2000 IU/mL、〉2000 IU/mL时的敏感度分别为100%、81.5%和75.9%;特异度分别为87.5%、95.3%和100%。结论国产试剂H系统和CAP/CTM系统在对CHB患者的抗病毒治疗筛选上以及停药的关键医疗决策浓度监测上有较大差异。     

拉米夫定治疗慢乙肝的病毒学反弹的预测因素研究

目的：观察拉米夫定治疗慢乙肝（CHB）患者的疗效,探讨拉米夫定治疗慢乙肝的病毒学反弹的预测因素。方法：146例CHB患者予拉米夫定100mg／d,随访治疗12个月以上,检测基线、治疗后每个月、HBV DNA转阴后3个月的HBV DNA拷贝数、定量HBeAg及ALT指标,以分析疗程、基线HBV DNA、定量HBeAg、ALT指标、治疗3、6个月病毒学应答与病毒学反弹的关系。结果：①在疗程12～18个月组中,基线HBV DNA 5log10～组病人病毒学反弹率低于6log10～组病人和≥7log10组病人（P〈0．05）,基线ALT％2ULN病人病毒学反弹率高于2～5ULN组病人（P〈0．05）;②在疗程19～24个月中治疗6个月有病毒学应答病人与无应答病人反弹率分别为21．7％和55．6％,差异有统计学意义（P〈0．05）。结论：基线HBV DNA水平和ALT水平是疗程12～18个月时病毒反弹的重要预测指标;治疗6个月病毒学应答可以预测19～24个月的维持应答。     

国产试剂HBVDNA检测下限与核苷(酸)类似物停药后乙肝复发的分析

目的比较实时荧光定量PCR与COBAS Ampliprep检测血清HBVDNA水平的相互关系,探讨慢性乙型肝炎患者使用核苷酸类似物抗病毒治疗,达到停药标准停药后病情复发的风险。方法收集178份血清标本,分别采用COBAS Ampliprep/COBAS TaqMan HBV Test version、实时荧光定量PCR方法进行检测,分析其相关性,比较HBVDNA检测下限以下(HBVDNA<100 IU/mL)两者之间的差异。结果 (1)相关性:实时荧光定量PCR与COBAS Ampliprep方法所测HBVDNA结果呈线性相关(r=0.789,P<0.01),HBVDNA水平4～7 log检测值与COBAS Ampliprep所测HBVDNA水平呈线性相关(r=0.650,P<0.01),HBVDNA水平<4 log10IU/mL及>7log10IU/mL检测值与COBAS Ampliprep所测HBVDNA水平均无相关性(r=0.430,P=0.163;r=0.422,P=0.172)。(2)率的比较:实时荧光定量PCR检测HBVDNA下限为100 IU/mL(2 log10IU/mL),COBAS Ampliprep检测下限为20 IU/mL(1.3 log10IU/mL),两者HBVDNA检测限以上的百分率分别为33.1%、62.4%,差异有统计学意义(P<0.001)。实时荧光定量PCR检测HBVDNA水平在检测限以下119例,COBAS Ampliprep平行检测仍有52例(43.7%)能检测到HBVDNA,35例(29.4%)在检测下限以下(<20 IU/mL,1.3 log10IU/mL),32例(26.9%)未检测到核酸(Target Not Detected)。实时荧光定量PCR检测HBVDNA>7 log10IU/mL有21例,9例大于COBASAmpliprep检测上限。结论实时荧光定量PCR检测方法经济实用、结果准确可靠,与COBAS检测具有很好的相关性。目前的HBVDNA检测手段下,慢性乙型肝炎患者即使达到停药标准,停用核苷(酸)类似物仍应慎重。     

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.