血清降钙素原对社区获得性肺炎与肺结核患者的诊断价值

目的:探讨血清降钙素原在鉴别诊断社区获得性肺炎和肺结核患者的价值。方法:采集社区获得性肺炎的89例患者(肺炎组)和57例肺结核患者(肺结核组)的血清标本,检测所有标本中血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞(WBC)和中性粒细胞4项指标,并进行比较。结果:社区获得性肺炎组患者C反应蛋白(CRP)、白细胞(WBC)和中性粒细胞4项指标和PCT阳性率均明显高于肺结核组(P<0.05)。结论:PCT对鉴别社区获得性肺炎和肺结核有一定的诊断价值。     

血清降钙素原鉴别肺结核与社区获得性肺炎的价值

目的 探讨血清降钙素原（PCT）在肺结核与社区获得性肺炎（CAP）患者中的表达是否有差异,以及在两种疾病临床鉴别中的意义.方法 收集四川大学华西医院2013年1月～2013年6月所有拟诊断为肺结核与社区获得性肺炎的住院病例.收集每份病例入院24小时内及治疗好转出院前的PCT、CRP、血常规、红细胞沉降率值及病原学等指标.治疗随访1～3个月,将纳入研究的确诊病例分为肺结核组与细菌性肺炎组.结果 102例患者明确诊断中肺结核38例,细菌性肺炎64例.肺结核组血清PCT平均值为0.059ng/ml,细菌性肺炎组血清PCT平均值为0.78ng/ml组间差异有显著性（P＜0.001）.结论 肺结核血清PCT值明显低于社区获得性肺炎,在肺结核与社区获得性肺炎的鉴别诊断中,血清PCT测定有一定价值.     

血清降钙素原及C反应蛋白在社区获得性肺炎和肺结核中的诊断价值

目的:探讨血清降钙素原及C反应蛋白在社区获得性肺炎和肺结核中的诊断价值。方法:选取社区获得性肺炎136例、肺结核28例患者作为调查对象,收集患者入院资料,对相关指标进行观察。结果:血清PCT及CRP白在社区获得性肺炎的水平高于肺结核患者(P<0.05),与CRP相比,血清PCT区别社区获得性肺炎和肺结核的准确性对比差异具有统计学意义(P<0.05)。结论:社区获得性肺炎患者的血清降钙素原和C反应蛋白水平高于肺结核患者,对区别社区获得性肺炎和肺结核病症有一定帮助作用。     

降钙素原和端粒酶在胸腔积液鉴别诊断中的作用研究

目的:探讨降钙素原及端粒酶活性检测在胸腔积液鉴别诊断中的敏感度及特异度,以及两者联合是否可提高胸腔积液鉴别诊断的敏感度及特异度。方法:回顾性分析诊断明确的类肺炎性胸腔积液(炎症组)、结核性胸腔积液(结核组)、癌性胸腔积液患者(癌性组)的临床资料,收集、检测三组患者胸腔积液标本中降钙素原和端粒酶活性并进行比较。结果:炎症组降钙素原最高为(0.990±0.200)ng/m L、结核组为(0.560±0.057)ng/m L、癌性组最低为(0.380±0.067)ng/m L,三组间两两比较差异均有统计学意义(P0.05)。癌性组端粒酶活性为(206.39±8.46),与炎症组的(182.63±27.46)和结核组的(192.17±13.74)比较,差异均有统计学意义(P0.05);炎症组与结核组比较,差异无统计学意义(P0.05)。在诊断价值分析方面,当降钙素原0.75 ng/m L时,支持类肺炎性胸腔积液诊断;当降钙素原0.485 ng/m L且≤0.75 ng/m L时,支持结核性胸腔积液诊断;当降钙素原≤0.485 ng/m L时,支持癌性胸腔积液诊断。当端粒酶活性≥205时强烈支持癌性胸腔积液诊断,但是当端粒酶205时,无法鉴别类肺炎性还是结核性胸腔积液。进一步通过等级logistic回归分析发现,降钙素原与端粒酶联合检测对于胸腔积液的诊断界值很好。结论:联合检测PCT、端粒酶活性在类炎性胸腔积液、结核性胸腔积液及癌性胸腔积液的鉴别诊断中有较好的作用。     

The value of PCT in differential diagnosis of infections pneumonia

目的 探讨降钙素原(PCT)在感染性肺炎鉴别诊断中的价值.方法 检测80例细菌性肺炎、70例肺炎支原体肺炎和65例病毒性肺炎患者及50例健康人血清的PCT,对其结果进行分析,PCT的检测采用化学发光免疫分析法.结果 细菌性肺炎组血清PCT浓度及阳性率明显高于肺炎支原体肺炎组、病毒性肺炎组及健康组,差异有显著性统计学意义(F=34.732,x2=173.210,P＜0.05),肺炎支原体肺炎组、病毒性肺炎组及健康组血清PCT浓度及阳性率的差异无统计学意义(F=1.847,x2=0.278,P＞0.05);细菌性肺炎组中,男、女性别PCT阳性率差异无统计学意义(x2=0.356,P＞0.05);细菌性肺炎组中,年龄在35天～81岁之间,PCT阳性率之间差异无统计学意义(x2=0.01,P＞0.05).结论细菌性肺炎PCT的阳性率不受年龄、性别的影响;在感染性肺炎时,PCT可用于细菌性肺炎的鉴别诊断,但不能用于鉴别诊断肺炎支原体肺炎及病毒性肺炎.     

降钙素原和C-反应蛋白检测对细菌性肺炎的诊断价值

目的:评价降钙素原(PCT)与C-反应蛋白(CRP)检测对肺炎的鉴别诊断价值及临床意义。方法:将110例肺炎患者分为细菌性肺炎组68例和非细菌性肺炎组42例,取健康体检者40例为对照组,测定其血清PCT和CRP含量并比较分析。结果:细菌性肺炎组的血清PCT和CRP的浓度显著高于非细菌性肺炎组和对照组(P<0.01);PCT和CRP诊断细菌性肺炎的阳性率分别为94.1%、91.1%,显著高于非细菌性肺炎(P<0.01)。结论:检测PCT和CRP的血清浓度有助于鉴别诊断细菌性肺炎和非细菌性肺炎。     

细菌性肺炎降钙素原监测的临床意义

目的：研究血清降钙素原在细菌性肺炎临床意义。方法回顾性研究2011年5月—2013年8月该院收治的肺炎患者86例,按照病原体分为两组,一组细菌性肺炎53例和另一组非细菌性肺炎33例。比较两组PCT及CRP。结果细菌性肺炎组PCT(1.03±0.46)ng/mL,非细菌性肺炎组为(0.20±0.08)ng/mL。两组差异有统计学意义（P＜0.05）。细菌性肺炎CRP (42.80±26.70)mg,非细菌性肺炎组(36.90±21.20)mg/L,差异无统计学意义。53例细菌性肺炎患者PCT≧0.5 ng/mL占86.79%,CRP≧10.0 mg/L占64.15%,差异有统计学意义(χ2=8.79,P＜0.05)。结论该试验表明PCT为临床上诊断细菌性肺炎提供了较好的诊断价值。可用于指导抗菌药物应用,减少抗菌药物滥用,有重要的临床和经济学意义。     

血清降钙素原检测在小儿感染性肺炎诊断中的应用价值

目的：研究血清降钙素原(PCT)检测在小儿感染性肺炎诊断中的应用价值。方法将该院2015年4月—2016年4月收治的100例小儿感染性肺炎病例按照感染病原体不同分为对照组(50例)与实验组(50例),采用电化学放光法检测两组血清PCT水平。结果实验组患儿血清PCT水平为(11.67±3.60)μg/L,明显高于对照组的(0.31±0.09)μg/L,组间差异具有统计学意义(P﹤0.05);两组血清PCT在﹤0.5、0.5~2.0、2.0~10.0、≥10.0μg/L区间的分布情况差异有统计学意义(P﹤0.05)。治疗前实验组患儿血清PCT水平为(11.67±3.60)μg/L,明显高于治疗后的(0.35±0.12)μg/L差异有统计学意义(P﹤0.05)。结论检测血清降钙素原水平可有力支持小儿感染性肺炎的临床鉴别诊断,正确指导临床合理用药,改善患儿病情预后。     

降钙素原、C-反应蛋白、细菌培养在下呼吸道感染的意义

目的探讨降钙素原(PCT)、C-反应蛋白(CRP)联合细菌培养在下呼吸道感染中的临床价值。方法将86例下呼吸道感染患者分为细菌感染组(54例)与非细菌感染组(32例),同期健康体检者50例作为健康组,测定血清PCT及CRP的浓度,同时对患者进行痰及血培养。结果细菌感染组的PCT及CRP血清浓度均高于非细菌感染组及健康组(P0.01)。以PCT0.5 ng/m L,CRP10 mg/L为阳性,PCT及CRP的灵敏度分别为88.9%和83.3%,均大于细菌培养的灵敏度(40.7%);PCT及CRP的灵敏度与非细菌感染组及健康组比较差异有统计学意义(P0.01);PCT及CRP对细菌感染诊断的特异性为87.7%高于CRP的75.6%(P0.05)。结论 PCT及CRP可作为下呼吸道细菌感染早期诊断的临床指标,联合细菌学检查对下呼吸道感染的诊断、鉴别诊断及治疗具有重要的临床意义。     

联合检测C反应蛋白、血清降钙素原及白细胞计数在诊断儿童感染性疾病中意义

目的:探讨联合检测C反应蛋白、血清降钙素原及白细胞计数在诊断儿童感染性疾病中意义。方法:选取我院2014年1月至2016年12月期间儿科收住的208例确诊感染性疾病的患儿,根据病原体检测结果分组,对患儿所测的CRP、PCT及WBC进行回顾性分析,运用统计学方法对数据进行分析。结果:1.细菌感染组血清CRP、PCT及WBC水平较病毒感染组明显升高(P0.05);肺炎支原体组CRP水平较病毒感染组明显升高(P0.05);细菌感染组血清PCT水平较肺炎支原体组明显升高(P0.05)。2.以PCT≥0.5ng/m L为阳性,PCT诊断细菌感染的灵敏度为92.01%,特异度为90.76%,阳性预测值为88.67%,阴性预测值为92.63%,约登指数为0.83。均高出CRP(≥10mg/ml)及WBC(≥10×10~9/L)时诊断细菌感染时的灵敏度、特异度、阳性预测值及阴性预测值。结论:在鉴别儿童感染性疾病时,联合检测血清CRP、PCT及WBC对鉴别有一定的指导价值;在诊断细菌感染时,PCT有着更好的灵敏度、特异度及准确率。     

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.