孕妇血清和羊水白细胞介素6、肿瘤坏死因子水平变化在绒毛膜羊膜炎中的诊断价值

目的 :探讨孕妇血清和羊水中白细胞介素 6 (inter leukin- 6 ,IL- 6 )、肿瘤坏死因子 - α(tum or necrosis factor- alpha,TNF-α)在绒毛膜羊膜炎中的变化。方法 :用放射免疫法测定 30例胎膜早破孕妇和 2 4例正常足月妊娠未临产孕妇血清和羊水中的IL- 6、TNF- α;两组孕妇均于产后留取胎膜送病理检查 ,确定有无绒毛膜羊膜炎。结果 :胎膜早破组羊水 IL- 6水平明显高于正常足月妊娠组 (P <0 .0 5 ) ;经病理证实的绒毛膜羊膜炎组母血清 IL- 6和羊水 IL- 6、TNF- α均明显高于无绒毛膜羊膜炎组 (P<0 .0 5 ,P <0 .0 5 ) ,而孕妇血清 TNF- α在两组间无差异 (P >0 .0 5 )。结论 :孕妇血清 IL- 6和羊水 IL- 6、TNF- α水平升高是绒毛膜羊膜炎的标志 ,可作为临床诊断早期绒毛膜羊膜炎的指标 ;孕妇血清 TNF- α水平与绒毛膜羊膜炎无关。     

白细胞介素8及相关因子在胎膜早破母血中的检测及分析

目的:探讨胎膜早破母血中IL-8对足月产前绒毛膜羊膜炎的诊断价值。方法:采用放射免疫法对30例胎膜早破和20例正常足月孕妇血IL-8进行测定,组织绒毛膜羊膜炎通过产后胎盘病理证实。结果:轻度、中重度绒毛膜羊膜炎与非绒膜羊膜炎相比均有显著性差异(P<0.01),轻度与中重度相比差异无显著性。轻度、中重度与非绒毛膜羊膜炎组IL-8水平分别为1.1141ng/ml,1.3287ng/ml,0.8108ng/ml。结论:母血IL-8水平可作为足月胎膜早破组织绒毛膜羊膜炎的一个预测指标。     

胎膜早破孕妇血清中白细胞介素8水平的观察

目的 探讨胎膜早破患者血清中自细胞介素8(IL-8)的含量与羊膜腔感染的关系.方法 用放射免疫法测定44例胎膜早破孕妇和26例正常孕足月无胎膜破裂未临产孕妇血清中的IL-8浓度,2组孕产妇均于剖宫产术后留取胎膜组织行病理检查.结果 胎膜早破组血清IL-8浓度高于对照组(P<0.05);胎膜早破组中绒毛膜羊膜炎孕妇20例血中IL-8明显高于非绒毛膜羊膜炎孕妇(P<0.05).结论 胎膜早破血清IL-8升高与绒毛膜羊膜炎有关,孕妇血清IL-8水平对识别绒毛膜羊膜炎起辅助作用.     

血清IL-6、IL-8在足月胎膜早破亚临床感染诊断中的临床意义

目的:观察血清白介素-6(IL-6)及白介素-8(IL-8)在胎膜早破亚临床感染孕妇中的变化,探讨其在胎膜早破及绒毛膜羊膜炎早期诊断中的临床意义。方法:选择100例胎膜早破孕妇为实验组,根据破膜时间进一步分两个亚组,A组破膜时间<12 h,B组破膜时间≥12 h;选择同期50例年龄、孕周与实验组相近的择期剖宫产孕妇作为对照组;所有孕妇均无临床感染征象。用酶联免疫吸附试验(ELISA)测定各组孕妇血清IL-6、IL-8水平,并于分娩时取胎盘送病理学检查。结果:(1)实验组孕妇血清中IL-6、IL-8水平明显高于对照组,且B组血清IL-6、IL-8水平及绒毛膜羊膜炎发生率高于A组;(2)病理学检查显示绒毛膜羊膜炎的孕妇血清中IL-6、IL-8水平高于无绒毛膜羊膜炎者。结论:检测胎膜早破孕妇血中IL-6、IL-8水平对胎膜早破并亚临床绒毛膜羊膜炎的早期诊断具有重要意义。     

血清IL-6、IL-8与TNF-α联合检测预测胎膜早破早期宫内感染的意义

目的研究血清IL-6、IL-8与TNF-α联合检测预测胎膜早破、早期宫内感染的价值。方法对比60例胎膜早破患者(研究组)和60例正常孕妇(对照组)血清和羊水IL-6、IL-8与TNF-α水平,分析血清IL-6、IL-8与TNF-α联合检测与绒毛膜羊膜炎的关系。结果研究组血清和羊水IL-6、IL-8及TNF-α水平均显著高于对照组(P<0.05)。血清IL-6、IL-8及TNF-α与羊水IL-6、IL-8及TNF-α水平分别成正相关(P<0.05)。研究组绒毛羊膜炎患病率显著高于对照组(P<0.01)。研究组绒毛羊膜炎患者血清IL-6、IL-8及TNF-α水平与绒毛膜羊膜炎严重程度呈正相关(P<0.05)。结论胎膜早破孕妇血清IL-6、IL-8与TNF-α水平显著升高,能够反映绒毛膜羊膜炎的严重程度,联合检测可作为预测胎膜早破早期宫内感染的指标。     

C-反应蛋白与早产胎膜早破及亚临床绒毛膜羊膜炎的关系

目的:探讨早产孕妇母血C-反应蛋白(CRP)与早产胎膜早破、亚临床绒毛膜羊膜炎的关系。方法:回顾性分析84例早产孕妇的临床资料,采用数率散射比浊法检测其血清CRP水平,进行比较分析。结果:58例(69%)在早产临产前出现胎膜早破,其血清CRP水平高于无胎膜早破组,差异有统计学意义(11.7vs±3.4vs,9.2±1.3,P<0.05)。31例(36.9%)诊断为亚临床绒毛膜羊膜炎,其血清CRP水平高于无亚临床绒毛膜羊膜炎组,差异有统计学意义(14.1vs±2.6vs,8.5±1.4,P<0.05)。结论:监测孕妇血清CRP的浓度变化,有助于亚临床型绒毛膜羊膜炎的早期诊治。     

绒毛膜羊膜炎的临床相关因素分析

目的分析绒毛膜羊膜炎的母血白细胞计数及临床相关因素。方法对近三年病理诊断为羊膜炎或绒毛膜炎病人的临床资料进行回顾性分析。结果绒毛膜羊膜炎母血白细胞计数平均值为(10.41±3.27)×109/L,与非绒毛膜羊膜炎孕妇血清白细胞计数(9.98±2.83)×109/L,无显著性差异(P>0.05),其中炎症病人组诊断为胎膜早破的64例,胎儿宫内窘迫59例,孕妇贫血30例,妊娠高血压和原发高血压18例等,而胎膜早破组白细胞计数为(11.27±2.87)×109/L,与非绒毛膜羊膜炎组有显著性差异(P<0.05)。结论绒毛膜羊膜炎不仅由感染引起,也可由缺氧等因素引起。     

血清IL-18、G-CSF的测定在胎膜早破中的临床意义

目的探讨孕妇血清中IL-18、G-CSF在胎膜早破合并亚临床绒毛膜羊膜炎的早期诊断中的临床意义。方法选择足月胎膜早破孕妇30例（实验组）,同期年龄、孕周、孕次与实验组相近的足月胎膜未破孕妇30例（对照组）,60例孕妇均没有临床感染表现。用酶联免疫吸附试验方法测定两组孕妇在分娩前血清中IL-18、G—CSF的水平,分娩对取胎膜组织做病理学检查。结果（1）实验组孕妇血清IL-18、G-CSF的水平明显高于对照组;（2）实验组孕妇亚临床绒毛膜羊膜炎的感染率明显高于对照组孕妇,且亚临床绒毛膜羊膜炎孕妇血清IL-18、G—CSF水平高于非绒毛膜羊膜炎者。结论孕妇血清IL-18、G—CSF水平的增高与亚临床绒毛膜炎有关。     

胎膜早破孕妇羊水白细胞介素6水平的研究

目的　探讨胎膜早破患者羊水白细胞介素 6(interleukin- 6 ,IL - 6)水平与羊膜腔感染的关系。方法　用放射免疫法测定 30例胎膜早破孕妇和 2 4例正常足月妊娠未临产孕妇羊水中的IL - 6浓度 ;两组孕妇均于产后留取胎膜送病理检查 ,确定有无绒毛膜羊膜炎。结果　胎膜早破组羊水IL - 6浓度为 0 .60 7± 0 .2 73ng/ml,明显高于对照组 0 .2 30± 0 .0 89ng/ml,差异有高度显著性 (P <0 .0 0 1 ) ;经病理证实的绒毛膜羊膜炎组羊水IL - 6为 0 .478± 0 .2 85ng/ml,非绒毛膜羊膜炎组为 0 .30 9± 0 .2 31ng/ml,P <0 .0 5 ,差异有显著性。结论　胎膜早破、绒毛膜羊膜炎孕妇羊水IL - 6水平显著升高 ,可作为临床诊断早期绒毛膜羊膜炎的指标     

胎膜早破与绒毛膜羊膜炎

目的　探讨胎膜早破与绒毛膜羊膜炎的关系。　方法　对胎膜早破孕妇 5 8例 (胎膜早破组 )及正常孕妇 40例 (对照组 )各于分娩后取胎膜行病理检查。　结果　胎膜早破组的绒毛膜羊膜炎的发生率明显高于对照组 (P <0 0 1) ,而胎膜早破组中 ,其破膜时间长短与绒毛膜羊膜炎发生率成正比。　结论　胎膜早破与绒毛膜羊膜炎关系密切 ,且随破膜时间延长 ,绒毛膜羊膜炎发生率增高。故对胎膜早破的足月孕妇预防性给予抗生素及尽快终止妊娠是必要的     

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.