宫颈糜烂与沙眼衣原体感染的相关性及其治疗

应用聚合酶链反应（ＰＣＲ）技术检测１１９例宫颈糜烂病人的沙眼衣原体（Ｃｔ）感染情况，同时以５２例非宫颈糜烂者做对照检测。并对部分Ｃｔ阳性者分别采用盐酸二甲胺四环素和爱宝疗治疗。结果：宫颈糜烂患者的Ｃｔ阳性率为３２．８％，明显高于对照组的７．５％（Ｐ＜０．０１）。有症状或合并盆腔炎的宫颈糜烂患者Ｃｔ阳性率高。盐酸二甲胺四环素和爱宝疗对宫颈Ｃｔ感染治疗１疗程的有效率分别为１００％和９３．８％，对宫颈糜烂的有效率分别为７１．４％和８１．３％。结果提示：宫颈糜烂患者中Ｃｔ阳性率高于正常人，衣原体的感染是盆腔炎的原因之一；盐酸二甲胺四环素和爱宝疗治疗Ｃｔ感染和宫颈糜烂均有较好疗效。     

宫颈癌及宫颈早期病变的2种筛查法比较

目的：引用脑神经网络模拟人工智能电脑技术，进行宫颈刮片分析，诊断宫颈病变。方法：采用电脑细胞学分析法（ＣＣＴ）、ＴＢＳ分级系统和传统光镜分析法、巴氏分级系统２种方法分别检诊２００５例宫颈刮片。结果：ＣＣＴ报告人乳头状瘤病毒感染与宫颈早期病变及宫颈癌的发生有关。ＣＣＴ的准确率（９９３０％）明显高于传统光镜巴氏分级法（９２３７％）；ＣＣＴ漏诊率（０７０％）明显低于传统光镜巴氏分级法（７６３％）；ＣＣＴ与活检病理符合率（７７４２％）明显高于传统光镜巴氏分级法（５１７２％）。结论：ＣＣＴ能省时、省力、准确、全面地反映宫颈早期病变，以及细菌、病毒、病原体的感染情况；是目前宫颈癌筛查的最好手段。     

人巨细胞病毒诱发小鼠宫颈癌的实验研究

为了探讨人巨细胞病毒（ｈｕｍａｎｃｙｔｏｍｅｇａｌｏｖｉｒｕｓ，ＨＣＭＶ）与宫颈癌发生之间的关系，我们利用紫外线灭活的ＨＣＭＶ诱发小鼠宫颈癌的动物模型进行了研究．经ＵＶ－灭活的ＨＣＭＶ液接种于小鼠宫颈部，３次／周×８周，并设ＨＥＬ培养液对照组．５个月后，ＨＣＭＶ组宫颈癌前病变率达２７．７％（２３／８３），癌发率２０．５％（１７／８３）；对照组仅１例发生宫颈内皮瘤（ＣＩＮ，Ｉ），癌发率为０（０／３１）．此结果提示：紫外线灭活的ＨＣＭＶ具有在体内转化宫颈上皮细胞，从而诱发宫颈癌发生的能力，因而也讨论了ＨＣＭＶ致癌的可能机制．     

乳头瘤病毒及巨细胞病毒在宫颈癌组织中的协同作用

应用ＤＮＡ－ＤＮＡ斑点杂交技术，对６４例宫颈标本（包括正常宫颈２６例，重度宫颈糜烂１７例，宫颈癌２１例）分别检测ＨＰＶ－１６ＤＮＡ及ＨＣＭＶＤＮＡ。结果发现正常宫颈、宫颈糜烂及宫颈癌组织中ＨＰＶ１６ＤＮＡ的检出率分别为２３．０８％、６４．７１％、７１．４３％。而ＨＣＭＶＤＮＡ的检出率则依次为３．８５％、２３．５４％、及４２．８６％，两者检出率呈直线相关（ｒ＝０．９２３）。因此，推测ＨＣＭＶ很可能与ＨＰＶ１６协同作用导致宫颈癌的发生。     

宫颈癌人乳头瘤病毒与人巨细胞病毒感染的病例对照研究

了解宫颈癌患者及对照患者宫颈组织中人乳头瘤病毒（ＨＰＶ）与人巨细胞病毒（ＨＣＭＶ）的感染状况。应用聚合酶链反应方法检测宫颈新鲜活检组织ＨＰＶ与ＨＣＭＶ。３６例宫颈癌及３８例子宫肌瘤患者的宫颈组织中，ＨＰＶ合并入ＨＣＭＶ感染检测阴性率分别为２．８％和３１．６％，ＨＰＶ单独感染的检出率分别为２５．０％和１５．８％（Ｐ〈０．０５），ＯＲ＝１８．０；ＨＣＭＶ单独感染的检出率分别为８．３％和２８．９％（Ｐ〉     

宫颈癌筛查诊断结果分析

目的分析宫颈细胞涂片配合阴道镜下活组织病理检查对早期宫颈癌和癌前病变筛查的检出率。方法应用宫颈细胞涂片检查发现异常细胞者再经阴道镜下取活组织病理检查对宫颈癌进行筛查，以病理诊断为标准，对结果进行分析。结果宫颈细胞涂片7626例，异常涂片94例（1．23％），宫颈活检病理确诊宫颈癌和癌前病变共10例，假阳性率为89．36％。阴道镜检查2915例，671例行阴道镜下活组织病理检查。病理结果显示：宫颈癌13例（1．94％）；宫颈上皮内瘤样病变（cervical intraepithdial neoplasia，CIN）30例（4．47％）；宫颈炎性病变628例（93．59％）；其他5例（0．75％）。其中巴氏阴性33例，假阴性率为76．74％，单纯用宫颈细胞学检查进行宫颈癌诊断其早期诊断率为0．039％，而结合电子阴道镜下活组织病理检查宫颈癌早期诊断率为1．94％，两者比较差别有非常显著性，P〈0．01。结论采用宫颈细胞学涂片检查配合阴道镜下活组织病理检查能及早发现宫颈癌和癌前病变，大大提高了宫颈癌和癌前病变的早期诊断率。     

应用PCR对女性生殖道沙眼衣原体感染的快速诊断

应用ＰＣＲ和双链ＤＮＡ循环测序检测妇女宫颈Ｃｔ感染状况。结果表明在５７例阴道炎和／或慢性宫颈炎患者的宫颈刮物中检出Ｃｔ阳性２１例（３６．８４％），提示Ｃｔ是女性生殖道感染的主要病原，好发于３０岁以下的妇女。临床表现多为轻型炎症反应，常有少量粘液脓性白带增多，随宫颈糜烂程度增加Ｃｔ感染呈上升趋势，３０例正常妇女未检出ＣｔＯ带病原体者。     

YAG与CO2激光治疗宫颈糜烂及宫颈上皮不典型增生

本文报道激光治疗宫颈糜烂１３４７例，其中经ＹＡＧ激光治疗的重度糜烂５３例（含宫颈上皮不典型增生３２例）痊愈１００％．经ＣＯ＿２激光治疗２６２例轻度宫颈糜烂痊愈１００％；中度糜烂７５８例，痊愈６９３例（９１．４２％），好转６５例（８．５８％）；重度糜烂２７４例，痊愈１８２例（６６．４２％），好转９２例（３３．５８％）．本文还对宫颈糜烂及宫颈上皮不典型增生的各种治疗方法及激光治疗的基础原理进行讨论．     

乳头瘤病毒及巨细胞病毒在宫颈癌组织中的协同作用

应用ＤＮＡ－ＤＮＡ斑点杂交技术，对６４例宫颈标本（包括正常宫颈２６例，重度宫颈糜烂１７例，宫颈癌２１例）分别检测ＨＰＶ－１６ＤＮＡ及ＨＣＭＶＤＮＡ。结果发现正常宫颈、宫颈糜烂及宫颈癌组织中ＨＰＶ１６ＤＮＡ的检出率分别为２３．０８％、６４．７１５、７１．４３％。而ＨＣＭＶＤＮＡ的检出率则依次为３．８５％、２３．５４％、及４２．８６％，两者检出率呈直线相关（ｒ＝０．９２３）。因此，推测ＨＣＭＶ很可能与     

巴豆油对人巨细胞病毒诱发小鼠宫颈癌的促进作用

为了探讨人巨细胞病毒（Ｈｕｍａｎｃｙｔｏｍｅｇａｌｏｖｉｒｕｓ，ＨＣＭＶ）与宫颈癌发生之间的关系，我们利用紫外线灭活的ＨＣＭＶ诱发小鼠宫颈癌的动物模型进行了研究。经紫外线灭活的ＨＣＭＶ液接种于小鼠宫颈部，３次／周×８周，接着以巴豆油按同样的方法２次／周×４周进行处理。同时设立ＨＣＭＶ及人胚肺细胞ＨＥＬ培养液对照组等。经２０个月后，折颈处死动物，取出完整的生殖道作病理学检测，结果发现：ＨＣＭＶ组宫颈癌前病变率为２７．８％（２３／８３），癌发率为２０．５％（１７／８３）；ＨＥＬ培养液对照组仅１例发生宫颈不典型增生（ＣＩＮⅠ），癌发率为零（０／３１）。在ＨＣＭＶ加巴豆油组，宫颈不典型增生的发生率为２６．４％（１４／５３）。而癌发率则提高到５２．８％（２８／５３）。此结果提示，人巨细胞病毒ＡＤ１６９株具有在体内转化宫颈内皮细胞，从而诱发宫颈癌的能力，巴豆油能够促进ＨＣＭＶ的诱癌能力，因此也讨论了ＨＣＭＶ致癌机制。     

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.