上海市成人肺功能医学参考值范围的初步研究

目的初步建立上海地区成人肺功能医学参考值范围和一秒率实测值占预计值百分比的正常值。方法选取2009年6月至2010年2月的健康成年体检者,对合格人群进行肺功能测定,根据华东地区肺功能正常预计值公式判断结果,以肺功能正常和基本正常2∶1的比例入选360例受试者,按年龄分为6组,每组60例,男女各半。收集14项肺功能参数：肺活量（VC）、功能残气量（FRC）、肺总量（TLC）、残气容积（RV）、残气容积/肺总量（RV/TLC）、用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、一秒率（FEV1/FVC）、呼气峰流量（PEF）、用力呼出25%肺活量时呼气流量（FEF25%）、用力呼出50%肺活量时呼气流量（FEF50%）、用力呼出75%肺活量时呼气流量（FEF75%）、一氧化碳弥散量（DLCO）、每升肺泡容积的一氧化碳弥散量（KCO）。以性别、年龄、身高、体重为自变量建立新的预计值公式,并根据新公式推算各参数的医学参考值范围,计算一秒率实测值占预计值的正常百分比。结果建立了新的肺功能正常预计值公式,其中DLCO=5.206＋4.314×性别（＂男＂=1,＂女＂=0）-0.144×年龄（y）＋0.098×身高（cm）＋0.082×体重（kg）,KCO=9.346-0.026×年龄（y）-0.031×身高（cm）＋0.025×体重（kg）。推算出VC、FVC、FEV1、FEV1/FVC的正常值低限（LLN）（P5）,FRC、TLC、RV、RV/TLC的LLN（P2.5）及正常值高限（P97.5）,其中FEV1/FVC LLN（P5）=101.924-0.144×年龄（y）-0.118×身高（cm）,其实测值占预计值百分比的正常值低限为92%。结论在国内无肺功能参数医学参考值和一秒率判断标准,而目前华东地区弥散量预计值偏高的情况下,可以参考本项研究结果。FEV1/FVC的LLN或其实测值占预计值百分比的92%可作为阻塞性通气障碍的诊断标准。FEV1     

小儿胃食管反流对肺功能的影响及意义

目的　探讨小儿胃食管反流对肺功能影响。方法　以胃钡餐及胃镜确诊为胃食管反流的 2 0例小儿作为观察对象。用婴幼儿肺功能仪进行潮气吸气峰流速 (PTIF)、潮气呼气峰流速 (PTEF)、潮气呼气中期流速 /潮气吸气中期流速 (ME/MI)、呼出 75 %潮气量时的呼气流速 /潮气呼气峰流速 (2 5 /PF)等肺功能指标检测 ,其中 >3岁者尚须运用Spirostrac肺功能仪进行第 1秒最大呼出量实测值 /预计值百分比 (FEV1% )、第 1秒最大呼出率 (FEV1/FVC % )检测。结果　胃食管反流的小儿均存在不同程度的肺功能损害 ,其中潮气容量环PTIF PTEF(35 .9± 35 .1)、ME/MI(0 .73± 0 .17)、2 5 /PE(0 .6 6± 0 .13)较正常健康儿童组PTIF PTEF(2 2 .5± 4 .9)、ME/MI(0 .98± 0 .0 4 )、2 5 /PF(0 .77± 0 .0 7)有显著差异。 2 0例中 ,9例 >3岁儿童 ,其FEV1% (70 .8± 5 .5 )、FEV1/FVC % (79.1± 9.6 )较健康对照组FEV1% (90 .8± 4 .8)、FEV1/FVC % (92 .8± 5 .5 )明显降低。结论　胃食管反流的小儿存在气道阻塞性改变     

中老年男性戒烟后肺功能改善与一氧化氮含量变化的相互关系

目的观察中老年男性戒烟10年者与吸烟10年以上者及同龄不吸烟健康者的肺功能情况与一氧化氮含量之间的关系.方法筛选24名健康男性吸烟者.按1∶1配对筛选24名健康同龄男性戒烟者(戒烟时间达10年以上),24名健康同年龄男性不吸烟者.受试者在1个月内每10天做1次肺功能、血清NO含量测定,连续3次.结果吸烟10年以上者与不吸烟者、戒烟10年以上者肺功能相比,肺活量(VC)、用力肺活量(FVC)、一秒钟用力呼气容积(FEV1)及残气量(RV)、残气量/肺总量(RV/TLC)有显著性差异;一秒钟用力呼气容积与用力肺活量之比(FEV1/FVC)、最大通气量(MMV)、最大呼气中期流量(MMEF)、功能残气量(FRC)、肺总量(TLC)有显著差异;血清NO含量变化有显著性差异.戒烟10年以上者与健康不吸烟者肺功能相比,VC、FVC、TLC、FEV1无显著性差异;RV、RV/TLC、FRC、MMV、MMEF有显著性差异;血清NO含量变化无显著性差异.结论长期大量吸烟可严重损害肺通气功能并形成某些不可逆病理变化,戒烟10年后仍不能完全消除吸烟对肺功能的损害.     

不同年龄组健康老人10年肺功能随访

目的：探讨不同年龄组健康老年人10年肺功能变化及各项肺功能指标改变具体数值。方法：经体检、胸片、心电图、肺功能等多项检查后确定为健康老年人作为研究对象;每年均进行查体及肺功能的随访。结果：第一秒用力呼气量占用力肺活量（FEV1%）在 60-64 岁组、65-69 岁组的初始值和 10 年后测量值相比未达到统计学意义,70 岁以上组的健康老年人 FEV1% 初始值与 10 年后测量值相比下降P<0.05。呼气峰流速（PEF）、肺总量（TLC）在 60-64 岁组初始值和 10 年后测量值相比P<0.05;在 65-69 岁组及 70 岁以上组 PEF、TLC 的初始值和 10 年后测量值相比P<0.01。肺活量（VC）、用力肺活量（FVC）、第一秒用力呼气量（FEV1）、最大通气量（MVV）、最大呼气中期流量（MMEF）、功能残气量（FRC）、残气量（RV）、RV/TLC 各年龄组初始值与 10 年后随访值相比P<0.01。VC、FVC、FEV1、PEF、RV、RV/TLC、FEV1%、MVV、MMEF、FRC、TLC 年改变值在各年龄组比较变化不显著。结论：肺功能随增龄而改变;绝大多数肺功能指标 10 年前、后对比变化差别极显著P<0.01; FEV1% 在 60-64 岁、65-69 岁年龄组 10 年前、后改变P>0.05,在 70 岁以上年龄组P<0.05; PEF、TLC 在 60-64 岁年龄组 10 年前、后改变P<0.05; 肺功能各指标年改     

COPD患者HRCT容积成像特点与肺功能的关系研究

目的：探讨慢性阻塞性肺疾病(COPD)患者高分辨CT (HRCT)容积成像特点与肺功能的关系。方法选取2011年3月至2015年2月十堰市郧阳区人民医院收治的62例COPD患者作为研究对象,所有患者均接受HRCT容积扫描及肺功能检查,图像传输至工作站,记录肺容积、肺密度各项参数,并按照COPD严重程度分组,分析HRCT参数与患者肺功能指标的相关性。结果随着COPD病情严重程度的上升,患者一秒用力呼气容积(FEV1)、用力肺活量(FVC)、一秒率(FEV1/FVC)、一秒用力呼吸容积占预计值比例(FEV1%)降低,残气量/肺总量(RV/TLC)上升;Ⅳ级COPD患者FEV1、FVC、FEV1/FVC、FEV1低于Ⅰ级者[(0.8±0.1) L、(2.2±0.3) L、(34.6±10.2)%、(56.3±3.6)%vs (2.3±0.3) L、(3.5±0.3) L、(81.6±8.3)%、(73.2±5.3)%],RV/TLC高于Ⅰ级者[(75.2±8.6)%vs (45.1±5.8)%],差异均有统计学意义(P<0.05);随着COPD病情严重程度的上升,患者深吸气、呼气末肺密度均上升;Ⅳ级COPD患者深吸气、呼吸末肺密度高于Ⅰ级者[(-956.8±22.4) HU、(-899.5±22.7) HU vs (-865.3±24.5)HU、-744.2±30.2) HU],差异均有统计学意义(P<0.05);其深吸气末容积（Vin）、深呼气末肺容积(Vex)上升,但差异均无统计学意义(P>0.05),仅Ⅱ级、Ⅲ级、Ⅳ级与Ⅰ级Vin对比,Ⅳ级与Ⅱ级Vin,Ⅲ级、Ⅳ级与Ⅰ级Vex对比差异有统计学意义(P<0.05);肺气肿体积(TEV)、肺气肿指数(EI)上升,Ⅳ级COPD患者TEV、EI高于Ⅰ级者[(1.1±0.2) L、(17.8±3.4)%vs (0.3±0.2) L、(6.1±4.2)%],差异均有统计学意义(P<0.05),但不同病情严重程度全肺体积(TLV)无明显变化(P>0.05);Vin与FVC、FEV1、FEV1/FVC相关,Vex、TEV、EI与所有肺功能指标均相关,深吸气肺密度、TLV与FEV1/FVC相关(P<0.05)。结论 HRCT容积成像可清晰显示COPD肺实质破坏,其定量参数与肺功能指标有较好的相关性,可用于评定COPD患者病情严重程度。     

肺弥散功能及容量与慢性持续期哮喘病情严重程度的相关性研究

目的 探讨肺弥散功能及容量与慢性持续期哮喘病情严重程度的相关性.方法 选取2015年诊治的慢性持续期哮喘患者100例,根据病情严重程度分为轻度组(22例)、中度组(46例)及重度组(32例),检测肺一氧化碳弥散量(DLCO)、肺总量(TLC)、残气容积(RV)及RV/TLC、第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FEV1/FVC),计算各项指标的预计值百分比(%pred).结果 DLCO、RV/TLC轻度组与中度组比较差异无统计学意义,DLCO重度组为(87.30±12.65)%pred低于轻度组(94.39±10.74)%pred及中度组(93.11±12.38)%pred,RV/TLC重度组为(55.92±6.91)高于轻度组(45.63±7.44)及中度组(47.16±7.35),比较差异有统计学意义(P<0.05);TLC%pred、RV%pred中度组为(119.34±12.08)%pred和(160.28±22.54)%pred与重度组(128.31±13.77)%pred和(195.15±34.65)%pred均高于轻度组(108.50±14.52)%pred和(135.86±28.75)%pred,重度组高于中度组,FEV1%pred、FEV1/FVC中度组为(70.58±4.81)%pred和(59.76±8.22)与重度组(52.09±6.81)%pred和(50.74±9.20)均低于轻度组(84.21±3.30)%pred和(65.11±10.62),重度组低于中度组,比较差异有统计学意义(P<0.05);Pearson相关分析DLCO%pred与TLC%pred、RV%pred、RV/TLC间具有负相关性(P<0.05),与FEV1%pred、FEV1/FVC间具有正相关性(P<0.05).结论 慢性持续期哮喘患者随着病情严重程度加重肺容量呈现增加、弥散功能呈现下降趋势,弥散功能与容量指标间关系密切.     

哮喘缓解期联用乌体林斯和黄芪注射液等穴位注射控制哮喘发作的临床观察

目的　观察哮喘缓解期联用乌体林斯、黄芪注射液、鱼腥草注射液穴位注射控制哮喘发作的疗效 ,探讨其作用机理。方法　哮喘缓解期患者 5 6例 ,随机分成两组。治疗组 3 2例采用相同穴位交替选择药物 ,隔日穴位注射治疗 ;对照组 2 4例予常规治疗。并观察两组疗效及治疗前后用力肺活量 (FVC) ,1秒钟用力呼气量 (FEV1)和肺活量 (VC)的变化。结果　两组总有效率为 96.87%和 79.17% ,治疗组优于对照组 ( χ2 =10 ,P <0 .0 1)。治疗组治疗前后肺功能明显改善 ,治疗前后比较VC分别为 ( 1.79± 0 .43 )L和 ( 2 .91± 0 .64 )L ,P <0 .0 5 ;FVC分别为 ( 1.64± 0 .46)L和 ( 2 .0 9±0 .62 )L ,P <0 .0 5 ;FEV1分别为 ( 0 .92± 0 .70 )L和 ( 1.3 5± 0 .3 5 )L ,P <0 .0 5。对照组治疗前后肺功能改善不明显 (P均<0 .0 5 )。治疗组明显优于对照组。结论　在哮喘缓解期联用乌体林斯、黄芪注射液、鱼腥草注射液穴位注射控制哮喘发作的临床疗效优于常规治疗     

抚顺市慢性阻塞性肺疾病患者低剂量MSCT肺容积测定与肺功能相关性的研究

目的探讨抚顺地区低剂量MSCT(multi-slice spiral CT,MSCT)肺容积测定在COPD患者肺功能测定中的应用。方法选取抚顺市健康自愿者20例,临床确诊为COPD患者20例,采用Philip公司生产的256层iCT,采用50mAs预设值于吸气末和呼气末进行扫描,采集层厚1mm,重建层厚为5mm,用自动化软件测量和计算容积指标:吸气末肺容积(V1)、呼气末肺容积(V2)、容积差(V1-V2)和容积比(V2/V1)。采用美国森迪斯Sensor Medics型号Vmax 22测定肺功能。测定指标有:第1s用力肺活量值与预测值百分比(FEV1﹪)、第1s用力肺活量与用力肺活量的比值(FEV1/FVC﹪)、残气量(RV)、肺总量(TLC)、肺活量(VC)、残气量与肺总量比(RV/TLC)。采用SPSS16.0软件包进行统计学分析。结果两组指标相比较,RV、RV/TLC%、FEV1%、FEV1/FVC%组间差异有统计学意义(P<0.05)。COPD组PFT检查结果 :TLC和RV增加,RV增加值明显高于TLC,RV/TLC增大;FEV1(%)和FEV1/FVC(%)明显减小。20例正常组成年人与20例COPD患者低剂量MSCT检测结果两独立样本t检验:呼气末容积(V2)、容积差(V1-V2)和容积比(V2/V1)指标有明显差异,P<0.05,有统计学意义。20例COPD患者的V2、V2/V1指标升高,V2明显升高,与PFT的检测值一致。对MSCT和PFT测得的指标,进行秩和检验及Spearman相关分析:在MSCT和PFT容积指标中,V1类似TLC,V2类似RV,V1-V2类似VC,V2/V1类似RV/TLC。V1与TLC(t=0.920,P<0.05)、V2与RV(t=0.908,P<0.05)的相关性最好,V2/V1与RV/TLC也显著相关(t=0.759,P<0.05)。结论低剂量MSCT胸部扫描能较好地评估COPD患者肺功能,而患者接受扫描曝光剂量较低,适于抚顺市推广应用。     

老年人的肺功能和血气变化

为探讨老年人呼吸系统的变化情况 ,现将本院2 0 0 0年 3月～ 2 0 0 2年 5月门诊和体检的 5 3例老年人肺功能和血气分析资料报道如下。1　临床资料1 1　一般资料　老年组 :经体检无明显心肺疾患的 6 0周岁以上的老年人 5 3例 ,其中男 39例 ,女 14例 ,年龄 6 0～ 81岁 ,平均 6 7 1岁 ;非老年组 :经体检无明显心肺疾患的中年人 32例 ,其中男 2 2例 ,女10例 ,年龄 4 0～ 5 9岁 ,平均 4 6 2岁。1 2　测定方法　肺功能测定用德国耶格公司组合式肺功能仪 ,分别测定用力肺活量 (FVC)、用力肺活量占预计值百分比 (FVC % )、1秒钟用力呼气容积(FV…     

BiPAP呼吸机治疗慢性阻塞性肺疾病急性呼吸衰竭的疗效观察

目的　探讨 (鼻 )面罩双水平气道正压通气 (BiPAP)对慢性阻塞性肺疾病 (COPD)急性呼吸衰竭的治疗作用。方法　 52例COPD急性加重合并呼吸衰竭患者应用BiPAP呼吸机辅助通气治疗 ,记录通气前及通气治疗 2h及 2 4h后呼吸空气条件下患者的血气分析及第 1秒用力肺活量(FEV1)、用力肺活量 (FVC)。结果　治疗前PaCO2 为 (76± 15)mmHg ,FVC为 (1 2 8± 0 2 0 )L ;治疗后2 4hPaCO2 为 (40± 9)mmHg ,FVC为 (1 3 2± 0 2 0 )L ,治疗前、后比较均无显著差异 (P >0 0 5)。治疗前PaO2 为 (48± 12 )mmHg ,FEV1为 (0 67± 0 0 7)L ;治疗后 2 4小时PaO2 为 (88± 16)mmHg ,FEV1为(0 85± 0 2 0 )L ,治疗前、后比较有显著差异 (P <0 0 5)。结论　应用BiPAP呼吸机辅助通气治疗COPD急性呼吸衰竭可改善肺功能 ,提高PaO2 。     

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.