广西慢性肝炎,肝硬化及肝癌患者中丙型肝炎病毒感染及

目的：调查广西慢性肝炎、肝硬化及原发性肝癌患者中的丙型肝炎病毒（ＨＣＶ）感染状况及ＨＣＶ基因型别,评价ＨＣＶ感染在上述肝病发病中的作用。方法：用第２代酶免疫试剂盒检测患者的抗－ＨＣＶ抗体,阳性者再用型特异ＰＣＲ方法检测ＨＣＶ基因型。结果：１８６例原发性肝癌、３８例慢性迁延性肝炎、３０例慢性活动性肝炎、５０例肝硬化及４８例健康成人抗－ＨＣＶ检出率依次为２．１５％,５．２６％,６．６７％,２．０％和０     

丙型肝炎患者HCV基因的检测,分型及临床分析

运用逆转录聚合酶链反应（ＲＴ－ＰＣＲ）技术检测临床肝炎患者血清中ＨＣＶ ＲＮＡ对５４例ＨＣＶＲＮＡ阳性标本用限制性内切酶Ｓａｕ３ＡＩ／ＨａｅⅢ春５’ＮＣ区扩增产物进行酶切。结果显示４种酶切类型：ＨＣＶ Ⅰ型感染３．７％（２／５４），ＨＣＶⅡ型感染７７．８％（４２／５４），ＨＣＶⅢ，Ⅳ型感染１１．１％（６／５４），ＨＣＶⅡ／Ⅲ，Ⅳ型混合感染７．４％（４／５４）；     

丙型肝炎病毒基因型与丙型肝炎临床病情关系的研究

应用引物特异ＰＣＲ法对沈阳地区８３例各型丙型肝炎，６例原发性肝癌抗－ＨＣＶ及ＨＣＶＲＮＡ均阳性的血清标本进行ＨＣＶ基因分型，旨在了解本地区ＨＣＶ基因型分布情况及ＨＣＶ不同基因型与丙型肝炎病人临床病情轻重的关系。结果表明：ＨＣＶ－Ⅱ型感染占５７．３％（５１／８９）、ＨＣＶ－Ⅲ型感染占２８．１％（２５／８９）、Ⅱ／Ⅲ混合型感染占１３．５％（１２／８９）、未分型占１．１％（１８９）；急性肝炎、慢性肝炎轻度、中度、重度、肝炎后肝硬化及原发性肝癌中ＨＣＶ－Ⅱ型感染分别占６２．５％、３５．５％、６６．７％、８５．７％、９０．９％及１００％，而ＨＣＶ－Ⅲ型感染分别占２５％、４６．７％、８．３％、０％、９．１％及０％。提示沈阳地区ＨＣＶ感染以Ⅱ型为主，其次为Ⅲ型及Ⅱ／Ⅲ混合型，ＨＣＶ不同基因型与丙型肝炎病人临床病情的严重程度呈密切相关     

慢性肝病和肝癌中HCV核心区三种寡肽抗原的抗体检测

检测１４８例慢性肝病和肝癌患者血清中丙型肝炎病毒核心区３种寡肽抗原的抗体，结果显示其阳性率在慢性迁延型肝炎、慢性活动型肝炎、肝炎肝硬化和原发性肝癌患者分别为７．７％，２３．１％，，２３．５％和１６．３％。在抗体阳性者中８０％以上有乙型肝炎病毒感染证据，提示我国ＨＢＶ和ＨＶＣ重叠感染较为常见。     

789例病毒性肝炎HCV、HBV、HDV病毒指标检测及临床意义

检测７８９例各型病毒性肝炎患者ＨＣＶ、ＨＢＶ、ＨＤＶ病毒指标。结果各型肝病总抗－ＨＣＶ阳性率１１．５％。其中有受血或血制品史者抗－ＨＣＶ阳性率６７．５％，高于非受血或血制品者的３．２％，前者老年人与非老年人差异无显著性，后者老年人高于２０～５９岁成年人及青少年者。急性肝炎中，急性乙、丙肝炎分别占１１．９％、４．２％；慢性肝炎中ＨＢＶＭ检出率７９．６％，抗－ＨＣＶ阳性率１５．２％，ＨＢＶＭ阳性率１．５％。提示：北京地区有输血或血制品史肝病患者ＨＣＶ感染率高，老年人与非老年人同样易感；非受血或血制品的肝病患者ＨＣＶ感染率很低，老年人比青壮年人及青少年易感。慢性肝病ＨＢＶ感染仍是主要病因，ＨＤＶ感染极少见；显性急性ＨＣＶ、ＨＢＶ感染少见     

血液病患者中HCV和HBV感染及其复制分析

对１２６例血液病患者ＨＣＶ和ＨＢＶ感染及其病毒复制进行了研究，结果：（１）１２６例患者中ＨＣＶ抗体阳性８例（６．４％）大约比献血员感染率高１０倍（Ｐ〈０．０１），在抗体阳性者中有７例ＨＣＶ－ＲＮＡ阳性（８７．５％）（２）所测患才中ＨＢＶ五项标志物单项或多项阳性２６例（２０．６％）其中ＨＢＶ－ＤＮＡ阳性１２例（４６．２％）在８例ＨＣＶ感染者中有３例与ＨＢＶ重叠感染（３７．５％）５例有既往输血史（６２     

GOR抗体,HCV感染与原发性肝癌关系的初步探讨

ＧＯＲ是与ＨＣＶ感染密切相关的宿主细胞单拷贝基因产物，本文报告了ＧＯＲ抗体原发性肝癌患者中的阳性的阳性率为９．４２％（１３／１３８）其中ＨＢｓＡｇ阳性者为６．３２％（６／９５）抗ＨＣＶ阳性者为０％（０／３），ＨＢｓＡｇ抗ＨＣＶ均为阳性者８７．５％（７／８），ＨＢｓＡｇ抗ＨＣＶ为均阴性者为０％（０／３２）；在其它非肝癌肿瘤者中为１４．２９（４／２８），而在慢性乙型肝炎，慢性丙型肝炎患者中阳性率分别为     

中国东北地区HCVRNA阳性血清RT－PCR产物的RFLP分型

为了解东北地区ＨＣＶ感染的基因型，对东北地区４５例ＨＣＶＲＮＡ阳性血清的ＰＣＲ产物用ＲＦＬＰ分析进行基因分型，结果：ＨＣＶⅡ型占８２．２％，Ⅲ型占１５．６％，Ⅱ／Ⅲ混合型占２．２％型。与国内其它地区ＨＣＶ基因型构成比无显著性差异。证明东北地区ＨＣＶ感染也以Ⅱ型为主。     

四子王旗饮食服务人员乙丙丁型肝炎病毒感染调查

于１９９５年４－６月用ＥＬＩＳＡ对四子王旗９３例饮食服务人员进行了乙，丙，丁型肝炎病毒感染情况调查。ＨＢＶ，ＨＣＶ，ＨＤＶ总感染率为３１．２％，ＨＢＶ阳性２８例，感染率为３０．１％；ＨＣＶ阳性３例，感染率为３．２％，其中有２例合并ＨＢＶ感染；ＨＤＶ阳性２例，感染率为２．２％。ＨＢＶ阳性者中抗－ＨＤＶ阳性率为７．１％。ＨＢＶ感染率在年龄，性别方面的差异无统计学意义。     

中国东北地区HCV RNA阳性血清RT—PCR产物的RFLP分型

为了解东北地区ＨＣＶ感染的基因型，对东北地区４５例ＨＣＶ ＲＮＡ阳性血清的ＰＣＶ产物用ＲＦＬＰ分析进行基因分型，结果：ＨＣＶⅡ型占８２．２％，Ⅲ型占１５．６％，Ⅱ／Ⅲ混合型占２．２％型。与国内其它地区ＨＣＶ基因型构成比无显著性差异。证明东北地区ＨＣＶ感染也以Ⅱ型为主。     

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.