自发性腹膜炎腹水G-CSF测定的临床意义

目的：探讨自发性腹膜炎腹水粒细胞集落刺激因子（Ｇ－ＣＳＦ）测定的临床意义。方法：应用酶联免疫技术测定２５ 例自发性腹膜炎和２５ 例非细菌感染性腹水患者腹水中的Ｇ－ＣＳＦ。结果：在自发性腹膜炎患者腹水中Ｇ－ＣＳＦ阳性率（９２％ ）明显高于非细菌感染性腹水中的阳性率（４％ ）,其差异有显著统计学意义（Ｐ＜ ０．００１）。其敏感性为９２％ ,特异性为９６％ 。并且腹水中的Ｇ－ＣＳＦ水平明显高于血清中的水平。随着自发性腹膜炎感染的控制,腹水Ｇ－ＣＳＦ水平逐渐降至正常。结论：腹水Ｇ－ＣＳＦ检测可有效区别自发性腹膜炎与非感染性腹水,对自发性腹膜炎的早期诊断和疗效观察均具有临床实际应用价值     

新生儿败血症粒细胞集落刺激因子的检测

采用双抗体夹心酶联法检测２８例正常新生儿、３４例非败血症及３１例败血症新生儿血清粒细胞集落刺激因子（Ｇ－ＣＳＦ）。结果显示，正常新生儿全部阴性，非败血症新生儿阳性率为３．５％（１２／３４），败血症新生儿全部阳性。同时对３１例新生儿败血症血清Ｇ－ＣＳＦ进行动态观察，发现１８例经过抗生素有效控制治疗后，第４天复查，１２例Ｇ－ＣＳＦ已转阴，第７天复查Ｇ－ＣＳＦ仅１例阳性，与耐药组有显著差异。表明血清Ｇ－ＣＳＦ可作为判断新生儿败血症的敏感指标，动态观察其变化是临床判断抗生素疗效的一个客观且准确的指标。     

血清粒细胞集落刺激因子对新生儿急性感染诊断价值探讨

采用双抗体夹心酶联免疫法测定６２例急性感染新生儿血清粒细胞集落刺激因子（Ｇ－ＣＳＦ），其阳性率显著高于血培养（Ｐ〈０．０５）；患儿感染控制后，Ｇ－ＣＳＦ全部转阴提示Ｇ－ＣＳＦ可作为新生儿急性感染诊断指标之一，优于血培养及白细胞计数。     

新生儿败血症血清TNF-α和sTNFR-Ⅱ的检测分析

目的：探讨血清ＴＮＦ－α，ｓＴＮＦＲ－Ⅱ水平在新生儿败血症诊断中的意义。方法：采用ＥＬＩＳＡ方法测定４２例新生儿败血症和２０例非感染新生儿血清ＴＮＦ－α、ｓＴＮＦＲ－Ⅱ水平。结果：败血症组血清ＴＮＦ－α，ｓＴＮＦＲ－Ⅱ水平显著高于对照组（Ｐ＜０．００１）。相关性分析显示，败血症组血清ＴＮＦ－α与ｓＴＮＦＲ－Ⅱ呈正相关。结论：新生儿败血症血清ＴＮＦ－α与ｓＴＮＦＲ－Ⅱ相应升高，可能提示新生儿败血症预后较好     

胎膜早破时粒细胞集落刺激因子测定的临床意义

目的：了解胎膜早破时测定粒细胞集落刺激因子（ｇｒａｎｕｌｏｃｙｔｅｃｏｌｏｎｙｓｔｉｍｕｌａｔｉｎｇｆａｃｔｏｒ，ＧＣＳＦ）的临床意义。方法：测定６４例胎膜早破产妇在分娩时母血清及脐血清的ＧＣＳＦ和Ｃ反应蛋白（ｃｒｅａｃｔｉｎｇｐｒｏｔｅｉｎ，ＣＲＰ）水平，同时以６４例正常产妇做对照。结果：观察组母及脐血清ＧＣＳＦ阳性分别为１０和１２例，较对照组４和５例增高，Ｐ＜０．０５；血清ＧＣＳＦ和ＣＲＰ都异常或脐血清任何一项测定异常时，７５％～１００％新生儿发病；观察组与对照组分别有２６与１６例新生儿发病，Ｐ＜０．０５。结论：胎膜早破时测定ＧＣＳＦ对预测新生儿的发病有一定的临床价值     

脑脊液中兴奋性氨基酸对新生儿缺氧缺血性脑病的诊断意义

应用丹酰氯－聚酰胺薄层层析法，测定３４例新生儿缺氧缺血性脑病（ＨＩＥ）及３０例非ＨＩＥ脑脊液（ＣＳＦ）和血清中谷氨酸（ＧＬＵ）、天冬氨酸（ＡＳＰ）水平，ＣＳＦ中两种氨基酸水平显著高于对照组（Ｐ〈０．００１），且其含量与ＨＩＥ病情严重程度呈正相关，（ｒ＝０．７２，Ｐ〈０．００１），但与血清中ＧＬＵ、ＡＳＰ均无相关性，ＣＳＦ中ＧＬＵ、ＡＳＰ含量测定可作为ＨＩＥ诊断的一个指标。     

血清G—CSF检测在小儿发热性疾病诊断中的意义

目的 探讨血清粒细胞集落刺激因子（Ｇ－ＣＳＦ）活性在小儿发热性疾病中的诊断价值。;方法 采用酶联免疫方法检测了６３例发热性疾病（急性白血病１４例,呼吸道感染病４９例）血清Ｇ－ＣＳＦ活性,同时采用Ｆ－８２０血球计数仪检测外周血中性粒细胞（ＡＮＣ）绝对值。结果 非细菌感染性病例血清Ｇ－ＣＳＦ呈阴性反应,外周血ＡＮＣ正常或低于正常 病例血清Ｇ－ＣＳＦ阳性,其活性与外周血ＡＮＣ计数呈正相关,而部分急性白血病患儿二者呈负相关。结论 检测血清Ｇ－ＣＳＦ活性有助于小儿发热性疾病的诊断、鉴别诊断及指导临床抗生素的合理应用。     

儿童哮喘粒细胞集落刺激因子与肿瘤坏死因子的关系

用酶联免疫法检测４０例发作期、２２例缓解期哮喘儿童血清粒细胞集落刺激因子（Ｇ－ＣＳＦ）和肿瘤坏死因子（ＴＮＦ－ａ）水平。结果显示：哮喘发作组Ｇ－ＣＳＦ阳性率４２．５％，显著高于缓解组及正常对照组。ＴＮＦ－α水平在哮喘发作组、缓解组都比正常组显著升高，发作组中Ｇ－ＣＳＦ阳性组的ＴＮＦ－α又低于阴性组。以上提示细菌性感染在哮喘发作期中仍占一定比例，此对哮喘起促发作用，建议对Ｇ－ＣＳＦ阳性者使用抗生素。由于两者均是重要的细胞因子，可参与哮喘的发病。     

急性白血病和恶性肿瘤患者化疗前后血清G—CSF水平的变化及意义

采用ＥＬＩＳＡ方法。检测了３６例急性白血病患者和４２例恶性肿瘤患者化疗前后血清Ｇ－ＣＳＦ水平,结果显示：两组化疗后血清－Ｇ－ＣＳＦ检出率分别为５２％和３３．３％,与化疗前比较无显著差异,而两组病程合并感染者,检出率高达８７．５％和７７．６％,显著高于无感染组（Ｐ〈０．００５）。Ｓｐｅａｒｍａｎ等级相关分析,急性白血病合并感染血清Ｇ－ＣＳＦ水平与白细胞总数呈负相关。恶性肿瘤仅于化疗后合并感染时,血清     

溃疡性结肠炎患者血清粒细胞集落刺激因子和C-反应蛋白检测及意义

目的：研究血清中粒细胞集落刺激因子（Ｇ－ＣＳＦ）和Ｃ－反应蛋白（ＣＲＰ）在溃疡性结肠炎时的（ＵＣ）作用和意义。方法：用酰联免疫吸附法测定了３３例ＵＣ患者及正常对照组４０例血清Ｇ－ＣＳＦ、Ｃ－反应蛋白（ＣＲＰ）和中性粒细胞水平。结果：活动性ＵＣ患者血清中Ｇ－ＣＳＦ和ＣＲＰ水平明显增高,并与病情的轻重有关（Ｐ〈０．０５）。结论：血清中Ｇ－ＣＳＦ水平增高可能参与ＵＣ的炎症发展,Ｇ－ＣＳＦ和ＣＲＰ可作为ＵＣ病情判断的指标。     

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.