上腹部手术病人术中血浆内皮素的变化

观察１２例硬膜外麻醉下上腹部手术中血浆内皮素（ＥＴ）、血流动力学及心电图的变化。结果显示：术中功能各参数均显著降低（ｐ〈０．０１）。切皮后１ｈＥＴ明显高于麻醉前（ｐ〈０．０１），与术中心输出量（Ｃ０），心脏指数（ＣＩ）呈负相关，（ＣＯｒ＝－０．９２２１；ＣＩｒ＝－０．８７６８）有心肌缺血改变者其升高更显著，提示血浆内皮素与心功能及心肌缺血密切相关。     

肺心病加重期及肺癌患者血浆内皮素和心钠素的初步研究

观察肺心病急性加重期和肺癌患者血浆内皮素（ＥＴ）及心钠素（ＡＮＰ）各３０例。结果表明：肺心病急性加重组（下简称肺心加重组）血浆ＥＴ及ＡＮＰ水平均较正常对照组显著升高（Ｐ＜０．０１及Ｐ＜０．０５），且ＥＴ水平与ＡＮＰ及ＰａＣＯ２呈正相关（ｒ＝０．７８，Ｐ＜０．０１；ｒ＝０．６６Ｐ＜０．０１），而与Ｐ３Ｏ；及ｐＮ呈负相关（ｒ＝－０．９５Ｐ＜０．０１；ｒ＝－０．５３Ｐ＜０．０５）；肺癌组ＥＴ，ＡＮＰ亦较对照组显著升高（Ｐ＜０．０５），且ＥＴ与ＡＮＰ呈正相关（ｒ＝０．７９Ｐ＜０．０１）。此结果提示在肺动脉高压、肺心病的形成和发展、肺癌的发生发展以及ＡＮＰ分泌调控中，内皮素可能起着重要作用。缺氧和高碳醚血症可能是ＥＴ合成、分泌的刺激因子。     

肺心病加重期及肺癌患者血浆内皮素和心钠素的初步研究

观察肺心病急性加重期和肺癌患者血浆内皮素（ＥＴ）及心钠素（ＡＮＰ）各３０例。结果表明：肺心病急性加重组（下简称肺心加重组）血浆ＥＴ及ＡＮＰ水平均较正常对照组显著升高（Ｐ〈０．０１及Ｐ〈０．０５），且ＥＴ水平与ＡＮＰ及ＰａＣＯ２呈正相关（ｒ＝０．７８，Ｐ〈０．０１；ｒ＝０．６６Ｐ〈０．０１）。而与ＰａＯ２及ｐＨ呈负相关（ｒ＝－０．９５Ｐ〈０．０１；ｒ＝－０．５３Ｐ〈０．０５）；肺癌组ＥＴ，ＡＮＰ亦较     

慢性阻塞性肺病患者血浆内皮素—1水平与肺血流动力学的关系

通过右心漂浮导管检测了２０例临床缓解期慢性阻塞性肺病（ＣＯＰＤ）患者的血流动力学参数，并用放射免疫分析法分别测定了体动脉和肺动脉血浆内皮素－１（ＥＴ－１）水平。结果显示：体动脉血浆ＥＴ－１水平（５７．００±８．８９）ｐｇ／ｍｌ小于肺动脉血浆ＥＴ－１水平（７５．９２±１７．３６）ｐｇ／ｍｌ（Ｐ＜０．００１）：ＣＯＰＤ并ＰＡＨ组肺动脉混合静脉血浆ＥＴ－１水平的（８３．９０±１７．１２）ｐｇ／ｍｌ明显高于ＣＯＰＤ非ＰＡＨ组肺动脉混合静脉血浆ＥＴ－１水平（６２．７３±４．４３）ｐｇ／ｍｌ（Ｐ＜０．０５）；肺动脉混合静脉血浆ＥＴ－１水平与肺动脉平均压（ＰＡＰｍ）及肺血管阻力（ＰＶＲ）呈显著的正相关（ｒ＝０．８８，Ｐ＜０．００１；ｒ＝０．０８１，Ｐ＜０．００１），与心输出量（ＣＯ）、氧饱和度（ＳＡＴ％）呈显著的负相关（ｒ＝－０．４７，Ｐ＜０．０５：ｒ＝－０．７９，Ｐ＜０．００１）。提示ＥＴ－１在ＣＯＰＤ并ＰＡＨ的发生发展中起着重要的病理生理学作用。     

慢性肾功能衰竭血、尿内皮素、一氧化氮水平与肾功能、血压相关性

目的　探讨慢性肾衰血浆及尿内皮素（ＥＴ）、一氧化氮（ＮＯ）改变及其与肾功能、血压的关系。方法：采用放免法及比色法测定血浆及尿中ＥＴ－ １、ＮＯ含量及其与血清肌酐（ＳＣｒ）、平均动脉压（ＭＡＰ）的相关性。结果：慢性肾衰组血浆及尿ＥＴ显著高于健康人（Ｐ＜ ０．０１）,其中ＣＲⅠ期血、尿ＮＯ 与健康人无显著差异（Ｐ＞ ０．０５）而ＣＲＦ期尿ＮＯ 低于健康人（Ｐ＜ ０．０５）,血浆及尿ＥＴ 与ＳＣｒ及ＭＡＰ均显著正相关（Ｐ＜ ０．０５）、ＮＯ与ＳＣｒ及ＭＡＰ均呈显著负相关（Ｐ＜ ０．０１）。结论：慢性肾衰时体内ＥＴ增高、ＮＯ 合成减少,且与肾功能及血压密切相关,说明ＥＴ及ＮＯ 在慢性肾衰的进展中可能起重要作用。     

慢性常压低氧高二氧化碳肺动脉高压大鼠血浆内皮素变化及意义

应用低Ｏ２高ＣＯ２肺动脉高压大鼠模型，观察了不同低Ｏ２高ＣＯ２时间血浆内皮素含量（ＥＴ）、平均肺动脉压（ｍＰＡＰ）、右心室重量（ＲＶ／１００ｇＢＷ、ＲＶ／ＴＶ）的变化。结果显示，随低Ｏ２高ＣＯ２时间的延长，ｍＰＡＰ与ＥＴ均逐渐升高，二者呈良好正相关（ｒ＝０．７４２，Ｐ＜０．００１）。各实验组的ＲＶ／１００ｇＢＷ和ＲＶ／ＴＶ均高于对照组（Ｐ＜０．０１或０．００１）。血浆ＥＴ浓度与ＲＶ／１００ｇＢＷ呈良好正相关（ｒ＝０．５８６，Ｐ＜０．００１）。表明慢性常压低Ｏ２高ＣＯ２肺动脉高压大鼠血浆内皮素浓度增加，与肺动脉高压的形成及右心室肥大有关。     

慢性肺心病患者血浆内皮素—1与PaO2,PaCO2的关系

目的：探讨肺心病患者血浆内皮素－１（ＥＴ－１）水平及其与ＰａＯ２、ＰａＣＯ２的关系。方法：用放射免疫分析法同批检测了３３例慢性肺心病急性加重期、１４例慢性肺心病缓解期患者血浆ＥＴ－１水平，并与ＰａＯ２、ＰａＣＯ２进行了相关分析。结果：肺心病患者血浆ＥＴ－１水平明显升高，急性加重期和缓解期均显著高于健康对照组（Ｐ均＜０．０１）。直线相关分析表明，急性加重期和缓解期患者血浆ＥＴ－１水平均与ＰａＯ２呈显著负相关（ｒ分别为－０．８３５和－０．６０３，Ｐ分别＜０．０１和０．０５），与ＰａＣＯ２无明显相关性。结论：慢性肺心病患者ＥＴ－１合成或分泌功能紊乱，缺氧可能是引起血浆ＥＴ－１水平升高的主要因素之一。     

血浆内皮素-1、醛固酮在肾病综合征患儿钠潴留中的作用

为探讨血浆内皮素－１（ＥＴ－１）和醛固酮（Ａｌｄ）在肾病综合征患儿钠潴留中的作用，对１４例肾病综合征患儿在水肿期和消肿期的血浆ＥＴ－１、Ａｌｄ及血清渗透压、白蛋白（Ａｌｂ）、Ｎａ＋的变化进行了观测。结果显示患儿水肿期血浆ＥＴ－１比消肿期显著性升高（Ｐ＜０．０１），水肿期血浆Ａｌｄ与消肿期无明显差异（Ｐ＞０．０５）；血浆ＥＴ－１与血清Ｎａ＋呈直线正相关（ｒ＝０．４８６，Ｐ＜０．０１），与血清Ａｌｂ呈直线负相关（ｒ＝－０．４９０，Ｐ＜０．０１）。提示肾病钠潴留可能与肾排钠减少有关，ＥＴ－１在其中起了重要作用。     

肺心病患者血浆内皮素-1水平的变化及卡托普利对其的影响

为了探讨内皮素（ＥＴ）在肺心病发病中的作用及卡托普利的治疗作用机理,将３６例肺心病患者随机分为两组,２０例采用常规治疗,１６例采用卡托普利加常规治疗,疗程为１４天,并以２０例健康人作为对照。用放射免疫分析法测定治疗前后血浆ＥＴ－１水平,并与患者动脉血氧分压（ＰａＯ２）进行相关分析。结果发现,肺心病患者治疗前ＥＴ－１水平明显高于对照组（Ｐ＜０．０１）,与ＰａＯ２水平呈负相关（Ｐ＜０．０１）,与ＰａＣＯ２、ｐＨ无明显相关（Ｐ＞０．０５）;治疗后两组患者血浆ＥＴ－１水平明显下降（Ｐ＜０．０１）,但仍明显高于对照组（Ｐ＜０．０５）,卡托普利组治疗后血浆ＥＴ－１水平显著低于常规治疗组（Ｐ＜０．０５）。提示内皮素在肺心病发病中起了重要作用,卡托普利的治疗作用与其降低ＥＴ水平有一定关系。     

肺心病人血浆4种血管活性多肽含量测定及临床意义

目的观察内皮素（ＥＴ）等４种血管活性多肽在肺心病发病中的作用。方法应用放射免疫法检测４０例肺心病人不同病期血浆ＥＴ、心钠素（ＡＮＰ）、血管紧张素Ⅱ（ＡＴⅡ）、肿瘤坏死因子－α（ＴＮＦ－α）含量。结果急性期各血管肽均显著高于缓解期（Ｐ＜０．０１）；心衰≥Ⅱ度者显著高于Ⅰ度及无心衰者（Ｐ＜０．０１）；急性期４种血管肽含量与ＰａＯ２呈显著负相关（Ｐ＜０．０１），与ＰａＣＯ２均无相关性。结论ＥＴ，ＡＮＰ，ＡＴⅡ，ＴＮＦ－α在肺心病发病、发展中起重要作用。     

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.