血清铁蛋白、同型半胱氨酸与急性脑梗死的关系

目的探讨血清铁蛋白（SF）、同型半胱氨酸（Hcy）含量与急性脑梗死（CI）患者的关系。方法对60例急性脑梗死患者、50例健康对照者以放免法测定血清铁蛋白（SF），采用化学发光法检测血清同型半胱氨酸（Hcy），同时检测Hcy的代谢因子维生素B，：（Vit．B12）、叶酸（Fa）含量。结果和健康对照组比较CI患者组血清SF、Hey明显增高，P〈0．01，Hcy的代谢因子叶酸和Vit．B12亦明显降低，P〈0．01。结论血清铁蛋白、同型半胱氨酸与急性脑梗死密切相关，而同型半胱氨酸主要与叶酸和Vit．B12营养性缺乏有关，SF、Hcy、Vit．B12、Fa参与了CI的病理、生理过程。对急性脑梗死患者应注意监测Hcy并予相应治疗，以利于患者的康复。     

叶酸、维生素B12对冠心病患者血清同型半胱氨酸、一氧化氮水平的影响

目的：探讨叶酸、维生素B12对冠心病伴高同型半胱氨酸（Hcy）血症患者的血清Hcy、一氧化氮（NO）水平的影响。方法：采用酶联免疫法测定冠心病组（98例）患者和正常对照组（57例）空腹血清Hcy水平,应用亚硝酸盐还原酶法测定其血清NO水平。69例高Hcy血症的冠心病患者（Hcy≥15μmol/L）随机分为对照组（30例,仅服用硝酸酯类、他汀类及阿司匹林等基础药物）、干预组（39例,除基础用药外加用叶酸5mg/d、维生素B12500μg/d口服）,治疗前及治疗4周后测定患者空腹血清Hcy、NO水平。结果：冠心病组患者血清Hcy水平明显高于正常对照组（P〈0.01）,NO水平明显低于正常对照组（P〈0.05）,冠心病组血清Hcy水平与NO水平呈明显负相关（r=-0.72,P〈0.05）,干预组患者治疗4周后Hcy水平平均降低了36.4%,治疗前、后Hcy水平差异有统计学意义（P〈0.01）,NO水平与服药前相比明显升高（P〈0.05）,治疗4周后对照组Hcy及NO水平亦有变化,但差异无统计学意义（P〉0.05）。结论：冠心病患者Hcy水平升高,NO水平降低,口服叶酸、维生素B12可明显降低冠心病患者高Hcy血症者的血浆Hcy水平,改善冠心病患者内皮功能。     

同型半胱氨酸与老年性痴呆的相关性研究

目的：探讨同型半胱氨酸（Hcy）与老年性痴呆（AD）的关系。方法：利用FPLA方法测定51例AD患者、53例血管性痴呆患者（VD）和50例健康老年人（HOP）血清的Hcy水平。并通过给予叶酸、维生素B12治疗，观察降低Hcy对AD病情的影响。结果：AD、VD组Hcy水平明显高于HOP组（P〈0．01）。AD组用叶酸、维生素B12干预半年后，Hcy明显下降（P〈0．001）。结论：AD病人的血清Hcy水平较高，补充叶酸、维生素B12有助于降低Hcy，可能对预防、减少AD发生有一定的帮助。     

缺血性脑卒中与血浆同型半胱氨酸水平关系的临床研究

目的：探讨血浆同型半胱氨酸（Hcy）水平与缺血性脑卒中之间的关系,以及维生素B12和叶酸联合治疗缺血性脑卒中的意义。方法：分别检测缺血性脑卒中患者62例（卒中组）和无心脑血管疾病的中老年消化系统疾病住院患者30例（对照组）血浆Hcy水平;将卒中组62例患者随机分为治疗组和常规组,2组均给予常规治疗,治疗组加用维生素B12和叶酸联合治疗;治疗后再次检测卒中组患者血浆Hcy水平。结果：卒中组患者血浆Hcy水平明显高于对照组（P〈0．01）;维生素B12和叶酸联合治疗后,治疗组患者血浆Hcy水平明显下降（P〈0．01）,而且降低Hcy效果优于常规组（P〈0．01）。结论：血浆Hcy水平与缺血性脑卒中存在相关性;维生素B12和叶酸联合治疗可以降低血浆Hcy水平,对防治缺血性脑卒中有一定意义。     

短暂性脑缺血发作患者血压及血浆Hcy、VitB12变化的临床研究

目的探讨短暂性脑缺血患者血浆同型半胱氨酸、内皮素、一氧化氮、叶酸和维生素B12的变化及临床意义。方法检测60例短暂性脑缺血患者血浆中同型半胱氨酸、内皮素、一氧化氮、叶酸、维生素B12水平,并与同期42例健康体检者进行对照。结果短暂性脑缺血组血浆Hcy、ET显著高于对照组,且差别有显著性（P〈0．01）;NO、FA、VitB12的水平低于对照组（P〈0．01）。短暂性脑缺血患者中高血压患者Hcy高于血压正常患者。结论短暂性脑缺血患者血浆Hcy、ET浓度升高,检测血浆Hcy含量变化对于患者病情观察、预后判断具有重要意义。     

高同型半胱氨酸血症与脑梗死的关系

目的：探讨脑梗死发病和病情程度与高同型半胱氨酸（Hcy）血症及叶酸、维生素B12缺乏的相关性。方法：检测136例急性脑梗死病人和70例对照组Hey及血浆叶酸、维生素B12水平。结果：急性脑梗死组血浆Hey高于对照组（P〈0．01）。轻、中、重型脑梗死组的血浆Hcy表现为逐渐对应升高（P〈0．05）。部分脑梗死合并高Hey血症的患者接受了维生素B12、叶酸治疗后,血浆Hey水平显著下降（P〈0．01）。结论：高Hcy血症与急性脑梗死的发病存在相关性,血浆Hcy水平可以作为急性缺血性脑卒中的检查及诊治观察的实验室指标。     

脑梗死与血浆同型半胱氨酸水平的关系

目的探讨脑梗死患者与其血浆同型半胱氨酸（Hcy）水平的关系。方法测定95例脑梗死患者血浆Hcy、叶酸、维生素B12,并与96例健康对照者相比较。结果脑梗死组的血浆Hcy水平[（19．5±4．8）umol/L]显著高于正常对照组[（11．2±3．8）umol/L,P〈0．01];脑梗死组的血浆叶酸[（4．5±2．0）ug/L]、维生素B12水平[（239±71）ug/L]显著低于正常对照组[分别为（8．9±2．0）ug/L、（387±66）ug/L,P〈0．01]。结论高同型半胱氨酸血症增加了脑梗死的发病危险性。     

高同型半胱氨酸血症与老年颈动脉粥样硬化的关系及干预治疗的研究

目的研究血浆同型半胱氨酸血症（Hcy）与老年颈动脉粥样硬化的关系;探讨老年颈动脉粥样硬化患者给予维生素B12制剂（甲钴胺）和叶酸治疗前后血浆同型半胱氨酸、叶酸和维生素12水平变化及其对预后的影响。方法检测60例老年颈动脉粥样硬化患者和60例我院体检中心的健康老年人血浆同型半胱氨酸、叶酸、维生素12水平。结果老年颈动脉粥样硬化组和正常健康对照组之间血浆Hcy水平有显著差异,病例组高于对照组;干预组与非干预组之间血浆Hcy水平、叶酸和维生素12水平无显著性差异（P〉0.05）,予以补充叶酸和维生素12（甲钴胺）治疗后,干预组血浆Hcy水平明显下降,与非干预组相比有显著性差异（P〈0.05）。结论老年颈动脉粥样硬化患者血浆Hcy水平升高,补充叶酸、维生素B12制剂有助于降低血浆Hcy水平,有利于老年颈动脉粥样硬化患者的转归。     

临床用药治疗脑梗死患者的疗效分析

目的探讨牛磺酸对伴有高同型半胱氨酸（Hhcy）血症的脑梗死患者的治疗作用。方法100例Hhcy脑梗死患者随机分为牛磺酸治疗组和叶酸＋维生素治疗组，给予相应的药物治疗8周。结果治疗后两组血浆Hcy水平较治疗前显著下降（均P〈0．01），但两组间差异无统计学意义；治疗后两组NIHSS及BI评分较治疗前显著改善（均P〈0．01），但两组间差异无统计学意义。结论牛磺酸治疗对Hhcy脑梗死患者的疗效与叶酸、维生素B12相同。     

高同型半胱氨酸血症与老年缺血性脑卒中的关系及干预治疗的研究

目的研究血浆同型半胱氨酸血症（Hcy）与老年人缺血性脑卒中的关系;探讨老年缺血性脑卒中患者给予维生素B12制剂（甲钴胺）和叶酸治疗前后血浆同型半胱氨酸、叶酸和维生素B12水平变化及其对预后的影响。方法检测60例老年缺血性脑卒中患者和60例我院体检中心的健康老年人血浆同型半胱氨酸、叶酸、维生素B12水平;将老年缺血性脑卒中随机分为干预组和非干预组,干预组给予甲钴胺联合叶酸治疗,治疗4周后复测血浆同型半胱氨酸、叶酸和维生素B12水平。结果老年缺血性脑卒中和正常健康对照组之间血浆Hcy水平有显著差异,病例组高于对照组;干预组与非干预组之间血浆Hcy水平、叶酸和B12水平无显著性差异（P〉0.05）,予以补充叶酸和甲钴胺治疗后,干预组血浆Hcy水平明显下降,与非干预组相比有显著性差异（P〈0.05）。结论高同型半胱氨酸血症是缺血性脑卒中的一个独立危险因素;老年缺血性脑卒中患者血浆Hcy水平升高,补充叶酸、B12制剂有助于降低血浆Hcy水平,有利于老年缺血性脑卒中转归。     

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.