急性心肌梗塞急性期与恢复期QT离散度的对比分析

目的分析急性心肌梗塞（ＡＭＩ）急性期和恢复期的心电图 ＱＴ离散度（ＱＴｄ）改变。方法对 １００例ＡＭＩ急性期及其中６０例的恢复期心电图 ＱＴ离散度（ＱＴｄ）进行测定。结果 ＡＭＩ急性期的心电图 ＱＴｄ和 ＱＴｃｄ均值均显著高于恢复期,分别为ＱＴｄ５０．４０±２０．２５ｍｓ和２４．８３±１２．６９ｍｓ,ＱＴｃｄ５７．４８±２５．１４ｍｓ和２７．３１±１３．８４ｍｓ。结论ＱＴ离散度在ＡＭＩ早期显著增大,在ＡＭＩ急性期监测ＱＴ离散度的动态变化有一定临床意义。     

QT离散度与冠心病心律失常

目的：了解冠心病ＱＴ离散度（ＱＴｄ）和心率校正ＱＴ离散度（ＱＴｃｄ）变化与恶性心律失常的关系。方法：选择冠心病５５例心律失常和４５例无心律失常患者,与３０例健康者的ＱＴｄ及ＱＴｃｄ进行对比分析。结果：冠心病心律失常ＱＴｄ（７２±１８ｍｓ）和ＱＴｃｄ（８１±１４ｍｓ）较冠心病无心律失常（５０±１６ｍｓ、５６±１５ｍｓ）及健康者（４３±１４ｍｓ、４９±２０ｍｓ）显著增加,Ｐ＜０．０１。结论：体表心电图ＱＴｄ和ＱＴｃｄ增加可作为区分冠心病高危人群、预测心律失常有价值的临床指标之一。     

健康成人QT离散度的正常值探讨

目的：了解国人 ＱＴ 离散度正常值;方法：测量了 ６５６例 １８～ ７０岁健康成人常规体表心电图的 ＱＴｄ值。结果：（１）ＱＴ、ＱＴｄ、ＱＴｃ、ＱＴｃｄ值分别为３６７．０３±３０．９５ ｍｓ、３９６．９０±１９．０３ ｍｓ、２３．７７ ± １１．２４ ｍｓ、２４．１０±１２．９２ ｍｓ,ＱＴｄ范围在０～５０ ｍｓ;（２）３个年龄组（１８～３５、３６～５５、５６～７０）ＱＴｄ、ＱＴｃｄ无显著性差异（Ｐ＞０．０５）;（３）ＱＴ、ＱＴｃ女性比男性长（Ｐ＜０．０５和 Ｐ＜０．０１）,ＱＴｄ、ＱＴｃｄ值不同性别无显著差异（Ｐ＜０．０５）。结论：认为 ＱＴｄ正常值可定为＜５０ ｍｓ。     

QT间期离散度与心肌梗塞预后的关系

目的探讨ＣＴ间期离散度对急性心肌梗塞近期预后的预测价值．方法计算方法：每导联均测ＱＴ间期３～５个．取均值．则ＱＴ间期离散度（ＱＴｄ）＝ＱＴｍａｘ－ＱＴｍｉｎ，用心率校正后的ＱＴ间期（ＱＴｃ）的离散度（ＱＴｃｄ）＝ＱＴｃｍａｘ－ＱＴｃｍｉｎ．结果急性心肌梗塞组与对照组ＱＴｃ、ＱＴｄ．ＱＴｃｄ值比较有显著差异（Ｐ＜０．００１）．梗塞组有无恶性心律失常及猝死者ＱＴｃ、ＱＴｄ、ＱＴｅｄ对比有显著差异（Ｐ＜０．０１）．当ＱＴＣ≥４４０ｍｓ，ＱＴｄ、ＱＴＣｄ≥６０ｍｓ时发生恶性心律失常及猝死的诊断正确指数ＱＴｃｄ与ＱＴＣ、ＱＴｄ比较有明显差异（Ｐ＜０．０５）．但ＱＴｄ与ＱＴＣ比较无明显差异（Ｐ＞０．０５）．结论ＱＴ离散度能更好反映心室复极过程，尤其是用心率校正后的ＱＴ离散度，对判断急性心肌梗塞近期预后具有重要指导价值．     

QT离散度对酷似心肌梗塞的重症病毒性心肌炎的早期诊断价值

探讨ＱＴ离散度（ＱＴｄ）对急性期心电图酷似心肌梗塞的重症病毒性心肌炎的早期诊断价值。方法：测量７例急性期心电图酷似心肌梗塞的重症病毒性心肌炎患者及３０例急性心肌梗塞（ＡＭＩ）患者,正常对照组的ＱＴ间期,计算其ＱＴｄ及校正后的ＱＴｄ（ＱＴｃｄ）。结果：ＡＭＩ组的ＱＴｄ及ＱＴｃｄ分别为７３．５±１７．７及８５．８±１９．８ｍｓ,急性期心电图酷似心肌梗塞的重症病毒性心肌炎组的ＱＴｄ及ＱＴｃｄ分别为４２．５±１２．４及５４．３±１４．２ｍｓ,两组有显著差异（Ｐ＜０．０１）。结论：ＱＴｄ对急性期心电图酷似心肌梗塞的重症病毒性心肌炎有早期诊断价值。     

QT离散度正常值和性别差异研究

报告５０４例健康成人同步１２导心电图ＱＴ离散度的分析结果。（１）各参数的测量结果（ｘ±ｓ）：ＱＴｄ、矫正的ＱＴｄ（ＱＴｃｄ）、ＱＲＳ离散工（ＱＲＳｄ）、ＱＴ顶点的离散度（ＱＴｐｄ）、ＱＲＳ起始早晚的离散度（ＯＱＴｄ）分别为：男性：４８±１３、５１±１４、３０±１１、４３±１６、１８±６（ｍｓ）；女性：４２±１２、４７±１４、２８±１０、３９±１７、１６±６（ｍｓ）。（２）性别差异；男性各参数离散度     

器质性心脏病患者室速室颤与QT离散度关系探讨

３４例器质性心脏病患者ＱＴ离散度（ＱＴｄ）、ＱＴｃ离散度（ＱＴｃｄ）测定结果说明，室速室颤组与非室速室颤组ＱＴｄ分别为７０±１４．１４ｍｓ与４５０±９．７８ｍｓ，ＱＴｃｄ分别为９１±３１．０７ｍｓ与４９．１７±１７．６７ｍｓ，两组差异极显著（Ｐ＜０．００１）．ＱＴｄ、ＱＴｏｄ＜６０ｍｓ者１８例均无室速室颤发生，６０～１００ｍｓ者１３例中７例发生了室速室颤，＞１００ｍｓ者３例均发生室速室颤，结果提示，器质性心脏病患者室速室回的发生与ＱＴｄ、ＱＴｃｄ明显增加有关。     

冠心病心肌缺血程度与QT间期离散度变化及药物干预

目的：为探讨冠心病患者心肌缺血程度与ＱＴ间期离散度（ＱＴｄ）的变化以及药物干预 对ＱＴｄ的影响。方法：通过观察３９例冠心病患者予硝酸异山梨酯治疗前后心电图的ＱＴｄ及校正后的ＱＴ间期离散度的改变。结果：测量ＱＴｄ与ＱＴｃｄ治疗前分别为（０．０５４４±０．０１９５）ｓ和（０．０６４３±０．０２４４）ｓ,治疗后分别为（０．０２５４±０．０１３７）ｓ和（０．０２８８±０．０１６０）ｓ。结论：表明心肌缺血程     

心电图QTc间期及其离散度的观测

应用１２导联同步描记的心电图，对１６０例健康成人，测量了同一心动周期的ＱＴｃ、ＱＴｄ、ＱＴｃｄ。旨在研究健康成人的参数正常值，为临床应用提供参照。结果为：ＱＴｃ３８１±１８．９（３３０～４１５）ｍｓ；ＱＴｄ２５．８±１１．８（５～４６）ｍｓ；ＱＴｃｄ２７．１±１２．７（２～５０）ｍｓ。各参数性别间未见统计学差异。     

运动对缺血性心脏病QT离散度的影响

目的观察运动对缺血性心脏病ＱＴ离散度的影响。方法记录标准１２导联ＥＣＧ，分析平板运动试验前后未校正ＱＴ离散度（ＱＴｄ）和心率校正ＱＴ离散度（ＱＴｃｄ）。结果运动试验阴性组（ｎ＝２２）运动试验前后ＱＴ离散度无显著性差异（ＱＴｄ：２７．５±９．８ｍｓ对２９．１±７．５ｍｓ，Ｐ＞０．０５；ＱＴｃｄ：３２．７±９．４ｍｓ对３７．９±１０．８ｍｓ，Ｐ＞０．０５），而运动试验阳性组（ｎ＝２１）运动试验前后ＱＴ离散度存在显著性差异（ＱＴｄ：３０．９±１０．４ｍｓ对４３．５±１０．９ｍｓ，Ｐ＜０．００５；ＱＴｃｄ：３４．７±１２．２ｍｓ对５９．９±１５．０ｍｓ，Ｐ＜０．００１）。结论运动诱发的ＱＴ离散度增加可以作为心肌缺血的心电标志     

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.