泌尿生殖道支原体检测及耐药性分析

目的 了解在相关门诊就诊者解脲脲原体（Uu）和人型支原体（Mh）感染及耐药情况，以指导临床诊断和合理用药。方法应用珠海丽珠公司试剂盒进行支原体培养及药敏试验。结果 320例就诊者中支原体培养阳性145例，阳性率45．3％，其中检出Uu109例，阳性率为34．1％（109／320），高于Mh（6例，1．87％）和Uu与Mh混合感染（30例，9．38％）；Uu药敏结果显示，敏感率较高的药物为强力霉素、美满霉素、交沙霉素和克拉霉素，其次为阿齐霉素、左氟沙星。结论 泌尿生殖道支原体感染主要是Uu，明显高于Mh、Uu和Mh混合感染，Uu对强力霉素、交沙霉素和美满霉素的耐药率最低，对氧氟沙星的耐药率最高。     

海口地区泌尿生殖道支原体感染的耐药趋势

目的了解海口地区泌尿生殖道解脲脲原体（uu）和人型支原体（Mh）的感染情况及其在体外对抗菌药物的耐药趋势。方法采用“支原体分离鉴定计数药敏”试剂盒对临床标本作支原体培养，并对检出的628株支原体作药敏试验进行分析。结果检出628株支原体中Uu471株占75．0％，Mh50株占8．0％，Uu合并Mh阳性107例占17．0％。对美满霉素、强力霉素耐药性最低，耐药率分别为15．1％和17．2％；对罗红霉素和阿奇霉素的耐药率最高分别为51．8％和50．3％。结论支原体感染已成为非淋菌性尿道炎的主要病原菌并有多重耐药株的出现，美满霉素和强力霉素可作为治疗的首选药物。     

男性泌尿道支原体感染与药物耐药性分析

目的：观察男性尿道炎患者支原体（解脲支原体Uu和人型支原体Mh）的阳性率及耐药性，指导临床用药。方法：从男性科门诊患有尿道炎的病人中选择64例仅有支原体感染的病例取材并做体外药物耐药性分析。结果：64例感染菌株Uu阳性52例（81．25％），Mh阳性7例（10．94％）、两者混合感染5例（7．81％）。耐药明显的是氧氟沙星（OFL）、司帕沙星（SPA）、左氧氟沙星（LEV）；阿奇霉素（AZI）、交沙霉素（JOS）、罗红霉素ROX）耐药和中介各占50％；克拉霉素（CLA）高敏和中介几乎各占50％；多西环素（DOX）、美满霉素（MIN）耐药最少。结论：在没有条件进行药敏的情况下多西环素、美满霉素、克拉霉素应作为本地区治疗男性非淋菌性尿道炎、前列腺炎、副睾炎的首选药物。     

妇女泌尿生殖道支原体检测和耐药性分析

目的了解妇女泌尿生殖道支原体的感染及耐药情况．为临床提供用药参考。方法采用一体化试剂盒,对疑似非淋菌性尿道炎（NGU）女性患者宫颈分泌物进行支原体培养、鉴定及药敏试验。结果441例疑似非淋菌性尿道炎患者中,支原体培养阳性率为35．8％（158例）。其中主要为解脲支原体（Uu）感染,占感染者的81．0％;人型支原体（Mh）阳性率为5．1％;Uu和Mh混合感染阳性率为13．9％。药敏试验显示支原体主要对美满霉素（82．2％）、强力霉素（80．4％）等抗生素敏感,对环丙沙星（50．3％）、螺旋霉素（48．6％）、氧氟沙星（42．7％）等抗生素耐药。结论NGU女性患者支原体感染主要为解脲支原体,对环丙沙星、螺旋霉素、氧氟沙星等抗生素耐药性较高,而对美满霉素、强力霉素等抗生素较敏感,并提示该类抗生素可作为治疗NGU支原体感染的首选药物。     

泌尿生殖道支原体感染及耐药性监测分析

目的 了解江门地区泌尿生殖道支原体感染情况及其耐药性。方法 对4935例泌尿生殖道感染患者进行解脲脲原体（Uu）和人型支原体（Mh）培养鉴定，并对阳性标本作12种抗生素药敏试验。结果 共检出支原体阳性1672例，总阳性率为33．88％。其中Uu1514例、Mh47例、Uu合并Mh 111例，阳性检出率分别为30．68％、0．95％、2．25％；男性组Uu、Mh、Uu合并Mh的阳性检出率分别为12．47％、0．97％、1．01％，女性组Uu、Mh、Uu合并Mh的阳性检出率分别为46．28％、0．95％、3．3l％。支原体对司巴沙星、阿岐霉素的耐药率较高，分别为33．2％和52．3％、而对美满霉素、强力霉素耐药率较低，分别为6．1％和7，6％。结论 江门地区支原体感染以Uu为主，女性组Uu及Uu合并Mh的检出率高于男性组，支原体对美满霉素和强力霉素较为敏感。     

1535例女性生殖道解脲脲原体和人型支原体的药敏分析

目的探讨女性生殖道解脲脲原体（Uu）和人型支原体（Mh）感染及耐药情况。方法采用解脲脲原体和人型支原体培养、分离鉴定、计数、药敏试剂盒,对我院妇科门诊疑似非淋菌性尿道炎（NGU）女性患者,进行支原体培养、鉴定及药敏试验。结果3926例疑似非淋球菌性尿道炎患者中,总的支原体检出率为43．8％,其中解脲脲原体检出率为38．1％,人型支原体检出率为1％,混合感染率为4．2％。药敏结果表明解脲脲原体对强力霉素、美满霉素最为敏感,敏感率分别为89％、85.3％;而耐药率最高的分别为壮观霉素（89．5％）、罗红霉素（67．9％）。对于人型支原体,敏感性高的药物分别是美满霉素（79、5％）、强力霉素（71．8％）;而耐药性最高的药物分别是罗红霉素（87．2％）、阿齐霉素（84．6％）。结论解脲脲原体在女性NGU疑似病人中感染率较高,强力霉素、美满霉素可作为首选药物对患者进行治疗。     

解脲脲原体与人型支原体感染检测的临床意义

①目的探讨泌尿生殖道支原体感染现状及对抗茵药物的敏感性,以期对临床合理用药提供依据。②方法应用支原体试剂盒对标本进行培养和药敏试验。③结果2119例标本中检出311例阳性,总检出率14．7％,其中男性检出率11．6％,女性检出率17．8％。解脲脲原体（uu）、人型支原体（Mh）混合型（uu＋Mh）检出率分别为83．O％、1．3％、15．8％。Uu对抗茵药物敏感率≥80％的有强力霉索、美满霉素、交沙霉素、克拉霉素;Mh对强力霉素、美满霉素、交沙霉素100％敏感;Uu＋Mh对抗茵药物敏感率〉80％的有强力霉素、美满霉素、交沙霉素。④结论支原体感染中,以Uu感染为主,女性高于男性;感染可选用克拉霉素、交沙霉素、强力霉素、美满霉素,不宜选用氧氟沙星、左旋氧氟沙星。     

男性非淋菌性尿道炎者支原体感染及耐药性分析

目的了解男性泌尿生殖道非淋菌性尿道炎者（NGU）支原体感染及其对抗菌药物的耐药性状况，指导临床合理使用抗菌药物。方法采用珠海丽珠试剂厂生产的支原体试剂盒进行支原体培养鉴定、计数和药敏试验，进行统计分析。结果从638份男性泌尿生殖道NGU标本中共检出253株支原体，阳性率39．7％，其中解脲脲原体（uu）205株，占81．0％，人型支原体（Mh）8株，占3．2％，UU合并Mh阳性40株（份），占15．8％。检出支原体对美满霉素、强力霉素耐药率最低，均为10．8％，对氧氟沙星、罗红霉素和阿奇霉素的耐药率最高，分别为53．0％、52．6％和50．6％。结论支原体已成为男性NGU的主要病原体并以Uu为主，已有多重耐药株的出现，美满霉素和强力霉素可作为治疗的首选药物。     

非淋菌性尿道炎支原体检测与耐药性分析

目的调查湖南长沙地区来长沙第四医院就诊的男女性非淋菌性尿道炎（NGU）患者支原体感染情况、抗生素的耐药率、流行趋势及年龄分布情况。方法采用珠海丽珠试剂有限公司解脲脲原体（Uu）、人型支原体（Mh）分离鉴定、计数、药敏试剂盒对1160例本地男女性尿道炎患者进行Uu和Mh检测及药敏试验，然后进行统计学分析。结果1160例泌尿生殖道感染患者，支原体培养阳性370例，总阳性率31．9％；其中Uu单独阳性282例（76．2％）；Mh单独阳性12例（3．2％）；Uu、Mh混合感染76例（20．6％）：女性阳性率34．9％；男性阳性率23．3％；女性感染阳性率显著高于男性p〈0．01（x^2=13．700）；年龄分布显示90％以上的患者在20—40岁范围内；且Uu和（或）Mh每年感染增长幅度有逐年下降的趋势；药敏试验结果显示单独Uu感染的临床治疗宜首选强力霉素；单独Mh感染首选交沙霉素；而Uu和Mh混合感染则首选克拉霉素。结论泌尿生殖道感染主要以Uu为主，单独Uu和Mh感染以及二者混合感染的耐药性存在差异，治疗两种支原体单独感染分别以强力霉素和交沙霉素为首选。     

558例泌尿生殖道标本支原体检测结果及对12种药敏分析

目的 了解泌尿生殖道支原体的感染现状，以及对12种不同药物的体外敏感性进行分析，为临床合理用药提供依据。方法 应用珠海黑马生物工程有限公司支原体分离、鉴定、计数药敏试剂盒进行体外检测。结果 558例患者中213例培养出支原体，占38．17％：其中男性为80例（阳性率为23．88％）；女性为133例（阳性率为59．64％）；女性明显高于男性（P〈0．005）。在检出的支原体中有3种阳性结果：解脲脲原体（uu）单项阳性163例（男性70例，女性93例，占76．52％）；人型支原体（Mh）单项阳性4例（男性2例，女性2例，占1．88％）和Uu、Mh混合感染46例（男性8例，女性38例，占21．60％），其中Uu单项阳性明显高于Mh单项阳性（P〈0．005）；并且在Uu、Mh混合感染中明显以女性为主，有明显差异（P〈0．005）。12种药物敏感性依次为：交沙霉素98．12％、美满霉素90．14％、强力霉素88．26％、四环素82．63％、克拉霉素73．71％、司帕沙星41．32％、左氟沙星29．58％、罗红霉素19．72％、阿齐霉素18．31％、氧氟沙星6．57％、红霉素5．16％、洛美沙星0．00％。结论 临床在治疗非淋菌性生殖道疾病时，应首先做支原体培养（包括Uu和Mh），然后根据药敏结果进行药物选择，实施足剂量和足疗程用药，对降低耐药株的产生、防止复发和提高治愈率将起到重要作用；在经验治疗支原体引起的泌尿生殖道感染时，可将交沙霉素、美满霉素、强力霉素及四环素等作为首选药物。     

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.