MDT模式的营养干预对妊娠期糖尿病糖脂代谢、妊娠结局及新生儿免疫功能的影响

目的探讨基于多学科团队协作(MDT)模式的营养干预对妊娠期糖尿病(GDM)孕妇糖脂代谢、妊娠结局及新生儿免疫功能的影响。方法选取规范产检并分娩的GDM孕妇150例,采用随机数字表法将其分为对照组及观察组,每组各75例。对照组给予常规营养干预,观察组给予基于MDT模式的营养干预。对比两组GDM孕妇糖脂代谢指标、妊娠结局及新生儿免疫功能。结果观察组孕妇干预后空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)、稳态模型-胰岛素抵抗指数(HOMA-IR)及甘油三酯(TG)低于对照组(P＜0.05);观察组孕妇顺产率高于对照组(P＜0.05);观察组孕妇剖宫产率、妊娠期高血压、新生儿低血糖、巨大儿发生率低于对照组(P＜0.05);观察组新生儿外周血免疫球蛋白G(IgG)水平高于对照组(P＜0.05);观察组新生儿CD3⁺、CD4⁺、CD8⁺及CD4⁺/CD8⁺低于对照组(P＜0.05)。结论基于MDT模式的营养干预可有效调控GDM孕妇糖脂代谢,提升新生儿免疫功能,改善妊娠结局。     

中西医结合治疗对Graves病患者外周血T、B淋巴细胞亚群的影响

目的：研究中西医结合治疗对Graves病患者外周血T、B淋巴细胞亚群及部分协同刺激分子表达的影响。方法：运用流式细胞术测定20例Graves病初发患者、11例他巴唑治疗患者（西药组）、16例他巴唑合用中药五岳抗甲丸治疗患者（中西医结合组）及16例正常对照外周血淋巴细胞CD19、CD40、CD80、CD3、CD4、CD8、CD28等分子的表达水平。结果：Graves病初发患者CD19⁺、CD40⁺、CD19⁺ CD40⁺、CD80⁺细胞比率高于正常对照组(P＜0.01或P＜0.05),CD3⁺CD8⁺细胞比率降低(P＜0.05),CD3⁺CD4⁺/CD3⁺CD8⁺比值高于正常对照(P＜0.05);西药组患者CD80+细胞恢复正常,CD3⁺CD4⁺细胞比率及CD3⁺CD4⁺/CD3⁺CD8⁺比值高于正常对照(P＜0.05,P＜0.01),而CD3⁺CD8⁺及CD8⁺CD28⁺细胞比率低于正常对照(P＜0.01,P＜0.05);除CD80+细胞比率高于正常对照外,中西医结合组所测各种分子的表达同正常对照组比较,差异无统计学意义;同西药组比较,中西医结合组CD3⁺CD4⁺细胞降低(P＜0.01),CD3⁺CD8⁺及CD8⁺CD28⁺细胞比率升高(P＜0.01,P＜0.05), CD3⁺CD4⁺/CD3⁺CD8⁺比值降至正常水平(P＜0.01)。结论：Graves病患者体液免疫处于较高水平,存在细胞免疫调节失衡,中西医结合治疗较单纯西药治疗更有利于患者免疫状态的恢复。     

腹型过敏性紫癜发生消化道出血患儿HP感染及免疫反应分析

目的探究腹型过敏性紫癜(AHSP)发生消化道出血患儿幽门螺杆菌(HP)感染情况及免疫功能分析。方法选取AHSP患儿80例,按照是否消化道出血分为出血组(n＝33)和非出血组(n＝47),另选择同期40例健康小儿为健康组,比较3组HP感染情况及HP分型、肠道菌群、炎症细胞因子、免疫球蛋白、T淋巴细胞亚群水平。结果出血组HP阳性率高于非出血组和健康组,且Ⅰ型HP检出率高于Ⅱ型HP(P＜0.05)。出血组和非出血组乳酸杆菌、双歧杆菌水平低于健康组,大肠杆菌水平高于健康组,且出血组较非出血组更为显著(P＜0.05)。出血组和非出血组血清炎症细胞因子水平均高于健康组,且出血组较非出血组更高(P＜0.05)。出血组IgA、IgG、IgM水平低于非出血组和健康组(P＜0.05),非出血组IgA水平低于健康组(P＜0.05)。出血组和非出血组T淋巴细胞亚群CD3⁺、CD4⁺、CD4⁺/CD8⁺低于健康组,CD8⁺高于健康组,且出血组较非出血组更为显著(P＜0.05)。结论AHSP消化道出血的发病与HP感染、免疫功能紊乱有关,通过HP及免疫指标检测有助于AHSP并发消化道出血的预防和治疗。     

非小细胞肺癌患者外周血CD8+CD39+T细胞水平及临床意义

目的探讨非小细胞肺癌(NSCLC)患者外周血CD8⁺CD39⁺T细胞水平及临床意义。方法选取60例NSCLC患者为NSCLC组,60例健康人群为对照组。检测两组外周血CD8⁺CD39⁺T细胞水平,分析NSCLC患者外周血CD8⁺CD39⁺T细胞水平与其临床特征和预后的关系。结果NSCLC组外周血CD8⁺CD39⁺T细胞水平显著高于对照组(P＜0.05)。肿瘤直径＞3 cm、低分化、TNMⅢ期的NSCLC患者外周血CD8⁺CD39⁺T细胞水平高于肿瘤直径≤3 cm、中高分化、TNMⅠ~Ⅱ期的患者(P＜0.05)。CD8⁺CD39⁺T细胞高水平组术后1年肿瘤无进展生存率及无进展生存期均低于低水平组(P＜0.05)。TNM分期、外周血CD8⁺CD39⁺T细胞水平是NSCLC患者预后的影响因素(P＜0.05)。结论CD8⁺CD39⁺T细胞在NSCLC患者外周血中呈高水平,且与临床病理特征及预后关系密切,可作为患者病情和预后的评估指标。     

退变腰椎间盘髓核组织HMGB2、LEF-1、Col Ⅱ的表达及相关性

目的探讨肠道病毒分型和T淋巴细胞亚群与手足口病(HFMD)病情程度的关系。 方法分析HFMD患儿92例(HFMD组)及健康儿童40例(对照组)的临床资料,HFMD组按照病情程度分为重症组和轻症组。探讨HFMD患儿肠道病毒分型和T淋巴细胞亚群与HFMD病情程度的关系。 结果HFMD患儿肠道病毒感染以单一感染为主,其中柯萨奇病毒A16(CA16)和CA6构成比较高;重症组与轻症组病毒分型情况比较差异无显著性(P＞0.05)。CD3⁺、CD4⁺、CD8⁺及CD4⁺/CD8⁺水平HFMD组低于对照组,重症组低于轻症组(P＜0.05)。 结论HFMD患儿T淋巴细胞亚群检测分析有助于其临床诊断和病情判断。     

多模式眼底影像联合房水细胞因子检测对糖尿病视网膜病变患者黄斑水肿严重程度的诊断价值

目的观察经肛括约肌间切开术(TROPIS)联合改良Hanley术治疗高位经括约肌肛瘘的临床疗效。 方法将本院收治的高位经括约肌肛瘘患者100例均分为观察组(TROPIS联合改良Hanley术治疗)和对照组(传统切开挂线术治疗)。记录两组肛门疼痛、渗出和肿胀评分,比较两组肛肠动力学指标、创面愈合时间、便血时间、脓腐脱落时间、创面瘢痕面积、血清炎症因子和免疫功能水平。 结果两组术后7天肛门疼痛、渗出和肿胀评分较术后1天降低,且观察组均低于对照组(P＜0.05)；两组术后直肠静息压、肛管静息压水平较术前降低,观察组高于对照组(P＜0.05)；观察组术后创面愈合时间、便血时间、脓腐脱落时间、创面瘢痕面积均低于对照组(P＜0.05)；两组术后TNF-α、IL-6、IL-8和CRP水平较术前升高,且观察组低于对照组(P＜0.05)；观察组术后CD3⁺、CD4⁺、CD4⁺/CD8⁺比值和NK细胞水平高于对照组(P＜0.05)。 结论TROPIS联合改良Hanley术,创伤更小,可减轻炎症反应,有利于机体免疫功能的恢复。     

过敏性紫癜患儿外周血miR-223 NLRP3表达及临床意义

目的 探讨核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、miR-223在过敏性紫癜(HSP)患儿外周血中的水平变化及临床意义,并分析二者相关性。方法 选取2019年7月至2020年5月恩施土家族苗族自治州中心医院收治的HSP患儿60例为HSP组,选取同期来本院体检且与患者一般资料匹配的健康体检儿童60例为对照组。收集研究对象一般资料,比较分析两组对象淋巴细胞亚群(CD3⁺、CD4⁺、CD4⁺/CD8⁺)和免疫球蛋白(IgA、IgG、IgM)水平;采用实时荧光定量PCR(qRT-PCR)法检测外周血miR-223水平,酶联免疫(ELISA)法检测NLRP3水平;Pearson法分析NLRP3与miR-223表达的相关性及NLRP3、miR-223与淋巴细胞亚群和免疫球蛋白水平的相关性;受试者工作特征(ROC)曲线评价血清NLRP3和miR-223水平对HSP发生的诊断价值。结果 与对照组比较,HSP组患儿外周血NLRP3表达水平明显上调,miR-223表达水平下调,差异均具有统计学意义(P＜0.05),HSP组患儿IgA、IgG、IgM、CD8⁺水平均高于对照组,CD4⁺、CD4⁺/CD8⁺均低于对照组,差异均有统计学意义(P＜0.05)。miR-223与IgA、IgG、IgM、CD8⁺水平呈负相关(r=-0.451、-0.355、-0.274、-0.581,P＜0.05),与CD4⁺、CD4⁺/CD8⁺水平呈正相关(r=0.712、0.461,P＜0.05);而NLRP3与CD4⁺、CD4⁺/CD8⁺呈正相关(r=0.553、0.348、0.294、0.456,P＜0.05),与IgA、IgG、IgM、CD8⁺呈负相关(r=-0.484、-0.354,P＜0.05);HSP患儿外周血中NLRP3和miR-223呈负相关(r=-0.340,P＜0.05);ROC结果显示,血清miR-223、NLRP3水平预测HSP患儿的曲线下面积(AUC)分别为0.974(95%CI:0.928~0.995)、0.956(95%CI:0.902~0.985),对应的敏感度分别为98.33%、83.33%,特异度分别为88.33%、96.67%,二者联合预测HSP患儿的AUC为0.987(95%CI:0.947~0.999),敏感度为98.33%,特异度为90.00%。结论 NLRP3在HSP患儿外周血中呈高表达,miR-223低表达,二者呈负相关,且二者联合检测有助于诊断HSP。     

TROPIS联合改良Hanley术治疗高位经括约肌肛瘘的临床疗效

目的观察经肛括约肌间切开术(TROPIS)联合改良Hanley术治疗高位经括约肌肛瘘的临床疗效。 方法将本院收治的高位经括约肌肛瘘患者100例均分为观察组(TROPIS联合改良Hanley术治疗)和对照组(传统切开挂线术治疗)。记录两组肛门疼痛、渗出和肿胀评分,比较两组肛肠动力学指标、创面愈合时间、便血时间、脓腐脱落时间、创面瘢痕面积、血清炎症因子和免疫功能水平。 结果两组术后7天肛门疼痛、渗出和肿胀评分较术后1天降低,且观察组均低于对照组(P＜0.05)；两组术后直肠静息压、肛管静息压水平较术前降低,观察组高于对照组(P＜0.05)；观察组术后创面愈合时间、便血时间、脓腐脱落时间、创面瘢痕面积均低于对照组(P＜0.05)；两组术后TNF-α、IL-6、IL-8和CRP水平较术前升高,且观察组低于对照组(P＜0.05)；观察组术后CD3⁺、CD4⁺、CD4⁺/CD8⁺比值和NK细胞水平高于对照组(P＜0.05)。 结论TROPIS联合改良Hanley术,创伤更小,可减轻炎症反应,有利于机体免疫功能的恢复。     

麻黄杏仁甘草石膏汤治疗急性脑梗死并发肺部感染的临床疗效观察

[目的] 探讨麻黄杏仁甘草石膏汤联合西药治疗急性脑梗死（ACI）并发肺部感染的疗效以及对血清可溶性髓样细胞触发受体1（sTREM-1）、可溶性血红蛋白道夫受体（sCD163）的影响。方法 选择2020年3月至2023年3月河北省沧州中西医结合医院收治的142例ACI并发肺部感染患者,随机数字表法将患者分为两组,每组各71例。对照组采用西药治疗,观察组采用麻黄杏仁甘草石膏汤联合西药治疗。比较两组疗效和不良反应,咳嗽消失时间、病灶吸收时间、啰音消失时间、中医症候积分、肺功能、临床肺部感染评分（CPIS）、外周血CD3⁺T细胞、CD4⁺ T细胞、CD8⁺ T细胞以及血清sTREM-1、sCD163水平。结果 观察组治疗总有效率高于对照组（P＜0.05）,观察组咳嗽消失时间、病灶吸收时间、啰音消失时间短于对照组（P＜0.05）。两组治疗后中医症候积分、CPIS评分,血清sTREM-1、sCD163水平以及外周血CD8⁺ T细胞较治疗前降低（P＜0.05）,FVC、FEV1、FEV1/FVC,外周血CD3⁺ T细胞、CD4⁺ T细胞较治疗前增高（P＜0.05）。观察组治疗后中医症候积分、CPIS评分,血清sTREM-1、sCD163水平以及外周血CD8⁺ T细胞低于对照组（P＜0.05）,FVC、FEV1、FEV1/FVC,外周血CD3⁺ T细胞、CD4⁺ T细胞高于对照组（P＜0.05）。观察组不良反应发生率低于对照组（P＜0.05）。结论 麻黄杏仁甘草石膏汤联合西药治疗ACI并发肺部感染能显著改善临床症状和肺功能,降低血清sTREM-1、sCD163水平,提高免疫功能和临床疗效。     

肺炎支原体肺炎患儿血清microRNA-21和microRNA-221水平变化及与炎症因子、T淋巴细胞亚群的相关性

目的 探讨肺炎支原体肺炎（MPP）患儿血清microRNA-21（miR-21）和microRNA-221（miR-221）的水平变化及与炎症因子、T淋巴细胞亚群的关系。方法 选取2017年1月—2019年1月邯郸市中心医院就诊的MPP患儿120例为研究对象（MPP组），另选取本院同期体检的健康儿童100例为对照组（CON组）。比较两组研究对象血清miR-21和miR-221的水平差异，并分析二者与患儿外周血中炎症因子［白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）］和T淋巴细胞亚群（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）之间的相关性。结果 MPP组血清miR-21和miR-221水平高于CON组（P <0.05）。MPP组外周血CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺低于CON组，而IL-6、IL-8、TNF-α的水平高于CON组（均P <0.05）。MPP组血清miR-21和miR-221与患者外周血CD3⁺（r =-0.494和-0.656，P =0.037和0.014）、CD4⁺（r =-0.621和-0.554，P =0.015和0.031）、CD8⁺（r =-0.772和-0.476，P =0.003和0.043）、CD4⁺/CD8⁺（r =-0.545和-0.660，P =0.023和0.014）均呈负相关，而与TNF-α（r =0.787和0.619，P =0.000和0.015）、IL-6（r =0.530和0.598，P =0.035和0.029）、IL-8（r =0.665和0.614，P =0.012和0.017）均呈正相关。结论 MPP患儿血清miR-21和miR-221水平升高，且与患儿T淋巴细胞亚群水平的降低、炎症因子水平的升高有一定的相关性，监测两者的水平变化有助于评估MPP患儿的免疫状态和炎症反应，并为合理制订治疗方案提供帮助。     

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.