糖尿病周围神经病变患者血浆纤维蛋白原水平 与神经传导速度的相关性

目的 探讨糖尿病周围神经病变（DPN）患者血浆纤维蛋白原（FIB）水平与神经传导速度的相关性, 并分析FIB 的影响因素。方法 选取2 型糖尿病（T2DM）患者252 例,根据是否合并DPN 分为DPN 组（150 例）和单纯T2DM 无并发症组（102 例）,另选取体检健康者100 例作为健康对照组（NC 组）,收集3 组临 床资料,比较纤维蛋白酶（FIB）水平。再根据FIB 水平将DPN 组分为低FIB 水平（FIB ≤ 4 mg/dl）亚组65 例和高FIB 水平（FIB>4 mg/dl）纤维蛋白酶亚组（85 例）,观察两亚组临床资料分布特点,检测神经传导速度。 采用Pearson 单因素相关和多元线性回归分析FIB 的影响因素。结果 ① DPN 组腰围（WC）、收缩压（SBP）、 舒张压（DBP）、空腹血糖（FPG）、餐后2 h 血糖（2 h PG）、空腹胰岛素（Fins）、糖化血红蛋白（HbA1c）、 HOMA-IR、TG、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）及FIB 均高于NC 组和T2DM 组（P < 0.05）;T2DM 组FPG、2 h PG、Fins、HbA1c、胰岛素抵抗指数（HOMA-IR）、TC、HDL-C、FIB 及吸烟 例数均高于NC 组（P <0.05）。② FIB>4 mg/dl 亚组年龄、糖尿病（DM）病程、BMI、FPG、2 hPG、Fins、 HbA1c、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、HOMA-IR 及吸烟例数均高于FIB ≤ 4 mg/dl 亚组 （P <0.05）。③ FIB>4 mg/dl 亚组SCV 和MCV 较FIB ≤ 4 mg/dl 亚组降低（P <0.05）。④ Pearson 相关分析显 示,血浆FIB 水平与年龄、糖尿病（DM）病程、体重指数（BMI）、FPG、HbA1c、TC、TG、LDL-C 及吸 烟呈正相关（P <0.05）。⑤多元线性回归分析显示,BMI、TG、HbA1c 及吸烟为FIB 的影响因素（P <0.05）。 结论 DPN 患者血浆FIB 水平升高,神经传导速度下降,BMI、TG,HbA1c 及吸烟是DPN 患者FIB 的影响因素。     

男性2型糖尿病患者腰身指数与胰岛功能的关系

目的 研究男性2型糖尿病(T2DM)患者腰身指数(WHtR)与胰岛功能的相关性.方法 男性T2DM患者152例,以WHtR 0.5为切点分为非肥胖组和肥胖组,比较两组间的胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-IS)、胰岛素曲线下面积(AUCINS)、血糖曲线下面积(AUCBG)、血压、血脂等的异同.结果 肥胖组较非肥胖组甘油三酯(TG)、VLDL-C、空腹胰岛素(FINS)、ln (AUCINS)、ln (HOMA-IR)和ln(HOMA-IS)升高,空腹血糖(FPG)和HbA1c降低,差异有显著性(P＜0.05);Pearson相关分析显示WHtR与舒张压、TG、VLDL-C、FINS、ln(HOMA-IR)、ln(HOMA-IS)、Ln(AUCINS)正相关,P＜0.01;与病程、HbA1c、FPG、AUCBG,负相关,P＜0.05;多元逐步回归分析显示,Ln(AUCINS)、TG、VLDL-C和FINS是WHtR的独立影响因素(P＜0.01).结论 WHtR有助于初步判断男性T2DM患者的胰岛功能和血脂状态.     

血清铁蛋白检测在2型糖尿病患者中的应用价值

目的 探讨血清铁蛋白(SF)检测在2型糖尿病(T2DM)患者中的应用价值。 方法 选取2013年2月—2015年10月在海口市人民医院内分泌科就诊治疗的T2DM患者(T2DM组)120例,根据糖化血红蛋白(HbA1c)水平分为:疗效良好组(A组)53例和疗效差组(B组)67例,同时选取正常健康人员(NC组)60例,测定血清铁(SI)、血清铁蛋白(SF)、转铁蛋白(TRF)、HbA1c、空腹血糖(FPG)、空腹胰岛素(FINS)并计算胰岛素抵抗指数(HOMA-IR)与胰岛β细胞功能(HOMA β-cell),比较T2DM组与NC组、A组与B组上述指标的变化,并分析其相关性。 结果 与NC组比较,T2DM组FPG、HbA1c、FINS、HOMA-IR、SF均升高(P＜0.05),而HOMA β-cell降低(P＜0.05);与A组比较,B组SF及HOMA-IR均升高(P＜0.05),而HOMA β-cell降低(P＜0.05);T2DM患者SF与HbA1c呈正相关(r=0.584,P＜0.05)、与HOMA-IR呈正相关(r=0.451,P＜0.05)、与HOMA β-cell呈负相关(r=-0.468,P＜0.05)。 结论 T2DM患者体内铁代谢紊乱,铁超载可能加重胰岛素抵抗及β细胞的损坏;SF可能是影响其疗效的重要因素,SF高者血糖难控制。      

2型糖尿病患者骨钙素与血糖、血脂关系的研究

目的 通过在不同血糖水平和糖尿病病程人群中进行骨钙素（BGP）、体质量指数（BMI）、空腹血糖（FPG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）、糖化血红蛋白（HbA1C）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）及高密度脂蛋白胆固醇（HDL-C）数值测定,探究在2型糖尿病患者中BGP与血糖、血脂间的相互关系及可能作用机制.方法 采用ELISA法、电化学发光法、高压液相法及全自动生化分析仪等检测BGP与相关实验室参数指标。结果 （1）BGP水平从NGT到IFG再到新诊断T2DM组最后到T2DM病程10年以上组逐渐降低（P＜0.01）.（2）BGP与FPG、HOMA-IR、HbA1C、TG呈负相关（P＜0.01）;BGP与BMI、TC无相关关系（P＞0.05）;BGP与FINS、HDL-C呈正相关,但相关性不显著（P＞0.05）.（3）新诊断T2DM组与T2DM病程10年以上组间BGP、FPG、FINS、HOMA-IR、HbA1C、TG、HDL-C水平均存在显著差异（P＜0.05）,且BGP与FPG、HOMA-IR、HbA1C、TG及病程呈负相关（P＜0.05）,BGP与FINS、HDL-C呈正相关（P＜0.05）。结论 BGP与血糖及血脂关系密切,是糖、脂代谢调节的重要参与因子。     

初诊2型糖尿病患者血清胎球蛋白A 变化及其相关因素分析

目的:观察初诊2型糖尿病(nT2DM)患者血清胎球蛋白A(FA)水平变化,并分析其与血脂、血糖、颈动脉粥样硬化、胰岛素抵抗的相关性。方法:纳入nT2DM患者80例作为实验组,同时纳入糖耐量正常者80例作为对照组,对比两组血脂、空腹血糖(FPG)、2h葡萄糖负荷血糖(2h OGTT)、糖化血红蛋白(HbA1c)、稳态模型胰岛素抵抗指数(HOMA-IR)、稳态模型β细胞胰岛素分泌指数(HOMA-IS)、空腹胰岛素(FINS)、2h葡萄糖负荷胰岛素(PINS)、颈动脉内中膜厚度(CIMT)、FA水平的异同,分析nT2DM患者血清FA与血脂、血糖、CTMI、胰岛素抵抗的相关性。结果:(1)与对照组比较,试验组患者体重指数(BMI)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDLC)、FPG、2h OGTT、HbA1c、HOMA-IR、HOMA-IS、CTMI、FA均明显升高,而高密度脂蛋白(HDLC)、FINS、PINS均明显降低。(2)Pearson相关分析结果显示:血清FA水平与HDLC、HOMA-IS、FINS、PINS均呈明显负相关,而与TG、BMI、LDLC、FPG、2h OGTT、HOMA-IR、HbA1c、CTMI均呈明显正相关。(3)Logistic回归分析显示:TG、BMI、LDLC、FPG、HOMA-IR、HbA1c为FA独立危险因素。结论:nT2DM患者血清FA明显升高,TG、BMI、LDLC、FPG、HOMA-IR、HbA1c为其独立危险因素。     

优泌乐50强化治疗对初诊2型糖尿病胰岛功能及炎症因子的影响

目的探讨优泌乐50强化治疗对初诊2型糖尿病（T2DM）胰岛β细胞功能及高敏C反应蛋白（hs-CRP）的影响。方法 40例新诊断T2DM患者,应用优泌乐50强化治疗2周,分析治疗前后空腹血糖（FPG）、餐后2 h血糖（P2hPG）、空腹胰岛素（FINS）、精氨酸刺激试验后胰岛素增值（△INS）、胰岛素抵抗指数（HOMA-IR）、胰岛素分泌指数（HOMA-IS）以及hs-CRP的变化。结果治疗2周,FPG、P2hPG、HOMA-IR及hs-CRP明显降低（P〈0.05或P〈0.01）,△INS和HOMA-IS明显升高（P〈0.01）。相关分析显示hs-CRP与△INS、HOMA-IS呈负相关,与HOMA-IR呈正相关。结论对显著高血糖初诊T2DM患者应用优泌乐50短期强化治疗可快速降低血糖,控制慢性炎症样反应,有效保护胰岛β细胞功能。     

新诊断2型糖尿病患者血清硫氧还蛋白、硫氧还蛋白相互作用蛋白与颈动脉粥样硬化的相关性

目的  探讨新诊断2型糖尿病（T2DM）患者血清硫氧还蛋白（Trx）、硫氧还蛋白相互作用蛋白（TXNIP）水平与颈动脉粥样硬化（CAS）的相关性。方法  选取2014年2月-2015年11月于河北省唐山市工人医院内分泌科就诊的新诊断T2DM患者160例作为病例组。根据颈动脉超声检查结果将患者分为T2DM伴CAS组（CAS组,n=65例）和T2DM不伴CAS组（NCAS组,n=95例）。同时从医院健康体检中心选取非糖尿病健康人群140例作为正常组。记录其年龄、性别、体重指数（BMI）、收缩压（SBP）、舒张压（DBP）,收集其临床检验结果,包括空腹血糖（FPG）、空腹胰岛素（FINS）、糖化血红蛋白（HbA1C）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、同型半胱氨酸（Hcy）,计算胰岛素抵抗指数（HOMA-IR）。采用酶联免疫吸附法（ELISA）检测血清Trx、TXNIP含量,采用胰岛素还原法检测血清Trx活性。结果  与正常组比较,T2DM患者FPG、HbA1c、HOMA-IR、Trx、TXNIP水平升高,Trx活性下降（均P <0.05）;T2DM患者CAS组较NCAS组年龄较大,FPG、HbA1c、SBP、Trx、TXNIP水平较高,Trx活性下降（均P <0.05）;在T2DM患者中,Trx与HbA1c呈正相关,TXNIP与HbA1c、HOMA-IR呈正相关,Trx活性与TXNIP呈负相关（均P <0.05）;在T2DM患者中,年龄、HbA1c、Trx、TXNIP及Trx活性为合并CAS的影响因素,其中年龄（■=1.134,P =0.032）、HbA1c（■=1.275,P =0.021）、Trx（■=1.532,P =0.015）、TXNIP（■=1.731,P = 0.005）为CAS发生的危险因素,而Trx活性（■=0.507,P =0.002）为CAS发生的保护因素。结论  新诊断T2DM患者血清Trx、TXNIP、Trx活性与其CAS相关,提示Trx系统可能参与了CAS的发生及发展。

     

Liraglutide治疗2型糖尿病的临床效果

目的探讨Liraglutide治疗2型糖尿病(T2DM)的临床效果。方法 28例T2DM患者在应用二甲双胍治疗的基础上给予Liraglutide,治疗16周。观察Liraglutide治疗前后糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2h血糖(2hPG)、空腹血浆胰岛素(FINS)水平、血脂、血压、体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR)及β细胞功能指数(HOMA-IS)的变化及低血糖事件和其他不良事件的发生率。结果 Liraglutide治疗后T2DM患者HbA1c、FPG、2hPG和BMI均较治疗前显著减低,差别有统计学意义(P<0.01);HOMA-IS较治疗前升高,差别有统计学意义(P<0.01)。Liraglutide治疗未出现严重不良反应。结论 Liraglutide治疗T2DM是安全有效的。     

无症状2型糖尿病周围神经病变患者监测血清NO和AGEs的临床意义

目的：研究一氧化氮（NO）、晚期糖基化产物（AGEs）监测对无症状2型糖尿病（T2DM）周围神经 病变（DPN）的临床意义。方法：选取2015年12月至2018年12月间浙江中医药大学附属第三医院的T2DM住 院患者80例,通过测定振动感觉阈值（VPT）联合神经传导速度（NCV）诊断为DPN的患者60例,其余20例为 单纯T2DM组。60例DPN患者再通过有无肢体麻木、烧灼感、疼痛等症状分为有症状DPN组29例和无症状DPN 组31例。比较3组患者的空腹血糖（FPG）、餐后2h血糖（PPG）、糖化血红蛋白（HbA1c）、甘油三酯（TG）、总 胆固醇（TC）、低密度脂蛋白胆固醇（LDL-c）、高密度脂蛋白胆固醇（HDL-c）、载脂蛋白a（APOa）、载脂蛋白b （APOb）水平;比较3组患者NO、AGEs水平差异。结果：有症状DPN组的FPG、PPG、HbA1c水平均明显高于无 症状DPN及单纯T2DM患者（ P ＜0.01）。无症状DPN组的FPG、PPG、HbA1c水平均高于单纯T2DM患者（ P ＜0.05）。 3组患者的TG、TC、LDL-c、HDL-c、APOa、APOb水平差异无统计学意义（ P＞ 0.05）。与单纯T2DM组比,DPN组 血清NO均明显下降,AGEs水平明显升高（ P ＜0.01）;2组DPN患者血清NO、AGEs水平差异有统计学意义（ P ＜ 0.01）。 结论：临床上早期无症状DPN发病率高,NO、AGEs是其重要的生物信号和效应分子,早期检测有助 于了解神经病变的程度。控制血糖对减少DPN的发生具有非常重要的临床意义。     

2型糖尿病一级亲属的代谢状态与炎症因子的相关性

目的 研究2型糖尿病(T2DM)一级亲属的代谢状态以及与炎症因子hs-CRP的相关性.方法 将入选患者分成4组,2型糖尿病(T2DM)组41例,糖尿病前期(PDM)组38例,T2DM 患者正常糖耐量一级亲属(FDR)组46例,正常对照(NC)组48例.分别测定血清hs-CRP及相关代谢指标.结果 在校正年龄、BMI、腰围后,FPG、2hPG、HbA1c、TG、LDL-C和hs-CRP在NC 组、FDR 组、PDM组和T2DM 组均呈增高趋势,而HOMA -β和HDL-C呈降低趋势(P＜0.05).HOMA-IR和FINS在NC 组、FDR 组和PDM组均呈增高趋势(P＜0.05),而在PDM组和T2DM 组差异无统计学意义(P＞0.05).hs-CRP与BMI、FPG、2hPG、HOMA-IR及TG 呈正相关(P＜0.01),与HDL-C呈负相关(P＜0.01).结论 T2DM患者一级亲属在糖耐量正常时就已经出现胰岛素抵抗及脂代谢紊乱,慢性炎症与高胰岛素血症、血脂紊乱及肥胖有关.     

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.