破裂颅内动脉瘤介入治疗的预后因素分析

目的 探讨介入治疗破裂颅内动脉瘤（IA）患者预后的影响因素。方法 回顾性分析2015 年 1 月—2018 年6 月绍兴市人民医院113 例行血管内介入治疗的破裂IA 患者的临床资料。采用改良Rankin 量 表（mRs）评价预后,根据随访结果分为预后良好组（mRs 评分0 ～ 1 分）和预后不良组（mRs 评分2 ～ 6 分）。 对可能影响预后的因素进行单因素分析和多因素Logistic 回归分析。结果 113 例患者中,83 例（73%）预后 良好,30 例（27%）预后不良。单因素分析结果显示,年龄、Hunt-Hess 分级、Fisher 分级、手术时机及脑积 水对预后有影响（P <0.05）。多因素Logistic 回归分析结果显示,年龄[Ol ^ R=1.065（95% CI ：1.012,1.121）]、 Hunt-Hess 分级[Ol ^ R=9.497（95% CI ：2.034,44.345）]、手术时机[Ol ^ R=3.957（95% CI ：1.242,12.604）] 及 脑积水[Ol ^ R=8.005（95% CI ：1.552,41.278）] 为影响预后的独立危险因素。结论 年龄、Hunt-Hess 分级、 手术时机及脑积水能够影响行介入治疗的破裂IA 患者预后。     

急性心力衰竭患者血清microRNA-1 水平 及与心功能和预后的关系

目的 探讨急性心力衰竭患者血清microRNA-1（miR-1）水平及其与心功能和预后的关系。 方法 选取2015 年1 月—2018 年12 月在台州市中心医院就诊的急性心力衰竭患者120 例作为心力衰竭组, 同期健康体检者120 例作为对照组。逆转录聚合酶链反应（RT-PCR）测定血清miR-1 相对表达量;采用 彩色多普勒心脏超声诊断仪测定患者左心房内径（LAD）、左心室舒张末期内径（LVEd）,计算左心室射血分 数（LVEF）。结果 心力衰竭组血清miR-1 和LVEF 低于对照组（P <0.05）;而LAD、LVEd 高于对照组（P <0.05）。 不同严重程度分级的心力衰竭患者血清miR-1 比较,差异有统计学意义（P <0.05）,随着心力衰竭严重程度增 加,其血清miR-1 降低。预后不良组血清miR-1 低于预后良好组（P <0.05）。心力衰竭患者血清miR-1 与 LVEF 呈正相关（r =0.578,P <0.05）;与LAD、LVEd 呈负相关（r =-0.442 和-0.473,P <0.05）。心力衰竭患 者预后影响因素Logistic 回归分析结果显示,miR-1[Ol ^ R=4.152（95% CI ：1.846,5.384）]、LVEF[Ol ^ R=2.971 （95% CI ：1.764,4.037）]、LAD[Ol ^ R=0.706（95% CI ：0.415,0.923）] 及LVEd[Ol ^ R=0.721（95% CI ： 0.427,0.928）] 为心力衰竭预后的影响因素。结论 心力衰竭患者血清miR-1 水平降低,其与心功能和预后 关系密切,是心力衰竭不良预后的独立影响因素。     

腔隙性梗死患者血管性认知障碍危险因素的 Logistic 回归分析

目的 收集腔隙性梗死患者临床资料,分析其血管性认知障碍（VCI）的危险因素。方法 选 取2016 年5 月—2017 年2 月赤峰学院附属医院收治的156 例腔隙性脑梗死患者的临床和实验室资料,应用 美国国立卫生研究院卒中量表和蒙特利尔认知评价量表（MoCA）对患者神经功能及认知障碍进行评价, 结合患者临床资料及实验室血浆同型半胱氨酸浓度对认知障碍的危险因素进行多因素的Logistic 回归分析。 结果 62.18% 腔隙性脑梗死患者发生不同程度的VCI。多因素Logistic 回归分析结果显示,关键部位梗死 灶[Ol ^ R=5.937（95% CI ：1.086,32.458）,P =0.040]、脑白质高信号[Ol ^ R=5.948（95% CI ：1.234,28.672）, P =0.026] 和血浆同型半胱氨酸浓度（Hcy）[Ol ^ R=4.389（95% CI ：1.039,18.535）,P =0.044] 是腔隙性梗 死患者出现血管性认知损害的影响因素。血浆Hcy 浓度与MoCA 评分呈负相关（r =-0.694,P =0.000）。 结论 关键部位梗死灶、脑白质高信号和血浆同型半胱氨酸浓度是影响腔隙性梗死患者发生血管性认知损害 的主要危险因素。     

宫内窘迫新生儿发生缺氧缺血性脑病的 危险因素分析

目的 研究具有宫内窘迫暴露因素的新生儿发生缺氧缺血性脑病（HIE）的危险因素。方法 收 集2016 年6 月—2018 年3 月于佳木斯大学附属第一医院收治的具有宫内窘迫暴露因素,但尚未确诊为 HIE 的患儿作为病例组。选取同一居住区、性别比例、民族、年龄相差3 个月左右且未罹患HIE 儿童作 为对照组,对两组临床资料进行Logistic 回归分析。结果 单因素Logistic 回归分析结果显示,县镇医院分 娩、母亲文化程度低（小学及以下）、居室周围环境差、早产（孕周<37 周）、分娩时异常、出生体重低 （<2 500 g）、孕期及新生儿各因素比较,差异有统计学意义（P <0.05）。多因素Logistic 回归分析结果显示, 出生体重低<2 500 g[Ol ^ R=9.268（95% CI ：1.765,30.908）,P =0.005]、孕周<37 周[Ol ^ R=16.036（95% CI ： 5.906,49.133）,P=0.005]、母亲文化程度低[Ol ^ R=2.392（95% CI ：1.202,4.961）,P =0.000]、新生儿肌张力 高[Ol ^ R=14.160（95% CI ：5.436,36.680）,P =0.027] 及新生儿出生窒息[Ol ^ R=14.051（95% CI ：1.575,125.361）, P =0.006] 是HIE 发病的影响因素。结论 孕期和围产期危险因素与宫内窘迫有协同作用,增加HIE 发病风险。     

不同偏头痛亚型与平衡障碍严重程度的关系

目的 探讨先兆性偏头痛、无先兆性偏头痛、慢性偏头痛患者与平衡功能障碍严重程度的关系。 方法 按照头痛疾患的国际诊断标准,选取偏头痛患者203 例。其中,先兆性偏头痛68 例,无先兆性偏头痛 73 例,慢性偏头痛62 例。分析3 种偏头痛亚型患者的临床资料和平衡障碍严重程度。采用Logistic 回归分析 平衡严重程度指标与3 种偏头痛亚型的关系。结果 多因素Logistic 回归分析结果显示,移动速度[Ol ^ R=2.96 （95%CI ：1.13,9.32）P =0.021]、方向控制[Ol ^ R=1.47（95%CI ：1.03,3.38）P =0.046] 是影响先兆性偏头痛患 者平衡功能障碍的重要因素;移动速度[Ol ^ R=3.76（95%CI ：1.21,9.28）P =0.042]、步宽[Ol ^ R=2.45（95%CI ： 1.73,6.74）P =0.009] 是影响无先兆性偏头痛平衡功能障碍的重要因素;移动速度[Ol ^ R=3.02（95%CI ：1.23, 8.96）,P =0.000],最大位移[Ol ^ R=1.59（95%CI ：1.22,3.67）,P =0.043],平均反应时间[Ol ^ R=1.89（95%CI ： 1.48,5.35）,P =0.041] 是影响慢性偏头痛患者平衡功能障碍的重要因素。结论 不同偏头痛亚型患者存在轻 度或持续加重的平衡功能障碍,其中移动速度是影响先兆性偏头痛、无先兆性偏头痛和慢性偏头痛患者平衡 功能障碍的重要因素。     

睡眠障碍与脑卒中患者抑郁的相关性研究

目的 探讨睡眠障碍与脑卒中患者抑郁的相关性。方法 选取2016 年1 月—2017 年12 月于安 徽医科大学附属巢湖医院收治的138 例初发脑卒中康复期患者作为研究对象,采用抑郁自评量表（SDS）、匹 兹堡睡眠量表指数量表（PSQI）分别评价脑卒中患者的抑郁状况和睡眠质量,根据SDS 评分诊断患者脑卒 中后抑郁（PSD）,分析睡眠障碍与PSD 的关系,采用多因素Logistic 回归探讨PSD 发生的影响因素,采用 Pearson 相关性分析探讨患者SDS 与PSQI 评分的关系。结果 离异或丧偶、伴有糖尿病史、出血性脑卒中、 脑卒中位于皮质下、左半球、无定期进行康复锻炼、自理能力明显障碍、有睡眠障碍患者的发生PSD 发生率 均有升高（P <0.05）。多因素Logistic 回归结果表明婚姻状况[Ol ^ R=2.517,（95 CI ：1.133,5.594）,P =0.023]、 脑卒中类型[Ol ^ R=1.126,（95 CI ：1.005,1.262）,P =0.041]、康复锻炼状况[Ol ^ R=1.283,（95 CI ：1.024, 1.607）,P =0.030]、自理能力明显障碍[Ol ^ R=2.942,（95 CI：1.291,6.707）,P =0.010]、睡眠障碍[Ol ^ R=1.585,（95 CI ：1.105,2.273）,P =0.012] 是患者发生PSD 的关键的独立危险因素。SDS 评分与主观睡眠障碍、睡眠效率、 睡眠障碍及日间功能障碍均呈正相关（r =0.303、0.178、0.269 和0.208,P =0.000、0.037、0.001 和0.014）。 SDS 评分与主观睡眠障碍、睡眠效率、睡眠障碍及日间功能障碍均呈正相关（r =0.303、0.178、0.269 和 0.208,P <0.05）。结论 脑卒中康复期患者容易发生睡眠障碍,睡眠障碍与PSD 发生具有一定的相关性,且 睡眠质量越差,抑郁表现越严重。     

IL-6 联合中性粒细胞与淋巴细胞比值对 三阴性乳腺癌的预后评估价值

目的 探究IL-6 联合中性粒细胞与淋巴细胞比值对三阴性乳腺癌预后的价值。方法 选取2013 年 1 月—2016 年5 月徐州医科大学附属医院甲乳外科收治的经术后病理确诊为三阴性乳腺癌的患者127 例。患 者均进行为期3 年的随访,根据随访结果绘制生存曲线;利用单因素和多因素回归分析筛选出影响三阴性 乳腺癌预后的独立危险因素;绘制ROC 曲线,评价各潜在指标对三阴性乳腺癌预后的影响。利用Logistic 回归模型探索联合诊断评估三阴性乳腺癌预后的可行性。结果 患者的不良预后率为14.96%。TNM 分期 [Rl ^ R=0.036（95 CI ：1.498,3.883）,P =0.036]、癌胚抗原[Rl ^ R=2.151（95 CI ：1.120,4.131）,P =0.000]、糖 类抗原125[Rl ^ R=1.775（95 CI ：1.073,2.937）,P =0.008]、中性粒细胞与淋巴细胞比值[Rl ^ R=1.641（95 CI ： 1.279,2.105）,P =0.032] 及IL-6[Rl ^ R=1.305（95 CI：1.120,1.521）,P =0.017] 是三阴性乳腺癌预后的影响因素。 癌胚抗原[Rl ^ R=2.115（95 CI ：1.353,3.307）,P =0.002]、中性粒细胞与淋巴细胞比值[Rl ^ R=1.851（95 CI ： 1.783,1.921）,P =0.027] 及IL-6[Rl ^ R=1.344（95 CI ：1.081,1.671）,P =0.018] 是影响预后的独立危险因素。 中性粒细胞与淋巴细胞比值联合IL-6 预测三阴性乳腺癌预后的AUC 最高（0.740）,高于两者单独诊断的 AUC。结论 中性粒细胞与淋巴细胞比值和IL-6 对三阴性乳腺癌的预后具有一定的评估价值,两者联合诊 断可作为三阴性乳腺癌预后的诊断指标。     

甲状腺乳头状癌中央区淋巴结转移的危险因素分析

目的 探讨甲状腺乳头状癌（PTC）中央区淋巴结转移（CLNM）的危险因素。方法 选取 2016 年8 月—2018 年12 月在锦州医科大学附属第一医院行手术治疗的303 例PTC 患者临床资料，回顾性 分析患者性别、年龄、体重指数（BMI）、肿瘤最大直径、肿瘤数量、肿瘤位置、被膜侵犯情况、甲状腺 球蛋白抗体（TgAb）及促甲状腺激素（TSH）等因素对CLNM 的影响。结果 303 例患者中，116 例发生 CLNM，总转移率为39.27%。单因素分析结果显示，性别、年龄、BMI、肿瘤最大直径、肿瘤数量、是否 被膜侵犯及CLNM 率比较，差异有统计学意义（P <0.05）。多因素Logistic 回归分析显示，性别[Ol ^ R=0.454 （95% CI ：0.224，0.921）]、年龄[Ol ^ R=0.957（95% CI ：0.936，0.978）]、肿瘤最大直径[Ol ^ R=1.438（95% CI ： 1.117，1.852）] 及被膜侵犯[Ol ^ R=0.399（95% CI ：0.230，0.691）] 是PTC 患者发生CLNM 的危险因素。受 试者工作特征曲线显示，年龄为45.5 岁、肿瘤最大直径为0.75cm 时约登指数最大，对应的曲线下面积分别为 0.643 和0.691，敏感性分别为0.620（95% CI ：0.580，0.706）和0.695（95% CI ：0.632，0.750），特异性分别为 0.682（95% CI ：0.580，0.706）和0.720（95% CI ：0.632，0.750）。结论 PTC 发生CLNM 与多个因素有关， 当患者为男性、年龄<45.5 岁、肿瘤最大直径≥ 0.75 cm 及存在被膜侵犯时，CLNM 发生可能性大，建议行 中央区淋巴结清扫。     

前哨淋巴结活检与乳腺癌分子分型的关系

目的 探讨前哨淋巴结活检结果与乳腺癌分子分型的关系。方法 选取2015 年1 月—2018 年 12 月于东莞市松山湖中心医院接受全乳切除术或保乳术加前哨淋巴结活检的302 例早期乳腺癌患者作为 研究对象,采用免疫组织化学法检测肿瘤组织中雌激素受体（ER）、孕激素受体（PR）、人体表皮生长因 子受体-2（Her-2）、Ki-67 的表达,并将患者划分为Luminal A 型、Luminal B 型、HER-2 阳性型及三阴 性型。分析前哨淋巴结转移与患者分型的关系。结果 患者中Luminal A 型134 例、Luminal B 型91 例、 Her-2 阳性型32 例及三阴性型45 例,各亚型中前哨淋巴结阳性者分别有31、37、7 及6 例。前哨淋巴结 阳性组年龄≤ 52 岁、T2 期、Luminal B 型占比均高于阴性组（P <0.05）,TNM 分期是前哨淋巴结阳性的危 险因素[Ol ^ R=3.531（95% CI ：1.936,6.438）,P =0.000],Luminal A 型[Ol ^ R=0.242（95% CI ：0.121,0.483）, P =0.000]、年龄[Ol ^ R=0.202（95% CI ：0.101,0.405）,P =0.000] 是其保护因素。前哨淋巴结阳性组年龄≤ 52 岁、T2 期、Luminal B 型占比均高于阴性组（P <0.05）, 年龄[Ol ^ R=0.250（95% CI ：0.063,0.987）, P =0.000] 是前哨淋巴结阳性数的保护因素。检出组年龄≤ 52 岁、T2 期、阳性前哨淋巴结数量≥ 2 枚、前哨 淋巴结宏转移者占比均高于未检出组（P <0.05）,前哨淋巴结阳性数量≥ 2 枚[Ol ^ R=27.926（95% CI ：6.433, 121.222）,P =0.000]、前哨淋巴结宏转移[Ol ^ R=10.662（95% CI ：1.620,70.177）,P =0.014] 是非前哨淋巴结转 移的危险因素。结论 分子分型与前哨淋巴结阳性有一定关系,其中Luminal A 型患者前哨淋巴结阳性风险 低于Luminal B 型患者,但分子分型与是否伴非前哨淋巴结转移无关。     

毛细血管指数评分在急性前循环缺血性卒中 血管内治疗中的应用价值

目的 探讨毛细血管指数评分（CIS）评估急性前循环缺血性卒中患者侧支循环情况,评价CIS 在急性前循环缺血性卒中血管内治疗中的价值。方法 回顾性分析2015 年2 月—2018 年12 月就诊于安庆 市第一人民医院行血管内治疗的52 例急性前循环缺血性卒中患者。纳入患者行全脑数字减影血管造影完成 CIS,分为充盈良好（fCIS 组）27 例和充盈不良（pCIS 组）25 例。根据改良Rankin 量表（mRS）评分分为 良好预后组24 例（≤ 2 分）和不良预后组28 例（>3 分）。单因素分析比较两组基线资料和临床资料,多因 素Logistic 回归分析CIS 对预后结局的影响。结果 fCIS 组与pCIS 组年龄、性别、糖尿病史、收缩压、心房 颤动、高脂血症、美国国立卫生研究院卒中量表（NIHSS）评分、发病至血管再通时间（TTR）比较,差异 无统计学意义（P >0.05）,而扩散加权成像Alberta 卒中早期CT 评分（DWI-ASPECTS）、改良脑梗死溶栓实 验分级（mTICI）≥Ⅱ b 患者比例比较,差异有统计学意义（P <0.05）。良好预后组与不良预后组年龄、性 别、糖尿病史、收缩压、心房颤动、高脂血症、NIHSS 评分、TTR 比较,差异无统计学意义（P >0.05）,而 DWI-ASPECTS 评分、≥Ⅱ b 及fCIS 比较,差异有统计学意义（P <0.05）。多因素Logistic 回归分析显示, mTICI[Ol ^ R=5.603（95% CI ：2.035,21.447）] 和DWI-ASPECTS 评分[Ol ^ R=0.625（95% CI ：0.472,0.826）] 是血管内治疗预后的危险因素,而CIS[Ol ^ R=8.474（95% CI ：2.478,32.516）] 是其保护因素。结论 CIS 可 用于评价脑组织灌注及毛细血管充盈情况,在EVT 时增加CIS 和DWI-ASPECT 评分评价,对预测急性缺血 性脑卒中患者的预后具有重要价值。     

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.