外周血淋巴细胞/单核细胞比值评估老年食管鳞癌患者放疗预后的价值

目的：探讨放疗开始前外周血淋巴细胞/单核细胞比值（lymphocyte/monocyte ratio,LMR）能否作为老年食管鳞癌患者预后的检测指标。方法：回顾性分析2015—2018年符合入组条件的40例患者,收集放疗前1周内的外周血常规检测结果,将其分为高LMR组（≥4.77,15例）和低LMR组（<4.77,25例）。比较两组患者的无进展生存（progression-free survival,PFS）和总生存（Overall survival,OS）情况。结果：高LMR组患者中位PFS (36个月)、中位OS (37个月)明显高于低LMR组（15个月、26个月）,差异有统计学意义（P<0.05）。单因素分析结果显示,肿瘤TNM分期、LMR对患者的PFS和OS差异有统计学意义(P<0.05),是影响患者预后的危险因素。多因素分析结果显示,TNM分期、N分期、LMR是影响预后的独立危险因素。结论：放疗前LMR可以作为老年食管鳞癌患者的预后预测指标,高LMR提示患者预后较好。     

宫颈癌组织中Hippo-Yes 相关蛋白1 的 表达及临床意义

目的 探讨宫颈癌组织中Hippo-Yes 相关蛋白1（YAP1）表达及临床意义。方法 选取2013 年 1 月—2019 年6 月杭州市妇产科医院和慈溪市妇幼保健院收治的100 例宫颈癌患者的宫颈癌组织作为宫颈癌 组,100 例宫颈上皮内瘤变（CIN）患者的宫颈组织作为CIN 组,100 例子宫肌瘤患者的正常宫颈组织作为 正常组。采用免疫组织化学染色测定组织中YAP1 蛋白表达。结果 CIN 组YAP1 蛋白阳性表达率高于正常 组（P <0.05）,宫颈癌组YAP1 蛋白阳性表达率高于CIN 组（P <0.05）。临床分期Ⅱ期宫颈癌组织中YAP1 蛋白阳性表达率高于Ⅰ期（P <0.05）,有淋巴结转移宫颈癌组织中YAP1 蛋白阳性表达率高于无淋巴结转移 （P <0.05）;不同年龄、组织学类型、组织学分级、宫颈浸润深度、神经脉管是否浸润及宫旁是否浸润宫颈 癌组织中YAP1 蛋白阳性表达率比较,差异无统计学意义（P >0.05）。YAP1 阳性表达组无病生存期（DFS） 和总生存期（OS）低于YAP1 阴性表达组（P <0.05）。Cox 比例风险模型分析显示,YAP1 表达[Rl ^ R=1.202 （95% CI ：1.114,1.415）,P =0.000]、临床分期[Rl ^ R=1.412（95% CI ：1.325,1.503）,P =0.000] 及淋巴结转移 [Rl ^ R=1.391（95% CI ：1.258,1.471）,P =0.000] 为宫颈癌OS 的独立影响因素。结论 宫颈癌组织YAP1 呈高 表达,YAP1 表达与宫颈癌临床分期和淋巴结转移关系密切,为宫颈癌预后的独立影响因素,高表达YAP1 的 宫颈癌患者预后差。     

MicroRNA-1301 在肝癌中的表达及临床意义

目的 检测microRNA-1301（miR-1301）在原发性肝细胞癌（HCC）中的表达及临床意义。 方法 选取2011 年1 月—2014 年1 月在南京医科大学附属无锡第二医院行HCC 根治手术的60 例患者临床资 料、组织样本及随访资料。qRT-PCR 检测肝癌及癌旁组织中miR-1301 的表达,分析miR-1301 的表达与肝 癌患者临床特征及预后关系。结果 HCC 癌组织中miR-1301 相对表达量低于癌旁组织（P <0.05）,且肿瘤直径、 临床分期、有无脉管癌栓和miR-1301 相对表达量与患者不良预后有关（P <0.05）。Kaplan-Meier 生存分析显 示,miR-1301 低表达组肝癌患者总生存率低于高表达组（P <0.05）。多因素Cox 分险比例模型提示,肿瘤直径 [Hl ^ R=1.417（95% CI ：1.432,4.166）]、脉管癌栓[Hl ^ R=0.493（95% CI ：0.205,0.936）]、临床分期[Hl ^ R=2.013 （95% CI ：0.933,3.114）]、miR-1301 低表达[Hl ^ R=2.893（95% CI ：1.139,3.452）,P =0.011] 是影响肝癌患者总 体生存率的独立危险因素。结论 miR-1301 在肝癌组织中低表达,与患者不良预后密切相关,可为肝癌患者预 后评估提供新的分子标志物。     

结肠癌组织中WWP1、C-myc 的 表达及临床意义

目的 检测WWP1、C-myc 在结肠癌组织中的表达，探究其与结肠癌患者病情进展、预后的关系。 方法 采用免疫组织化学法检测河北北方学院附属第一医院收治的135 例结肠癌患者的癌组织、癌旁正常组 织中WWP1、C-myc 蛋白表达情况，分析癌组织中WWP1、C-myc 表达与患者临床病理参数、无进展生存 期（PFS）及总生存期（OS）的关系，用Cox 回归分析结肠癌预后的危险因素。结果 结肠癌组织WWP1、 C-myc 蛋白阳性表达率高于癌旁正常组织（P <0.05）；结肠癌组织WWP1、C-myc 蛋白表达受Dukes 分 期、肿瘤浸润深度及淋巴结转移的影响较大（P <0.05）；Kaplan-Meier 生存分析表明，结肠癌组织WWP1、 C-myc 阳性表达患者术后PFS、OS 较短（P <0.05）；Cox 回归分析结果显示，分化程度[Rl ^ R=29.203（95% CI：4.759，179.192）]、肿瘤Dukes 分期[Rl ^ R=16.817（95% CI：2.765，102.271）]、浸润深度[Rl ^ R=3.285（95% CI ：1.450，7.442）]、淋巴结转移[Rl ^ R=18.723（95% CI ：4.131，84.861）]、WWP1 表达[Rl ^ R=11.344（95% CI ：3.472，37.060）] 及C-myc 表达[Rl ^ R=12.873（95% CI ：3.092，53.592）] 为影响结肠癌患者预后的独立 危险因素。结论 结肠癌组织中WWP1、C-myc 异常高表达，且与患者病情恶性进展、预后不良关系密切， WWP1、C-myc 可作为预测结肠癌患者预后的参考指标。     

外周血淋巴细胞与单核细胞比值在初诊多发性骨髓瘤患者中的预后价值

目的 探讨外周血淋巴细胞与单核细胞比值（lymphocyte-to-monocyte ratio,LMR）在初诊多发性骨髓瘤（multiple myeloma,MM）患者中的预后价值。方法 回顾性分析2016年2月至2022年1月浙江大学医学院附属金华医院收治的156例初诊为MM患者的临床资料,应用受试者操作特征曲线（receiver operator characteristic curve,ROC曲线）计算LMR最佳临界值,并分析LMR与总生存（overall survival,OS）和无进展生存（progression free survival,PFS）的关系。结果 外周血LMR临界值为3.01时,据此将患者分为低LMR组（LMR<3.01,n=49）和高LMR组（LMR≥3.01,n=107）。中位随访时间30.5（3～75）个月,低LMR组患者的中位OS时间（55个月vs.未达到）和中位PFS时间（21个月vs.39个月）均显著短于高LMR组（P<0.05）;低LMR组患者的OS率和PFS率均显著低于高LMR组（P<0.05）。多因素Cox回归分析结果显示...     

脱嘌呤脱嘧啶核酸内切酶1 在结直肠癌 组织中的表达及临床意义

目的 探讨脱嘌呤脱嘧啶核酸内切酶1（APE1）在结直肠癌组织中的表达及其与临床病理特征 和预后的关系。方法 选取2015 年10 月—2017 年9 月浙江省台州医院收治的100 例结直肠癌患者的结直 肠癌组织及其癌旁组织（距离肿瘤切缘≥ 5 cm）标本,组织标本采集后立即放入液氮中保存。免疫组织化学 （HE）染色测定结直肠癌和癌旁组织中APE1 蛋白表达。结果 APE1 在结直肠癌组织中表达率高于癌旁组织 （P <0.05）。APE1 在不同肿瘤大小、肿瘤分期、是否淋巴结转移及是否远处转移的表达比较,差异有统计学 意义（P <0.05）。肿瘤直径≥ 5 cm、肿瘤分期Ⅲ和Ⅳ期、有淋巴结转移及有远处转移结直肠癌组织中APE1 阳性表达率高于肿瘤直径<5 cm、肿瘤分期Ⅰ和Ⅱ期、无淋巴结转移及无远处转移者（P <0.05）。APE1 在 不同年龄、性别、肿瘤位置及分化程度表达比较,差异无统计学意义（P >0.05）。APE1 高表达组总生存率低 于APE1 低表达组（P <0.05）。Cox 比例风险模型分析显示,APE1 表达[Hl ^ R=1.198（95% CI ：1.102,1.276）, P =0.000]、肿瘤分期[Hl ^ R=1.426（95% CI ：1.358,1.492）,P =0.000]、淋巴结转移[Hl ^ R=1.384（95% CI ： 1.306,1.457）,P =0.000]、远处转移[Hl ^ R=1.735（95% CI ：1.164,2.237）,P =0.000] 为结直肠癌总生存期的独 立影响因素。结论 结直肠癌组织中APE1 表达升高,APE1 与结直肠癌的肿瘤大小、肿瘤分期、淋巴结转移、 远处转移及预后关系密切。     

腹腔镜手术治疗宫颈癌临床预后的影响因素分析

目的分析腹腔镜手术治疗宫颈癌临床预后的影响因素,并提出预防措施以改善患者的预后。方法回顾性分析98例宫颈癌患者的临床资料,并根据实体肿瘤疗效评判标准对患者的疗效进行评价,将完全缓解、部分缓解、疾病稳定的患者纳入良好组,疾病进展患者纳入不良组。对患者的年龄、病理类型、肿瘤分期、肿瘤直径、淋巴结转移、淋巴细胞/单核细胞比值(LMR)、术中出血量、盆腔感染等指标进行统计,先进行单因素分析,对单因素分析有统计学意义的指标再运用多因素Logistic回归分析法分析宫颈癌患者疗效的影响因素。结果良好组78例(79.59%),不良组20例(20.41%)。单因素分析结果显示,两组患者的肿瘤分期、肿瘤直径、淋巴结转移、LMR比较,差异均有统计学意义(均P0.05)。Logistic回归分析发现:肿瘤分期ⅠB2、肿瘤直径4 cm、淋巴结转移、LMR≥2.01是腹腔镜手术治疗宫颈癌临床预后的独立危险因素(均P0.05)。结论肿瘤分期ⅠB2、肿瘤直径4 cm、淋巴结转移、LMR≥2.01是影响腹腔镜手术治疗宫颈癌临床预后的重要因素,应根据这些因素给予相应处理。     

锁骨上淋巴结转移对N3-ⅢB期非小细胞肺癌根治性放化疗的预后意义

目的探讨锁骨上淋巴结（SCLN）转移对接受根治性放化疗的N3-ⅢB期非小细胞肺癌（NSCLC）患者的预后意义。方法回顾性分析245例接受根治性放化疗的N3-ⅢB期NSCLC患者,根据有无SCLN转移分为两组,即SCLN+117例,SCLN-128例。应用Kaplan-Meier法绘制生存曲线,比较总生存（OS）和无进展生存（PFS）;应用Cox比例风险回归模型评估影响生存的独立预后因素。结果所有患者总生存（OS）时间为19（10,31）个月,无进展生存（PFS）时间为10（7,16）个月。SCLN+与SCLN-组患者OS、PFS比较差异无统计学意义（P＞0.05）;病理诊断与临床诊断为SCLN+患者进行比较,OS差异无统计学意义（P＞0.05）。经影响生存的独立预后因素分析,SCLN+不是影响OS、PFS的独立预后因素（均P＞0.05）;原发肿瘤部位、放化疗方式是影响OS的独立预后因素（均P＜0.05）;年龄、原发肿瘤部位、放化疗方式是影响PFS的独立预后因素（均P＜0.05）。SCLN+与SCLN-患者远处转移（DM）率比较,差异无统计学意义（P＞0.05）。结论与SCLN-比较,SCLN+对N3-ⅢB期NSCLC患者接受根治性放化疗的效果影响不大。     

左右半结肠癌根治性切除术患者的临床病理特征及预后对比

目的 比较左、右半结肠癌根治性切除术患者的临床病理特征和预后。方法 分析2010年1月— 2013年12月哈励逊国际和平医院行根治性手术的196例结肠癌患者临床病理资料,根据肿瘤位置分为右半结肠癌组（104例）和左半结肠癌组（92例）,比较两组临床病理特征及预后是否存在差异。采用Kaplan-Meier法绘制生存曲线,比较用Log-rank χ2检验,多因素分析采用Cox回归模型。结果 右半结肠癌组患者年龄偏大、低分化或黏液腺癌比例高、淋巴结检出数目高。临床首发症状中,右半结肠癌组贫血或体重下降比例高,而左半结肠癌组中便血或排便习惯改变比例高。全组中位随访时间为69个月。右半结肠癌组与左半结肠癌组的5年无病生存率（DFS）分别为53.8%和70.5%（P?>0.05）,5年总生存率（OS）分别为65.4%和77.2%（P?< 0.05）。pTNM Ⅱ期中,右半结肠癌组与左半结肠癌组的5年DFS分别为62.7%和70.0%（P?>0.05）,5年OS分别为74.6%和78.0%（P?>0.05）;pTNM Ⅲ期中,右半结肠癌组与左半结肠癌组的5年DFS分别为36.6%和65.1%（P?<0.05）,5年OS分别为48.8%和71.4%（P?<0.05）。多因素分析显示,pTNM分期[HlR=3.07（95% CI：1.95,4.85）]和pT分期[HlR=1.83（95% CI：1.38,2.43）]是影响结肠癌术后DFS的独立危险因素,pT分期[HlR= 1.91（95% CI：1.41,2.61）]及pN分期[HlR=2.21（95% CI：1.62,3.00）]是影响结肠癌术后OS的独立危险因素,而肿瘤位置不是影响结肠癌预后的危险因素。结论 左右半结肠癌临床病理特征存在差异。右半结肠癌整体预后较左半结肠癌差,在Ⅲ期患者中更明显。     

18F-FDG PET/CT体积及肿瘤异质性参数对宫颈癌临床分期、病理类型及预后预测价值的研究

目的 探讨¹⁸F-FDG PET/CT体积及肿瘤异质性参数对宫颈癌的临床分期、病理类型和无进展生存(progression-free survival,PFS)及总生存(overall survival,OS)的预测价值。方法 回顾性分析47例确诊宫颈癌并于治疗前行¹⁸F-FDG PET/CT患者的数据,记录下列参数:原发病灶最大和平均SUV(SUVmax和SUVavg)、肿瘤代谢体积(metabolic tumor volume, MTV)、糖酵解总量(total lesion glycolysis, TLG)、肿瘤最大体积(Dmax)和变异系数(coefficient of variation, COV)。两组间的比较采用student t检验及Mann-Whitney U检验,ROC曲线判定各参数的预测效能并确定最佳临界值,COX回归分析和Kaplan-Meier生存曲线进行PFS和OS分析。结果 鳞癌组的COV显著低于非鳞癌组(P=0.009),临床分期早期组(FIGOⅠ~Ⅱ期)和晚期组(FIGO Ⅲ~Ⅳ期)的Dmax、MTV、TLG和COV比较,差异有统计学意义(P<0.05)。COX多因素回归分析表明,MTV(HR=2.83,P=0.030)和FIGO分期(HR=4.23,P=0.003)是PFS的独立预测因子。同时MTV(HR=5.01,P=0.016)和FIGO分期(HR=4.85,P=0.023)也是OS的独立预测因子。取最佳临界值,MTV高于临界值组和FIGO晚期组的PFS率(P=0.002,P=0.000)和OS率(P=0.000)均显著低于MTV低于临界值组和FIGO早期组。结论 基于体积的代谢参数MTV、TLG和肿瘤异质性参数COV在宫颈癌的临床分期、病理类型和预后预测方面都较SUVmax和SUVavg敏感,尤其是MTV,是PFS和OS的独立预测因子。     

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.