腹腔镜下高难度子宫肌瘤剔除术85例分析

目的：探讨腹腔镜下进行高难度子宫肌瘤剜出术的可行性和手术技巧。方法：对85例子宫肌瘤直径超过9cm或肌瘤个数超过4个或子宫肌瘤位于子宫肌层深部及子宫后壁、阔韧带内、子宫颈而行子宫肌瘤剜出术的病例资料进行回顾性分析。结果：83例手术在腹腔镜下完成，手术过程顺利，2例因肌瘤数目超过10枚而中转开腹，无一例发生手术并发症。手术时间平均（85．5±42）min，术中平均出血量（115±46．5）ml，术后平均住院时间3．8d。结论：高难度子宫肌瘤剜出术可在腹腔镜下完成，关键在于手术者的手术操作技巧。     

腹腔镜下高难度子宫肌瘤剜除术48例分析

目的探讨腹腔镜下进行高难度子宫肌瘤剜除术的可行性、安全性和手术技巧。方法对48例子宫肌瘤直径超过9cm（子宫大小〉孕12周）或肌瘤个数超过4个或子宫肌瘤位于子宫肌层深部及子宫后壁、阔韧带内、子宫颈而行子宫肌瘤剜除术患者的临床资料进行回顾分析。结果 48例手术均在腹腔镜下完成,手术过程顺利,无1例发生手术并发症。手术时间平均（113.5±38）min,术中平均出血量（104±43）ml,术后平均住院时间5d。结论高难度子宫肌瘤剜除术可在腹腔镜下完成,关键在于手术者的手术操作技巧。     

腹腔镜子宫肌瘤剔除术50例临床分析

目的:探讨腹腔镜下子宫肌瘤剔除术的安全性及效果。方法:对我院2009年5月~2010年4月50例腹腔镜子宫肌瘤剔除术患者的临床资料进行回顾性分析。结果:50例患者均于腹腔镜下完成手术,无一例中转开腹,无一例手术并发症发生。手术时间平均(86.35±10.12)min,出血量平均为(60.13±20.34)m1。术后排气时间平均为(20.31±6.63)h。术后住院时间平均为(4~5)d。结论:腹腔镜子宫肌瘤剔除术是一种安全可行的手术方法,只要合理选择适应症,熟练掌握腹腔镜操作技巧,尤其是腹腔镜缝合技术,此术式是安全可靠的。     

超声止血刀在腹腔镜子宫肌瘤挖除术中的应用

目的探讨超声止血刀在子宫肌瘤挖除术中的切割、止血的效果.方法2001年8月～2003年6月期间,对82例有症状且要求保留子宫的子宫肌瘤患者采用腹腔镜下10mm超声止血刀进行子宫肌瘤挖除术治疗.结果所有病例均在腹腔镜下采用超声止血刀完成手术,本组病例大部分为多发子宫肌瘤患者,其中肌壁间肌瘤49例,浆膜下肌瘤33例,数目1～6个,肌瘤直径大小2～15cm,66例子宫切口进行了缝合.平均手术时间为(109.2±35.4)min,估计平均失血量为(121.8±47.3)ml,病人平均住院日为(5.2±1.5)d.所有病例腹腔镜手术均成功,无手术并发症.随访2～22个月,所有有症状者术后均改善,无1例复发和手术后并发症.结论腹腔镜下采用超声止血刀切割和止血具有手术时间短,止血效果更佳,对周围组织无损伤且并发症少等优点.     

超声刀在腹腔镜下子宫肌瘤剔除术中的应用（附143例分析）

目的探讨超声止血刀在腹腔镜下子宫肌瘤剔除术中的应用价值。方法对143例有症状但要求保留子宫的子宫肌瘤患者应用超声刀、单极电凝行腹腔镜下子宫肌瘤剔除术。结果所有病例均在腹腔镜下完成手术,其中单发肌瘤62例,多发81例,肌瘤最多为5个,肌瘤直径在1~10cm,平均手术时间分别为(58±15)m in、(98±28)m in,平均出血量分别为60、85m l,均无手术并发症。结论腹腔镜下子宫肌瘤剔除术是一种安全可行的手术方法,但需有良好的腔镜设备和娴熟的腔镜操作技巧,超声刀因其优异的性能,有省时、便捷、损伤更小、安全性更高等优点,可广泛用于妇科腔镜手术。     

腹腔镜手术治疗子宫肌瘤114例临床分析

目的:探讨腹腔镜下进行子宫肌瘤剔除术及子宫切除术的可行性.方法:对114例子宫肌瘤行腹腔镜手术,观察手术时间、术中出血量、住院时间及术后恢复情况.结果:TLH、LAVH组病例56例全部腹腔镜下完成手术.肌瘤剔除组58例中,浆膜下肌瘤36例,肌壁间肌瘤19例,阔韧带肌瘤3例；1例峡部肌瘤直径8cm,因剖宫产史膀胱黏连中转开腹.全部病例无并发症发生；均经病理证实为子宫平滑肌瘤.结论:随着微创理念逐渐深入人心,腹腔镜手术应用越来越广泛,本文从腹腔镜在子宫肌瘤剔除术、子宫切除术的应用介绍腹腔镜手术的新技术、新理念,手术器械的不断创新、病例的合理选择及熟练地手术技巧是手术成功的关键.     

腹腔镜下袋式子宫肌瘤切除术的54例分析

目的：探讨腹腔镜下袋式子宫肌瘤切除治疗多发性子宫肌瘤的临床效果及可行性。方法腹腔镜组为54例多发性子宫肌瘤患者行腹腔镜袋式子宫肌瘤切除术,对照组为54例患者行经腹多发性子宫肌瘤切除,观察两组手术时间、术中出血量、术后排气时间、术后住院天数等情况。结果所有病例手术均获成功,无一例中转开腹,无手术并发症发生。腹腔镜组平均手术时间(118.35±2.98)min,术中出血(96.06±1.86)mL,术后排气时间(22.13±0.53)h ,术后住院天数(4.17±0.15)d。腹腔镜组术中出血少、术后肠功能恢复快、住院天数短,与开腹组比较差异有统计学意义(P<0.05)。结论腹腔镜下袋式子宫肌瘤切除术是安全、可行的,扩大了腹腔镜子宫肌瘤切除术的手术指征。     

腹腔镜下困难性子宫肌瘤剔除120例分析

目的 探讨腹腔镜下进行困难性子宫肌瘤剔除术的可行性.方法 收集我院2009年1月至2012年2月巨大、多发、特殊部位的子宫肌瘤患者120例.在腹腔镜下,术中采用腹腔镜超声监护、输尿管插管,必要时联合宫腔镜行子宫肌瘤剔除术,观察手术并发症、手术时间、术中出血量及术后恢复情况.结果 在全部120例患者中,多发子宫肌瘤肌瘤数目＞5个者59例,单发子宫肌瘤直径＞8 cm者43例(其中子宫肌壁间肌瘤29例,子宫浆膜下肌瘤14例),子宫阔韧带肌瘤9例,子宫颈肌瘤9例.剔除子宫肌瘤最多达15个,子宫肌瘤直径≥10 cm者11例,其中直径最大的达12 cm(为阔韧带肌瘤,重1800g).患者手术均在腹腔镜下顺利完成,无一例中转开腹.平均手术时间(114±32)min,平均术中出血量(106±35)ml,术后平均住院时间5.1d.结论 困难性子宫肌瘤剔除术可以在腹腔镜下完成,术中适当进行输尿管插管可降低输尿管损伤,术中超声的应用有助于彻底剔除肌瘤,降低术后复发率.联合宫腔镜手术可同时剔除粘膜下肌瘤,术后月经量增多症状明显缓解,合理应用辅助检查及熟练的手术技巧是手术成功的关键.     

无气腹腹腔镜子宫肌瘤剥出术48例

目的 探讨无气腹腹腔镜子宫肌瘤剥出术的临床应用价值.方法 对48例子宫肌瘤患者在无气腹腹腔镜下行子宫肌瘤剥出术.结果 全部病例在无气腹腹腔镜下完成手术,无一例中转开腹,无一例手术副损伤发生.手术时间为20～120 min,平均60 min;术中出血量20～160 ml,平均70 ml;术后肠功能恢复时间为6～20 h,平均14 h;术后6～18 h内均下床活动,住院时间平均4.4 d.结论 无气腹腹腔镜下子宫肌瘤剥出术安全、可行、方便、经济,适用于临床.     

双侧子宫动脉凝固术在腹腔镜下子宫肌瘤剔除术中的应用

目的:探讨双侧子宫动脉凝固术在腹腔镜下子宫肌瘤剔除术中的应用价值.方法:对85例子宫肌瘤患者,50例行腹腔镜下双侧子宫动脉凝固术后子宫肌瘤剔除术(治疗组),35例行腹腔镜下子宫肌瘤剔除术(对照组).结果:所有手术均在腹腔镜下完成,治疗组手术时间约为(91±11) min,与对照组(94±11) min相比稍缩短(P=0.112);治疗组出血量为(89±17) mL,明显少于对照组的(139±43) mL(P＜0.000).术后随访1～27个月,症状明显改善,无复发及术后并发症.结论:腹腔镜下双侧子宫动脉凝固阻断后行子宫肌瘤剔除术有术中出血少的优点,是一种安全、有效、有应用前景的手术方法.     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.