112例妊娠合并子宫肌瘤的疗效分析

目的:研究与探讨妊娠合并子宫肌瘤的位置、数量和大小对产妇分娩、产科结果和并发症的影响。方法:选择接受治疗的妊娠合并子宫肌瘤产妇112例,分成两组,浆膜下肌瘤组和肌壁间肌瘤组,其中浆膜下肌瘤组89例,肌壁间肌瘤组23例。对112例产妇的治疗方式和产科结局进行回顾性分析。结果:同期收治的产妇共9 840例,有112例妊娠合并子宫肌瘤,占1.14%,肌瘤的位置、数量和大小对并发症发生率、生产结果以及分娩结果经统计学检验差异无统计学意义(P>0.05)。结论:多种产科并发症均会发生在妊娠合并子宫肌瘤当中,并且具有极高的剖宫产率,剖宫产术中要慎重实施肌瘤剔除术。     

腹腔镜下假包膜内子宫肌瘤剔除术患者的预后和生育结局

目的通过回顾性研究来评价腹腔镜下假包膜内子宫肌瘤剔除术的预后和生育结局。方法2007年3月~2012年3月,673
例浆膜下和肌壁间肌瘤患者接受了腹腔镜下假包膜内子宫肌瘤剔除术,观察指标为术后合并症,症状缓解,需要再次手术及生
育结局。结果浆膜下肌瘤占42.4%,肌壁间肌瘤占57.6%,平均手术时间是96±41 min,平均失血量是128±46.2 ml,82.3%的患
者在术后48 h出院,无近期并发症。2.3%的患者因肌瘤复发而接受了二次腹腔镜下子宫肌瘤剔除术。有生育要求的297例患
者中71%最终成功妊娠,剖宫产率为49.8%,阴道助产分娩8%,自然分娩率为42.2%,无子宫破裂。结论腹腔镜下假包膜内子宫
肌瘤剔除术保留了纤维假包膜,通过保留子宫肌层的完整性而增强了愈合,没有近期手术并发症,有较好的妊娠率和分娩结局。
     

腹腔镜下假包膜内子宫肌瘤剔除术患者的预后和生育结局

目的通过回顾性研究来评价腹腔镜下假包膜内子宫肌瘤剔除术的预后和生育结局。方法 2007年3月~2012年3月,673例浆膜下和肌壁间肌瘤患者接受了腹腔镜下假包膜内子宫肌瘤剔除术,观察指标为术后合并症,症状缓解,需要再次手术及生育结局。结果浆膜下肌瘤占42.4%,肌壁间肌瘤占57.6%,平均手术时间是96±41 min,平均失血量是128±46.2 ml,82.3%的患者在术后48 h出院,无近期并发症。2.3%的患者因肌瘤复发而接受了二次腹腔镜下子宫肌瘤剔除术。有生育要求的297例患者中71%最终成功妊娠,剖宫产率为49.8%,阴道助产分娩8%,自然分娩率为42.2%,无子宫破裂。结论腹腔镜下假包膜内子宫肌瘤剔除术保留了纤维假包膜,通过保留子宫肌层的完整性而增强了愈合,没有近期手术并发症,有较好的妊娠率和分娩结局。     

腹腔镜下子宫肌瘤剔除术106例

目的:总结腹腔镜下子宫肌瘤剔除术的临床经验。方法:选择106例浆膜下或肌壁间肌瘤行腹腔镜子宫肌瘤剔除术。结果106例均顺利完成手术,无中转开腹,平均手术时间75min,平均出血量150ml,无并发症及副损伤发生。结论:对于浆膜下肌瘤或靠近子宫浆膜的肌壁间肌瘤行腹腔镜下肌瘤剔除术安全、美观,对内环境干扰少,出血少、术后病率低,恢复快。     

腹腔镜下不同大小子宫肌壁间肌瘤剔除术后妊娠的临床分析

目的 探讨腹腔镜下较大子宫肌壁间肌瘤剔除术对妊娠和分娩的影响.方法 对53例较大子宫肌壁间肌瘤患者行腹腔镜下子宫肌壁间肌瘤剔除,术前经阴道B超测量肌瘤大小,分为肌瘤直径5～7.9 cm组,肌瘤直径8～12 cm组.比较两组术中出血量、手术时间、穿破内膜例数、术后妊娠时间、孕周、产科妊娠并发症、分娩方式等差异.结果 8 ～12 cm组手术时间、术中出血量和穿破内膜率均较5 ～7.9 cm组高,差异有统计学意义(P＜0.05),而两组术后妊娠时间、孕周、肌瘤部位、产科妊娠并发症和分娩方式差异均无统计学意义(P＞0.05).结论 腹腔镜下子宫肌壁间肌瘤剔除术后具有创伤小、恢复快等特点,严密随访下,较大子宫肌壁间肌瘤剔除术后妊娠、分娩是安全的.     

妊娠合并子宫肌瘤不同手术方法的结果比较

目的探讨妊娠合并子宫肌瘤剖宫产时的临床处理。方法将妊娠合并子宫肌瘤150例分为：剔除子宫肌瘤组84例，未剔除子宫肌瘤组66例，选择同期无任何合并症的正常剖宫产50例为对照组，比较三组剖宫产的情况。结果肌瘤剔除组、肌瘤未剔除组及正常剖宫产组术中出血量、术后24h出血量及术前、术后HB差值无显著性差异。剖宫产术同时行子宫肌瘤剔除术，剔除单发、多发，浆膜下、粘膜下、肌壁间肌瘤，术中出血量无显著性差异。剔除直径≤5cm和直径〉5cm的肌瘤，术中出血量有显著性差异。所有病例术后无一例发生产褥感染，三组的伤口愈合无显著性差异。结论剖宫产同时应尽量行子宫肌瘤剔除术，以免除患者受二次手术的痛苦，但对于直径〉5cm，位于子宫下段或远离切口的肌壁间、粘膜下肌瘤，由于手术困难风除较大．不丰张剖宫产同时剔除子宫肌瘤．     

腹腔镜子宫肌瘤剔除术96例临床分析

目的:探讨腹腔镜下子宫肌瘤剔除术的影响因素和技术处理特点。方法:对196例腹腔镜下子宫肌瘤剔除术的缝合技术及疗效进行总结分析。结果:单发肌瘤124例,多发69例,肌瘤合并卵巢单纯性囊肿3例;浆膜下肌瘤71例,肌壁间肌瘤73例,浆膜下与肌壁间肌瘤同时存在52例,肌瘤数最多5个,肌瘤平均直径2.51cm;手术时间25~120分钟,平均64.60±37.14分钟;术中出血30~180ml,平均74.10±41.89ml,子宫肌瘤直径>5cm者手术时间和术中出血量明显大于直径<5cm者,肌瘤数目和肌瘤类型对手术时间和出血量无明显影响。结论:子宫肌瘤大小是影响手术时间、术中出血的关键因素。腹腔镜下子宫肌瘤剔除术具有创伤小,恢复快的优点,可以保留子宫,是一种有价值的微创手术。     

妊娠合并子宫肌瘤的临床处理

【目的】探讨妊娠合并子宫肌瘤剖宫产时的临床处理。【方法】对164例妊娠合并子宫肌瘤行剖宫产的情况进行分析。【结果】肌瘤剔除组、肌瘤未剔除组及正常剖宫产组术中出血量、术后24h出血量及术前、术后HB差值无显著性差异。剖宫产术同时行子宫肌瘤剔除术,剔除单发、多发,浆膜下、粘膜下、肌壁间肌瘤,术中出血量无显著性差异。剔除直径≤5cm和直径>5cm的肌瘤,术中出血量有显著性差异。所有病例术后无一例发生产褥感染,3组的伤口愈合无显著性差异。【结论】剖宫产同时应尽量行子宫肌瘤剔除术,以免除患者受二次手术的痛苦,但对于直径>5cm,位于子宫下段或远离切口的肌壁间、粘膜下肌瘤,由于手术困难风险较大,不主张剖宫产同时剔除子宫肌瘤。     

妊娠合并子宫肌瘤152例临床分析

目的 探讨妊娠合并子宫肌瘤术中处理方法.方法 回顾性分析2000年1月至2009年10月在本院治疗的152例妊娠合并子宫肌瘤患者的临床资料,并按分娩方式、肌瘤大小、肌瘤类型进行分组,对其术中出血量、手术时间及术后住院天数进行比较.结果 剖宫产前诊断妊娠合并子宫肌瘤98例,术前诊断率64.5%;剖宫产加子宫肌瘤剔除术术中出血量、手术时间和术后住院天数与单纯剖宫产相比差异无统计学意义妊娠合并浆膜下肌瘤组手术时间较妊娠合并子宫肌壁间肌瘤及子宫下段肌瘤组明显缩短;>8cm肌瘤组与≤2cm肌瘤组相比较,手术时间明显延长,术中出血量明显增多.结论 对于妊娠合并子宫肌瘤患者,需尽早明确诊断,并根据子宫肌瘤的类型、位置及大小和患者有无其他严重妊娠合并症等综合考虑以决定分娩方式和术中处理方法.对直径>8cm的肌瘤、子宫下段肌瘤的处理须谨慎.     

不影响宫腔形态的肌壁间子宫肌瘤对体外受精-胚胎移植妊娠结局的影响

目的 探讨不影响宫腔形态的肌壁间子宫肌瘤对体外受精-胚胎移植(IVF-ET)妊娠结局的影响及随访观察.方法 选取于生殖中心行IVF-ET,不孕合并超声检查示不影响宫腔形态的肌壁间子宫肌瘤患者91例,共行胚胎移植100个周期(观察组),抽取同期行IVF-ET治疗的单纯输卵管性不孕不合并子宫肌瘤患者100例(对照组).对两组的一般情况、控制性超排卵情况、体外受精参数和妊娠结局进行回顾性对照分析.结果 两组的基本情况差异无统计学意义.观察组与对照组的胚胎种植率(26.7% vs 30.5%)、临床妊娠率(48.0% vs 51.0%)、自然流产率(20.8% vs 31.4%)、活产率(32.0% vs 28.0%)、早产率(9.4% vs 7.1%)差异无统计学意义(P>0.05).随访示观察组和对照组的剖宫产率为81.3%(26/32)和71.4%(20/28),差异无统计学意义(P>0.05).观察组剖宫产术中行肌瘤剔除者超过半数(11/20),剔除的肌瘤大小为2~5 cm,无出现术中大出血.结论 不影响宫腔形态的肌壁间子宫肌瘤对IVF-ET临床妊娠结局无明显不良影响.     

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.