慢性萎缩性胃炎120例胃镜与病理的对照分析

目的探讨胃镜对慢性萎缩性胃炎（CAG）的诊断价值。方法对胃镜诊断的120例慢性萎缩性胃炎进行镜下,幽门螺旋杆菌（Hp）感染情况,病理结果对照分析,分别计算胃镜下CAG各种表现对病理诊断CAG、肠上皮化生及异型增生的敏感性,HP感染和肠上皮化生的相关性。结果 120例CAG中病理诊断107例,胃镜与病理诊断符合率为89.2%。胃镜下各种表现对病理诊断CAG的敏感性为20.5%～98.2%。胃镜下3种表现共存时对病理诊断CAG、肠上皮化生及异型增生的敏感性较高,其阳性率与单一表现比较有显著性差异（P〈0.01）。结论胃镜直视下的黏膜变薄、皱襞变平;血管透见、白相为主,黏膜粗糙、颗粒状或结节样改变共存时对CAG、肠上皮化生及异型增生的病理诊断价值最高,但正确的诊断还需要胃镜直视与病理诊断密切结合。     

慢性萎缩性胃炎的胃镜下表现与病理诊断对照分析

目的 :对比分析慢性萎缩性胃炎的病例诊断与胃镜下表现.方法 :将我所操作的胃镜检查当中,其中100例接受胃镜检查诊断为慢性萎缩性胃炎患者的病理诊断结果与胃镜诊断结果进行对比分析,总结胃镜下慢性萎缩性胃炎的表现对病理诊断异型增生、肠上皮化生的特异性、敏感性和阳性预测值.结果 :本组100例慢性萎缩性胃炎患者中,病理诊断出84例,病理诊断与胃镜诊断符合率为84.0%.结论 :胃镜检查下结节样或颗粒状改变、黏膜粗糙,血管透见、黏膜变薄、红白相间,以白相为主等症状共存时对慢性萎缩性胃炎的病理诊断价值较高,临床中想要提高慢性萎缩性胃炎的诊断准确性应将病理诊断与胃镜检查相结合.     

慢性萎缩性胃炎胃镜下表现与病理诊断对照

目的探讨内窥镜下表现对萎缩性胃炎（CAG）的诊断价值。方法对68例内镜诊断的CAG与病理结果进行对照,分别计算镜下CAG各种表现对病理诊断CAG、肠上皮化生及异型增生的敏感性和特异性。结果内窥镜直视与病理诊断符合率为88.24%。CAG内镜下的各种表现对病理诊断的敏感性为24.62%～50.67%。3种表现共存时的敏感性、特异性及阳性预测值最高。两者间阳性率比较有显著差异（P〈0.05）。结论3种表现共存时对CAG病理诊断的准确性最高。     

慢性萎缩性胃炎胃镜检查与病理诊断结果的相关性研究

目的探讨慢性萎缩性胃炎(CAG)胃镜下表现与病理检查结果的相关性。方法对胃镜下诊断为CAG的患者106例再进行胃镜检查,比较胃镜下表现与病理结果的相关性。结果 106例患者中胃镜诊断CAG116例,CAG合并慢性浅表性胃炎(CSG)52例;病理诊断CAG103例,CSG34例,CAG合并CSG31例。CAG胃镜诊断与病理诊断的符合率为79.76%。胃镜下黏膜粗糙不平,部分呈颗粒状或结节状改变与病理诊断CAG的符合率为83.33%,而与黏膜红白相间并以白为主,血管透见,黏膜变薄,皱襞变平并存时,对CAG的符合率高达100.00%,肠上皮化生、异型增生的诊断符合率分别为76.47%和41.18%,并且CAG主要伴随Ⅲ型肠上皮化生。结论 CAG胃镜诊断和病理诊断有一定相关性。     

慢性萎缩性胃炎内镜与病理结果的相关性探讨

目的 探讨中重度慢性萎缩性胃炎(CAG)的胃镜下表现与病理结果的关系,提高胃镜诊断CAG的水平.方法 对50例中重度CAG的胃镜下诊断及表现与病理学结果进行相关性探讨.结果 病理诊断中重度CAG33例,轻度CAG10例,正常6例.肠上皮化生27例,异型增生31例.中重度CAG的胃镜诊断与病理结果比较肉眼符合率为67.35%.胃镜下表现与病理结果比较,胃粘膜的各种表现对CAG的阳性预测值均达到80%以上,多种表现同时存在对CAG阳性预测值接近90%,其阳性率之间比较无显著差异.各种胃镜下表现的灵敏度及特异度均在95%以上.黏膜变薄等表现对肠上皮化生及异型增生的阳性预测值均较低在70%以下,灵敏度及特异度在30%以下.黏膜粗糙不平颗粒样改变对IM及异型增生诊断的灵敏度分别为92.85%和83.33%,特异度也均在70%左右.结论 中重度CAG的胃镜下诊断符合率较低,但是通过对胃镜下表现的认识可提高诊断符合率.     

胃镜下黏膜形态对慢性萎缩性胃炎诊断的价值

目的探讨胃镜下黏膜形态对慢性萎缩性胃炎(CAG)诊断的价值。方法对胃镜普通白光下诊断为CAG的400例病人的镜下与病理诊断符合程度进行研究,并计算各种黏膜形态对CAG诊断的灵敏度、特异度和阳性预测值。结果胃镜诊断为CAG的400例标本病理诊断为CAG者279例,慢性浅表性胃炎(CSG)121例,胃镜与病理诊断符合率为69.75%。胃镜下的各种表现对CAG诊断的灵敏度为5.02%～35.13%,一种表现的特异度与阳性预测值低,两种表现共存的特异度和阳性预测值分别为93.39%、95.87%和79.49%、89.36%,3种表现同时存在时特异度、阳性预测值均为100.00%。黏膜粗糙伴淡黄色结节、瓷白色结节、鱼鳞状改变对肠上皮化生的诊断准确率分别为91.43%、86.36%、100.00%。结论胃镜下两种及以上表现并存对CAG诊断准确率高,黏膜粗糙伴淡黄色结节、瓷白色结节、鱼鳞状改变对诊断肠上皮化生具有指导意义。     

萎缩性胃炎的胃镜表现对黏膜组织学改变的预测

目的 探讨萎缩性胃炎(CAG)胃镜下典型表现对病理组织学改变的预测价值。方法 对64例胃镜下诊断为萎缩性胃炎的胃镜表现及病理改变进行相关性研究，分别计算胃镜下典型表现对CAG预测的敏感性、特异性、阳性预测值及阴性预测值。结果 64例患者中胃镜诊断CAG22例，CAG与浅表性胃炎(CSG)合并42例；病理结果CAG32例，CSG22例，CAG与CSG合并10例。胃镜诊断与病理诊断比较，符合率为70．31％。胃镜下CAG的各种典型表现对病理组织学诊断的敏感性和阴性预测值都不高，均在52％以下。胃镜下某些表现对CAG诊断有较高的特异性，疣状改变、铺路石样改变特异性分别达到84．21％和94．74％，红白相间白相为主伴黏膜不平、颗粒样改变其特异性达到100％。胃镜下CAG的各种典型表现对肠上皮化生的阴性预测值都在75％以上。结论 胃镜下CAG的各种典型表现对病理组织学诊断的敏感性和阳性预测值都不高，胃镜下某些表现对CAG诊断有较高的特异性和阳性预测值，胃镜下CAG的各种典型表现对病理肠上皮化生有较高的阴性预测值。     

慢性萎缩性胃炎的胃镜下表现与病理诊断对照分析

目的比较分析慢性萎缩性胃炎的胃镜诊断与病理诊断结果,以此来探讨胃镜检查在诊断慢性萎缩性胃炎中的价值。方法选取近年在我院接受胃镜检查且直视下诊断为慢性萎缩性胃炎的患者240例,所有病例在胃镜检查之后均进行组织病理学检查。结果240例患者在胃镜直视下均诊断为慢性萎缩性胃炎,经病理检查确诊214例为慢性萎缩性胃炎,其中112例伴随肠上皮化生,46例伴随异型增生;26例为慢性浅表性胃炎。胃镜诊断结果与病理诊断结果的诊断符合率为89.2%。胃镜下的各种表现对病理诊断慢性萎缩性胃炎的敏感性为20.5%-98.2%。胃镜下三种表现同时存在时对病理诊断慢性萎缩性胃炎、肠上皮化生及异型增生的敏感性较高,且阳性率与单一表现比较差异具有统计学意义(P0.05)。240例慢性萎缩性胃炎患者中,174例为Hp阳性,66例为Hp阴性;Hp阳性患者肠上皮化生占73.2%(82/112),显著高于Hp阴性患者的27.8%(30/112),二者比较差异具有统计学意义(P0.05)。结论胃镜检查与组织病理学检查对于慢性萎缩性胃炎的诊断存在一定的差异,因此在临床工作中有必要将胃镜诊断与病理诊断有机结合起来,才能显著提高慢性萎缩性胃炎的临床诊断准确率。     

慢性萎缩性胃炎的胃镜下表现与病理诊断结果比较

目的探讨慢性萎缩性胃炎的胃镜下表现与病理诊断结果的符合率。方法选取本院2014年1月至2018年12月内镜室接受胃镜检查的5 010例患者为研究对象,其中167例患者经胃镜诊断为慢性萎缩性胃炎,分析黏膜病理活检与胃镜诊断的一致性。结果在167例患者中4例拒绝送病理检查,慢性浅表性胃炎77例,慢性萎缩性胃炎86例,其中伴有非典型增生7例,上皮内瘤变13例,肠上皮化生20例。萎缩性胃炎胃镜诊断准确率为51.50%(86/167),内镜下表现为颗粒状或结节状改变、黏膜粗糙不平49例,其中病理诊断为萎缩性胃炎16例,诊断符合率为32.65%;颗粒状或结节状改变,黏膜粗糙不平且红白相间以白为主51例,其中病理诊断为萎缩性胃炎13例,诊断符合率为25.49%,符合率比较差异无统计学意义。颗粒状或结节状改变,黏膜粗糙不平且红白相间以白为主,黏膜血管暴露且透明,褶皱变薄、变平或消失67例,其中病理诊断为萎缩性胃炎57例,诊断符合率为85.07%,符合率比较差异有统计学意义(P<0.05)。结论慢性萎缩性胃炎的胃镜诊断与病理活检诊断结果具有一定差异性,具体还应根据内镜下表现的特征性并结合病理诊断来提高诊断准确率,以早期发现慢性萎缩性胃炎。     

慢性萎缩性胃炎内镜与病理诊断的相关性研究

目的对中重度慢性萎缩性胃炎(CAG)经过胃镜检查的结果与病理结果的关系进行分析探讨。方法将本院近几年收治的中重度CAG患者共计180例作为研究资料,将全部患者在胃镜下诊断结果与表现与病理学结果进行相关性研究。结果经病理诊断,有60例为中重度CAG,有110例为轻度CAG,有10例为正常。有80例为肠上皮化生(IM),有100例为异型增生。中重度CAG的胃镜诊断和病理结果进行比较,肉眼符合率:68%。其中的20例患者经过在胃镜下美蓝染色后,诊断符合率:80%。应用胃镜检测结果与病理结果进行比较,胃黏膜的各种表现对CAG的阳性预测值都大于80%,多种表现同时存在对CAG阳性预测值可大于90%,其阳性率之间进行比较,无显著的统计学意义。各种胃镜下表现的灵敏度与特异度都大于95%。黏膜变薄等表现对IM和异型增生的阳性预测值均低于70%,灵敏度与特异度都低于30%。黏膜粗糙不平对IM与异型增生诊断的灵敏度分别是93%与83%,特异度大概在70%。结论中重度CAG的胃镜下诊断符合率是比较低的,但是通过对胃镜下表现的认识与应用染色技术能够使诊断符合率提升。     

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…     

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     

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.     

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.