垂体后叶素在腹腔镜下大子宫次全切除术中的应用

目的 观察垂体后叶素在腹腔镜下大子宫次全切除术中的应用效果.方法 选取2013年1月至2014年11月在我院妇科行腹腔镜下大子宫次全切除术治疗的患者102例,根据患者是否使用垂体后叶素分为观察组(n=70)和对照组(n=32),观察组患者给予垂体后叶素子宫体肌层注射治疗,并根据给药剂量分为A组(n=34,垂体后叶素6U)和B组(n=36,垂体后叶素12 U),对照组患者术中未应用垂体后叶素.比较三组患者术中及术后情况,并分别于给药前、给药后1 min、3 min、5 min、10 min、30 min监测患者氧分压(SpO2)、心率(HR)、血压(BP)的变化和并发症发生情况.结果 观察组与对照组患者在手术时间、术中出血量、术后血红蛋白(Hb)下降水平和并发症发生率方面比较差异均具有统计学意义(P<0.05),但A组和B组间的上述各指标间比较差异均无统计学意义(P>0.05);垂体后叶素给药前后,观察组患者SpO2均无明显变化(P>0.05),A组和B组患者HR均降低,A组患者的HR在给药后5 min、10 min、30 min明显低于给药前(P<0.05),B组患者的HR在给药后3 min、5 min、10 min、30 min明显低于给药前(P<0.05),且下降幅度明显大于A组(P<0.05);与给药前比较,A组和B组患者收缩压(SBP)和舒张压(DBP)在给药后1 min、3 min、5 min、10 min、30 min时均明显升高(P<0.05),且B组患者升高幅度明显大于A组(P<0.05).结论 腹腔镜下大子宫次全切除术中应用垂体后叶素可明显缩短手术时间,减少术中出血量.小剂量垂体后叶素对机体循环系统影响较少,可广泛应用于临床.     

垂体后叶素及普鲁卡因联合应用治疗中大量咯血48例临床分析

目的:研究垂体后叶素及普鲁卡因联合应用治疗中大量咯血的临床治疗效果。方法:选取144例大量咯血患者,将其随机分成三组,即普鲁卡因组47例,垂体后叶素组49例,垂体后叶素和普鲁卡因联合用药组48例,比较三组的治疗效果。结果:普鲁卡因组和垂体后叶素组止血效果比较差异无统计学意义(P>0.05),垂体后叶素组不良反应显著高于普鲁卡因组(P<0.05);垂体后叶素联合普鲁卡因组止血效果优于普鲁卡因组和垂体后叶素组(P<0.05)。结论:普鲁卡因和垂体后叶素联用止血效果更强,不良反应更少。     

酚妥拉明联合垂体后叶素治疗老年支气管扩张伴大咯血的临床分析

目的：探讨酚妥拉明联合垂体后叶素治疗老年支气管扩张伴大咯血的临床效果。方法选取老年支气管扩张伴大咯血患者72例，采取随机分组方式将患者分为对照组和观察组，各36例。观察组与对照组患者入院后均采取止咳、镇静、体位引流等常规对症治疗。对照组患者给予静脉注射垂体后叶素治疗，将20 U的垂体后叶素注入500 mL的5%的葡萄糖溶液中，静脉注射，1天2次；观察组患者给予酚妥拉明联合垂体后叶素治疗，将30mg的酚妥拉明加入到500mL的5%的葡萄糖溶液中，静脉注射，1天2次。结果本研究观察组治疗总有效率为88.9%，对照组治疗总有效率为66.6%，差异具有统计学意义（P<0.05)。观察组治疗不良反应率为5.6%，对照组治疗不良反应率为22.2%，差异具有统计学意义（P<0.05)。结论酚妥拉明联合垂体后叶素治疗老年支气管扩张伴大咯血具有良好效果，安全性高，值得进行推广。     

小剂量垂体后叶素治疗体外循环后血管麻痹综合征

目的 观察小剂量垂体后叶素在体外循环后血管麻痹综合征(VS)患者治疗中的作用及其并发症.方法 对24例体外循环后VS患者分别予以小剂量垂体后叶素(0.04 u·kg-1·h-1,A组)和去甲肾上腺素治疗(N组),治疗目标为达到平均动脉压(MAP)≥70 mm Hg,记录两组患者的性别、年龄、体质量、心功能分级、诊断、治疗前及治疗后(治疗后1、3、5、10、20、30、60、120 min)的血流动力学参数、尿量、肾功能、电解质、耗用去甲肾上腺素的剂量及病例数、临床并发症等.结果 予小剂量垂体后叶素治疗后1 min MAP和外周循环阻力指数(SVRI)均显著升高(P＜0.01),与N组患者相比,A组患者治疗后1 min的MAP升高显著(P＜0.01);在治疗后3 min的心指数(CI)显著降低(P＜0.01);中心静脉压(CVP)和平均肺动脉压(MPAP)无明显变化;每搏量变异(SVV)明显下降(P＜0.05).尿量显著增加(P＜0.05),血肌酐(Cr)显著下降(P＜0.05).结论 小剂量垂体后叶素治疗可明显改善体外循环后VS患者的血流动力学,并改善肾功能.     

不同剂量阿司匹林应用于老年急性脑梗死患者的效果及对神经功能与并发症的影响分析

目的:分析老年急性脑梗死患者应用不同剂量阿司匹林治疗后神经功能的改善效果及并发症的变化。方法:采用随机数字表法将我院119例老年急性脑梗死患者分为低剂量组39例(100mg/d)、中剂量组40例(200mg/d)、高剂量组40例(300mg/d),对比三组患者治疗14d后的临床疗效、神经功能改善效果及并发症发生率。结果:中、高剂量组总有效率均高于低剂量组(P <0. 05);中、高剂量组治疗后NIHSS评分均低于低剂量组(P <0. 05);中、高剂量组总有效率及治疗后NIHSS评分对比差异均无统计学意义(P> 0. 05);低、中、高剂量组并发症发生率两两对比,差异均无统计学意义(P> 0. 05)。结论:阿司匹林200mg日剂量治疗急性脑梗死效果显著,安全性佳,值得临床推广应用。     

垂体后叶素雾化吸入治疗老年人咯血的疗效观察

目的观察垂体后叶素雾化吸入治疗老年人咯血的效果与副作用。方法将43例60岁以上老年咯血病人随机分为治疗组22例和对照组21例,治疗组给予垂体后叶素用垂体后叶素6-12U加入生理盐水20ml雾化吸入,3次/d;对照组给予5%的葡萄糖注射液或生理盐水500m加入脑垂体后叶素15-30U静脉滴注维持治疗。疗程均为3d。观察两组治疗效果及不良反应发生率。结果治疗组与对照组临床总有效率分别为94%和93%,差异无统计学意义（P〉0.05）;治疗组各种副作用发生率均明显低于对照组（P〈0.05）。结论垂体后叶素雾化吸入治疗老年人咯血与静脉应用疗效无显著差异,但可显著减少不良反应发生。     

垂体后叶素联合酚妥拉明治疗支气管扩张大咯血的疗效观察

目的观察垂体后叶素联合酚妥拉明治疗支气管扩张伴大咯血的临床疗效.方法将2009年3月~2012年4月我院收治的支气管扩张伴大咯血患者72例随机分为对照组与观察组,对照组单纯采用垂体后叶素,观察组采用垂体后叶素联合酚妥拉明治疗,比较两组患者临床治疗效果.结果观察组患者临床总有效率为97.22%,明显高于对照组(86.11%),两组比较具有显著性差异(P<0.05);观察组患者平均止血时间为(5.10±1.68)d,不良反应发生率为5.56%,均明显少于对照组,两组比较差异显著,具有统计学意义(P<0.05).结论垂体后叶素联合酚妥拉明治疗支气管扩张伴大咯血疗效显著,不良反应少,值的临床推广和应用.     

酚妥拉明联合垂体后叶素治疗老年支气管扩张伴大咯血的疗效

目的探究酚妥拉明联合垂体后叶素治疗老年支气管扩张伴大咯血的临床疗效。方法选取2012年7月至2016年7月我院收治的114例老年支气管扩张伴大咯血患者进行研究,以患者入院时间为分组依据,给予B组57例患者单纯垂体后叶素进行治疗,给予a组57例患者酚妥拉明联合垂体后叶素进行治疗,对两组患者的治疗效果及不良反应发生情况进行对比。结果 a组患者的治疗有效率(96.49%)显著高于B组患者82.46%,组间差异有统计学意义(P0.05),a组患者的不良反应发生率(8.77%)与B组24.56%相比,差异较大,二者存在统计学意义(P0.05)。结论酚妥拉明与垂体后叶素联合应用对老年支气管扩张伴大咯血疾病的治疗有显著效果,用药后,患者不良反应率有明显降低,临床应用价值较高。     

垂体后叶素联合酚妥拉明治疗老年支气管扩张伴大咯血临床疗效观察

目的:对垂体后叶素联合酚妥拉明治疗老年支气管扩张伴大咯血临床疗效进行观察和研究。方法:资料选取收治的老年支气管扩张伴大咯血患者64例,平均分为两组,对照组患者单纯采用垂体后叶素进行治疗,研究组患者则采用垂体后叶素联合酚妥拉明进行治疗,并对两组临床资料进行回顾性分析。结果:经治疗后,研究组总有效率96.88%,明显高于对照组总有效率84.38%;且研究组不良反应发生率3.12%,明显低于对照组12.50%,两组比较,差异具有统计学意义(P<0.05)。结论:垂体后叶素联合酚妥拉明治疗老年支气管扩张伴大咯血的临床疗效较为显著,值得在临床中广泛推广应用。     

不同剂量的右美托咪定复合丙泊酚和瑞芬太尼用于腹腔镜胆囊手术的麻醉效果观察

目的 探讨不同剂量的右美托咪定复合丙泊酚和瑞芬太尼用于腹腔镜胆囊手术的麻醉效果.方法 选取2017年1月至2019年11月在本院治疗的80例腹腔镜胆囊手术患者,随机分为对照组、低剂量组、中剂量组、高剂量组,各20例.观察比较4组不同时间点HR、MAP水平、不良反应发生率.结果 用药后10 min,低、中剂量组的HR、MAP水平显著低于诱导前5 min,高剂量组HR水平升高(P<0.05);用药后60 min,低剂量组患者血压未达标,高剂量组HR降低,MAP低于基础值(P<0.05);与对照组比较,拔管即刻低剂量组血压反跳升高(P<0.05),高剂量组HR、MAP明显降低(P<0.05);高剂量组不良反应发生率显著高于其他组,低、中剂量组不良反应发生率与对照组比较差异无统计学意义,低、中剂量组不良反应发生率比较差异无统计学意义.结论 针腹腔镜胆囊手术患者应用中剂量右美托咪定可维持患者手术过程中血流动力学稳定,降低拔管引起的应激反应,降低不良反应发生率,值得临床推广应用.     

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.