阴道斜膈综合征临床分析

目的探讨阴道斜膈综合征的临床特征、诊断及治疗。方法对2000年3月至2006年5月间我院收治的10例阴道斜膈综合征患者的临床资料进行回顾性分析。结果患者年龄13-30岁,Ⅰ型2例,Ⅱ型7例,Ⅲ型1例;临床表现为下腹痛和痛经7例,阴道流脓3例,不孕症3例;10例例均合并双子宫,单角子宫2例,内膜囊肿3例;8例合并同侧肾脏缺如,2例合并马蹄肾;误诊2例;治疗以斜膈切开术为主,部分病例同时行内膜囊肿剥除和单角子宫切除。结论阴道斜膈综合征临床表现较多样,常合并泌尿系畸形,结合临床表现、超声检查和阴道探查可以早期诊断,提高对该疾病的认识可以减少误诊。     

阴道斜隔综合征6例临床分析及文献复习

目的：探讨阴道斜隔综合征的合理诊疗方法。方法：对6例阴道斜隔综合征患者的临床资料进行回顾性分析。结果：6例患者中解剖分型Ⅱ型5例,Ⅲ型1例。6例患者均行B超检查。4例提示双子宫,2例提示完全性子宫纵隔。右侧阴道斜隔3例,左侧阴道斜隔3例。6例均合并斜隔侧肾缺如。3例行阴道斜隔切除术,3例行宫腹腔镜诊治+阴道斜隔切除术。2例术中诊断盆腔子宫内膜异位症,1例术中诊断盆腔炎及输卵管积液。3例术前痛经,术后痛经消失。3例有生育要求,其中2例术后自然受孕。结论：阴道斜隔综合征临床表现多样,易误诊漏诊。准确诊断该病是治疗的关键。阴道斜隔综合征最根本的治疗方式是斜隔切除引流。     

先天性阴道斜隔综合征7例分析

目的：探讨先天性阴道斜隔综合征的临床、声像图特征，指导临床正确手术。方法 回顾性分析7例手术证实阴道斜隔综合征患者的临床、声像图特征，误诊的主要原因，总结诊断要点。结果 Ⅰ型4例，发病年龄小，月经初潮后短时间以痛经、阴道囊肿或盆腔包块就诊；Ⅱ型3例，发病年龄较大，除痛经、盆腔包块外，可有阴道排液症状，易误诊。超声声像图特征双子宫、双宫颈，不同程度的积液，伴有斜隔侧肾脏缺如。超声是诊断阴道斜隔首选的可靠方法。斜隔患者是可以正常受孕的，结局较好。     

阴道三维彩超联合宫腔镜诊治阴道斜隔综合征的临床分析

目的:探讨阴道三维彩超联合宫腔镜在阴道斜隔综合征的诊断与治疗的价值。方法:回顾性分析7例经阴道三维彩超诊断阴道斜隔综合征患者行宫腔镜检查并行宫腔镜下电切治疗。结果:诊断为Ⅰ型1例,Ⅱ型4例,Ⅲ型2例;术后随访6月～3年,临床治愈率为100%。结论:阴道三维彩超联合宫腔镜诊治阴道斜隔综合征安全、准确、微创。     

阴道斜隔综合征(OVSS)的诊断与处理

目的探讨阴道斜隔综合征的诊断及治疗。方法回顾性分析我院1999年1月—2008年4月收治的阴道斜隔综合征10例临床资料并复习相关文献。结果10例患者中,Ⅰ型4例,Ⅱ型5例,Ⅲ型1例。双子宫、双宫颈9例,双子宫、单宫颈1例,斜隔位置均在右侧。10例全部伴斜隔侧肾脏缺如。8例行阴道斜隔切除术。结论病史、临床表现及B超检查对诊断阴道斜隔综合征有重要意义,行阴道斜隔切除术是主要的治疗手段。     

阴道斜隔综合征十例的诊断与治疗

目的 探讨阴道斜隔综合征的病理解剖特点、临床表现、诊断及治疗要点.方法 对我院1991～2008年间诊断的10例阴道斜隔综合征临床资料进行回顾性分析并复习相关文献.结果 阴道斜隔综合征10例双子宫、双宫颈,伴斜隔侧肾脏缺如.主要临床表现为进行性加重的痛经、经期延长、阴道流液或流脓及盆腔或阴道壁囊性肿块.10例均经阴道行斜隔切除术治愈,随访9例.结论 阴道斜隔综合征临床上并非罕见,病史、临床表现及B超检查对诊断有重要意义,一经诊断应及时行阴道斜隔完全切除术.     

道斜隔综合征5例的诊治体会

阴道斜隔综合征是指双子宫、双宫颈、双阴道,一侧阴道完全或不完全闭锁的先天性畸形,多伴闭锁阴道侧的肾缺如。本病由于临床上少见,易被忽视而误诊。我院1994年9月至2007年7月诊治的阴道斜隔综合征5例,现分析报告如下。1临床资料1.1一般资料发病年龄13~26岁,平均15岁。均为月经初潮后发病,发病距初潮时间0.5~13年,已婚2例,未婚有性生活1例,未婚2例。Ⅰ型2例,Ⅱ型2例,Ⅲ型1例。1.2临床表现痛经3例,阴道流脓3例,经期延长3例,腹痛5例,阴道壁囊肿5例,囊肿上极均达盆腔,下极位于阴道上段2例,中段2例,下段1例。1.3辅助检查B超示双子宫,单侧肾缺如…     

阴道斜隔综合征的CT 征像分析

目的 探讨阴道斜隔综合征的CT 表现。方法 回顾性分析云南省第一人民医院经妇科阴道镜或 宫腔镜证实的7 例阴道斜隔综合征患者的CT 资料。结果 所有患者均显示双子宫、双宫颈。其中,6 例患者 显示隔后腔,隔后腔扩张伴积液4 例。所有7 例患者均为单肾畸形并伴有肾体积增大,左侧单肾4 例,右侧单 肾3 例。3 例患者合并输尿管轻度扩张。3 例患者合并单纯性卵巢囊肿。1 例患者合并卵巢巧克力囊肿。结论 阴道斜隔综合征有其特征性CT 表现,识别这些征象有助于影像学医师做出正确诊断。     

宫颈癌合并原发性阴道肿瘤性病变10例

目的 探讨宫颈癌合并阴道肿瘤性病变的临床特征及预后.方法 对1999年6月至2008年4月收治的10例宫颈癌合并原发性阴道癌或阴道上皮内瘤变患者的临床资料及随访结果 进行回顾性分析.结果 在10例病人中,宫颈癌合并原发性阴道癌4例,合并阴道上皮内瘤变(vagina intraepithelial neoplasia,VAIN) 6例,平均年龄50.6岁(32～75岁);平均孕次2.6次,平均产次1.6次,绝经前4例,绝经后6例,主诉不规则阴道出血3例,接触性出血3例,绝经后阴道流液3例,无症状1例.妇科检查阴道病变特征:6例阴道穹隆黏膜异常,2例阴道肿物,2例肉眼观察未发现异常; 宫颈癌表现:宫颈糜烂型4例,外生型2例,溃疡型2例,光滑2例.10例患者中,7例手术治疗,3例因分期较晚及合并严重内科并发症行放化疗,随访时间3个月至9年,未发现复发.结论 宫颈癌合并阴道上段癌或阴道断端VAIN,临床表现无特征性症状和体征,诊断主要依靠阴道镜检查,治疗以手术为主,预后相对较好,因病例数少,有待进一步总结.     

先天性阴道斜隔综合征的超声诊断分析

[目的]探讨先天性阴道斜隔综合征的超声诊断,为临床诊疗提供参考.[方法]选择2010年1月～2014年11月间经手术证实的阴道斜隔综合征病例6例,回顾性分析其临床资料及声像图特征.[结果]6例患者中,超声正确诊断4例,1例误诊为盆腔包块,1例误诊为阴道闭锁,诊断符合率为66.7％,误诊率为33.3％.6例阴道斜隔综合征患者均为双宫颈,有5例为双子宫,1例为单宫体双宫腔.6例均伴斜隔侧肾缺如.[结论]超声对先天性阴道斜隔综合征的诊断及鉴别诊断具有重要意义,提高对该病的认识能减少误诊.     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.