软组织肿瘤的治疗

目的：探讨软组织肿瘤的规范化治疗。方法：对良、恶性软组织肿瘤42例治疗方法进行分析。结果：良性软组织肿瘤25例全部治愈,17例恶性软组织肿瘤收到较为满意的效果。结论：对软组织肿瘤病人应综合评估和分期并由此制定手术方案,同时配合综合治疗。     

四肢恶性骨与软组织肿瘤的保肢手术（31例报告）

四肢恶性骨与软组织肿瘤的保肢手术（３１例报告）施能木，胡世平，林祥松关键词骨肿瘤，恶性，软组织肿瘤，恶性，保肢手术四肢原发性恶性骨肿瘤的治疗，过去多采用高位截肢术，近２０年来随着外科技术与化疗等方法的发展，国内外许多医生采用保留肢体的手术为主，化疗为...     

软组织肿瘤的磁共振成像诊断

目的：探讨良、恶性软组织肿瘤的磁共振成像（MRI）征象，进一步提高MRI诊断良、恶性软组织肿瘤的作用。方法：回顾性分析手术后病理确诊的26例良性软组织肿瘤和21例恶性软组织肿瘤的MRI资料。统计学方法应用四格表确切概率法。结果：（1）边界清楚、含铁血黄素沉积、周围结构的推压移位不宜作为区分软组织肿瘤良、恶性的MRI征象；（2）肿瘤的大小、信号情况、是否有液化坏死和骨质破坏可作为区分软组织肿瘤良、恶性的MRI征象；（3）瘤周浸润和附近淋巴结肿大是区分软组织肿瘤良、恶性的可靠征象；（4）肿瘤直径大于5cm，同时有液化坏死和瘤周浸润是区分软组织肿瘤良、恶性最可靠的MRI征象。结论：在软组织肿瘤的定性诊断中MRI能够区分其良、恶性，具有重要的诊断价值。     

软组织肿瘤的术后放疗14例报告

软组织肿瘤的术后放疗１４例报告青海医学院附属医院肿瘤放疗科李安临软组织肿瘤一直被认为恶性程度高，临床治疗较为困难，易复发易转移的恶性肿瘤，过去多年均采用截肢或扩大根治术的手段以图控制肿瘤的复发和转移，然而这种治疗方法逐渐被临床所排斥［１］。为探讨软组...     

软组织肿瘤微血管生成因素初步研究

目的:通过对良、恶性软组织肿瘤血管内皮生长因子(VEGF)和微血管密度(MVD)之间的相关性研究,探讨良、恶性软组织肿瘤VEGF、MVD的临床应用意义。方法:43例软组织肿瘤,其中良性19例,恶性24例。采用免疫组织化学S-P法检测VEGF表达和MVD计数。结果:良、恶性软组织肿瘤间的VEGF、MVD计数间均有显著性差异(P<0.05)。结论:VEGF高表达、MVD值高的恶性软组织肿瘤,预示其浸润程度和转移率高,预后差。     

探讨骨与软组织肿瘤的综合治疗

目的综合国内外学者对骨与软组织肿瘤的治疗方法,提出最新治疗骨与软组织肿瘤及恶性肿瘤的方法。方法通过收集97例软组织肿瘤的病人数据,随机分成两组,即对照组(目前临床治疗方案)与治疗组(最新治疗方案),对照组又分为良性组和恶性组;治疗组也是分为良性组及恶性组。比较对照组与治疗组的临床效果。结果应用SPSS17.0统计软件计算得出:χ~2为11.896552,P为0.000562,校正χ2为10.178987,P为0.001421,对照组恶性的存活率是10.7%,治疗组恶性的存活率是92.9%,治疗组较对照组明显高出很多,说明综合治疗是有统计学意义的。结论治疗组较对照组的临床效果取得了明显的差异,有统计学意义。     

经腹壁超声、CT及MRI对软组织肿瘤的诊断价值对比

目的 对比分析经腹壁超声、CT及MRI对软组织肿瘤的诊断价值。方法 选取本院2016年2月至2019年3月收治的114例软组织肿瘤患者为研究对象,比较不同检查诊断良、恶性软组织肿瘤的灵敏度、特异度。结果 腹壁超声检查、CT检查诊断良性软组织肿瘤的灵敏度、特异度比较差异无统计学意义(P>0.05),MRI检查诊断灵敏度、特异度优于腹壁超声(P<0.05)。腹壁超声检查诊断恶性软组织肿瘤的灵敏度与CT、MRI检查比较差异无统计学意义(P>0.05),腹壁超声检查诊断恶性软组织肿瘤特异度低于CT、MRI检查(P<0.05)。结论 腹壁超声、CT与MRI检查均可有效鉴别诊断良、恶性软组织肿瘤,临床上可结合患者自身情况,选择最佳的诊断方法,为临床治疗方案的选择提供可靠的依据。     

腺泡状软组织肉瘤14例临床及病理特点分析

腺泡状软组织肉瘤（alveolar soft part sarcoma，ASPS）又称恶性颗粒细胞肌母细胞瘤，是发生在软组织内的一种罕见肿瘤。我们对14例ASPS的临床治疗、预后及病理形态学进行了分析。     

肝原发性恶性巨细胞瘤1例报告并文献复习

目的结合文献复习探讨肝原发性恶性巨细胞瘤（pnmary malignant giant cell tumor of liver）的临床病理特点，免疫组化及预后。方法对本院的1例肝原发性恶性巨细胞瘤进行观察，结合文献复习对该肿瘤进行研究。结果肿块较大，大片出血、坏死，细胞异型明显，核分裂象较多。随访半年，患者死亡，诊断为肝原发性恶性巨细胞瘤。免疫组化染色：CD68几乎所有多核细胞均为阳性，部分单核细胞CD68染色阳性。结论原发性软组织巨细胞瘤是一类罕见肿瘤，好发于四肢及躯干表浅软组织，发生于肝更是罕见；好发年龄为成年人，男女性别差异不大。免疫组化染色CD68阳性。该肿瘤具有潜在恶性，大多数经过是良性，但确有恶性患者。治疗以扩大切除为主。     

阔筋膜张肌肌皮瓣修复腹股沟恶性肿瘤切除后缺损的临床探讨

目的探讨阔筋膜张肌肌皮瓣带蒂转移修复腹股沟区域恶性肿瘤切除后巨大软组织缺损的临床疗效。方法2006年1月-2010年1月，我科收治腹股沟区域恶性体表肿瘤6例，行扩大切除术后形成继发软组织缺损，缺损范围10．0cm×8．5cm-27．Ocm×17．5cm，采用同侧阔筋膜张肌肌皮瓣带蒂转移修复。结果6例患者皮辩全部成活，且一期愈合；术后随访1年以上，2例出现肿瘤局部复发，修复后外形满意，惠侧肢体功能良好，生活质量明显提高。结论阔筋膜张肌肌皮瓣可以满意修复腹股沟区域恶性体表肿瘤切除后的软组织缺损，有效保护腹股沟区域重要神经血管，是一种简便，安全，有效的治疗方法。     

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.     

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.