鼻内镜在慢性鼻窦炎鼻息肉的临床运用

目的：探究鼻内镜在慢性鼻窦炎鼻息肉治疗中的临床疗效。方法：回顾性分析2010年1月-2012年1月本院收治的慢性鼻窦炎鼻息肉患者48例,按随机数字表法分为传统治疗组22例和鼻内镜治疗组26例,分别柯陆氏手术及鼻内镜治疗。术后随访1年,对比两组患者的临床疗效及并发症。结果：鼻内镜治疗组痊愈17例,显效8例,总有效率96．15％,术后并发症1例;传统治疗组痊愈9例,显效9例,总有效率81．81％,术后并发症4例。两组临床疗效比较差异具有统计学意义（P〈0．05）。结论：鼻内镜治疗慢性鼻窦炎鼻息肉疗效确切,术前充分准备、麻醉方式合理选择及严格的手术操作可降低术后并发症,值得临床借鉴。     

护理干预对慢性鼻窦炎鼻息肉鼻内镜术后康复的影响

目的：探究慢性鼻窦炎鼻息肉鼻内镜手术后采用护理干预对术后康复质量的影响。方法：选取我院2012年3月～2012年9月间164例慢性鼻窦炎或鼻息肉患者,随机分为综合治疗组和常规治疗组各82例。观察慢性鼻窦炎鼻息肉鼻内镜手术护理干预后对术后康复效果的影响。结果：经过护理干预的慢性鼻窦炎鼻息肉鼻内镜术后的患者疗效显著和总有效率明显高于常规组患者,有显著的统计学差异（P〈0．05）。护理干预患者的鼻腔鼻窦结局测试20条明显优于常规组患者,差距有明显统计学意义（P〈0．01）。结论：慢性鼻窦炎鼻息肉经过鼻内镜手术前后采用护理干预,会提高手术后的康复效果。     

鼻内镜手术治疗慢性鼻窦炎鼻息肉临床效果观察

目的探讨鼻内镜手术治疗慢性鼻窦炎鼻息肉的临床效果。方法选择我院2010年1月-2011年1月收治的88例慢性鼻窦炎鼻息肉患者,随机将其分为观察组和对照组各44例,给予观察组患者鼻内镜手术治疗,给予对照组患者传统根治手术治疗。对2组患者的治疗总有效率、并发症发生率进行对比。结果观察组患者的治疗总有效率明显高于对照组（P〈0．05）,观察组患者的并发症发生率明显低于对照组（P〈0．05）。结论给予慢性鼻窦炎鼻息肉患者鼻内镜手术治疗有助于提高治疗效果,降低并发症发生率,值得推广和应用。     

鼻内镜下行慢性鼻窦炎鼻息肉手术治疗分析

目的：探讨鼻内镜下行慢性鼻窦炎鼻息肉手术治疗疗效。方法：将我院2004年至2009年收治的120例慢性鼻窦炎鼻息肉患者随机均分为两组,对照组60例行传统手术治疗,研究组60例行鼻内镜手术治疗,统计分析两组患者手术疗效。结果：对照组治疗总有效率61.6%;研究组治疗总有效率96.7%,经统计学分析处理X2=22.28,P〈0.01,两组差异比较显著,有统计学意义。结论：鼻内窥镜手术是治疗慢性鼻窦炎鼻息肉的有效方法,术前、术中及术后正确处理可显著提高手术疗效。     

鼻内镜手术治疗慢性鼻窦炎鼻息肉的临床疗效分析

目的：：探讨鼻内镜手术治疗慢性鼻窦炎鼻息肉的临床疗效。方法：收集2012年12月~2014年7月于本院治疗的慢性鼻窦炎鼻息肉的97例患者为研究对象,将其随机分为对照组和观察组,对照组46例给予传统手术治疗,观察组51例给予鼻内镜手术治疗,然后对2组患者的临床疗效及并发症进行统计及比较。结果：观察组：总有效率为92.16%;术后并发症发生情况：上颌窦口狭窄或闭锁1例,鼻腔粘连4例,发生率：9.80%。对照组：总有效率为92.16%;术后并发症发生情况：发热2例,出血2例,上颌窦口狭窄或闭锁4例,鼻腔粘连6例,发生率30.43%。2组对比均P<0.05,存在统计学差异。结论：鼻内镜手术治疗慢性鼻窦炎鼻息肉,要明显优于传统手术治疗,且并发症发生率低,建议临床医师采用。     

鼻内镜手术对鼻窦炎合并鼻息肉患者嗅觉检测评分的影响研究

目的：研究鼻内镜手术对鼻窦炎合并息肉患者嗅觉检测评分的影响。方法回顾性分析我院2013－01～2014－01间收治的60例鼻窦炎合并鼻息肉患者的资料,根据患者采取的治疗方法分为观察组和对照组,每组各30例患者。对照组患者采用药物治疗患者,观察组进行鼻内镜手术的治疗,观察两组患者的嗅觉检测评分等指标变化情况。结果观察组患者在术后12周各项临床症状均显著优于对照组,差异具有统计学意义,P＜0．05;观察组患者在对酸、香蕉等5种不同气味的嗅觉察觉阈值（ DT）和嗅觉识别阈值（ IT）的比较中,显著优于对照组,差异具有统计学意义,P＜0．05。结论较药物等保守治疗方法,鼻内镜手术治疗鼻窦炎合并鼻息肉患者效果显著,手术后患者嗅觉功能得到显著的改善,预后情况良好。     

鼻内镜下治疗慢性鼻窦炎鼻息肉的临床疗效观察

目的:探讨鼻内镜下治疗慢性鼻窦炎鼻息肉的临床疗效。方法:选择我院2008年1月-2011年12月期间收治的84例慢性鼻窦炎鼻息肉患者随机分为观察组和对照组,每组各42例,对照组采取传统鼻息肉根治手术,观察组采取鼻内镜下手术治疗,比较两组患者的临床疗效。结果:观察组治疗总有效率为95.2%,显著高于对照组的83.3%,组间差异有统计学意义(P<0.05)。所有患者均未发生脑脊液鼻漏、失明等并发症,对照组1例患者术后发生鼻腔粘连,经对症分离粘连处理后治愈。结论:鼻内镜下手术治疗慢性鼻窦炎鼻息肉临床疗效好,术中患者出血量小,术后恢复快,不良反应发生率低,且操作简便,是一种安全有效的治疗方法,值得临床进一步推广使用。     

鼻内镜手术治疗慢性鼻窦炎鼻息肉400例

目的：探讨鼻内镜手术治疗慢性窦炎鼻息肉的远期疗效及影响因素。方法：对2001～2007年400例慢性鼻窦炎鼻息肉患者行鼻内镜手术治疗，分为初期组和近期组，全部病例随访1年。结果：初期组治愈率60％，好转率32％，无效81％；近期组治愈率82％，好转率18％，无效0（P〈0．01）。结论：鼻内镜手术是治疗慢性鼻窦炎鼻息肉的有效方法，手术疗效与临床分期密切相关；合理围手术期处理，矫正鼻腔解剖形，术后定期随访可提高疗效。     

鼻内镜手术治疗慢性鼻窦炎鼻息肉临床观察

目的：分析鼻内镜手术治疗慢性鼻窦炎鼻息肉的临床疗效。方法：收集我院2011年7月～2013年7月期间诊治的慢性鼻窦炎鼻息肉患者100例作为研究对象,所有患者均经鼻内镜手术治疗,采用回顾性的方式分析患者的临床资料,观察治疗效果,同时对患者治疗前后的生活质量评分进行分析对比。结果：研究结果显示,本组患者经鼻内镜手术治疗后取得了良好的临床效果,其中有77例（77．0％）显效,21例（21．0％）有效,2例（2．0％）无效,总有效率为98．0％。所有患者均未出现严重术后并发症。患者术前生活质量平均评分为22．45±3．56分,术后生活质量平均评分为44．54±5．36分,患者术后生活质量明显提高,与术前比较具有明显差异（P＜0．05）。结论：鼻内镜手术治疗慢性鼻窦炎鼻息肉具有良好的临床疗效,能有效提高患者的生活质量,值得在临床应用上推广。     

鼻内镜手术治疗慢性鼻窦炎鼻息肉的临床观察与护理

[目的]观察鼻内镜与传统开放手术治疗慢性鼻窦炎鼻息肉的疗效。[方法]将我院2009年1~6月收治的慢性鼻窦炎鼻息肉患者40例作为对照组,2012年1~6月收治的慢性鼻窦炎鼻息肉患者40例作为观察组,其中对照组采用传统开放手术进行治疗,观察组采用鼻内镜手术进行治疗。[结果]对照组总有效率为82.5%,观察组总有效率为97.5%,两组疗效比较差异有统计学意义(P0.05);与对照组比较,观察组的手术时间和住院时间明显缩短(P0.05),术中出血量明显减少(P0.01)。[结论]采用鼻内镜治疗慢性鼻窦炎鼻息肉患者治疗效果好,值得在临床上推广使用。     

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.     

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.