乳晕乳头去表皮双菱形皮瓣填充支撑治疗乳头内陷

目的探讨一种去表皮皮瓣填充乳头组织及乳头下基底支撑组织治疗乳头内陷的手术方法。方法乳头内陷14例,采用乳晕乳头去表皮双菱形皮瓣,翻转一侧皮瓣填充乳头组织,翻转另一侧皮瓣填充乳头下基底支撑组织,同时收紧乳头根部去表皮的创缘以缩小乳头基底的周径。结果14例乳头内陷患者术后均未发生乳头血运障碍。随访2个月-2年,乳头内陷无复发,乳头外形医患双方均满意,乳头感觉无障碍。结论采用乳晕乳头双菱形去表皮皮瓣填充支撑治疗乳头内陷操作简单,乳头形态自然,血运无障碍,感觉功能正常,切口瘢痕不明显,哺乳功能得以保留,符合理想的乳头内陷矫治术的5个方面的要求。     

乳晕纺锤型皮瓣结合人工真皮填充法矫治乳头内陷

目的:介绍一种乳晕去表皮纺锤型皮瓣结合人工真皮填充矫治乳头内陷的手术方法。方法:采用乳晕去表皮纺锤型皮瓣缝合支撑乳头基底,并结合人工真皮填充乳头基底,使乳头隆起,重塑乳头外凸形态。结果:2010年3月-2013年10月采用此方法治疗42例,40例效果满意,术后随访3个月到2年,乳头内陷无复发,乳头感觉良好,外形满意。结论:乳晕去表皮纺锤型皮瓣结合人工真皮填充矫治乳头内陷的手术方法,操作简便,效果持久,不易复发,是矫正乳头内陷的一种较理想的手术方法。     

双三角去表皮皮下蒂皮瓣转移治疗先天性乳头内陷

目的：介绍一种矫治乳头内陷的手术方法。方法：设计双三角去表皮皮下蒂皮瓣转移矫治乳头内陷,术后持续牵引2—3周。结果：治疗15例,术后切口均一期愈合,无乳头血运障碍。随访6～12个月,切口瘢痕不明显,外形满意无复发。结论：本法是矫正乳头内陷的一种较好方法。     

去表皮双菱形组织瓣矫正先天性乳头内陷

目的 探讨去表皮双菱形组织瓣矫正先天性乳头内陷的效果.方法 设计皮下蒂去表皮双菱形乳头乳晕真皮与乳腺腺体复合组织瓣,松解短缩的乳腺导管及纤维束,将组织瓣推进由乳头下方的隧道内穿出作为支撑组织治疗乳头内陷.结果 治疗先天性双侧乳头内陷21例,术后切口均Ⅰ期愈合,乳头血运均良好,术后随访2～18个月,切口瘢痕不明显,乳头感...     

改良乳晕真皮瓣沉降技术矫正中重度乳头内陷的临床疗效

【摘要】 目的 评价改良乳晕真皮瓣沉降技术治疗中重度乳头内陷的临床效果。 方法 收集2011年9月～2016年9月四川大学华西医院采用改良乳晕真皮瓣沉降技术治疗中、重度先天性乳头内陷患者36 例（59 只）。观察患者术后的临床疗效。 结果 36 例患者手术均顺利完成，术中乳头内陷矫正率100%。术后切口均Ⅰ期愈合，无切口红肿、出血、感染及乳头血运障碍等发生。患者均获随访，随访时间6～30个月。患者乳头轮廓和突度满意，未见乳头回缩及内陷，双侧乳头外形基本对称，2只重度内陷的乳头（34%）早期出现轻度感觉障碍，术后6个月逐渐恢复，其余感觉基本一致且无异常感觉。 结论 改良乳晕真皮瓣沉降技术能有效矫治中、重度乳头内陷。改良法相对于传统方法具有对乳头支撑好，损伤小和瘢痕轻的优势。     

去表皮乳晕双菱形组织瓣内翻充填矫治乳头内陷

目的探讨乳头内陷的治疗方法。方法应用去表皮双菱形乳晕真皮瓣与乳腺腺体组织瓣内翻充填治疗先天性乳头内陷,松解短缩的乳腺导管及纤维束,将组织瓣由乳头下方的隧道内穿出作为支撑组织。结果8例患者随访半年至2年,形态均良好,其中1例术后正常哺乳。结论该术式是矫正乳头内陷的较好方法之一,效果确切,不易复发。     

乳晕真皮瓣填充矫治乳头内陷

乳头内陷是一种较为常见的女性乳房畸形 ,发生率为 2 % 〔1〕。目前主要依靠手术矫治 ,但术后复发率较高。我们利用乳晕真皮瓣填充矫治先天性乳头内陷 1 2例 ,效果满意。现报道如下。1　资料与方法1 .1　一般资料　本组 1 2例 (2 4个乳头 )均为严重的 (Ⅲ型 )先天性乳头内陷 ,年龄 2 2～ 3 1岁 ,已婚 8例 ,未婚 4例 ;均为美容而求治 ,不强调术后保留哺乳功能。1 .2　手术方法　局部浸润麻醉 ,用一粗线将内陷乳头牵出 ,以乳头为中心设计一梭形切口 ,其长径约 3 .0～ 3 .5ｃｍ ,与乳头基底的圆形轮廓线相交 ,其弧形长度视乳头大小及内陷程度而…     

保留哺乳功能的乳头内陷整形术

目的探讨理想的矫正乳头内陷的最佳方法,同时兼顾保留哺乳功能。方法松解主乳管周围挛缩,应用去表皮对偶三角乳晕瓣充填乳头凹陷下方的组织缺损,同时收紧乳头颈部,使乳头成形外观良好。结果 12例乳头内陷得到矫正,切口一期愈合,未发生主乳管损伤,随访哺乳功能正常。结论该方法手术操作简便,乳头牵出后下方缺损填充可靠,效果良好,不易复发,术后保留哺乳功能,是较为理想的方法,值得推广应用。     

乳头基部松解加悬吊法矫治乳头内陷28例

乳头内陷是一种较常见畸形，表现为乳头不凸出于乳晕平面或凹入陷于皮面之下，致局部呈火山口状。乳头内陷的程度有所差别，轻度表现为乳头退缩，重者表现为乳头凹人甚至翻转。我们利用乳头基部松解加悬吊方法共矫治28例53个原发性乳头内陷，术后随访半年至1年，效果满意。报告如下：     

改良新月形组织瓣法矫正原发性乳头内陷

原发性乳头内陷系由于乳头、乳晕的平滑肌发育不良，乳头下缺乏支撑组织撑托所致。轻度乳头内陷者，可自行用手法牵引或电动吸引矫治，对于较严重的乳头内陷畸形，应针对病因进行手术矫正。以往多种手术对严重的乳头内陷矫正常有外形不佳或乳头部分坏死、内陷复发等各种不足。     

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.