腹股沟斜疝疝囊高位结扎无张力疝修补术的临床应用评价

目的:探讨分析腹股沟斜疝疝囊高位结扎无张力疝修补术的临床应用效果。方法:选择收治的腹股沟斜疝患者134例,其中,对照组67例,均行传统疝修补术,无张力组67例,均行疝囊高位结扎无张力疝修补术;对其临床资料进行分析,比较两组患者术后疼痛程度、复发率和并发症的发生率。结果:无张力组患者术后疼痛评分以及住院时间、下床活动时间等均明显优于对照组,差异具统计学意义(P<0.05);但是,两组患者术中出血量、手术和住院时间则差异无统计学意义(P>0.05);无张力组与对照组患者术后并发症发生差异无统计学意义(P>0.05);经6个月随访后,无张力组复发率为1.5%,对照组则为11.9,组间差异有统计学意义(P<0.05)。结论:采用疝囊高位结扎无张力疝修补术对腹股沟斜疝患者进行临床治疗,可有效缩短术后下床活动时间,减轻术后疼痛程度;同时,也极大地降低了术后复发率,对患者的身体康复起到积极的促进作用。     

填充式无张力疝修补术与传统疝修补术治疗腹股沟斜疝效果分析

目的比较填充式无张力腹股沟疝修补术与传统疝修补术治疗腹股沟斜疝的临床效果。方法选取行填充式无张力疝修补术的腹股沟斜疝患者27例作为观察组,同期行传统疝修补术的腹股沟斜疝患者27例作为对照组。回顾性分析两组手术时间、下床活动时间、术后住院时间、术后并发症情况;对所有患者随访两年,观察术后复发情况。结果观察组手术时间、下床活动时间、术后住院时间均短于对照组(P<0.01);观察组术后并发症发生率低于对照组(P<0.01),术后2年内复发率也低于对照组(P<0.05)。结论填充式无张力疝修补术与传统疝修补术治疗腹股沟斜疝比较,具有手术时间短、术后恢复快、术后并发症发生率及复发率低的优点,值得在基层医院推广应用。     

无张力疝修补术治疗成人腹股沟斜疝60例临床观察

目的：探讨无张力疝修补术在成人腹股沟斜疝中的治疗效果。方法收集2010年3月-2013年11月我院成人腹股沟斜疝住院患者118例,其中60例行无张力疝修补术（观察组）,58例行传统疝修补术（对照组）。分析比较2组术后疼痛评分、平均手术时间、平均住院时间、平均下床活动时间、复发率、并发症发生率的差异。结果2组术后疼痛评分、复发率、平均下床活动时间比较有差异性（P〈0.01）,观察组少于对照组;而在平均住院时间、并发症发生率比较2组差异无统计学意义（P〉0.05）。结论无张力疝修补术治疗腹股沟斜疝可有效缩短手术时间,降低复发率,减轻术后疼痛,能更好地促进患者的康复。     

无张力疝修补术治疗老年腹股沟斜疝效果观察

目的：观察无张力疝修补术治疗老年腹股沟斜疝的疗效。方法选择我院2011年1月-2012年6月收治的老年腹股沟斜疝患者88例,采用随机数字表法分为对照组和观察组,对照组给予传统疝修补术治疗,观察组给予无张力疝修补术治疗。比较2组的疗效。结果观察组的手术时间、住院时间、术后疼痛程度明显优于对照组（P〈0.05）;观察组术后并发症发生率为13.63%,明显低于对照组的34.09%（P〈0.01）;观察组的术后复发率为4.55%,明显低于对照组的22.73%（P〈0.01）。结论无张力疝修补术能有效治疗老年腹股沟斜疝,减轻患者疼痛,加快术后恢复速度,降低术后并发症发生率和复发率,疗效显著,值得在临床上推广。     

平片无张力疝修补法治疗斜疝30例临床分析

目的 探讨分析平片无张力疝修补法治疗斜疝的效果.方法 选取该院收治的30例采用平片无张力疝修补法治疗的腹股沟斜疝患者作观察组,另选取该院2011年1月以前收治的30例采用传统疝修补法治疗的腹股沟斜疝患者作对照组,观察两组患者的手术时间、住院时间、术后疼痛情况、术后并发症的发生率、术后复发率.结果 观察组与对照组在手术时间、住院时间、术后疼痛情况、术后并发症的发生率、术后复发率方面比较,观察组明显优于对照组.两组比较,差异有统计学意义（P＜0.05）.结论 平片无张力疝修补法治疗斜疝的效果显著,具有操作简单、安全度高、手术时间短、住院时间短、术后疼痛轻、术后并发症少、术后复发低的特点,值得临床推广.     

无张力疝修补术治疗老年腹股沟斜疝的效果观察

目的观察无张力疝修补术治疗老年腹股沟斜疝的临床治疗效果。方法选取我院58例老年腹股沟斜疝患者为观察对象,并将其平均分为治疗组（29例）和对照组（29例）。对照组患者采用传统手术方法进行治疗,治疗组患者采用无张力疝修补术进行治疗,对比2组患者临床治疗效果。结果 2组患者手术时间、疼痛率及住院时间存在显著差异（P〈0.05）;治疗组患者并发症发生率为17.24%,复发率为3.4%;对照组患者并发症发生率为41.38%,复发率为24.14%,2组比较差异有统计学意义（P〈0.05）。结论无张力疝修补术对老年腹股沟斜疝具有显著的治疗效果,可在一定程度上提高患者生活质量。     

两种不同术式治疗腹股沟斜疝的临床疗效分析

目的：观察无张力疝修补术和传统疝修补术在治疗腹股沟斜疝中的临床疗效。方法选取我院2009年7月～2012年4月收治的120例腹股沟斜疝患者,将入选患者随机分为观察组和对照组各60例。观察组患者采用无张力修补术,对照组患者采用传统疝修补术。比较分析两组患者的手术时间、住院时间、疼痛视觉模拟评分（VAS）及术后并发症等情况。结果观察组患者的手术时间、住院时间及VAS 评分和对照组相比较,差异具有统计学意义（P＜0．05）。观察组患者的术后发热率、切口感染率、术后尿潴留发生率、术后疼痛加剧的发生率及术后复发率等指标和对照组相比,差异具有统计学意义（P＜0．05）。结论无张力疝修补术和传统疝修补术相比,创伤较小、痛苦小、患者住院时间短,并且术后患者并发症较少,是一种较理想的腹股沟斜疝修补术,有一定的临床借鉴意义。     

疝环充填式无张力疝修补术治疗老年人复发性腹股沟斜疝的效果

目的探讨疝环充填式无张力疝修补术治疗老年人复发性腹股沟斜疝的临床疗效。方法20例老年人复发性腹股沟斜疝随机分为治疗组和对照组各10例,对照组采用常规手术治疗,治疗组采用疝环充填式无张力疝修补术治疗,然后通过住院时间、并发症的发生率、手术时间、疼痛率和复发率来观察两组的疗效。结果采用疝环充填式无张力疝修补术的治疗组经过治疗后,并发症发生率、疼痛率、手术时间、复发率和住院时间均低于对照组。结论疝环充填式无张力疝修补术具有术后并发症发生率较低、复发率低、手术时间短、恢复快、手术创伤小和易操作等显著的优势,因而其应用范围也比较广,适应证比较多,值得临床大力推广。     

充填式无张力疝修补术治疗腹股沟斜疝 80 例临床疗效观察

目的探讨充填式无张力疝修补术治疗腹股沟斜疝临床效果。方法选取2011年1月至2012年12月收治的腹股沟斜疝患者160例,采用随机数字表法分为对照组和观察组,每组各80例,其中对照组患者采用传统疝修补术治疗,观察组患者采用充填式无张力疝修补术治疗。比较两组患者手术时间、住院时间、术后疼痛及并发症发生率等。结果对照组患者手术时间和住院时间分别为（97．5±18．0）min和（7．2±1．8）d;观察组患者手术时间和住院时间分别为（40．2±11．5）min和（4．6±1．0）d;观察组患者手术时间和住院时间均明显少于对照组（P均〈0．05）。观察组患者术后疼痛发生率、切口感染、阴囊积液及尿潴留等并发症发生率均明显低于对照组（P〈0．05）。结论充填式无张力疝修补术治疗腹股沟斜疝与传统疝修补术相比,具有快速、微创、术后恢复快,并发症少等优势。     

无张力疝修补术在腹股沟斜疝中的应用

目的:探讨疝环充填式无张力疝修补术在腹股沟斜疝中的应用。方法:自2003年1月至2005年6月,共有90例腹股沟斜疝患者,随机分成对照组和治疗组,比较两组的手术效果及并发症。结果:采用疝环充填式无张力斜疝修补术在手术时间,平均下床活动时间以及疼痛等并发症方面优于传统腹股沟斜疝修补术。结论:疝环充填式无张力斜疝修补术具有手术时间短,术后恢复快,并发症少等优点,是治疗腹股沟斜疝的理想术式。     

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.