鼻腔解剖结构与慢性鼻-鼻窦炎

目的探讨鼻腔解剖结构对慢性鼻-鼻窦炎的影响因素。方法选择慢性鼻-鼻窦炎患者152例,结合CT和鼻内镜检查情况,分析解剖结构异常与慢性鼻窦炎的关系。结果解剖结构异常如鼻中隔偏曲、钩突肥大、中鼻甲异常与慢性鼻-鼻窦炎的发生有密切关系。结论鼻腔解剖结构生理性或病理性变异,是慢性鼻窦炎发生发展的病理学基础。     

鼻中隔偏曲与鼻窦炎的相关性探讨

随着鼻窦内窥镜的广泛应用及对鼻腔鼻窦解剖的深入了解,人们认识到鼻中隔偏曲与鼻窦炎之间有密切关系。本文旨在观察鼻中隔偏曲与窦口鼻道复合体解剖变异及鼻窦炎病变的关系进行探讨。1资料与方法1.1一般资料前瞻性连续收集2005年10月至2007年5月住院手术治疗的鼻中隔偏曲伴鼻窦炎患者71例,男39例,女32例,年龄17～76岁。     

54例鼻内镜下鼻中隔偏曲和多鼻窦联合手术的护理

慢性鼻窦炎是耳鼻喉科的常见病、多发病,鼻中隔偏曲并发肥厚性鼻炎往往是慢性鼻窦炎的重要原因.在慢性鼻窦炎手术治疗的同时,进行鼻中隔偏曲矫正术、中下鼻甲的手术以及鼻息肉切除术,使鼻内解剖结构正常化,对防止复发有重要意义.我科于2006年8月～2008年9月实行鼻内镜下鼻中隔偏曲联合多鼻窦手术54例,护理体会报告如下.     

鼻部解剖变异与鼻源性头痛的相关性研究

目的研究鼻部解剖异常与鼻源性头痛的发病关系。方法对215例术前经CT检查和手术证实为鼻源性头痛患者的临床资料进行分析。结果215例鼻部解剖变异的发生率为:鼻丘气房92.1%,Haller气房19.0%,中鼻甲气化40.0%,反常曲线中鼻甲6.5%,钩突异常(增生、偏曲、气化)10.7%,鼻中隔偏曲52.1%,鼻中隔偏曲合并中鼻甲异常17.2%,鼻中隔偏曲合并中鼻甲异常及钩突、筛泡异常11.6%,上颌窦发育不良4.2%。手术矫正变异结构,鼻源性头痛的治愈率达87.1%。结论鼻部解剖变异与鼻源性头痛的发病密切相关。     

鼻中隔偏曲和慢性鼻窦炎的相关性分析

目的：探讨鼻中隔偏曲与慢性鼻窦炎的关系。方法：通过前鼻镜、鼻内窥镜、鼻窦冠状位CT检查，观察鼻中隔偏曲患者鼻腔、鼻窦情况及慢性鼻窦炎患者鼻中隔情况，并作统计分析。结果：53例鼻中隔偏曲患者中，高位偏曲38例，其中16例患鼻窦炎，低位偏曲15例，其中4例患鼻窦炎，96例慢性鼻窦炎中，38例鼻中隔偏曲，其中29例为高位偏曲，9例为低位偏曲。结论：鼻中隔偏曲尤其是高位偏曲与鼻窦炎发病密切相关。     

鼻中隔偏曲和慢性鼻窦炎的联合鼻内镜手术治疗

目的 探讨鼻中隔偏曲和慢性鼻窦炎鼻内镜联合手术疗效.方法 39例鼻中隔偏曲合并慢性鼻窦炎进行鼻中隔偏曲矫正术联合鼻内镜鼻窦开放术,观察疗效和并发症.结果 术后随访6个月~1年,所有患者鼻中隔矫正居中,无1例鼻腔粘连,鼻中隔穿孔或感染、脑脊液鼻漏等并发症.结论 鼻中隔偏曲和慢性鼻窦炎的鼻内镜联合手术方式有效,是一种比较安全的手术方式.     

鼻中隔偏曲与慢性鼻-鼻窦炎的关系分析

目的对鼻中隔偏曲和慢性鼻-鼻窦炎之间的关系进行深入的分析。方法将在我科室接受治疗的慢性鼻-鼻窦炎患者141例作为研究对象,作为研究组并选择同期我科室无鼻病症状的患者136例作为对照组,对鼻中隔偏曲的发生情况进行对比分析。结果研究组141例患者中共有74例患者存在鼻中隔偏曲,而对照组136例患者中只有24例患者存在鼻中隔偏曲,对照组与研究组的鼻中隔偏曲患者所占比例存在巨大差异(P0.05),具有统计学意义。结论鼻中隔偏曲与慢性鼻-鼻窦炎之间存在相关性。     

慢性鼻窦炎与鼻腔解剖变异的联合鼻内镜手术

目的:探讨慢性鼻窦炎合并鼻腔解剖变异的鼻内镜手术方法及疗效.方法:对156例慢性鼻窦炎伴鼻腔鼻窦解剖变异患者行鼻内镜手术,术中并对鼻中隔偏曲、中鼻甲变异及下鼻甲肥大同期进行处理纠正.结果:术后随访6～18个月,共治愈126例(80.8%),好转25例(16%),无效5例(3.2%),总有效率为96.8%,无严重手术并发症发生.结论:对于慢性鼻窦炎患者术前及术中应注意观察及判定其有无明显鼻腔解剖变异,对相关解剖变异应同期在鼻内镜下予以处理矫正,可通畅鼻窦引流,提高手术疗效,减少术后复发.     

窦口鼻道复合体解剖变异与慢性鼻窦炎的CT表现

目的 :分析窦口鼻道复合体解剖变异与慢性鼻窦炎的关系。方法 :对 5 0例窦口鼻道复合体解剖变异伴鼻窦炎行CT冠状位扫描并进行分析。结果 :中鼻甲肥大或气化 3 2例 ,鼻中部鼻中隔偏曲 2 1例 ,异常钩突 4例 ,Haller气房 3例 ,上颌窦发育不良 2例 ,其他解剖变异 11例。结论 :窦口鼻道复合体解剖变异是引起鼻窦炎的重要原因 ,其中前组鼻窦炎与窦口鼻道复合体病变有明显关系。     

鼻中隔偏曲与慢性鼻窦炎的相关性分析

目的 探讨鼻中隔偏曲在慢性鼻窦炎发生过程中的作用.方法 选取我科治疗的慢性鼻窦炎患者35例作为研究组,选取门诊就诊的无鼻部症状患者35例作为对照组,患者均行鼻内镜及鼻窦CT检查.比较不同类型的鼻中隔偏曲对慢性鼻窦炎的影响,并分析其相关性.结果 研究组35例慢性鼻窦炎患者中有27例患者存在鼻中隔偏曲,其中高位偏曲18例,低位偏曲9例;对照组35例患者有8例患者存在鼻中隔偏曲,其中高位偏曲2例,低位偏曲6例,研究组的鼻中隔偏曲的发生率明显高于对照组(P＜0.05).结论 鼻中隔偏曲与慢性鼻窦炎有相关性,在慢性鼻窦炎发生及发展中起着重要作用.     

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.     

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.