可吸收螺钉在儿童肱骨外髁骨骺骨折的应用

目的研究可吸收螺钉在儿童肱骨外髁骨骺骨折中的临床应用价值。方法2004年1月～2007年6月以来，用可吸收螺钉内固定治疗32例儿童肱骨外髁骨骺骨折，术后屈肘90。位石膏托固定，3周后去除膏托，行肘关节功能锻炼。结果随访6个月。4年，骨折全部愈合。疗效优者24例，良者5例，可3例；优良率为90％。结论可吸收螺钉固定儿童肱骨外髁骨骺骨折临床疗效是确切的，经随访不会加重骨骺损伤，骨折固定后经短期石膏托外固定，即进行关节功能锻炼，改善了关节功能，无需二次手术，减轻患者的创伤和痛苦，节约了医疗费用。     

可吸收螺钉治疗儿童肱骨外髁骨折分析

目的探讨可吸收螺钉内固定治疗儿童肱骨外髁骨折的临床效果。方法回顾性分析我科1997年1月至2004年12月使用可吸收螺钉治疗的30例儿童肱骨外髁骨折进行分析。结果30例病人均得到随访6个月至2年,平均随访时间为1年。骨折全部愈合,肘关节功能良好,效果满意。结论可吸收螺钉内固定作用坚强,有利于骨折的愈合,可避免二次手术,减轻病人负担,对儿童肱骨外髁骨折的治疗具有特殊的优越性。     

可吸收钉、棒内固定治疗儿童肱骨内上髁骨折

目的：探讨可吸收钉、棒内固定治疗儿童肱骨内上髁骨折的疗效及优缺点。方法：2009-2011年我院采用切开复位可吸收钉、棒内固定治疗儿童肱骨内上髁骨折23例,术后外固定3周后早期功能锻炼,随访6个月～3年,平均18个月。结果：本组23例均获得随访,骨折愈合23例,肘关节功能优20例,良3例,劣0例,优良率100%。结论：可吸收钉、棒内固定治疗儿童肱骨内上髁骨折能达到满意的骨折复位及牢固的内固定效果。可吸收材料在体内随着时间推移自行分解对人体无害,不影响影像学检查,无需二期手术取出内固定材料。术后可行早期功能锻炼,骨折愈合效果肯定,不影响关节功能及骨骺发育。     

可吸收螺钉内固定治疗儿童肱骨外髁骨折

目的:研究可吸收螺钉在儿童肱骨外髁骨折中的临床应用。方法:2002年1月~2003年9月以来,应用可吸收螺钉内固定治疗16例儿童肱骨外髁骨折,术后予长臂石膏托固定于屈肘90度位,2周~3周后去除石膏托,行肘关节功能锻炼。结果:随访3个月~20个月,骨折全部愈合。疗效优者9例,良者4例,可2例,差1例;优良共计13例,优良率为81.3%。结论:可吸收螺钉固定儿童肱骨外髁骨折是较为理想的生物材料,骨折固定后仅辅以短期石膏托外固定即可达到骨折愈合,且能进行早期关节功能锻炼,省去了二次手术给患儿带来的痛苦及扣损伤,节约了二次手术的费用。     

闭合复位经皮穿针石膏托外固定对儿童肱骨髁上骨折的治疗

目的:探讨闭合复位经皮穿针、石膏托外固定治疗儿童肱骨髁上骨折的临床疗效。方法:1997年11月至2006年6月采用闭合复位经皮穿针、石膏托外固定治疗儿童肱骨髁上骨折48例,男25例,女23例。结果:按照Ju-piter等肘关节评分系统,评价肘关节功能。肘关节功能优44例、良3例、可1例。优良率97.9%。肱骨髁上骨折临床愈合时间3.5周~4.5周,平均1个月。骨折完全愈合时间2.0个月~3.5个月,平均时间2.5个月。结论:闭合复位经皮穿针、石膏托外固定治疗儿童肱骨髁上骨折能够使骨折在早期进行有效固定,骨折愈合时间早,肘关节功能恢复良好,并发症少,方法操作简便适合于开展。     

可吸收线张力带合并克氏针交叉固定治疗儿童陈旧性肱骨外髁骨折

目的探讨可吸收线张力带合并克氏针治疗儿童陈旧性肱骨外髁骨折的治疗效果及儿童肱骨外髁骨折治疗的注意事项和经验。方法回顾性研究2014年1月至2016年1月江西中医药大学附属医院收治的18例陈旧性肱骨外髁骨折患儿临床资料,均采用可吸收线张力带合并克氏针交叉固定治疗,术后定期随访患儿骨折愈合情况。结果 18例患儿均获得随访。骨折愈合时间4~12周,平均6周。无术后感染、神经损伤、肱骨小头缺血坏死、骨不连等并发症。肘关节活动根据Hardacre的疗效标评估,优16例(88.9%),良2例(11.1%)。结论可吸收线张力带合并克氏针交叉固定治疗儿童陈旧性肱骨外髁骨折获得较为满意的治疗效果;肱骨外髁骨折骨折的处理第一要务就是在于早期的诊断,及时正确的治疗,防止陈旧性肱骨外髁骨折的产生,而对于陈旧性肱骨外髁骨折的早期手术治疗却能够使得肘关节的外观和功能得到有效的纠正。     

可吸收线配合克氏针治疗儿童肱骨髁上骨折

目的:探讨采用交叉克氏针加外侧可吸收线张力带内固定治疗儿童肱骨髁上骨折临床疗效。方法:对收治的23例儿童肱骨髁上骨折采用交叉克氏针加外侧可吸收线张力带内固定术临床资料进行回顾性分析。结果:本组病例骨折均达解剖复位,骨折均Ⅰ期愈合,优18例,良4例,可1例,优良率95.6%。6例于功能锻炼时出现针尾处红肿反应,换药后好转,骨折愈合后拔除克氏针,针孔均愈合。患者随访时间为24～48个月。结论:交叉克氏针加外侧可吸收线张力带内固定治疗儿童肱骨髁上骨折符合肘关节生物力学要求,手术创伤小,固定可靠,能早期进行肘关节功能锻炼,是较理想的治疗方法。     

可吸收棒内固定治疗肱骨外髁骺损伤临床应用研究

目的探讨采用切开复位可吸收棒内固定治疗儿童肱骨外髁骺损伤的效果。方法作者总结了4例肱骨外髁骺损伤病人。均有明显旋转移位,采用切开复位可吸收棒内固定治疗。结果经随访24～28月,平均26个月;骨折愈合时间为3～6周,平均5周。患肘屈伸功能均完全恢复正常,无肘内外翻及骨骺生长停滞发生。结论采用切开复位可吸收棒内固定治疗肱骨外髁骺损伤由于其解剖复位,固定可靠,对骨骺生长发育影响小,术后肘关节外观及功能恢复良好。     

可吸收内固定物在治疗儿童肱骨髁上骨折的临床应用

目的与方法：作者采用SR—PGA、PLLA可吸收螺钉、固定棒手术治疗儿童肱骨髁上骨折27例(均为GarlandⅢ型),27例病人均获得随访,平均随访时间11个月。疗效的判断以局部功能判断及术后不同时期影像学检查综合判断。结果：优24例、良1例、可1例,优良率92．5％,全部病例骨折固定至愈合无移位,无伤口感染。结论：作者认为可吸收内固定棒是治疗儿童肱骨髁上骨折的理想内固定物。     

可吸收螺钉治疗肱骨髁部骨折78例分析

目的探讨减少肱骨骨折术后后遗症的方法。方法对我院收治的78例儿童肱骨髁部骨折患者采用可吸收螺钉内固定治疗。结果78例肘关节功能评定,总优良率97％,无肘内翻、肘关节活动受限及继发性尺神经损伤等后遗症。结论可吸收螺钉内固定治疗肱骨骨折效果显著,优良率高,术后后遗症少。     

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.