腹腔镜手术治疗输卵管妊娠的临床观察

目的:探讨腹腔镜手术在治疗输卵管异位妊娠中的临床应用价值.方法:将我院经临床诊断为输卵管异位妊娠的82例患者,随机分为腹腔镜组52例和开腹手术组30例,比较两组手术时间、术中出血量、术后输卵管复通率及术后处理等情况.结果:本组中手术时间、手术方式、输卵管妊娠部位及血β-HCG下降,持续性输卵管妊娠情况腹腔镜组与开腹手术...     

腹腔镜手术与开腹手术治疗异位妊娠的临床疗效比较

目的:研究比较腹腔镜手术和开腹手术治疗异位妊娠的临床疗效.方法:将我院2011年02月到2012年11月收治的160例异位妊娠患者随机分为腹腔镜手术组和开腹手术组,腹腔镜手术组患者应用腹腔镜采取输卵管切口取胚手术及伞端挤取胚术,开腹手术组患者使用常规开腹手术治疗.对两组患者的手术时间、术中出血量、术后肛门首次排气时间及输卵管通畅率进行对比观察.结果:腹腔镜手术组患者在手术时间、术中出血量、术后肛门首次排气时间及输卵管通畅率方面均优于开腹手术组患者(P＜0.05).结论:腹腔镜手术取得的临床疗效较开腹手术组更显著,能够满足患者的生育需求.     

腹腔镜手术治疗异位妊娠58例临床分析

目的探讨腹腔镜手术治疗异位妊娠的临床疗效。方法将58例经腹腔镜手术治疗的异位妊娠患者与同期开腹手术治疗的58例异位妊娠患者进行比较,比较两组患者的术中出血量、手术时间、住院时间、术后肛门排气时间、术后发热、术后镇痛药使用情况。结果腹腔镜手术组1例输卵管峡部妊娠患者因术中剥离面止血困难中转开腹手术,其余手术均腹腔镜下顺利完成,开腹手术组均顺利完成。与开腹手术组相比,腹腔镜手术组术中出血量少、手术时间短、住院时间短、术后恢复快(P0.05)。结论腹腔镜手术治疗异位妊娠具有创伤小,出血少,术后恢复快等优点,值得在临床推广应用。     

开腹手术与腹腔镜手术治疗异位妊娠的临床观察

目的 对临床上开腹手术与腹腔镜手术治疗异位妊娠进行研究观察.方法 系统性分析本院于2009年5月~2011年6月住院治疗的170例异位妊娠患者的临床资料.采用随机分组的方法分为两组,开放手术组80例,行传统的开腹手术,腹腔镜手术组90例,行腹腔镜手术,分析比较两组患者的平均住院时间、术后体温恢复情况、下床时间.结果 在平均住院时间、术后体温恢复情况、下床时间上,腹腔镜手术组明显优于开放手术组,差异具有统计学意义(P<0.05).结论 对于异位妊娠手术治疗的患者,行腹腔镜手术能够缩短住院时间,促进患者术后体温恢复,提早患者下床活动,与传统开腹手术比较有诸多的优点.     

腹腔镜与开腹手术治疗输卵管妊娠的疗效比较

目的比较腹腔镜与开腹手术治疗输卵管妊娠的疗效。方法分析156例输卵管妊娠的病例,腹腔镜手术94例,开腹手术62例,比较两组手术时间、术中出血量,抗生素应用时间、术后住院天数、术后疼痛及切口愈合情况。结果腹腔镜手术组术中出血量、术后应用止痛药、术后住院时间、术后抗生素使用时间明显优于开腹手术组（P〈0.05）。结论在治疗输卵管妊娠方面,腹腔镜手术优于开腹手术。     

腹腔镜手术与剖腹手术治疗输卵管妊娠的对照研究

目的 探讨腹腔镜手术治疗输卵管妊娠的临床价值.方法 对经临床诊断为输卵管异位妊娠的75例患者.随机分为电视腹腔镜手术组40倒和剖腹手术组35例,进行临床资料对比分析.结果 电视腹腔镜手术组均顺利完成,无中转开腹者.两组患者术中出血量、术后镇痛、术后肛门排气时间、住院时间比较均有显著差异(P＜0.05),手术时间、住院费用等情况无显著差异(P＞0.05).结论 电视腹腔镜手术是治疗输卵管妊娠的较为理想的手术方式.     

腹腔镜手术与开腹手术对治疗输卵管妊娠的疗效比较

目的比较初期开展腹腔镜手术与开腹手术治疗输卵管妊娠的疗效．方法分析76例输卵管妊娠的病例,腹腔镜手术32例,开腹手术44例,比较两组手术时间、术中出血量,术后病率,抗生素应用时间、术后住院天数、术后镇痛泵使用率及切口愈合情况．结果腹腔镜手术组术中出血量、术后应用止痛药、术后发热时间、术后住院时间、术后抗生素使用时间明显优于开腹手术组（P〈0．05）．结论在腹腔镜手术方面治疗输卵管妊娠优于开腹手术．     

腹腔镜与开放手术治疗精索静脉曲张的疗效比较

目的 比较腹腔镜与开放手术治疗精索静脉曲张的临床疗效.方法 选择2008年2月至2011年6月该院收治的精索静脉曲张患者60例,其中腹腔镜组29例,开放手术组31例,比较两组患者手术情况及治疗费用等.结果 腹腔镜组术后住院时间、术后止痛药使用及术后复发率均明显少于或低于开放手术组(P＜0.05),而住院费用则高于开放手术组(P＜0.05);两组手术时间、术后肠功能恢复时间及并发症发生率比较差异均无统计学意义(P＞0.05).结论 腹腔镜手术治疗精索静脉曲张安全、有效,术后恢复快,复发率低,但其手术费用较高.     

腹腔镜与开放手术治疗输卵管异位妊娠的疗效对比

目的:比较腹腔镜与开放手术治疗输卵管异位妊娠的临床疗效。方法:采用回顾性方法选取我院自2011年10月-2013年10月以来收治的68例输卵管异位妊娠患者的临床资料,按照手术方法分为对照组及观察组,每组各34例。对照组给予开放手术,观察组患者给予腹腔镜手术,比较两组患者的临床疗效。结果:两组患者手术均成功,无死亡病例,且在手术时间、血β-hCG恢复时间上两组无显著差异,不具有统计学意义(P>0.05);在镇痛剂使用率、术中出血量、术后肛门排气时间、住院时间及妊娠几率上差异具有统计学意义(P<0.05)。结论:输卵管异位妊娠患者行腹腔镜手术的疗效确切,且创伤性小、恢复快,可作为异位妊娠治疗的理想方法,具有临床推广应用价值。     

腹腔镜治疗输卵管妊娠的临床观察

目的探讨研究腹腔镜手术方法在治疗输卵管妊娠患者的临床诊治方面的应用。方法采集114例输卵管妊娠患者作为研究对象，并选定其中62例输卵管妊娠患者作为治疗组行腹腔镜手术组，并选取同期52例行开腹式手术的患者作为对照组进行比较。结果两组患者在输卵管妊娠类型、身高体重、年龄等术前指标比较差异均无统计学意义（P＞0.05），但在手术时间、术中失血量、住院时间、术后排气时间、术后下床时间、术后止痛药应用、等方面比较差异均有统计学意义（P＜0.05）。结论腹腔镜手术方法应用于临床治疗输卵管妊娠患者较其他方法有较好疗效。     

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.