超声引导微创旋切系统在乳腺良性肿瘤治疗中的应用

目的探讨超声引导微创旋切系统与常规开放手术在治疗乳腺良性肿瘤中的效果。方法将2014年9月~2015年8月我院收治的328例乳腺良性肿瘤患者根据手术方案分为研究组150例和对照组178例,研究组实施超声引导下的微创旋切手术,对照组则实施常规开放手术,术后随访1个月,比较两组患者的手术时间、术中出血量、切口长度、愈合时间、术后瘢痕大小等,并采用调查问卷了解患者的手术满意度。结果研究组和对照组的手术切除率分别为98.0%和99.4%,差异无统计学意义(P0.05);研究组患者的手术时间、术中出血量、切口长度、愈合时间、术后瘢痕长度均显著低于对照组,差异有统计学意义(P0.05);研究组术后并发症发生率为1.3%,显著低于对照组的5.1%(P0.05);随访满意度调查结果显示,研究组总体满意度为96.0%,显著高于对照组的79.2%(P0.05)。结论超声引导下的麦默通微创旋切系统用于乳腺良性肿瘤的治疗具有创伤小、术后恢复快、安全性高且手术美观程度好的特点,比常规开放手术更具优势,值得在临床上推广和应用。     

经乳晕边切口乳房微创旋切术对治疗乳腺小结节的美容优势及治疗效果

目的:探讨经乳晕边切口乳房微创旋切术对治疗乳腺小结节的美容优势及治疗效果。方法:回顾性分析2017年2月-2019年4月本院收治的150例女性乳腺小结节患者的病历资料。根据手术方法的不同将其分成对照组和微创组,每组75例。对照组行传统手术治疗,微创组采用EnCor乳房微创旋切术治疗。比较两组手术相关指标情况、并发症发生情况及术后患者满意度情况。结果:微创组的手术时长、切口长度、瘢痕长度及切口愈合时间均明显短于对照组,术中出血量少于对照组,差异均有统计学意义(P0.05)。微创组手术并发症发生率为6.67%,低于对照组的29.33%,差异有统计学意义(P0.05)。微创组行乳房微创旋切术治疗后满意度为93.33%,明显高于对照组的69.33%,差异有统计学意义(P0.05)。结论:经乳晕边切口乳房微创旋切术治疗乳腺小结节疗效显著,可缩短手术时长、缩小切口长度及瘢痕长度、降低术中出血量、促进伤口愈合恢复,明显降低术后并发症发生率,并且患者切口愈合后无明显疤痕,提高患者对乳房美观的满意度,值得推广运用。     

超声引导下乳腺微创真空旋切术治疗乳腺良性肿瘤的可行性研究

目的研究分析超声引导下乳腺微创真空旋切术治疗乳腺良性肿瘤的可行性及有效性。方法选择2017年4月至2019年4月期间在我院接受治疗的乳腺良性肿瘤患者作为研究对象,共随机选择96例患者,采用随机数字抽取表法将患者分为观察组与对照组,每组各48例,其中对照组患者采用传统肿瘤切除术治疗,观察组患者采用超声引导下乳腺微创真空旋切术治疗,对两组患者的手术时间、术中出血量、切口长度及术后满意度进行比较分析。结果观察组患者手术时间短于对照组,术中出血量少于对照组,切口长度短于对照组,数据比较差异具有统计学意义(P0.05);观察组患者术后满意度96.87%,与对照组患者术后满意度75.00%,观察组明显更高,数据比较差异具有统计学意义(P0.05);在患者年龄,肿瘤大小及肿瘤数量上差异无统计学意义(P0.05)。结论对乳腺良性肿瘤患者采用超声引导下乳腺微创真空旋切术治疗具有较好的效果,不仅手术时间短,且切口小,对患者外观影响更小,值得在临床上推广应用。     

真空辅助微创旋切术与传统开放手术治疗乳腺良性肿瘤的效果比较

目的：比较真空辅助微创旋切术与传统开放手术治疗乳腺良性肿瘤的效果。方法：选取2021年6月—2022年5月滨州市中心医院收治的200例乳腺良性肿瘤患者作为研究对象,采用随机数字表法分为研究组和对照组,各100例。对照组接受传统开放手术治疗,研究组接受真空辅助微创旋切术治疗。比较两组治疗效果。结果：研究组手术时间、住院时间、切口长度短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。治疗前,两组躯体功能、心理功能、社会功能、物质生活评分比较,差异无统计学意义(P>0.05);治疗后,两组躯体功能、心理功能、社会功能、物质生活评分高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05)。研究组治疗满意度高于对照组,差异有统计学意义(P=0.011)。研究组并发症发生率低于对照组,差异有统计学意义(P=0.014)。结论：与传统开放手术相比,真空辅助微创旋切术治疗乳腺良性肿瘤的效果更优,可减少术中出血量,缩短切口长度,促进术后康复,改善患者生活质量,提高患者满意度,降低并发症发生率。     

超声引导下乳腺微创旋切术与开放手术在治疗乳腺良性肿块中的对比

目的:对比超声引导乳腺微创旋切术与传统开放性手术治疗乳腺良性肿块的临床疗效。方法:选取收治的乳腺良性肿块120例作为研究对象。根据患者术式分为观察组与对照组,对照组55例接受传统开放性手术切除,观察组65例则在超声引导下行乳腺微创旋切术治疗,比较两组手术治疗安全性以及患者满意度。结果:观察组手术用时、术中出血量、切口愈合时间、瘢痕长度明显小于对照组,差异有统计学意义(P<0.05);观察组患者治疗满意度、乳房外观满意度明显高于对照组,差异有统计学意义(P<0.05)。结论:超声引导乳腺微创旋切术治疗乳腺良性肿块疗效确切,定位准确,手术安全性高,具有临床应用及推广价值。     

微创旋切术与传统外科手术治疗乳腺良性肿瘤的临床效果对比分析

目的对比微创旋切术与传统开放性手术治疗乳腺良性肿瘤的效果。方法选择于2014年6月~2016年6月在我院就诊的50例乳腺良性肿瘤患者,分为观察组和对照组,每组25例,观察组在超声引导下行乳腺微创旋切术治疗,对照组采用传统开放性手术切除,比较两组手术治疗的安全性及患者满意度。结果观察组在手术用时、术中出血量、切口愈合时间及瘢痕长度方面较对照组明显改善,差异有统计学意义(P0.05)。观察组的术后并发症发生率(4.00%)明显低于对照组(44.00%),差异有统计学意义(P0.05)。观察组的治疗满意度及外观美观度优于对照组,差异有统计学意义(P0.05)。结论超声引导乳腺微创旋切术治疗乳腺良性肿瘤具有较好的临床疗效,风险低,安全性好,值得临床应用及推广。     

Mammotome微创旋切术治疗乳腺良性肿瘤疗效分析

目的探讨Mammotome微创旋切术治疗乳腺良性肿瘤的疗效。方法将2009年8月～2011年7月在该院接受手术治疗的142例乳腺良性肿瘤患者随机分为观察组与对照组,每组各71例。观察组患者接受Mammotome微创旋切术治疗,对照组患者接受常规手术治疗。治疗结束后,所有患者均接受2 a的随访,现对比分析两组患者的疗效。结果①观察组手术时间显著长于对照组（P〈0.05）,术中出血量、住院时间显著低于对照组,两组比较差异有统计学意义（P〈0.05）。②观察组术后乳房变形率、乳房皮肤感觉异常率显著低于对照组,两组比较差异有统计学意义（P〈0.05）。③观察组切口瘢痕明显程度显著低于对照组,两组比较差异有统计学意义（P〈0.05）。结论 Mammotome微创旋切术治疗乳腺良性肿瘤具有乳房外形影响小、术后乳房皮肤感觉无异常、切口瘢痕不明显等优点,值得推广。     

超声引导下麦默通微创旋切系统治疗乳腺良性肿瘤临床观察

目的探讨超声引导下麦默通微创旋切系统治疗乳腺良性肿瘤的临床应用价值。方法选取郑州市第十五人民医院收治的140例乳腺良性肿瘤患者作为此次研究的分析对象,并按抽签分配法将其分为研究组与对照组,每组各70例。对照组采用传统的开放手术治疗,研究组采用超声引导下麦默通微创旋切除术进行治疗,观察并比较两组的病灶切除率、术后并发症、满意度及相关指标。结果对照组的手术时间、愈合时间、术中出血量及瘢痕长度比研究组高,研究组的病灶切除率、术后并发症及满意度优于对照组,差异有统计学意义(P<0.05)。结论将超声引导下麦默通微创旋切系统应用于乳腺良性肿瘤的治疗中,不仅能有效缩短患者的愈合时间与手术时间,还能提高患者的病灶切除率与满意度,并能减少患者术中的出血量与并发症的发生率,且安全性较高,建议推广。     

超声引导下麦默通乳腺微创旋切术治疗乳腺良性肿瘤的临床效果

目的探究超声引导下麦默通乳腺微创旋切术治疗乳腺良性肿瘤的临床疗效。方法选取我院收治的乳腺良性肿瘤患者92例作为研究对象,将所有患者随机分为研究组和对照组,研究组采取超声引导下麦默通乳腺微创旋切术治疗,对照组采取传统的开放性切除术。观察并记录两组患者手术综合指标及术后并发症情况。结果研究组术中出血量、手术时间及瘢痕长度等指标均明显优于对照组(P0.05),差异有统计学意义;研究组并发症总发生率(4.35%)明显低于对照组(17.39%),P0.05,差异有统计学意义。结论超声引导下麦默通乳腺微创旋切术治疗乳腺良性肿瘤的疗效显著,且创伤小、并发症少,值得临床推广。     

麦默通乳腺微创旋切术治疗乳腺良性肿块的临床疗效及安全性分析

目的探讨分析麦默通乳腺微创旋切术治疗乳腺良性肿块的临床疗效及安全性。方法抽取2015年3月至2018年3月就诊于我院的乳腺良性肿块患者94例作为研究对象,按照随机数字表达法将94例入组患者随机分为对照组(n=47)与研究组(n=47),给予对照组患者实施常规乳腺肿块切除术,给予研究组患者实施麦默通乳腺微创旋切术治疗,对比两组患者的术中出血量、瘢痕长度、手术时间、住院时间等手术指标及术后并发症情况。结果研究组患者术中出血量、瘢痕长度、手术时间、住院时间等手术指标均优于对照组(P0.05),差异显著,有统计学意义;研究组患者术后并发症发生率(4.2%)低于对照组(19.2%),差异显著(P0.05),有统计学意义。结论与传统开放性手术相比,采用麦默通乳腺微创旋切术对乳腺良性肿块患者进行治疗,能够取得更好的临床治疗效果,手术切口更小,出血量更少,可缩短手术时间与住院时间,并且术后并发症更少,具有较高的安全性与可行性,值得临床推广与应用。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.