53例妇科腹腔镜手术并发症分析

目的:探讨妇科腹腔镜手术并发症发生类型处理及预防.方法:对2003年7月至2009年12月在我院妇科行腹腔镜手术3 478例的临床资料作回顾分析.结果:腹腔镜手术并发症发生率1.52%(53/3478),腹腔内出血9例,膀胱损伤9例,输尿管损伤8例,肠管损伤1例,腹壁血管损伤6例,切口疝4例,感染2例,烧伤1例,下肢深部静脉血栓6例,继发腹腔妊娠1例,皮下气肿6例,宫腹腔镜联合手术组的并发症发生率与附件手术组比较,差异无统计学意义(P＞0.05),子宫全切除术组及子宫肌瘤剔除术组的并发症的发生率与附件手术组比较,差异有统计学意义(P＜0.01).结论:妇科腹腔镜手术并发症与手术难度和术者技巧有关,应严格按照操作规范开展腹腔镜手术,合理选择手术适应证.     

妇科腹腔镜手术并发症分析

目的：探讨妇科腹腔镜手术的并发症发生情况。方法：回顾分析2546例妇科腹腔镜手术病例的临床资料。手术包括子宫全切除术471例（子宫切除组）,子宫肌瘤剔除术365例（肌瘤剔除组）,附件手术1658例（附件手术组）,诊断性腹腔镜手术52例（诊断性手术组）。结果：2546例手术中发生各种并发症14例,发生率为0．55％。子宫切除组并发症发生率为1．91％（9／471）,显著高于肌瘤剔除组（0．55％,2／365）和附件手术组（0．18％,3／1658）,诊断性手术组并发症发生率为0。结论：妇科腹腔镜手术并发症发生率有所降低,并发症以脏器损伤为主。     

腹腔镜妇科手术并发症41例分析

目的探讨妇科腹腔镜手术并发症的发生、处理及预防.方法对41例妇科腹腔镜手术并发症情况进行回顾性分析.结果1326例妇科腹腔镜手术中有41例出现并发症,发生率为3.1%,经开腹处理者7例,占17%.并发症包括皮下气肿11例,腹壁血管损伤4例,术中术后出血6例,脏器损伤9例(膀胱、输尿管及肠管),切口疝1例,切口大网膜嵌顿1例,切口感染3例,宫颈囊肿3例以及缝合针及断裂分离钳遗留腹腔3例(原则上讲此3例并非真正的并发症)等.结论妇科腹腔镜手术并发症应引起足够重视,复杂手术、困难手术并发症增多且严重,应重视手术适应证的选择.     

妇科腹腔镜手术并发症临床分析与处理

目的探讨妇科腹腔镜手术的常见并发症及其处理和预防策略。方法回顾性分析我院妇产科收治的1579例实施腹腔镜手术的患者,总结分析36例出现并发症患者的临床资料。结果 1579例妇科腹腔镜手术中36例发生并发症,发生率为2.27%,其中子宫切除术并发症的发生率最高(5.92%),其次是盆腔粘连分解术(4.26%)和子宫肌瘤剔除术(2.45%)。并发症的类型主要以术后盆腔感染、血管损伤、腹腔内出血、皮下气肿、泌尿系统损伤和肠管损伤为主。结论妇科腹腔镜手术并发症主要与手术难易程度和操作技巧等有关。     

泌尿外科腹腔镜手术并发症临床分析

目的对泌尿外科腹腔镜手术进行回顾性分析,了解并发症的发生情况,并探究预防并发症的措施。方法选取我院在2014年3月至2016年3月收治的150例进行腹腔镜手术患者的资料进行回顾性分析,按照手术类型分为简单手术组(n=90)和复杂手术组(n=60),首先观察对比两组患者的并发症发生率,然后分析并发症出现的原因。结果 150例患者中,一共有20例患者出现了并发症,并发症发生率为12.50%,患者出现的主要并发症类型为皮下气肿5例(3.33%)、切口渗液2例(1.33%)、尿潴留4例(2.67%)、腹膜损伤3例(2.00%)、出血6例(4.00%)等;简单手术组患者中有4例(4.44%)患者出现并发症,复杂手术组患者中有16例(26.67%)患者出现了并发症,二者之间的差异显著(χ~2=15.3846;P0.05)。结论泌尿外科腹腔镜手术出现并发症的发生率较高,并且在术中和术后均可能出现,不同手术出现并发症的情况也有所不同,需要医务工作者进行综合性的预防。     

腹腔镜妇科手术并发症的临床分析与防治探讨

目的　探讨腹腔镜妇科手术的并发症及防治措施.方法　２０１１年２月至２０１５年３月我院共施行妇科腹腔镜手术４６２７例,所有患者均接受腹腔镜妇科手 术共出现并发症７９例,回顾性分析其临床资料.结果　４６２７例妇科腹腔镜手术中,发生率为１．７％.并发症类型以盆腔感染、腹腔内出血、皮下气肿、血管损伤等 为主.结论　腹腔镜妇科手术过程中,需要加强手术医师基本功的训练,严格遵守腹腔镜手术适应症指标,规范手术操作,注重细节,降低并发症的发生率.     

妇科腹腔镜手术并发症原因分析

目的:探讨妇科腹腔镜手术常见并发症的原因。方法:对两家医院妇科2006年6月至2012年8月完成的951例妇科腹腔镜手术及其并发症进行回顾性分析。结果:953例腹腔镜手术中有31例出现并发症,发生率为3.25%。附件手术并发症发生率最低1.88%,其次是子宫肌瘤剔除和子宫次全切除术,为3.22%,全子宫切除和子宫(次)广泛切除术加盆腔淋巴结清扫术的并发症较前三者明显增高,分别为6.58%和33.33%,子宫(次)广泛切除术加盆腔淋巴结清扫术并发症最多、手术风险最大。31例并发症包括与CO2气腹相关的并发症6例,血管脏器损伤9例,热损伤和电损伤5例,术后并发症11例。结论:腹腔镜手术难度越大,手术并发症越多,应严格适应证选择,尤其是既往有腹腔或盆腔手术史、腹腔或盆腔粘连明显的手术。妇科腹腔镜手术并发症应该重视预防并积极予以有效干预处理。     

妇科腹腔镜手术并发症发生原因及处理

目的 探索妇科腹腔镜手术并发症发生原因及处理对策.方法 选择2008年6月-2011年6月行妇科腹腔镜手术患者2 355例.回顾分析各类手术并发症发生情况、导致并发症的不同因素及不同并发症处理方案.结果 附件手术组患者并发症发生率为0.27%,与其他4组比较差异有统计学意义(P<0.05).与穿刺及气腹相关的并发症发生率为0.42%,占所有并发症的43.5%;术中并发症发生率为0.38%,占所有并发症的39.1%;术后并发症发生率为0.17%,占所有并发症的17.4%.结论 妇科腹腔镜手术的并发症主要与手术操作难度有关.     

妇科腹腔镜手术并发症37例诊治分析

目的：分析妇科腹腔镜手术并发症的发生原因,探讨并发症发生的预防措施。方法：对我院2003年1月～2010年12月2 038例经腹腔镜治疗的妇科患者的临床资料进行回顾性分析。结果：2 038例妇科患者中发生并发症37例,发生率1.82%。其中腹腔镜辅助阴式子宫切除9例,发生率2.37%,腹腔镜子宫肌瘤剔除11例,发生率2.95%,附件手术16例,发生率1.30%,并发症种类主要为血管损伤,皮下气肿及气胸,皮下出血和术中出血、肠管损伤、输尿管损伤、膀胱损伤等。结论：妇科腹腔镜并发症的发生与手术的难易程度、医生操作经验、手术器械完善、手术范围的选择等有关,积极预防可减少并发症的发生。     

妇科腹腔镜手术并发症原因分析及防治

目的:探讨妇科腹腔镜手术并发症的发生原因和防治方法。方法:回顾性分析我院2002年1月-2008年12月进行的2 262例妇科腹腔镜手术的临床资料。结果:2 262例妇科腹腔镜手术中,34例出现并发症,占1.5%,其中持续性宫外孕9例、腹腔内出血3例、膀胱损伤2例、直肠损伤1例、腹壁瘀血3例、腹壁切口疝2例、皮下气肿5例、肩胛痛9例。结论:腹腔镜手术并发症发生与器械、手术难度及医师的技术水平等有关。积极预防可降低其发生率。     

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.