DHS内固定治疗老年人股骨粗隆间骨折

目的:评价DHS内固定治疗老年股骨粗隆间骨折的疗效。方法:回顾分析47例采用DHS内固定治疗老年股骨粗隆间Ⅰ～Ⅴ型骨折,对术后并发症、Harris髋关节评分随访。结果:47例均获随访,随访时间平均20个月(5～39个月),骨折骨性愈合44例,平均愈合时间3.2个月(2～5个月),内固定失效畸形愈合3例。采用Harris髋关节评分评定疗效,优27例,良12例,可5例,差3例,优良率82.9%。结论:DHS是手术治疗股骨粗隆间骨折较好的内固定方法。     

DHS、PFLCP与PFNA治疗股骨粗隆间骨折疗效比较

目的:比较动力髋螺钉(DHS)、股骨近端锁定加压钢板(PFLCP)与防旋股骨近端髓内钉(PFNA)治疗股骨粗隆间骨折的临床疗效。方法:对70例股骨粗隆间骨折患者分别采用DHS、PFLCP、PFNA内固定治疗,其中DHS组22例,PFLCP组17例,PFNA组31例。比较3组患者的手术时间,术中出血量,术中、术后并发症的发生情况,骨折愈合时间及术后Harris髋关节功能评分。所有患者均随访6~14个月。结果:PFNA组患者手术时间、术中出血量及骨折愈合时间均明显少于DHS组与PFLCP组(P<0.01),而3组患者术中、术后并发症及术后Harris髋关节功能评分差异均无统计学意义(P>0.05)。结论:PFNA内固定治疗股骨粗隆间骨折较DHS和PFLCP固定牢固,手术操作简便、手术时间短、创伤小,是治疗股骨粗隆间骨折的理想方法。     

动力髁螺钉与动力髋螺钉配合中药内服治疗股骨粗隆间骨折的临床疗效分析

[目的]探讨DCS与DHS配合中药内服治疗股骨粗隆间骨折临床疗效。[方法]将所有的病例分为A、B两组。A组采取动力髁螺钉配合中药内服治疗,B组为动力髋螺钉配合中药内服治疗,观察两组在手术时间、术中出血量、术后离床时间、术后并发症发生人数及优良率进行疗效对比。[结果]DCS组22例均随访,两组疗效比较无显著差异。术后一年髋关节功能评分:DCS组为(85.92±8.23)分,DHS组为(75.38±15.56)分,P0.01,二者比较有显著差异;术后并发症:DCS组出现髋内翻1例,DHS组出现髋内翻5例,出现内固定失效3例,二组并发(P0.01)。[结论]DCS与DHS配合中药内服治疗股骨粗隆间骨折疗效好,在术后并发症、术后关节功能恢复上,选择DCS内固定优于DHS内固定。     

不同内固定方法治疗老年骨质疏松性股骨粗隆间骨折临床观察

目的:观察对比股骨近端防旋髓内钉(PFNA)、股骨近端锁定加压接骨板(PFLCP)及动力髋螺钉(DHS)内固定治疗老年骨质疏松性股骨粗隆间骨折。方法:选择老年骨质疏松性股骨粗隆间骨折患者82例,分成三组,PFNA组30例采用PFNA内固定治疗,PFLCP组32例采用PFLCP内固定治疗,DHS组30例采用DHS内固定治疗,在Harris髋关节评分、手术时间、术中出血量、骨折愈合时间、术后并发症等方面进行组间比较。结果:所有患者均获随访,平均16(10～24)月。与PFLCP、DHS组相比,PFNA组具有手术时间缩短、术中出血量少,骨折愈合时间短的优势,差异有统计学意义;术后并发症比较三组无显著性差异;术后对Harris髋关节功能评分进行比较,DHS组较差。结论:PFNA组与PFLCP及DHS相比,PFNA是治疗老年骨质疏松性股骨粗隆间骨折的有效方法之一。     

牵引复位DHS内固定治疗老年股骨粗隆间骨折

目的探讨牵引复位DHS内固定治疗老年股骨粗隆间骨折的手术方法及临床效果。方法应用切开后牵引复位DHS内固定治疗老年股骨粗隆间骨折86例。结果术后随访6～24个月,3例死亡,其余骨折全部愈合,平均愈合时间21周。髋关节功能优72例,良11例。结论牵引复位DHS内固定治疗老年股骨粗隆间骨折操作简单,效果肯定,是治疗老年粗隆间骨折的良好方法。     

牵引复位DHS内固定治疗老年股骨粗隆间骨折

目的 探讨牵引复位DHS内固定治疗老年股骨粗隆间骨折的手术方法 及临床效果. 方法 应用切开后牵引复位DHS内固定治疗老年股骨粗隆间骨折 86例.结果 术后随访6～24个月,3例死亡,其余骨折全部愈合,平均愈合时间21周.髋关节功能优72例,良11例. 结论 牵引复位DHS内固定治疗老年股骨粗隆间骨折操作简单,效果肯定,是治疗老年粗隆间骨折的良好方法 .     

动力髋螺钉钢板内固定治疗老年不稳定股骨粗隆间骨折24例

目的；探讨动力髋螺钉钢板(DHS)内固定治疗老年不稳定股骨粗隆间骨折的临床疗效。方法：采用DHS内固定治疗老年性不稳定股骨粗隆间骨折24例，观察骨折的愈合情况，综合评价髋关节功能。结果：随访10～18个月，平均骨折愈合时间5个月，髋关节功能：优16例，良7例，可1例。出现内固定松动，髋外翻畸形1例。结论：对于老年不稳定粗隆间骨折采用DHS内固定治疗，可以早期活动，疗效满意。     

动力髋螺钉治疗股骨粗隆间骨折临床分析(附26例报告)

目的观察动力髋螺钉(DHS)治疗股骨粗隆间骨折的临床效果。方法对使用DHS内固定治疗的26例股骨粗隆间骨折的分类、手术方法、术后结果进行分析。结果所有病例经术后随访骨折均愈合,髋关节功能优良率为92.31%。结论DHS是内固定治疗股骨粗隆间骨折比较理想的方法。     

三种内固定治疗骨质疏松性股骨粗隆间骨折的疗效观察

目的 观察比较PFNA、DHS和解剖型锁定钢板三种内固定方式治疗骨质疏松性股骨粗隆间骨折的临床疗效。方法 将2013年5月~2015年5月住院的150例骨质疏松性股骨粗隆间骨折患者根据内固定方式不同分为三组:PFNA内固定组52例,DHS内固定组50例,解剖型锁定钢板内固定组48例。观察比较三组手术时间、出血量、骨折愈合时间、Harris髋关节功能评分等指标。结果 随访10~24个月,平均(15.5±2.5)个月。PFNA组患者的手术时间、出血量均优于另外两组(P0.05),PFNA组疗效优于DHS组(P0.05)。三种内固定治疗组的骨折愈合时间比较差异有统计学意义(P0.05),PFNA组骨折愈合时间最短,解剖型锁定钢板组次之,DHS组骨折愈合时间最长。结论 PFNA内固定治疗股骨粗隆骨折具有手术时间短、出血量少、骨折愈合时间短、术后关节功能恢复良好等优点,比较适合治疗老年骨质疏松性股骨粗隆间骨折的治疗。     

中药配合DHS内固定治疗老年股骨粗隆间骨折的疗效分析

目的：观察中药配合DHS内固定治疗老年股骨粗隆间骨折的疗效。方法：采用中药配合DHS内固定治疗老年股骨粗隆间骨折91例,根据髋关节活动范围和疼痛及是否出现跛行判断其疗效。结果：成功随访了72例（随访率：79%）,其中优50例,良19例,差3例。优良率：96%。结论：中药配合DHS内固定治疗老年粗隆间骨折疗效确切,但应注意掌握手术指征、手术技巧和术后处理的方法。     

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.