二维基波、自然组织谐波和彩色多普勒超声对未破裂异位妊娠团块的诊断价值

目的探讨在二维基波和自然组织谐波条件下,结合彩色多普勒超声在未破裂异位妊娠团块检查中的实用价值。方法对167例因腹痛、阴道流血或可疑未破裂异位妊娠的患者,分别在二维基波、自然组织谐波和彩色多普勒超声条件下,使用高频阴道探头和低频腹部探头进行超声检查,分析未破裂异位妊娠团块的图像特点,对比经腹部超声及经阴道超声检查对未破裂异住妊娠团块显示的效果。结果全部病例经手术或保守治疗后随访观察证实,167例病例中,普通腹部超声检查确诊97例（58．1％）,阴道超声检查确诊151例（90．4％）。异住妊娠团块的彩色血流信号显示经腹部检查51例（52．6％）,经阴道检查109例（72．2％）。结论阴道超声在显示未破裂异住妊娠团块上更具有特异性,能明显提高未破裂异住妊娠团块的显示率。彩色多普勒超声检查有助于未破裂异住妊娠的诊断,二维基波、自然组织谐波和彩色多普勒超声检查可作为临床诊断未破裂异位妊娠的重要依据。     

阴道与腹部B超对异位妊娠的诊断价值分析

目的 比较阴道超声检查和腹部超声检查对异位妊娠的诊断价值。方法回顾性分析2009年住院的异位妊娠患者86例,对所有患者均行阴道超声和腹部超声检查,以手术病理结果作为金标准,比较两种超声检查的诊断价值。结果86例患者均经过手术病理检查为异位妊娠,其中阴道超声检查正确率为95．3％,腹部超声检查正确率为86．0％,两种超声的检查正确率有显著性差异（x^2=4．41,P〈0．05）。阴道超声的漏诊率为213％,误诊率为2．3％,腹部超声漏诊率为8．1％,误诊率为5．8％。结论阴道超声对异位妊娠的正确检出率高于腹部超声;两种方法对异位妊娠均有较高的诊断价值,各有优缺点;临床需结合HCG检查及患者高危因素进行确诊。     

经腹超声检查诊断异位妊娠的临床分析

目的 探讨彩色多普勒超声在异位妊娠中的诊断价值。方法 回顾性分析2003年1月～2007年12月间在我院入院手术治疗并经病理证实112例异位妊娠的超声检查结果并进行分型。结果 112例异位妊娠，经手术病理所证实，经腹部超声检查，符合率95．5％，其中肿块型占39．29％，破裂型占26．7％，妊娠囊成活型占10．7％，陈旧包块型占18．8％，5例误诊，占4．4％。结论 经腹部超声检查，能清晰显示异位妊娠的声像图特征，且准确、快捷、方便，为临床明确诊断及鉴别诊断提供了较为可靠的依据。     

阴道B超诊断异位妊娠的探讨

目的 通过对异住妊娠声像图特征的分析，以提高其诊断及鉴别诊断的水平。方法 回顾分析102例异住妊娠的超声特征，对术前B超诊断与术后病理诊断进行对比分析。结果 诊断符合率为92．2％（94／102）。异位妊娠声像图主要表现为盆腔内不同回声的包块，伴有子宫增大或腹腔内游离液体。结论 阴道B超检查是简便、无创伤，是诊断异位妊娠最理想的检查方法。     

经阴道超声检查对异位妊娠的诊断价值

目的：探讨经阴道超声检查对异位妊娠的诊断价值。方法：回顾性分析经临床手术和病理证实32例异位妊娠患者的术前超声表现。结果：32例患者中经腹部超声检查发现18例,诊断符合率56．3％,经阴道超声检查发现27例,诊断符合率84．3％,术前超声误诊为炎性包块2例、黄体破裂出血1例、畸胎瘤1例,漏诊1例。与经腹部超声检查比较,经阴道超声检查更易发现附件区较小的包块回声。结论：经阴道超声检查对异位妊娠的诊断具有较高的应用价值。     

异位妊娠96例分析

目的总结异位妊娠超声像图表现及特点,提高超声对异位妊娠的诊断符合率。方法分析96例经手术证实的异位妊娠患者经腹或经阴道超声声像图表现,总结声像图特点,并分析误诊原因。结果96例异住妊娠患者输卵管壶腹部妊娠71例,超声诊断符合率为91．5％（65／71）;宫角妊娠12例,超声诊断符合率为83.3％（10／12）;问质部妊娠4例,诊断符合率为75％（3／4）;子宫瘢痕妊娠4例,诊断符合率为100％（4／4）;宫颈妊娠3例,诊断符合率为66．7％（2／3）;宫内外复合妊娠及残角妊娠各1例均误诊。结论超声是异位妊娠的首选检查方法,经阴道超声与腹部超声结合应用,可提高异位妊娠的检测率。     

经阴道超声检查在异位妊娠诊断中的临床应用价值

目的：探讨经阴道超声（ TVS）检查在异位妊娠（ EP）诊断中的临床应用价值。方法：将2011年7月～2013年4月收治并经手术与病理检查证实的193例异位妊娠（ EP）患者临床经阴道超声（ TVS）诊断资料进行回顾性分析。结果：经阴道超声检查诊断异位妊娠188例,与手术病理结果比较符合率97．4％,漏诊3例,误诊2例,漏误诊率2．59％。经腹部超声检查诊断异位妊娠163例,与手术病理结果比较符合率为84．5％,漏诊22例,误诊8例,漏误诊率15．5％。 TVS诊断方法符合率明显高于TAS诊断方法,差异具有显著性（P＜0．05）;TVS诊断未破裂型77例（97．5％）,破裂型58例（86．6％）,流产型18例（85．7％）,与手术病理结果比较符合率91．6％。 TAS诊断未破裂型61例（77．2％）,破裂型51例（76．1％）,流产型14例（66．7％）,与手术病理结果比较符合率75．4％,2种超声诊断方法符合率比较,差异具有统计学意义（P＜0．05）。结论：通过与手术病理检查结果比较,对于异位妊娠（ EP）诊断经阴道超声（ TVS）较经腹超声（ TAS）检查准确性高,且图像清晰、直观可作为早期异位妊娠诊断的首选方法。     

分析经阴道超声与腹部超声在诊断异位妊娠的价值

目的：探讨经阴道超声与腹部超声诊断异位妊娠的诊断价值及临床意义,对早期诊断异位妊娠提供理论依据。方法：回顾性分析2012年1月至2013年4月我院经手术证实的异位妊娠患者126例,按超声检查分为经阴道超声检查组（63例）及腹部超声检查组（63例）,对比分析两组检查方法的诊断符合率及超声声像图的阳性率。结果：经阴道超声诊断并位妊娠的诊断率为96．7％,而腹部超声对异位妊娠的诊断率为82．4％,比较两组数据,差异有统计学意义（P〈0．05）,经阴道超声检查异位妊娠的声像图较腹部超声的阳性率高,差异有统计学意义（P〈0．05）。结论：经阴道超声检查诊断异位妊娠较腹部超声诊断符合率高,具有一定的临床实用价值。     

经阴道彩色多普勒超声诊断异位妊娠51例分析

目的：探讨经阴道彩色多普勒超声诊断异位妊娠的临床价值。方法：结合手术及病理诊断对我院经阴道彩色多普勒超声诊断为异位妊娠的51例病例进行回顾分析。结果：经阴道彩色多普勒超声诊断为异位妊娠的51例患者中,经手术及病理证实者48例,诊断准确率为94．12％。结论：经阴道彩色多普勒超声诊断异位妊娠是一种经济、快速、无创伤、无痛苦的检查手段。     

腹部B超对异位妊娠诊断价值分析

目的 探讨腹部B超对异位妊娠的临床诊断价值.方法 回顾性分析2009年2月～2011年4月经手术及病理检查结果证实的36例异位妊娠患者的临床资料.结果 本组36例异位妊娠中,超声诊断与手术及病理检查诊断结果的符合率达86.11%.误诊5例,占13.89%.其中3例超声诊断为腹腔妊娠,手术及病理证实为卵巢妊娠,2例超声诊断为宫角妊娠,手术及病理证实为输卵管妊娠.结论 经腹部超声检查异位妊娠是无创性检查方法,临床确诊率较高,同时掌握异位妊娠的各种超声图像对减少误诊率具有重要意义.     

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.     

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.     

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.