大黄联合芒硝外敷治疗宫颈癌术后并发淋巴囊肿的疗效观察

探讨大黄联合芒硝外敷治疗宫颈癌根治术后并发淋巴囊肿的临床疗效。方法：抽取我院68例宫颈癌根治术后并发淋巴囊肿的患者随机分为对照组、观察组两组,对照组34例,采用单纯口服中药汤剂的方法进行治疗,观察组34例。在对照组基础上加用大黄联合芒硝外敷的方法进行治疗;观察两组之间对术后并发淋巴囊肿疗效的差异。结果：观察组患者中治愈2l例,占61.8％,有效11例,占32.4％,无效2例,占5.8％,总有效率94.2％,而对照组患者中治愈11例,占32.3％,有效14例,占41.1％,无效9例,占26.6％,总有效率73.4％,观察组与对照组疗效比较差异显著（P〈0.05）。结论：中药大黄联合芒硝外敷治疗宫颈癌根治术后并发淋巴囊肿较单纯口服中药汤剂疗效较好,值得临床上推广应用。     

大黄芒硝外敷在妇科恶性肿瘤患者淋巴结切除术后淋巴囊肿中的治疗效果及安全性

目的观察大黄芒硝外敷在妇科恶性肿瘤患者淋巴结切除术后淋巴囊肿中的治疗效果及安全性。方法选取2017年3月至2020年3月本院收治的于淋巴结切除术后出现淋巴囊肿的50例妇科恶性肿瘤患者作为研究对象。以随机、单盲法均分为两组,每组各25例。两组患者均采用单纯抗感染治疗,观察组在此基础上增加大黄芒硝外敷治疗。观察两组治疗效果及安全性。结果观察组治疗总有效率高于对照组,差异有统计学意义(P0.05)。观察组局部肿胀消失时间、囊肿消退时间短于对照组,差异有统计学意义(P0.05)。观察组囊肿直径短于对照组,差异有统计学意义(P0.05)。观察组术后3、7及14 d的VAS评分均持续下降,且低于对照组,差异有统计学意义(P0.05)。观察组感染发生率低于对照组(P0.05),皮肤红肿和皮肤瘙痒发生率比较,差异无统计学意义(P0.05)。结论妇科恶性肿瘤患者实施淋巴结切除术后常发生淋巴囊肿并发症,在常规治疗基础上采用大黄芒硝外敷治疗,可有效消除患处疼痛,预防感染,缩短术后恢复时间。且不会引发严重不良反应,临床用药安全性高。     

310例宫颈癌根治术后并发盆腔淋巴囊肿的临床分析

目的分析宫颈癌根治术后发生盆腔淋巴囊肿的相关因素及治疗效果。方法回顾分析宁夏医科大学附属医院2005年1月至2010年4月行宫颈癌根治术的310例患者的临床资料,其中Ⅰa2期33例,Ⅰb期118例,Ⅱa期159例。结果术后发生淋巴囊肿的患者共36例,发生率为11.61%,其发生与临床分期及术中清扫淋巴结的个数有关,与患者年龄、有无下腹部手术史、有无内科合并症及病理组织分型无关。淋巴囊肿均经局部外敷大黄、芒硝,口服中成药活血化瘀制剂治疗,22例治疗2周后淋巴囊肿消失;8例延长治疗时间2周后,再次复诊,淋巴囊肿亦消失;5例效果不佳,经B超引导穿刺治疗后淋巴囊肿消失;1例因囊肿较大且存在压迫症状手术治疗。结论临床分期及根治术中清扫淋巴结的个数是发生盆腔淋巴囊肿的主要因素,采用中药局部外敷及口服活血化瘀制剂效果较佳。     

310例宫颈癌根治术后并发盆腔淋巴囊肿的临床分析

目的分析宫颈癌根治术后发生盆腔淋巴囊肿的相关因素及治疗效果。方法回顾分析宁夏医科大学附属医院2005年1月至2010年4月行宫颈癌根治术的310例患者的临床资料,其中Ⅰa2期33例,Ⅰb期118例,Ⅱa期159例。结果术后发生淋巴囊肿的患者共36例,发生率为11．61％,其发生与临床分期及术中清扫淋巴结的个数有关,与患者年龄、有无下腹部手术史、有无内科合并症及病理组织分型无关。淋巴囊肿均经局部外敷大黄、芒硝,口服中成药活血化瘀制剂治疗,22例治疗2周后淋巴囊肿消失;8例延长治疗时间2周后,再次复诊,淋巴囊肿亦消失;5例效果不佳,经B超引导穿刺治疗后淋巴囊肿消失;1例因囊肿较大且存在压迫症状手术治疗。结论临床分期及根治术中清扫淋巴结的个数是发生盆腔淋巴囊肿的主要因素,采用中药局部外敷及口服活血化瘀制剂效果较佳。     

宫颈癌根治术后盆腔淋巴囊肿的预防与治疗

目的:探讨宫颈癌根治术后盆腔淋巴囊肿的预防与治疗。方法:对宫颈癌根治术后246例患者随机采用烟卷引流管经阴道引流126例(研究组)及引流管经腹引流120例(对照组)进行对比研究。对34例淋巴囊肿患者按囊肿大小分为两组,A组:囊肿≤5cm 18例;B组:囊肿>5cm 16例,均采用中药外敷治疗;对囊肿较大者在B超监测下穿刺抽液后中药外敷治疗。结果:宫颈癌根治术后经阴道烟卷引流与经腹引流淋巴囊肿发生率的差异有统计学意义(P<0.01);囊肿≤5cm 18例中药布袋外敷治疗有效17例(94.44%);囊肿>5cm中10例穿刺引流后中药外敷治疗有效9例与6例未穿刺治疗相比差异有统计学意义(P<0.05)。结论:经阴道引流明显减少盆腔淋巴囊肿的发生;中药袋外敷治疗囊肿疗效肯定;囊肿体积较大者,穿刺引流后中药袋外敷治疗效果更好。     

大黄芒硝防治剖宫产切口愈合不良临床研究

目的:观察大黄芒硝在防治剖宫产切口愈合不良的临床疗效。方法:选取112例腹壁切口有红肿、硬结、脂肪液化的患者,随机分为观察组60例,对照组52例。两组患者术后均预防使用抗生素24~48 h。观察组以大黄芒硝按1∶3比例配伍,术后48 h予外敷,隔日换药1次,对照组为术后48 h红外线照灯,隔日换药1次,观察切口红肿、硬结及伤口渗液消退情况。结果:大黄芒硝外敷治疗剖宫产切口红肿、硬结、脂肪液化等不良情况明显优于常规红外线照射治疗(P<0.05),两组不良情况消退时间比较,差异亦有统计学意义(P<0.05)。结论:大黄芒硝散外敷可防治切口愈合不良。     

宫颈癌术后并发症的临床治疗

目的：探讨减少宫颈癌根治术后尿潴留、盆腔淋巴囊肿发生的治疗方法。方法：将宫颈癌根治术患者146名随机分为治疗组84例,术中锐性分离膀胱阴道隔,盆底腹膜不缝合或部分缝合,术后延长盆髂区引流时间,针灸治疗尿潴留。对照组62例,术中钝性分离膀胱阴道隔,盆底腹膜全部缝合,术后盆髂区引流48h。结果：治疗组术后留置尿管时间明显短于对照组（P〈0.05）,盆腔淋巴囊肿发生率明显低于对照组（P〈0．05）。结论：盆底腹膜开方、术后延长盆腔髂区引流时间,可减少盆腔淋巴囊肿发生;锐性分离膀胱阴道隔,结合术后针灸治疗．尿潴留发生明显减少。     

芒硝联合大黄外敷在胃癌术后的应用

目的研究芒硝联合大黄外敷对于胃癌患者术后胃肠道功能早期恢复的作用。方法将103例行胃癌根治术后患者分为两组,对照组(在术后常规给予禁食、抗感染、输液等基础治疗)51例,治疗组(在对照组的基础上加用芒硝、大黄外敷)52例。观察两组患者腹痛持续时间、腹胀持续时间、首次排气时间、肠鸣音恢复时间、腹部切口感染发生率。结果与对照组比较,治疗组首次排气时间缩短(P0.05),肠鸣音恢复时间缩短(P0.05)。而术后腹痛持续时间、腹胀持续时间、腹部切口感染发生率两组比较,差异均无统计学意义(P0.05)。结论芒硝联合大黄外敷对胃癌术后患者早期胃肠道功能恢复有一定作用,但改善腹痛时间及腹部切口感染率方面有待于进一步研究。     

宫颈癌术后盆腔淋巴囊肿发病因素及治疗效果分析

目的探讨宫颈癌术后盆腔淋巴囊肿发病因素及治疗效果分析。方法选取我院2015年1月至2016年1月期间行宫颈癌根治术的患者共计36例,分析患者的年龄、肿瘤病理学类型、临床分期、手术方式、术前放疗、淋巴结切除数目、化疗及内科合并症等因素与淋巴囊肿发生的相关性。分析硫酸镁外敷疗法治疗效果。结果宫颈癌患者的年龄、肿瘤病理学类型、淋巴结切除数目及术前行放化疗治疗对术后盆腔淋巴囊肿的发生有影响(P0.05),而临床分期、内科合并症、手术方式与淋巴囊肿发生无关(P0.05)。硫酸镁体外湿敷治疗宫颈癌术后盆腔淋巴囊肿,疗效显著。结论腹股沟区硫酸镁体外湿敷治疗宫颈癌术后淋巴囊肿的疗效肯定,有独特的作用,无明显副作用,病人耐受性好。     

红外线联合中药外敷用于预防宫颈癌术后并发淋巴囊肿的观察

目的观察两种不同辅助治疗方式在宫颈癌根治术后淋巴囊肿的发生率。方法将96例宫颈癌病人分为实验组与对照组,对照组采用术后72h拔除经腹负压引流管后经红外线电烤;实验组在采用术后72h拔除经腹负压引流管后经红外线电烤联合中药外敷,其余治疗相同,观察两组病人淋巴囊肿的发生率。结果实验组比对照组的淋巴囊肿的发生率低,差异有统计学意义（P〈0．05）。结论红外线电烤联合中药外敷可减少宫颈癌根治术后淋巴囊肿的发生。     

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.