全程双极儿童扁桃体切除术在欠发达地区医院的临床应用

目的:探究全程双极儿童扁桃体切除术在欠发达地区医院的临床应用。方法:选取2018年1-11月于本院行扁桃体切除术的63例患儿为研究对象。根据不同的扁桃体切除手术方式随机分为对照组35例和观察组28例,对照组采用低温等离子切除术,观察组采用双极电凝切除术。比较两组的手术时间、术中出血量、术后白膜脱落时间、术后疼痛评分、住院时间及住院费用。结果:两组患儿均顺利完成手术,且术后均无严重并发症发生。观察组手术时间长于对照组,住院费用明显低于对照组,差异均有统计学意义(P0.05);两组的出血量、白膜脱落时间及住院时间比较,差异均无统计学意义(P0.05)。两组术前及术后的VDS、VAS评分比较,差异均无统计学意义(P0.05)。观察组并发症发生率为3.57%,与对照组的2.86%比较,差异无统计学意义(P0.05)。结论:双极电凝的术中出血量、术后疼痛程度、白膜脱落时间、住院时间及术后并发症等指标与等离子切除术比较无明显差异,但采用双极电凝切除扁桃体患儿住院费用较低温等离子术明显降低,值得在欠发达地区医院进行临床推广应用。     

双极电凝在扁桃体切除术中的应用

目的:比较双极电凝与常规剥离法对扁桃体切除术患者术中、术后的影响。方法:将80例患者分为双极电凝组43例和对照组37例。对照组采用常规剥离法切除扁桃体,双极电凝组采用双极电凝切除。记录2组术中出血量、手术时间、术后疼痛程度、恢复正常活动时间、恢复正常饮食时间、伪膜脱落情况。结果:双极电凝组手术时间、术中出血量均较对照组少,且比对照组更早恢复饮食,术后疼痛也较对照组轻,但伪膜脱落时间长,差异均有统计学意义(P0.01)。结论:双极电凝切除扁桃体与常规剥离法相比,术中出血少,手术时间短,患者术后疼痛减轻,能更早地恢复饮食,且方法容易掌握,值得推广。     

双极电凝在扁桃体切除术中的应用

目的:比较双极电凝与常规剥离法对扁桃体切除术患者术中、术后的影响。方法:将80例患者分为双极电凝组43例和对照组37例。对照组采用常规剥离法切除扁桃体,双极电凝组采用双极电凝切除。记录2组术中出血量、手术时间、术后疼痛程度、恢复正常活动时间、恢复正常饮食时间、伪膜脱落情况。结果:双极电凝组手术时间、术中出血量均较对照组少,且比对照组更早恢复饮食,术后疼痛也较对照组轻,但伪膜脱落时间长,差异均有统计学意义(P0.01)。结论:双极电凝切除扁桃体与常规剥离法相比,术中出血少,手术时间短,患者术后疼痛减轻,能更早地恢复饮食,且方法容易掌握,值得推广。     

双极电凝用于鼾症患儿扁桃体及腺样体切除中的临床效果

目的:探讨双极电凝用于鼾症患儿扁桃体及腺样体切除中的临床效果。方法:根据不同治疗方法将2014年7月至2015年7月期间我院收治的62例鼾症患儿分为两组,每组31例,对照组采用常规手术治疗,观察组采用双极电凝治疗,比较两组患儿治疗效果,围术期相关手术指标以及围术期并发症情况。结果:观察组治疗总有效率显著高于对照组,两组比较,差异有统计学意义,P0.05。观察组围术期手术相关指标均优于对照组,两组比较,差异有统计学意义,p0.05,观察组术后并发症发生率明显低于对照组,两组比较,差异有统计学意义,p0.05。结论:在鼾症患儿扁桃体及腺样体切除中采用双击电凝疗效显著,可缩短手术时间,减少术中出血量,且术后并发症少,值得临床推广。     

无损包扎法在压力性损伤创面治疗中的临床效果

目的观察改良电刀联合双极电凝在扁桃体切除术中的应用效果。方法选取2020年6月到2021年9月在嘉兴市第一医院（52例）及海宁市人民医院（48例）行扁桃体切除术治疗的患者100例,50例患者术中应用改良电刀联合双极电凝治疗,为观察组;另50例患者应用等离子刀治疗,为对照组。比较两组患者的手术时间、术中出血量、住院时间、术后疼痛程度（采用视觉模拟评分法）、术后伪膜脱落时间、术后并发症发生情况。结果观察组与对照组患者的手术时间[(7.74±1.37）min比（7.70±1.50）min]、术中出血量[（7.50±3.33）ml比（7.52±1.64）ml]、住院时间[（5.24±1.87）d比（5.12±0.85）d]比较差异均无统计学意义（均P＞0.05）。两组患者术后第1、2、3、4、5天疼痛程度比较差异均无统计学意义（均P＞0.05）。观察组患者术后伪膜脱落时间短于对照组[（15.82±0.72）d比（16.92±0.97）d,P＜0.05）]。两组患者术后并发症发生率比较差异无统计学意义（2.00%比2.00%,P＞0.05）。结论在扁桃体切除术中使用改良电刀联合双极电凝进行治疗,患者的术后疼痛情况、术后并发症与使用等离子刀进行手术相当,且术后伪膜脱落时间缩短,手术设备简单,值得推广应用。     

超声刀止血和双极电凝止血在肝细胞癌患者肝切除术中行肝创面局部止血的效果对比

目的 探讨运用超声刀止血和双极电凝止血法在肝细胞癌患者肝切除术中的应用效果。方法 选择142例肝癌切除术患者作为研究对象,根据术中行不同止血方式将患者分为研究组（71例）和对照组（71例）,研究组采用双极电凝止血术治疗,对照组采用超声刀止血治疗,比较两组患者相关的临床指标和相关手术情况。结果 两组患者分别采用不同断肝止血技术后,研究组患者的手术时间、手术相关费用、术后腹腔引流量、输血率和术中出血量均低于对照组,差异均有统计学意义（P <0.05）。研究组患者术后并发症总发生率低于对照组,差异有统计学意义（P <0.05）。结论双极电凝止血效果明显优于超声刀止血,其可以有效减少患者术中出血,而且术后并发症发生率较低,有利于患者术后的康复。     

传统扁桃体剥离术与高频电刀电凝扁桃体切除术的疗效比较

目的 观察传统扁桃体剥离术与高频电刀电凝扁桃体切除术在术中、术后对患者的影响.方法 对110例患者采取单号行高频电刀电凝扁桃体切除术、双号行传统扁桃体剥离术,比较两种手术方式的手术时间、出血量及术后恢复正常饮食时间、疼痛时间.结果 高频电刀电凝扁桃体切除术时间平均3 min35 s,出血量3ml;传统扁桃体剥离术时间平均13 min 40 s,出血量15ml.高频电刀电凝扁桃体切除术恢复正常饮食时间平均5d,疼痛平均3 d;扁桃体剥离术恢复正常饮食时间平均7d,疼痛平均5d.两种术式比较差异有统计学意义(P＜0.01).结论 高频电刀电凝扁桃体切除术手术时间短,简便易行,术中损伤小、出血少,术后恢复快,值得临床推广.     

双极电凝镊在扁桃体摘除术中的应用

目的:通过比较采用双极电凝镊与传统的剥离法实施扁桃体摘除的手术效果,探讨双极电凝镊在扁桃体摘除术中的应用效果。方法:选取行扁桃体手术摘除的患者100例,前瞻性地分为两组,比较手术时间、术中出血量及术后患者并发症、疼痛程度及恢复时间。结果:用双极电凝镊行扁桃体摘除与普通法扁桃体摘除相比,手术时间短,术中出血少,术后并发症发生率低,患者痛苦轻。结论:采用双极电凝镊扁桃体摘除手术效果明显优于普通剥离法扁桃体摘除,两方法术后恢复时间无统计学差别。     

低温等离子刀与传统剥离法在儿童扁桃体切除术中应用效果对比分析

目的：探讨分析低温等离子刀与传统剥离法在儿童扁桃体切除术中的应用效果比较。方法随机选取儿童扁桃体切除术患者120例作为研究对象,随机分为观察组和对照组,各60例。其中观察组给予低温等离子刀切除术,对照组给予传统剥离法切除,对比观察2组患者的手术时间、术中出血量、术后疼痛时间及白膜剥落时间。结果观察组儿童与对照组儿童比较,手术时间短、术中出血量少、术后1周内疼痛程度较轻,疗效对比差异有统计学意义（P＜0.05）;观察组儿童在术后白膜剥落时间上长于对照组,数据对比差异有统计学意义（P＜0.05）。结论与传统剥离法比较,低温等离子刀切除法具有手术时间短、出血量少、术后疼痛轻、手术操作简单等优势,但术后白膜脱落时间迟,需避免饮食不当造成继发性出血,是扁桃体切除术的理想治疗方案,值得在临床上推广和普及。     

儿童鼾症治疗方法与术后出血的原因及处理措施

目的：研究儿童鼾症的治疗方法与术后出血原因以及处理方式。方法：选择2019年2月～2022年2月天津市儿童医院收治的儿童鼾症共86例,按照患者入选先后顺序随机分为对照组(高频单极电凝双侧扁桃体切除术联合鼻内镜下腺样体切除术)与观察组(低温等离子扁桃体射频消融术+鼻内镜下腺样体消融术)各43例,比较两组患儿的手术指标、术后出血情况、其他并发症发生率等指标。结果：观察组患儿的手术时间(21.74±4.13)min、术中出血量(2.89±0.33)ml明显低于对照组患儿的手术时间(35.19±4.82)min、术中出血量(15.17±3.82)ml,差异有统计学意义(P<0.05)。观察组患儿原发性出血率2.32%,继发性出血率0%明显低于对照组患儿原发性出血率9.30%,继发性出血率4.65%,差异有统计学意义(P<0.05)。观察组患儿的其他并发症率4.65%明显低于对照组的18.60%,差异有统计学意义(P<0.05)。结论：手术是治疗儿童鼾症的有效方式,通过低温等离子射频消融术将患儿肥大的扁桃体及腺样体切除,可以使儿童鼾症得到有效治疗,不仅能减少术后出血量,还能有效...     

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.