子宫输卵管造影术在诊断宫腔粘连中的应用

目的探讨子宫输卵管造影(HSG)在宫腔粘连中的诊断价值。方法回顾性分析该院2005年1月至2011年3月资料完整经HSG诊断为宫腔粘连的37例患者临床资料。结果经HSG诊断为宫腔粘连37例患者,其中中央型粘连8例(21.62%),周围型粘连13例(35.14%),混合型粘连16例(43.24%)。37例患者中,经宫腔镜检查证实为宫腔粘连的34例,符合率为91.897%。结论 HSG不但可明确是否存在宫腔粘连,同时可定位粘连的位置和范围,且病人痛苦较少,方便、安全、简单,仍是目前基层医院拟诊宫腔粘连首选的检查方法。     

超声结合宫腔声学造影在宫腔粘连中的应用

  目的  以宫腔镜检查为金标准,通过分析超声结合宫腔声学造影(sonohysterography,SHG)诊断宫腔粘连(intrauterine adhesion,IUA)的敏感性、分度及类型检出率,探讨超声结合SHG在IUA中的应用价值。  方法  选取2018年4月—2019年10月于湖州市妇幼保健院经宫腔镜检查确诊为IUA的患者65例,研究对象均接受经阴道三维超声(three-dimensional transvaginal ultrasound,3D-TVUS)与SHG检查,比较65例患者经3D-TVUS结合SHG与宫腔镜检查的诊断结果。  结果  3D-TVUS与SHG的结合检查确诊病例为62例,敏感性为95.38%,与宫腔镜的结果差异无统计学意义(P>0.05)。宫腔镜诊断轻度粘连者为15例(23.08%),中度18例(27.69%),重度32例(49.23%),超声结合宫腔声学造影检查诊断为轻度者15例(23.08%),中度19例(29.23%),重度28例(43.08%),2种检查结果对比差异无统计学意义(P>0.05),Kappa值为0.801(P < 0.001)。宫腔镜在子宫粘连的类型中,确诊为单纯颈管粘连的病例数是15例(23.08%),宫腔内粘连33例(50.77%),混合粘连有17例(26.15%),3D-TVUS结合SHG检查在粘连类型中检出人数分别为14(21.54%)、30(46.15%)、18例(27.69%),对比差异无统计学意义(P>0.05),Kappa值为0.900(P < 0.001)。  结论  超声结合宫腔声学造影适用于宫腔粘连患者的诊断,具有较高的诊断准确性,值得临床推广使用。      

子宫输卵管造影术在官腔粘连中的应用

目的探讨子宫输卯管造影术（HSG）在诊治宫腔粘连（IUA）中的价值。方法回顾性分析本院2007年3月～2011年4月经HSG诊断为宫腔粘连的200例患者的临床资料。结果经HSG诊断,宫腔完全性粘连22例（11．0％）,中央型粘连34例（17．0％）,周围型粘连69例（34．5％）,混合性粘连75例（37．5％）。经官腔镜检查,HSG与宫腔镜诊断符合率为91．0％,误诊率为9．0％。结论HSG可以确定粘连的部位和范围、程度,且操作简单、方便,患者痛苦较少,是诊断宫腔粘连常规、可靠的检查手段。     

子宫输卵管造影和宫腹腔镜联合诊断女性不孕症118例分析

目的探讨子宫输卵管造影(hysterosalpingography,HSG)和宫腹腔镜联合手术在诊断女性不孕症中的价值。方法对118例女性不孕症患者先后行子宫输卵管碘海醇造影和宫腹腔镜手术和分析。结果 HSG与宫腹腔镜手术诊断输卵管阻塞无统计学意义(P>0.05),HSG诊断输卵管阻塞的敏感度为82.54%,特异度为60.74%;HSG时75例患者盆腔未显影,腹腔镜发现其中42例有盆腔粘连,HSG、腹腔镜对显影的43例患者诊断盆腔粘连无统计学意义(P>0.05),HSG诊断盆腔粘连的敏感度为40.91%,特异性为52.38%;对宫腔病变的检出率HSG和宫腔镜分别为7.63%、50.85%(P<0.05)。结论 HSG对输卵管阻塞有较好的诊断价值,对盆腔粘连的诊断价值有限,对宫腔病变的诊断远不及宫腔镜。     

不同方法对不孕症患者宫腔粘连的诊断价值分析

目的 探讨阴道超声(TVS)、子宫输卵管碘造影(SHG)对不孕症患者宫腔粘连的诊断价值.方法 回顾性分析48例经宫腔镜检查或治疗的不孕症患者的临床资料,评价TVS、SHG两种检查方法及其二者联合对宫腔粘连诊断的准确性、可靠性及预测值.结果 TVS的灵敏度、阳性似然比、阳性预测值以及与金标准的一致性均高于HSG,但是HSG检查的特异度较高、误诊率低.TVS联合HSG后诊断准确性、可靠性均提高,和金标准的一致性极佳.结论 单一TVS或HSG检查诊断宫腔粘连具有较高的漏诊率,将二者检查联合可以大幅降低漏诊率,提高诊断的准确性.     

宫腔镜诊治宫腔粘连的临床体会

目的：探讨宫腔镜手术治疗宫腔粘连（IUA）的有效性和安全性。方法：2006年1月至2009年1月对124例经宫腔镜确诊的IUA施行宫腔镜IUA分离术。结果：124例患者1次手术后宫腔形态恢复正常占87.5%,术后1月临床症状（闭经、月经量少、腹痛）改善率93.7%。结论：宫腔镜检查是诊断宫腔粘连的首选方法,宫腔镜手术治疗IUA安全有效。     

经阴道二维超声联合三维超声容积成像技术对宫腔粘连及分型的诊断价值

目的 分析经阴道二维超声联合三维超声容积成像技术对宫腔粘连(IUA)及其分型的诊断价值。方法 选取2020年5月—2022年6月海口市妇幼保健院收治的128例IUA患者为研究组，另取同期该院宫腔检查正常的71例女性为对照组。所有患者行经阴道二维超声、三维超声容积成像检查，将宫腔镜检查结果作为金标准。比较两组宫腔血流参数，对比经阴道二维超声、三维超声容积成像技术诊断IUA结果，比较研究组不同IUA程度患者宫腔血流参数，比较经阴道二维超声、三维超声容积成像技术诊断IUA分型结果。结果 宫腔镜检查显示，128例IUA患者中，78例轻度粘连，27例中度粘连，23例重度粘连；其中，20例周围型，45例中央型，63例混合型。研究组子宫内膜厚度(ED)、子宫内膜容积(EV)、血管指数(VI)、血流指数(FI)、血管化血流指数(VFI)均低于对照组(P <0.05)。经阴道二维超声、三维超声容积成像技术及两者联合诊断IUA的敏感性分别为85.16%(95%CI:0.775,0.906)、94.53%(95%CI:0.886,0.976)、97.66%(95%CI:0.928,0.994)，经阴道...     

经阴道超声声学造影评价子宫宫腔粘连

评价声学造影经阴道超声诊断子宫宫腔粘连的价值。方法 :15例疑为宫腔粘连的患者于黄体期行经阴道彩色多普勒超声 (TVS)、宫腔注射生理盐水后经阴道超声 (C -TVS)和子宫输卵管X线造影术 (HSG)检查。结果 :15例患者C -TVS和HSG检查均证实为宫腔粘连 ,两种方法的结果完全相关 ,TVS仅 7例患者诊断为宫腔粘连。结论 :C -TVS具有与HSG同样的诊断价值。     

经阴道超声诊断宫腔粘连的临床应用价值

目的分析经阴道超声诊断宫腔粘连的临床应用价值。方法回顾分析2015年12月至2016年12月期间在我院检查怀疑为宫腔粘连的106例患者临床资料,患者首先采用经阴道超声检查,然后进行宫腔镜术后病理检查,对比两种方法检查结果。结果宫腔镜术后病理检查结果显示宫腔粘连90例,无宫腔粘连16例,检出率为84.90%;阴道超声检查宫腔粘连82例,无宫腔粘连24例,检出率为77.35%;经阴道超声诊断与宫腔镜术后病理结果对比,漏诊8例,诊断准确率为91.11%,与宫腔镜术后病理结果对比,差异无统计学意义(P0.05)。结论经阴道超声诊断宫腔粘连,诊断准确率高,且对患者无创伤,具有临床推广的重要意义。     

经阴道超声对子宫腔内粘连的诊断价值研究

目的:探讨经阴道超声（TVS）诊断宫腔内粘连的价值。方法：对临床怀疑宫腔粘连的213例病例，均行经阴道超声（TVS）与子宫输卵管造影（HSG）检查，并取活检做病理学检查，对TVS诊断子宫腔内粘连的价值进行评价。运用成本效果分析对HSG、TVS联合HSG诊断宫腔内粘连进行经济学的评价。结果：TVS诊断IUA的敏感性为90．6％，特异性为100％，准确性为92％。HSG诊断IUA的敏感性为100％，特异性为90．6％，准确性为98．6％。181例IUA患者根据HSG的分级标准分为轻度（40例），中度（109例）， 重度（32例），TVS对轻度的检出率为62．5％，中度的检出率为98．1％，重度的检出率为100％。TVS联合HSG及HSG诊断宫腔内粘连的效果相同，成本为55490元及74550元。结论：TVS具有较高的临床实用价值和推广价值。     

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.