乳晕下新月形切口治疗男性乳房肥大症

目的：乳晕下新月形切口乳房切除术治疗男性乳房肥大症。方法：4年为10例男性乳房肥大症患者实施了乳晕下新月形切口乳房整形术。结果：采用此方法为10例男性乳房肥大症患者治疗,切除100～150g腺体及周围组织,无乳头乳晕坏死等并发症,随访3～12个月,外形良好,患者满意。结论：本方法出血少,损伤轻,安全,恢复快。经过乳晕下新月形切口乳房整形术,切口瘢痕不明显,乳头乳晕无变形,可以充分满足男性乳房肥大症患者要求。     

脂肪抽吸及腺体部分切除术配合可控压力胸带治疗男性乳房肥大症

目的 分析总结肿胀麻醉脂肪抽吸加乳晕下缘小切口腺体部分切除配合自制可控压力胸带治疗男性乳房肥大症的临床效果.方法 回顾分析2007年6月～2009年1月本院收治的26例男性乳房肥大症患者临床资料.26例患者均采用肿胀吸脂术联合乳晕下缘小切口腺体部分切除术,术后即刻乳房区棉垫覆盖后以自制压力可控胸带加压包扎,拆线后继续坚持应用胸带1个月.结果 术后所有患者均未出现皮下血肿和积液,切口均Ⅰ期愈合,无乳头及孔晕坏死.26例患者均荻随访,随访时间6～12个月.12例患者术后第1天即出现乳头麻木,未予特殊处理,随访6个月2例患者乳头仍有感觉减退,10例患者明显好转.所有患者乳房区外形良好,无复发.结论 肿胀麻醉脂肪抽吸加乳晕下缘小切口腺体部分切除配合自制可控压力胸带治疗男性乳房肥大症具有并发症少、疲痕小、术后恢复快、外观自然、患者满意度高等优点,是目前治疗男性乳房肥大症有效方法之一.     

肿胀吸脂联合乳晕下弧形切口治疗中重度男性乳房肥大症

目的探讨肿胀麻醉吸脂联合乳晕下缘弧形微创切口腺体切除术治疗男性乳房肥大的方法和临床疗效。方法自2002年4月—2012年6月,收治29例男性乳房肥大患者。年龄16～47岁。单侧3例,双侧26例。其中脂肪型14例,脂肪混合型13例,腺体型2例。其中3例PRL、LH、FSH、E2水平增高,睾酮水平较低;其余患者体内相关激素水平正常,以上患者均采用肿胀吸脂联合乳晕下弧形切口腺体切除术。结果 1例患者于术后2 d出现皮下血肿,经对症处理后最终一期愈合;1例乳头下乳腺组织残留过多,经二次整复后效果满意,其他病例切口均Ⅰ期愈合。未见乳头、乳晕缺血、坏死及乳头感觉功能减退等并发症发生。20例患者随访,随访日期6～24个月,乳房外形良好,无复发。结论肿胀吸脂联合乳晕下弧形切口腺体切除术具有瘢痕小、安全性高、外观自然、患者满意度高等优点,是目前治疗男性乳房发育有效方法之一。     

48例男性乳房肥大症的手术治疗体会

目的：探讨经乳晕小切口治疗男性乳房肥大症的临床效果。方法：经乳晕弧形切口“夹心分离”并切除肥大乳腺组织,保留乳头乳晕区下方的部分乳腺组织垫。结果：48例患者96侧乳腺组织切除彻底,出血少,损伤小,术后患者胸部平坦,无凹陷,外形满意,切口疤痕隐蔽。结论：采用乳晕小切口能完整、彻底去除肥大乳腺组织,并发症少,效果好,是治疗男性乳房肥大症的良好手术方法。     

环乳晕小切口治疗男性乳腺发育症24例临床研究

目的探讨环乳晕小切13治疗男性乳房发育症的可行性及临床疗效。方法在局部肿胀麻醉或合并静脉镇痛麻醉下,对24例青年男性乳房发育患者经环乳晕小切口（2cm左右）切除皮下乳腺。结果24例手术均获成功。术中未出现并发症。手术时间平均47．2min（单侧）,全组术后伤口均为甲级愈合,无感染、皮下气肿、血肿、乳头乳晕坏死等并发症,24例经6～36个月随访,胸廓平整,外观良好,切口瘢痕不明显,乳头、乳晕无内陷．乳头感觉无异常可勃起,所有患者对手术美容效果表示满意。结论环乳晕小切口手术治疗青年男性乳房发育症切口微小隐蔽．美容优势明显．患者生活质量提高。     

脂肪抽吸加乳晕小切口治疗28例男性乳房发育症

目的 探讨男性乳房发育症的治疗方法及脂肪抽吸加乳晕小切口治疗男性乳房发育症的手术效果.方法 在乳房肥大区域皮下脂肪层注射肿胀麻醉液,采用负压吸引抽吸该区域内的脂肪组织及部分乳腺组织,后经乳晕小切口切除增生肥大的乳腺组织.结果 采用本法为28例男性乳房发育症患者治疗,切口均达到Ⅰ期愈合且疤痕不明显;全部乳头、乳晕均无坏死;胸部平坦、自然,无凹凸不平感.3例患者4侧术后出现乳头乳晕感觉减退,经随访3～18个月,感觉减退恢复.结论 本方法操作简单、安全、损伤小、出血少、恢复快,适用于治疗脂肪型和脂肪腺体型男性乳房发育症.     

经乳晕切口行全乳腺切除术

１９９５年以来，我科经乳晕切口行全乳腺切除术，治疗男性乳房肥大症和女性慢性囊性乳腺病共２３例３２侧。手术保留了乳头乳晕，且乳头乳晕感觉功能保持良好，切口疤痕不明显，取得了满意效果，现报告如下。１临床资料本组共２３例３２侧，男性９例１４侧，年龄１９～２...     

小切口切除和超声吸脂治疗男性乳房肥大症

目的 介绍2种治疗男性乳房肥大症的新方法及治疗体会。方法 男性乳房肥大症患者11例（15侧）,对乳腺管增生为主者经乳晕下缘小切口分叶切除增生乳腺管,对脂肪堆积者行超声脂肪抽吸术治疗。结果 术后效果良好。较乳房下皱襞切口手术具有明显优越性：切口小,瘢痕不显,超声抽吸者损伤更小,不导致患者术后心理障碍,患者较为满意。结论 小切口切除和超声吸脂治疗男性乳房肥大症值得临床推广。     

乳晕小切口治疗青年男性乳房发育症

目的:探讨全身麻醉下乳晕小切口治疗青年男性乳房发育症的手术治疗方法及临床效果.方法:回顾性分析5年来采用全身麻醉下乳晕小切口治疗青年男性乳房发育症17例(21侧)的临床资料.结果:每侧乳房切除腺体及脂肪组织直径5～12cm,无乳头乳晕坏死等并发症,无乳头感觉障碍,随访6个月～3年,外形良好,疗效满意.结论:全身麻醉下乳晕小切口治疗青年男性乳房发育症疗效确切满意.     

保留乳房正常外观的良性肿物切除术23例报告

我们根据乳房腺体周围有脂肪组织包裹且血运丰富的解剖特点,采用乳晕沿或乳房下沿皱褶弧形切口,保留乳头、乳晕及其周围皮肤,自1981年起共作乳房良性肿物潜行切除23例。由于手术疤痕隐蔽,乳房外观正常,病人满意。兹报道如下。一、临床资料:23例均经临床检查(包括肿物针吸穿刺活检)诊断为良性肿物者。其中男性5例,女性18例。肿物位于单个象限17例,位于整个乳腺6例(肿物直径3～12cm)。施行乳晕沿弧形切口手术14例,施行乳房下沿皱褶弧形切口手术9例。经病理切片诊断为慢性囊性乳腺病8例,乳房纤维腺瘤10例,男性乳腺发育症5例。二、手术方法: 1.肿物位于单个象限者:肿物至相应乳晕沿距离<5cm,且肿物直径<5cm者,作相应乳晕沿弧形切     

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.