小儿腹部术后早期炎性肠梗阻的诊治分析

目的 探讨小儿腹部术后早期炎性肠梗阻的诊断和治疗方法.方法 回顾性分析22例小儿腹部术后出现的早期炎性肠梗阻的诊断和治疗的资料.结果 所有病例经禁食、胃肠减压、抗感染、静脉营养支持及生长抑素、皮质激素应用等保守治疗后均治愈出院.结论 小儿腹部术后早期炎性肠梗阻诊断成立后,经过严格、规范的保守治疗,均能得到有效的治疗,应尽量避免再次手术.     

82例术后早期炎性肠梗阻临床诊治分析

目的探讨腹部术后早期炎性肠梗阻的特点及临床诊断治疗经验。方法选择2007年2月-2011年5月笔者所在医院收治的86例术后炎性肠梗阻患者,其中82例采取保守方法治疗,主要包括肠外营养支持,腹部理疗,合理应用生长抑素,给予糖皮质激素治疗,胃肠减压,维持酸碱平衡,抑酸及中药灌肠,对足三里穴位行电针炙等,以促进胃肠功能恢复。另4例患者因腹腔发生脓肿实施手术治疗。结果 86例患者均是在腹部术后14d内出现早期炎性肠梗阻,最后均全部治愈。结论术后早期炎性肠梗阻常常在手术后6～14d发生(机械性肠梗阻排除在外)。保守方法治疗,不仅可有效治愈,还可避免不必要的二次手术损伤。     

小儿腹部手术后早期炎性肠梗阻的诊断及治疗（附28例报告）

小儿腹部手术后早期炎性肠梗阻是一种常见的临床病症。由于炎性肠梗阻发生在术后的早期，其临床特点及治疗措施均有一定特殊性，治疗方法的选择及手术时机的掌握对降低病死率及减少并发症极为重要。现就我院1991年1月至2008年6月收治的小儿腹部手术后早期炎性肠梗阻28例的临床资料进行回顾性分析，以探讨小儿腹部手术后早期炎性肠梗阻的特点和诊断、治疗原则。     

术后早期炎性肠梗阻的临床特点及诊断治疗方法

目的探讨术后早期炎性肠梗阻的临床特点及其诊断与治疗方法。方法应用病例对照研究分析近5年入住我院的36例腹部手术后发生早期炎性肠梗阻患者的临床资料,系统归纳、整理后做出分析报告。结果 36例患者中29例行保守治疗取得了很好的治疗效果,另外7例行手术治疗,其中1例患者10d后复发肠粘连行保守治疗缓解,1例因肠瘘而再次手术,1例因并发败血症死亡。结论术后早期炎性肠梗阻因其症状典型,且易导致肠外瘘、再梗阻、短肠综合征等严重并发症而应引起大家的重视,治疗应以非手术为主,只有在非手术治疗无效或者怀疑有肠绞窄、继发腹腔脓肿时采取手术治疗。     

术后早期炎性肠梗阻的诊治

目的探讨术后早期炎性肠梗阻的特点及治疗方法。方法对1996年1月~2005年11月我院收治的43例术后早期炎性肠梗阻患者的临床资料进行回顾性分析。结果43例患者均经胃肠减压、抗炎、应用生长抑素、营养支持等保守治疗痊愈,平均治愈时间为15.6d。结论术后早期炎性肠梗阻与腹部手术创伤,腹腔炎症、渗出、粘连有关。其特点:①多在腹部手术后早期1~2周内起病;②肠功能一度恢复,进食后马上出现梗阻;③腹胀为主,腹痛较轻,很少发生绞窄;④保守治疗有效,对术后早期炎性肠梗阻,首先行保守治疗。     

腹部手术后早期炎性肠梗阻28例的诊治体会

术后早期炎性肠梗阻为腹部手术后常见的并发症之一,是指因手术刨伤或腹部炎症等导致肠壁水梗阻[1].临床表现有其特殊性,治疗方法有别于其他肠梗阻.我院2000年1月至2007年12月收治术后早期炎性肠梗阻患者208例,现报告如下.     

腹部手术后早期炎性肠梗阻的护理体会

目的:总结腹部手术后早期炎性肠梗阻的治疗和护理经验。方法:选取腹部术后早期炎性肠梗阻患者资料26例,总结患者术后肠梗阻临床表现,探讨临床护理治疗方法,并就术后早期炎性肠梗阻的病理生理基础回顾了解。结果:26例经积极有效的保守治疗和护理措施,均解除了梗阻而避免了手术治疗。结论:术后早期炎性肠梗阻可以通过积极有效的保守治疗和护理治愈。     

术后早期肠梗阻36例诊疗体会

目的探讨腹部术后早期炎性肠梗阻的诊断及合理治疗方法。方法对我院2002年7月-2009年7月收治的36例术后早期炎性肠梗阻患者的临床资料进行回顾性分析。结果32例经保守治疗痊愈，平均住院16．1d；4例手术治愈。其中1例保守治疗期间出现肠绞窄而急诊手术，2例经保守治疗4周无效行手术治疗，1例因患者信心不足改行手术。术后1例并发肠瘘，其余均无并发症发生。结论术后早期炎性肠梗阻以保守治疗为主，手术治疗并发症多，疗效差，再次梗阻概率增加。     

26例炎性肠梗阻诊断与治疗

目的探讨术后早期炎性肠梗阻的病因,临床特点,诊断与治疗。方法对我院26例腹部手术后早期炎性肠梗阻病人的临床资料进行回顾性分析。结果 24例经胃肠减压应用生长抑素全胃肠外营养支持等非手术治愈。2例中转手术治疗。结论术后早期炎性肠梗阻好发于腹腔污染严重,创伤大的腹部手术多数发生于术后两周以内,非手术治疗是炎性肠梗阻的首选治疗方法。首选保守治疗。     

术后早期炎性肠梗阻52例临床分析

目的对炎性肠梗阻的治疗方法及预后进行观察。方法回顾性分析52例炎性腑梗阻患者临床资料。结果收治52倒术后早期炎性肪梗阻,均治愈。结论发生术后早期炎性硒梗阻的病人住院时间比较长,治疗过程中要耐心等待,同时要严密动态观察病人腹部症状,体征以及影像学变化,了解病程进展情况。勿将机械性肠梗阻诊断为炎性肠梗阻,以免延误手术时机。     

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.