开腹与腹腔镜下阑尾切除术105例临床对比观察

目的 对比开腹与腹腔镜下行阑尾切除术的临床效果.方法 将我院2013年1月—2016年8月收治的105例急性阑尾炎患者随机分为2组:腹腔镜组(n=53)行腹腔镜下阑尾切除术;开腹组(n=52)行开腹阑尾切除术.比较2组术中、术后情况及并发症发生率.结果 腹腔镜组除手术时间长于开腹组外,术中出血量、术后下床活动时间、肛门排气时间、住院时间均少于或短于开腹组,差异有统计学意义(P<0.01);与开腹组比较,腹腔镜组术后疼痛程度轻、使用镇痛剂的患者少,且并发症发生率低,差异均有统计学意义(P<0.05).结论 腹腔镜下手术治疗急性阑尾炎安全、可靠,且对患者机体损伤小,术后恢复快、并发症少,综合疗效优于开腹切除术.     

腹腔镜和开腹手术治疗急性阑尾炎临床疗效观察

目的:观察并比较腹腔镜和开腹手术治疗急性阑尾炎临床疗效。方法:120例急性阑尾炎患者随机分为传统开腹组和腹腔镜组各60例,分别采用开腹手术和腹腔镜手术,观察术中和术后相关指标。结果:腹腔镜组的切口长度、手术时间、肛门排气时间和术中出血量比较差异具有统计学意义(P<0.05)。腹腔镜组需要镇痛和切口感染的发生率要明显高于传统开腹组,卧床时间和住院时间明显短于对照组,差异均具有统计学意义(P<0.05)。结论:腹腔镜手术治疗急性阑尾炎创伤小、术后恢复快,优于传统开腹手术。     

腹腔镜与开腹手术治疗急性阑尾炎的临床对比分析

目的:对比分析腹腔镜手术与开腹手术治疗急性阑尾炎的临床疗效。方法:该临床研究所选的研究对象为在我院治疗的急性阑尾炎患者,其就诊时间为2016年1月至2017年6月,共计纳入100例,分为腹腔镜组(n=50)和开腹组(n=50)。腹腔镜组患者采取腹腔镜阑尾切除术进治疗,开腹组患者采取开腹阑尾切除术进行治疗。结果:手术治疗情况比较,除了手术操作时间和治疗费用两项之外,其余的术中出血量、术后肛门排气时间、术后镇痛率、住院时间等指标,腹腔镜组均优于开腹组,比较差异有统计学意义P0.05。而手术时间,两组相当P0.05;治疗费用,腹腔镜组明显高于开腹组,比较差异有统计学意义P0.05。并发症发生情况比较,腹腔镜组以2.00%明显低于开腹组的10.00%,比较差异有统计学意义P0.05。结论:与传统开腹阑尾切除术相比较,腹腔镜阑尾切除术治疗急性阑尾炎创伤较小、疗效确切,并发症较少、术后恢复较快,是一种安全有效的急性阑尾炎治疗方式。     

腹腔镜与传统开腹手术治疗急性阑尾炎的临床疗效比较

目的:比较腹腔镜与传统开腹手术治疗急性阑尾炎的临床疗效。方法:选取2011年1月～2012年6月在我院救治的50例急性阑尾炎患者,随机平均分为观察组(腹腔镜手术)和对照组(传统开腹手术),分析比较两组手术的治疗效果。结果:两组患者疗效、并发症、术后排气时间、手术出血量、住院时间及手术疼痛评分相比,差异有统计学意义(P<0.05);两组手术时间相比,无统计学差异(P>0.05)。结论:腹腔镜手术治疗急性阑尾炎疗效显著,具有创伤小、恢复快、并发症少和住院时间短等优点,是治疗急性阑尾炎较理想的手术方式。     

腹腔镜治疗急性阑尾炎的临床效果分析

目的与传统开腹手术相比,评价腹腔镜治疗急性阑尾炎的疗效。方法回顾性分析2009年6月至2012年11月期间手术治疗127例急性阑尾炎患者,其中59例应用腹腔镜治疗,68例应用传统开腹手术方法,对两组患者手术时间、出血量、术后进食时间、疼痛程度、术后并发症(切口感染、腹腔脓肿)住院花费等指标进行比较。结果与开腹组相比,腹腔镜组手术时间及住院花费增加,但术后疼痛程度轻、术后进食时间缩短、术后并发症减少,差异有统计学意义P<0.05。两组在术中出血量差异无统计学意义P>0.05。结论腹腔镜治疗急性阑尾炎优于传统手术方法,但费用较高。     

急性阑尾炎应用腹腔镜和开腹手术治疗的临床对比

目的比对并分析急性阑尾炎应用腹腔镜和开腹手术治疗的临床效果。方法选取本院在2014年10月至2018年9月收治的急性阑尾炎患者40例,将40例患者采用随机数字表法分成的开腹组(n=20例)与腹腔镜组(n=20例),腹腔镜组开展腹腔镜手术,开腹组实施传统开腹手术,比对两组患者手术时间、术中出血量、住院时间、肛门排气时间。结果腹腔镜组患者手术时间、术中出血量、住院时间、肛门排气时间与开腹组临床指标数据比对有意义(P0.05)。结论分析急性阑尾炎应用腹腔镜手术,可以有效缩短手术时间、术中出血量、住院时间、肛门排气时间,促进患者术后康复。     

腹腔镜手术与开腹手术治疗儿童急性阑尾炎的临床比较

目的对比分析腹腔镜手术和开腹手术治疗儿童急性阑尾炎的临床效果。方法选取2011年12月-2013年12月我院确诊收治的130例儿童急性阑尾炎患者作为研究对象,将所有患儿随机分为对照组和观察组各65例,对照组患儿给予开腹手术治疗,观察组患儿给予腹腔镜手术治疗,观察两组患儿术中出血量、疼痛持续时间、术后进食时间、肛门排气时间、手术时间、住院时间和不良反应发生率情况,并作对比分析。结果观察组患儿的临床治疗有效率为95.4%,显著高于对照组的81.5%,两组对比差异有统计学意义(P0.05);观察组患儿的术中出血量、疼痛持续时间、术后进食时间、肛门排气时间、住院时间均显著短于对照组,两组对比差异有统计学意义(P0.05);观察组患儿的手术时间与对照组相比,差异无统计学意义(P0.05);观察组的不良反应发生率为,显著低于对照组的,两组对比差异x有统计学意义(P0.05)。结论与开腹手术相比,腹腔镜手术治疗儿童急性阑尾炎具有较高的临床应用价值,疗效确切,能够有效减少术中出血量,减轻患儿疼痛,缩短患儿住院时间,安全可靠,值得临床大力推广。     

急性阑尾炎手术治疗效果观察

目的观察急性阑尾炎手术的临床治疗效果。方法随机选取2010年10月-2011年10月于湖南省衡东县人民医院接受手术治疗的152例急性阑尾炎患者,其中72例患者采取开腹切除手术治疗(开腹组)、80例患者采取腹腔镜下阑尾切除术治疗(腹腔镜组),选取同期60例接受非手术治疗的急性阑尾炎患者(非手术组),对接受手术治疗的两组患者的手术时间、出血量、住院时间、排气恢复时间及止痛药使用率等指标进行比较,对手术组和非手术组的有效率、并发率及复发率进行比较。结果腹腔镜组患者术中出血量、术后排气回复时间、术后下床活动时间、止痛药使用率和住院时间显著优于开腹组,差异有统计学意义(P<0.05);手术治疗的总有效率和复发率分别为100.0%和0.66%,非手术的总有效率为90.0%和5.0%,两者比较差异有统计学意义(P<0.05);手术治疗的并发率为3.29%,非手术的并发率为1.67%,两者比较差异无统计学意义(P>0.05)。结论手术疗法是一种有效切除急性阑尾的方法,腹腔镜手术的效果要明显好于开腹手术,但手术费用较高,因此要根据患者病理类型选择适当的手术方法予以治疗。     

腹腔镜与传统开腹对小儿急性坏疽性阑尾炎的疗效分析

目的比较腹腔镜手术与传统开腹手术对小儿急性坏疽性阑尾炎的治疗效果。方法 2009年5月-2012年3月来九江市都昌县妇幼保健院就诊的105例急性坏疽性阑尾炎患儿,使用随机数表将以上患者随机分成腹腔镜组50例和传统开腹组55例。比较两组患儿年龄、手术时间、住院时间、术后进食时间和术后并发症情况。结果腹腔镜组和传统开腹手术组手术时间分别为(58±8)min和(62±10)min,P>0.05,无显著性差异,而腹腔镜手术组患者术后进食时间(1.5±0.5)d,比开腹手术组(2.5±1.2)d早,P<0.05,腹腔镜组的住院时间比传统开腹组短,且并发症少,P<0.05。结论腹腔镜手术治疗儿童急性坏疽性阑尾炎安全有效且术后并发症少。     

腹腔镜治疗急性化脓性阑尾炎与开腹手术的疗效比较

目的:探讨腹腔镜阑尾切除术与传统开腹手术治疗急性化脓性阑尾炎的疗效。方法:选取急性化脓性阑尾炎患者100例,其中腹腔镜治疗组52例,开腹治疗组48例。回顾分析两种手术的治疗效果,比较两种手术的手术时间、肛门排气时间、术后胃肠道功能恢复时间、平均住院时间、伤口感染率、术后残余感染率等方面的差异。结果:两组患者术后无严重并发症,其中腹腔镜组在手术时间、腹腔残余感染率、肛门排气时间、术后胃肠道功能恢复时间等方面显著低于开腹手术组,差异有统计学意义(P<0.05)。结论:腹腔镜治疗急性化脓性阑尾炎安全、有效,治疗效果优于常规开腹手术。     

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.