人工全髋关节置换术后早期康复训练的作用

目的研究早期康复训练对人工全髋关节置换术后患肢功能恢复的作用. 方法对51例人工全髋关节置换术后的患者进行2 ～ 4周的系统康复治疗,在治疗前后做肌力、关节活动范围及Harris评分对照. 结果系统康复治疗后,患者的肌力、关节活动范围及Harris评分均明显高于对照组(P<0.01). 结论人工全髋关节置换术后早期系统的康复治疗可增加患肢的肌力及关节活动范围,提高手术疗效,改善患者的生存质量.     

早期康复护理对人工全髋关节置换术后患肢功能恢复的影响

目的：探讨早期康复护理对人工全髋关节置换术后患肢功能恢复的影响。方法将48例人工全髋关节置换术后患者随机分为对照组和试验组,各24例。对照组患者均实施骨科常规药物治疗和护理,试验组患者在常规治疗和护理的基础上实施早期康复护理,如早期冰敷、严格肢体的摆放、肌力训练负重行走、预防并发症练习等措施。采用Harris评分比较2组的康复效果。结果试验组的Harris评分显著高于对照组（P<0.05）。结论早期康复护理对人工全髋关节置换术后患肢功能恢复起着至关重要的作用,值得临床中重视并推广。     

人工全髋关节置换术后康复护理

目的 探讨人工全髋关节置换术康复护理的措施及效果.方法 对42例人工全髋关节置换术患者实施积极的预防感染、体位指导、肌力训练、关节活动训练等系统的循序渐进的康复护理.结果 42例患者均获随访,随访时间6～24个月,患者步行能力、髋关节活动度满意,患肢关节功能恢复良好,优良率达100.0%.无1例患者发生髋关节脱位、假体松动等并发症.结论 对人工髋关节置换术后患者进行系统护理和康复训练,能减少并发症发生,最大限度恢复患肢关节功能,提高患者的生活质量.     

肢体功能缺陷患者人工髋关节置换后康复疗效观察

目的探讨不同原因所致患肢肌力不足人工髋关节置换术后肢体康复的方法及疗效观察。方法对39例下肢功能不全患者人工关节置换术后采用综合护理及系统康复,经过6个月的随访,对肢体功能恢复情况进行评定,并对功能康复的影响因素进行分析。结果本组采用Harris评分3,9例中关节源性21例全部恢复到术前水平,而神经源性18例中只有9例恢复到术前水平。结论经过合理的外科手术配合针对性的康复训练,关节源性患肢肌力缺陷关节置换术后功能恢复接近正常肢体,而神经源性则相对较差。     

组配式半骨盆假体置换术后围术期康复干预对患肢功能的影响

目的探讨围术期康复治疗对骨盆恶性肿瘤半骨盆切除、组配式半骨盆+全髋关节置换术后的患肢功能的影响。方法 2004年9月—2007年5月采用半骨盆切除、组配式半骨盆假体+全髋关节置换术治疗骨盆恶性骨肿瘤8例。术后根据肿瘤切除范围、人工假体置换术后稳定性和骨盆髋周动力肌修复后的平衡程度,决定术后患肢体位、患髋活动范围、是否使用髋部支具,同时指导患者分阶段、渐进地进行患肢足踝、膝、髋关节的主被动训练,下床负重时间和步态调整。结果随访8～30个月,平均13个月。术后8个月患肢功能评定:优2例,良6例。ISOLS评分:15～26分,平均19.5分。结论①术后患者的合理体位和良好的支具保护能有效的防止髋关节早期脱位;②患肢各关节的分阶段有序的主动训练能提高骨盆和髋周肌肉肌力及其平衡度,对术后患者行走和步态有重要意义。     

人工全髋关节置换术患者的康复指导

目的：通过康复训练，帮助患者恢复日常生活能力，重获关节功能。方法：通过对32例全髋关节置换术患者进行循序渐进的康复指导与护理。结果：无感染、并发症发生，髋关节功能恢复良好。结论：人工全髋关节置换术后，早期进行患肢功能锻炼，对减少术后并发症和患者患肢康复十分重要。     

人工全髋关节置换病人的康复护理

目的探讨行人工全髋关节置换术的病例,于术前、术后早期进行康复训练对术后患者的患肢功能恢复作用。方法对76例行人工全髋关节置换术的病例,术前向病人讲解术后康复锻炼的方法以及相关知识,使病人认识到早期活动的重要性和必要性,学习各种锻炼方法以提高肌力;术后在预防并发症的同时,当天即开始康复锻炼,逐日递增,直至出院。结果本组所有病例均在术后3天内即可部分负重行走,术后2周出院,出院时均可在助行器辅助下独立行走,无疼痛及其他不适,康复锻炼期间无一例发生并发症。结论行人工全髋关节置换术的病例,于术前、术后早期进行康复训练对术后患者的患肢功能恢复效果好。     

人工全髋关节置换术患者采取的康复护理措施

目的探讨人工全髋关节置换术患者的康复护理措施.方法 针对人工全髋关节置换术患者的术后采取有效的护理措施进行一系列的康复训练.结果 人工全髋关节置换术后的患者进行康复护理,并发症明显减少,Harris评分明显增高,Barthel指数评分明显提高.结论 全髋关节置换术,对患者进行积极有效的康复护理可预防并发症的发生,保证全髋关节置换术后的关节功能良好恢复,提高了患者的生活质量.     

PNF疗法对人工全髋关节置换术后早期康复疗效观察

目的:观察PNF疗法对人工全髋关节置换术后早期患者的康复疗效影响。方法:42例人工全髋关节置换术后患者随机分为PNF治疗组21例和对照组21例,THA术后均采用常规康复治疗方法,PNF治疗组增加PNF疗法。2组治疗前及治疗2周后、8周后进行Harris评分、目测类比评分法(VAS)评定结果进行对照研究。结果:治疗2周后及8周后2组患者Harris评分较治疗前提高,目测类比评分法(VAS)评分有下降,与对照组比较PNF治疗组显著提高(p<0.05)。结论:PNF疗法可有效提高人工全髋关节置换术后早期患者的康复疗效。     

人工全髋关节置换术的康复训练及护理

目的:探讨人工全髋关节置换术(THA)后康复训练及护理的重要性。方法:对笔者所在医院183例人工全髋关节置换术患者进行康复训练及护理,观察治疗效果。结果:术后Harris评分平均85分,功能评分平均83分。结论:良好的康复训练及护理可加速人工全髋关节置换术患者的康复,恢复髋关节的活动功能,减少并发症。     

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.