小肠气钡双对比造影法的研究

目的:研究一种新的、简便易行的小肠双对比造影法—无管法快速小肠气钡双对比造影法。初步评价其效果,并与传统口服钡剂小肠造影法相比较,同时比较西沙必利与胃复安在小肠双对比造影中的药效。方法:将产气粉装入小肠溶胶囊,口服并在小肠内崩解,释放二氧化碳气体,配合口服钡剂及西沙必利,形成小肠双对比像。选取100例拟行小肠造影检查者,随即分为研究组和对照组,研究组67例采用本法,对照组33例采用口服钡剂法加肌注胃复安。结果:研究组53例效果满意,12例基本满意,2例未观察到明显双对比效果,其中1例因吞咽困难无法检查,总有效率97.02%,平均检查时间34.63±16.66m in;对照组均为单钡造影效果,平均检查耗时77.12±32.98m in;两种检查方法耗用时间及两种药物的效果在统计学上具有显著性差异(P<0.01)。结论:无管法快速小肠气钡双对比造影法确能形成良好的气钡双对比像,小肠观察效果较口服钡剂法有明显提高;西沙必利较胃复安药效更好、更安全。     

新型产气剂在小肠造影中的研发应用

目的 根据临床需要,尝试研发一种新型简便易行的小肠双对比造影法-无管法快速小肠气钡双对比造影法.评估新方法的检查效果,并与传统口服钡剂小肠造影法进行比较分析,同时分析胃复安与西沙必利在小肠双对比造影中的药物作用.方法 将胃肠道造影检查专用产气粉自制成小肠溶糖衣片,口服使其在小肠内自然分解释放出二氧化碳（CO2）,同时配合口服硫酸钡和胃肠动力药,完成小肠双对比影像学检查.随机选取130例行小肠造影检查的患者,随机分为研究组及对照组,70例采用口服小肠溶糖衣片产气粉加口服西沙比利片入选研究组,60例采用口服钡剂法并肌注胃复安入选对照组.结果 在研究组中63例效果满意,有5例基本满意,2例未观察到明显的双对比造影效果,总有效率占97.14％,平均检查时间为（34.63±10.12）min;对照组均为单钡造影效果,平均检查耗时（77.12±18.23）min;两种检查方法耗用时间及两种药物的效果在统计学上具有显著性差异（P＜ 0.005）.结论 小肠溶糖衣产气片在无管法快速小肠气钡双对比造影法中确能形成良好的气钡双对比影像,小肠观察效果较口服钡剂法有明显提高;西沙必利较胃复安药效更好、更安全.     

改良法产气胶囊小肠气钡双对比造影影像效果观察

目的探讨改良法产气胶囊小肠气钡双对比造影的影像效果。方法将12例小肠疾病患者作为研究对象,行改良法产气胶囊小肠气钡双对比造影。结果得到的小肠气钡灌肠双重对比图像清晰,可较好地显示小肠病变情况。结论改良法产气胶囊小肠气钡双重造影,可获得较高质量的影像资料,具有较高的临床实用价值,可作为诊断小肠疾病的常规检查方法之一。     

插管法小肠造影临床应用探讨

目的：探讨插管注入钡剂法小肠气钡双重造影在临床中应用。方法：回顾性分析50例插管注入钡剂法小肠气钡双重造影患者的临床资料。结果：50例插管注入钡剂法小肠气钡双重造影中12例X线表现异常,38例表现正常。结论：插管注入钡剂法小肠气钡双重造影检查法是一种经济有效的小肠检查方法。     

小肠导管双对比造影38例的体会

小肠导管双对比造影,是将小肠导管经口腔或鼻腔插至十二指肠空肠曲,通过导管将造影剂直接注入小肠进行造影检查的方法。本组38例小肠导管气钡双对比造影均获得成功。本文重点介绍小肠导管气钡双对比造影方法及正常X线表现。并对小肠导管的选择、病人造影前准备、插管技术、造影剂灌入、低张药物应用及小肠导管气钡双对比造影的优缺点进行讨论。     

载体介导双向小肠气钡双重造影的临床应用

目的：探讨一种简便易行,患者乐于接受的小肠双对比造影法—载体介导双向小肠气钡双重造影并应用于临床。方法：以空心肠溶胶囊为载体盛装产气剂,口服后载体胶囊至小肠溶解,产生CO2,在高张及低张药物的作用下,CO2与口服钡剂形成小肠气钡双对比。结果：45例造影患者,32例(71．1％)获得满意效果,6例(13．3％)空肠显示较好,回肠欠佳;3例(6．6％)回肠显示可,空肠未见气体,总有效率达91％,4例呈单对比效果。结论：载体介导双向小肠气钡双对比造影法安全实用,影像清晰,可做为首选检查法。     

46例小肠气钡灌肠双对比造影对空回肠肿瘤的诊断

目的：探讨小肠气钡灌肠双对比造影对空回肠肿瘤的诊断价值，并对常见的误诊原因进行分析方法：回顾性分析46例小肠气钡灌肠双对比造影的表现．并与临床和病理结果进行对照．结果：小肠气钡灌肠双对比造影可观察黏膜小病变，清晰显示病灶，与病理诊断结果的符合率为89.1％(41／46)。结论：小肠气钡灌肠双对比造影对小肠肿瘤的诊断准确，具有重要价值     

经胃镜引导小肠气钡双重造影的临床应用

目的　评价经胃镜引导小肠气钡双重造影检查法的实用性。方法　常规胃镜检查后胃镜镜端置于十二指肠降部与水平部交界处 ,经胃镜活检孔道置入导丝 ,退镜。经导丝置入双腔气囊导管 ,气囊定位于十二指肠降部后注气5 0～ 60ml,经导管行小肠气钡双重造影。服药组术前 2～ 4h口服普瑞博思 10mg。结果　 5 1例患者中 48例一次置管成功 ( 94.1% )。确诊病例 12例 ,检查阳性率 2 3 .5 %。服药组钡剂抵达回盲部所需时间短于对照组 (P <0 .0 1)。结论　经胃镜引导小肠造影方法简便 ,适宜在基层医院开展。     

小肠钡餐逆行注气及十二指肠插管法小肠双重造影检查比较

目的为了探求简便、易行、费用低、患者容易接受的小肠造影双对比检查法。方法收集"胃镜引导下十二指肠插管法双重造影"和"小肠钡餐逆行注气双对比造影"各32例,分别作比较。结果两组检查均顺利完成。十二指肠插管法组整个造影时间为25~35min,有阳性发现12例,胃镜引导下十二指肠插管法插管需要消化科协作,病人痛苦,不易接受,且有禁忌症。小肠钡餐逆行注气组整个造影时间为65~95min,有阳性发现15例。小肠钡餐逆行注气组采取多次服钡,避免钡剂的积聚重叠,又可以使小肠各组连续显示,使钡剂分布均匀,较胃镜引导下十二指肠插管法费用低,病人容易接受,且无明显禁忌症。结论小肠钡餐逆行注气双对比造影是一种费用低、病人容易接受、无明显禁忌症的小肠造影方法。     

小肠钡气逆行灌肠双重造影

小肠造影除口服法外 ,用直接插管法至十二指肠屈氏韧带附近经导管注入钡气双对比造影[1～ 3 ] ,此法操作费时 ,对病人及医生都不利。我院经长期实践探索与研究 ,现改进为经肛管注钡气由回盲瓣逆行进入小肠造影 ,此法经多次临床验证行之有效 ,特报告如下。造影方法与结果1.检查前准备　肠道内腔的空净干燥 ,是逆行钡气造影的关键。若清洁准备不彻底 ,其内容物随灌钡时被推到回盲部聚集 ,妨碍钡进入回盲瓣。此外 ,检查前不宜作清洁灌汤 ,否则残留于回盲部液体进入小肠而影响其充盈速度及钡气与肠壁涂布的均匀程度 ,因此强调下列几点 :(1)多饮…     

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.