米非司酮配伍经阴联合用药终止10至15周妊娠临床研究

目的:观察米非司酮配伍经阴羊膜腔外注入利凡诺、阴道放米索前列醇终止10~15周妊娠的效果及安全性。方法:选择10~15周妊娠要求终止的妇女400例,随机分为观察组和对照组。两组均服米非司酮每次25mg,一天3次,总量150mg,妊娠物排出后常规清宫。观察组经阴置入12号尿管,注入利凡诺50mg+注射用水30ml,同时后穹窿放置米索前列醇600μg。对照组助手两指放入阴道内托起子宫,经腹羊膜腔穿刺注入利凡诺100mg。观察两组的引流产效果、副反应及并发症。结果:两组的流产成功率均为100%。观察组及对照组的注药至宫缩的时间分别为2.08±1.23h和25.28±8.12h(P<0.001);宫缩至妊娠产物排出的时间分别为4.26±2.65h和10.84±6.65h(P<0.001);注药至妊娠产物排出的时间分别为6.34±3.12h和36.12±19.08h(P<0.001);产后2h阴道出血量观察组<100ml的195例、100~200ml的0例,对照组<100ml的187例、100~200ml的6例(P<0.05)。两组无1例发生软产道裂伤、子宫损伤,且用药后的副反应小,不需特殊处理。结论:米非司酮联合经阴羊膜腔外注入利凡诺、阴道放米索前列醇用于终止10-15周妊娠引产成功率高、时间短、并发症少,是安全、有效的方法。     

米非司酮配伍米索前列醇联合利凡诺用于中孕引产的观察

目的 探讨米非司酮配伍米索前列醇联合利凡诺用于中孕引产的临床效果.方法 将2010年1～12月笔者所在生殖健康中心收治的要求终止妊娠的中孕(20～27周孕)孕妇280例,随机分为两组.观察组入院后经腹羊膜腔内注射利凡诺100 mg,同时口服米非司酮75 mg,12 h 1次,总量150 mg,在服完最后75 mg米非司酮后1 h口服米索前列醇0.6 mg,并经阴道后穹隆放置米索前列醇0.2 mg,4 h后宫缩弱或未启动、宫颈软化不佳者可经阴道重复给药0.2 mg.对照组入院后单一经腹羊膜腔内注射利凡诺100 mg.结果 对照组中1例孕妇行二次羊膜腔穿刺注药引产成功,观察组无类似情况,联合用药组从注药至宫缩开始时间及从宫缩开始至胎盘娩出时间均明显缩短(P＜0.05),胎盘胎膜残留、产后2 h阴道流血量及宫颈撕裂伤的发生率均较对照组明显减少(P＜0.05).结论 米非司酮配伍米索前列醇联合利凡诺羊膜腔内注射用于中孕引产使引产总产程缩短,降低了引产并发症的发生率,是一种值得推广的中孕引产方法.     

利凡诺联合米非司酮终止中期妊娠的临床研究

目的：探讨利凡诺联合米非司酮用于中期妊娠引产的临床效果。方法：选择70例中期妊娠妇女随机分为研究组和对照组各35例。研究组羊膜腔内注射利凡诺100mg,同时口服米非司酮50mg,每12h1次,共服4次。对照组只在孕妇羊膜腔内注射利凡诺100mg。结果：观察组产程发动早、总产程时间短、胎膜娩出完全、无胎盘滞留、完全流产率高,产后出血少,产道损伤少,无产后感染,与对照组相比,差异有显著性。,结论：米非司酮与利凡诺配伍宫缩开始时间、宫缩至胎盘娩出时间明显缩短,产后出血量减少,是用于中期妊娠引产较理想的方法。     

不同方式终止中期妊娠的效果比较

目的探讨不同方式终止中期妊娠的效果比较。方法将2006年1月-2007年12月,孕13-27周自愿要求引产的孕妇156例随机分成A组80例及B组76例,A组口服米非司酮25 mg,每日2次,连用3 d,第4天阴道后穹隆放置米索前列醇200 ug,如无腹痛间隔6 h再次重复上药,直到胎儿、胎盘排出;B组利凡诺100 mg羊膜腔内注射给药。均观察腹痛、阴道出血、及胎儿、胎盘排出情况。结果A组宫缩时间短于B组,而且完全流产率高,两组阴道出血无差异,药物副反应A组高于B组,胎膜残留率则B组高于A组。结论两种引产方法各有优缺点,但近年来利凡诺药品短缺,米非司酮联合米索前列醇用于中期妊娠引产安全有效可以临床应用。     

联合应用米非司酮终止中期妊娠

目的　探索联合应用米非司酮终止 10～ 2 5周妊娠的临床效果。方法　我院孕 10～ 2 5周要求终止妊娠的妇女分成 2个大组。孕 10～ 16周妊娠者随机分为 2组 ,对照组予米非司酮配伍米索前列醇 ,研究组予米非司酮加用宫颈内导管插入法配伍米索前列醇。孕 17～ 2 5周妊娠者亦随机分为 2组 ,对照组利凡诺 10 0mg羊膜腔内注入 ,研究组予米非司酮口服配伍利凡诺 10 0mg羊膜腔内注入。结果　孕 10～ 16周阶段 :研究组宫缩出现时间较对照组明显缩短 ,服药后 3h及 6h胎儿、胎盘排出率增加 ,有显著性差异 (P <0 .0 1)。孕 17～ 2 5周阶段 :研究组宫缩出现时间及引产时间明显缩短 ,有显著性差异 (P <0 .0 1)。结论　联合应用米非司酮终止中期妊娠具有更好的临床效果。     

米非司酮配伍米索前列醇与利凡诺联合应用于中孕引产

目的 观察米非司酮配伍米索前列醇与利凡诺联合应用于终止16～27周妊娠的疗效.方法 280例妊娠16～27周要求终止妊娠者,其中观察组130例,米非司酮150 mg顿服,24～36 h行羊膜腔内注射利凡诺100 mg,于24 h阴道内放置米索前列醇200 mg,根据宫缩2～3 h放1次,24 h内最多4次.对照组150例行羊膜腔内注射利凡诺100 mg,观察两组产程,出血量,胎盘胎膜遗留以及引产后阴道出血时间.结果 观察组产程短,出血少,引产后出血时间短,11.5%有胎膜遗留,清宫率低;对照组产程长,出血多,引产后出血时间长,90%有胎膜遗留,清宫率高.结论 米非司酮配伍米索前列醇与利凡诺联合应用于中孕引产,具有方法简单、安全、产程短、出血少、减少阴道手术操作、降低感染机会的优点.     

三种药物终止妊娠的方法比较

对于孕11～32周要求终止妊娠的健康妇女,我院过去采用利凡诺羊膜腔注射引产法,自1996年来用米非司酮(Mife)联合米索前列醇法(Miso)及利凡诺羊膜腔注射引产联合米索法,现对这三种药物终止妊娠方法进行比较。1　资料与方法1.1　对象　150例孕11～32周要求终止妊娠的健康妇女,无急、慢性病史,无药物过敏史、无阴道流血史。经妇科及B超检查确诊妊娠后,常规作阴道清洁度、血尿常规、出凝血时间检查。1.2　分组　随机分为A、B、C三组,三组的年龄、孕产次、孕周经t检验均无明显差异(P>0.05),有可比性。A组50例均用利凡诺羊膜腔注入法,B组50例为…     

利凡诺联合米非司酮中晚期引产的效果研究

目的 评价利凡诺联合米非司酮中期引产的疗效和安全性.方法 40例中晚期妊娠妇女随机分成两组:对照组(20例)和实验组(20例).对照组单用利凡诺羊膜腔内穿刺注射引产.实验组每12h口服米非司酮50mg,共2d,在口服1d之后利凡诺羊膜腔内注入引产.观察两组宫缩发动时间、宫缩至胎盘排出时间、宫颈撕裂伤情况、阴道流血量等.结果 米非司酮应用后,明显缩短了利凡诺引产时间、不增加阴道出血时间并可减少产后出血量.结论 利凡诺联合米非司酮中期引产显著缩短引产时间,减少产后出血量.     

复方米非司酮配合利凡诺中期引产的疗效观察

目的:探讨复方米非司酮联合利凡诺用于终止中期妊娠的疗效。方法:将120例孕16～27周要求终止妊娠者分为两组,观察组60例空腹顿服复方米非司酮30 mg,同时经腹壁利凡诺100 mg羊膜腔内注射,隔天空腹再顿服复方米非司酮30 mg。对照组60例经腹壁利凡诺100 mg羊膜腔内注射,观察两组宫缩开始时间、宫缩开始至胎儿娩出时间、产后1 h出血量、软产道损伤、胎盘胎膜残留、引产成功情况。结果:观察组产程发动早,胎儿娩出时间短,产时出血少,软产道损伤小,胎盘胎膜残留少,引产成功率100%。与对照组比较,差异有统计学意义(P<0.05)。结论:复方米非司酮联合利凡诺用于中期妊娠引产,具有临床效果显著,方法简单、安全、缩短产程、减轻疼痛、损伤小、出血少、引产成功率高、住院时间短等优点。     

米非司酮配伍米索前列醇药物中妊引产的研究

目的 探讨米非司酮配伍米索前列醇药物中妊引产的方法,以缩短药物引产的时间及减少患者痛苦.方法 2000年7月1日至2004年12月31日金溪县中医院1250例孕12周-24周行药物引产与利凡诺引产.分为2组.即观察1组,观察2组.观察1组580例,米非司酮每日100mg顿服连用2天,第三天阴道塞米索前列醇400mg必要时4小时加服1次.观察2组,利凡诺100mg行羊膜腔内或腔外注入.结果 按照观察1组,观察2组流产率均为100%.胎儿排出时间分别(5.06士2.56) (10.23士2.46)小时.胎盘胎膜娩出完整性95%、90%阴道出血量分别为(200±50)、 (300±50)ml,观察1组,胎儿娩出时间胎盘胎膜娩出的完整性和阴道出血量,差异有显著性意义(P<0.01),二组副反应及有经复潮时间比较差异无显著性意义(P>0.05).结论 米非司酮与米索前列醇可缩短引产时间,减少患者的痛苦和阴道出血量.不加重副反应,不影响月经复潮.米非司酮和米索前列醇配伍合用小月份引产,值得推荐.     

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.