经尿道电切治疗膀胱疾病10例报道

经尿道切除术 (ＴＵＲ)治疗膀胱疾病已被广泛应用于临床 ,本科自 1997年 7月开展此术至今 ,治疗 10例计 18例次 ,疗效满意 ,报告如下。1　资料与方法1 1　一般资料　 9例男性 ,1例女性。年龄 36～ 78岁 ,平均 6 6岁。病种 :膀胱肿瘤 7例 ,其中膀胱部切术后复发及再生者 5例。单发肿瘤 11例次 ,多发肿瘤 4例次 ,其它良性病变 3例。病灶大小为 1～ 2ｃｍ。部位 :膀胱底部 7例次 ,侧壁 6例次 ,顶部及前壁 4例次 ,顶部及颈口 1例次。病理类型 :移行上皮乳头状癌Ⅰ级 7例次 ,Ⅰ～Ⅱ级 5例次 ,Ⅲ级 3例 ;息肉 2例 ,非特异性炎性假瘤 1例。术前并发…     

膀胱颈会阴贯穿缝合固定尿道会师治疗骨盆骨折合并后尿道损伤27例

尿道损伤是泌尿系统常见的损伤之一，通常需要急症手术处理。我们采用膀胱颈会阴贯穿缝合固定尿道会师术，治疗骨盆骨折合并后尿道断裂27例，效果满意，现报道如下。1临床资料1．1一般资料本组27例均为我院1997年2月至2006年8月收治的男性患者，年龄19～61岁，平均38．5岁。致伤原因：车祸伤20例，塌方压伤6例，挖掘机击伤1例，均同时合并骨盆骨折，另合并腹内脏器损伤7例、     

女性膀胱颈梗阻的内镜诊治

该文报告６６例女性膀胱颈梗阻的膀胱尿迟镜检查所见和经尿道膀胱颈口电切术的方法，６２例获随访治愈率达９５％，认为本方法损伤小、治疗效果可靠，并对电切时应注意的问题进行了讨论。     

女性腺性膀胱炎38例报告

目的 探讨女性腺性膀胱炎的诊治方法。方法 38例均行经尿道电切汽化术，33例合并膀胱颈梗阻者，同时行膀胱颈电切术，对病变范围较大者，同时行药物注射术。结果 全组病例随坊6～24个月，3例复发，治愈率为92．1％。结论 梗阻是引起女性腺性膀胱炎的重要原因之一。放宽膀胱镜检查指征是防止漏诊的主要措施。经尿道电切应作为治疗该病的首选方法，电切后同时行药物注射可能提高治愈率。     

男性尿道断裂101例术后阳痿发生率分析

目的探讨不同手术方法对男性尿道断裂后阳痿发生率的影响。方法采用I期开放性尿道吻合术,耻骨上膀胱切开尿道会师术,内窥镜下尿道会师术治疗尿道断裂患者101例。结果Ⅰ期开放性尿道吻合术患者术后阳痿发生率为50％。耻骨上膀胱切开尿道会师术患者术后阳痿发生率为13．5％,内窥镜下尿道会师术患者术后阳痿发生率为1．9％。结论内窥镜下尿道会师术治疗尿道断裂是减少术后患者阳痿发生的最佳方法。     

女性膀胱颈梗阻的诊断与治疗

目的 探讨女性膀胱颈梗阻的诊断与治疗。方法 对32例女性膀胱颈梗阻患行经尿道膀胱颈电切术。结果 32例治疗术后无剩余尿，临床症状消失。结论 经尿道膀胱颈电切术是治疗女性膀胱颈梗阻的首选方法，具有痛苦小，住院时间短等优点。     

女性膀胱颈硬化症32例临床诊治体会

目的探讨女性膀胱颈硬化症的诊断及治疗。方法收集我院自2002年6月-2007年12月间收治的32例女性膀胱颈硬化症的临床资料进行分析总结，平均年龄52岁，病程平均2．9年。经临床症状、尿流动力学和膀胱镜检等检查得以确诊，对其中28例行经尿道膀胱颈电切术，4例行保守治疗。结果28例均一次手术成功，拔除尿管后排尿通畅，无尿失禁。随访6～24个月，疗效稳定。结论女性膀胱颈硬化症经保守治疗无效者，经尿道膀胱颈部电切术是一种安全而有效的治疗选择。     

经尿道电切术治疗女性膀胱颈硬化症(附65例临床分析)

目的探讨女性膀胱颈硬化症的诊断及治疗。方法收集我院自2005-09~2007-07间,治疗的65例女性膀胱颈硬化症的临床资料并进行分析。年龄平均64岁。病程平均3.1年。经临床症状、尿液动力学和膀胱镜等检查得以确诊,对其中63例行经尿道膀胱颈电切术,2例行保守治疗。结果63例均1次手术成功,拔除尿管后,排尿通畅,无尿失禁。随访6~24个月,疗效稳定。结论女性膀胱颈硬化症经保守治疗无效者,给予经尿道膀胱颈部电切术是一种安全而有效的治疗选择。     

经尿道膀胱颈电切术治疗女性膀胱颈梗阻

目的探讨经尿道膀胱颈电切术治疗女性膀胱颈梗阻的疗效。方法对24例女性膀胱颈梗阻患者的临床资料和腔内治疗情况进行回顾性分析。结果 24例经尿道膀胱颈电切术治疗后排尿通畅,无明显残余尿量,效果满意,术后无1例发生并发症。结论经尿道膀胱颈电切术是一种治疗女性膀胱颈梗阻安全有效的方法,可作为首选治疗。     

女性膀胱颈梗阻的腔内治疗

目的探讨女性膀胱颈梗阻的诊断和经尿道电切术的治疗方法。方法对37例女性膀胱颈梗阻患者作尿动力学和膀胱镜等检查,采用经尿道膀胱颈电切术(TURBN)加钩状电极切开颈口治疗女性膀胱颈梗阻。结果术后临床症状明显改善,30例基本无残余尿(RU),7例少量RU。最大尿流率(Qmax)明显改善,无严重并发症。24例随访6-27个月,疗效满意。结论尿动力学检查是诊断女性膀胱颈梗阻的主要方法,也是评价治疗效果最有用的客观指标,TURBn是治疗女性膀胱颈梗阻的首选方法,具有损伤小、操作简便、痛苦少等优点。     

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.