经鼻腔—蝶窦径路蝶鞍区人手术的相关解剖

目的 测定蝶窦及蝶鞍区手术解剖数据，为临床应用提供依据。方法 观察３０例尸头和３５例干燥颅骨标本蝶窦和蝶鞍区的结构，测量自前鼻棘至有关结构的长度、矢状角和侧偏角。结果 自前鼻棘至后床突的长为８１．６±７．２ｍｍ，矢状角为３４．６°±３．４°，偏侧角为５．９°±０．７°；至颈动脉管的长度为６７．７±６．２ｍｍ，矢状角为３２．３°±３．５°，侧偏角为６．８°±０．５°；至前床突的长为７５．８±５．３ｍ     

蝶窦和蝶鞍区的解剖观察及临床意义

①目的观察蝶窦和蝶鞍区的解剖结构，探讨其毗邻关系和临床意义。②方法用３０例尸头，３５例、７５侧干燥颅骨标本，观察蝶窦和蝶鞍区结构，测量并计算自能鼻棘至有关结构的长度和角度。③结果自前鼻棘至后床突的长为８１．６±７．２ｍｍ，矢状角为３４．６°±３．４°，侧偏角为５．９°±０．７°；至颈动脉管的长为６７．７±６．２ｍｍ，矢状角为３２．３°±４．１°，侧偏角为６．８°±０．５°；至视神经管颅口的长为６８．９±６．５ｍｍ，矢状角为３６．６°±６．３°，侧偏角为５．３°±０．４°．④结论蝶窦和双恻蝶窦口间部为蝶窦和蝶鞍区手术的最佳入路。     

与鼻内窥镜术有关的鼻腔外侧壁的应用解剖

①目的探讨与鼻内窥镜术有关的鼻腔外侧壁结构及其毗邻关系，为临床积累资料。②方法观察了３０个尸头和７５侧干燥颅骨标本上鼻腔外侧壁结构，测量自前鼻棘至有关结构的长度和矢状角。观测了钩突、筛泡和筛漏斗等结构的形态与数据。③结果自前鼻棘至中鼻甲前端长为３６．１±３．４ｍｍ，矢状角为６９．８°±７．９°；至中鼻甲后端长为５１．２±５．２ｍｍ，矢状角为１９．８°±４．１°；至上颌窦口的长为３３．８±４．５ｍｍ，矢状角为３４．２°±３．７°；至额窦口的长为４２．９±８．２ｍｍ，矢状角为７０．４°±４．４°；至前筛窦口的长为４４．１±７．８ｍｍ，矢状角为６８．３°±６．２°．④结论本文的观测结果对上颌窦、筛窦等鼻腔外侧壁鼻内窥镜术有重要的指导作用，所测角度有助于手术的空间定位     

股三角区血管的局部解剖和临床探讨

为给股动脉静脉穿刺插管提供解剖学数据，对４０例成人尸体进行肌三角的解剖学研究，结果提示：穿刺点矩耻骨联合中点垂直距离，股动脉为７．０±０．７ｃｍ股静脉为６．１±０．９ｃｍ穿刺两血管的夹角；针矢角，股动脉为８．４±１．６，股静脉８．４°±１．８°，针额角，股动脉为１６．１°±２．３°股静脉为１６．０°±２．４°股动脉穿刺深度分别为２．８±０．２ｃｍ，２．９±０．２ｃｍ，按此进针点及角度和深度穿刺，并     

股三角区血管的局部解剖和临床探讨

为给股动静脉穿刺插管提供解剖学数据，对４０侧成人尸体进行股三角的解剖学研究。结果提示：穿刺点距耻骨联合中点垂直距离，股动脉为７０±０７ｃｍ；股静脉为６１±０９ｃｍ。穿刺两血管的夹角：针矢角，股动脉为８４°±１６°，股静脉８４°±１８°。针额角：股动脉为１６１°±２３°，股静脉为１６０°±２４°。股动静脉穿刺深度分别为２８±０２ｃｍ，２９±０２ｃｍ。按此进针点及角度和深度穿刺，并发症少、成功率高。同时讨论了临床应用要点。     

眶上神经的走行层次及其临床意义

目的探讨眉区和额部不同手术层面眶上神经的保护方法。方法在１５例成人头部标本上,对眶上神经在眉区和额部的行程、走行层次和入肌点的位置进行解剖观测。结果眶上神经出眶上孔后,以５２．８±７．４°角向外上经额肌筋膜附着处入帽状腱膜下隙,达发际附近穿帽状腱膜和额肌至皮下。眶上神经起始部直径１．４±０．３ｍｍ,本干入肌点至眶上孔的直线距离为４０．２±９．１ｍｍ,水平距离和垂直距离分别为３０．５±８．８ｍｍ和３３．８±８．４ｍｍ。结论根据手术层面的不同,额眉区的深层面手术应注意保护眶上神经     

经皮球囊肺动脉瓣成形术18例报告

本文报告经皮球囊肺动脉瓣成形术１８例。其中，中度狭窄１５例，术后右心室收缩平均３．７±０．３ｋＰａ，下降６１．６％；右心室与肺动脉压力阶差平均１．３±０．３ｋＰａ，下降８５．５％；瓣口内径平均１６．１±２．０ｍｍ，增加２２０％。重度狭窄３例，右心室收缩压平均６．０±０．５ｋＰａ，下降５４．８％；右心室与肺动脉压力阶差平均４．９±０．３ｋＰａ，下降５９．０％；瓣口内径平均８．６±０．９ｍｍ，增加１９     

大隐静脉股段及其属支轴型静脉皮瓣的解剖学研究

解剖５０侧成人尸体大隐静脉，测量大隐静脉注入股静脉处和大隐静脉主要属支注入大隐静脉处的外径，及各注入处与髂前上棘间连线的垂直距离。大隐静脉入股静脉处的直径为４．９±０．７ｍｍ，其属支注入大隐静脉处的直径分别是：旋髂浅静脉４．０±１．１ｍｍ，腹壁浅静脉３．６±１．０ｍｍ，阴部外静脉３．３±０．９ｍｍ，股外侧静脉４．６±１．２ｍｍ，股内侧静脉４．３±１．１ｍｍ；大隐静脉点均位于股内侧，距髂前上棘８～１５ｃｍ。同时讨论了以大隐静脉股段及其主要属支为蒂轴型静脉皮瓣的解剖学要点。     

脊髓型颈椎病与发育性颈椎椎管狭窄临床研究

为探讨脊髓型颈椎病与发育性颈椎椎管狭窄的关系，测量了６０例正常人和１００例脊髓型颈椎病颈椎侧位Ｘ线片的椎管矢状径和椎体矢状径，测量范围从Ｃ２－Ｃ４。结果：６０例正常人椎管矢状平均值为（１６．６９±０．２５）ｍｍ；１００例脊髓型颈椎病椎管中矢径平均值为（１５．７±０．１７）ｍｍ。Ｃ３－Ｃ７椎管矢状径与椎体矢状径之比值平均值正常给为０．９０６，颈椎病组为０．７７４。颈椎３节以上比值小于０．７５在正常     

人体髋骨、股骨的形态与高难运动技术的关系

对６６名从事高难运动技术的体操、跳水、艺术体操运动员的髋骨和股骨进行了活体与Ｘ线的测量。健将级运动员的大转子间距男子为２８±１．５ｃｍ，女子为２８±１。７ｃｍ：业余运动员男子为２５±２．０ｃｍ，女子为２５±１．８ｃｍ，均较对照组小（Ｐ＜０．１，Ｐ＜０．２），表明运动员的髋部普遍窄小。股骨颈的垂直颈健特级运动员男子为４．２±０．８ｃｍ，女子为３．２±０．８ｃｍ，业余运动员男子为２．５±０．５ｃｍ，女子为２．４５±０．４ｃｍ，均大于对照组（Ｐ＜０ｄ．２，Ｐ＜０．５）。股骨颈干角健将级运动员男子为１２９±３°，女子为１３０±３°，业余运动员男子为１５２±３°，女子为１５８±３．３°，均小于对照组（Ｐ＜０．１，Ｐ＜０．２），表明经过长期训练的运动员股骨颈增粗，颈干角变小，有利于高难动作的完成。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.