两种不同术式治疗卵巢子宫内膜异位囊肿合并不孕患者的临床疗效观察

目的：研究腹腔镜治疗卵巢子宫内膜异位囊肿合并不孕患者的临床疗效。方法：选取2008年1月-2010年1月在本院本科室90个卵巢子宫内膜异位囊肿并不孕的患者,根据手术方式分为腹腔镜组（46例）及开腹组（44例）。比较两组患者手术时间长短,术中出血量,肛门排气时间及住院时间,评价两组患者临床症状缓解情况及术后18月患者的妊娠率及复发率。结果：腹腔镜组手术时间、出血量、肛门排气时间及住院天数均少于开腹组（P〈0．05）,而术后总妊娠率为47．83％高于开腹组的29．55％（P〈0．05）,同时三大临床症状的缓解率及复发率与开腹组间无统计学差异（P〉0．05）。结论：对于卵巢子宫内膜异位囊肿患者,腹腔镜手术可达到与开腹手术相同治疗效果,且具有微创,术后恢复快的特点,并且可获得高于开腹手术的术后妊娠率。     

卵巢子宫内膜展位囊肿81例临床分析

目的　探讨卵巢子宫内膜异位囊肿的临床特点和手术方法。方法 回顾性分析53例腹腔镜手术、45例开腹手术治疗卵巢子宫内膜异位囊肿的临床资料,分析比较两组病人的术前临床特点、手术过程和术后状况。结果 腹腔镜组和开腹组在年龄、囊肿直径、囊肿周围粘连程度及手术方式上差异无显著性（P>0.05）;腹腔镜组的平均手术时间、术中出血量、肛门排气时间和住院时间均显著性低于开腹组（P<0.01）,两组术中囊肿破裂率和术后复发率之间的差异无显著性（P>0.05）。结论 腹腔镜手术治疗卵巢子宫内膜异位囊肿优于开腹手术,应作为卵巢子宫内膜异位囊肿患者手术治疗的首选。     

开腹手术和腹腔镜手术治疗卵巢子宫内膜异位囊肿疗效对比分析

目的：总结分析开腹手术与腹腔镜手术在卵巢子宫内膜异位囊肿治疗中的疗效差异。方法：选择2010年6月至2012年11月期间我院收治的60例卵巢子宫内膜异位囊肿患者为研究对象,根据手术方式分为腹腔镜手术组35例、开腹手术组25例,比较两组患者手术时间、手术出血量、住院时间、术后镇痛泵应用率以及切口愈合情况。结果：①两组患者手术时间、切口甲级愈合比例相比无显著差异（P＞0．05）;②腹腔镜手术组患者出血量（50．55±4．68）mL、术后复发率2．86％、术后镇痛泵应用率14．29％、住院时间（4．57±1．62）d及术后发热时间（1．54±0．29）min均明显优于开腹手术组,差异显著（ P＜0．05）。结论：腹腔镜手术治疗卵巢子宫内膜异位囊肿效果较好,值得推广使用,但应严格掌握手术适应证,积极预防术后并发症的发生。     

腹腔镜手术治疗卵巢子宫内膜异位囊肿疗效观察

目的：观察腹腔镜手术治疗卵巢子宫内膜异位囊肿的临床疗效。方法：将我院收治的85例卵巢子宫内膜异位囊肿患者随机分为两组,对照组40例采用开腹手术治疗,观察组45例患者采用腹腔镜手术治疗,比较分析两组的临床治疗情况。结果：观察组术中出血量及住院时间均明显少于对照组,组间差异有统计学意义（P〈0.05）,两组术后均无严重并发症。结论：腹腔镜手术治疗卵巢子宫内膜异位囊肿疗效满意,利于患者的康复,值得临床关注。     

腹腔镜和开腹手术治疗卵巢子宫内膜异位囊肿的临床观察

目的比较腹腔镜手术与开腹手术治疗卵巢子宫内膜异位囊肿的临床效果。方法对90例卵巢内膜异位囊肿腹腔镜手术（腹腔镜组）与同期60例卵巢内膜异位囊肿开腹手术（开腹组）进行分析比较。结果术中出血量腹腔镜组65ml（34～112m1）,开腹组136ml（60～500m1）;腹腔镜组术后住院日为2.5d（2～3d）,开腹组为10d（6～14d）;手术时间腹腔镜组65min（30～90min）,开腹组为73min（40～110min）,两组存在显著的差异。腹腔镜组痛经术后缓解57例（63.33）,开腹组痛经术后缓解35例（58.33）;腹腔镜组术后7例妊娠,妊娠率为38.89;开腹组术后2例妊娠,妊娠率为28.57;腹腔镜组卵巢囊肿复发者17例（18.89）,开腹术术组复发者16例（26.67）,两组均无显著性差异。结论腹腔镜具有微创手术的优点,可作为治疗卵巢子宫内膜异位囊肿的首选方法。     

内美通用于卵巢子宫内膜异位症腹腔镜手术治疗的临床观察

目的研究腹腔镜手术与内美通联合治疗卵巢子宫内膜异位囊肿的疗效。方法2005年11月至2006年12月我院将98例腹腔镜下卵巢子宫内膜异位囊肿术后的患者随机分两组：单纯腹腔镜手术组43例；联合治疗组55例，术后口服内美通2．5mg每周两次连续3个月。所有患者随访3—12个月。结果随访率94．9％（93／98）。联合治疗组有效率61．5％，单纯手术组有效率46．3％，联合治疗的疗效明显高于单纯手术组（P〈0.05）。服用内美通的患者有4例转氨酶轻度升高。结论腹腔镜术后联合内美通治疗优于单纯手术治疗，可以作为卵巢子宫内膜异位囊肿临床治疗选择方案。     

腹腔镜手术与开腹手术治疗卵巢子宫内膜异位囊肿临床分析

目的:比较腹腔镜手术与传统开腹手术治疗子宫内膜异位囊肿的临床疗效.方法:将50例行腹腔镜手术的卵巢子宫内膜异位囊肿的患者设为观察组,同期行开腹手术的45例卵巢子宫内膜异位囊肿的患者设为对照组.观察两组手术持续时间、术中出血情况、肛门排气时间、术后卧床时间及住院时间等情况.结果:两组均顺利完成手术,手术持续时间、术后镇痛情况、肛门排气时间、术后卧床时间,观察组均优于对照组,术中出血情况两组比较无统计学差异.结论:腹腔镜手术治疗子宫内膜异位囊肿与传统开腹手术相比,创伤小,恢复快,值得临床大力推广.     

开腹及腹腔镜下卵巢子宫内膜异位囊肿剥出术的比较

目的：通过对腹腔镜下和开腹卵巢子宫内膜异位囊肿剥出术的比较,探讨腹腔镜下卵巢子宫内膜异位囊肿剥出术的有效方法。方法：回顾性分析了1996年1月－2001年8月在新华医院妇科施行的166例腹腔镜下卵巢子宫内膜异位囊肿剥出术,和同期施行的132例开腹卵巢子宫内膜异位囊肿剥出术的手术情况,比较两种方法的优缺点。结果：166例腹腔镜手术患者,平均手术时间63min,平均出血量60ml,术后平均住院日2．5d,无1例中转开腹,术中无1例发热超过38℃,随访3个月,无术时,术后并发症,132例开腹卵巢子宫内膜异位囊肿剥出术患者,平均手术时间71min平均出血量7ml,术后平均住院日7d,结论：对于Ⅲ,Ⅳ期的卵巢子宫内膜异位囊肿行腹腔镜下剥出术是安全可行的,与开腹手术相比,有创伤小, 恢复快,术后住院时间短的优势,可作为首选术式。     

腹腔镜治疗卵巢子宫内膜异位囊肿53例临床分析

目的:探讨腹腔镜手术治疗卵巢子宫内膜异位囊肿的临床疗效。方法:回顾2008年1月至2010年1月在我院手术治疗的96例卵巢子宫内膜异位囊肿患者的临床资料,按手术方式将其分为腹腔镜组53例和开腹组43例,比较两组手术时间、术中出血量、抗生素应用时间、术后住院时间、术后镇痛泵使用率、切口愈合等情况。结果:腹腔镜组术中出血量少于开腹组,手术时间、抗生素使用时间、术后术后镇痛泵使用率均低于开腹组。结论:腹腔镜是治疗卵巢子宫内膜异位囊肿的金标准。     

腹腔镜手术治疗子宫内膜异位症相关性不孕临床分析

目的：探讨腹腔镜手术治疗子宫内膜异位症相关性不孕的临床效果。方法：本研究选取2011年9月～2013年11月之间于本院收治的100例行腹腔镜手术进行子宫内膜异位症相关性不孕治疗的患者为对象,根据症状的不同分为腹膜型子宫内膜异位症组68例和卵巢子宫内膜异位囊肿组32例。腹膜型子宫内膜异位症组患者行异位病灶电凝术,卵巢子宫内膜异位囊肿组患者行异位囊肿剔除术,统计分析2组患者术后的妊娠率。结果：子宫内膜异位症合并不孕行腹腔镜手术治疗后的总妊娠率较高,其中腹膜型子宫内膜异位症行电灼术后妊娠率高于子宫内膜异位囊肿术后的妊娠率,2组差异具有显著性意义（ P＜0．05）。结论：腹腔镜手术治疗子宫内膜异位症相关性不孕的临床效果显著,有一定的临床实用价值。     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.