几丁糖预防屈肌腱粘连的临床效果

目的：观察几丁糖预防肌腱粘连的临床效果。方法：对Ⅱ区肌腱损伤４８例７２条肌腱断裂行一期修复,术中采用改良Ｋｅｓｓｌｅｒ法缝合肌腱,在肌腱鞘管内注入２％医用几丁糖０．５￣１．０ｍｌ,缝合皮肤。     

几丁糖和聚乳酸防粘连凝胶及玻璃酸钠预防硬膜外瘢痕粘连的实验研究

目的:观察和评价几丁糖、聚乳酸防粘连凝胶及玻璃酸钠对椎板切除模型大鼠硬膜外瘢痕粘连的干预效果,并探讨其作用机制。方法:72只成年雄性SD大鼠随机分为几丁糖组、聚乳酸防粘连凝胶组、玻璃酸钠组和生理盐水组,每组18只。行L1椎板切除术,造成0.4cm×1.0cm大小缺损,同时于硬膜外分别涂以几丁糖、聚乳酸防粘连凝胶、玻璃酸钠及生理盐水冲洗,术后常规饲养。分别于术后第4、8、12周处死大鼠,每批每组随机抽取6只大鼠取术段脊椎进行大体观察、HE染色光学切片组织学观察,评估瘢痕粘连程度,电镜观察纤维细胞结构。结果:术后4周,生理盐水组大体、组织学观察结果评分与几丁糖组、聚乳酸防粘连凝胶组及玻璃酸钠组比较,差异有统计学意义(P0.01),几丁糖组、聚乳酸防粘连凝胶组及玻璃酸钠组间差别无统计学意义(P0.05);术后8周及12周,聚乳酸防粘连凝胶组大体、组织学观察结果评分优于几丁糖组、玻璃酸钠组及生理盐水组(P0.01),几丁糖组、玻璃酸钠组优于生理盐水组(P0.01),几丁糖组优于玻璃酸钠组(P0.01)。术后12周,电镜观察,生理盐水组纤维细胞细胞器充分,合成胶原功能完全;几丁糖组细胞器较玻璃酸钠组少,合成胶原功能较低;聚乳酸组中细胞器最少,合成胶原功能最低。结论:几丁糖、聚乳酸防粘连凝胶、玻璃酸钠对椎板切除模型大鼠硬膜外瘢痕形成均有明显抑制作用,聚乳酸防粘连凝胶预防粘连效果优于几丁糖和玻璃酸钠。     

几丁糖防治屈肌腱粘连的临床应用

目的 :研究几丁糖在屈肌腱断裂手术中的应用。方法 :选择屈肌腱断裂 36例 ,应用Kessler法Ⅰ期缝合同时应用几丁糖在腱周局部浸润 ,以单纯缝合者为对照组 ,随访按TAM系统评定法评定患指功能。结果 :应用组优良率88.9% ,对照组 6 8.7% ,经统计学处理 ,P <0 .0 5 ,两者有显著性差异。结论 :几丁糖局部浸润可有效防治屈肌腱粘连。     

生物蛋白胶与几丁糖预防肌腱粘连的临床研究

目的：评价生物蛋白胶和几丁糖对肌腱吻合后防止粘连及促功能恢复的作用。方法：３９例涂以生物蛋白胶、３９例涂以几丁糖及４１例不涂以任何药物的肌腱吻合,观察患者手指功能恢复情况,术后随访２～１４个月。结果：应用生物蛋白胶、几丁糖及不涂任何药物三组的手指功能恢复优良率分别为８４．７％、８７．３％、５１．２％,前两组明显优于后一组（Ｐ〈０．０１）。结论：生物蛋白胶、几丁糖对肌腱吻合后功能恢复有良好疗效。     

人发角蛋白人工腱移植肌腱粘连的实验研究

目的通过动物实验对人发角蛋白人工腱移植后肌腱粘连情况进行较为细致的研究.方法以雄性成年鸡的趾深屈肌腱为实验模型,切除第二趾骨段相当于A2-A4滑车间趾深屈肌腱0.5cm,实验组用人发角蛋白人工腱(HHKAT)行肌腱移植,对照组用普通人发腱移植,分别于术后2、4、6、8周取材做大体病理观察,屈趾度及肌腱滑动度测量以及组织学观察,并进行比较.结果实验组移植肌腱滑动功能及屈趾活动好,且粘连程度轻,与对照组相比差异有统计学意义(P＜0.05,P＜0.01),组织学显示肌腱修复实验组优于对照组.结论①人发角蛋白人工腱移植后肌腱粘连程度较普通人发腱轻微.②人发角蛋白人工腱移植后修复主要依靠"外源性愈合方式",肌腱滑动功能主要依赖术后早期的功能活动.     

肌腱在可降解聚碳酸酯套管内愈合情况的实验观察

目的了解可降解聚碳酸酯套管套接肌腱的效果.方法采用两种可降解聚碳酸酯材料聚(2，2二甲基三亚甲基碳酸酯-共-ε-己内酯)[P(DMTC-CL)]及聚(2，2二甲基三亚甲基碳酸酯-共-ε-己内酯-共-丙交酯)[P(DMTC-CL-LA)]，分别制成肌腱套管A、B.将24只成年雄性纯种三黄鸡随机分为A、B组：A组Ⅱ、Ⅲ趾以A管修复趾深屈肌腱，B组Ⅱ、Ⅲ趾以B管修复趾深屈肌腱，两组Ⅳ趾以尼龙线修复肌腱作为自身对照.分别观察术后1周、2周、3周、30 d、45 d、60 d修复肌腱的形态学变化.结果B管术后2周即开始降解，术后3周肌腱初步愈合，但肌腱粘连明显；A管术后60d仍未见明显降解，术后30 d肌腱初步愈合，但愈合质量较差，粘连轻；对照趾术后3周肌腱初步愈合，肌腱粘连明显.结论(1)肌腱在相对密闭的套管内可以最终达到愈合，但愈合的速度及质量均受到一定的影响.(2)套管可以有效阻止肌腱吻合口与周围组织的粘连.(3)套管的通透性及降解速度对肌腱的愈合及粘连均有明显影响.     

几丁糖防治椎板切除术后瘢痕粘连的形态学研究

目的：通过观察椎板切除术后硬膜外瘢痕粘连的形态学改变，认识几丁糖对防治硬膜外瘢痕粘连形成的作用及其机制。方法：用36只新西兰兔制作椎板切除模型，在椎板缺损处分别覆盖等渗盐水、地塞米松和几丁糖，分别于2、3、4周观察瘢痕形态学的改变。结果：对照组瘢痕粘连日趋明显，地塞米松组可减轻硬膜周围的纤维化，其机制主要与抑制创伤局部的炎性反应有关，几丁糖组又明显优于地塞米松的抗瘢痕粘连作用。结论：几丁糖对硬膜外周围瘢痕形成、粘连有明显预防作用。     

胶原酶预防肌腱腱鞘内粘连的实验研究

目的 研究胶原酶预防肌腱鞘内粘连的作用。方法 采用鸡屈趾肌腱损伤的修复模型。实验趾和对照趾腱鞘内分别注入胶原酶和生理盐水。术后对实验趾和对照趾进行生物力学测定;解剖和组织学观察粘连性状、肌腱愈合情况。结果 各组实验趾和对照趾的肌腱滑动距离和关节活动度差异有显著性（Ｐ〈０．０５）,实验趾优于对照趾。术后早期两者肌腱吻合口最大抗张力强度无差异。解剖和组织学观察实验趾肌腱粘连程度轻于对照趾。结论 胶原酶     

“无人区”肌腱损伤修复的实验研究

作者以83只鸡的双足中趾为模型,行单纯屈趾深肌腱修复,深肌腱浅肌腱同时修复及肌腱移植术;术后第1,5,21日开始被动活动,通过显微实体照像、光镜、扫描电镜和透射电镜观察肌腱的愈合情况,实验结果表明、术后的早期被动活动可有效的防止肌腱术后粘连,促进肌腱自愈和腱痂塑形,恢复光滑腱表,但不能减少屈趾     

几丁糖预防椎板切除术后硬膜外瘢痕粘连及促进TGF形成的实验研究

目的观察椎板切除术后用几丁糖预防硬膜外瘢痕粘连及椎板修复的效果。方法以20只日本大耳白兔为对象,随机分成A、B两组,制作L4椎板损伤模型,A组硬膜以生理盐水作为对照组,B组用几丁糖。术后12周进行大体观察、生化检查、TGF-β免疫组化染色检查。结果几丁糖对预防硬膜外瘢痕粘连有明显的效果,且利于椎板缺损的修复。经Rydell-Balazs粘连韧度评分,硬膜外胶原含量测定及Nussbaum组织学评分,B组显著优于A组(P<0.01)。结论几丁糖能有效预防硬膜外瘢痕粘连及使骨引导因子在局部浓集利于骨缺损的修复。     

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.