十二指肠球部溃疡与胃癌共存临床分析

目的分析十二指肠球部溃疡合并胃癌的临床特点。方法回顾分析3年来胃镜检查中发现的十二指肠球部溃疡合并胃癌病例的临床、胃镜检查及病理资料。结果十二指肠球部溃疡合并胃癌发病以中老年多见，男性多于女性，青年发病者以女性多见。临床表现以上腹部疼痛最多见。胃镜下病变部位多在胃窦胃体部，幽门螺旋杆菌感染率较高，病理类型以腺癌居多。结论十二指肠球部溃疡合并胃癌临床上并不罕见，临床及胃镜医生要给予充分重视。对有上消化道症状，曾有十二指肠球部溃疡和胃炎或幽门螺旋杆菌感染者作定期的胃镜与病理学追踪检查，以免延误诊治。     

奥美拉唑四联疗法治疗十二指肠球部溃疡52例临床观察

幽门螺旋杆菌感染是引起十二指肠球部溃疡的重要原因.HP的根除治疗在HP阳性的消化性溃疡的治疗中占重要地位.过去传统的治疗方法用HP受体拮抗剂,PPI疗程一般为4-8 w.我院采用奥美拉唑、克拉霉素、果胶铋、阿莫西林四联疗法治疗幽门螺旋杆菌阳性十二指肠球部溃疡52例的临床观察,疗效显著.     

泮托拉唑联合治疗幽门螺旋杆菌阳性的十二指肠球部溃疡疗效观察

目的：评价泮托拉唑联合甲硝唑、阿莫西林治疗幽门螺旋杆菌阳性的十二指肠球部溃疡的疗效。方法：将78例幽门螺旋杆菌阳性的十二指肠球部溃疡患者随机分为两组，治疗组42例，对照组36例。治疗组应用泮托拉唑钠肠溶胶囊40mg，每日1次；甲硝唑片0．4，每日2次；阿莫西林胶囊1．0，每日2次。对照组应用雷尼替丁胶囊0．15，每日2次；甲硝唑片0．4，每日2次；阿莫西林胶囊1．0，每日2次。疗程2—4周，观察两组疗效。结果：治疗组临床症状消失时间少于对照组，治疗组溃疡愈合率、幽门螺旋杆菌根除率均高于对照组。结论：泮托拉唑三联疗法具有治愈率高、根除幽门螺旋杆菌率高，作用持久，副作用较少，不易复发，值得推广。     

儿童十二指肠球部溃疡72例临床分析

目的:探讨儿童十二指肠球部溃疡临床特点。方法:对72例儿童十二指肠球部溃疡与成人患者的症状、胃镜下特点、诱因、幽门螺旋杆菌感染情况等进行对比分析。结果:儿童组嗳气、泛酸症状低于对照组,恶心、呕吐、食欲减退症状高于对照组,上消化道出血、胃潴留等并发症高于对照组。儿童组溃疡多较小、浅。结论:儿童十二指肠球部溃疡症状不典型,并发症多,易漏诊。     

四联疗法治疗十二指肠球部溃疡并幽门螺旋杆菌阳性近期疗效观察

目的：研究四联疗法治疗十二指肠球部溃疡并幽门螺旋杆菌阳性的治疗效果。方法：收集我院2008年6月—2010年12月十二指肠球部溃疡并幽门螺杆菌阳性的患者120例,均经胃镜,险查证实十二指肠球部溃疡及MC尿素呼气试验检测幽门螺旋杆菌阳性。随机分为治疗组与对照组,每组60例。治疗组每次口服雷贝拉唑10mg、RBC350mg（RBC为枸橼酸铋和雷尼替丁在特殊条件下的生成物）、阿莫西林1000mg、呋喃唑酮100mg,2次／天,共服用7天。对照组每次口服奥美拉唑20mg、阿莫西林1000mg、克拉霉素500rag,2杉天,共服用7天。7天后两组继续口服10mg雷贝拉唑,1次/天,治疗（4—6）周。结果：治疗组中有效病例56例,经c尿素呼气试验检测幽门螺旋杆菌阴性54例,转阴率96．43％。经胃镜检查55例患者溃疡愈合,愈合率98．21％。对照组中有效病例58例,经HC尿素呼气试验检测幽门螺旋杆茵阴性45例。转阴率77．59％。经胃镜检查-牺例患者溃疡愈合,愈合率79．3l％。结论：四联疗法治疗十二指肠球部溃疡并幽门螺旋杆茵阳性较传统治疗方法疗效显蒌     

幽门螺旋杆菌阳性十二指肠溃疡患者应用不同三联疗法治疗的效果比较研究

目的探讨幽门螺旋杆菌阳性十二指肠溃疡患者应用不同三联疗法治疗的效果。方法将2016年3月至2017年1月40例幽门螺旋杆菌阳性十二指肠溃疡患者作为研究对象随机原则分组,各纳入20例。对照组用奥美拉唑、甲硝唑、阿莫西林,治疗组用雷贝拉唑、左氧氟沙星、阿莫西林。比较两组幽门螺旋杆菌阳性十二指肠溃疡治疗效果;幽门螺旋杆菌转阴时间、溃疡愈合时间;不良反应。结果治疗组幽门螺旋杆菌阳性十二指肠溃疡治疗效果高于对照组,P0.05;治疗组幽门螺旋杆菌转阴时间、溃疡愈合时间短于对照组,P0.05。两组均无出现不良反应。结论雷贝拉唑、左氧氟沙星、阿莫西林三联疗法治疗幽门螺旋杆菌阳性十二指肠溃疡效果优于奥美拉唑、甲硝唑、阿莫西林三联疗法治疗,可缩短疗程。     

洛赛克/法莫替丁联合甲硝唑、羟氨苄青霉素治疗HP阳性十二指肠球部溃疡

幽门螺旋杆菌（ＨＰ）是溃疡病尤其十二指肠球部溃疡（ＤＵ）重要病因之一,应用抗菌药物,消除ＨＰ后,有利于溃疡痊愈。本文观察洛赛克／法莫替丁联合甲硝唑、羟氨苄青霉素治疗ＨＰ阳性十二指肠球部溃疡,比较溃疡愈合率及ＨＰ根除率。１材料与方法１１病例选择：６０...     

腹腔镜结合电子胃镜微创手术治疗十二指肠球部溃疡穿孔效果观察

目的观察腹腔镜和电子胃镜下微创手术治疗十二指肠球部溃疡穿孔的临床效果。方法将我院收治的58例十二指肠球部溃疡穿孔患者作为研究对象，对临床资料进行回顾性分析，以探讨腹腔镜、电子胃镜对十二指肠球部溃疡穿孔的治疗效果。结果本研究中十二指肠球部溃疡穿孔直径0．2～0．6cm，手术时间60-90min，手术成功率100％。手术后对所有患者进行了抗溃疡、抗幽门螺杆菌治疗。结论在腹腔镜、电子胃镜下对十二指肠球部溃疡穿孔患者进行微创手术治疗，其安全性高，疗效显著。     

培菲康联合标准三联疗法治疗Hp相关十二指肠球部溃疡临床观察

目的 探讨培菲康联合标准三联疗法治疗幽门螺旋杆菌(Hp)相关十二指肠球部溃疡的临床效果.方法 选取在我院接受治疗的Hp相关十二指肠球部溃疡患者82例,按随机数字表法分为2组,各41例.对照组采用标准三联疗法治疗,观察组在对照组基础上加用培菲康治疗.比较2组临床疗效.结果 与对照组比较,观察组根除率、溃疡愈合率及症状缓解率明显升高,不良反应发生率及复发率明显降低,差异均有统计学意义(P<0.05).结论 给予Hp相关十二指肠球部溃疡患者培菲康联合标准三联疗法治疗,可促进患者症状缓解、溃疡愈合,提高根治率,减少不良反应,降低复发率.     

学龄儿十二指肠溃疡43例分析

分析４３例学龄儿十二指肠溃疡的临床表现，内窥镜检查等，认为学龄儿ＤＵ男多于妇，临床以突发型多见；溃疡部位以球部前壁常见，直径多≤０．５ｃｍ。Ｈ２受体阻滞剂加挤菌治疗有效；发病与幽门螺旋杆菌有关外，还与精神因素有关。     

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.