剖宫产术后硬膜外持续自控镇痛对产妇早期乳汁分泌的影响

目的观察剖宫产术后应用镇痛泵对产妇镇痛效果及术后早期融乳的影响。方法将120例需行剖宫产的孕妇，根据自愿选择术后镇痛方式随机分为两组，观察组术后采用硬膜外自控镇痛泵，对照组术后不使用镇痛泵，观察两组产妇切口疼痛程度、乳汁分泌情况。结果观察组镇痛效果明显，初乳时间明显早于对照组（P〈0.05）。结论镇痛泵能有效地解决剖宫产术后产妇疼痛问题，促进早期泌乳。     

术后镇痛对剖宫产妇泌乳及肠蠕动的影响分析及阶梯护理

目的：通过观察术后自控硬膜外镇痛（PCEA）与常规肌注哌替啶镇痛对产妇泌乳及肠蠕动的影响，制定相应的阶梯护理方案。方法：选择80例健康足月孕初产妇，在硬膜外麻醉下施行剖宫产术，术毕随机分成镇痛组和对照组（各40例），镇痛组用持续硬膜外镇痛，对照组常规按需肌注哌替啶进行镇痛．观察镇痛镇静效果。泌乳时间及肛门排气时间（作为肠蠕动恢复的指标）。结果：镇痛组的镇痛镇静效果明显优于对照组（P〉0．01）。镇痛组泌乳时间较对照组提前（P〈0．05）。镇痛组肠蠕动恢复时间明显快于对照组（P〈0．01）。患者对持续硬膜外镇痛十分满意（P〈0．01）。结论：剖宫产术后PCEA能促进产妇早泌乳。提高母乳喂养成功率；促进胃肠功能早恢复，有利产妇康复，并为阶梯护理提供有力依据。     

剖宫产术后硬膜外自控镇痛的临床观察和护理

目的：通过对剖宫产术后硬膜外自控镇痛（PCEA）的产妇的临床观察和护理，旨在找出一套适合和规范的护理方法。方法：将400例剖宫产术产妇随机分为两组，实验组（n=200）术后采用PCEA；对照组（n=200）采用被动止痛法。比较两组术后疼痛强度、母乳喂养、生命体征、不良反应等情况，探讨对剖宫产产妇施行PCEA期间的护理方法。结果：PCEA组产妇分娩后疼痛较对照组明显减轻（P〈0．01），泌乳量增加，睡眠好，不良反应少。结论：剖宫产术后硬膜外自控镇痛安全，镇痛效果好，通过合理的防治，细致的观察及护理可以减少副作用的发生。     

硬膜外镇痛对产后泌乳的影响

目的探讨硬膜外麻醉自控性镇痛对剖宫产产妇泌乳功能的影响。方法选择硬膜外麻醉下剖宫产的初产妇100例,随机分成两组,每组50例,观察组采用硬膜外自控性镇痛,术后硬膜外导管连接镇痛泵注入镇痛药液,对照组采用传统镇痛方法,观察两组产妇术后生命体征的变化、镇痛情况和泌乳情况的变化。结果观察组的镇痛效果较对照组明显差异（P〈0．01）;观察组术后泌乳率明显高于对照组（P〈0．05）;两组产妇生命体征差异无明显差异。结论剖宫产术后硬膜外镇痛能促进早泌乳,增加乳量。     

剖宫产术后连续硬膜外自控镇痛对产妇及血清泌乳素水平的影响

目的：探讨剖宫产术后连续硬膜外自控镇痛对产妇及血清泌乳素水平的影响。方法：选取2008年1月～2009年1月进行剖宫产的800例产妇为研究对象,将其随机分为观察组（连续硬膜外自控镇痛组）400例和对照组（杜非合剂镇痛组）400例,将两组产妇的术后不同时段VAS评分、QOL评分及血清泌乳素、CRP、IL－8及IL－6水平进行统计及比较。结果：观察组的术后6h、12h及24h的VAS评分低于对照组,QOL评分高于对照组,血清泌乳素高于对照组．血清CRP、IL－8及IL－6水平低于对照组,差异均有统计学意义（P〈0．05）。结论：剖宫产术后连续硬膜外自控镇痛对产妇机体及血清泌乳素水平影响较小,值得临床推广应用。     

剖宫产术后硬膜外持续镇痛对产妇的影响

目的：探讨剖宫产术后硬膜外持续加自控泵镇痛对产妇的影响。方法：将248例宫内单胎妊娠剖宫产术后产妇随机分为两组,镇痛组124例,采取硬膜外持续加自控泵镇痛;对照组124例,采用间断肌内注射镇痛剂。观察对比两组产妇的镇痛效果、阴道流血量、肠鸣音恢复时间、肛门排气时间、副作用等。结果：术后4、8、24h的伤口疼痛视觉模拟评分（VAS）,镇痛组分别为（1.56±0.65）、（2.58±0.42）、（2.24±0.36）分;对照组分别为（4.67±0.66）、（5.49±0.37）、（5.10±0.31）分,镇痛组各时点VAS均低于对照组（P〈0.05）。术后阴道流血量、肠鸣音恢复和肛门排气时间,两组比较,均无显著性差异（P〉0.05）。结论：术后硬膜外持续镇痛可达到充分镇痛的目的,亦不影响剖宫产术后产妇的阴道流血量与胃肠运动功能的恢复。     

硬膜外自控镇痛对剖宫产产妇产后机体恢复状态的影响研究

目的：研究分析硬膜外自控镇痛对剖宫产产妇产后机体恢复状态的影响。方法：选取2012年6月至2013年5月于本院采用剖宫产进行生产的96例产妇为研究对象,将96例产妇随机分为对照组（哌替啶肌内注射组）48例和观察组（硬膜外自控镇痛组）48例,然后将两组的排气时间、泌乳时间、产后不同时间疼痛程度及干预前后的炎性指标进行比较。结果：观察组在排气时间、泌乳时间方面均明显优于对照组,产后不同时间疼痛程度也均轻于对照组,干预后不同时间的血清炎性指标也明显低于对照组,P均＜0．05,均有显著性差异。结论：硬膜外自控镇痛对剖宫产产妇产后机体恢复状态的影响更为积极,不仅仅有助于缓解患者的疼痛程度,且对患者的其他相关指标也发挥着积极的改善作用。     

连续硬膜外自控镇痛对剖宫产术后产妇泌乳的影响

目的：观察剖宫产术后应用连续硬膜外自控镇痛对产妇镇痛效果及术后对产妇泌乳情况的影响。方法：将326例剖宫产产妇随机分为实验组与对照组163例,实验组剖宫产术后保留硬膜外导管接镇痛泵给药,对照组术后即拔除硬膜外导管,按传统方法根据产妇的疼痛情况使用镇痛剂止痛。结果：（1）两组术后镇痛效果采用VAS评分比较,实验组优于观察组;（2）实验组平均镇痛维持时间为68h,对照组为3.5h;（3）术后24h产妇例数及母乳喂养次数实验组明显多于观察组。结论：连续硬膜外自控镇痛能明显减轻剖宫产后产妇疼痛感,且镇痛时间长,促进产妇24h内乳汁的分泌,早开奶,提早开始母乳,提高母乳喂养的成功率。     

硬膜外白控镇痛对剖宫产术后情况影响246例分析

目的：探讨硬膜外自控镇痛（PCEA）对剖宫产术后镇痛效果、子宫复旧情况、术后泌乳时间、肛门排气时间及母乳喂养情况的影响。方法：选择2007年6月至12月沈阳市红十字会医院妇产科246例剖宫产产妇按术后自愿选择镇痛方式分成镇痛组和对照组，术后两组产妇随访72小时，观察各项指标。结果：镇痛组镇痛效果明显（P〈0．05），初乳时间明显早于对照组（P〈0．05），母乳喂养次数明显多于对照组（P〈0．05），术后阴道出血及肛门排气时间差异无显著性（P〉0．05）。结论：剖宫产术后使用PCEA镇痛泵效果确切安全，促进乳汁分泌，有利于母乳喂养，产后恢复良好。     

剖宫产术后硬膜外自控镇痛效果的比较研究

目的观察硬膜外自控镇痛（PCEA）用于剖宫产术后的镇痛效果。方法将180例剖宫产术后病人随机分成实验组90例和对照组90例，实验组使用PCEA，对照组术后采用哌替啶镇痛。结果镇痛有效率实验组明显高于对照组（Х^2=46．3，P〈0．01）；患者睡眠时间实验组明显长于对照组（t=5．68，P〈0．01）；早接触、早吮吸率、按需哺乳和母乳喂养成功率实验组明显高于对照组（Х^2=29．6、21．6、19．4，均P〈0．01）。结论剖宫产术后用PCEA镇痛效果好，利于产妇的康复和母乳喂养。     

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.