PHILOS自锁钢板与LPHP治疗成人肱骨近端骨折的临床研究

目的：对比分析肱骨近端内锁定系统（PHILOS）自锁钢板与肱骨近端锁定钢板（LPHP）治疗成人肱骨近端骨折的临床疗效。方法：选择46例肱骨近端骨折患者,按照国际内固定研究学会（AO/ASIF）成人肱骨近端骨折分类标准（AO11.A1-3.B1-3.C1-3）,分别应用PHI-LOS自锁钢板或LPHP两种内固定方式治疗。采用ASES肩关节评价标准测定肩关节功能,统计学比较两组疗效。术后38例获得随访,中位随访时间12.5个月。结果：3个月显示骨折愈合,PHILOS自锁钢板组15例、LPHP组14例;6个月显示骨折愈合,PHILOS自锁钢板组18例、LPHP组17例;1年均全部达骨性愈合。两组骨折愈合时间、关节功能康复（ASES评分）差异无统计学意义（P〉0.05）。结论：对于成人肱骨近端骨折应用PHILOS自锁钢板与LPHP均能解剖复位、坚强固定、早期活动,获得良好的治疗效果。     

肱骨近端锁定钢板治疗肱骨近端粉碎性骨折

目的:肱骨近端锁定钢板治疗肱骨近端粉碎性骨折的临床疗效。方法:采用切开复位肱骨近端锁定钢板治疗62例肱骨近端粉碎性骨折。结果:所有患者术后切口均一期愈合,没发现有骨折不愈合及感染、内固定物松动剂肱骨头坏死现象。结论:肱骨近端锁定钢板(LPHP)治疗肱骨近端粉碎性骨折具有固定可靠,骨折愈合率高等优点,是治疗肱骨近端粉碎性骨折的理想方法。     

肱骨近端加压锁定钢板与传统钢板治疗肱骨近端骨折的临床疗效比较

目的:观察并比较分别应用传统钢板与肱骨近端加压锁定钢板(LPHP)治疗肱骨近端骨折患者的效果。方法:选取.2018年6月-2019年7月我院78例接受手术治疗的肱骨近端骨折患者,按入院顺序将其均分为2组,分别实施LPHP内固定(观察组)与传统钢板内固定治疗(对照组)。比较并评价不同手术取得的效果。结果:治疗优良率方面,观察组相比于对照组明显升高;骨折愈合时间以及并发症发生率相比于对照组明显降低,数据差异P<0.05。结论:LPHP内固定术可促进肱骨近端骨折患者骨折的愈合,且并发症少,疗效显著。     

改良三叶草钢板治疗肱骨近端骨折35例

目的评价改良三叶草钢板内固定严重粉碎性肱骨近端骨折的疗效。方法选用4-8孔三叶草钢板通过改良塑形治疗肱骨近端骨折。结果35例肱骨近端粉碎性骨折经切开复位,改良三叶草钢板内固定治疗,骨折均愈合。结论改良三叶草钢板内固定牢靠,术后辅助治疗有助肩关节功能恢复。     

MIPPO技术结合LPHP内固定治疗老年肱骨近端骨折

目的:探讨微创经皮钢板接骨术(Minimally invasive percutaneous plate osteosynthesis,MIPPO)结合锁定钢板(Loc-king proximal humeral plate,LPHP)内固定治疗老年肱骨近端骨折的疗效。方法:采用MIPPO技术结合LPHP内固定治疗21例老年肱骨近端骨折患者。按Neer分型标准:两部分骨折13例,三部分骨折5例,四部分骨折3例。结果:所有患者获随访5¹2个月。按Constant Scoring System评分标准评定疗效,优9例,良8例,可2例,差2例,优良率为80.6%。结论:MIPPO技术结合LPHP内固定治疗老年肱骨近端骨折具有创伤小、固定可靠、并发症少、临床效果满意等优点,是治疗老年肱骨近端骨折的一种优良方法。     

锁定钢板固定治疗肱骨近端骨折

目的研究和分析锁定钢板在肱骨近端骨折治疗中的应用价值。方法对26例肱骨近端骨折行切开复位肱骨近端锁定钢板（LPHP）内固定,并分析疗效。结果26例患者术后随访6～18个月,平均12个月,骨折均愈合,平均愈合时间5个月。按Neer评分标准评定,总优良率88％。结论LPHP治疗肱骨近端骨折疗效满意。     

肱骨近端锁定钢板微创手术治疗老年肱骨近端骨折

目的探讨采用肱骨近端锁定钢板（LPHP）微创手术治疗老年肱骨近端骨折的疗效。方法 2008年1月—2012年7月间对25例老年肱骨近端骨折采用肱骨近端锁定钢板（LPHP）微创手术治疗。根据NEER分类,二部分骨折10例,三部分骨折15例。结果该组25例患者均获随访,随访时间6～12个月,平均10个月。采用NEER评分：优12例,良11例,可2例,优良率为92%。结论采用肱骨近端锁定钢板（LPHP）微创手术治疗老年性肱骨近端骨折,具有创伤小、固定牢固、能够早期功能锻炼的优点,治疗效果良好。     

加压锁定钢板治疗肱骨近端骨折临床疗效研究

目的:探讨加压锁定钢板治疗肱骨近端骨折的临床疗效。方法:选取我院2009年1月～2011年1月收治的90例肱骨近端骨折患者,随机分为两组,观察组42例,采用锁定加压钢板治疗肱骨近端骨折,对照组48例,临床采用传统T型钢板、三叶草钢板治疗肱骨近端骨折,术后3、6、12个月对患者定期随访,对比两组患者术后螺钉松动、钢板断裂、骨折不愈合等情况。结果:所有患者均获随访,平均12个月,观察组全组优良率85.0%,对照组优良率为58.3%,两组比较有统计学意义(P<0.05)。结论:加压锁定钢板治疗肱骨近端骨折疗效确切、并发症少,可允许肩关节早期功能锻炼,是治疗肱骨近端骨折的首选内固定材料。     

三种内固定治疗肱骨外科颈骨折的疗效探讨

目的探讨在肱骨外科颈骨折治疗过程中,AOT型钢板模式、肱骨近端锁定钢板模式及其克氏针内固定治疗模式的临床疗效。方法通过对该院2006年8月—2012年8月手术治疗情况的剖析,实现56例肱骨外科颈骨折患者临床病例的深入了解,其中有26例AO T型钢板内固定临床疗法,LPHP内固定与克氏针内固定模式各10例,来进行这三种医疗模式分析。结果从平均手术时间上进行比较,AOT型钢板固定组平均手术时间为130 min,LPHP组与AOT型钢板固定组的结果接近,差异无统计学意义（P〉0.05）。其手术平均出血量为120 mL,明显高于克氏针固定组与LPHP组。结论比较有效的肱骨外科颈骨折方法是AOT型钢板内固定及其LPHP内固定模式,相对来说术后功能恢复能力比较强的是LPHP内固定疗法。     

钢板内固定治疗肱骨近端骨折63例疗效分析

目的：探讨钢板内固定治疗肱骨近端骨折的临床疗效。方法：选取我院2004年6月-2010年8月收治的63例肱骨近端骨折患者的临床资料,所有患者均经过钢板内固定治疗,将其分为肱骨近端解剖钛板组（43例）、三叶草钛板组（8例）及肱骨近端锁定钛板组（12例）,随访6～24个月,依照Neer百分功能评分标准,观察三组术后并发症及临床疗效。结果：所有患者均为骨性愈合,平均愈合时间为7．2周,三叶草固定术后并发外展功能受限较多,锁定钛板能保证颈干角不丢失,疗效满意。结论：微创锁定钢板治疗肱骨近端骨折,术后并发症少,疗效满意,值得在临床推广。     

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.