后路椎弓根钉治疗胸腰椎骨折的围手术期护理

目的：总结后路椎弓根钉治疗胸腰椎骨折围手术期护理方法。方法：对154例行后路椎弓根钉治疗胸腰椎骨折病人术前、术后实施相应生理、心理、专科及并发症等护理。结果：154例胸腰椎骨折患者均愈合良好,除5例泌尿系感染、4例脑脊液漏经治疗痊愈外,无其他并发症。9例泌尿系统感染及脑脊液漏患者经治疗及护理后,均治愈出院,未留后遗症。随访未发现其他并发症。145例患者无并发症。结论：胸腰椎骨折患者应早期进行心理疏导,增强患者战胜疾病信心。严密观察生命体征、脊髓功能,观察有无颅脑、内脏损伤等合并伤的存在。围手术期加强生命体征观察、脊髓神经功能观察、做好体位护理、心理护理等,积极预防肺部感染、腹胀、脑脊液漏、神经根粘连、肌肉萎缩、关节僵直等护理并发症是患者手术成功的重要保障。     

功能性鼻内窥镜手术的护理体会

报告了功能性鼻内窥镜手术治疗100例鼻腔鼻窦疾病的护理。术前做好心理护理及术前准备。术后重点做好鼻腔填塞护理;密切观察有无出血、纸样板及视神经损伤、颅内感染、脑脊液鼻漏等并发症;并认真、详细地做好出院指导。本组病人95例定时来院复查,治愈率为95%。     

脑脊液耳、鼻漏的围手术处理

2001年1月至2008年6月6例脑脊液耳、鼻漏患者围手术期治疗体会。手术前应加强基础护理,仔细询问病史,以明确漏口位置;术中耐心细致,依据缺损的部位和类型,采用多种手术方法;手术后密切观察生命体征,注意相关并发症。脑脊液耳、鼻漏围手术期医护应加强责任心,才可能提高手术成功率。     

先天性内耳畸形致脑脊液耳鼻漏三例报告

先天性内耳畸形致病脑脊液耳漏引起反复发作性脑膜炎3例，该3例患者均有脑脊液耳漏，患耳完全性耳聋，患侧前庭功能减退或消失，经采用手术修补瘘道治疗，术后效果满意，本文就先天性内耳畸形致脊液耳漏的病因，诊断、瘘道的部位以及手术治疗方法进行了探讨。     

脑脊液耳漏的护理

目的 探讨脑脊液耳漏鼻漏病人有效的护理措施。方法 采用保守疗法及手术疗法治疗脑脊液耳漏、耳鼻漏,采取腰穿行持续外引流护理,结合一般护理和手术治疗的护理,观察其效果。结果 28例病人均治愈。结论 对先天性疾病以及炎症、肿瘤所致脑脊液耳漏病人给予手术治疗,对于因外伤引起的脑脊液耳漏耳鼻漏病人施以保治疗法,同时给予正确的护理,并发症少,效果满意。     

胸腰椎手术并发脑脊液漏的原因及护理

目的探讨胸腰椎手术并发脑脊液漏的主要原因,并制定相应护理对策。方法采用自行设计的问卷,结合患者病历,对37例患者手术后14天进行问卷调查。结果脑脊液漏的主要原因为：原发性硬脊膜损伤,医源性因素和术后因素。结论护理工作中,护士应根据脑脊液漏发生原因,密切观察病情,加强心理护理及对症护理,促使患者身体和心理痊愈。     

1例重度脊柱后凸患者围手术期护理

总结了1例重度脊柱后凸患者围手术期的护理经验。术前护理重点为心理护理、呼吸功能的训练、营养支持、手术体位训练。术后护理重点为生命体征观察、呼吸道护理、饮食护理、神经系统与脑脊液漏等并发症的观察、心理护理等。经过积极的治疗和精心的护理，患者最终痊愈出院。     

儿童先天性内耳畸形伴自发性脑脊液耳漏的病例系列报道

目的 探讨儿童先天性内耳畸形伴自发性脑脊液耳漏的临床特征、诊断及治疗.方法 收集我院2012-2021年9例先天性内耳畸形伴自发性脑脊液耳漏患儿的临床资料,回顾性总结本组病例的临床表现、辅助检查、治疗及预后等情况.结果 9例患儿均为单侧发病,左耳1例,右耳8例,均伴发热.部分患儿伴头痛、呕吐、惊厥发作、耳溢液、耳痛等临...     

单侧内耳Mondini畸形并发脑脊液耳漏1例报告及文献复习

目的：探讨单侧内耳Mondini畸形并发脑脊液耳漏患者的发病机制、临床表现、诊断和手术方法,提高对其临床特征的认识。方法：收集1例单侧内耳Mondini畸形并发脑脊液耳漏患者的临床资料,结合国内外相关文献,分析其临床特征、影像学表现、诊断和手术方法。结果：患者因"左侧鼻腔流水、头痛20年,加重1个月"就诊。查体见左耳鼓膜内陷、完整,左耳听力下降。鼻内镜下,颅内压增加时左侧咽鼓管咽口有脑脊液流出。结合患者相关检查结果和临床表现初步考虑左耳Mondini畸形并脑脊液耳漏。行左脑脊液耳漏修补术,患者术后听力良好,无鼻腔流液和头痛不适。随访1年,患者未复发脑膜炎。结论：反复发作不明原因的脑膜炎患者应考虑先天性内耳畸形的可能。颞骨薄层CT与MRI检查是确诊的主要手段,鼓室探查修补术是填补漏口的有效方法,手术是主要的治疗方法。     

24例颈椎前后路手术患者的护理

目的:通过报告24例颈椎前后路切开手术治疗颈椎病患者的围手术期护理过程,总结对该类患者手术后正确的护理,以保证手术成功,解除患者痛苦。方法:术前做好心理护理,指导患者进行有效的呼吸功能训练,前路手术患者进行气管,食管推移训练,后路手术患者进行俯卧位适应性训练。术后严密观察患者意识,监测生命体征,预防脊髓水肿,观察切口及引流情况,注意有无出血,脑脊液漏,喉返神经损伤,椎间隙感染等并发症,术后第1天即开始进行康复训练。结果:本组3例术后出现脑背液漏,2例切口血肿,经处理后均于2周内痊愈。结论:前后路切开手术治疗颈椎病,固定疗效确切,能从根本上解决患者的痛苦,而做好手术前后系统护理是手术成功的重要保证。     

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.