面部基底细胞癌术后缺损的修复治疗

目的探讨面部基底细胞癌术后缺损的修复方法，评价鼻唇沟皮瓣等对手术创面的修复效果。方法总结分析27例面部基底细胞癌切除术后分别应用鼻唇沟皮瓣、前额皮瓣、耳后皮瓣和全厚游离皮瓣，转移修复创面的临床效果。堵果全部病例转移皮瓣Ⅰ期存活，面容无明显畸形，外耳道口无狭窄；21例随访2a，无复发。6例随访1a以上，修复区无复发，其中2例在供皮区出现种植转移，无死亡病例。结论手术切除面部基底细胞癌，转移皮瓣修复创面是最佳治疗方法。     

手术治疗面部基底细胞癌23例报告

目的探讨面部基底细胞癌的手术治疗和美容修复方法。方法本院1988年6月￣2000年11月共收治面部基底细胞癌患者23例,根据美学理论与整形美容技术,分别采用直接缝合、皮片移植、局部皮瓣转移的方法修复创面。结果病灶扩大切除23例患者切口愈合良好,术后外形满意,其中1例因切除残留行第2次手术,余无1例复发。结论面部基底细胞癌首选手术治疗,适宜的手术方式与美学结合,可取得理想的治疗效果。     

手术治疗面部基底细胞癌23例报告

目的 探讨面部基底细胞癌的手术治疗和美容修复方法。方法 本院1988年6月-2000年11月共收治面部基底细胞癌患者23例，根据美学理论与整形美容技术，分别采用直接缝合、皮片移植、局部皮瓣转移的方法修复创面。结果 病灶扩大切除23例患者切口愈合良好，术后外形满意，其中1例因切除残留行第2次手术，余无1例复发。结论 面部基底细胞癌首选手术治疗，适宜的手术方式与美学结合，可取得理想的治疗效果。     

颜面部皮肤基底细胞癌的整复治疗

目的选择颜面部基底细胞癌切除后的修复方法。方法应用各种邻近局部皮瓣修复颜面皮肤基底细胞癌切除后的创面56例。结果 56例皮瓣均一期愈合,供区及受区无并发症,随访1个月～5年,术后外形满意,肿瘤无复发。结论局部邻近皮瓣可以作为面部基底细胞癌切除后创面修复的首选方法。     

应用局部皮瓣修复面部基底细胞癌切除后缺损的临床体会

目的探讨面部基底细胞癌切除后,创面的修复原则和术式选择。方法对32例进行局部皮瓣修复的面部基底细胞癌切除后缺损患者临床资料进行回顾性分析。结果 32例患者的皮瓣全部成活,切口一期愈合。随访18例患者3个月至2年,局部平整,切口瘢痕不明显,效果满意,无1例复发。结论应用局部修复面部基底细胞癌切除后缺损可获得满意的修复效果。     

叶状旋转皮瓣和游离植皮修复鼻侧壁 基底细胞癌创面缺损30 例

目的 探讨发生于鼻侧壁基底细胞癌（以下简称简称基癌）切除后叶状旋转皮瓣或自体皮片移植 在创面修复中的应用。方法 选取2013 年1 月—2018 年7 月于天津市第五中心医院皮肤科就诊的30 例鼻侧 壁基癌患者,患者皮损切除后局部行叶状旋转皮瓣和自体皮片移植修复创面缺损,定期随访并观察疗效。结果 30 例患者皮损区皮瓣全部成活,伤口愈合良好,随访6 个月～ 5 年,局部无瘢痕形成,皮损未复发。结论 叶 状旋转皮瓣和皮片移植设计简单,操作方便,非常适合鼻侧壁基癌缺损区创面修复。     

头皮恶性肿瘤切除后创面的皮瓣修复

目的探讨利用皮瓣转移修复头皮恶性肿瘤切除后创面的疗效。方法对38例头皮恶性肿瘤患者（鳞状细胞癌25例、基底细胞癌9例、黑色素瘤2例、疣状癌2例）实施肿瘤扩大切除术（切口距肿瘤边缘3～5cm,其中17例切除局部颅骨,10例切除局部硬脑膜,5例行同侧颈部淋巴清扫）。肿瘤切除后创面采用皮瓣转移修复（24例采用一个单蒂头皮瓣,6例采用多个单蒂头皮瓣,3例采用双蒂头皮瓣,3例采用下斜方肌皮瓣,2例采用背阔肌皮瓣）。硬脑膜缺损采用阔筋膜修补,颅骨缺损暂不修补。供瓣区直接缝合或中厚植皮修复结果其中31例患者皮瓣血运完全正常,另7例患者共8个皮瓣出现皮瓣远端静脉回流障碍,经高压氧治疗后皮瓣最终存活。所有患者供瓣区愈合好或植皮全部存活。患者对疗效均感满意。术后随访6个月～3年,未见肿瘤复发。结论利用皮瓣转移修复头皮恶性肿瘤切除后创面的疗效基本满意。     

面部皮肤癌切除应用双叶皮瓣修复的效果

目的 探究采用双叶皮瓣修复面部巨大皮肤癌切除后缺损的疗效.方法 选取2013年1月至2019年12月本院实施手术切除治疗的面部皮肤癌患者10例作为研究对象,其中基底细胞癌患者7例,鳞状上皮细胞癌患者3例.根据患者的病灶位置以及范围、术前病理及术中切缘冰冻切片作为依据,展开扩大切除术式,然后应用局部双叶皮瓣转移方案修复治疗,一期修复创面.结果 所有患者均进行肿瘤病灶的完全切除,并对其组织缺损进行一期修复,所有转移皮瓣均无坏死现象发生,得到较为理想的颜面部外观,同时,也较好的保留了局部功能,术后对患者随访6个月～3年,局部未见肿瘤复发,且未发现转移病灶,面部外形和功能恢复均已达到预期效果.结论 早期的手术扩大切除后应用双叶皮瓣转移的方式修复创面,可使面部巨大皮肤癌的患者获得较好的面部外观修复及功能重建,并有效提升预后效果,值得临床推广应用.     

头部恶性肿瘤术后游离皮片或带蒂皮瓣移植修复缺损创面的经验分析

目的:分析头部恶性肿瘤术后游离皮片或皮瓣移植修复缺损创面的临床疗效。方法:回顾性研究广西医科大学附属肿瘤医院10例头部恶性肿瘤术后游离皮片或带蒂皮瓣移植修复缺损创面的病例。结果:10例游离皮片及皮瓣均成活,其中1例下腹部全厚皮瓣移植修复及1例胸大肌带蒂皮瓣修复出现局部坏死,经及时换药后,创面均愈合良好。10例患者均获得术后随访,随访时间5-30个月,中位随访时间16个月,其中1例患者因出现全身多发转移于术后14个月死亡,其余患者均存活且未出现局部复发或远处转移。结论:头部恶性肿瘤术后游离皮片或带蒂皮瓣移植修复缺损创面是临床有效的治疗方法。     

外鼻基底细胞癌的手术治疗

目的：探讨外鼻基底细胞癌手术切除和外鼻组织缺损修复的方法。方法：外鼻基底细胞癌23例均手术彻底切除，用全层游离皮片(12例)、局部皮瓣(4例)、鼻唇沟岛状皮瓣(6例)和额部皮瓣(1例)整复外鼻组织缺损。22例行一期手术修复，1例二期修复。结果：全层游离皮片整复者中1例局部坏死，换药后愈合，术后局部复发2例，均再次手术治疗。患者鼻部外形满意，鼻前孔无狭窄，局部瘢痕不明显。随访0．5～20年无死亡。结论：手术完整彻底切除和整复术是治疗外鼻基底细胞癌的有效方法，操作简单，临床效果满意。     

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.