超选择性插管栓塞治疗子宫肌瘤

目的研究和探讨子宫动脉栓塞术（UAE）治疗妇科子宫肌瘤的临床疗效。方法选择32例子宫肌瘤患者,采用Seldinger技术行单侧股动脉穿刺插管,选用管径为4—5F的Cobra导管行髂内动脉造影,根据血管造影检查结果,进一步超选择插管达双侧子宫动脉,经血管造影证实后,用携带有抗生素的PVA颗粒和明胶海绵颗粒栓塞该处血管。结果血管造影检查发现,子宫动脉是子宫肌瘤的主要供血动脉,且血管迂曲扩张,血液供应丰富。经子宫动脉栓塞治疗6～12个月后,子宫肌瘤患者的症状明显改善,月经量明显减少。子宫肌瘤体积明显缩小。术后患者有不同程度的下腹胀痛、低热,经对症处理后症状逐渐消失。结论超选择性插管栓塞治疗子宫肌瘤可有效地缩小子宫肌瘤体积,并明显改善子宫肌瘤患者的临床症状。     

海藻酸钠微球介入治疗子宫肌瘤的近期临床疗效

目的　探讨新型栓塞剂海藻酸钠微球(KMG)应用于子宫动脉栓塞术(UAE)治疗子宫肌瘤的近期临床疗效及不良反应。方法　选择10 0例子宫肌瘤患者,以Seldinger’s技术完成单侧股动脉插管,用4～5F眼镜蛇导管(Cobra)或3F微导管超选择插管至双侧子宫动脉上行支,以携带有抗生素的5 0 0～90 0 μmKMG进行栓塞。结果　数字减影血管造影(DSA)显示子宫肌瘤血供丰富,由子宫动脉供血,部分患者卵巢动脉也参与供血。KMG应用于UAE治疗子宫肌瘤3～6个月后临床症状明显缓解,月经量减少2 5 3%～75 0 % ;UAE治疗后第3,6个月肌瘤体积分别缩小4 1 7% ,6 5 8% ,子宫体积分别缩小35 4 % ,4 4 9%。术后有不同程度的下腹痛、低热,持续1～3周不等,对症处理后消失。结论　新型栓塞剂KMG应用于UAE治疗子宫肌瘤可有效地缩小肌瘤体积,并明显改善子宫肌瘤的临床症状,是一种适用于子宫肌瘤介入治疗的安全、有效、易于操作的新型栓塞剂。     

经子宫动脉介入栓塞治疗子宫肌瘤61例分析

目的探讨超选择性子宫动脉栓塞术治疗子宫肌瘤的价值、不良反应及并发症。方法对61例子宫肌瘤患者行超选择性子宫动脉插管造影确认供血动脉后,选用碘化油与平阳霉素混悬液及明胶海绵颗粒行子宫肌瘤栓塞治疗。结果 61例子宫肌瘤栓塞治疗术后随访1～12个月,子宫肌瘤体积均有缩小,3个月后肌瘤体积缩小平均约50.2%,6个月后缩小约59.2%。16例轻、中度贫血患者12个月后贫血完全改善,2例重度贫血患者明显改善,临床压迫症状不同程度的缓解,无严重并发症发生。结论超选择性子宫动脉栓塞术治疗子宫肌瘤创伤小,临床症状改善明显,并发症少。     

选择性子宫动脉栓塞术治疗子宫肌瘤20例分析

目的研究经导管子宫动脉栓塞术治疗子宫肌瘤的临床效果。方法选择子宫肌瘤患者20例，采用Seldinger技术行双侧子宫动脉插管，造影确认后注入PVA栓塞颗粒，阻断肌瘤血液供应。分别于术后3个月、6个月、12个月观察疗效。结果子宫动脉栓塞术治疗后，肌瘤体积缩小，月经周期恢复正常，贫血、压迫症状改善，保留了子宫和卵巢完整的生理功能。结论子宫动脉栓塞术治疗子宫肌瘤是一种疗效显著的微创治疗方法。     

经导管子宫动脉栓塞治疗子宫肌瘤的疗效观察

目的:探讨经导管子宫动脉栓塞(UAE)治疗子宫肌瘤的临床疗效及安全性。方法:采用子宫动脉栓塞(UAE)对118例子宫肌瘤患者进行超选择性子宫动脉插管,经导管注入造影剂优维显作数字减影血管造影,再用平阳霉素碘化油乳剂和明胶海绵粒栓塞治疗。随访3～24个月,观察术后临床症状、缓解情况和子宫(含瘤体)缩小情况。结果:118例患者血管造影均有明显富血管情况,栓塞治疗后,子宫(含瘤体)体积缩小,临床症状明显改善,临床有效率90.87%。结论:经导管超选择动脉栓塞治疗子宫肌瘤近期疗效显著,对卵巢内分泌功能及正常子宫肌组织无明显影响,是非手术治疗子宫肌瘤的较好的微创治疗方法。     

子宫动脉栓塞术治疗子宫肌瘤的临床应用

目的:探讨子宫动脉栓塞术(UAE)治疗子宫肌瘤的临床应用价值。方法:选择43例子宫肌瘤患者,行双侧子宫动脉插管造影和栓塞治疗,栓塞剂为聚乙烯醇颗粒(PVA)和明胶海绵颗粒。结果:治疗3个月~6个月后临床症状明显缓解,月经量减少;肌瘤体积和子宫体积均缩小。结论:子宫动脉栓塞术可有效地缩小肌瘤及子宫的体积,并明显改善子宫肌瘤的临床症状。     

子宫肌瘤的介入治疗

目的探讨子宫动脉栓塞术治疗子宫肌瘤(简称肌瘤)的临床疗效和副反应。方法采用Seld inger技术,对28例子宫肌瘤患者行子宫动脉栓塞(UAE)。经右侧股动脉穿刺,将4F Cobra导管超选择性插入两侧子宫动脉,造影证实肿瘤供血动脉后,经导管注入海藻酸钠微球混合庆大霉素及先锋霉素。术后常规静滴抗生素预防感染。结果本组病例均一次插管成功,术后1、3、6个月经B超复查,肌瘤分别平均缩小37.0%、56.2%及60.0%;有2例肌瘤消失,1例黏膜下肌瘤坏死后经阴道排出。痛经者术后症状消失,月经增多及经期延长者术后3月后均恢复正常。本组病例均无闭经及其他严重并发症。结论经子宫动脉插管栓塞治疗子宫肌瘤简便、安全、有效、并发症少、恢复快。     

选择性子宫动脉栓塞术治疗子宫肌瘤的临床研究

目的 研究经导管行选择性子官动脉栓塞术治疗子宫肌瘤。方法 选择27例子宫肌癯患者。采用Seldinger方法行双侧选择性子宫动脉插管。造影证实后经导管注入PVA栓塞颗粒。阻断肌瘤供血。结果，经造影证实。子宫肌瘤多由双侧子宫动脉供血。一侧为主。且血流丰富。行双侧子宫动脉栓塞后。肌瘤供血可完全墨薪。治疗后3个月、6个月随访，肿瘤体积明显缩小。月经量及月经周期恢复正常。贫血及压迫症状改善。结论 选择性子宫动脉栓塞术治疗子宫肌瘤是一种疗效显著的微创治疗新方法。     

子宫动脉栓塞治疗子宫肌瘤疗效因素分析

目的：探讨子宫动脉栓塞术(uterine artery embolization UAE)对子宫肌瘤的治疗效果，并对影响疗效的因素进行分析。方法：32例症状性子宫肌瘤患者，经超选择性插管双侧子宫动脉内注入PVA微粒栓塞治疗，术后6个月随访复查，观察患者临床症状改善和子宫及肌瘤体积变化情况。结果：UAE术后患者子宫出血症状改善最为明显，栓塞后6个月肌瘤体积平均缩小55.6％，肌壁间和黏膜下肌瘤的临床症状改善和体积缩小较浆膜下肌瘤明显。结论：双侧子宫动脉栓塞治疗子宫肌瘤是一种安全有效的新方法；其疗效与栓塞术后肌瘤血管的重新构建，肌瘤类型，血供状态，子宫动脉单双侧栓塞等多种因素有关。     

平阳霉素碘油乳剂加明胶海绵颗粒介入治疗子宫肌瘤的临床应用

目的：探讨平阳霉素碘油乳剂及明胶海绵颗粒联合应用栓塞子宫动脉（TUAE）治疗子宫肌瘤的疗效及安全性。方法：选择34例子宫肌瘤患者。以Seldinger技术完成单侧股动脉插管,根据数字减影血管造影（DSA）检查结果。插管至双侧子宫动脉并经DSA检查证实后,向子宫动脉注射平阳霉素碘油乳剂及明胶海绵颗粒以栓塞子宫动脉,随诊6～12个月,观察月经改变、肌瘤与子宫体积变化以及卵巢内分泌功能改变。结果：TUAE治疗6～12个月后,子宫肌瘤患者的临床症状明显缓解,月经量为原月经量的65．95％;第6、12个月肌瘤体积分别缩小66．87％、76．04％,子宫体积分别缩小45．14％、60．45％。术后有不同程度的下腹痛、低热,持续1～3周,经对症处理后症状逐渐消失。结论：TUAE可有效地缩小肌瘤及子宫的体积,并明显改善子宫肌瘤患者的临床症状。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.