前庭大腺梭形造口术与传统术式的治疗效果对比

目的 观察前庭大腺梭形造口术与传统术式在前庭大腺囊肿治疗中的效果对比。方法 将60例前庭大腺囊肿患者随机分为观察组与对照组。观察组28例，采用梭形造口术，对照组32例，采用传统术式。观察两组患者的复发率。结果 术后随访12个月，观察组复发1例，对照组复发8例。两组比较差异有显著性（P〈0．05）。结论 前庭大腺囊肿患者采用梭形造口可减少复发率。     

高频电离子治疗前庭大腺囊肿及脓肿疗效分析

目的探讨高频电离子治疗前庭大腺囊肿及脓肿的临床效果。方法69例前庭大腺囊肿及脓肿患者随机分为两组,观察组35例,采用高频电离子行前庭大腺囊肿造口或脓肿切开引流术;对照组34例,行常规前庭大腺造口术或脓肿切开引流术。结果观察组术中出血量少于对照组（P〈0．01）;平均手术时间较对照组缩短（P〈0．01）;观察组术后局部无红肿,疼痛轻微,炎症缓解或消退迅速,创口愈合快,远期无局部瘢痕形成,亦无复发。结论高频电离子治疗前庭大腺囊肿及脓肿临床效果优于常规方法。     

前庭大腺囊肿挂线造口术的临床应用

目的探讨前庭大腺囊肿挂线造口术治疗前庭大腺囊肿（脓肿）的有效性和可行性。方法将112例前庭大腺囊肿或脓肿患者分为两组,对照组56例行常规造口术（又称袋状缝合术）,观察组56例行挂线造口术（改进的前庭大腺囊肿造口术）,比较、分析其疗效。结果观察组手术麻醉方式、术中出血、手术时间、术后疼痛、切口愈合情况、术后抗生素使用时间、住院时间均优于对照组,差异有统计学意义（P〈0.05）。结论挂线造口术治疗前庭大腺囊肿（脓肿）是一种痛苦小、临床效果好、安全可靠、复发率极低（本研究中目前尚无复发者）的治疗方法,适宜临床推广应用。     

改良前庭大腺囊肿造口术临床效果观察

目的：探讨改良前庭大腺造口术治疗前庭大腺囊肿的临床疗效。方法将2009年3月-2013年5月收治的60例前庭大腺囊肿患者随机分为观察组（n=30）和对照组（n=30）,观察组患者采用改良前庭大腺囊肿造口术治疗,对照组患者采用传统前庭大腺囊肿造口术,比较两组手术时间、出血量、疼痛程度、疼痛持续时间和切口愈合时间。结果观察组患者在手术时间、出血量、疼痛程度、疼痛持续时间、切口愈合时间方面均显著优于对照组（P〈0.05）。结论改良前庭大腺造口术治疗前庭大腺囊肿疗效确切,操作简单,值得临床推广应用。     

老年直肠癌患者经腹腔镜与开腹行根治术的疗效比较

目的 探讨应用腹腔镜技术治疗老年直肠癌的可行性及临床疗效。方法 对60例患者采取行腹腔镜直肠癌根治术（腹腔镜组）和开腹直肠癌根治术（开腹组）各30例进行疗效对比分析。结果腹腔镜组的术中失血量明显少于开腹组p〈0．001（264ml vs 317ml，z=5．661），术后镇痛药物的使用明显少于开腹组p=0．028（53.3％ vs 80％，x^2=4．800）；术后肠道排气时间明显短于开腹组p〈0．001（2．9d vs 4．4d，z=6．123）；住院时间亦明显短于开腹组p〈0．001（8．8d vs 13．6d，z=6．637），住院费用也明显少于开腹组p〈0．001[（2．69±0．29）万元 vs（2．16±0．31）万元，t=5．446]；腹腔镜组和开腹组的手术时间分别（153±21）min和（148±23）min，差异无统计学意义p=0．469（t=0．728）；腹腔镜组术后并发症发生率明显低于开腹组p=0．024（16．7％ vs 43．3％，x^2=5．079）；腹腔镜组和开腹组总复发率分别为17％和27％，5a生存率分别为80％和74％，差异均无统计学意义p〉0．05。结论 相对于开腹手术而言，腹腔镜直肠癌根治术治疗老年直肠癌具有更好的短期疗效，且两者远期疗效相当。     

挂线造口术在治疗前庭大腺囊肿(脓肿)的临床观察

目的 探讨挂线造口术与传统术式治疗前庭大腺囊肿(脓肿)的临床疗效.方法 选取我院治疗前庭大腺囊肿(脓肿)70例随机分为两组:观察组和对照组,观察组35例采用挂线造口术,对照组35例采用传统造口术,观察2组手术时间、手术出血、术后复发等情况.结果 挂线造口术在手术时间、术中出血、术后复发等均优于传统术式,差异有统计学意义(P<0.05).结论 挂线造口术治疗前庭大腺优于传统术式,术后复发少,值得临床推广应用.     

腹腔镜甲状腺次全切除术38例

目的总结腹腔镜甲状腺次全切除术的治疗经验。方法81例结节性甲状腺肿患者,征得患者及家属同意分别采用腔镜手术（腔镜组,n=38）和常规手术（对照组,n=43）。比较两组平均手术时间、术中出血量、术后弓l流量、患者对切口的满意度、术后并发症及不良反应等。结果两组平均手术时间分别为（90．1&#177;11．5）min与（112．9&#177;13．4）min（P〈0．01）;术中出血量分别为（30．3&#177;9．8）ml与（50．8&#177;10．6）ml（P〈0．01）;术后平均引流量分别为（85．1&#177;26．3）mI与（47．5&#177;21．4）ml（P〈0．05）。腔镜组1例术后发生皮下积液,经穿刺抽液后治愈;对照组术后低钙抽搐1例,均经对症治愈出院,丽组术后均未发生不良反应。随访6—24个月,两组患者均未见复发。结论腔镜甲状腺手术安全,美容效果好,与传统手术相比具有明显优势。     

BELSON700系列全程超导可视妇产科手术仪在计划生育手术中的应用

目的：探讨BELSON700系列全程超导可视妇产科手术仪在计划生育手术中的优势。方法：分别采用腹式B超、BELSON700系列全程超导可视妇产科手术仪及传统盲视手术方法进行比较分析。回顾分析了早孕合并高危因素受术者121例，其中BELSON700系列全程超导可视妇产科手术仪引导下的人工流产术31例为观察组，腹式B超引导下的人工流产术30例为对照组1，常规人工流产术60例为对照组2。比较观察组与对照组术中术后并发症情况。结果：观察组平均手术时间（2．5±1．3）min，平均术中出血量（5．5±2．4）ml；对照组1平均手术时间（2．8±1．3）min，平均术中出血量（5．7±2．5）ml，对照组2平均手术时间（5．6±1．1）min，平均术中出血量（10．2±2．01ml，观察组与对照组1之间差异无显著性（P〉0．05），观察组与对照组2之间差异有显著性（P〈0．05）。结论：可视下计划生育手术准确可靠，但就可操作性来讲，BELSON700系列全程超导可视妇产科手术仪要优于腹式B超。     

改良前庭大腺囊肿造口术临床观察

目的：改良前庭大腺囊肿造口术临床观察取得良好效果。方法：在我院就诊的前庭大腺囊肿患者67例,随机分为2组，以常规造口术为对照组，挂线造口术为研究组，两组患者的年龄、囊肿大小、发病次数等一般情况比较，差异无显著性（P〉0.05）。结果：两组术后复发率差异有非常显著性（P〉0．01）。结论：改良传统的造口术，对前庭大腺脓肿亦适用，患者依从性好，值得推广。     

前庭大腺囊肿或脓肿皮片对穿引流术疗效分析

目的观察前庭大腺囊肿或脓肿皮片对穿引流术临床效果.方法前庭大腺囊肿或脓肿患者160例,随机分为两组,A组为皮片对穿引流术组（n=82）,B组为造口术组（n=78）,两组均于术后3周复查,B组同时拆出皮片,比较两组手术时间、病程、疗效、局部炎症、性交痛及复发率.结果前庭大腺囊肿或脓肿应用皮片对穿引流术及传统造口术手术时间分别为（5.16±0.02）min,（20.24±2.15）min,病程为（0.96±0.15）月,（1.49±1.11）月;局部炎症发生率为4.88%,15.38%;性交痛发生率2.44%,10.26%;皮片对穿引流组显著低于造口组（P〈0.05）;有效率为98.78%,96.15%;复发率为3.17%,2.67%,两者无显著性差异（P〉0.05）.结论前庭大腺囊肿或脓肿皮片引流术为简单、方便、价廉、副反应小、疗效肯定的一种手术方法,值得推广应用.     

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.