米索前列醇联合利多卡因在人工流产手术中的应用

目的:探讨口服米索前列醇联合利多卡因宫颈注射在人工流产手术中扩张宫颈和镇痛的作用。方法:选择2004年4月～2005年12月在门诊自愿要求终止妊娠的早孕妇女100例,随机分为两组:A组单纯使用米索前列醇,B组在A组基础上联合利多卡因宫颈注射,观察两组孕妇在人工流产手术中宫颈松弛程度、扩张难易度、疼痛程度、手术时间、出血量、人工流产综合征的发生率。结果:宫颈扩张程度两组无明显差异,手术时间、手术出血量、镇痛效果比较两组有明显差异,人工流产综合征A组发生2例,B组无一例发生。结论:B组联合用药的药物有协同互补作用,使药物在不同途径发挥最好效果,达到满意的扩张宫颈和镇痛要求,提高手术的安全性和受术者的舒适度。     

米索前列醇联合利多卡因在人工流产术中的作用

目的观察舌下含服米索前列醇联合利多卡因宫颈旁注射用于人工流产术中的效果,以选择最佳的人工流产方法。方法将170例早孕拟行人工流产术的妇女,随机分为A组（舌下含服米索前列醇）、B组（舌下舍服米索前列醇联合利多卡因宫颈旁注射）、C组（行常规人工流产术）,观察三组镇痛效果、人工流产综合征反应、宫颈松弛程度、扩张宫颈的时间及术中出血量。结果B组镇痛有效率明显,与A、C两组比较差异有统计学意义（P〈0．01）,A、B两组宫颈松弛、人工流产综合征发生率低,扩宫时间短,术中出血少,与C组比较差异有统计学意义（P〈0．01）。结论米索前列醇联合利多卡因用于人工流产术中,镇痛效果好,人工流产综合征发生率低,宫颈松弛,扩宫时间短,术中出血少,值得推广。     

人流术前宫颈准备的临床观察

目的 探讨米索前列醇联合利多卡因用于人工流产手术的效果. 方法将300例无阴道分娩史并要求人工流产的早孕妇女随机分3组:A组(利多卡因组)100列,宫颈黏膜与阴道穹隆黏膜交界的3点与9点处注入2%利多卡因5ml,lmin后手术;B组(米索前列醇组)95例,术前3h阴道放置米索前列醇400ug;C组(米索前列醇联合利多卡因组)105例,术前3h阴道放置米索前列醇400ug,术时宫颈注射利多卡因剂量与用法同A组.观察各组镇痛效果、宫颈扩张程度、出血量、人流综合征. 结果 C组镇痛效果优于A组和B组(P＜0.05),C组扩宫程度优于A组. 结论 米索前列醇联合利多卡因用于人工流产较单纯用药效果好,用药简单、安全,值得临床推广.     

三种扩宫方法用于人工流产术的临床效果分析

目的比较三种方法对早孕妇女宫颈扩张的临床效果。方法抽取240例自愿行人工流产患者随机分为米索前列醇组（A）利多卡因组（B）米索前列醇联合利多卡因组（C）,对3组扩宫情况、镇痛效果、手术时间、术中出血量等情况进行比较。结果米索前列醇联合利多卡因组用于人工流产宫颈扩张、镇痛效果明显优于单纯应用米索前列醇组和利多卡因组。结论米索前列醇联合利多卡因可在人工流产术中推广使用。     

米索前列醇配伍利多卡因用于人工流产镇痛的观察

目的 探讨口服米索前列醇配伍利多卡因用于人工流产术的镇痛效果.方法 采用前瞻性对比研究,将200例6~10周早孕妇女随机分为米索前列醇600 μg术前3 h服用、米索前列醇600 μg术前4 h服用米索前列醇600 μg术前3 h服用配伍1%利多卡因宫颈注射及不采用任何药物的A、B、C、D四组,观察并比较宫颈松弛程度、扩宫难易度、疼痛程度、手术效果、术前术后宫腔长度差、手术时出血量及人工流产综合征等参数.结果 A、B、C组在术前宫颈松弛和扩宫难易度方面差异无显著性(P>0 05),而A、B、C组与D组比较差异具有显著性(P=0 000);手术效果及疼痛评分比较,A、B组比较差异无显著性(P>0 05),A、B组与C组之间差异有显著性(P<0 01),A、B、C组与D组比较差异有极显著性(P=0 000),宫腔长度与出血量在A、B、C、D之间差异均无显著性(P>0 05),A、B、C、D均无人工流产综合征发生,D组有2例发生人工流产综合征.结论 口服米索前列醇600 μg可以有效软化扩张宫颈,减少受术者痛苦,减少人工流产综合征,术前3 h和4 h同样可以软化扩张宫颈,口服米索前列醇配伍利多卡因局部麻醉镇痛效果更佳.     

米索前列醇联合利多卡因用于无痛人工流产的临床观察

目的:观察米索前列醇联合利多卡因应用于无痛人工流产的临床效果.方法:在人工流产时使用米索前列醇联合利多卡因与使用异丙酚及一般人工流产手术作比较,观察镇痛效果、宫颈扩张情况、术中出血量、手术时间、手术费用及人工流产综合征发生率等指标.结果:在人工流产时使用米索前列醇联合利多卡因与使用异丙酚在观察镇痛效果、手术时间及人工流产综合征发生率方面无显著性差异,而在宫颈扩张情况、术中出血量、手术费用方面米索前列醇联合利多卡因组明显优于异丙酚组.结论:米索前列醇联合利多卡因应用于无病人工流产.具有效果好、副反应少、费用低及麻醉风险少等优点.     

笑气联合米索前列醇在无痛人流术中的临床应用

目的：探讨笑气联合米索前列醇在人工流产中的作用。方法：将笑气联合米索前列醇应用于1000例研究组（A组）,同时设对照组1000例（B组）。结果：A组中镇痛总有效率、手术时间及出血量、人工流产综合征发生率与B组比较都有显著差异性（P〈0.01）,同时宫颈扩张情况及子宫深度明显优于B组。结论：笑气联合米索前列醇在人工流产中镇痛及宫颈扩张方面的作用确切,是一种理想的无痛人工流产方法。     

宫腔镜检查前软化宫颈药物应用的临床观察

目的选择一种简单、有效宫腔镜检查前软化宫颈的药物.方法选择202例宫腔镜检查患者,随机分成A、B、C三组,分别采用米索前列醇联合利多卡因宫颈注射(A组)、米索前列醇口服(B组)、利多卡因宫颈注射(C组),将镇痛效果、心脑综合征RAAS发生率、宫颈松弛情况及出血量进行比较.结果A组镇痛效果、宫颈松弛情况与B、C组相比,差异极显著(P＜0.01),心脑综合征发生率A组显著低于B、C组(P＜0.01).结论米索前列醇联合利多卡因用于宫腔镜检查前镇痛和扩张宫颈是一种安全有效的方法.     

三种镇痛方法在人工流产中的临床观察

目的：探讨几种镇痛方法在人工流产（人流）中的作用。方法：行无病人工流产早孕妇女691例随机分为三组，A组宫颈局部注射2％利多卡因，B组使用异丙酚，C组使用杜冷丁、异丙嗪联合米索前列醇。另选择不用药，直接进行人流术的早孕妇女作为D组（对照组）。结果：B、C组的镇痛效果较好，A组次之。三组人流综合征发生率比较，差异无显著性。C组术中出血及宫颈扩张情况优于A、B组。异丙酚有呼吸抑制，需要麻醉师操作。结论：利多卡因、异丙酚、度冷丁、异丙嗪联合米索前列醇应用于人工流产术中均有镇痛效果；度冷丁、异丙嗪联合米索前列醇组不增加阴道出血量，宫颈扩张情况优于其他三组，方法简便、安全有效，值得推广；异丙酚对呼吸循环系统有一定的抑制作用，术中需加强监测。     

米索前列醇与利多卡因用于人工流产的疗效对比分析

目的观察利多卡因、米索前列醇分别用于人工流产的临床效果。方法将行人工流产终止妊娠的早孕及初孕妇女101例随机分为两组。A组45例于术前2h空腹口服米索前列醇400μg,B组56例于术前5min宫颈注射利多卡因。观察镇痛效果、宫颈松弛度、手术时间、人工流产综合征发生率等指标。结果 A组在宫颈软化及缩短手术时间方面均优于B组(P<0.05),尤其宫颈软化显效率比较差异有统计学意义(P<0.01)。两组镇痛效果及人工流产综合征发生率比较,差异无统计学意义(P>0.05)。结论利多卡因、米索前列醇用于人工流产均安全、简便、有效,术前口服米索前列醇有更好的扩张宫颈作用,可降低手术难度,适合初学者应用。     

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.     

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.