超声引导下32P胶体注射治疗甲状腺良性病变的临床研究

目的：探讨超声引导下^32P胶体注射治疗甲状腺腺瘤和腺瘤囊性变的可行性和治疗效果。方法：采用稀释浓度为37－74MBq/1.0-1.5ml和18．5－37MBq/ml的两种注射液,按病变的体积调整剂量,分别对38例甲状腺腺瘤和30例腺瘤囊性变进行超声引导下^32P胶体注射治疗。68例患者术前均经超声检查确诊,同期甲状腺扫描对照,病理穿刺证实。治疗前后均作血清FT3,FT4,TT3,TT4及TSH,血常规检查,其结果进行对比。32例随访6－36个月评价其治疗结果。结果：甲状腺腺瘤治愈率71．1％（27／38）,腺瘤囊性变治愈率86．7％（26／30）。甲状腺腺瘤囊性变的治疗效果优于甲状腺腺瘤。治疗前后血常规、甲状腺激素检查结果对比差异无显著意义。所有病例均未出现明显副反应。结论：超声引导下^32P胶体注射治疗甲状腺腺瘤和腺瘤囊性变疗效显著,方法简便安全,在临床上具有重要的实用价值。     

超声引导下聚桂醇硬化治疗甲状腺囊肿的疗效和安全性研究

目的 探究超声引导下聚桂醇硬化治疗甲状腺囊肿患者的临床疗效与安全性。方法 选取2019年10月至2021年4月西安国际医学中心医院收治的90例甲状腺囊肿患者为研究对象，按随机数表法分为观察组和对照组各45例，观察组患者进行超声引导下聚桂醇硬化治疗，对照组患者进行超声引导下无水乙醇治疗。治疗后3个月、6个月及12个月，分别比较两组患者的临床疗效、囊腔体积及囊肿缩小率；治疗前和治疗后6个月，分别比较两组患者的游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)及促甲状腺素(TSH)水平；同时比较两组患者治疗后的不良反应发生情况。结果 治疗后3个月、6个月及12个月，观察组与对照组患者的临床疗效分别为93.33%与91.11%、97.78%与93.33%、97.78%与95.56%，差异均无统计学意义(P>0.05)；治疗6个月后，观察组与对照组患者的FT3水平分别为(3.82±0.70) pmol/L与(3.96±0.77) pmol/L,FT4水平分别为(10.68±2.73) pmol/L与(11.04±2.91) pmol/L,TSH水平分别为(2.68±0.63) ...     

超声引导下经皮穿刺微波消融术对甲状腺良性结节的疗效

目的探讨超声引导下经皮穿刺微波消融术对甲状腺良性结节的疗效。方法选取2015年2月至2016年12月于开封市人民医院就诊的86例甲状腺良性结节患者,采用超声引导下经皮穿刺微波消融术治疗。统计术前及术后1、3、6、12个月甲状腺结节体积、血清游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)、促甲状腺激素(TSH)水平,根据结节体积计算术后6个月临床疗效。结果术后1、3、6、12个月甲状腺结节体积均小于术前,差异有统计学意义(均P<0.05)。术后6个月治疗总有效率为83.72%(72/86)。手术前后血清FT_3、FT_4、TSH水平比较,差异无统计学意义(均P>0.05)。结论超声引导下经皮穿刺微波消融术可有效缩小甲状腺良性结节体积,不影响甲状腺功能。     

注射“液体隔离带”对超声引导下射频消融治疗甲状腺结节患者颈部结构损伤的影响

目的探析注射"液体隔离带"在超声引导下射频消融治疗甲状腺结节患者中的应用效果及对颈部结构损伤的影响。方法以91例甲状腺结节患者作为研究对象,将其随机分为观察组(46例)与对照组(45例)。两组均行超声引导下射频消融治疗,观察组在射频消融治疗基础上注射"液体隔离带"将喉返神经与腺体分离。比较两组治疗前后甲状腺功能(FT3、FT4及TSH)、术中及术后并发症及术后1个月、2个月、3个月的甲状腺结节体积缩小率。结果两组治疗前甲状腺功能指标差异无统计学意义(P>0.05),治疗后两组FT3、FT4均升高,TSH降低,组内治疗前后差异有统计学意义(P<0.05),但手术后甲状腺功能指标两组间差异不明显。观察组术中并发症发生率为4.3%(2/46),对照组为11.1%(5/45),差异无统计学意义(P>0.05);观察组术后并发症发生率为4.3%(2/46),对照组为17.8%(8/45),差异有统计学意义(P<0.05)。观察组术后1个月、2个月、3个月甲状腺结节体积缩小率均高于对照组,差异有统计学意义(P<0.05)。结论超声引导下射频消融的应用为甲状腺结节治疗的有效方法,但易引起喉返神经损伤等并发症,注射"液体隔离带",可有效预防该并发症,有利于保护患者颈部结构。     

TPOAb对良性甲状腺结节微波消融治疗效果的影响

目的：探究与分析甲状腺过氧化物酶抗体(TPOAb)对良性甲状腺结节微波消融治疗效果的影响。方法：选取2018年2月～2021年12月南方医科大学顺德医院接受甲状腺良性结节微波消融手术的患者,按TPOAb阳性、阴性,即是否合并桥本甲状腺炎分为两组,分别为桥本甲状腺炎组(观察组)40例,非桥本甲状腺炎组(对照组)113例,观察两组手术前后甲状腺功能[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)]、结节体积变化以及手术并发症发生情况(包括声音嘶哑、吞咽不适、饮水呛咳、血肿)。结果：两组术后6个月与术前相比均为FT3及FT4较低、TSH较高。桥本甲状腺炎组术前及术后FT3较高,术前FT4较高,术后FT4较低,术前及术后TSH较高,但差异均无统计学意义(P>0.05)。两组术后结节体积均比术前缩小。桥本甲状腺炎组术前结节体积较小,差异有统计学意义(P<0.05),但术后6个月结节体积较大,差异无统计学意义(P>0.05)。桥本甲状腺炎组结节体积缩小率(VRR)较小,差异有统计学意义(P<0.05)。桥本甲状腺炎组术后声音嘶哑及饮水呛咳发生率...     

超声引导下经皮微波消融治疗甲状腺良性结节的效果观察

目的:观察超声引导下经皮微波消融治疗甲状腺良性结节的临床效果。方法:选取48例甲状腺良性结节患者作为研究对象,按照随机数字表法分为观察组和对照组各24例。观察组在超声引导下接受经皮微波消融术治疗,对照组接受常规手术治疗,对比两组临床治疗效果和并发症发生情况,评估两组手术前后甲状腺功能指标水平,包括游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)。结果:观察组总有效率明显大于对照组,并发症发生率明显低于对照组,差异均有统计学意义(P<0.05);治疗后,观察组FT3、FT4和TSH指标水平均明显优于对照组,差异有统计学意义(P<0.05)。结论:超声引导下经皮微波消融术治疗甲状腺良性结节的临床效果显著,且安全性好。     

^32P胶体与无水乙醇介入性超声治疗甲状腺结节对比研究

目的 评价^32P胶体与无水乙醇介入性超声治疗甲状腺良性结节的疗效差异。方法 超声介入32P胶体局部注射治疗甲状腺良性结节的患者124例，无水乙醇治疗122例。3个月和12个月后评价两种方法的疗效。结果 无水乙醇硬化及^32P治疗甲状腺良性结节均有明显的效果，3个月和12个月的总有效率分别为91．8％和93．4％，91．9％和96．8％，两者差异无显著性（P〉0．05）；其中，囊性病变疗效好于实性病变，3个月总的有效率分别为100％和73．8％（P〈0．01）。^32P胶体治疗实性病变稍优于无水乙醇治疗，两者3个月有效率分别为79．5％和69．4％，差异有显著性（P〈0．05）；对于囊性病变，两种治疗的效果差异无显著性（P〉0．05）。结论 ^32P胶体与无水乙醇介入性超声治疗甲状腺良性结节均有良好的效果，^32P胶体治疗实性病变效果更好。     

超声引导微波消融术与开放式手术治疗甲状腺良性大结节的临床疗效比较

目的 比较超声引导微波消融(MWA)术与开放式手术治疗甲状腺良性大结节的临床效果。方法 选取2020年4月至2022年4月在沧州中西医结合医院收治的96例甲状腺良性大结节患者为研究对象,按照随机数字表法将其分为开放组(实施开放式手术)和MWA组(实施超声引导MWA术),每组48例。比较两组手术相关指标、结节清除率、甲状腺激素水平、术后并发症发生情况。结果 与开放组相比,MWA组手术时间、术中失血量、术后住院天数更少(P<0.05),术后24 h NRS评分更低(P<0.05)。术后6个月两组结节清除率比较,差异无统计学意义(P>0.05)。促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)在组间及时间的主效应比较,差异有统计学意义(P<0.05)。与开放组相比,术后3、6个月MWA组TSH明显降低(P<0.05),FT3、FT4明显升高(P<0.05)。MWA组并发症发生率(4.17%)低于开放组(18.75%)(P<0.05)。结论 超声引导MWA术与开放式手术对甲状腺良性大结节的治疗效果均较好,但超声引导MWA术...     

超声下射频消融术与甲状腺手术治疗甲状腺良性结节的临床疗效对比

目的比较超声下射频消融术与甲状腺手术治疗甲状腺良性结节的临床疗效。方法将67例甲状腺良性结节患者分为消融组和对照组。对照组采用甲状腺切除术治疗。消融组采用超声下射频消融术治疗。对比两组手术情况及并发症发生情况。术后6个月,检测两组患者甲状腺相关激素变化,检测消融组术后6个月的结节大小。结果消融组的手术时间、术中失血量、住院时间、手术瘢痕显著低于对照组,差异有统计学意义(P0.05);消融组并发症的发生率(8.57%)显著低于对照组(31.25%),差异有统计学意义(P0.05);术前和术后6个月,消融组的TSH、TT4、FT3无明显改变(P0.05);术后6个月,对照组TSH明显升高,TT4、FT3明显降低(P0.05);术后6个月,两组TSH、TT4、FT3对比,差异有统计学意义(P0.05);术后6个月,消融组的结节大小显著降低,差异有统计学意义(P0.05),缩小率为(84.36±7.18)%。结论超声下射频消融术治疗甲状腺良性结节,具有创伤小、恢复快、并发症低的优点,对甲状腺功能无明显影响。     

胶体32P囊内注射治疗甲状腺囊肿无效1例分析

患者 ,女 ,49岁 ,发现左颈部渐进性长大的包块 1月 ,不伴全身及局部症状。查体 :甲状腺左叶部位可扪及一乒乓球大小的包块 ,随吞咽运动 ,质地软 ,无压痛 ,心率 72次 /ｍｉｎ ,律齐。Ｂ超示 :甲状腺左叶一囊性占位 ;甲状腺ＥＣＴ显像示 :左叶冷结节 ,结节处血供减少。综合以上的情况诊断患者甲状腺左叶囊肿 ,因患者不愿手术治疗 ,于 2 0 0 0年 7月在我院采用胶体3 2 Ｐ囊内注射治疗。注射胶体3 2 Ｐ的放射性活度 (Ａ)按公式计算 :Ａ(ＭＢｑ) =4πｆＲ3 /3 ,Ｒ为囊肿半径 (ｃｍ ) ,ｆ为每立方厘米囊肿胶体3 2 Ｐ的放射性活度。该患者囊肿半径…     

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.