前列腺增生并慢性前列腺炎患者前列腺电切术后下尿路症状及膀胱颈挛缩发生的临床分析

目的总结分析前列腺增生并慢性前列腺炎患者前列腺电切术后下尿路症状及膀胱颈挛缩发生情况。方法选择2014年6月至2018年6月我院收治的396例前列腺增生患者为研究对象,其中152例并发前列腺炎,均接受前列腺电切术治疗,观察其术后LUTS(下尿路症状)变化及BNC(膀胱颈挛缩)发生情况。结果 B组Qmax(5.6±1.3)m L/s明显低于A组,AUR(尿潴留)发生率58.55%、IPSS评分(25.2±1.3)分、BNC发生率9.87%均明显高于A组,且两组之间差异非常显著(P0.05)。结论与单纯前列腺增生患者相比,前列腺增生合并慢性前列腺炎患者经TURP治疗后下尿路症状更严重、膀胱颈挛缩率更高,临床上要高度重视。     

组织学前列腺炎对前列腺增生患者尿动力学参数及尿潴留的影响

目的探讨合并组织学前列腺炎(HP)对前列腺增生患者的尿动力学参数及尿潴留的影响。方法回顾性分析98例接受经尿道前列腺等离子双极电切术治疗的良性前列腺增生(BPH)患者资料,根据病理诊断分为单纯BPH组和BPH合并HP组,比较国际前列腺症状评分(IPSS)、前列腺体积（PV）、前列腺特异性抗原(PSA)、最大尿流率、最大膀胱容量（MBC）、最大逼尿肌收缩力和膀胱出口梗阻指数（BOOI）等尿动力学指标及膀胱逼尿肌过度活动、尿潴留发生率间的差异。结果与单纯BPH组比较,BPH合并HP组具有更高的IPSS评分(P=0.020)和PSA值(P=0.009),更高的BOOI指数(P=0.003),较小的最大膀胱容量(P=0.004),更高的膀胱逼尿肌过度活动的发生率(P=0.041)和尿潴留发生率(P=0.010)。结论合并HP的BPH患者下尿路症状更重,血清PSA升高,导致MBC降低、膀胱出口梗阻加重和逼尿肌过度活动的发生等尿动力学参数改变,更易发生尿潴留。     

良性前列腺增生症合并糖尿病患者 的尿动力学临床价值

目的：通过尿动力学检查对良性前列腺增生症（BPH）合并糖尿病(DM)患者的下尿路症状评估,分析尿动力学的表现,对该类型患者作出合理的治疗与处理。方法：106例行经尿道前列腺电切术（TURP）治疗的BPH患者,年龄53～92（63.21±7.18）岁;下尿路症状史3～12年,均行肛门指检、前列腺特异性抗原（PSA）、B超、静脉肾盂造影（IVU）及尿动力学检查和IPSS评分。排除尿路感染及颅脑、脊髓等神经系统病史。BPH合并DM患者（47例）为研究组（A组）,单纯BPH患者（59例）为对照组（B组）,对2组的尿动力学检查情况,IPSS评分及术后疗效进行对比分析。结果：2组比较,IPSS评分A组较B组高,最大尿流率（Qmax）A组较B组显著降低,疗效不满意者A组高于B组,差异有统计学意义(P＜0.05),但是2组平均年龄及残余尿量差异无统计学意义(P＞0.05)。2组的尿动力学检查比较,A组中膀胱逼尿肌不稳定、低顺应性膀胱、膀胱逼尿肌功能受损比例要高于B组,差异有统计学意义(P＜0.05)。结论：DM加重了BPH患者的膀胱功能障碍;尿动力学检查对于BPH合并DM患者治疗方法的选择,预测术后疗效能提供客观依据,具有重要的临床参考价值。     

保留部分尿道黏膜改良经尿道钬激光前列腺剜除术治疗良性前列腺增生患者的疗效观察

目的 研究保留部分尿道黏膜改良经尿道钬激光前列腺剜除术(HoLEP)治疗良性前列腺增生(BPH)患者的效果。方法 选取我院BPH患者145例(2017年6月～2019年6月),根据手术方式不同分为B组、A组。B组(n=72)行经尿道前列腺电切术(TURP),A组(n=73)行保留部分尿道黏膜改良HoLEP,比较两组手术基本情况、并发症发生率及手术前后前列腺症状(IPSS)评分、最大尿流率(Qmax)评分。结果 与B组比较,A组术中出血量、手术用时、导尿管置留时间、住院天数、术后6个月IPSS评分、Qmax、QOL评分、并发症发生率较优(P＜0.05)。结论 BPH患者采用保留部分尿道黏膜改良HoLEP治疗,能减轻症状,减少并发症发生,提高生活质量,促进患者康复。     

经尿道双极等离子电切治疗前列腺增生症

目的:探讨前列腺增生症(BPH)经尿道双极等离子电切(TUPKP)治疗效果.方法:采用经尿道双极等离子前列腺电切术治疗BPH 75例,随访3个月,随访前后检查最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、生活质量评分(QOL),并进行疗效分析. 结果:本组手术时间(67.13±12.33)min,无电切综合征发生,Qmax由术前的(3.33±2.99)mL/s上升至术后3个月的(22.63±3.49)mL/s(P<0.05),IPSS由术前的(23.95±2.56)分降至术后3个月的(5.16±0.93)分(P<0.05),QOL由术前的(5.07±0.64)分降至术后3个月的(0.92±0.61)分(P<0.05).结论:TUPKP治疗BPH疗效好,并发症少,手术安全.     

微创等离子前列腺电切对高危良性前列腺增生疗效观察

目的 探讨微创经尿道等离子体前列腺电切术(PKVP)治疗高危良性前列腺增生(BPH)患者的疗效.方法 采用微创PKVP,改变传统的前列腺电切部位,治疗高危BPH 21例.结果 术后平均随访12～18个月,本组21例均有效(100%).国际前列腺症状评分(IPSS)由术前29.3±2.3减少至7.8±2.1(P＜0.01...     

经尿道前列腺等离子体剜除术与电切术治疗前列腺增生

目的:比较经尿道前列腺等离子电切剜除术(PKEP)与经尿道前列腺电切术(PKRP)治疗良性前列腺增生(BPH)的安全性及临床疗效。方法:将82例BPH患者随机分成两组,分别行电切术(45例)和剜除术(37例),比较手术时间、术中出血量、前列腺切除量、术后膀胱冲洗时间和并发症发生率等指标,评价两种手术方式的安全性,通过比较术后6个月前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)和剩余尿量(PVR)等评价两种手术方式的疗效。结果:剜除术组的手术时间、术中出血量、术后恢复时间(术后冲洗时间、留管时间以及住院时间)以及并发症发生率明显低于电切术组,前列腺切除量明显高于电切术组,差异均具有统计学意义(均P<0.05);术后随访6个月,两组IPSS、QOL、Qmax和PVR术后与术前比较均明显改变(均P<0.05),但两组间改善程度比较差异无统计学意义(P>0.05)。结论:两种手术都是治疗BPH的有效方法,但经尿道前列腺等离子电切剜除术更省时、并发症更少、安全性更高。     

前列腺手术治疗临床分析

目的探讨经尿道前列腺电切术(TURP)治疗前列腺增生(BPH)的临床疗效.方法选择2010年1月~2011年3月收治的98例前列腺增生(BPH)患者为研究对象,均给予经尿道前列腺电切术(TURP)治疗,记录并对比分析患者手术前后的平均最大尿流率(MFR)、前列腺症状国际评分(IPSS)以及生活质量评分(QOL);所有前列腺增生(BPH)患者均进行为期2~10个月术后随访.结果术后6例暂时性尿失禁,5例继发性出血,10例附睾炎以及6例尿道狭窄,采取对症治疗之后均痊愈;前列腺增生(BPH)患者手术前后的平均最大尿流率(MFR)、前列腺症状国际评分(IPSS)以及生活质量评分(QOL)差异显著,具有统计学意义(P<0.05).结论经尿道前列腺电切术(TURP)在治疗前列腺增生(BPH)方面临床疗效可靠,而且术中创伤较小,术后并发症较少,建议临床推广应用.     

经尿道前列腺电气化联合电切术治疗前列腺增生症165例分析

目的探讨经尿道前列腺电气化联合电切术治疗前列腺增生症(BPH)的安全性和有效性.方法采用经尿道前列腺电切术和气化术(TUVP+TURP)治疗BPH患者165例.结果全部患者均安全度过围手术期,疗效满意,术后随访1～2个月,国际前列腺症状评分(IPSS)8.1分,无严重并发症,提高了高龄高危患者的生活质量.结论经尿道前列腺电气化联合电切术治疗BPH是一种安全性高、并发症少、疗效确切的手术方法,具有操作易掌握、出血少、速度快、安全可靠等优点.     

经尿道钬激光前列腺剜除术治疗良性前列腺增生的效果

目的研究经尿道钬激光前列腺剜除术(HoLEP)治疗良性前列腺增生(BPH)的效果。方法选取2018年1月至2019年7月河南圣德医院收治的100例BPH患者,依据手术方式分为经尿道前列腺电切术(TURP)组和HoLEP组,各50例。对比两组手术相关指标、并发症发生率及术前、术后1个月临床症状[国际前列腺症状评分(IPSS)]。结果 HoLEP组住院时间、导尿管置留时间均短于TURP组,手术时间长于TURP组,术中出血量少于TURP组,差异有统计学意义(均P<0.05)。术后1个月,两组IPSS均低于术前,且HoLEP组IPSS低于TURP组,差异有统计学意义(均P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论与TURP比较,HoLEP治疗BPH可显著改善手术情况,缓解临床症状,缩短康复进程。     

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.