米非司酮配伍米索前列醇联合小水囊用于小月份引产的探讨

目的　探索小月份引产的安全、有效方法。方法　选择 1 2～ 1 8周要求引产的健康初产妇2 2 0例 ,观察用米非司酮配伍米索前列醇引产时加用与不加用小水囊的引产成功率及产程时间。结果加用小水囊能缩短产程 (P <0 .0 1 ) ,提高引产成功率 (P <0 .0 1 )。结论　米非司酮配伍米索前列醇加用小水囊在小月份引产中是一种实用有效、值得推广的方法。     

米非司酮配伍米索前列醇用于中期妊娠引产的临床观察

目的：探讨米非司酮配伍米索前列醇用于中期妊娠引产的疗效。方法：回顾性分析了200例使用米非司酮配伍米索前列醇引产和200例使用依沙吖啶引产的中期妊娠产妇的临床资料。结果：两组用药至宫缩时间、分娩时间、总产程比较差异有显著性（P〈0．05），而引产成功率比较差异无显著（P〉0．05）；两组产后情况比较，两组产后出血量、胎盘胎膜残留、软产道损伤、清官率比较差异有显著性（P〈0．05）。结论：米非司酮配伍米索前列醇引产具有成功率高、产程短、软产道损伤小的优点。     

小水囊配伍米索前列醇晚期妊娠引产效果的观察

目的 :观察小水囊配伍米索前列醇 (以下简称米索 )在晚期妊娠引产中的效果 ;方法 :将 1 2 2例孕足月单胎初次妊娠具有引产指征、宫颈评分≤ 4分的孕妇随机分成两组。研究组 62例 ,用小水囊促宫颈成熟 1 2小时后阴道用米索 ( 2 5μg)进行引产 ;对照组 60例 ,阴道用米索 ( 50 μg)进行引产 ;结果 :研究组 1 2小时后取出水囊 ,宫颈评分≥ 7分占 82 .3 % ,从用米索到临产时间以及到分娩时间明显少于对照组 (P <0 .0 1 ) ,用药次数少于对照组 (P<0 .0 1 ) ,两组剖宫产率、产后出血量、新生儿窒息率无明显差异 (P >0 .0 5) ;结论 :小水囊配伍米索用于妊娠晚期引产安全、有效 ,值得推广应用     

中期妊娠两种引产方式的对比研究

目的对比米非司酮配伍米索前列醇与利凡诺在中期妊娠引产的差异。方法将126例中期妊娠患者随机分成A、B两组，A组63例使用米非司酮配伍米索前列醇引产，B组63例使用羊膜腔内注射利凡诺引产。结果A组从平均产程时间、产后出血、胎盘胎膜残留量、引产的成功率明显高于B组（P〈0．05）。结论米非司酮配伍米索前列醇在中期妊娠引产中明显优于利凡诺。     

瘢痕子宫妊娠中晚期引产方式临床分析

目的:探讨剖宫产术后瘢痕子宫妊娠的中晚期引产的治疗方法。方法:回顾性分析我院收治的56例因母体因素或胎儿异常原因行引产的瘢痕子宫妊娠孕妇的临床资料,分别采用米非司酮联合利凡诺尔、米非司酮联合水囊,米非司酮配伍米索前列醇引产方法,选择同期非疤痕子宫引产者224例,将引产方法相同的疤痕子宫与非疤痕子宫进行比较,对比其产程、产后出血、引产成功率、产后清宫率。结果:56例剖宫产术后半年后妊娠的瘢痕子宫引产分别采用上述3种方法,同种引产方法比较,疤痕子宫与正常子宫引产时间、产后出血、清宫率比较差异无统计学意义(P>0.05)。瘢痕子宫水囊引产组出现1例重度胎盘早剥,瘢痕子宫米非司酮配伍米索前列醇组出现1例子宫破裂。结论:米非司酮联合水囊或利凡诺尔引产均适用于剖宫产术后半年以上瘢痕子宫妊娠的中晚期引产;妊娠中期瘢痕子宫采用米非司酮配伍米索前列醇引产安全性较大,但对于孕晚期瘢痕子宫引产需慎重。     

小水囊联合米非司酮配伍依沙吖啶终止中期妊娠的临床观察

目的：探讨小水囊联合米非司酮配伍依沙吖啶终止中期妊娠的临床效果和安全性。方法：选择2007年1月至2009年12月间住院自愿要求终止妊娠的健康孕妇126例,采用小水囊联合米非司酮配伍依沙吖啶的70例孕妇为观察组,单用依沙吖啶56例孕妇为对照组。结果：两组成功率比较无差异,但引产时间、宫缩痛的程度、阴道出血量两组比较均有统计学意义（P〈0．05）。结论：小水囊联合米非司酮配伍依沙吖啶用于中期妊娠引产成功率高,引产时间短,宫缩痛轻,产后出血少,安全性高。     

米非司酮配伍米索前列醇用于晚期妊娠引产的临床应用研究

为探讨米非司酮配伍米索前列醇用于晚期妊娠引产的效果，安全性和可接受性。对３６例晚期妊娠孕妇采用米非司酮配伍米索前列醇引产，并与对照组比较。结果显示两组的总产程，分娩时出血量，产后胎盘，胎膜残留均有非常显著的差异，表明米非司酮配伍米索前列醇用于晚期妊娠引产具有安全可靠，患者易接受等优点，是一种值得推广的引产方法。     

米非司酮与米索前列醇联合水囊用于中期引产的临床观察

目的：探讨中期妊娠引产应用米非司酮与米索前列醇联合水囊方法的有效性与安全性。方法：对2007年8月-2010年6月来我院自愿要求终止妊娠的孕12～28周孕妇160例,分别采用A组米非司酮与米索前列醇联合水囊引产方法、B组米非司酮配伍米索前列醇方法及C组利凡诺羊膜腔内注射方法终止妊娠,进行回顾性研究。结果：A组引产成功率高于B组,差异有统计学意义（P〈0．05）,明显高于C组,A组从首次口服米索前列醇开始至分娩时间明显短于C组（P〈0．01）,A组与B组比较,差异有统计学意义（P〈O．05）。引产成功病例中,产后清宫率A组少于B组（P〈0．05）,明显少于C组（P〈0．01）,产后2h出血量A组与B组比较,差异无统计学意义（P〉0．05）,明显少于C组（P〈0．01）。结论：米非司酮与米索前列醇联合水囊终止中期妊娠具有引产时间短、引产成功率高、胎盘残留少、宫颈裂伤少、副作用少的优点。     

米非司酮配伍米索前列醇在中晚期妊娠引产中的应用

目的探讨米非司酮配伍米索前列醇在中晚期妊娠引产中的临床疗效。方法将68例行中晚期妊娠引产的孕妇随机分为观察组36例和对照组32例,观察组用米非司酮配伍米索前列醇引产,对照组单用依沙吖啶引产,比较两组的治疗效果。结果观察组的引产成功率为94．4％,明显高于对照组引产成功率75.0％,差异有统计学意义（P〈0.05）。观察组用药至宫缩发动时间、宫缩至胎儿胎盘娩出时间、用药至胎儿胎盘娩出时间均明显短于对照组,差异有统计学意义（P〈0.05）。结论米非司酮配伍米索前列醇用于中晚期妊娠引产能够提高引产的成功率、缩短引产时间．值得临床推广使用。     

两种方式终止12～17孕周妊娠的效果比较

目的：探讨米非司酮配伍米索前列醇终止12—17孕周妊娠的疗效。方法：应用米非司酮配伍米索前列醇终止12～17孕周妊娠118例(B组)，并和102例(A组)应用利凡诺引产作对照。结果：B组成功率明显高于A组，且患者易于接受。结论：米非司酮配伍米索终止小月份妊娠引产效果好。     

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.