TOT手术在治疗女性SUI中的临床观察

目的:探讨经闭孔尿道中段悬吊术治疗女性压力性尿失禁的有效性和安全性。方法:采用TOT方法治疗女性压力性尿失禁患者23例,对比分析术前术后ICI-Q-SF评分、最大尿流率、残余尿检测等临床指标进行分析。结果:术后患者随访12-36月,均治愈,无失败病例;其中手术前后ICI-Q-SF评分、尿动力学检查差异有统计学意义。结论:经闭孔尿道中段无张力悬吊术(TOT)治疗女性压力性尿失禁安全、微创、效果满意,对改善压力性尿失禁患者生活质量具有重要意义。     

TOT术治疗女性压力性尿失禁的护理体会

目的 探讨经闭孔阴道无张力尿道中段悬吊术(TOT)治疗女性压力性尿失禁的护理.方法 40例女性压力性尿失禁患者,通过术前心理护理、阴道准备,术后排尿的观察、指导.结果 40例患者通过2-24个月随访,均达到排尿自控的目的.结论 经闭孔阴道无张力尿道中段悬吊术是治疗女性压力性尿失禁的有效方法,配合积极的护理、有效的膀胱功能锻炼,可提高术后效果,预防尿失禁的发生.     

经闭孔尿道中段悬吊治疗女性压力性尿失禁15例临床分析

目的探讨经闭孔尿道中段治疗女性压力性尿失禁的有效性和安全性。方法采用TOT方法治疗女性压力性尿失禁患者15例,对比分析术前、术后患者Qmax、残余尿、1h尿垫值以及ISI-Q-SF评分。结果手术前后的Qmax、1 h尿垫实验结果和ISI-Q-SF评分差异有统计学意义(P0.01),平均手术时间(32±10.5)min,平均术中出血(15±6.0)ml,术后无一例主诉有尿失禁,无一例尿潴留发生。结论 TOT治疗女性压力性尿失禁是安全、有效的。     

经闭孔尿道中段阴道无张力悬吊术治疗女性压力性尿失禁

目的探讨经闭孔尿道中段阴道无张力悬吊术(TOT)治疗女性压力性尿失禁(SUI)的疗效及安全性。方法对10例临床及尿动力检查诊断为女性压力性尿失禁(SUI)的患者进行TOT治疗。结果手术时间为(25±5)min,术中出血量为(40±10)ml,术后3 d拔除导尿管,所有患者小便自控,无尿失禁,随访半年无复发。结论 TOT治疗SUI安全、微创、疗效满意。     

改良经闭孔尿道中段悬吊术治疗女性压力性尿失禁的临床资料研究

目的：评价改良经闭孔尿道中段悬吊术治疗女性压力性尿失禁的临床效果。方法：选取压力性尿失禁患者64例平分为两组,治疗组采用改良经闭孔尿道中段悬吊术,对照组采用经阴道耻骨后无张力尿道中段悬吊术,对比分析两组手术的临床效果。结果：两组患者手术均顺利,术后6h去除导尿管后均能自行排尿。治疗组的手术时间、住院时间都明显短于对照组（P〈0.05）,术中出血量明显少于对照组（P〈0.05）,治疗有效率明显好于对照组（P〈0.05）。结论：改良经闭孔尿道中段悬吊术治疗女性压力性尿失禁手术时间与住院时间短、出血量少、治愈率高、复发率低、避免闭孔血管和神经损伤、膀胱损伤,明显提高患者术后的生活质量,值得临床推广。     

经闭孔尿道中段阴道无张力悬吊术治疗女性压力性尿失禁72例临床分析

目的探讨经闭孔尿道中段阴道无张力悬吊术(TVT-O)治疗女性压力性尿失禁的临床效果。方法于2007年1月1日至2011年6月1日对收治的72例压力性尿失禁女性患者采用行经闭孔尿道中段阴道无张力悬吊术治疗,分析其临床疗效及并发症。结果 72例压力性尿失禁患者接受经闭孔无张力阴道吊带术,术后随访12～24个月,平均14个月。65例(90%)治愈,4例(6%)有效,3例(4%)尿失禁复发。结论经闭孔尿道中段阴道无张力悬吊术具有微创、易操作、恢复快、疗效好等特点,是治疗女性压力性尿失禁的安全有效方法。     

经闭孔尿道吊带术治疗女性混合性尿失禁近期疗效

目的:评估经闭孔尿道中段无张力悬吊术(TOT)治疗女性混合性尿失禁的临床疗效及安全性.方法:回顾性分析23例以压力性尿失禁为主的混合性尿失禁患者行TOT手术的临床资料.随访时间1年,填写国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)、膀胱过度活动症状评分表(OABSS)、国际盆底器官脱垂/尿失禁患者性生活质量问卷简表(PISQ-12),比较患者手术前后膀胱残尿量(PVR)和最大尿流率(Qmax)评价手术效果.结果:局麻下完成手术,手术平均时间20.3 min,出血量较少.术中无膀胱损伤、尿道损伤、闭孔血管及神经损伤.术后(末次)Qmax为(28.37±7.26)mL/s;PVR为(2.87±3.54)mL.术后随访:治愈率73.9％,有效率86.9％.患者术后随访症状、ICI-Q-SF评分及OABSS评分较术前均显著改善(P＜0.01).结论:经闭孔尿道中段无张力悬吊术,是治疗以压力性尿失禁为主的混合性尿失禁的一种微创、安全和有效的手术方法,但长期疗效仍需大量临床资料随访证明.     

经闭孔尿道中段悬吊术用于治疗女性压力性尿失禁的术式探讨

目的:选择适当的术式治疗女性压力性尿失禁。方法:采用经闭孔尿道中段悬吊手术方法。结果:手术时间短,出血少,有效率达100%。结论:经闭孔尿道中段悬吊术是治疗女性压力性尿失禁行之有效的方法。     

TVT-O在女性压力性尿失禁中的运用

目的观察经闭孔经阴道无张力尿道中段悬吊(tension—free vaginal tape-obtttrator,TVT-O)治疗女性压力性尿失禁的效果。方法采用经闭孔经阴道无张力尿道中段悬吊术治疗女性压力性尿失禁8例。结果8例患者术后尿失禁得到控制,平均手术时间48min,平均出血量40ml。术后随访6月无再次尿失禁发生。结论TVT—O手术创伤小、悬吊合适疗效可靠,手术并发症低。     

改良经闭孔尿道中段无张力悬吊术对女性压力性尿失禁患者术后康复及疼痛程度的影响

目的:分析改良经闭孔尿道中段无张力悬吊术对女性压力性尿失禁(SUI)患者的影响.方法:选取新郑市公立人民医院2018年11月—2020年7月女性SUI患者97例,其中48例实施常规尿道中段无张力悬吊术为对照组,另49例实施改良经闭孔尿道中段无张力悬吊术为观察组,比较两组术中失血量、手术时间、术后6h疼痛程度、留置尿管时间、住院时间、手术效果、术前及术后1周尿流动力学(残余尿量、尿失禁次数).结果:两组术中失血量、手术时间、留置尿管时间均无明显差异;观察组术后6 h疼痛程度较对照组低,住院时间较对照组短;观察组手术总有效率97.96％(48/49)与对照组91.67％(44/48)无明显差异;术后1周两组残余尿量、尿失禁次数均明显减少,且观察组较对照组少.结论:改良经闭孔尿道中段无张力悬吊术治疗女性SUI患者,可促进术后恢复,降低术后疼痛,改善尿流动力学,安全可靠.     

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.