应用复合组织瓣再造软腭

用全腭粘骨膜瓣加咽后壁复合组织瓣再造软腭，用此手术方法修复鳞癌切除所致软腭缺损４例，腭粘骨膜瓣面积为５ｃｍ×４．５ｃｍ～５．５ｃｍ×５ｃｍ，咽后壁瓣长５ｃｍ，宽２．５ｃｍ，４例切口均Ｉ期愈合，形态及功能恢复良好。     

应用复合组织瓣再造软腭

用全腭粘骨膜瓣加咽后壁复合组织瓣再造软腭。用此手术方法修复鳞癌切除所致软腭缺损４例，腭粘骨膜瓣面积为５ｃｍ×４．５ｃｍ～５．５ｃｍ×５ｃｍ，咽后壁瓣长５ｃｍ，宽２．５ｃｍ，４例切口均Ⅰ期愈合，形态及功能恢复良好。     

二瓣后退与黏骨膜瓣"Z"成形术修复完全性腭裂

目的 探索一种简便，安全，有效的完全性腭裂修复术。方法 通过二瓣后退术与口腔侧黏骨膜瓣“Z”成形术联合对完全性腭裂患者行腭裂修复共36例。为保证“Z”形瓣设计、切开、缝合后的组织成活．需增加黏骨膜瓣的宽度，松弛切口尽量靠近牙龈缘或仅保留牙龈乳头。第一个“Z”臂设计在裂隙的患侧黏骨膜瓣，使健侧黏骨膜三角瓣做为延长黏骨膜瓣长度的主瓣。结果 36例患者经联合术式修复后，保证了软腭后退及腭咽闭合，覆盖了硬腭裂隙前端，手术2周后拆线未见有硬腭前端复裂及穿孔形成。结论 二瓣后退术与口腔侧黏骨膜瓣“Z”成形术联合修复完全性腭裂，方法简单、并发症少、效果确切、易于推广。     

翻转硬腭粘骨膜瓣作衬修复软腭裂

翻转硬腭粘骨膜瓣作衬修复软腭裂哈尔滨铁路中心医院口腔科韩蓬，于云洲哈医大一院口腔颌面外科刘贤君软腭裂术后穿孔的发生率虽不很高，但为了避免或减少其发生，笔者沿用了刘贤君自７０年代开始采用的硬腭舌形粘骨膜瓣作衬修复软腭裂的方法，并将其应用于后推软腭的手术...     

三度唇腭裂联合一次整复术意义探讨

对4～6岁单侧、双侧三度唇腭裂病人，采用唇腭裂联合同期手术修复，用犁骨鼻中隔骨膜—牙龈辩与裂例粘骨膜—牙龈瓣缝合以封闭硬腭及牙槽突裂处鼻腔面，并与唇裂修复相连续，口腔面采用常规腭粘骨膜瓣与唇粘膜共同封闭裂隙．     

W—M形Abbe下唇瓣修复上唇缺损

采用Ｗ－Ｍ形Ａｂｂｅ下唇瓣修复上唇缺损８例，下唇瓣设计呈Ｗ成形，其大小为１．３～２．２ｃｍ×１．２～２．０ｃｍ，移转后形成Ｍ形瓣，使鼻孔底部瘢痕彻底作或松解，鼻小柱延长，鼻孔工大后的创面得到修复，下唇供瓣区遗留“人”字形切口瘢痕，更为自然隐蔽，唇瓣于５～１２天断蒂，８例中２例为１期完成的改良式Ａｂｂｅ瓣，该瓣移转时应分离出足够长度的血管蒂，移转后早期肿胀显著，渗血明显，可能与完美的静脉系统有关，８     

游离龈瓣移植术— — —种植及其普通修复中不可或缺的关键技术

目的探讨和评估附着龈不足的修复病人采用游离龈瓣移植术进行附着龈补偿修复的临床效果、 技 术要点及应用价值。方法２ ０ ０ ９ － ０ ２～ ２ ０ １ １ － １ ０采用游离龈瓣移植术对义隆口腔门诊部修复前附着龈不足的 ８ 例病人１ １个牙位通过自体游离龈瓣移植术获得足够的附着龈。对获得的附着龈颜色变化、 牙龈形态、 修复体边 缘等进行观察和评价。结果游离龈瓣移植术成活率较高； 附着龈宽度增加量均在 ５ ｍ ｍ以上。结论具有适应 症的附着龈缺失病人游离龈瓣移植术可增加种植牙和基牙的附着龈宽度； 成活率高。     

唇部轴型皮瓣推进修复严重唇组织缺损

用唇动脉轴型皮瓣推进修复红唇组织缺损。方法设计以唇动脉为轴心的红唇瓣,切开游离唇瓣向缺损的方向,推进延伸,以修复红唇缺损。结果本方法治疗不同原因引起的红唇缺损２８例,缺损最大面积３．５ｃｍ＊２．５ｃｍ,最小面积２．０ｃｍ＊１．５ｃｍ手术一期完成,红唇瓣全部成活。结论：唇部轴型皮瓣修复红唇缺损,达到正常的解剖学要求,恢复口轮匝肌的连续性;修复后,唇外形丰满。     

舌瓣修复口咽缺损二例

舌瓣修复口咽缺损二例斯琴，王惠琴，李云华（第一附属医院口腔科）例１，男性，６７岁，因右侧颊后区鳞状细胞癌在全麻下行鳞癌扩大切除术、颈淋巴清扫术及舌瓣修复术。癌切除术后颊部缺损区为３ｃｍ×２ｃｍ，作者根据缺损大小，在右侧舌根部取蒂，设计２．０ｃｍ×１．...     

肿胀法头皮软组织扩张术修复颅骨外露和瘢痕性秃发

用肿胀法头皮软组织扩张修复电烧伤颅骨外露３例，烧伤后瘢痕性秃发８例，颅骨外露或头发缺失面积为５０～２５０ｃｍ＾２，平均７６ｃｍ＾２，成人４例，儿童７例，成人全部采用肿胀法局部麻醉，儿童采用基础全麻加肿胀法局部麻醉，肿胀液用量１００～５００ｍｌ，利多卡因浓度为０．０５％～０．５％上肾腺素浓度为１／（１０万），采用常规扩张法，结果表明，术中出血明显减少，手术时间明显缩短，术后切口均一期愈合，均未输血，     

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.