布托啡诺和地佐辛应用于人工流产术的疗效观察

目的:将布托啡诺及地佐辛分别与丙泊酚配伍用于人工流产术进行比较,重点观察镇痛效果、不良反应与苏醒质量。方法:60例人工流产术患者,随机分为布托啡诺+丙泊酚组(B组)与地佐辛+丙泊酚组(D组)两组,每组30例。B组静脉注射布托啡诺10μg/kg,2 min后静脉注射丙泊酚2 mg/kg,D组先静脉注射0.05 mg/kg地佐辛,5 min后再静脉注射丙泊酚2 mg/kg。术中当患者体动时追加异丙酚0.5 mg/kg.记录围术期呼吸循环变化、唤醒时间、定向力恢复时间、离院时间及不良反应发生率;评定术中术后镇痛效果。结果:苏醒时间,不良反应发生率两组比较差异无统计学意义;两组均获得了满意的术中术后镇痛效果;D组定向力恢复时间和离院时间明显短于B组(P<0.01)。结论:布托啡诺及地佐辛分别联合异丙酚应用于人工流产术,镇痛效果确切,安全性高。但地佐辛联合异丙酚的应用,患者定向力恢复更快,苏醒质量更高。     

地佐辛复合丙泊酚用于无痛人工流产疗效分析

目的 观察地佐辛与丙泊酚联合应用于无痛人工流产术的可行性.方法 将60例无痛人工流产患者随机分成A、B两组,每组30例.A组单用丙泊酚麻醉,B组应用地佐辛＋丙泊酚,静脉注射地佐辛5 mg后静脉注射丙泊酚.观察2组患者的苏醒时间、丙泊酚用量、并发症、术后宫缩痛VAS评分和患者留院观察时间.结果 与A组比较,B组患者丙泊酚的用量明显减少,患者苏醒时间缩短,镇痛效果良好,生命体征无明显变化,无不良反应的发生,术后宫缩痛VAS评分较低.结论 地佐辛复合丙泊酚应用于无痛人工流产术麻醉效果较好,值得临床推广应用.     

地佐辛超前镇痛在无痛人工流产术中的应用

目的探讨肌肉注射地佐辛用于无痛人工流产术的有效性及安全性。方法择期无痛人工流产术患者40例．随机分为两组：地佐辛＋丙泊酚组（A组）和丙泊酚组（B组）。观察丙泊酚用量、诱导、苏醒及恢复正常行走时间、术中及术后镇痛、术中体动反应、术后宫缩痛及患者满意度。结果A组丙泊酚用量明显少于B组;诱导时间显著短于B组（P〈0．01）。A组术中及术后镇痛效果均明显优于B组（P〈0．05）;丙泊酚注射痛、体动、宫缩痛发生率明显低于B组。结论地佐辛超前镇痛用于人工流产术麻醉效果好,并发症少,值得临床推广应用。     

地佐辛联合丙泊酚应用于无痛人流的临床观察

目的 观察地佐辛联合丙泊酚静脉麻醉用于人工流产术的临床镇痛效果及安全性.方法 将健康早期妊娠,自愿要求人工流产的妇女800例随机分成两组:第1组400例,术中单用丙泊酚2.5mg/kg静脉麻醉(A组);第2组400例,术前先静脉推注地佐辛0.1mg/kg,然后静脉推注丙泊酚2mg/kg(B组).比较两组情况.结果 B组比A组有显著镇痛效果;B组的丙泊酚总用药量比A组明显减少;两组用药后,呼吸、血压、血氧饱和度、心率稍有下降,但在正常范围;第2组比第1组苏醒时间缩短.术后下腹痛评分A组明显高于B组.结论 丙泊酚联合地佐辛用于门诊无痛人流术临床镇痛效果显著,安全可行.     

丙泊酚复合地佐辛用于无痛人工流产术的临床观察

目的探讨并比较丙泊酚复合地佐辛或芬太尼对无痛人工流产术的效果。方法选择ASAⅠ~Ⅱ级早孕需人工流产者70例,随机分为A组(丙泊酚+地佐辛)和B组(丙泊酚+芬太尼)两组,每组35例。A组静注地佐辛5mg,B组静注芬太尼0.0007~0.0015mg·kg-1,两组均于5min后缓慢静注丙泊酚2 mg·kg-1,观察并比较两组患者麻醉相关指标、不良反应及镇痛效果。结果手术开始时丙泊酚+地佐辛组的SpO2高于丙泊酚+芬太尼组,苏醒和离院时间短于丙泊酚+芬太尼组,呼吸抑制、以及头晕、恶心呕吐等不良反应发生率均少于丙泊酚+芬太尼组(P<0.05),两组镇痛效果差异无统计学意义(P>0.05)。结论丙泊酚复合地佐辛应用于人工流产术,安全性高、并发症少、病人离院早,值得临床推广。     

丙泊酚复合地佐辛静脉麻醉在人工流产术中的应用

目的:观察人工流产术丙泊酚复合地佐辛静脉麻醉的临床效果。方法:120例自愿要求无痛人工流产术的早期妊娠患者,随机分为两组:芬太尼组(A组),地佐辛组(B组),每组60例,术前分别臀部肌内注射阿托品0.5 mg,两组患者麻醉诱导给予丙泊酚靶控输注,同时,A组缓慢静脉滴注芬太尼0.05~0.1 mg;B组缓慢静脉滴注地佐辛5~10 mg,麻醉起效后开始手术。术中监测患者心电图(ECG)、无创动脉血压(NIBP)、心率(HR)、脉搏血氧饱和度(SpO2);记录患者手术时间、苏醒时间、术中麻醉效果、术后镇痛评分(VAS)、不良反应(恶心、呕吐、呼吸抑制)。结果:和A组患者比较,B组术中麻醉效果欠佳、手术时间延长、术后镇痛评分(VAS)升高,但是苏醒时间缩短、不良反应降低(P<0.05)。结论:丙泊酚复合地佐辛静脉麻醉用于人工流产术苏醒迅速完全、不良反应减少。     

不同用药方式用于无痛人流手术麻醉的对比观察

目的:对比研究丙泊酚、丙泊酚复合瑞芬太尼、丙泊酚复合地佐辛3种不同用药方式用于无痛人流手术麻醉的安全性和有效性。方法:120例人工流产手术患者,随机分A(丙泊酚组)、B(丙泊酚复合瑞芬太尼组)、C组(丙泊酚复合地佐辛)3组,A组、B组、C组各4O例。并观察这3组药物麻醉在无痛人流术不同时点对病人MAP、HR、SpO2的影响、术后镇痛效果及不良反应的发生。结果:和A组比较,B、C组患者异丙酚的用量减少,注射痛发生率降低,苏醒时间缩短。与A、B2组比较,C组术中循环平稳,低氧血症发生率低,术后宫缩痛VAS评分较低。结论:地佐辛复合丙泊酚用于无痛人流手术的麻醉镇痛效果好、术中生命体征较平稳、呼吸抑制轻微、术后恢复迅速,且能有效地抑制人工流产术后的子宫收缩痛,可安全、有效应用于无痛人流术。     

地佐辛超前镇痛用于无痛人工流产术的临床研究

目的 观察静脉注射地佐辛超前镇痛对丙泊酚复合芬太尼无痛人工流产术中及术后疼痛的影响.方法 选择自愿终止妊娠且无麻醉禁忌证的早孕妇女70例,随机分为地佐辛组和对照组,术前10 min两组分别静推地佐辛0.2 mg/kg,或安慰剂(生理盐水)2 ml.两组均在小剂量丙泊酚复合芬太尼静脉麻醉下行无痛人工流产术,记录丙泊酚用量、术中呼吸和循环监测指标、丙泊酚引起注射痛、意识恢复时间、自由对答时间、苏醒时、苏醒后5 min、15 min及30 min宫缩痛及VAS评分.结果 两组患者麻醉诱导时间、手术时间以及不同时间点MBP、RR、HR和SpO2比较差异无统计学意义(P>0.05),地佐辛组丙泊酚用量较对照组减少,差异有统计学意义(P<0.05),地佐辛组和对照组注射痛VAS评分分别为(2.3±1.1)分和(6.5±1.9)分;患者清醒后不同时间点VRS口述痛觉评分对照组均较地佐辛组高,差异有统计学意义(P<0.05);两组均未见严重不良反应.结论 地佐辛超前镇痛可显著降低丙泊酚复合芬太尼无痛人工流产术注射痛及苏醒期宫缩痛的发生率和疼痛程度,减少丙泊酚用量,且不增加呼吸抑制等不良反应的发生率.     

地佐辛超前镇痛对无痛人工流产孕妇呼吸循环及苏醒时间的影响

目的:探讨地佐辛超前镇痛在丙泊酚无痛人工流产麻醉中对孕妇呼吸循环及苏醒时间的影响。方法:将60例人工流产孕妇随机分为3组,在消毒前5 min分别静脉注射等量生理盐水(A组)、芬太尼1μg/kg(B组)、地佐辛(0.05 mg/kg)(C组),消毒后按2 mg/kg注入丙泊酚,孕妇意识消失(睫毛反射消失)后开始手术,术中根据需要追加丙泊酚每次20～40 mg。记录心率及基础值(T1)、麻醉后(T2)、手术中扩宫颈口时(T3)及术毕时(T4)脉搏血氧饱和度(SpO2)的变化,以及手术时间、苏醒时间、丙泊酚用量和术中麻醉效果。结果:C组患者术后心率低于术前(P0.05),但无需处理;在T2时点,B组SpO2明显低于A、C组(P0.01),在整个手术中B组SpO2均明显低于A、C组(P0.01);A组丙泊酚用量最大(P0.01),C组苏醒时间最短(P0.01),A组麻醉效果均较B组和C组差(P0.05)。结论:丙泊酚复合地佐辛(0.05 mg/kg)应用于人工流产术中较丙泊酚复合芬太尼及单独应用丙泊酚均更安全、有效,值得推广。     

地佐辛预先给药对丙泊酚无痛人流麻醉效果的影响

目的:探讨地佐辛预先给药对丙泊酚无痛人流麻醉效果的影响。方法:收集200例拟行人工流产患者入组,按入组编号随机分为观察组与对照组,每组100例,观察组患者采用丙泊酚联合地佐辛预先给药麻醉,而对照组采用丙泊酚联合芬太尼预先给药麻醉,观察比较两组患者麻醉起效时间、术后苏醒时间,镇痛效果,术中、术后不良反应。结果:两组患者麻醉起效时间比较差异无统计学意义(P>0.05);术后苏醒时间观察组短于对照组,差异有统计学意义(P<0.05);观察组镇痛效果优于对照组,30min时相比差异有统计学意义(P<0.05);而观察组丙泊酚用量虽低于对照组,两组相比差异无统计学意义(P>0.05);观察组术中术后不良反应情况少于对照组,两组相比差异有统计学意义(P<0.05)。结论:地佐辛预先给药虽对丙泊酚无痛人流麻醉起效时间无明显影响,但可缩短术后苏醒时间,提高镇痛效果,减轻不良反应,临床值得推广应用。     

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.