新生儿急性化脓性腮腺炎的早期诊治

目的 探讨新生儿急性化脓性腮腺炎的早期诊断和治疗.方法 分析2例新生儿化脓性腮腺炎的临床特点及诊治经过.结果 2例新生儿急性化脓性腮腺炎,日龄10 ～26天,均为男孩,其中1例生产过程中接触污染羊水；2例均有典型临床表现,如发热、腮腺区肿胀、触痛、皮温增高,白细胞增高及腮腺导管流脓,脓液培养为金黄色葡萄球菌,经抗生素等治疗后7～10天后痊愈；随诊6个月至1年无复发.应注意非典型病例的早期诊断及少见致病菌感染.结论 新生儿化脓性腮腺炎的早期诊断需结合典型临床表现、体征及辅助检查和微生物培养结果,并警惕其非典型表现,避免延误诊治.     

碘化油导管注入治疗慢性腮腺炎

我科自1981年以来,采用碘化油导管注入用以诊断、治疗慢性腮腺炎患者13例(15侧腺体),介绍于下。一、临床资料: 我们采用碘化油导管注入治疗慢性腮腺炎共13例(15侧),其中男性8例(10侧),女性5例(5侧);年龄最小者12岁,最大者63岁;病程最长者4年,最短者为1个月。     

消瘰汤加减治疗慢性化脓性腮腺炎

目的临床观察消瘰汤加减治疗慢性化脓性腮腺炎的疗效,探究较好的治疗方法,提高临床治疗水平。方法选取慢性化脓性腮腺炎患者79例,随机分为对照组(39例)和治疗组(40例)。对照组采用导管内注射抗菌素治疗,治疗组在对照组的基础上应用消瘰汤治疗,并依病情加减调治。结果两组患者治疗后症状都有所改善,对照组总有效率为87.2%,治疗组总有效率为97.5%,两组比较差异有统计学意义(P<0.05)。结论消瘰汤加减治疗慢性化脓性腮腺炎疗效显著,值得在临床推广应用。     

中药捻治愈12例慢性化脓性中耳炎

<正> 慢性化脓性中耳炎多见于儿童,成人也有发生;如不彻底治愈,易反复发作。笔者用“董氏药膏”制成药捻治疗慢性化脓性中耳炎获得良效,现报告如下。临床资料:本文12例慢性化脓性中耳炎,均经五官科耳镜检查确诊。其中双耳同时发生5例,病程最长2年,最短半个月,平均8.8个月。治疗时间最长者换药7次,最短3次。一般每天换药1次,临床治愈标准为外耳道无脓、无痛。全部病例随访1—6年,无一例复发。     

108例慢性重症化脓性中耳炎的临床治疗体会

目的 探讨经正规保守治疗4～6个月仍反复流脓的慢性重症化脓性中耳炎的原因及临床治疗体会.方法 回顾性分析108例经正规保守治疗后仍反复流脓的慢性重症化脓性中耳炎患者临床病例资料和随访结果.结果 行单纯性鼓室成形术32例,开放式鼓室成形术 62例,闭合式鼓室成形术14例;术后随访4月～2年,干耳101例(93.52%),89例(82.41%)听力提高.结论 慢性化脓性中耳炎经正规保守治疗4～6个月仍反复流脓者,根据病因选择合适的手术方式,可提高疗效,减少复发和并发症的发生.     

内镜辅助治疗慢性阻塞性腮腺炎的临床研究

目的评价涎腺内镜治疗慢性阻塞性腮腺炎的价值。方法对26例(28侧)慢性阻塞性腮腺炎患者行内镜辅助40%碘化油导管内药物灌注(EADP)治疗并进行疗效观察和综合评价。结果术后6个月腮腺胀痛的数据化测定(VAS)统计分析提示治疗非结石性慢性阻塞性腮腺炎缓解率达75·2%。结论EADP对非结石性慢性阻塞性腮腺炎的治疗效果良好。     

内镜辅助治疗慢性阻塞性腮腺炎的临床研究

目的评价涎腺内镜治疗慢性阻塞性腮腺炎的价值.方法对26例(28侧)慢性阻塞性腮腺炎患者行内镜辅助40%碘化油导管内药物灌注(EADP)治疗并进行疗效观察和综合评价.结果术后6个月腮腺胀痛的数据化测定(VAS)统计分析提示治疗非结石性慢性阻塞性腮腺炎缓解率达75.2%.结论EADP对非结石性慢性阻塞性腮腺炎的治疗效果良好.     

Arrow管引流分次硬化治疗21例巨大肝囊肿

目的 评价用Arrow管引流分次无水酒精硬化治疗巨大肝囊肿的治疗方法和效果.方法 对2000年1月至2008年1月收治的单纯性巨大肝囊肿19例施行穿刺置Arrow管引流并分次行无水酒精硬化治疗的病例进行总结和临床分析.19例中单发囊肿17例,多发囊肿2例.囊肿直径10～15cm 14个,15～20cm 5个,大于20cm 2个.在B超引导下穿刺置管,并分次注入无水酒精.结果 21个囊肿3个月内闭合者5个,3～6个月闭合者9个,7～12个月闭合者 3个,4个经随访1年仍未闭合,其中2个为导管脱落者,但此4个囊肿均明显缩小.所有患者临床症状消失,无明显并发症.结论单纯性巨大肝囊肿穿刺置管分次硬化治疗方法简单,疗效确切,安全性高,对老年且伴合并症者尤为适用.     

成人腮腺炎的临床诊治体会

目的:探讨门诊成人腮腺炎的发病特点和临床治疗效果.方法:对2008年5月～2010年5月门诊治疗的24例腮腺炎的临床资料进行了回顾性分析.结果:经治疗后半年随访,其中急性化脓性腮腺炎6例均未复发;慢性阻塞性腮腺炎10例中,有9例未复发;慢性复发性腮腺炎8例中,有5例未复发.结论:应重视对成人腮腺炎的临床治疗,加强腮腺炎疫苗的接种,减少其发生率.     

1%亚甲蓝治疗慢性化脓性腮腺炎30例疗效分析

慢性化脓性腮腺炎患者30例．其中男性12例，女性18例。有10例为双侧病变。年龄5.5～63岁，平均37．8岁。病史最短6个月，最长40年。诊断标准：病变侧腮腺区肿痛，反复发作(至少2次)有阳塞症状．并经碘油造影后确诊。     

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.