阴道B超检测绝经后阴道出血患者子宫内膜病变的价值

目的通过经阴道超声对绝经后阴道出血患者子宫内膜病变的超声声像图的分析,确定子宫内膜病变的程度。方法选取48例绝经后阴道出血患者为研究对象,在诊刮术前常规行阴道B超检查,测量子宫内膜厚度,观察病灶范围,然后行诊刮术,诊刮标本送病理检查。结果在48例患者中,有34例绝经后阴道出血患者的子宫内膜≥5mm,其中18例(52.9%)经病理确诊为子宫内膜癌;14例子宫内膜厚度<5mm者,病理检查未发现1例子宫内膜癌。结论阴道B超检测子宫内膜无创痛,可作为绝经后阴道出血患者进行诊刮术前的一种筛选手段。     

绝经后阴道出血行诊刮术前B超检测的价值

目的：评估绝经后阴道出血患者应用B超检测子宫内膜，以减少不必要的诊刮术的价值。方法：对6例绝经后阴道出血患者于诊刮术前进行B超检查，测量子宫大小及子宫内膜厚度，然后行诊刮术，标本送病理检查。结果：4例子宫内膜厚度小于或等于4mm者，子宫内膜属于生理性改变；2例内膜厚度大于5mm者为子宫内膜癌。结论：运用B超检测，可作为绝经后阴道出血患者行诊刮术前的一种筛选手段，当超声检测内膜厚度小于或等于4mm时应考虑避免诊刮术。     

220例绝经后阴道出血子宫内膜病变的临床与病理分析

目的：探讨绝经后阴道出血子宫内膜病变与绝经年限、B超下子宫内膜增厚和病理类型的关系。方法：分析220例绝经后阴道出血子宫内膜病变患者腹部和阴道超声检查,诊断性刮宫或分段诊刮、子宫切除患者的临床和病理资料。结果：绝经后阴道出血子宫内膜病变的主要病理诊断分别是：功能性子宫内膜102例、子宫内膜炎34例、子宫内膜增生52例、子宫内膜息肉14例、子宫内膜癌18例。B超检测子宫内膜厚度≤4mm时,99%的内膜属于良性病变。结论：绝经后阴道出血子宫内膜病变以功能性子宫内膜居首位,依次为内膜增生性病变、子宫内膜癌。绝经年限长,子宫内膜厚度在5mm以上的妇女,子宫内膜癌的发生率较高。当B超检测子宫内膜厚度≤4mm时,可以结合临床考虑免除部分诊刮手术,以减轻病人的痛苦。     

阴道超声对绝经后子宫出血的诊断价值

目的:通过经阴道超声对绝经后子宫出血患者子宫内膜病变的超声声像图的分析,确定子宫内膜病变的程度。方法:选取130例绝经后子宫出血患者为研究对象,在诊刮术前常规行阴道B超检查,测量子宫内膜厚度,观察病灶范围,然后行诊刮术,诊刮物送病理检查。结果:在130例患者中,有78例绝经后子宫出血患者的子宫内膜>5mm,其中10例经病理确诊为子宫内膜癌,52例子宫内膜厚度≤5mm者,病理检查未发现1例子宫内膜癌。结论:阴道超声检查可作为绝经后子宫出血患者进行诊刮术前的一种筛选手段。     

B超检测绝经后阴道出血患者子宫内膜的价值

对１８２例绝经后阴道出血患者,于诊刮术前行Ｂ超检查,测量子宫内膜厚度、观察病灶范围,然后进行诊仍刮术,标本送病理检查,结果绝经期内膜或良性内膜疾病１６５例,占９０．６６％;子宫内膜癌１７例,占９．３４％。子宫内膜厚均〉５ｍｍ。结果提示：超声检查可作为绝经后阴道出血患者进行诊刮术前的一种筛选手段,当超声检测内膜厚度〈５ｍｍ时,可考虑避免诊断刮宫术。     

绝经过渡期无排卵型功血患者子宫内膜厚度与病理状况分析

目的通过分析绝经过渡期无排卵型功血患者在治疗前后子宫内膜厚度及其与相应的子宫内膜病理状况的关系,对诊断性刮宫术、内分泌治疗的疗效及预后进行评估。方法对293例绝经过渡期无排卵型功血的患者,于诊刮术前及治疗后行B超检查,测量子宫内膜厚度,诊刮术后标本送病理检查。结果子宫内膜病理为复杂型过增生、不典型增生的患者,其出血期内膜厚度均≥12mm,与内膜厚度<12mm者差异有显著性(P<0·01)。治疗后内膜厚度≥8mm者,应密切随访。结论B超检测子宫内膜厚度可作为绝经过渡期无排卵型功血患者诊刮术前评估和筛选的重要指标,治疗后的监测对指导治疗和预后评估有着重要的意义。     

阴道超声检查绝经后阴道出血结果分析

目的：分析阴道超声在绝经后阴道出血的诊断价值。方法对89例绝经后阴道出血的患者采用经阴道超声诊断,统计子宫内膜厚度与病理检查结果。结果89例患者中, B 超诊断子宫内膜厚度<5 mm 者32例,超声显示内膜较薄,回声均匀;子宫内膜厚度(5~10) mm 者49例,超声显示内膜增厚、回声欠均匀,部分患者可见小囊腔病变,行刮诊确诊;子宫内膜厚度>10 mm 者8例,超声表明内膜明显增厚,且呈现不均匀高回声,子宫内膜形态不规则,行刮诊确诊。主要诊断结果为子宫内膜癌(3.37%)、内膜炎性渗出(9.10%)、内膜息肉(9.10%)及宫颈糜烂(58.43%)。其中,子宫并内膜厚度≥10 mm 组子宫内膜癌的发生比例高于子宫内膜厚度为5~10 mm 组,且两组比较差异有统计学意义(P<0.05)。结论绝经后经阴道出血的致病原因较多,但多数患者均为良性病变。经阴道超声可通过对子宫内膜厚度的判断并结合病理检查确定阴道出血的原因,为子宫内膜病变的筛查提供参考。     

293例绝经过度期功血患者子宫内膜厚度与病理状况分析

目的 通过分析在绝经过渡期无排卵型功血患者在治疗前后子宫内膜厚度及其与相应的子宫内膜病理状况的关系,对诊断性刮宫术、内分泌治疗的疗效及预后进行评估。方法 对293例绝经过渡期无排卵型功血的患者,于诊刮术前及治疗后行B超检查,测量子宫内膜厚度,诊刮术后标本送病理检查。结果 子宫内膜病理为复杂型过增生、不典型增生的患者,其出血期内膜厚度均≥12mm,与内膜厚度<12mm者差异非常（P<0.01）。治疗后内膜厚度≥8mm者,应密切随访。结论 B超检测子宫内膜厚度可作为绝经过渡期无排卵型功血患者诊刮术前评估和筛选的重要指标,治疗后的监测对指导治疗和预后评估有着重要的意义。 【关键词】 绝经过渡期 子宫出血 子宫内膜 超声检查     

绝经过渡期无排卵型功血患者子宫内膜厚度与病理状况分析

目的通过分析绝经过渡期无排卵型功血患者在治疗前后子宫内膜厚度及其与相应的子宫内膜病理状况的关系,对诊断性刮宫术、内分泌治疗的疗效及预后进行评估。方法收集本院收治的绝经过渡期无排卵型功血患者293例,收集时间是2010年6月至2015年6月,在刮诊术前与治疗后均进行B超检查,测量子宫内膜厚度,诊刮术后标本送病理检查。结果子宫内膜病理为复杂型过增生、不典型增生的患者,其出血期内膜厚度均≥14 mm,与内膜厚度14 mm者差异有显著性(P0.01)。治疗后内膜厚度≥10 mm者,应密切随访。结论 B超检测子宫内膜厚度可作为绝经过渡期无排卵型功血患者诊刮术前评估和筛选的重要指标,治疗后的监测对指导治疗和预后评估有着重要的意义。     

绝经后妇女子宫内膜阴道超声测值观察分析

目的：探讨阴道超声对绝经后妇女子宫内膜病变的诊断价值。方法：539例绝经后妇女采用经阴道超声测量子宫内膜厚度,子宫内膜≥5mm作诊刮术,进行病理检查。结果：87例子宫内膜≥5mm,诊刮内膜病理检查。结论：阴道超声测量绝经后妇女子宫内膜厚度,可作为内膜病变检查的首选筛查方法,有利于子宫内膜病变的早期检出。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.