输卵管结扎术后宫外孕31例临床分析

<正> 我院自1991年1月至1993年12月共收治宫外孕78例,其中输卵管结扎术后宫外孕31例,占39.74％,现分析如下: 临床资料 发病年龄:22～45岁,多发生在26～33岁,占70.97％。 结扎术后至发病时间:多发生在2～5年,共17例,占54.84％,小于2年的有4例,大于5年的有10例,其中1例结扎术后5年足月妊娠1次,上环半年后发病。     

经阴道超声检查对宫外孕的诊断价值

回顾分析我院2003年1月~2004年7月行阴道超声检查,并经手术和病理证实的宫外孕38例,以探讨经阴道超声对宫外孕的诊断价值。1临床资料1.1一般资料宫外孕病人38例,年龄18~43岁,平均28岁。38例均经手术和病理证实。33例有停经史,35例有下腹痛,23例有不规则阴道流血,37例尿妊娠试验     

妇科腹腔镜微创手术诊治异位妊娠33例分析

临床资料选取2003年4月～2004年1月住院病人,临床诊断异位妊娠63例。随机分成微创手术组33例和开腹手术组30例。微创手术组:年龄17～42岁,平均30±3岁;有腹部手术史者3例,其中剖宫产术后1例,宫外孕术后2例;经产妇25例,陈旧性宫外孕27例,低血容量休克型病人2例。开腹手术组:年龄19～40岁,平均31±4岁;有腹部手术史者3例,均为剖宫产术后,经产妇24例,陈旧性宫外孕26例,低血容量休克型病人3例。两组在年龄、产次、腹部手术史、生命体征等无明显差异(p>0.05),有可比性。手术器械:微创手术组使用上海金宝隆公司的腹腔镜设备及器械(电视摄像系统,腹…     

陈旧性宫外孕的诊断和处理

<正> 陈旧性宫外孕,诊断比较困难,处理方法各异。现将我科1975年1月至1984年12月住院后经手术证实的47例陈旧性宫外孕作一回顾性分析。临床资料一般资料:我院同期收治的313例宫外孕患者中有47例经手术证实为陈旧性宫外孕。本组20～29岁13例,～39岁30例,～49岁4例。 47例中原发不孕10例,继发不孕13例,近1/2患者有原发或继发不孕史。     

宫外孕出血性休克自体血回输106例临床效果评价

笔者于1990年1月~2000年1月共收治宫外孕患者960例,其中腹腔内出血性休克603例,在手术过程中自体血回输106例,现报告如下。1资料与方法1.1临床资料106例均确诊为宫外孕腹腔内出血伴出血性休克,行自体血回输,年龄18~40岁(中位年龄29岁),初产妇33例,经产妇73例。另选择同期宫外孕     

宫外孕181例分析

宫外孕是妇产科常见的急腹症之一 ,若得不到及时诊断治疗 ,就会危及患者生命 ( 1)。现对我院 1 81例 1 985年元月至 1 999年 1 2月住院的宫外孕进行分析。1　临床资料1 .1　一般资料 :本组年龄为 1 9～ 45岁 ,以 2 5～ 35岁最多 ,占 64.7%。宫外孕的类型以输卵管妊娠为多 ,共 1 71例 ,占 94.5% ,其余依次为卵巢妊娠 5例 ( 2 .8% ) ,宫角妊娠 3例 ( l.6% ) ,阔韧带妊娠1例 ( 0 .6% ) ,腹腔妊娠 1例 ( 0 .60 )。在宫外孕发病因素中 ,有盆腔炎病史的为 69例 ( 38.1 % ) ,有盆腔手术史 33例 ( 8.2 % ) ,有宫外孕保守治疗史者 5例 ( 2 .8% ) ,置…     

B超诊断先天性子宫畸形5例

<正> 我院自1997年7～12月,应用B超诊断先天性子宫畸形5例,现报告如下。 资料与方法 1 临床资料 本组5例均为门诊病人,年龄最小19岁,最大28岁。病史:青春期后无月经来潮,怀疑子宫发育不良1例;停经46d,突然腹痛,右下腹明显压痛,尿HCG阳性,怀疑宫外孕1例;妇科检查时发现紧贴子宫的实质性包块,怀疑子宫肌瘤1例;月经过多2例。     

宫外孕经阴道超声早期诊断76例分析

宫外孕是产科急腹症中最为常见的一种疾病 ,并有逐渐增加趋势[1 ] 。由于超声波的普及和广泛应用 ,为临床早期诊断宫外孕提供有力证据。为探讨经阴道超声对宫外孕早期诊断的声象图特征 ,准确有效地选择治疗方案 ,现将我院近年来 76例宫外孕的诊治体会报道如下。1　资料与方法本组 76例为我院 1999年 2月至 2 0 0 1年 11月疑为宫外孕的患者 ,年龄 2 1～ 4 3岁 ,平均 4 2岁 ,其中 5 7例有 3 6～ 5 2 d不等的停经史 ,16例停经史不清 ,伴有程度不同的腹痛及不规则阴道流血史 ,3例人流时未见绒毛组织 ,尿 HCG检查 69例阳性。使用仪器 EUB- 4 2…     

89例宫外孕超声显像分析

近年来 ,超声对宫外孕的监测、诊断、特别是未破裂前的诊断或发生破裂后出血量多少的估测 ,为临床医师提供可靠的诊断依据 ,决定处理方案显得尤为重要。笔者对 1995年5月至 1999年 8月 ,89例宫外孕超声显像的特征和误诊原因进行分析 ,探讨超声检查对宫外孕的诊断价值。1　临床资料1.1　一般资料 :89例患者均为本院妇科住院病人。年龄 2 0～ 43岁 ,有停经史 73例 (时间 33～ 5 6 d) ,不规则阴道流血6 9例 ,不同程度腹痛 38例 ,肛门坠胀感 3例 ,休克 2例。本次发病前做人工流产术 8例 ,药物流产术 3例。过去有结扎史 1例 ,宫内置节育环 9例。1…     

异位妊娠病因与早期诊断的探讨

宫外孕是危及育龄妇女生命和健康的一种常见病。近年来宫外孕发病率明显增高。本文对我院自1995年 1月～ 1999年 2月收治的经手术及病理证实的 12 0例宫外孕病例进行分析 ,以探讨宫外孕的早期诊断为预防和治疗提供资料。1　临床资料1.1　一般资料　本组 12 0例异位妊娠 ,年龄 2 1～ 4 7岁 ,好发年龄为 2 6～ 35岁。其中有 114例为输卵管妊娠 ,占 95 % ;4例为卵巢妊娠 ,占 3.33% ;2例为间质部妊娠 ,占 1.6 7%。.2　孕产史　本组宫外孕中有 2 3例为初次妊娠 ,占19 .17% ;有妊娠史及人流史的 97例 ,占 80 .83%。同时收集年龄相匹配 4 7例正常孕…     

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.