彩色多普勒超声对睾丸扭转的诊断价值

目的 探讨彩色多普勒超声(CDFI)对睾丸扭转的诊断价值。方法 分析7例睾丸扭转患者的彩色多普勒超声表现。结果 7例中，6例诊断为睾丸扭转，CDFI显示睾丸血流减少或消失；1例因睾丸血流增多而误诊急性睾丸炎。结论 病变测睾丸血流减少是诊断睾丸扭转的敏感指标；病变测睾丸血流消失是诊断睾丸扭转的可靠指标。     

彩色多普勒超声在睾丸扭转诊断中的应用

目的 探讨彩色多普勒超声在睾丸扭转诊断中的应用价值。方法 回顾性分析经手术证实44例睾丸扭转的超声诊断结果及其彩色多普勒超声声像图特点。结果 39例鞘膜内扭转，超声诊断符合率100％。5例鞘膜外扭转，超声诊断符合率40％。超声诊断总符合率95．45％。睾丸扭转超声特异性表现为睾丸内血运减少或消失，睾丸上方可见精索扭转团块影像。结论 彩色多普勒超声在睾丸扭转诊断中具有重要诊断价值。熟悉睾丸扭转声像图特点，结合其临床表现可提高睾丸扭转的诊断率。     

彩色多普勒超声在睾丸扭转中的诊断价值及意义

应用彩色多普勒超声对15例睾丸扭转患者进行检查，结合手术病理情况，对声像图进行回顾性分析。结果：15例睾丸扭转患者均经手术病理证实，彩色多普勒诊断睾丸扭转符合率达100％。认为彩色多普勒趣声诊断睾丸扭转准确率高，可作为睾丸扭转的首选检查方法。     

21例睾丸扭转的诊治体会

目的探讨睾丸扭转的早期诊断和治疗。方法收集我院自1994年9月～2008年4月收治的21例睾丸扭转患者的临床资料进行总结分析。结果21例患者中，初诊确诊为睾丸扭转者13例，误诊为急性睾丸附睾炎7例，嵌顿疝1例，其中5例行睾丸坏死切除术，其他均经手法复位或手术治愈。结论睾丸坏死与睾丸扭转的时间和程度有关。彩色多普勒超声对睾丸扭转具有重要的诊断与鉴别诊断意义，早期诊断和手术治疗对提高睾丸的存活率具有重要的临床意义。     

彩色多普勒超声对睾丸扭转的诊断价值

目的探讨彩色多普勒超声对睾丸扭转的诊断价值。方法12例疑为睾丸扭转的病人首先用二维超声显示睾丸、附睾的形态、结构及内部回声，再用彩色多普勒超声观察其血供状况。病人手术后行病理检查，将超声检查结果与手术病理检查结果对照。结果12例睾丸扭转病人患侧睾丸内血流消失或减少，睾丸内血流阻力指数增高．与手术病理诊断相符。结论彩色多普勒超声诊断睾丸扭转具有较高的价值，无创伤，简便易行，且能较准确地判断睾丸扭转的程度及病情发展的不同时期，为手术的选择提供了有力的依据，应作为诊断睾丸扭转的首选方法。     

彩色多普勒超声检查在睾丸扭转诊断中的应用

目的：探讨彩色多普勒超声（CDFI）在睾丸扭转的诊断价值。方法：回顾性分析经手术证实为睾丸扭转16例患者的彩色多普勒超声声像图表现及诊断要点。结果：16例中，15例诊断为睾丸扭转，睾丸扭转特异性表现为睾丸血供减少或消失。结论：彩色多普勒超声在睾丸扭转及鉴别诊断中具有重要诊断价值。     

多普勒能量图对急性睾丸扭转及睾丸附件扭转的应用研究

目的探讨彩色多普勒能量图（CDEI）在睾丸扭转和睾丸附件扭转诊断及鉴别中的应用价值。方法分析104例睾丸扭转和52例睾丸附件扭转彩色多普勒能量图声像图特点，总结两者鉴别诊断要点。结果睾丸扭转特异性表现为睾丸血供减少或消失以及睾丸上方无血供的高回声团块。睾丸附件扭转超声表现为睾丸与附睾头之间或睾丸旁不均质高回声结节及睾丸、附幸内血供轻度增多。结论彩色多普勒能量图在睾丸扭转和睾丸附件扭转诊断及鉴别诊断中具有重要诊断价值。     

睾丸扭转的诊断及治疗

目的：提高睾丸扭转的诊治水平。方法：对我院2002．2-2008．3收治的10例睾丸扭转的诊断及治疗作回顾性分析总结。结果：10例中均行CDFI确诊，其中手术切除6例，2例为隐睾扭转，因睾丸生机恢复而行睾丸固定术。术后均获随访。结论：CDFI是诊断睾丸扭转的可靠方法。早期诊断，及时手术是提高睾丸存活率的关键。     

睾丸扭转的超声学特征

睾丸扭转又称精索扭转，严重者可引起睾丸缺血或坏死，是青少年最紧急的阴囊急症。而且一侧睾丸扭转可增加对侧睾丸细胞凋亡或者诱导抗精子抗体产生，损害健侧睾丸，影响生育。所以早期诊断和及时手术治疗是能否保全扭转睾丸的关键，本文就睾丸扭转的超声特征报道如下。     

睾丸扭转12例临床分析

目的探讨提高睾丸扭转诊断及治疗水平的临床措施。方法对12例睾丸扭转患者的临床资料进行回顾性分析。结果12例患者年龄5—35岁，平均17．4岁。病史和临床表现足以提供诊断依据，辅助检查和手术探查有助于本病的诊断。12例均接受手术探查，7例予以保留睾丸，5例行睾丸切除，睾丸切除率达41．7％（5／12）。5例12h内手术者，睾丸均存活；7例超过12h手术者，仅2例睾丸存活。本组8例行对侧睾丸预防性固定。结论睾丸扭转误诊切除率高，早期诊断甚为重要，对本病应保持足够的警惕与认识，睾丸毁损与扭转的时间密切相关。彩色多普勒超声检查简便易行，对明确睾丸扭转有较高的临床价值，临床高度怀疑时，应及早手术探查。一侧睾丸扭转对侧睾丸的预防性固定有手术的必要性，但并非绝对必须。     

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.