国产吻合器痔上黏膜环切术38例临床观察

目的探讨国产吻合器痔上黏膜环切术(PPH)治疗重度痔的临床应用价值。方法应用特制国产直管形肛痔吻合器对重度脱垂痔行手术治疗。结果手术时间平均20分钟,单纯PPH术后平均住院4天,行合并手术的术后平均住院8天。结论国产吻合器PPH手术具有安全、有效、手术时间短、并发症少、恢复快、费用较低等特点。     

PPH手术治疗重度痔的临床观察

[目的]总结吻合器痔上黏膜环切术（PPH）治疗重度痔的临床经验。[方法]115例以肿物脱出及便血为症状的Ⅲ、Ⅳ度痔患者分为PPH组45例和传统手术组（Milligan-Morgan组）70例．分别进行手术,对比分析手术时间、住院时间、恢复工作时间、术后疼痛、出血、肛门狭窄等并发症。[结果]两组相比较,PPH组的住院时间及恢复工作时间短．术后疼痛轻．肛门狭窄少。[结论]PPH治疗重度痔疗效确切．并发症少．术后恢复抉。     

吻合器痔上黏膜环切术与外剥内扎术治疗重度痔的临床比较研究

目的:分析研究吻合器痔上黏膜环切术(PPH)治疗重度痔的临床疗效。方法:将吻合器痔上黏膜环切术与传统外剥内扎术两种术式方法及临床疗效进行比较分析。结果:通过临床分析研究吻合器痔上黏膜环切术组再术中术后疼痛、出血情况及术后并发症等方面明显优于外剥内扎术组。结论:PPH是临床治疗重度痔疮有效治疗方法。     

PPH术与外剥内扎术治疗重度痔的疗效比较

目的探讨吻合器痔上黏膜环形切除术（PPH）治疗重度痔的疗效。方法将60例重度痔患者用抽签法随机分PPH组和对照组每组30例,分别进行吻合器痔上黏膜环切术和外剥内扎术。比较两组手术时间、住院时间及术后疼痛、并发症发生情况。结果PPH组手术时间、住院时问均比对照组显著缩短,差异有统计学意义（P〈0．05）;术后3dPPH组患者创口疼痛、出血和尿潴留发生率低于对照组,差异有统计学意义（P〈0,05）;PPH纽并发症发生率低于对照组（P〈0．05）。结论PPH术治疗重度痔具有手术时间、住院时间短,恢复快、并发症少等优点,值得临床推广。     

应用国产吻合器行痔上黏膜环切钉合术治疗重度痔104例疗效观察

目的 探讨应用国产吻合器行痔上黏膜环切钉合术(PPH)治疗重度痔(Ⅱ一Ⅳ度)是否优于传统的内扎外剥术式.方法 将184例需手术治疗的重度痔患者分成2组.PPH组104例采用国产吻合器行PPH,对照组80例采用传统内扎外剥术.比较2组患者疗效及术后出血、黏膜脱出及疼痛情况.结果 PPH组治愈率明显高于对照组(93.3%vs.52.5%,P<0.01).PPH组术后出血2例(1.92%),对照组8例(10.00%).PPH组术后黏膜脱出1例(0.96%),对照组7例(8.75%).PPH组术后疼痛第1天39例(37.50%),第2天2例(1.92%),第5天始没有疼痛病例;对照组术后疼痛第1天80例(100%),第2天80例(100%),第5天18例(22.50%),第9天5例(6.25%).PPH组术后出血、黏膜脱出及疼痛发生率均明显低于对照组(P<0.05).结论 应用国产吻合器行PPH治疗重度痔优于传统的内扎外剥术,疗效满意.     

吻合器痔上黏膜环切术(PPH)及其术后出血的处理

目的 :探讨吻合器痔上黏膜环切术 (PPH)对重度痔的治疗及双腔导尿管在术后止血中的临床价值。方法 :总结 95例重度痔的吻合器痔上黏膜环切术的临床资料。结果 :PPH治疗重度痔 95例 ,平均手术时间 2 0 min,术后平均住院日为 2 .7d。术后吻合口出血 5例 ,双腔导尿管压迫止血 4例。结论 :PPH治疗重度痔具有安全 ,术程短 ,无复发 ,恢复快等优点。双腔导尿管压迫止血对于 PPH术后大出血治疗具有明显效果 ,简单易行。     

应用国产吻合器痔上黏膜环切术治疗痔的临床疗效

目的：探讨用国产吻合器痔上黏膜环切术治疗痔的临床效果。方法：将88例重度痔患者分为国产吻合器组(46例)和进口吻合器组(42例),分别为其使用国产吻合器和进口吻合器进行痔上黏膜环切治疗,并比较两组患者的临床疗效。结果：国产吻合器组患者和进口吻合器组患者的手术时间及术中出血量相比较,差异不显著(P>0.05),无统计学意义。两组患者发生肛门疼痛、大便带血、尿潴留和痔脱出复发等术后并发症的几率相比较,差异不显著(P>0.05),无统计学意义。国产吻合器组患者的手术费用明显低于进口吻合器组患者,差异显著（P<0.05）,有统计学意义。结论：用国产吻合器痔上黏膜环切术治疗痔的临床疗效确切,费用低廉,此法值得在临床上推广应用。     

吻合器痔上黏膜环切术治疗重度痔和嵌顿性痔临床观察

目的：探讨吻合器痔上黏膜环切术（PPH）在治疗重度痔疮中应用价值。方法：采用国产圆形吻合器对25例重度脱垂痔和嵌顿性痔进行PPH治疗。结果：25例患者随访3～18个月,无明显复发,无大便失禁、肛门狭窄或肛周脓肿形成等并发症。结论：PPH治疗重度痔具有安全、有效、术后痛苦少、恢复快、并发症少等优点,是治疗重度痔疮的有效方法。     

吻合器痔上黏膜环形切除术治疗重度痔的临床应用

目的比较吻合器痔上黏膜环形切除术（PPH）与外剥内扎创面开放术（Milligan-Morgan术式）治疗重度痔的疗效。方法 31例重度痔患者行PPH（试验组）和22例重度痔患者行Milligan-Morgan术式（对照组）,对2组的手术时间、住院时间、恢复正常时间、并发症和3个月近期疗效进行比较。结果试验组与对照组相比手术时间、住院时间、恢复正常时间明显缩短。试验组术后并发症发生率低,近期疗效也优于对照组。结论 PPH治疗重度痔明显优于Milligan-Morgan术式。     

吻合器痔上黏膜环切术治疗重度混合痔87例临床观察

目的探讨吻合器痔上黏膜环切术（PPH）治疗重度混合痔及直肠黏膜脱垂的临床疗效。方法采用国产吻合器治疗重度混合痔及直肠黏膜脱垂87例。结果87例全部治愈。术后出血3例,疼痛7例,尿潴留6例,下腹部疼痛7例,吻合口狭窄2例。术后平均住院4d。无肛门失禁。随访2～4年,有1例复发。结论PPH治疗重度混合痔及直肠黏膜脱垂具有操作简便,疗效可靠,痛苦小,并发症少,复发率低,安全性高及恢复快等优点。     

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.