高血压丘脑出血破入脑室的微创治疗

目的探讨微创颅内血肿清除术治疗高血压性丘脑出血并破入脑室的临床疗效。方法对96例高血压丘脑出血破入脑室患者行微创丘脑血肿穿刺和(或)微创侧脑室穿刺引流并联合尿激酶灌注液化血凝块治疗,观察其临床疗效。结果术后96例患者存活率84.4%,病死率15.6%,死亡15例。存活者行日常生活能力(activity of daily life,ADL)分级:Ⅰ级24例,Ⅱ级28例,Ⅲ级17例,Ⅳ级10例,Ⅴ级2例。结论对于高血压丘脑出血并破入脑室的患者依病情采用微创治疗方法能快速清除血肿,降低颅内压,减轻脑水肿,促进患者意识恢复,降低死亡及致残率,是治疗高血压性丘脑出血的有效方法。     

影响微创血肿清除术治疗高血压脑出血预后的因素

目的：探讨影响微创血肿清除术治疗高血压脑出血预后的相关因素。方法：对应用微创血肿清除术治疗高血压脑出血96例中死亡的18例患者做回顾性分析。结果：再出血死亡7例，引流不畅、减压不充分9例，并发症死亡2例。结论：影响微创血肿清除术治疗高血压脑出血预后的主要因素是再出血、引流不畅、减压不充分、出血量大与并发症。     

YL-1型穿刺针治疗高血压性脑出血37例临床分析

目的 探讨YL-1型穿刺针治疗基底节区高血压性脑出血的手术方法和疗效.方法 对37例基底节区高血压性脑出血的患者行YL-1型穿刺针微创血肿清除术,并与同期34例行传统开颅血肿清除患者的临床疗效进行对比.结果 YL-1型穿刺针血肿清除术后恢复良好率(ADL Ⅰ～Ⅲ级)明显高于开颅血肿清除组.结论 YL-1型穿刺针微创血肿清除术治疗基底节区高血压性脑出血具有创伤小、术后神经功能恢复好等优点.     

微创血肿清除术治疗高血压性脑出血420例疗效观察

目的探讨微创血肿清除术治疗高血压性脑出血的疗效。方法选用适当长度的YL-1型颅内血肿粉碎穿刺针,应用微创血肿清除术对420例高血压性脑出血患者进行血肿抽吸、粉碎、液化、引流,观察术后28d的临床疗效、术后3个月的病残情况和术后再出血、并发症情况。结果本组总有效率为80.7%,病死率为12.1%,术后3个月ADL1～3级占70.2%,ADL4～5级占17.6%,术后再出血率为13.8%,术后并发肺部感染率为17.6%,上消化道出血率为13.1%,急性肾功能衰竭率5.2%。结论微创血肿清除术是治疗高血压性脑出血的安全有效方法,值得临床推广应用。     

微创穿刺清除术治疗高血压丘脑出血36例体会

目的 探讨颅内血肿微创穿刺清除术在治疗高血压丘脑出血中的应用及体会.方法 回顾分析近2年对36例高血压丘脑出血病人施行颅内血肿微创穿刺清除术的经验.结果 全组高血压丘脑出血存活35例,术后6月随访,按ADL日常生活能力分级评定Ⅰ级8例,Ⅱ级13例,Ⅲ级8例,Ⅳ级4例,Ⅴ级2例,死亡1例.结论 颅内血肿微创穿刺清除术,是进行高血压丘脑出血血肿清除的最适宜技术,加之术后综合治疗,能有效降低死亡率和致残率,提高生存质量.     

微创清除术治疗高血压脑出血临床分析

目的探讨微创清除术治疗中重度高血压脑出血的临床效果。方法选择血肿量在20-105ml的高血压脑出血患者146例,采用北京万特福科技有限公司生产的YL-1型一次性使用颅内血肿粉碎穿刺针,碎吸抽血,注入液化液反复冲洗。结果146例患者首次血肿清除率20％-40％96例,40％～50％50例。住院1个月时偏瘫肌力达3～5级者40例,1～2级者42例,0级24例,植物状态生存8例,死亡32例。治愈好转率72．6％,病死率21．2％,其中出血在80-105ml者9例,死亡6例。15例死于再出血。结论微创颅内血肿清除术,手术操作简单,脑损伤轻微,能快速清除血肿,降低致残率,提高生存质量,适于有CT机的基层医院开展此项技术,但要掌握好适应证。     

CT定位微创血肿清除治疗高血压脑出血710例临床分析

目的 探讨CT定位微创血肿清除治疗高血压脑出血的适应证、时机和疗效.方法 回顾分析710例高血压脑出血患者行CT定位,用YL-1型穿刺针对血肿抽吸、液化、引流行微创治疗.结果 ADL疗效评估Ⅰ级195例,Ⅱ级121例,Ⅲ级148例,Ⅳ级89例,Ⅴ级21例,死亡136例.结论 微创血肿清除术方法简单、安全、创伤小、时间短、适应证广、后期神经功能恢复明显好于传统开颅术,是治疗高血压脑出血的有效方法.     

34例高血压脑出血开颅与微创清除血肿分析

目的:探讨微创与开颅血肿清除术对高血压脑出血治疗的可行性和有效性,为临床提供适宜的治疗措施。方法:应用开颅血肿清除治疗高血压脑出血18例,应用微创血肿清除治疗高血压脑出血16例。结果:开颅血肿清除抢救成功12例,抢救成功率66.6%。微创血肿清除抢救成功8例,抢救成功率50%;其中出血8h内手术12例,抢救成功4例;4例在出血后3～5d手术均抢救成功。结论:高血压脑出血早期,血肿量大,中线移位明显,特别是伴有脑疝时,应开颅血肿清除。出血早期因微创术有引起再出血的危险,要慎用。出血3d后的患者,出血已停止,血肿已液化,适宜微创血肿清除。     

颅内血肿微创清除术治疗重症高血压脑出血102例临床分析

目的观察颅内血肿微创清除术治疗重症高血压脑出血的临床疗效。方法采用YL-1型一次性颅内血肿穿刺针进行穿刺引流清除血肿术治疗高血压性脑出血102例与内科保守治疗84例作对照。结果微创治疗组患者存活率与内科对照组比较差异有统计学意义(P<0.05),两组患者治疗4周后生存者GCS评分比较差异有统计学意义(P<0.01)。结论微创治疗颅内血肿是一种抢救重症高血压脑出血的有效治疗方法。     

颅内血肿微创清除术治疗高血压性脑出血25例分析

目的:颅内血肿微创清除术治疗高血压性脑出血25例分析。方法:2004年12月~2007年3月共用颅内血肿微创清除术治疗25例高血压脑出血患者,对治疗方法、治疗效果等给予综合阐述。结果:颅内血肿微创清除术治疗高血压脑出血死亡率低,致残率下降,恢复快。结论:颅内血肿微创清除术治疗高血压脑出血疗效明显。     

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.