微型外固定架结合有限内固定治疗38例46处开放性粉碎性掌指骨骨折分析

目的 探讨应用微型外固定架结合有限内固定治疗开放性粉碎性掌指骨骨折方法及疗效.方法 自2002年以来对38例46处手开放性粉碎性掌指骨骨折应用微型外固定架治疗.结果 术后随访6个月至2年,无骨不连及骨髓炎并发症,临床愈合时间平均6周,手功能恢复按TAM标准评价优良率达78.9%.结论 微型外固定架结合有限内固定治疗手部开放性粉碎性掌指骨骨折创伤小,固定可靠,愈合率高,利于早期功能锻炼,有良好的治疗效果.     

微型外固定架治疗掌指骨骨折

目的探讨应用微型外固定架治疗手掌指骨骨折的方法及疗效。方法对38例46处手掌指骨骨折应用微型外固定架治疗。结果术后随访6个月～2年,骨折均达到或近似达到解剖复位,临床愈合时间平均6w,手功能恢复按TAM标准评价优良率达93.75%。结论微型外固定架治疗手部掌指骨骨折创伤小,固定可靠,愈合率高,利于早期功能锻炼,有良好的治疗效果。     

微型外固定架治疗掌指骨骨折

目的探讨应用微型外固定架治疗手掌指骨骨折的方法及疗效。方法对38例46处手掌指骨骨折应用微型外固定架治疗。结果术后随访6个月～2年，骨折均达到或近似达到解剖复位，临床愈合时间平均6w，手功能恢复按TAM标准评价优良率达93．75％。结论微型外固定架治疗手部掌指骨骨折创伤小，固定可靠，愈合率高，利于早期功能锻炼，有良好的治疗效果。     

微型外固定架治疗掌指骨粉碎性骨折

目的探讨微型外固定架治疗掌指骨粉碎性骨折的疗效。方法 2010年2月~2014年6月采用微型外固定架治疗掌指骨粉碎性骨折24例。结果 24例均获随访,随访时间6月~1年,平均7月。X线片示10例术后8周骨折愈合,14例术后12周愈合。术后6月按手部关节总活动度功能评分,24例骨折愈合者中,优6例,良9例,可5例,差4例,优良率62.5%。结论应用微型外固定架治疗掌指骨粉碎性骨折固定可靠,损伤小,有利于手部早期功能锻炼,是治疗掌指骨粉碎性骨折的有效方法。     

微型外固定架治疗掌指骨开放性粉碎骨折

目的探讨微型外固定架治疗掌指骨开放性粉碎骨折临床疗效。方法随机抽取该院2012年期间收治的24例掌指骨开放性粉碎骨折患者的临床资料进行回顾性分析,采用微型外固定架治疗方法给予治疗,并对其治疗效果进行评价。结果该组患者均随访8~24个月,其中,有1例患者发生切口感染,其余所有患者骨性愈合,以TAM为标准进行评价,功能恢复优18例,良好5例,差1例。结论采用微型外固定架治疗掌指骨开放性粉碎骨折,操作简单,固定可靠,术后早期患者可以进行功能锻炼,疗效确切,是目前临床上一种较为理想的治疗掌指骨开放性粉碎骨折方法,值得临床推广与应用。     

应用微型外固定架治疗掌指骨骨折的临床分析

目的：探讨微型外固定架治疗掌、指骨骨折的治疗效果。方法：我科2003年6月～2008年9月采用微型外固定架治疗掌、指骨骨折23例。结果：临床应用23例均得到随访,随访时间3～12个月,平均10个月。骨折愈合时间6-8周,按TAM标准评分,优19例,良3例,可1例,优良率为95．6％。结论：微型外固定架治疗掌、指骨骨折,操作简单。能早期进行功能锻炼,避免了关节僵硬,骨质疏松等并发症的发生。     

微型外固定支架治疗掌、指骨骨折

目的探讨微型外固定支架用于治疗掌、指骨骨折的临床疗效。方法总结该院2004年4月至2007年4月用微型外固定支架治疗42例掌、指骨骨折病例,分析治疗效果。结果42例患者骨折全部愈合,大部分患者于术后4~6周拆除外固定支架。结论应用微型外固定支架治疗掌、指骨骨折具有使用方便、固定可靠、可进行早期功能锻炼、疗效满意等优点。     

微型钢板治疗掌指骨骨折

目的 评价采用微型钢板内固定治疗掌指骨骨折30例的效果.方法 对30例38处掌指骨骨折的病例应用微型钢板内固定治疗.结果 术后随访7～10个月,平均8.8个月,骨折愈合时间平均8.5周,功能评价采用TMA系统,优良率 84.1%.结论 微型钢板治疗掌指骨骨折疗效显著.     

应用微型钢板螺钉治疗掌指骨骨折

目的 评价微型钢板螺钉在治疗掌指骨骨折中的疗效.方法 采用开放复位、微型钢板螺钉内固定治疗掌指骨骨折共76例102指,术后1周内疼痛减轻即开始功能锻炼.结果 术后平均随访4.6个月,骨折临床愈合时间平均6.5周.无骨折移位、不愈合、内固定松动和伤口感染发生.按照TAM系统评定法进行关节功能评价,优良率为85.3%.结论 微型钢板螺钉治疗掌指骨骨折,固定可靠有效,并发症少,可早期活动关节,是一种有效的内固定方法.     

微型外固定架结合有限切开复位骨胶固定治疗手部关节内固定骨折

目的：探讨微型外固定架结合有限切开复位骨胶固定治疗手部关节骨折的方法及疗效。方法：2007年5月～2009年5月应用微型外固定架结合有限切开复位骨胶固定治疗手部关节内骨折25例,男20例,女5例,年龄17～50岁,平均年龄25．5岁。涉及近侧指间关节6例,拇指指间关节4例,掌指关节6例,拇指掌指关节5例,所有病例临床用微型外固定架同时用内固定主要为骨胶,同时有克氏针细钢丝,及可吸收线、指骨螺钉等。结果：全部病例随访、8～28个月,平均11．5个月,术后均愈合。愈合时间5～12周,平均7周随诊时X线示指骨短缩旋转畸形2例关节间隙狭窄3例,所有关节无不稳定发生。术后患指运动功能优9例,良12例,可3例,差2例,优良率80％。结论：微型外固定架结合有限切开复位骨胶固定治疗手部关节内固定骨折方法可靠,有效。指骨短缩或外旋畸形,关节间隙狭窄为主要并发症。①手部关节内骨折的治疗是手外科临床难题之一,骨折块常为粉碎性,同时合并关节脱位及关节周围稳定结构损伤。骨折稳定性较差。②传统的治疗方法也无法保证关节早期活动易引起关节囊侧副韧带挛缩或肌腱粘连。③本文讨论用微型外固定架结合有限切开复位骨胶固定治疗手部关节内固定骨折既能有效维持骨折复位,又能在一定程度上尽早开始关节早期功能训练。     

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.