带锁髓内钉治疗股骨干骨折的疗效观察

目的为了提高带锁髓内钉治疗下肢长管状骨骨折的效果。总结分析了 2 0 0 0年 - 2 0 0 2年 3月用现代带锁髓内钉治疗的 35例股骨干骨折。材料与方法男 2 9例 ,女 6例 ,平均年龄 35岁。新鲜骨折 2 8例 ,陈旧性骨折 7例。均采用扩髓静力型带锁髓内钉固定。结果经 6个月 - 2年零 3个月随访 ,34例骨折愈合 ,下肢功能和关节活动良好。 1例远端锁钉退出骨折未愈合 ,1例皮下脂肪液化两周愈合。结论带锁髓内钉是目前治疗股骨骨折的首选方法。对骨折愈合力差或粉碎性Ⅲ型、Ⅳ型骨折术后应延迟负重时间 ,否则会发生不良后果     

交锁髓内钉治疗下肢长管状骨骨折的效果

①目的 探讨交锁髓内钉治疗下肢长管状骨骨折的效果。②方法 应用交锁髓内钉治疗下肢长管状骨骨折56例，随访8～26个月，观察治疗结果。③结果 56例病人术后对位、对线均满意，股骨骨折平均愈合时间为19．9周，胫骨骨折平均愈合时间为17．7周，2例延迟愈合。无主钉或锁钉断裂．无肢体短缩、功能障碍发生。④结论 交锁髓内钉是治疗下肢长管状骨骨折的一种理想、可靠的内固定方法，其疗效满意，值得临床推广应用。     

闭合复位带锁髓内钉结合螺钉固定治疗胫骨粉碎骨折

目的探讨闭合复位带锁髓内钉结合加钉治疗胫骨粉碎性骨折的疗效。方法 2007年7月—2009年12月采用小切口复位带锁髓内钉结合螺钉治疗下肢长管状骨粉碎性骨折患者17例。结果 17例患者术后随访7~17个月,平均15.5个月。愈合时间4~9个月,平均6.5个月,骨折全部愈合,无畸形愈合及不愈合。结论闭合复位带锁髓内钉结合螺钉综合运用可以有效治疗胫骨粉碎性骨折,效果较好。     

静力型带锁髓内钉动力化固定临床应用的初步探讨

目的 初步探讨静力型带锁髓内钉及其动力化的临床应用。方法 作者总结了2000年6月～2003年6月期间采用静力型带锁髓内钉治疗下肢长管状骨骨干骨折的患者184例，其中随访资料较全者135例，改动力化固定47例，平均随访时间14个月(5～24个月)。结果 135例患者中88例均于16周内出现通过骨折线的环形骨痂早期愈合，47例患者于12～20周出现早期骨折延迟愈合征象时予以静力型带锁髓内钉动力化(去除一侧锁钉)，全部患者均在动力化固定后8～16周骨折愈合。结论 作者认为带锁髓内钉是治疗下肢长管状骨骨折的一种理想方法，其中部分静力型带锁髓内钉的固定在一定阶段的动力化对于减少骨折不愈合具有尤为重要的临床意义。     

带锁髓内钉治疗四肢长骨骨折9例报告

目的：探讨带锁髓内钉治疗四肢长骨骨折的效果。方法：引进带锁髓内钉治疗四肢长骨骨折,8人9例,随访2个月至21个月,平均1年零1个.结果：切口均Ⅰ期愈合,8例骨折愈合,1例仍在治疗中,1例已取出髓内钉,骨折愈合,关节活动正常。结论：带锁髓内钉固定四肢长骨干骨折,效果确切。     

交锁髓内钉在骨折不愈合或骨折畸形愈合中的应用

目的：探讨交锁髓内钉对骨折不愈合或畸形愈合切开复位内固定的治疗作用。方法：对9例下肢长管状骨骨折不愈合及延迟愈合患者均采用交锁髓内钉治疗,并术中同时植骨8例,所有病例术中行静力型交锁,其中8例术后6周解除下端交锁改为动力型交锁。结果：9例患者均达到骨性愈合,愈合时间（11～18）个月,平均13．7个月。结论：交锁髓内钉治疗下肢长管状骨骨折的不愈合及延迟愈合效果满意,治疗的关键在于适合的髓内钉、动力型锁定。     

带锁髓内钉治疗下肢长管状骨骨折56例疗效分析

为了评价带锁髓内钉治疗下肢长管状骨骨折疗效及并发症发生率,回顾分析带锁髓内钉治疗下肢长管状骨骨折56例患者的临床资料。结果,55例I期愈合,骨折不愈合1例,膝关节功能障碍2例。带锁髓内钉治疗下肢长管状骨骨折疗效较好,且适用范围广,固定可靠,创伤小,感染率低。     

带锁髓内钉治疗股骨、胫骨骨折42例临床分析

目的带锁髓内钉治疗股骨、胫骨骨折的临床应用及其疗效评价.方法1998年8月～2002年6月用交锁钉治疗股骨、胫骨骨折42例.其中,新鲜闭合性骨折24例,开放性骨折(Ⅰ,Ⅱ型)15例,陈旧性骨折3例.结果42例均得到随访,平均9个月(3.5～20.0个月),骨折愈合时间平均4个月,延迟愈合3例,骨折未愈合1例.结论带锁髓内钉内固定具有防旋转、弹性固定,软组织损伤轻、早期负重,骨折愈合率高.是治疗下肢长管状骨折的一种比较理想的方法.     

带锁髓内钉治疗下肢长骨骨折疗效分析

目的：探讨带锁髓内钉治疗下肢长管状骨骨折的疗效及并发症。方法：回顾性分析180例股骨、胫骨骨折应用带锁髓内钉治疗后效果评价及并发症的防治。结果：103例股骨骨折患者中97例愈合，愈合时间平均4.5个月；77例胫骨骨折患者中69例愈合，平均愈合时间6.1月。结论：带锁髓内钉是治疗长骨骨折的一种较好方法，有较高的成功率，并发症少，以及术后进行正确的康复训练对治疗效果有着关键性作用。     

带锁髓内钉治疗下肢长骨骨折

目的 观察带锁髓内钉治疗骨折的效果。方法 用带锁髓内钉治疗的50例52个下肢长骨骨折。结果 随防4-35个月，平均15个月。骨折全部愈合，平均愈合时间3.5个月。其中肢体延长1例；远端锁钉放置失败1例；膝外翻1例；膝外翻1例；继发性感染1例。结论 带锁髓内钉是治疗四肢长干骨骨折的一种很好的内固定器；可提供病人早期活动；骨折愈合率高。     

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.