过期妊娠300例临床研究

目的分析过期妊娠对母儿的危害及适时终止妊娠的意义。方法对2004年1月～2006年12月在我院分娩的5268例产妇中诊断为过期妊娠的321例产妇,将其妊娠结局与同期按1：1比例随机抽取的足月单胎妊娠321例产妇的妊娠结局进行比较。结果过期妊娠组的剖宫产率、产后出血率和巨大儿的发生率与足月妊娠组相比差异极显著（P〈0.01）,且胎儿窘迫、新生儿窒息、围产儿死亡率也明显高于对照组（P〈0.05）。结论过期妊娠对母儿危害大,应对过期妊娠采取干预措施,适时终止妊娠,降低过期妊娠的死亡率。     

过期妊娠分娩时机和方式的选择对母婴的影响

目的: 探讨过期妊娠对母体及围生儿的影响及适时终止妊娠的意义。方法: 对4 383例分娩产妇作一回顾性分析。结果: 过期妊娠组手术产、产后出血、羊水过少、巨大胎儿、胎儿宫内窘迫、新生儿窒息、围生儿死亡率等均高于足月妊娠组(P<0.01~P=0.000)。结论: 过期妊娠对母婴的危害极大,应尽力避免过期妊娠的发生,适时终止妊娠,选择适当的分娩方式,改善母儿预后。     

过期妊娠137例临床分析

目的过期妊娠对母儿影响及其适时终止妊娠的意义。方法对137例过期妊娠与同期足月妊娠1823例进行分析对照。结果过期妊娠相对于足月妊娠组其胎儿宫内窘迫、剖宫产率、新生儿窒息率、巨大儿、胎儿生长受限,均高于足月妊娠组。结论过期妊娠对母儿均有不利影响,应提高孕产妇对过期妊娠的认识,加强产前宣教,适时终止妊娠,减少对母儿危害。     

过期妊娠128例临床分析

目的 探讨过期妊娠对母体及围生儿的影响及适时终止妊娠的意义。方法 对128例过期妊娠和同期分娩的116例足月妊娠的妊娠结局进行回顾性分析。结果 过期妊娠的手术产率、产后出血、胎儿窘迫、新生儿窒息、围生儿死亡、羊水过少的发生率均高于足月妊娠分娩者。结论 过期妊娠对母儿危害较大，应加强监护并适时终止妊娠，以减少围生儿并发症和死亡率。     

过期妊娠72例临床分析

目的 探讨过期妊娠的分娩方式、终止妊娠的时机和对围生儿的影响。方法 回顾性分析2000年1年至2006年12月住院分娩的72例过期妊娠的临床资料，并与同期足月妊娠产妇70例进行比较。结果 过期妊娠胎儿宫内窘迫、新生儿窒息率明显高于足月妊娠对照组。结论 对过期妊娠应予重视，适时终止妊娠可改善过期妊娠的不良结局。     

足月胎膜早破82例妊娠结局分析

目的探讨足月胎膜早破对妊娠结局的影响.方法分析足月分娩的妊娠胎膜早破产妇82例患者的临床资料(观察组),并与同期住院分娩的足月妊娠胎膜未破产妇82例(对照组)对比分析.结果观察组剖宫产率、新生儿窒息发生率均较对照组显著升高,两组差异有统计学意义(P<0.05).结论重视产前检查以及对足月胎膜早破后感染的防治,并适时以缩宫素引产或剖宫产结束妊娠,降低母儿并发症的危害.     

过期妊娠对母儿影响的临床分析

目的：探讨过期妊娠对母儿的影响。方法：分析1999年1月1日到2000年12月31日住院分娩的1267例产妇，其中足月妊娠1185例，过期54例，胎龄未满37周者28例，对比分析分娩方式、孕产期并发症及新生儿窒息率等情况。结果：过期妊娠组的手术产、孕产期并发症及新生儿窒息率均高于足月组，结论：在孕晚期加强产前监所，适时终止妊娠，以降低过期妊娠的发生率，从而降低手术产、新生儿窒息及围产儿病死率。     

过期妊娠75例的临床分析

目的探讨过期妊娠对母儿的不良影响及临床处理。方法回顾性分析75例过期妊娠者分娩方式及母婴结局。结果过期妊娠者手术产率、围产儿病死率均高于同期足月妊娠者。结论加强产前监测,适时终止妊娠,可降低过期妊娠的发生率。     

过期妊娠与足月妊娠结局的比较研究

目的：通过对足月妊娠及孕42周及以上妊娠结局的分析，探讨终止妊娠时机，过期妊娠对分娩方式及胎儿新生儿的影响。方法：回顾性研究，对2003年6B-2007年2月住院分娩的51例过期妊娠的临床资料进行分析，同期共有3895名住院分娩产妇，选其中60例同期足月妊娠产妇作对照比较（p〈0．05）。结果；过期妊娠组剖富产率，胎儿窘迫发生率，新生儿窒息率均明显高于对照组。结论：妊娠满41周以后胎儿有宫内缺氧的危险应适时终止，以改善过期妊娠的不庭结局。     

143例过期妊娠临床分析

目的:探讨过期妊娠对母婴的影响及终止妊娠的时机及意义。方法:将143例过期妊娠患者(过期妊娠组)与同期1327例足月妊娠产妇(足月妊娠组)临床资料进行对比、分析。结果:过期妊娠剖宫产组新生儿重度窒息、产后出血率明显高于阴道产组;过期妊娠组剖宫产率、新生儿重度窒息率、产后出血率明显高于足月妊娠组。结论:过期妊娠会对母婴造成极其不良的影响,加强孕期母婴监护,适时终止妊娠可降低胎儿官内窘迫、新生儿窒息的发生。     

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.