286例下颌骨骨折的临床分析

目的分析下颌骨骨折的临床特点及治疗方法。方法对286例患者的年龄、性别、职业、就诊时间、受伤原因、骨折部位、合并伤及治疗方法进行临床分析。结果下颌骨骨折男性明显多于女性，25～35岁为高发年龄段，大部分患者能够及时就诊，骨折部位以颏部最多，面中部骨折为最多见合并伤，本组病例手术者均采用开放复位，钛板钛钉坚固内固定，近远期疗效良好。结论下颌骨骨折好发于青壮年男性，交通事故是首发病因，颏部高发，面中部骨折是最多见合并伤，坚固内固定是目前最好的治疗方法。     

微型钛板坚固内固定治疗下颌骨骨折30例

目的:总结微型钛板坚固内固定技术在下颌骨骨折治疗中的应用效果。方法:下颌骨骨折30例均采用手法复位,微型钛板内固定技术治疗,部分病例辅以颌间结扎牵引。结果:30例均获满意的治疗效果,咬合关系恢复良好。术后复查X线片对位好。结论:微型钛板坚固内固定治疗下颌骨骨折是一种有效合理的方法。     

坚强内固定术治疗下颌骨骨折36例

0　引言　下颌骨骨折是口腔颌面部创伤中较为多见的一种疾病 ,治疗时既要尽量恢复其解剖外形 ,还要恢复其运动功能 .我们自 1 999年以来利用坚强内固定技术 (rigidintenalfx ationRIF)治疗 36例下颌骨骨折 ,取得了良好效果 .1　对象和方法1 .1　对象　本组 36 (男 2 2 ,女 1 4 )例 ,均经临床及X线片确诊为下颌骨骨折 ,其中闭合性骨折 1 2例 ,占 33% ;开放性骨折2 4例 ,占 6 7% ,所选择病例骨折部位均为下颌骨 ,其中颏部 1 2例、体部 1 1例、下颌角区 9例、髁突区 4例 .1 .2　方法　①术前根据X线片及临床检查选择合适的微型钛板、钛钉 ;②…     

颌骨骨折190例临床分析

本文分析190例颌骨骨折,其中下颌骨骨折最多;骨折部位以下颌骨颏孔部及体部多见,男多于女;致伤原因多为交通事故和工伤。治疗:成人用小环颌间结扎和单颌夹板固定;儿童颌骨骨折多用头颏绷带固定;髁状突骨折也用颌间结扎方法。对于骨折线上的牙齿除为开放性而有污染的给予拔除,其它的尽量保留以利骨折固定。     

56例颌骨骨折坚固内固定术临床体会

目的探讨应用微型钛板在坚固内固定治疗颌骨骨折中的临床体会。方法2000～2004年收治56例口腔颌面部骨折。下颌骨骨折36例，2处以上7例，占64.2％；上下颌骨骨折12例，其中伴有颧弓骨折3例，占21．4％；单纯颧弓骨折18例。采用微型钛板固定8例，占14．2％.结果56例患者除1例延期愈合，均Ⅰ期愈合。术后3个月全景X线、CT片检查，无愈合不良及功能障碍。结论微型钛板坚固内固定治疗颌骨骨折，具有良好效果，改善面部畸型、恢复正常咬合关系。     

下颌骨骨折347例临床分析

目的：分析下颌骨骨折的临床特点及治疗方法。方法：对我院2000~2009年收治的下颌骨骨折患者347例,就其年龄、性别、受伤原因、骨折部位、合并损伤及治疗方法进行临床分析。结果：下颌骨骨折男性明显多于女性,21~40岁为高发年龄,骨折部位以颏部最多,面中部为最多见的合并伤,其次是颅脑、四肢等,治疗方法以坚强内固定为主。结论：下颌骨骨折好发于男性青壮年,交通事故是主要致伤原因,坚强内固定是目前最好的治疗方法。     

口内进路小型钛板内固定治疗下颌骨体部骨折的临床分析

目的：观察经口内途径应用小型钛板治疗下颌骨体部骨折的临床效果.方法：经口内前庭沟切口入路暴露下颌骨折部位,恢复咬he关系后,先行颌间结扎,后用小型钛板做单层骨皮质内固定.术毕解除颌间结扎,保留下颌单颌结扎.结果：所有病例均创口Ⅰ期愈合.术后1,3,6个月X线复查,骨愈合良好,咬he关系稳定,无并发症.结论：经口内切口应用小型钛板治疗下颌骨体部骨折,术后不用颌间结扎,疗效可靠.     

下颌骨骨折的临床研究

目的:探讨下颌骨骨折发生的特点。方法:对289例下颌骨骨折患者的性别、年龄、致伤原因、骨折部位及治疗方法进行分析。结果:男性多于女性,20岁~39岁为高发年龄,交通事故为主要原因;多发骨折多余单发骨折,好发部位为下颌体、颏部和髁状突。骨折移位者占76%;31%的伤员有颅面、颅脑和四肢合并伤;主要采用颌间牵引复位恢复咬合关系。结论:男性及青壮年为骨折高发人群,下颌体、颏部和髁状突为好发部位;交通事故是下颌骨骨折的主要致伤因素;治疗以颌间牵引复位为主,对严重移位及多发骨折需行手术切开复位。     

下颌骨骨折病例回顾性分析研究

目的：研究下颌骨骨折的发生特点。方法：对我院自1986年至2000年间收治的206例下颌骨骨折住院患者的性别、年龄、致伤原因，骨折部位、骨折合并伤及治疗方法进行分析。结果：下颌骨骨折男性明显多于女性，20－39岁为高发年龄；交通事故为主要致伤原因；骨折部位以颏部最多；34．95％的伤员有面中部骨折、颅脑和四肢等处的合并伤；非手术治疗的颌间牵引复位固定为本组病例的主要治疗手段。近年来，坚固内固定在下颌骨骨折治疗中的应用取得了形态和功能均较满意的效果。结论：男性及20－39岁青壮年为下颌骨骨折高发人群。90年代以来，下颌骨骨折患者明显增多。交通事故是主要致伤原因。坚固内固定是目前治疗下颌骨骨折的较好办法。     

微型钛板坚强内固定治疗下颌骨骨折48例效果观察

目的 探讨微型钛板坚强内固定治疗下颌骨骨折的临床疗效.方法 对收治的48例下颌骨骨折患者行微型钛板坚强内固定治疗,术后恢复一定时间行X线片检查、颌骨咬合关系及张口度检查,观察其疗效.结果 48例患者手术伤口均一期愈合,术后1周X线片示骨折对位良好.3～4周张口度≥30mm者42例,4例联合骨折在附以颌间结扎牵引固定2周后去除结扎并行张口训练3～4周,其张口度≥30 mm.47例咬合关系恢复良好,1例出现轻度咬合错乱,经颌间牵引3周后恢复正常,术后3个月、6个月、1年骨折愈合良好.结论 微型钛板坚强内固定术操作简单,复位牢固,骨折愈合快,对患者创伤小,治疗效果理想,值得在临床广泛推广.     

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.