探讨3种栓塞剂联合行子宫动脉栓塞治疗子宫肌瘤的临床价值

目的评价3种栓塞剂联合应用栓塞子宫动脉治疗子宫肌瘤的临床价值，寻找理想的栓塞剂及使用方法。方法对46例有症状的子宫肌瘤患者，行双侧子宫动脉造影，根据血供情况经导管向双侧子宫动脉注入平阳霉素碘油乳剂、真丝线段及明胶海绵进行栓塞。结果子宫肌瘤血供丰富，多数由双侧动脉供血，栓基术后3．6个月B超检查肌瘤体积均明显缩小，月经周期恢复正常、月经量恢复正常或减少占96．7％，腹痛、贫血等症状明显改善，尿频、排尿障碍和便秘等压迫症状也有不同程度的缓解。结论3种栓塞剂联合应用栓塞子宫动脉治疗子宫肌瘤效果好且廉价、安全，值得推广。     

平阳霉素碘油乳剂加明胶海绵颗粒介入治疗子宫肌瘤的临床应用

目的：探讨平阳霉素碘油乳剂及明胶海绵颗粒联合应用栓塞子宫动脉（TUAE）治疗子宫肌瘤的疗效及安全性。方法：选择34例子宫肌瘤患者。以Seldinger技术完成单侧股动脉插管,根据数字减影血管造影（DSA）检查结果。插管至双侧子宫动脉并经DSA检查证实后,向子宫动脉注射平阳霉素碘油乳剂及明胶海绵颗粒以栓塞子宫动脉,随诊6～12个月,观察月经改变、肌瘤与子宫体积变化以及卵巢内分泌功能改变。结果：TUAE治疗6～12个月后,子宫肌瘤患者的临床症状明显缓解,月经量为原月经量的65．95％;第6、12个月肌瘤体积分别缩小66．87％、76．04％,子宫体积分别缩小45．14％、60．45％。术后有不同程度的下腹痛、低热,持续1～3周,经对症处理后症状逐渐消失。结论：TUAE可有效地缩小肌瘤及子宫的体积,并明显改善子宫肌瘤患者的临床症状。     

子宫动脉栓塞对卵巢功能的影响

目的探讨平阳霉素碘油乳剂及明胶海绵颗粒联合应用栓塞子宫动脉（UAE）治疗子宫肌瘤对卵巢功能的影响。方法选择64例子宫肌瘤患者行经导管子宫动脉注射碘油平阳霉素乳剂（LPE）加明胶海绵颗粒栓塞治疗，测定手术前后黄体生成素、促卵泡素、雌二醇等水平。结果治疗后3、6个月血促卵泡激素（FSH）、促黄体生成素（LH）、雌二醇值及FSH／LH比值与治疗前比较差异均无统计学意义（P〉0．05）。结论UAE治疗子宫肌瘤对卵巢功能影响轻微、短暂，不会引起闭经及卵巢功能早衰。     

子宫动脉栓塞治疗子宫肌瘤26例临床分析

目的 分析子宫动脉栓塞治疗症状性子宫肌瘤的效果及副反应。方法 对26例符合筛选条件的症状性子宫肌瘤患者在数字减影技术指导下，采用平阳霉素碘油乳剂及明胶海绵颗粒栓塞双侧子宫动脉，观察术后症状缓解情况、子宫及肌瘤缩小程度和副反应。结果 26例行栓塞治疗患者，除1例巨大肌瘤者碘油充填不满意，术后1周行子宫切除术外，25例临床症状均有不同程度改善。术后3个月和6个月子宫体积平均缩小45．0％和60．7％，肌瘤平均缩小65．6％和81．1％。主要副反应为下腹疼痛，一般较轻微。结论 子宫动脉栓塞治疗症状性子宫肌瘤，疗效显著且副作用轻。     

子宫动脉栓塞治疗子宫肌瘤的初步临床应用

目的：研究经导管子宫动脉栓塞治疗子宫肌瘤的疗效、副反应、并发症及其防治方法。方法：对9例症状性子宫肌瘤患者进行双侧子宫动脉插管，6例用平阳霉素碘油乳剂（Pingyangmycin lipiodol emulsion,PLE）加明胶海绵颗粒栓塞，另3例用聚乙烯醇颗粒（Polyvinyl alcohol particles,PVA）加少许真丝小线段栓塞。结果：随访12-16个月，瘤块缩小30％-74％。所有子宫出血病例月经恢复正常，贫血病例，血红蛋白升至正常。瘤块所致压迫症状消失。结论：对希望保留子宫，或不愿手术的子宫肌瘤患者，子宫动脉栓塞是一种有效的治疗方法，可替代手术治疗。     

子宫肌瘤栓塞治疗中卵巢支处理技术探讨

目的:探讨子宫肌瘤栓塞治疗中卵巢支处理技术。方法:对15例子宫动脉造影中双侧或单侧卵巢支显影和卵巢染色的子宫肌瘤患者行超选择性子宫动脉栓塞术(UAE)。结果:双侧子宫动脉碘油—平阳霉素乳剂栓塞12例;病灶优势侧子宫动脉碘油—平阳霉素乳剂栓塞,对侧明胶海绵栓塞3例;15例患者术前术后3个月女性激素无明显变化,均未出现闭经或提早停经。结论:UAE治疗子宫肌瘤,只要正确处理好卵巢支,不会损伤卵巢内分泌功能。     

超选择性子宫动脉栓塞治疗子宫肌瘤30例临床分析

目的:观察用聚乙烯醇(PVA)颗粒或碘油 平阳霉素 明胶海绵超选择性子宫动脉栓塞治疗子宫肌瘤的临床效果.方法:30例子宫肌瘤患者均采用经皮股动脉穿刺,双侧子宫动脉插管,其中超选至双侧子宫动脉28例,单侧2例,8例用聚乙烯醇(PVA)颗粒栓塞,22例用碘油 平阳霉素 明胶海绵栓塞.结果:所有病例随访4～16个月,8例用聚乙烯醇栓塞,6例临床症状消失,1例明显改善,1例粘膜下子宫肌瘤栓塞后脱落,后经宫腔镜取出;22例用碘油 平阳霉素 明胶海绵栓塞,其中18例临床症状消失,4例有所改善.B超示瘤体缩小40%～90%.无1例严重并发症发生.结论:超选择性子宫动脉栓塞治疗子宫肌瘤是1种创伤小、安全、有效的治疗方法.     

碘油平阳霉素乳剂栓塞治疗子宫肌瘤的疗效及影响因素

目的探讨经导管注入超液化碘油加平阳霉素混悬乳剂（LPE）行子宫动脉栓塞术（TUAE）对症状性子宫肌瘤治疗的临床疗效及影响因素。方法58例临床诊断症状性子宫肌瘤患者,采用seldinger技术穿刺右侧股动脉依次选择性插管双侧子宫动脉造影进一步证实,根据瘤体血供多少分配计量注入超液化碘油平阳霉素乳剂（LPE）,至子宫动脉血流停滞。术后定期随访复查,观察治疗效果收集相关影响因素进行分析。结果TUAE术后临床症状改善,尤其以月经量多、尿频、下腹坠胀改善明显。栓塞后6个月肌瘤体积平均缩小52%,9个月肌瘤体积平均缩小76%。结论采用超液化碘油加平阳霉素混悬乳剂经子宫动脉栓塞治疗症状性子宫肌瘤是一种安全、有效的方法。子宫肌瘤类型、供血血管解剖、内分泌、栓塞技术及栓塞剂的选择等因素影响子宫肌瘤栓塞后的疗效。     

子宫动脉栓塞治疗子宫肌瘤的临床疗效分析

目的 分析平阳霉素混合乳剂加明胶海绵在子宫动脉栓塞治疗症状性子宫肌瘤的疗效.方法 对50例符合筛选条件的症状性子宫肌瘤患者在数字减影技术指导下,采用平阳霉素及明胶海绵颗粒栓塞双侧子宫动脉,观察手术后症状缓解情况、子宫肌瘤缩小程度.结果 50例行栓塞治疗患者,除5例患者子宫肌瘤为多发,5个月后症状有明显缓解,其余45例临...     

经子宫动脉栓塞治疗子宫肌瘤疗效研究

目的：研究平阳霉素碘化油乳剂经子宫动脉栓塞治疗子宫肌瘤的疗效,安全性和不良反应。方法：对127例子宫肌瘤患者进行超选择性子宫动脉栓塞治疗,所用材料为平阳霉素碘化油乳剂及明胶海绵颗粒,术后随访3～15个月,观察术后子宫大小与肌瘤体积的变化及不良反应。结果：102例行双侧子宫动脉栓塞,25例完成单侧栓塞,术中造影显示子宫动脉明显增粗,肌瘤滋养血管呈螺旋状,肌瘤染色明显。排空延迟。4例术后1周行子宫切除术。手术标本病理观察,肌瘤呈点片状坏死,小出血点。随访3个月症状缓解率达92％。其中子宫出血症状完全消失者占90．5％。盆腔胀痛及腹胀等压迫症状消失约占93％。肌瘤体积平均缩小84％。子宫体积缩小49．5％。结论：早期结果表明,平阳霉素碘化油乳剂行子宫动脉栓塞治疗子宫肌瘤疗法安全有效,并发症发生率低,是子宫肌瘤的较好治疗方法。     

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.