挤压缝合法在剖宫产术中处理宫旁血肿的应用

目的:提高剖宫产术中处理并发症的水平,探讨剖宫产术中宫旁血肿缝合方法及临床价值。方法:回顾性分析:84例剖宫产术中宫旁血肿采用挤压缝合法的患者的临床资料与同期80例剖宫产术中宫旁血肿常规缝合方法的患者的临床资料进行比较。结果:两组在术后病率、排气时间、切口感染、盆腔B超包块有显著性P<0.05。结论:剖宫产术中宫旁血肿采用挤压缝合法具有术后恢复快、手术效果好的优点,为缝合宫旁血肿的首选方法。     

剖宫产术切口皮内缝合与切口间断缝合后脂肪液化率降低的关系探讨

目的探究剖宫产术切口皮内缝合与切口间断缝合后脂肪液化率降低的关系。方法选取2017年3月至2018年我院妇产科接收的44例产妇进行研究,均行剖宫产手术,根据剖宫产术切口缝合方法分成两组,22例产妇的皮下脂肪层行间断缝合法,皮肤行皮内缝合法(观察组),22例产妇的皮下脂肪层、皮肤均行间断缝合法(对照组),比较两种缝合法的效果及缝合后的脂肪液化率。结果观察组的脂肪液化发生率(4.55%)明显低于对照组(13.64%),P0.05;观察组的换药次数明显少于对照组,观察组的切口完全愈合时间及住院时间均明显短于对照组,P0.05。结论对剖宫产术切口皮下脂肪行间断缝合法,皮肤行皮内缝合法,可显著降低脂肪液化率,减少换药次数,缩短治愈时间,值得推广应用。     

不同缝合术在防治剖宫产术中出血的临床疗效对比

目的:将不同缝合术应用于剖宫产中,探讨其对术中出血的防治效果。方法:选取我院行剖宫产术的产妇92例,随机分为研究组和对照组,各46例。研究组采用单层连续缝合法缝合子宫切口,对照组则采用双层连续缝合法。比较2组产妇的手术相关指标及术前、术后24h血常规指标。结果:研究组术中出血量、缝合时间、术后24h出血量明显低于对照组(P<0.05),子宫切口愈合良好率、子宫复旧良好率明显高于对照组(P<0.05);2组产妇术后24h血红蛋白(Hb)、红细胞计数(RBC)、红细胞压积(HCT)均明显降低(P<0.05),但研究组各项指标下降幅度均明显低于对照组(P<0.05)。结论:相较于双层连续缝合法,单层连续缝合法应用于剖宫产术临床效果更为显著,能有效降低术中出血量,且术后子宫切口愈合及子宫复旧良好,值得临床推广应用。     

剖宫产腹部纵切口不同缝合方式的临床分析

目的：评价剖腹产腹部纵切口不同缝合方式的临床疗效。方法选取2013年1-12月该院剖宫产手术的产妇210例,随机选取120例进行改良式缝合法作为观察组,对照组90例,采取传统缝合法进行缝合,观察并比较两组患者术后切口愈合情况。结果观察组产妇切口甲级愈合115(95.8%)例,乙级愈合5(4.2%)例,对照组甲级愈合80(83.3%)例,乙级愈合10(16.7%)例,两组患者切口愈合情况比较差异有统计学意义(P<0.05)。结论改良式缝合法用于剖宫产腹部纵切口的临床效果好,能减少对于产妇切口的异物刺激,提高了腹部切口的甲级俞合率,值得在临床上予以推广。     

剖宫产腹部切口不同缝合方法的临床分析

目的：分析剖宫产腹部切口不同缝合方法的临床疗效。方法选取2014年12月—2015年12月在我院行剖宫产手术的产妇220例,观察组110例,采取可吸收肠线皮内缝合法进行缝合;对照组110例,采取丝线间断缝合法进行缝合。对2组手术切口缝合时间、切口愈合、住院时间等指标进行对比分析。结果观察组产妇切口平均缝合时间与对照组比较无明显差异（P>0.05）;观察组产妇术后切口甲级愈合率高于对照组,平均住院时间短于对照组,差异均有统计学意义（P<0.05）。结论产科手术采用可吸收缝线行皮内缝合,切口愈合良好,可缩短住院时间,具有较高的安全性和有效性。     

改良减张缝合法在腹部切口的临床应用及对比研究

目的：研究改良减张缝合法对腹部切口愈合的影响。方法归纳经腹正中切口及腹直肌切口并行减张缝合的病例87例,按缝合方式分成两组：改良组（44例）采用改良减张缝合法;对照组（43例）采用传统减张缝合法。对两组患者的切口甲级愈合例数、切口裂开数、使用强阿片镇痛例数进行观察并作分析。结果改良减张缝合法与传统减张缝合法相比,前者切口甲级愈合情况优于后者,差异有统计学意义（P＜0．05）,两者术后切口裂开情况相比差异无统计学意义（P＞0．05）,改良组术后切口疼痛减轻,强阿片类镇痛药物使用率较对照组低,差异有统计学意义（P＞0．05）。结论改良减张缝合法在切口愈合上明显优于传统减张缝合法,可在临床应用中广泛推广。     

剖宫产子宫切口单层缝合与双层缝合的对比分析

目的对比分析剖宫产子宫切口单层缝合与双层缝合的临床效果。方法选取我院2014年3月至2015年3月收治的158例剖宫产产妇进行研究,依据子宫切口缝合方法的不同,分为参照组和研究组,参照组采用单层连续缝合法,研究组采用双层连续缝合联合间断褥式包埋法,对两组产妇手术近期状况、再次妊娠情况及术后3～4年的随访情况进行观察和比较。结果两组产妇子宫血肿、产后出血、晚期产后出血、切口愈合不良发生率差异不明显(P0.05),研究组切口缝合时间明显比参照组长(P0.05);两组产妇术后3～4年随访,子宫瘢痕憩室、腹壁切口子宫内膜异位症及月经不调发生率差异不大(P0.05);再次妊娠后研究组临产前子宫瘢痕厚度明显比参照组厚(P0.05),两组再次剖宫产盆腔粘连比较差异不明显(P0.05)。结论双层缝合子宫切口瘢痕较厚,可为瘢痕子宫孕妇再次妊娠经阴道分娩打下基础,值得应用。     

横切口剖宫产脂肪层自然对合法45例分析

目的:探讨腹部横切口剖宫产脂肪层不缝合自然对合法的可操作性和优点。方法:随机选取45例采用横切口剖宫产脂肪层不缝合皮肤埋缝设为观察组,将40例采用传统缝合的剖宫产患者设为对照组。结果:观察组与对照组比较,手术时间和平均住院天数有明显缩短,观察组甲级愈合率明显高于对照组,且愈合后皮肤较对照组平整成一条线形状,皮下无硬结。结论:横切口剖宫产脂肪层自然对合法的临床效果满意,值得临床推广应用。     

剖宫产术两种缝合皮肤方法的临床对比研究

目的通过对剖宫产手术两种不同切口缝合法的效果观察,改进剖宫产手术切口的缝合方法.方法将我院2011年2月至2012年2月200例择期剖宫产患者随机分为两组,100例采用镍钛记忆合金组织吻合器缝合(治疗组),100例采用传统三角针丝线间断褥式缝合手术切口(对照组).两组比较拆线天数、切口缝合时间、伤口愈合情况、产后42天疤痕情况及病人满意度.结果切口缝合时间两组差异无统计学意义(P>0.05),而伤口愈合情况、产后42天疤痕情况及病人满意度有统计学意义.结论镍钛记忆合金组织吻合器缝合方法使患者住院时间缩短、切口愈合快且美观、病人满意度高,值得临床推广.     

两种剖宫产缝合方式的子宫切口瘢痕憩室发生情况分析

目的:分析两种剖宫产缝合方式后子宫切口瘢痕憩室的发生情况。方法:选取2015年1月至2016年1月在我院分娩的90例剖宫产产妇,随机分为两组各45例,对照组单层缝合剖宫产切口,观察组双层连续缝合切口,术后1年查看子宫切口愈合情况。结果:两组患者术后肛门排气时间、住院时间组间差异不显著(P0.05),观察组子宫切口瘢痕憩室6.7%明显低于对照组的17.8%,憩室肌层厚度明显高于对照组,憩室容积明显小于对照组(P0.05)。结论:在缝合剖宫产手术切口时,采取双层连续缝合的方式对切口愈合更加有利,且可降低瘢痕憩室发生风险,值得推广。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.