压力性尿失禁患者会阴二维超声对盆底的动态检测分析

目的 分析压力性尿失禁患者经会阴二维超声对盆底的动态检测效果.方法 比较45例压力性尿失禁患者(观察组)与45例健康女性(对照组)经会阴二维超声检查膀胱颈口形态和移动度,并进一步比较观察组不同严重程度患者膀胱颈口形态和移动度.结果 2组研究对象静息状态下膀胱颈口均闭合良好;最大Valsalva状态下观察组膀胱颈口扩张率和膀胱颈口移动度均显著高于对照组,差异有统计学意义(P<0.05).压力性尿失禁Ⅰ度与Ⅱ度患者最大Valsalva状态下膀胱颈口扩张率对比,差异无统计学意义(P>0.05);但Ⅰ度患者膀胱颈口移动度显著低于Ⅱ度患者,差异有统计学意义(P<0.05).结论经会阴二维超声能够准确显示压力性尿失禁患者最大Valsalva状态下膀胱颈口扩张情况,并能够依据膀胱颈口移动度初步对患者病情严重程度进行判断,值得临床推荐.     

经会阴超声对老年女性的盆底形态学观察及盆底功能障碍性疾病的诊断分析

目的:经会阴超声对老年女性的盆底形态学观察及盆底功能障碍性疾病的诊断。方法:选取2010年8月-2014年3月在本院就诊的盆底功能障碍性疾病患者80例,分为尿失禁组48例和器官脱垂组32例,对照组选取具有相近年龄、产次和体重指数的女性40例,对比分析两组超声学检测结果。结果:Valsalva状态下,尿失禁组、器官脱垂组M均明显高于对照组,差异均有统计学意义(P0.05);缩肛状态下,器官脱垂组M明显高于对照组,差异有统计学意义(P0.05)。静息状态下,尿失禁组、器官脱垂组A均明显高于对照组,差异均有统计学意义(P0.05);Valsalva状态下,尿失禁组、器官脱垂组A均明显高于对照组,差异均有统计学意义(P0.05);缩肛状态下,器官脱垂组A明显高于对照组,差异有统计学意义(P0.05)。结论:经会阴超声对老年女性的盆底形态学观察及盆底功能障碍性疾病具有较高的临床价值,值得推广应用。     

盆底超声影像在妇女压力性尿失禁中的临床应用

目的 探讨妇女压力性尿失禁的盆底超声影像特征,为提高压力性尿失禁患者的临床疗效提供理 论依据。方法 选取2015 年3 月—2017 年3 月于深圳市第六人民医院门诊及住院治疗的压力性尿失禁妇女 98 例作为研究组,选取同期在该院健康体检的妇女98 例作为对照组,采集患者静息状态下以及Valsalva 状态 下的二维、三维的图像,将图像收集后采用多普勒超声原装软件进行分析。结果 研究组静息状态下尿道倾 斜度、膀胱尿道后角小于对照组（P <0.05）,研究组肛提肌裂孔面积大于对照组（P <0.05）。研究组Valsalva 状态下膀胱位置、膀胱颈位置低于对照组（P <0.05）,研究组尿道倾斜度、膀胱尿道后角和肛提肌裂孔面积 高于对照组（P <0.05）。研究组膀胱颈移动度、尿道旋转角大于对照组（P <0.05）。研究组尿道口漏斗形成 率高于对照组（P <0.05）。结论 盆底超声影像技术可以有效鉴别压力性尿失禁盆底形态的改变。压力性尿 失禁的发生与尿道、膀胱颈及肛提肌等支持结构的缺陷存在密切的联系。     

盆底四维超声对盆腔脏器脱垂患者术后下尿路结构的评估及尿失禁的预测价值

目的 探讨盆底四维超声检查对于盆腔脏器脱垂（Pelvic Organ Prolapse,POP）患者术后下尿路结构评估以及尿失禁情况的预测价值。方法 选择2019年1月至2021年8月于我院接受手术治疗的121例POP患者为研究对象。通过盆底四维超声检查患者手术前后的下尿路结构以及尿失禁情况。结果 患者术后静息状态和最大Valsalva动作状态（Max Valsalva Action,MVA）时的肛提肌-尿道间隙（Levator Urethra Gap,LUG）值、MVA时的膀胱颈移动度以及不同状态下的肛提肌裂孔面积均显著低于术前（P<0.05）,而不同状态下手术前后的尿道倾斜角（∠α）以及尿道膀胱后角均无显著差异（P>0.05）,缩肛状态下手术前后的LUG值无显著差异（P>0.05）。术后出现排尿困难者8例（6.61%）,出现新发压力性尿失禁者16例（13.22%）。术后有尿失禁患者的比例显著高于术前（P<0.05）。术后通过盆底四维超声检查,有尿失禁者65例（53.72%）,术后实际有尿失禁者68例（56.20%）,盆底四维超声的准确度为95.59%(65/...     

经会阴二维及三维超声对压力性尿失禁患者TVT-O手术前后盆底结构的观察

目的:探讨二维及三维超声对压力性尿失禁(SUI)患者TVT-O手术疗效评估的价值。方法:选择SUI患者40例,所有患者均行TVT-O手术治疗,分别于术前及术后行二维及三维盆底超声检查。结果:最大Valsalva动作后膀胱颈向后、下移动度距离ΔX、ΔY,术后较术前测值减小(P<0.05);最大Valsalva动作后尿道旋转度Δβ术后较术前减小(P<0.05);最大Valsalva动作后尿道长度L2术后较术前长(P<0.05);静息状态下尿道长度L1,静息状态膀胱颈距X轴及Y轴的距离X、Y,静息状态下尿道倾斜角β及膀胱尿道后角α,最大Valsalva状态下盆膈裂孔面积及耻骨直肠肌厚度等术后较术前均无统计学差异。经会阴三维声像图上SUI术后吊带表现为低回声尿道下方的"V"字形高回声结构,清晰可辨。结论:经会阴二维及三维超声能够为TVT-O术前及术后盆底结构提供有意义的测量参数,能够清晰显示术后吊带的位置与形态,为术后疗效评估提供可靠的影像学支持。     

经会阴二维超声对女性压力性尿失禁诊断价值

目的:探讨经会阴二维超声对女性压力性尿失禁(S U I)的诊断价值.方法:选取87例患有SUI的术前患者及72例同年龄组无SUI的女性作为对照组,应用经会阴二维超声技术,在静息状态下测量膀胱逼尿肌厚度,在Valsalva动作下测量膀胱颈的移动距离、近端尿道旋转角、膀胱尿道后角及观察尿道内口漏斗是否形成.结果:对照组与SUI组间静息下膀胱逼尿肌厚度比较差异无统计学意义(P>0.05),Valsalva动作下SUI组膀胱颈的移动距离,近端尿道旋转角、膀胱尿道后角及尿道内口漏斗形成率明显高于对照组(P<0.05).结论:经会阴二维超声技术可对女性SUI的诊断进行评估.     

应用盆底超声评价全子宫切除术后盆底功能障碍的临床研究

目的探究采用盆底超声评价全子宫切除术后盆底功能障碍的临床疗效。方法选择2013年8月‐2015年8月于该院行全子宫切除术后80例术后盆底功能障碍患者,其中,45例压力性尿失禁(SUI组),35例盆腔器官脱垂(POP组),另选32例全子宫切除术后非盆底功能障碍患者为对照组,3组均经盆底超声检查,观察在缩肛、静息及Valsalva状态下形态改变,并测量参数。结果在缩肛状态下,POP组肛提肌裂孔前后径(M)为(5.87±0.64)cm,肛提肌裂孔面积(A)为(18.06±3.06)cm2,均显著优于对照组,差异有统计学意义(P0.05);在静息状态下,SUI组M、肛提肌裂孔横径(N)、A、肛提肌左右支夹角(γ)分别为(6.15±0.76)cm、(5.03±0.88)cm、(16.31±5.68)cm2、(69.93±7.72)°,POP组M、N、A、γ分别为(6.05±0.79)cm、(4.99±0.79)cm、(16.41±5.71)cm2、(68.92±8.59)°,均显著优于对照组,差异有统计学意义(P0.05);在Valsalva状态下,SUI组M为(6.12±0.53)cm,POP组M、A、γ分别为(6.37±0.63)cm、(23.29±6.02)cm2、(78.01±9.85)°,均显著优于对照组,差异有统计学意义(P0.05)。结论应用盆底超声检查全子宫切除术后盆底功能障碍性疾病,可清晰显示盆底解剖结构,以利于疾病预防治疗。     

MRI与盆底超声用于诊断产后早期压力性尿失禁临床价值比较

目的 比较核磁共振成像(MRI)与盆底超声用于诊断产后早期压力性尿失禁(SUI)的临床价值。方法 回顾性分析2017年4月至2020年1月本院收治的产后早期SUI患者68例,均进行MRI与盆底超声检查。分别在MRI图像和盆底超声图像测量静息状态和Valsalva用力屏气状态下肛提肌裂隙面积(LHA)、膀胱尿道后角(RVA)、尿道倾斜角(UIA)。Valsalva用力屏气状态下测量膀胱颈移动度(BND)、尿道旋转角(URA),观察尿道内口有无漏斗形成。结果 所有SUI患者均可以获得清晰的MRI和盆底超声图像,观察到完整的盆腔结构;静息状态和Valsalva用力屏气状态下,MRI检测SUI患者的RVA、UIA和LHA均明显高于盆底超声检测(P<0.05);Valsalva用力屏气状态下,MRI检测SUI患者的URA和BND均明显高于盆底超声检测(P<0.05);MRI组检测尿道内口漏斗形成率为60.29%,明显低于盆底超声检测的77.94%(χ²=4.960,P=0.026)。结论 MRI对产后早期SUI患者的盆腔结构改变更敏感,而盆底超声可以提高SUI患...     

经会阴盆底超声在二维状态下对压力性尿失禁的应用价值研究

目的研究经会阴盆底超声在二维状态下对压力性尿失禁的应用价值。方法选取2017年6月～2018年6月年在牡丹江医学院附属红旗医院因压力性尿失禁就诊的患者40例作为研究对象,选取同期在我院因其他疾病就诊的女性患者30例作为对照组,在二维经会阴盆底超声情况下观察逼尿肌厚度、膀胱颈位置、尿道倾斜角、膀胱后角、膀胱颈下降距离、尿道旋转角、尿道内口有无开放。结果实验组患者在静息状态下及Valsalva最大化状态下、膀胱后角、膀胱颈下降距离及尿道旋转角较对照组患者明显增加(P0.05);逼尿肌厚度、膀胱颈位置及尿道倾斜角,实验组患者与对照组患者比较,差异无统计学意义(P0.05)。结论经会阴盆底超声对评价压力性尿失禁具有一定的临床应用价值。     

四维超声在剖宫产术后盆底功能障碍性疾病评估中的应用

目的:探究四维(4D)超声在剖宫产术后盆底功能障碍性疾病(FPFD)评估中的应用效果.方法:选取100例剖宫产术后FPFD患者作为研究组,100名盆底功能检查正常的产后女性作为对照组.两组均行4D彩色多普勒超声诊断,分析两组静息及Valsalva动作下膀胱尿道后角及肛提肌超声参数,分析两组膀胱颈移动度及尿道旋转角.结果:静息状态下,研究组肛提肌裂孔面积(LHA)、肛提肌厚度(LAT)高于对照组(P<0.05),但两组膀胱尿道后角与肛提肌夹角比较,差异无统计学意义(P>0.05);Valsalva动作下研究组膀胱尿道后角、LAT、肛提肌夹角、LHA均与对照组存在统计学差异(P<0.001);研究组膀胱颈移动度、尿道旋转度均高于对照组(P<0.001).结论:4D超声在剖宫产术后FPFD评估中的作用显著,能较准确诊断肛提肌超声参数等,明确静息与Valsalva动作盆底指标间的差异性.     

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.