经口径路鼻内镜下腺样体切除术治疗腺样体肥大的临床分析

目的 研究并分析经口径路鼻内镜下腺样体切除术对腺样体肥大的临床治疗效果.方法 选取腺样体肥大患者1 60例,随机分为2组,各80例.对照组患者运用传统的腺样体刮除术治疗,观察组患者运用经口径路鼻内镜下腺样体切除术治疗,对比2组患者的临床治疗总有效率与并发症发生率.结果 观察组患者的临床治疗总有效率为91.25％,并发症发生率为2.50％,明显优于对照组患者的76.25％和15.00％,差异具有统计学意义(P＜0.05).结论 对于腺样体肥大患者而言,经口径路鼻内镜下腺样体切除术的临床治疗效果明显优于传统的腺样体刮除术,且十分安全,值得推广.     

腺样体切除3种手术方式的比较

目的 比较传统的经口腔腺样体刮除术(TGA),经鼻内镜腺样体切除术(TEA)及内镜辅助经口腺样体切除术(ETA)的优缺点.方法 分析230例接受腺样体肥大手术患者的临床资料,比较3种术式的术后听力、夜间打鼾、鼻塞、鼻漏等症状恢复和腺样体残留等情况.结果 术后随访2～18个月,平均7.3个月.TCA术后鼻塞改善有效率显著低于ETA(P＜0.05).TCA术式中,有25例患者存在腺样体残留,其他两种术式无腺样体残留.结论 腺样体肥大的最佳手术方法 为ETA,伴有鼻腔,鼻窦疾病者可行TEA.     

腺样体切除3种手术方式的比较

目的 比较传统的经口腔腺样体刮除术(TGA),经鼻内镜腺样体切除术(TEA)及内镜辅助经口腺样体切除术(ETA)的优缺点.方法 分析230例接受腺样体肥大手术患者的临床资料,比较3种术式的术后听力、夜间打鼾、鼻塞、鼻漏等症状恢复和腺样体残留等情况.结果 术后随访2～18个月,平均7.3个月.TCA术后鼻塞改善有效率显著低于ETA(P＜0.05).TCA术式中,有25例患者存在腺样体残留,其他两种术式无腺样体残留.结论 腺样体肥大的最佳手术方法 为ETA,伴有鼻腔,鼻窦疾病者可行TEA.     

经口径路行鼻内镜下腺样体切除术78例疗效观察

目的：观察经口径路鼻内镜下腺样体切除术治疗腺样体肥大的临床效果。方法选择我院收治的156例腺样体肥大患儿为研究对象,采用随机、双盲法将156例患儿随机分为对照组和观察组各78例,对照组采用传统腺样体刮除术治疗,观察组采用经口径路行鼻内镜下腺样体切除术治疗。比较两组患者的治疗效果及随访过程中并发症发生情况。结果观察组治疗总有效率为98.7%,明显高于对照组的86.1%,差异有统计学意义(P<0.05);观察组的手术时间、术中出血量、术后疼痛评分、并发症发生率与对照组比较差异均有统计学意义(P<0.05)。结论经口径路行鼻内镜下腺样体切除术治疗腺样体肥大临床效果佳,不良反应少,值得临床推广应用。     

鼻内镜下经口腺样体切除术33例临床分析

目的:探讨鼻内镜下经口腺样体切除术的效果。方法:对33例腺样体肥大患者在鼻内镜辅助下经口电动切割吸引器切除肥大的腺样体。结果:随访6个月～1年,术后打鼾、鼻塞及鼻漏、听力下降的治疗有效率分别为90.9%、94.1%、77.8%。结论:鼻内镜下经口腺样体切除术视野清晰,切除范围准确,疗效满意且并发症少。     

鼻内镜下腺样体切除术治疗腺样体肥大的效果观察

目的探讨腺样体肥大应用鼻内镜下腺样体切除术治疗的临床效果.方法对自2010年1月~2011年12月所收治的腺样体肥大患者的临床资料进行回顾性分析,其中选择行鼻内镜下腺样体切除术患儿53例,设为观察组;行腺样体刮除术患儿53例,设为对照组,随访12个月,观察两组患者手术时间以及出血量情况.结果观察组较对照组出血量减少显著,手术时间较短,差异有统计学意义(P<0.05).结论对腺样体肥大患者行鼻内镜下腺样体切除术,效果较好,临床上优势明显,值得推广使用.     

口腔径路鼻内镜动力系统下小儿腺样体切除术54例疗效分析

目的:探讨口腔径路鼻内镜动力系统下小儿腺样体切除术的疗效和优点。方法:在鼻内镜动力系统下对3~15岁的腺样体肥大患者经口腔径路行腺样体切除术54例,治疗由腺样体肥大引起的睡眠呼吸障碍、慢性鼻窦炎、阻塞和咽鼓管功能障碍等,并进行随访。结果:术后腺样体切除彻底,无残体存留,鼻咽部结构显示良好,无出血、咽鼓管损伤等并发症,随访6个月~1年,术前与术后比较,鼻塞、脓涕、咳嗽、头痛、嗅觉减退、张口呼吸、打鼾等症状基本消失(P<0.01)。结论:经口腔径鼻内镜动力系统下腺样体肥大切除手术能在直视下进行,增加了手术的安全性和准确性,手术疗效显著,并发症少。     

鼻内镜下腺样体切除术对儿童分泌性中耳炎患者临床症状及听力的影响

目的分析鼻内镜下腺样体切除术治疗儿童分泌性中耳炎(SOM)的效果及对患儿临床症状与听力的影响。方法选取焦作市马村区人民医院收治的腺样体肥大的SOM患儿176例,根据治疗方式的不同将其分为研究组与对照组,各88例。研究组行鼻内镜下腺样体切除术治疗,对照组行传统腺样体切除术治疗。术后随访3个月,比较手术前后两组患儿临床症状及听力改善情况。结果术后研究组患儿鼻鼾、鼻窦炎、鼻端分泌物等临床症状发生率低于对照组,差异有统计学意义(P<0.05)。与术前相比,术后1周、3个月两组ABR阈值水平均降低,差异有统计学意义(P<0.05);术后3个月两组ABR阈值水平均低于术后1周,差异有统计学意义(P<0.05);术后1周及术后3个月研究组ABR阈值水平均低于对照组,差异有统计学意义(P<0.05)。结论鼻内镜下腺样体切除术治疗SOM,可有效缓解患儿临床症状,恢复患儿听力。     

鼻内镜下腺样体切除术与常规腺样体刮除术的疗效比较

目的 比较鼻内镜腺样体切除术与传统腺样体刮除术的治疗效果.方法 将68例腺样体肥大患者随机分为两组各34例,分别行鼻内镜腺样体切除术与传统腺样体刮除术.结果 鼻内镜组术后12个月、24个月的总有效率分别为94.1%（32/34）、91.2%（31/34）,均明显高于传统手术组的76.5%（26/34）、70.6%（24/34）（P＜0.05）;手术时间、术中出血量、住院时间均明显少于或短于传统手术组（P＜0.05）;术后并发症发生率、术后24个月复发率均明显低于传统手术组（P＜0.05）.结论 鼻内镜下腺样体切除术治疗腺样体肥大的远期疗效明显优于传统手术,且并发症少,有利于术后恢复,降低复发率.     

鼻口联合动力系统腺样体吸割术治疗腺样体肥大96例

目的:探讨鼻内窥镜下鼻口联合动力系统腺样体切除术在腺样体肥大治疗中的临床应用价值。方法:将192例腺样体肥大患者随机分为观察组和对照组各96例,观察组采用鼻内窥镜下鼻口联合动力系统腺样体切除术,对照组采用常规腺样体刮除术。结果:观察组总有效率93.75%,对照组总有效率81.25%(P<0.01),随访期间,观察组未见并发症发生病例,对照组有10例患者出现腺样体组织残留(P<0.01)。结论:鼻内窥镜下鼻口联合动力系统腺样体切除术避免了常规操作的盲目性,术野清晰、切除完全、减少了术后并发症的发生。     

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.