经皮椎体成形术及血管内栓塞化疗治疗椎体转移性肿瘤

目的 观察经皮椎体成形(PVP)、PVP 和血管内栓塞化疗术综合治疗椎肿瘤的疗效.方法 16例患者(男性10例,女性6例)共22个椎体,均表现为胸腰部疼痛.9例患者共14个椎体单独行PVP治疗,7例8个椎体先后行PVP和(或)血管内栓塞化疗术.结果 16例患者经PVP和血管内栓塞化疗后症状完全缓解者11例(68.8%),部分缓解5例(31.2%),再经血管内栓塞化疗疼痛减轻,所有患者无严重并发症发生.结论 椎体恶性肿瘤经P V P和(或)血管内栓塞综合治疗可获得很好的近期疗效,明显提高患者的生存质量.     

经皮椎体成形术及血管内栓塞化疗治疗椎体转移性肿瘤

目的 观察经皮椎体成形(PVP)、PVP 和血管内栓塞化疗术综合治疗椎肿瘤的疗效.方法 16例患者(男性10例,女性6例)共22个椎体,均表现为胸腰部疼痛.9例患者共14个椎体单独行PVP治疗,7例8个椎体先后行PVP和(或)血管内栓塞化疗术.结果 16例患者经PVP和血管内栓塞化疗后症状完全缓解者11例(68.8%),部分缓解5例(31.2%),再经血管内栓塞化疗疼痛减轻,所有患者无严重并发症发生.结论 椎体恶性肿瘤经P V P和(或)血管内栓塞综合治疗可获得很好的近期疗效,明显提高患者的生存质量.     

经皮椎体成形术治疗症状性椎体血管瘤

[目的]探讨经皮椎体成形术（PVP）治疗症状性椎体血管瘤的临床效果。[方法]采用经皮椎体成形术（PVP）治疗症状性椎体血管瘤16例,共20个椎体,术后进行1年以上的临床和影像学随访。[结果]技术操作成功率为100％,无严重并发症发生。术后随访12～24个月,疼痛完全缓解14例,部分缓解2例。未出现新的椎体压缩性骨折,血管瘤无复发。[结论]PVP可以缓解症状性椎体血管瘤引起的疼痛,防止复发,增加椎体的稳定性,预防压缩性骨折,是治疗症状性椎体血管瘤的理想方法。     

脊椎骨转移瘤行经皮椎体成形术的护理

目的介绍脊椎骨转移瘤进行经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗的护理。方法总结自2001年9月起，对22例26个椎体的骨转移瘤患者行PVP的配合。结果术后l～3天，疼痛消失14例、明显减轻7例、部分减轻1例．有效率95．45％。随访3～12个月(平均5．8个月)。只有3例因其他椎体出现新的转移病灶再次出现不同程度的疼痛。术中术后均无严重并发症。结论脊椎骨转移瘤行PVP治疗并配合适当的护理是有效缓解疼痛的方法之一。     

经皮椎体成形术治疗椎体转移瘤疼痛效果的观察

目的 探讨经皮椎体成形术对缓解椎体转移瘤疼痛的价值.方法 采用经皮椎体成形术治疗胸腰椎椎体转移瘤47例,观察其止痛效果.结果 术后1周疼痛明显减轻,疼痛缓解率为97.9%.随访6个月,疼痛缓解的46例均无复发.随访1年,1例疼痛复发.结论 经皮椎体成形术可明显减轻椎体转移瘤引起的疼痛.     

经皮椎体成形术治疗脊椎溶骨性转移癌的临床应用

目的探讨经皮椎体成形术(PVP)在脊椎转移癌治疗中的临床应用。方法在DSA导引下,对15例脊椎转移癌患者的27个椎体,经皮椎弓根穿刺病变椎体并注入聚甲基丙烯酸甲酯(PMMA)。结果全部患者术后18~72h内疼痛均有不同程度缓解,活动状况改善,术中和术后均未出现严重并发症。术后随访3~16个月,平均6个月,12例疼痛缓解,其中9例疗效稳定。结论PVP治疗脊椎溶骨性转移癌能迅速缓解疼痛,增加脊柱稳定性和改善患者生活质量;而且具有安全、操作简易的优点。     

经皮椎体成形术在脊柱转移瘤中的应用

目的探讨经皮椎体成形术（PVP）治疗椎体转移瘤的临床效果。方法对23例椎体转移瘤患者共30个椎体在DSA监视下行椎体成形术,观察手术后临床效果及并发症发生情况。结果手术成功率100.0%。术后72h疼痛完全缓解率82.6%,部分缓解率17.4%,并发症发生率17.4%。结论 PVP能迅速缓解椎体转移瘤引起的疼痛,手术安全有效。     

一次性经皮穿刺椎体成形术治疗多椎体骨质疏松新鲜压缩骨折

目的探讨多椎体骨质疏松压缩骨折一次性经皮穿刺椎体成形术的操作方法、临床治疗效果和注意事项。方法在C型臂X线机监视引导下,对39例3个以上的骨质疏松性椎体新鲜压缩骨折的患者同时进行一次性经皮穿刺椎体成形术(PVP)。术后1 d、1周及1、3、6个月对疼痛缓解进行随访和评价。结果每次手术3~5个椎体,共进行129个椎体的成型术治疗。各椎体内骨水泥注射剂量2.0~4.0 mL,术中未发生明显并发症,术后疼痛明显缓解或消失者31例。视觉疼痛模拟评分法(VAS)术前评分为(8.92±1.24)分,术后(2.74±1.84)分。术前与术后比较,差异有统计学意义(P<0.01);术后各时间点VAS评分比较,差异无统计学意义(P>0.05)。结论一次性经皮穿刺椎体成形术是一种治疗多椎体骨质疏松新鲜压缩骨折疼痛快速、安全、有效的方法 。     

经皮椎体成形术(PVP)的临床应用

目的 探讨经皮椎体成形术(PVP)的治疗效果。方法 采用经皮椎体成形术(PVP)治疗骨质疏松引起的压缩骨折,椎体血管瘤及转移瘤32例。结果 全部获得随访,随访时间6-15个月,所有病例术后腰背部疼痛明显减轻或消失,X光照片复查术后椎体无进一步压缩。结论 经皮椎体成形术(PVP)是治疗骨质疏松性压缩骨折,椎体血管瘤及转移瘤的理想方法。     

经皮椎体成形术治疗椎体疾病

目的：探讨经皮椎体成形术（ PVP）治疗椎体骨质疏松性压缩骨折、血管瘤、溶骨性转移瘤的临床效果。方法在C臂X线机透视下,经单侧或双侧椎弓根入路PVP治疗46例75个椎体。结果术后1～3 d患者疼痛消失或明显缓解。随访6～15个月,疗效评价根据WHO标准：疼痛完全消失26例,疼痛明显减轻17例,无严重并发症发生。结论经皮椎体成形术治疗椎体骨质疏松性压缩骨折、血管瘤和溶骨性转移瘤是一种安全、微创、有效的方法。     

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.     

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.