睾丸扭转的诊治（附46例报告）

目的：提高睾丸扭转的诊治水平。方法：对46例睾丸扭转患者的临床资料进行总结：46例平均年龄17岁，左侧31例占67．4％，发病至确诊时间3小时～11天。46例均有睾丸或下腹部绞痛症状，Prehn征阳性28例；彩色多普勒超声显示29例睾丸、附睾血流减少或消失。结果：8例12小时以内手法复位或手术者，睾丸均存活；6例12～24小时手术者，3例睾丸存活；31例超过24小时手术者，仅1例睾丸存活；2例未手术。结论：彩色多普勒超声有助于睾丸扭转的早期诊断，应作为诊断该疾病的首选检查方法。早期诊断、及时治疗是提高疗效的关键。     

睾丸扭转的诊断与治疗(附38例报告)

目的:提高对睾丸扭转的临床诊断和治疗水平。方法:回顾性分析38例睾丸扭转的临床资料,38例均有睾丸绞痛症状,Prehn征阳性25例。35例彩超显示睾丸内血流减少或消失。结果:5例发病后6h内就诊手术者,睾丸均存活;10例发病后6～12h手术者,4例睾丸存活;21例发病后12～24h手术者,仅4例睾丸存活。2例超过24h手术者无睾丸存活。结论:彩色多普勒超声是首选辅助检查方法。早期诊断、及时手术探查是提高睾丸存活率的关键。     

睾丸扭转的诊断和治疗

目的提高睾丸扭转的诊治水平。方法对32例睾丸扭转患者的临床资料进行总结。32例皆有睾丸绞痛症状，Prehn征阳性30例。28例行彩色多谱勒超声（CDU）检查，均显示睾丸附睾在阴囊内位置改变，睾丸血流减少或消失。结果8例6h以内手术者，7例睾丸存活；6例6—10h手术者，2例睾丸存活；3例10-24h内手术者，仅1例存活；15例超过24h手术者，无1例存活。结论CDU检查对睾丸扭转早期诊断很有帮助。早期诊断、及时治疗是提高疗效的关键。     

18例睾丸扭转的诊治体会

目的提高睾丸扭转的诊治水平。方法对18例睾丸扭转患者的临床资料进行回顾性分析。结果本组患者均行阴囊彩色多普勒血流动态显像(CDFI)检查,其中16例经临床诊断后手术证实,临床疑似者2例手术探查证实;发病12h内手术者3例,睾丸均存活;发病12~24h手术者3例,1例睾丸存活,2例睾丸失活;发病超过24h手术者睾丸均失活。对手术复位存活睾丸及健侧睾丸行固定术,对失活睾丸行切除术及健侧睾丸固定术。结论睾丸扭转的早诊断,早期手术治疗是挽救睾丸的关键。CDFI检查对睾丸扭转的诊断特异性和敏感性较高,应作为首选。CDFI检查疑似者亦建议早期手术探查。     

18例睾丸扭转的诊治体会

目的提高睾丸扭转的诊治水平。方法对18例睾丸扭转患者的临床资料进行同顾性分析。结果本组患者均行阴囊彩色多普勒血流动态显像（CDFI）检查,其中16例经临床诊断后手术证实,临床疑似者2例手术探查证实;发病12h内手术者3例,睾丸均存活;发病12～24h手术者3例,1例睾丸存活,2例睾丸失活;发病超过24h手术者睾丸均失活。对于术复位存活睾丸及健侧睾丸行固定术,对失活睾丸行切除术及健侧睾丸固定术。结论睾丸扭转的早诊断,早期手术治疗是挽救睾丸的关键。CDFI检查对睾丸扭转的诊断特异性和敏感性较高,应作为首选。CDFI检查疑似者亦建议早期手术探查。     

睾丸扭转诊治体会(附31例报告)

目的提高睾丸扭转的诊治水平。方法对31例睾丸扭转患者的临床资料进行总结,31例均有睾丸绞痛症状。Prehn征阳性20例。B超显示睾丸附睾在阴囊内位置改变,睾丸内血流减少或消失。结果左侧睾丸扭转25例,右侧6例;发病至就诊时间3h~4d;5例12h内手术者,睾丸均存活,5例12~24h手术者,3例睾丸存活;19例超过24h手术者;仅5例存活,2例未手术。结论B超对睾丸扭转早期诊断有帮助。早期诊断及时治疗是提高疗效的关键。     

睾丸扭转的诊断与治疗

目的探讨睾丸扭转的诊断、治疗方法。方法总结分析21例睾丸扭转的临床资料，21例均有睾丸绞痛。Prehn征阳性16例。提睾反射消失18例。B超、彩色多普勒血流显像(a]F1)及多普勒听诊器检查显示睾丸、附睾在阴囊内位置改变，睾丸血流消失或减少。结果手法复位3例。5例6小时内手术者。睾丸均存活。7例6—12小时手术者。睾丸存活3例。6例12—72小时手术者。睾丸存活1例。结论B超、CDFI及多普勒听诊器检查有助于睾丸扭转早期诊断。早期诊断、及时治疗是避免睾丸坏死的关键。     

儿童睾丸扭转16例诊治体会

目的提高睾丸扭转的诊治水平。方法通过对16例睾丸扭转的临床资料进行系统回顾性分析。结果10例12h以内手术者睾丸均存活,6例超过12h手术者,仅1例因睾丸不完全扭转(180°)存活。结论阴囊彩超对睾丸扭转早期诊断有帮助,睾丸扭转应早期诊断,及时手术治疗。治疗上要做预防性睾丸固定。     

睾丸扭转15例分析

目的探讨睾丸扭转的诊断和治疗方法。方法回顾性分析15例睾丸扭转患者的诊断和治疗经验。结果开放手术8例，手法复位7例。均为单侧发病。3例行睾丸切除，病理检查证实睾丸坏死。随访6个月～3年，无复发。结论睾丸扭转的诊断主要依靠临床症状，体征及彩超检查确定。手法复位宜早期施行，发病10h后如症状重，彩超提示无血流信号者则仍以手术治疗为宜。     

睾丸扭转21例误诊分析

目的探讨睾丸扭转误诊的原因与对策。方法总结分析21例睾丸扭转的临床资料。结果21例均有睾丸绞痛,提睾反射消失18例。B超检查显示睾丸、附睾在阴囊内位置改变,睾丸血流消失。手法复位1例,6h内手术者1例,睾丸存活;6-12h手术者7例,睾丸存活2例;12-48h手术者12例,睾丸存活1例。结论早期确诊是避免睾丸坏死,防止睾丸切除的关键。     

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.     

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.     

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.