痔疮吻合器（HCS33）治疗重度痔疮

目的;探讨吻合器痔疮环状切除术（PPH)临床应用价值。方法：总结了吻合器痔上粘膜环切术治疗15例Ⅲ-Ⅳ痔病的临床资料。结果;经肛门镜下采用33mm吻合器切除重度内痔患者15例,平均手术时间12min,术后平均住院2.3d,8例术后第1－7天有便血,经保守治疗好转。12例术后当天无肛门疼痛。随访1－7月效果良好,结论;PPH治疗重度痔疮是一种新技术,具有安全、有效、手术时间短,病人痛苦少,住院时间少,无复发,无肛门狭窄和恢复快等优点。     

吻合器痔上黏膜环切术（PPH）治疗痔疮的应用体会

目的探讨吻合器痔上黏膜环切术（PPH）治疗痔疮的效果。方法采用吻合器痔上黏膜环切术（PPH）对64例重度脱垂痔及以内痔为主的环状混合痔患者手术治疗并对结果进行分析,随访。结果手术时间8—22min,平均15min,住院时间3—5d,平均3．8d,经PPH治疗后,所有病人脱出痔核全部回缩,切除直肠黏膜完整者98％,术后90％病人不用止痛剂。术后随访3个月,有效率100％,满意率88％,基本满意率12％。结论吻合器痔上黏膜环切术（PPH）在环形脱垂内痔治疗中具有手术创伤小、手术时间短、病人疼痛轻、住院时间短等优点,是治疗重度脱垂痔及以内痔为主的环状混合痔的较好术式。     

吻合器痔上黏膜环切术在痔治疗中的合理应用

目的总结吻合器痔上黏膜环切术（PPH）在痔治疗中的应用经验,探讨合理应用PPH在痔治疗中的安全性和临床应用价值。方法本组Ⅲ度内痔20例,Ⅳ度内痔4例,环状混合痔30例。均用国产痔疮环状切除吻合器行PPH,对痔块脱出较严重者联合传统痔切除术。结果53例PPH吻合一次成功,1例PPH吻合失败改行手工吻合完成手术。单纯PPH10例,PPH联合传统痔切除术（MM）44例。手术时间平均55min,术中失血量平均95．6mL,平均住院6．9d。术中出血34例（63．0％）,术后出血1例。尿潴留42例（77．8％）,肛门疼痛44例（81．5％）,治疗后均好转。54例肛门痔块消失,痔症状能有效控制,随访3～6个月无严熏并发症。结论PPH在痔治疗中合理应用安全、可行,能更有效地控制痔的症状;国产PPH吻合器性能可靠。     

吻合器痔环切除术治疗痔病428例临床分析

目的探讨吻合器痔上黏膜环形切除钉合术（PPH）治疗痔病的临床效果。方法回顾性分析采用PPH治疗的428例痔病患者的临床资料。结果本组平均手术时间28min，平均住院5d。术后近期发生肛门疼痛276例，尿潴留262例，发热233例，肛门坠胀感206例，术后72h内大出血再次行手术止血15例，术后1周后大出血再次行手术止血3例。结论PPH治疗痔病安全有效，但术中注意操作规范，能减少并发症及提高满意度。     

吻合器痔上黏膜环切术治疗混合痔的临床应用

目的探讨吻合器痔环切术的临床使用价值。方法采用吻合器痔上黏膜环切术（PPH）对14例混合痔患者进行手术治疗。结果14例患者术后脱垂痔核完全回缩，术中平均出血量28ml（20～50ml），平均手术时间25min（15～45min）。术后3例出现大便带血，2例有可耐受的肛门疼痛，5例尿潴留。手术后平均治愈时间4．25d，平均住院时间5．23d。结论PPH具有操作简单、安全、有效，患者痛苦小，恢复快等优点，有望替代传统手术。     

PPH治疗重度痔病56例观察

目的：探讨吻合器痔上黏膜环切术（PPH）治疗Ⅲ、Ⅳ度痔病的疗效。方法：用PPH治疗Ⅲ、Ⅳ度痔病56例。结果：手术时间15～35分钟，平均20分钟，退出吻合器时吻合口有出血需缝合止血的有16例（28．5％）。术后出血2例。术后肛门疼痛18例（32．1％），术后1天患者均能下床活动。结论：PPH治疗重度痔病具有创伤小，手术简单，并发症少，住院时间短，恢复快等特点。     

吻合器痔上粘膜环切术的临床探讨

目的探讨吻合器痔上粘膜环切术（PPH）治疗Ⅱ、Ⅲ、Ⅳ期内痔和混合痔的临床疗效。方法回顾分析31例接受PPH治疗患者的临床资料。结果平均手术时间16min，平均住院时间4d，无严重并发症，很快恢复正常生活。结论与传统痔环切除相比，PPH手术操作简单、时间短、未破坏肛管正常结构、痛苦小、恢复快、近期效果好。     

吻合器痔上黏膜环切术治疗重度痔病的临床评价

目的探讨吻合器痔上黏膜环切术（PPH）治疗重度痔病的价值和手术技巧。方法用PPH方法治疗重度痔病患者120例，分析手术效果，总结手术经验。结果手术时间8～25min，平均13min，退出吻合器时吻合口有出血需用缝线结扎止血的有28例，占23．3％。术后感觉疼痛者有36例，占30％。术后2d病人均能下床活动，观察1～4d出院。术中吻合器退出后，大部分患者脱出的内痔、黏腱及皮赘立即回缩到肛管内，2～14d痔块基本完全萎缩。全组病人无1例发生大便失禁，肛门狭窄，感染或肛同脓肿形戍。随访1个月～2a无复发和其它不晟现象发生。结论PPH方法治疗重度痔病具有安全、有效、手术时间短、住院时间少、恢复快等优点。     

PPH手术治疗痔病的临床观察及探讨

目的：探讨吻合器上黏膜环切术（PPH）手术治疗痔病的疗效和价值。方法：采用美国强生公司的PPH01专用器械对32例痔病患者作吻合器痔上黏膜及黏膜下层环切术。结果：吻合均一次成功,平均手术时间25min,平均住院3．2d,无严重并发症,手术过程顺利,无术中大出血等手术意外情况。结论：PPH治疗症状性环状痔具有疗效显著、手术简单、术后痛苦少、术后并发症少、恢复正常生活早、住院时间短等特点。     

痔上黏膜环切“∞”字术治疗环状脱垂痔30例体会

目的：总结痔上黏膜环切术（PPH）治疗重度环状脱垂痔临床经验及疗效。方法：回顾分析30例经PPH治疗环状脱垂痔的临床资料。结果：手术时间15min～25min，术中搏动性出血9例，术后平均住院时间4d，术后尿潴留10例，肛门局部坠胀感8例，大便带血8例，肛门轻微疼痛12例，全部治愈。随访5个月～23个月，无再出血，较大内痔再次脱出2例，吻合口狭窄1例，肛门轻度失禁1例。结论：PPH治疗重度环状脱垂痔和痔引起出血效果明显，与传统手术方法相比，具有疼痛轻、时间短、恢复快、并发症少、复发率低等优点。远期效果有待于进一步观察。     

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.