无张力疝修补术与传统疝修补术临床疗效比较

目的探讨无张力疝修补术在腹股沟疝手术中的优势。方法 50例腹股沟疝患者采用无张力疝修补术（无张力手术组）,同期50例腹股沟疝患者采用传统疝修补术（传统手术组）。比较2组手术时间、术后疼痛、术后患处牵拉感、术后下地时间、住院时间及并发症和复发情况。结果无张力疝修补术组手术时间、住院时间均短于传统方法修补组（P〈0.05）,术后下地时间小于传统手术组,术后疼痛轻,牵拉感小,并发症和复发率均少于传统修补术组。随访8个月￣36个月无1例复发。结论无张力疝修补术是最符合生理的手术方法,具有无张力、疼痛轻、术后并发症少、复发率低等特点,是治疗腹股沟疝的理想术式。     

疝环充填式无张力疝修补术治疗老年人腹股沟疝

目的总结应用疝环充填式无张力疝修补术治疗老年腹股沟疝的临床经验.方法采用美国巴德公司的疝环充填物及成型补片,对52例老年腹股沟疝病人进行无张力修补治疗,观察手术时间、术后病人活动时间、伤口疼痛、住院时间、并发症、复发情况等.结果与传统的疝修补术相比,疝环充填式无张力疝修补术具有操作简便、损伤小,术后疼痛轻,恢复快,并发症少,复发率低的优点.结论疝环充填式无张力疝修补术是一项更符合人体生理解剖结构的治疗技术,是腹股沟疝较理想的术式,尤其适用于老年人腹股沟疝及复发性腹股沟疝.     

疝环充填式无张力疝修补术与传统疝修补术治疗腹股沟疝临床疗效比较

目的：比较疝环充填式无张力疝修补术及传统疝修补术治疗腹股沟疝的临床疗效。方法：选取2011年7月∽2013年6月大同大学附属医院收治的178例腹股沟疝患者,随机分为观察组与对照组,观察组采用疝环充填式无张力疝修补术治疗,对照组采用传统的疝修补术治疗。结果：观察组与对照组相比较,手术时间无明显差异（P〉0.05）,观察组术后疼痛时间、术后下地活动时间、术后并发症发生率、术后复发率均明显优于对照组,差异有统计学意义（P 〈0.05）。结论：疝环充填式无张力疝修补术治疗腹股沟疝具有损伤小、痛苦小、并发症少、复发率低,术后下地活动时间早等优势,有助于患者的康复,是治疗腹股沟疝的首选方法。     

疝环充填式无张力修补术治疗腹股沟疝的临床分析

目的:对疝环充填式无张力修补术治疗腹股沟疝的临床价值进行观察分析。方法:将我院近年来收治的76例腹股沟疝患者随机分为观察组与参考组,各为38例,观察组采用疝环充填式无张力修补术治疗,参考组采用传统疝修补术治疗,对两组患者手术时间、平均住院时间、术后疼痛及术后并发症发生情况进行观察比较,观察两组患者随访期内复发情况。结果:观察组患者手术时间及平均住院时间均明显短于参考组(P0.05);观察组术后疼痛率、术后并发症发生率及复发率均明显低于参考组(P0.05)。结论:疝环填充式无张力修补术治疗腹股沟疝具有操作方便、并发症发生率及复发率低等优势,可在临床推广使用。     

平片式和疝环充填式无张力疝修补术治疗腹股沟疝临床效果对比观察

目的对比观察平片式无张力疝修补术与疝环充填式无张力修补术治疗腹股沟疝的临床效果。方法将250例腹股沟疝患者随机分为2组,Ⅰ组125例采用平片式无张力修补术,Ⅱ组125例行疝环充填式无张力修补术。比较两组的手术时间、住院时间、术后疼痛持续时间、恢复工作时间、住院总费用、并发症发生率和复发率。结果两组患者手术时间、住院时间、术后疼痛持续时间差异无统计学意义(P0.05),而平片组的补片费用、住院总费用明显低于充填组(P0.01)。两组术后并发阴囊积液、切口感染、切口疼痛、尿潴留、局部血肿、缺血性睾丸炎及复发情况差异无统计学意义(P0.05),而平片组的异物感明显低于充填组(P0.05)。结论平片式无张力疝修补术和疝环充填式无张力修补术治疗腹股沟疝疗效肯定,但平片式无张力疝修补法费用低廉。     

无张力疝修补术与传统疝修补术的比较

目的 比较疝环充填式无张力腹股沟疝修补术和传统的腹股沟疝修补术。方法 疝环充填式无张力腹股沟疝修补术30例，Bassini腹股沟疝修补术29例。结果 术后伤口牵拉痛传统腹股沟疝修补组有16例；疝环充填式无张力疝修补组仅6例：传统腹股沟疝修补组2例复发，疝环充填无张力腹股沟疝修补组无复发。结论 疝环充填式无张力疝修补术具有符合生理、复发率低、术后疼痛轻、不易感染等优点，值得推广。     

无张力疝修补术治疗老年腹股沟疝的临床观察

目的：探讨疝环充填式无张力疝修补术治疗老年腹股沟疝效果。方法：70例老年腹股沟疝采用传统疝修补术，68例老年腹股沟疝采用疝环充填式无张力修补术。结果：138例手术均顺利，疝环充填式无张力修补术的病人的手术时间、住院日、术后并发症及术后复发均优于传统疝修补术的病人。结论：疝环充填式无张力修补术是一种符合生理解剖、操作快捷、创伤小、恢复快、复发率低的理想术式，适合老年和（或）伴有合并症患者。     

无张力疝修补术治疗老年腹股沟疝50例报告

目的总结老年腹股沟疝应用疝环充填式无张力疝修补术治疗的临床经验。方法对老年腹股沟疝采用无张力修补50例病例进行回顾性总结,对手术方法及时间、术后病人自主能力的恢复、术后伤口疼痛、并发症、住院时间和复发率等进行观察。结果和传统疝修补手术相比,具有方法简便、术后疼痛轻、恢复快、住院时间短、并发症少和复发率低的优点。结论疝环充填式无张力疝修补术是一种完全符合生理解剖的理想术式,尤其适合老年和(或)伴有其它疾病者。     

疝环充填式无张力疝修补术在老年腹股沟疝中的应用

目的:探讨老年腹股沟疝疝环充填式无张力修补术的应用价值。方法:同期40例老年腹股沟疝患者随机分为两组,对照组(n=20)采用传统修补术,研究组(n=20)采用疝环充填式无张力修补术,分析两组手术效果。结果:研究组术后疼痛程度、下床活动时间均明显少于对照组(P<0.05)。两组患者住院时间、并发症发生率差异无统计学意义(P>0.05)。结论:无张力疝修补术应用于老年腹股沟疝安全有效。     

疝环充填式无张力修补术治疗腹股沟疝的临床分析

目的：对疝环充填式无张力修补术治疗腹股沟疝的临床价值进行观察分析。方法：将我院近年来收治的76例腹股沟疝患者随机分为观察组与参考组,各为38例,观察组采用疝环充填式无张力修补术治疗,参考组采用传统疝修补术治疗,对两组患者手术时间、平均住院时间、术后疼痛及术后并发症发生情况进行观察比较,观察两组患者随访期内复发情况。结果：观察组患者手术时间及平均住院时间均明显短于参考组（P＜0．05）;观察组术后疼痛率、术后并发症发生率及复发率均明显低于参考组（P＜0．05）。结论：疝环填充式无张力修补术治疗腹股沟疝具有操作方便、并发症发生率及复发率低等优势,可在临床推广使用。     

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.