子宫下段环形捆扎术在剖宫产产后出血中的应用

目的:评价子宫下段环形捆扎术在剖宫产术中治疗难治性产后出血的有效性和安全性。方法:对18例剖宫产术中采用常规方法止血无效的产妇进行子宫下段环形捆扎术。结果:18例剖宫产术中出血患者采用子宫下段环形捆扎术全部止血成功,其中1例加用水囊宫腔压迫止血,无并发症发生全部保留子宫。结论:子宫下段环形捆扎术处理剖宫产术中难治性产后出血简单、有效、安全,值得推广。     

宫腔尿管联合子宫环形捆绑治疗剖宫产术中产后出血疗效观察

目的研究宫腔尿管联合子宫环形捆绑治疗剖宫产术中产后出血的临床疗效。方法抽取2014年1月至2016年4月漯河市第三人民医院收治的132例剖宫产术中产后出血产妇,随机分为两组,各66例。对照组行宫腔内填塞纱布联合子宫捆绑术治疗,观察组行宫腔尿管联合子宫环形捆绑术治疗。对两组产妇术中出血量、止血物放置时间、止血时间及术后止血物留置时间、术后24 h内出血量、再次出血率、住院时间进行统计分析。结果观察组术后均未发生再出血情况,对照组出现6例,再出血率为9.09%,观察组再出血率低于对照组(P<0.05);观察组术中止血及术后止血恢复情况均显著优于对照组(P<0.05)。结论宫腔尿管联合子宫环形捆绑治疗剖宫产术中产后出血效果显著,患者再次出血率低,值得推广运用。     

子宫捆扎治疗剖宫产术中大出血21例临床分析

目的:分析子宫捆扎在治疗剖宫产术中出血的应用价值。方法:回顾2年来在我院剖宫产术中,行子宫捆扎(21例)和宫腔纱条填塞(39例)的病例,分析比较24h内的出血量、产后出血发生率以及术后血浆中的P-选择素、D-二聚体。结果:与宫腔填塞组相比,子宫捆扎组24h内的出血量、P-选择素和D-二聚体显著减少,产后出血率降低(P<0.05)。结论:子宫捆扎是治疗剖宫产术中出血的重要措施之一。     

宫腔纱布填塞术在产后出血中的应用探讨

目的探讨官腔纱布填塞术在治疗产后出血中的临床治疗效果.方法对12例应用官腔纱布填塞术治疗产后出血的病例进行回顾性分析.结果12例产妇经过纱布填塞术后疗效明显,均保留子宫和生育功能,体温均在7天内恢复正常痊愈出院.无1例发生产褥期感染和晚期产后出血.9例为胎盘因素性产后出血.结论宫腔纱布填塞术治疗产后出血积极有效,并能保留生育功能,临床可推广应用.     

剖宫产术后晚期产后出血11例临床分析

目的:探讨剖宫产术后晚期产后出血的临床原因及治疗效果。方法:选取近年来治疗的晚期产后出血产妇11例为研究对象,作为观察组,选取同期阴道分娩晚期产后出血产妇15例作为对照组。对两组产妇出血量、休克发生情况进行对比,分析剖宫产术后晚期产后出血的临床原因及治疗效果。结果:观察组产妇出血量和休克发生率明显高于对照组,差异有统计学意义(P<0.05)。剖宫产术后晚期产后出血的临床原因主要有切口感染、子宫恢复不良、胎盘或蜕膜残留和子宫内膜炎等。经过积极治疗,全部患者均得到治愈。结论:剖宫产术后晚期产后出血危险性更大,应特别重视剖宫产术后晚期产后出血指征,及时进行预防和治疗。     

子宫压迫缝合术在治疗产后出血中的临床应用研究

目的 分析对产后出血产妇应用子宫压迫缝合术治疗的疗效.方法 选取60例产后出血产妇作为研究对象,分为A组与B组,各30例.给予B组常规药物治疗,对A组实行子宫压迫缝合术治疗,对比两组产妇的疗效及并发症的发生情况.结果 治疗后,A组产妇止血总有效率为93.33%,高于B组70.00%;并发症发生率为6.67%,低于B组的26.67%,差异具有统计学意义(P<0.05).结论 对产后出血产妇实行子宫压迫缝合术治疗,可有效改善产后出血情况,减少产妇并发症的发生,值得推广.     

子宫捆绑术治疗剖宫产宫缩乏力性产后出血40例疗效观察

目的:探究子宫捆绑术治疗剖宫产宫缩乏力性产后出血的治疗效果.方法:2012年12月-2014年12月我院收治的80例剖宫产宫缩乏力性产后出血产妇,随机分为观察组和对照组,每组40例.对照组产妇给予常规剖宫产术止血法,观察组产妇给予子宫捆绑术止血法.治疗结束后,比较两组患者的治疗效果和术后并发症情况.结果:观察组产妇的有效率为97.5％(39/40),明显高于对照组产妇(P＜0.05).观察组产妇血红蛋白、红细胞明显高于对照组,术中出血量明显低于对照组(P＜0.05);两组产妇住院时间比较,差异无统计学意义(P＞0.05).观察组产妇术后感染、术后腹痛、宫腔粘连等并发症的发生率为17.5％(7/40),明显低于对照组(P＜0.05).结论:采用子宫捆绑术治疗剖宫产宫缩乏力性产后出血可明显改善患者的各项临床指标和治疗效果,减少术后并发症,值得临床推广.     

探讨子宫压迫缝合术在产后出血治疗中的止血效果

目的:探讨子宫压迫缝合术在产后出血治疗中的止血效果。方法:选取产后出血产妇30例,进行随机分组,分为观察组和对照组两组,每组各15例。观察对比两组产妇产后出血的止血效果,包括止血成功情况、出血减少情况、止血无效情况,并且观察对比两组产妇的并发症发生情况。对照组产妇根据产后出血的发生原因给予对症治疗,观察组产妇给予子宫压迫缝合术进行治疗。结果:观察组产妇的止血效果显著优于对照组产妇,两组比较差异具有统计学意义(P<0.05)。结论:子宫压迫缝合术治疗产后出血止血效果良好,安全性较高,有降低子宫切除率的临床效果。     

宫颈捆扎联合X形子宫缝扎术治疗剖宫产产后出血的研究

目的：探讨剖宫产术中宫颈捆扎联合X形子宫缝扎术治疗剖宫产产后出血的效果。方法：将40例剖宫产术中发生产后出血的患者随机分为实验组（20例）和对照组（20例）。实验组行宫颈捆扎联合X形子宫缝扎术;对照组行＂8＂字缝合,结扎双侧子宫动脉,宫腔填塞纱条。结果：实验组在平均出血量、平均手术时间、子宫切除、产褥病率方面明显优于对照组,差异有高度统计学意义（P〈0.01）;两组无一例因血液循环不良或再出血而行二次手术或子宫切除。结论：宫颈捆扎联合X形子宫缝扎术具有操作简单、止血迅速、安全易行等优点,治疗剖宫产产后出血效果显著。     

宫腔纱条填塞在产后出血的应用

目的观察宫腔纱条填塞术治疗产后出血的疗效。方法11例产后大出血产妇行宫腔纱条填塞术。结果11例产妇经宫腔纱条填塞术后,宫腔出血迅速减少,生命征均平稳,无1例发生产褥感染及隐性宫腔出血,无1例切除子宫。结论宫腔纱条填塞术治疗产后出血效果良好,方法简单,止血速度快,值得临床推广应用。     

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.     

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.     

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.