面部软组织损伤的即时修复

面部是人体的重要部位，又是暴露部位，容易遭受外伤，该部位受伤后，患考虑术后创面能否Ⅰ期愈合的同时，更希望局部不留瘢痕和畸形，在门诊急诊经常会遇到此类患。我科于2005～2006两年时间收治的145例面部170处面部软组织损伤的患，通过即时整形修复，取得比较满意的效果，现总结如下。[第一段]     

急性面部软组织损伤的美容外科修复

目的探讨急性面部软组织损伤的美容外科修复。方法回顾性分析52例急性面部软组织损伤患者的临床资料。结果52例病例中,50例为一期愈合,1例因狗咬伤未曾缝合,后作二期修复,1例因颊部重度挫裂伤缝合后出现血肿而再次清创。结论急性面部软组织损伤予以美容外科修复,伤口愈合时间短,疤痕不明显,减轻了患者的心理负担。     

158例颜面部损伤即时整形修复效果分析

目的 探讨早期修复颜面部软组织损伤的有效方法,以求减轻伤后瘢痕和畸形的程度。方法 根据整形美容外科的原则,对158例不同程度颜面部软组织损伤的患者,利用不同的处理方法,在伤后24h内进行即时整形修复。其中包括细小针线分层缝合、“Z”字改型术、游离植皮、皮瓣转移和显微外科修复等方法。结果 158例患者术后伤口愈合良好,瘢痕较轻,无显著器官移位现象,随访3个月～2年外观恢复良好,均无严重瘢痕增生和畸形发生,患者满意。结论 根据整形美容外科的原则,对颜面部损伤进行即时整形修复,可明显减轻创伤性瘢痕和畸形的程度,使伤后外观恢复理想。     

面部软组织损伤的即时修复

面部是人体的重要部位,又是暴露部位,容易遭受外伤,该部位受伤后,患者考虑术后创面能否Ⅰ期愈合的同时,更希望局部不留瘢痕和畸形,在门诊急诊经常会遇到此类患者。我科于2005～2006两年时间收治的145例面部170处面部软组织损伤的患者,通过即时整形修复,取得比较满意的效果,现总结如下。     

面部软组织损伤的整形美容修复

目的探究面部软组织损伤的整形美容修复方法及其效果。方法针对40例面部软组织损伤患者进行病情分析,同时按照其损伤的实际情况对患者进行整形美容修复,总结其修复的效果;本次40例患者均为我院2014年4月到2016年6月间收治。结果 40例患者经过治疗均顺利恢复,对患者进行至少为期半年的随访,患者均未出现感染、血肿等并发症,其修复的成功率为100%。结论面部软组织损伤的整形美容修复分析发现,通过对患者损伤情况及时进行分析,合理安排其整形美容修复手术,能够使得患者得到良好恢复,同时具有较高的美学价值,因此值得临床借鉴。     

纯钛小夹板在颌面部骨折急诊中的临床应用

目的：提高急诊口腔面部骨折复位后固定的可靠性，修复和防止伤后畸形，即刻修复局部解剖结构，尽早恢复患者咬合功能。方法：利用医用纯钛小夹板即刻固定，治疗30例急诊口腔颔面部骨折患者。结果：患者局部和全身状况恢复良好。结论：在颔面急性骨折中使用该项技术，操作简便，创伤小，利于骨段间的快速愈合，是颔面部骨折急诊中的一种理想的固定技术．     

面部外伤的急诊整形外科治疗

目的探讨在急诊面部手术中应用整形外科处理方法和原则,修复患者面部软组织损伤,使患者面部的功能和形态得到恢复。方法根据患者的伤情采用适当的修复方法,应用彻底清创、真皮缝合、皮瓣法等技术修复伤口。结果 258例患者,创口愈合良好,无感染,血肿,瘢痕增生等严重并发症。结论在面部急性损伤的处理过程中,使用整形外科技术处理方法和原则是恢复患者面部功能及形态的重要手段。     

颜面部软组织损伤的急诊整形美容修复

目的：按整形美容外科技术和原则急诊修复颜面部软组织损伤。方法：对68例颜部外伤患者进行急诊整形美容修复。结果：所有手术均获成功，疗效满意，瘢痕细小，有的患者半年手术痕迹已不明显。结论：颜面部软组织损伤按美容外科技术及整形原则修复可减少后期畸形，减少瘢痕。     

邻近皮肤扩张修复面部瘢痕术

目的：面部瘢痕手术修复的最佳方法，方法：设计面部瘢痕面周围正常皮肤下植入扩张器，皮肤扩张后再切除瘢痕组织，用扩张皮瓣修复，结果：面部瘢痕被扩张后的皮瓣修复，供瓣区刀口直接缝合。结论：以扩张的皮瓣修复面部瘢痕具有供受区邻近，皮瓣转移方便，血运可靠，颜色质地面部正常皮肤且平整，以及刀口均无张力缝合，瘢痕细小等特点。     

美容整形技术在鼻外伤修复治疗中的应用分析

目的：探讨和分析鼻外伤修复治疗中应用美容整形技术的效果。方法：选取该院于2013年10月至2014年6月期间收治的35例鼻外伤患者，对全部患者应用美容整形修复技术，并及时采取有效的处理措施处理愈合过程中出现的各种问题以取得最理想的修复效果。结果：全部患者均取得了理想的修复效果，甲级愈合患者为33例，乙级愈合患者为2例，随访结果显示31例患者修复效果理想，没有出现畸形和明显的鼻部瘢痕；4例严重鼻外伤患者中，有2例发生鼻中隔偏曲的患者为2例，有2例出现鼻梁塌陷，对上述患者行二次手术治疗后，均取得了理想的修复效果。结论：将美容整形技术应用于鼻外伤患者的修复治疗中能够取得理想的修复效果，加快鼻部功能恢复并使患者面部形象获得改善。     

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.