椎间孔镜下髓核摘除术在腰椎间盘突出症治疗中的应用效果评价

目的:探讨在腰椎间盘突出症治疗中应用椎间孔镜下髓核摘除术的效果。方法:将2016年11月1日—2018年5月31日我院骨科收治的60例腰椎间盘突出症患者纳入研究,借助双盲随机抽样法分为对照组、研究组,每组30例,对照组给予后路椎板开窗髓核摘除术治疗,研究组实施经皮椎间孔镜下髓核摘除术治疗,对比两组患者的疗效、疼痛、腰椎功能障碍状况。结果:研究组相对于对照组患者恢复优良率明显提升(P<0.05)。术前,两组患者的VAS评分、ODI指数差异无统计学意义(P>0.05);研究组相对于对照组患者术后1周、1个月、3个月VAS评分、ODI指数明显降低(P<0.05)。结论:在腰椎间盘突出症治疗中应用椎间孔镜下髓核摘除术效果显著,可有效改善疼痛及功能障碍状况。     

中药联合手术对腰椎间盘突出患者炎症及退变的影响

目的探讨枳壳甘草汤联合经皮椎间孔镜髓核摘除术对腰椎间盘突出症患者炎症及退变的影响。方法选取2016年1月～2018年3月我院收治的腰椎间盘突出症患者60例,随机分为两组各30例,对照组应用经皮椎间孔镜髓核摘除术进行治疗,研究组应用枳壳甘草汤联合经皮椎间孔镜髓核摘除术治疗。对比两组患者的治疗效果、疼痛程度、VAS评分等。结果研究组治疗效果优于对照组(P0.05);研究组疼痛程度优于对照组(P0.05);研究组患者VAS评分低于对照组(P0.05)。结论在腰椎间盘突出症的治疗过程中,枳壳甘草汤联合经皮椎间孔镜髓核摘除术的治疗具有良好效果,临床中应加大应用。     

经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症35例效果观察

目的:分析经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症的临床疗效.方法:70例腰椎间盘突出症患者随机分为观察组和对照组,每组35例患者.对照组采用传统椎板开窗减压髓核摘除术治疗,观察组采用经皮椎间孔镜下髓核摘除术治疗,对比两组患者手术相关指标、疼痛(VAS评分)和腰椎功能恢复情况(ODI评分).结果:观察组患者术中出血量明显少于对照组,手术时间明显长于对照组,手术切口长度、住院时间、卧床时间明显短于对照组,VAS评分和ODI评分均明显低于对照组,组间比较差异具有统计学意义(P＜0.05).结论:采用经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症临床效果显著,可有效恢复患者的腰椎功能,减轻患者痛苦,对促进患者康复具有重要作用,值得在临床应用中推广.     

腰椎间盘突出症经皮椎间孔镜下髓核摘除术治疗的疗效研究

目的探究分析腰椎间盘突出症患者采用经皮椎间孔镜下髓核摘除术进行治疗的临床疗效。方法将我院于2016年3月至2018年9月接收的80例腰椎间盘突出症患者分成研究组和常规组各40例,前一组施予患者经皮椎间孔镜下髓核摘除术治疗,后一组施予患者小切口椎板间开窗髓核摘除术治疗,观察两组患的临床疗效。结果研究组和常规组患者的优良率差异无统计学意义P 0.05。研究组和常规组T1、T2、T3的JOA互比差异甚微,P 0.05,但T2、T3的JOA均高于T1,P0.05。研究组患者的围手术期指标中除手术用时与常规组对比差异不明显外,其余指标均优于常规组患者的,P0.05。结论经皮椎间孔镜下髓核摘除术与小切口开窗术在腰椎间盘突出症患者中疗效相当,但前者创伤更小,更利于患者预后。     

经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症

目的探讨经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症的疗效。方法选取了院2014年2月到2015年2月间收治的腰椎间盘突出症患者76例,随机抽取,每组38例;对照组采用小切口髓核切除术,观察组采用经皮椎间孔镜下髓核摘除术,比较两组治疗效果。结果经治疗,观察组显效20例,有效17例,无效1例,总有效率为97.4%,对照组显效14例,有效18例,无效6例,总有效率为84.2%;两组比较差异显著,具有统计学意义(P0.05)。结论在治疗腰椎间盘突出症方面,经皮椎间孔镜下髓核摘除术的治疗效果优于小切口髓核切除术,而且属于微创手术、患者康复较快。     

经皮椎间孔镜与椎板开窗术治疗腰椎间盘突出症的近期疗效

目的比较经皮椎间孔镜与椎板开窗术治疗腰椎间盘突出症的近期疗效。方法选取2015年1月至2017年1月我院收治的腰椎间盘突出症患者83例,其中行椎板开窗髓核摘除术治疗的患者35例,将其设定为对照组,行经皮椎间孔镜治疗的患者48例,将其设定为观察组。比较两组治疗效果。结果观察组的手术时间短于对照组,术中出血量少于对照组,差异具有统计学意义(P0.05);观察组的术后疼痛评分和Lehmann腰椎功能评分分别为,优于对照组的,差异具有统计学意义(P0.05)。结论临床上在对腰椎间盘突出症进行治疗时,相较于椎板开窗髓核摘除术,经皮椎间孔镜具有更好的临床效果。     

经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症的疗效

目的探讨经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症的临床疗效,并在此基础上总结相应的治疗经验。方法回顾分析本院2016年7月至2018年7月收治的经皮椎间孔镜下髓核摘除术治疗的68例腰椎间盘突出症患者,借助疼痛视觉模拟评分(VAS)和改良MacNab标准评估标准对经皮椎间孔镜下髓核摘除术的各项临床指标进行评价。结果治疗后,78例患者术后1 d、30 d、90 d的VAS评分均逐渐下降,且显著低于治疗前,有统计学意义(P0.05);治疗后1 d的优良率为70.59%,治疗后30 d的优良率为77.94%,治疗后90d的优良率为85.29%。结论在腰椎间盘突出症临床治疗中,经皮椎间孔镜下髓核摘除术效果极佳,有良好的临床应用价值。     

经皮椎间孔镜下髓核摘除术治疗高龄腰椎间盘突出症的护理措施

目的:探讨经皮椎间孔镜下髓核摘除术高龄患者围手术期的护理。方法:对37例老年LDH患者经皮椎间孔镜治疗,并给予精心围术期护理,比较治疗前后疼痛视觉模拟评分(VAS),观察临床效果。结果:本组患者治疗前后VAS评分比较差异有统计学意义(P0.01)。结论:根据合理规范的护理及功能锻炼,经皮全内窥镜下髓核摘除术治疗老年腰椎间盘突出症效果显著,其微创性更加适合老年腰椎间盘突出患者的临床特点。     

机器人辅助椎间孔镜治疗伴有严重脊柱畸形的腰椎间盘突出症临床疗效观察

目的探讨机器人辅助椎间孔镜治疗伴有严重脊柱畸形的腰椎间盘突出症的临床疗效。方法选取我院2016年12月～2017年4月住院接受治疗的诊断为伴有严重脊柱畸形的腰椎间盘突出症患者90例,随机分为A组(经皮椎间孔镜下腰椎间盘髓核摘除术)和B组(机器人辅助椎间孔镜下腰椎间盘髓核摘除术)。两组患者均进行VAS评分、JOA评分、手术时间、出血量、X线次数、术后并发症及住院时间等比较分析。结果两组患者手术前后VAS评分、JOA评分比较,差异均具有统计学意义(P0.05);两组手术时间、出血量、X线次数方面比较,差异均具有统计学意义(P0.05);两组患者术后并发症比较差异无统计学意义(P0.05);而住院时间比较差异有统计学意义(P0.05)。结论机器人辅助椎间孔镜下腰椎间盘髓核摘除术治疗腰椎间盘突出症安全有效,值得在临床应用和推广。     

椎间孔镜下行腰椎间盘突出髓核摘除术围术期护理体会

目的 总结经皮椎间孔镜下髓核摘除术患者的围术期护理经验.方法 对60例腰椎间盘突出症患者应用经皮椎间孔镜技术治疗,同时加强围术期护理,并总结体会.结果60例患者术后症状明显缓解或消除,未发生并发症.结论 加强经皮椎间孔镜下髓核摘除术患者的围术期全程有效护理,是手术成功的重要保障.     

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.