宫腔镜下子宫内膜切除术治疗绝经后子宫出血112例分析

目的 探讨宫腔镜下子宫内膜切除术对绝经后子宫出血的诊断和治疗价值.方法 对112例绝经后子宫出血患者进行宫腔镜检查,其中62例行宫腔镜下子宫内膜切除术治疗.结果 62例行宫腔镜下子宫内膜切除术治疗的患者均痊愈出院,绝经后子宫出血宫腔镜检查与病理诊断符合率81、2%.结论 宫腔镜下子宫内膜切除术对绝经后子宫出血的诊断和治疗具有实用价值.     

绝经后子宫出血宫腔镜诊疗价值

目的:探讨宫腔镜在绝经后子宫出血诊疗中的应用价值。方法:回顾分析136例绝经后子宫出血患者宫腔镜检查和诊断结果,并与病理诊断结果对照,对其中33例行宫腔镜治疗。结果:萎缩性子宫内膜占43.38%(59/136),子宫内膜、宫颈及阴道炎占19.85%(27/136),子宫内膜息肉及宫颈息肉占14.71%(20/136),子宫内膜增生症10.29%(14/136),子宫内膜癌占6.62%(9/136),黏膜下肌瘤占3.68%(5/136),宫内节育器1.47%(2/136);宫腔镜与病理诊断内膜息肉、宫颈息肉的符合率85.00%(17/20);诊断黏膜下肌瘤的符合率80.00%(4/5);诊断子宫内膜癌的符合率为66.67%(6/9)。结论:宫腔镜是诊治绝经后子宫出血的一种有效方法。     

宫腔镜联合B超检查对绝经后子宫出血的诊断价值

目的 探讨绝经后子宫出血的原因和评价宫腔镜对绝经后子宫出血的诊断价值.方法 采用宫腔镜联合B超检查与病理组织学检查相结合的方法,对130例绝经后子宫出血患者的出血原因进行回顾性分析,并比较临床诊断、B超诊断、宫腔镜联合B超诊断与病理诊断的符合率.结果 子宫内膜炎是引起绝经后子宫出血的主要原因,其次为子宫内膜息肉、子宫黏膜下肌瘤、子宫颈管息肉、子宫内膜癌.官腔镜联合B超检查与病理组织学检查的符合率为83.8%.结论 宫腔镜联合B超检查结合病理组织学检查对发现绝经后子宫出血的原因,尽早确诊子宫内膜癌,预防子宫内膜癌的发生具有积极的作用.     

宫腔镜在诊断绝经后子宫出血的价值

目的：分析宫腔镜诊断绝经后子宫出血的可行性与诊断价值。方法：收治绝经后子宫出血患者共109例进行宫腔镜检查,107例患者在宫腔镜指引下进行病理检查,对比诊断结果。结果：宫腔镜在诊断具有明显形态学病变,如萎缩性子宫内膜、内膜息肉、黏膜下肌瘤、子宫内膜Ca、宫腔积脓准确有效,诊断符合率达86.7%～100%。结论：宫腔镜诊断绝经后子宫出血具有极高的应用价值。     

阴道超声联合宫腔镜检查对诊断绝经后子宫出血的价值

目的探讨阴道超声联合宫腔镜检查对诊断绝经后子宫出血的价值。方法应用阴道超声联合宫腔镜检查绝经后子宫出血患者160例,行定位取材或诊断性刮宫,将刮出物送病理检查;单用阴道超声检查的绝经后子宫出血妇女160例,以全子宫切除术、诊断性刮宫术取得子宫内膜进行病理检查。评价2种方法的诊断符合率。结果阴道超声联合宫腔镜检查对绝经后子宫出血中各种疾病诊断与病理诊断结果的符合率:子宫内膜息肉76.67%(23/30),子宫内膜增生62.50%(5/8),子宫内膜萎缩87.64%(78/89),黏膜下子宫肌瘤75.00%(15/20),子宫内膜癌76.92%(10/13);而单项阴道超声检查对绝经后子宫出血中各种疾病诊断与病理诊断结果的符合率:子宫内膜息肉41.38%(12/29),子宫内膜增生42.86%(3/7),子宫内膜萎缩25.56%(23/90),黏膜下子宫肌瘤53.85%(7/13),子宫内膜癌42.85%(9/21)。2种方法诊断结果与病理诊断结果的符合率比较差异有统计学意义(P<0.05)。结论阴道超声联合宫腔镜检查是绝经后子宫出血病因诊断的最佳诊断方法。     

宫腔镜协助诊断绝经后子宫出血临床分析

目的评价宫腔镜对绝经后子宫出血原因的诊断价值。方法对我院2008年6月至2010年6月121例绝经后阴道出血患者进行宫腔镜检查并与病理结果对照。结果宫腔镜检查后经病理确诊引起已绝经后子宫出血的原因中子宫内膜良性病变占81.0%,子宫恶性肿瘤占9.9%,宫内节育环占5.0%。宫腔镜诊断与病理检查的符合率为84.0%。结论宫腔镜是诊断和治疗绝经后子宫出血的有效方法 。     

宫腔镜检查对绝经后子宫出血的诊断价值

为探讨绝经后子宫出血的原因和评从宫腔镜对绝经后子宫出血的诊断价值,作者采用宫腔镜与病理组织学检查相结合的方法,对２３４例绝经后子宫出血患者的出血原因进行了分析。结果显示：子宫内膜萎缩是引起绝经后子宫出血的主要原因,其次为子宫内膜增生、子宫内膜癌及癌前病变、子宫内膜息肉及子宫粘膜下肌瘤。本组病例宫腔镜诊断与病理组织学检查的符合率为７４．６１％,其中良性病变７６例,子宫内膜癌前病变２７例,其年龄及绝经     

宫腔镜检查对妇女绝经后子宫出血的诊断价值

目的评价宫腔镜应用于绝经后子宫出血的诊断价值。方法对行宫腔镜检查的198例绝经后子宫出血的患者资料回顾性分析,并与其病理检查诊断相比较。结果萎缩性子宫内膜66例,子宫内膜息肉30例,黏膜下子宫肌瘤15例,子宫内膜增生症33例,子宫内膜炎12例,可疑子宫内膜癌12例,环变形、断裂、嵌顿30例。宫腔镜检查与病理检查总的符合率为84.8%（168/198）。结论宫腔镜对妇女绝经后子宫出血的诊断具有实用价值,诊断阳性率高,临床漏诊率低,且操作简单,患者容易接受。     

探讨经阴道超声和宫腔镜对绝经后子宫出血的诊断价值

目的观察分析经阴道超声和宫腔镜对绝经后子宫出血的诊断价值。方法选取我院2013年6月至2015年10月收治的26例绝经后子宫出血患者为研究对象,所有患者均给予阴道超声和宫腔镜检查,将宫腔镜检查结果及经阴道超声检查结果与病理检查结果相比较。结果观察组中引起绝经后子宫出血各种疾病诊断的符合率为:子宫内膜萎缩61.5%(8/13),子宫内膜癌38.5%(5/13),子宫内膜增生46.2%(6/13),子宫内膜息肉38.5%(5/13);对照组中引起绝经后子宫出血各种疾病诊断的符合率为:子宫内膜萎缩15.4%(2/13),子宫内膜癌23.1%(3/13),子宫内膜增生30.5%(4/13),子宫内膜息肉15.4%(2/13)。两种方法诊断与病理诊断结果符合率相比,(P0.05)差异具有统计学意义。结论经阴道超声和宫腔镜在诊断绝经后子宫出血方面具有重要作用,经阴道超声联合宫腔镜定位活检能最大程度上提高诊断效果。     

宫腔镜检查对绝经后子宫出血的诊断价值

目的：探讨宫腔镜检查应用于绝经后子宫出血中的临床价值。方法：对我院收治的180例绝经后子宫出血的患者行宫腔镜检查及病理检查。结果：萎缩性子宫内膜45例,子宫内膜息肉45例,子宫内膜增生症33例,子宫内膜炎15例,黏膜下子宫肌瘤17例,子宫内膜癌11例,子宫平滑肌肉瘤1例,未取出宫内节育器13例。结论：宫腔镜对绝经后子宫出血的诊治无可替代,病理符合率高,值得推广。     

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.