胫骨远端骨折应用微创经皮锁定加压钢板与传统切开复位内固定术治疗的疗效对比分析

目的探讨胫骨远端骨折应用微创经皮锁定加压钢板与传统切开复位内固定术治疗的疗效。方法将2016年2月至2017年2月70例胫骨远端骨折患者作为研究对象随机原则分组,各纳入35例。切开复位组采用传统切开复位内固定术治疗,微创组应用微创经皮锁定加压钢板。比较两组胫骨远端骨折治疗优良率;手术过程出血量、手术操作时间、骨折平均愈合时间;干预前后患者踝关节功能评分。结果微创组胫骨远端骨折治疗优良率高于切开复位组,P0.05;微创组手术过程出血量、手术操作时间、骨折平均愈合时间低于切开复位组,P0.05;干预前两组踝关节功能评分相近,P0.05;干预后微创组踝关节功能评分优于切开复位组,P0.05。结论胫骨远端骨折应用微创经皮锁定加压钢板治疗的效果优于传统切开复位内固定术治疗效果,可减少出血,缩短操作时间和骨折愈合时间,改善踝关节功能。     

微创经皮钢板内固定治疗胫骨Pilon骨折

目的探讨微创经皮钢板内固定（MIPPO）治疗胫骨Pilon骨折的方法和疗效.方法49例胫骨Pilon骨折23例采用微创经皮钢板内固定,26例采用传统切开复位钢板内固定,进行对比研究.结果MIPPO治疗组的手术失血量和并发症较传统钢板内固定治疗组显著减少,骨折愈合更快,踝关节功能恢复更满意.结论微创经皮钢板内固定治疗胫骨Pilon骨折符合生物学内固定要求,降低软组织手术损伤,有利于骨折的愈合和踝关节功能的恢复,是治疗胫骨Pilon骨折的有效方法.     

微创经皮钢板内固定治疗胫骨骨折的临床观察

目的:观察微创经皮钢板内固定治疗胫骨骨折的临床效果。方法:以我院2006年6月-2012年6月间应用微创经皮钢板内固定的50例患者为微创组,以我院同期应用传统切开复位固定的例患者为传统组,评定两组疗效。结果:微创组患者平均愈合时间显著短于传统组,出血量显著少于传统组,功能恢复优良率显著高于传统组,并发症发生率发生率显著少于传统组,两组比较差异显著,(P0.05)。结论:微创经皮钢板内固定应用于胫骨骨折治疗中,疗效较好,安全可靠,值得临床进一步推广应用。     

外侧锁定钢板微创治疗胫骨远端骨折的临床观察

目的：对比分析外侧锁定钢板微创治疗与传统观切开复位钢板内固定治疗胫骨远端骨折的临床疗效。方法：选取2012-09～2013-06间我院收治的38例胫骨远端骨折患者作为研究对象,男26例,女12例,将其随机均分为实验组和对照组各19例,观察组采用外侧锁定钢板微创治疗,对照组采用传统观切开复位钢板内固定治疗,观察记录两组治疗后关节功能比较、手术出血量、骨折愈合时间等。结果：观察组关节功能优良率明显高于对照组,观察组术中出血量、骨折平均愈合时间、手术时间以及出院时间明显低于对照组,组间比较,差异具有统计学意义（ P＜0．05）。结论：外侧锁定钢板微创治疗与传统观切开复位钢板内固定治疗胫骨远端骨折相比,治疗后关节功能恢复良好,术中出血量少,骨折愈合时间短,值得临床进一步推广应用。     

微创经皮加压钢板内固定治疗胫骨干骨折

目的目的评价微创经皮加压钢板固定技术治疗胫骨干骨折的临床疗效。方法采用微创经皮加压钢板固定术式治疗胫骨干骨折32例。结果32例病人均获得随访，随访时间平均为14．6个月，骨痂形成时间平均8．3周，临床愈合时间平均14．3周。结论微创经皮加压钢板固定符合生物学治疗原则，避免了传统钢板内固定弊端，有利于骨折愈合。     

胫骨下段骨折微创与传统治疗方法比较

目的评价和比较微创经皮锁定钢板内固定与传统解剖钢板内固定技术在治疗胫骨下段骨折的临床疗效。方法将61例胫骨下段骨折患者分成两组,分别行微创经皮锁定钢板固定术和传统解剖钢板内固定术,并对两组患者的手术过程及结果进行比较。结果 61例病人获得随访,随访时间10～20个月,平均14.6个月。微创组术中出血少于传统固定组,骨痂形成时间平均8.3周,普通组平均10.2周,微创组骨折临床愈合时间平均15.2周,普通组平均19.8周。结论微创经皮锁定钢板内固定符合生物学及力学原则,创伤及并发症较少,有利于骨折愈合,是治疗胫骨下段骨折的有效方法,值得推广应用。     

微创经皮插入钢板治疗胫骨骨折

目的比较微创经皮钢板固定技术（MIPPO）与传统切开有限接触加压钢板（LC-DCP）固定治疗胫骨骨折的临床疗效。方法将71例胫骨骨折病人随机分为两组，MIPPO组37例采用微创经皮插入钢板治疗，LC-DCP组34例采用传统切开有限接触加压钢板固定治疗。按Johner-Wuhs方法评价两组临床疗效。结果MIPPO组骨痂形成时间平均6.4周，骨折临床愈合时间平均12.8周；LC-DCP组骨痂形成时间平均8.2周，骨折临床愈合时间平均17.2周，MIPPO组优良率81.1%，LC-DCT组优良率73.15%。结论微创经皮钢板固定符合生物接骨原理，有利于骨折愈合，治疗胫骨骨折避免了传统方法的弊端。     

MIPPO技术治疗胫骨远端骨折的疗效观察

目的探讨微创经皮钢板内固定术（MIPPO）治疗胫骨远端骨折的临床疗效,并总结治疗经验。方法46例胫骨远端骨折患者采用微创经皮钢板内固定技术治疗,观察手术时间、术中失血量、切口愈合、骨折愈合时间和完全负重时间,并按照Johner—Wruhs临床功能评分标准对患者最终功能进行评价。结果全部病例均获随访,切口均I期愈合;平均手术时间71min;平均术中失血量95mL;平均骨折愈合时间15．6周;平均完全负重时间16-3周;无延迟愈合、骨不连及钢板断裂、松动、再骨折发生。按照Johner—Wruhs临床功能评分标准,功能优35例,良9例,中2例。结论微创经皮钢板内固定治疗胫骨远端骨折创伤小,恢复快,并发症少,符合美学要求,是治疗胫骨远端骨折安全、有效的方法。     

微创内固定技术和切开复位钢板内固定治疗胫骨远端骨折疗效对比观察

目的：对比观察微创内固定技术和切开复位钢板内固定治疗胫骨远端骨折患者的临床疗效。方法：随机抽取2013年1月～2014年3月在我院行微创内固定技术的胫骨远端骨折患者33例作为微创组,抽取同期行切开复位钢板内固定的33例胫骨远端骨折作为切开组,对比观察两组临床疗效。结果：治疗后,微创组和切开组手术时间、住院时间及优良率比较无明显差异（P＞0．05）;但微创组术中出血量、骨折愈合时间,明显优于切开组,比较差异有统计学意义（P＜0．05）。结论：与切开复位钢板内固定治疗胫骨远端骨折相比,微创内固定技术的创伤更小,更有利于术后患者的康复,值得进一步推广应用。     

微创经皮钢板内固定技术结合中医药综合治疗胫骨远端骨折

目的观察应用微创经皮钢板内固定技术结合中医药治疗胫骨远端骨折的疗效。方法采用微创经皮钢板内固定技术结合中医药治疗胫骨远端骨折16例,对其进行分析评定。结果本组16例患者伤口均Ⅰ期愈合,无一例出现感染、内固定物松动断裂以及骨折延迟愈合等并发症。踝关节功能优12例,良4例。结论微创经皮钢板内固定结合中医药治疗胫骨远端骨折疗效可靠。     

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.