微创法单株自体毛囊移植胡须再造

目的探索应用微孔裂隙法单株毛囊移植进行胡须再植的临床效果.方法2001年5月～2003年6月30例患者应用1～1.5 mm双刃宝石微孔裂隙刀行自体单株毛囊移植治疗胡须稀疏.其中,幼年性器官因外伤受损所致第二性征胡须稀疏者3例,内分泌发育正常而先天性胡须稀疏要求改善者18例,唇部细小疤痕所致的胡须散在稀疏者9例.结果27例患者经过术后6～9个月的随访,单株毛囊微孔裂隙移植较单纯微小带发皮片移植具有术后恢复迅速,出血较少,外型逼真,移植体存活率高等特点.结论应用单株毛囊微孔裂隙法再造胡须毛发易存活,手术安全,毛发外观改善极为自然,且恢复迅速,但在疤痕区可能尚需二次种植.     

毛发游离移植治疗唇裂修复术后上唇瘢痕

目的：应用毛发游离移植胡须再造,治疗唇裂修复术后遗留的上唇瘢痕。方法：切取枕部头皮,分割成含单一毛囊的皮条,供区缝合,应用崔式植毛器移植到上唇瘢痕。结果：临床应用4例,单侧唇裂3例,双侧唇裂1例,移植毛发生长良好,效果满意。结论：毛发游移植治疗唇裂修复术后上唇瘢痕是一种切实可行的方法。     

应用打孔与植入同步的显微毛发单位移植技术行阴毛再造

目的评价应用针具打孔与植入同步的显微毛发单位移植技术行阴毛再造的临床治疗价值。方法在局部浸润麻醉下,从枕部切取长4-5cm、宽1．0～1．5cm的含有完整毛发的头皮组织,其供区伤口直接拉拢分层缝合之。然后,在立体显微镜下将其头皮组织进行分割,制备成一系列含有1～2根毛发的显微毛发移植单位。继之,应用针具打孔,并与其植入同步的技术方法,将备用的移植单位植入到预先设计好的阴毛分布区域。结果自2002年1月～2010年7月,应用这一毛发移植技术,笔者共完成31例成年女性先天性阴毛缺失的修复治疗。每例阴毛再造所需的显微毛发单位移植物一般为280—440个,平均302个;毛发根数为360～760根,平均为556根。一年以上的较远期随访发现移植的毛发生长自然、良好。在随机选择的10例患者中,计数测定其成活率为92．5％～97．2％,平均95．64％。全部患者为一期手术即达到治疗要求。术后非常满意者28例,占90.3％;满意者为3例,占9．7％。结论针具打孔与植入同步的显微毛发单位移植技术具有手术创伤小、出血少、安全、恢复快、效果显著等优点。并可以达到意向性分布的个性化治疗效果,是改善阴毛缺失外观、恢复阴毛生长的理想治疗手段。     

单根毛囊改良分离法在疤痕性秃发毛囊移植中的临床研究

目的采用改良的单根毛囊分离法得到单根完整毛囊,用于毛发移植治疗头部及眉部的疤痕性秃发,探讨该法应用于疤痕植发的技术要点和临床效果,为毛发移植治疗提供一定的临床数据。方法头部和眉部疤痕性秃发17例患者,使用改良法获得单根毛囊并植入疤痕秃发区域。统计供区所得完整单根毛囊数和受区毛囊成活数,并在术中取所得毛囊进行组织学检查。结果 17例患者随访3～12个月,生长外观自然,原有疤痕基本遮盖。供区毛囊提取率为54.87%～86.01%,受区毛囊成活率为70.27%～96.36%,组织学检查显示毛囊生发结构完整。结论改良分离法获取的单根完整毛囊具生长活性,植入后天获得性的疤痕秃发区域内后生长良好,可改善疤痕区外观。     

毛囊移植睫毛种植术的临床体会

目的 探讨自体单株毛囊游离移植进行睫毛种植的手术经验.方法 2005年1月～2006年8月,对23例睫毛稀少患者行单株毛囊游离移植进行睫毛种植手术.结果 随访3月～1.5年,效果满意,其中一次种植成功者18例,经补种成功者5例.种植存活后的睫毛浓密纤长,并会保持头发不断生长的特性,在新的移植区内继续生长,而且终生存在,须进行周期性地修整.结论 自体单株毛囊游离移植进行睫毛种植的手术可以应用于睫毛脱失或希望丰满睫毛者.     

毛囊移植睫毛种植术的临床体会

目的 探讨自体单株毛囊游离移植进行睫毛种植的手术经验.方法 2005年1月～2006年8月,对23例睫毛稀少患者行单株毛囊游离移植进行睫毛种植手术.结果 随访3月～1.5年,效果满意,其中一次种植成功者18例,经补种成功者5例.种植存活后的睫毛浓密纤长,并会保持头发不断生长的特性,在新的移植区内继续生长,而且终生存在,须进行周期性地修整.结论 自体单株毛囊游离移植进行睫毛种植的手术可以应用于睫毛脱失或希望丰满睫毛者.     

毛囊移植睫毛种植术的临床体会

目的 探讨自体单株毛囊游离移植进行睫毛种植的手术经验.方法 2005年1月～2006年8月,对23例睫毛稀少患者行单株毛囊游离移植进行睫毛种植手术.结果 随访3月～1.5年,效果满意,其中一次种植成功者18例,经补种成功者5例.种植存活后的睫毛浓密纤长,并会保持头发不断生长的特性,在新的移植区内继续生长,而且终生存在,须进行周期性地修整.结论 自体单株毛囊游离移植进行睫毛种植的手术可以应用于睫毛脱失或希望丰满睫毛者.     

游离自体毛发移植治疗瘢痕性秃发

目的 探讨使用微小头发移植体治疗各种因素引起的瘢痕性秃发的临床效果。方法 14例瘢痕性秃发患者进行自体微小头发移植术，其中13例进行1次移植，1例进行2次移植。结果 14例患者术后随访3～9个月，外观较术前明显改善，无并发症发生。结论应用微小头发移植体治疗瘢痕性秃发，术后移植头发存活率高，外观自然，但一次移植仍显稀疏．有时需二次移植。     

显微单株毛发游离移植修复中老年人眉毛稀疏或缺损

由于生理因素或外伤等原因导致中老年人眉毛稀疏或缺损的较多,随着人们生活水平的提高,要求改善眉毛形态的中老年人越来越多。传统的眉毛稀疏或缺损再造通常采用头皮条游离移植或采用颞浅动脉岛状皮瓣修复眉毛稀疏或缺损。但再造的眉毛均有明显缺憾,组织厚重,与原有眉毛生长方向存在较大差异。要么毛发存活率较低,外观稀疏;要么毛发生长过密,不能恢复眉毛的原有特性。2004年2月-2008年4月,我们应用显微单株毛发游离移植修复中老年人眉毛稀疏或缺损,取得了较好的效果,现报告如下。     

胡须联合头发移植在治疗重度雄激素性秃发中的应用

目的：针对V级以上,后枕部供区严重不足的雄激素性秃发（AGA）患者,探讨胡须联合头发移植治疗秃发的治疗效果。方法：选取2016年7月至2018年7月杭州市第一人民医院收治的18例V级以上的AGA患者,用毛囊单位提取技术（FUE）获取胡须和后枕部头发,联合移植于秃发区。结果：18例AGA患者随访12个月,胡须移植后成活率高达90%,生长良好,术后17例患者非常满意,秃发区大部分覆盖。结论：对于V级以上,供区严重不足的AGA患者,胡须联合头发移植获得满意的手术效果,胡须可作为补充供区的新选择。     

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.