锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位

目的探讨AO锁骨钩钢板（CHP）治疗TossyⅢ型肩锁关节脱位和NeerⅡ型锁骨远端骨折的疗效。方法1999—2002年运用锁骨钩钢板治疗TossyⅢ型肩锁关节脱位和NeerⅡ型锁骨远端骨折22例，所有病例均直接修复断裂的肩锁韧带。结果22例患者均获随访，随访6—24个月、平均12个月。术后2周肩关节活动基本恢复正常，平均屈曲90°，外展90°，取出CHP时间为6～12个月，平均8个月，按Karlsson疗效评定标准，肩关节功能优良率100％。结论锁骨钩钢板是治疗TossyⅢ型肩锁关节脱位和NeerⅡ型锁骨远端骨折的一种良好的方法。     

锁骨钩钢板治疗肩锁关节脱位及锁骨远端骨折

目的：探索锁骨钩钢板治疗肩锁关节脱位及锁骨远端骨折的疗效。方法：2000—2004年应用锁骨钩钢板治疗肩锁关节完全脱位及锁骨远端骨折42例。结果：所有病例随访6个月到23月，按照Lazzcano评分标准，41例肩关节功能优，有1例术后出现锁骨钩变形。结论：锁骨钩钢板是一种优异的治疗肩锁关节完全脱位和锁骨远端骨折的方法，值得，临床推广。     

肩锁钩钢板治疗锁骨远端骨折与脱位15例

目的：探讨肩锁钩钢板治疗锁骨远端损伤的疗效。方法：对锁骨远端骨折12例、肩锁关节脱位3例．采用肩锁钩钢板内固定治疗。直接修复断裂的喙锁韧带13例，用喙肩韧带代替重建无法直接修复的喙锁韧带2例，其中3例肩锁关节脱位者还直接修复了断裂的肩锁韧带。结果：15例随访时间3～32个月，平均25个月，无术后再脱位、钢板断裂及螺钉松动。按KarLsson疗效评价标准，优11例（73．3％），良4例（26．7％），综合评价：优良。结论：肩锁钩钢板治疗锁骨远端骨折与肩锁关节脱位，符合生物力学原理，是一种较好的手术方法。     

锁骨钩钢板治疗锁骨远端骨折及肩锁关节脱位

目的:探讨锁骨钩钢板内固定治疗锁骨远端骨折及肩锁关节脱位的疗效。方法:应用锁骨钩钢板治疗锁骨远端NeerⅡ型骨折36例,TossyⅢ型肩锁关节脱位26例。结果:所有病例根据肩关节功能评价标准进行了随访,随访时间为6～20个月,平均为10个月,锁骨骨折全部愈合,肩锁关节无再脱位。按Karlsson标准进行评价,优良56例,满意6例,优良满意率为100%。结论:锁骨钩钢板具有固定确切、操作简单、疗效可靠、关节功能恢复快等特点。     

肩锁钩钢板治疗肩锁关节脱位和锁骨远端骨折

目的探讨治疗肩锁关节脱位和锁骨远端骨折的新方法。方法采用肩锁钩钢板治疗Ⅲ度肩锁关节脱位8例，锁骨外端骨折3例，9例获得随访，随访时间4—11个月，平均7.2个月。结果按照Lazzcano疗效标准，评定优7例，良2例，无其他并发症，骨折全部愈合，肩锁关节无再脱位。结论肩锁钩钢板治疗肩关节脱位和锁骨远端骨折具有固定确实，不损伤关节面，可以早期功能锻炼等优点，值得推广。     

锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位的疗效评价

目的评价肩锁钩钢板在治疗NeerⅡ型锁骨远端骨折和完全性肩锁关节脱位（TossyⅢ型以上）的临床疗效。方法2002年2月—2007年2月84例锁骨远端骨折,32例肩锁关节脱位,采用切开复位肩锁钩钢板固定。结果随访6-30个月,116例病例全部愈合。按Karlsson疗效评价,A107例,B6例,C3例。结论锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折,固定确切,创伤小,不损伤关节面,可早期行功能锻炼,无需刻意修复喙锁韧带、喙肩韧带。     

锁骨钩钢板治疗锁骨远端骨折及肩锁关节脱位

目的:观察运用锁骨钩钢板对锁骨远端骨折(NeerⅡ型)和肩锁关节脱位(TossyⅢ型)进行切开复位内固定手术的临床效果.方法:锁骨远端骨折(NeerⅡ型)和肩锁关节脱位(TossyⅢ型)患者36例,应用锁骨钩钢板切开复位内固定及韧带修补术进行治疗.结果:按照Lazzcano标准评定患者术后的功能,所有患者均获得良好复位和固定.本组随访6～24个月,平均15个月,优28例,良8例.肩锁关节无再脱位,无钢板断裂和松动的表现,锁骨骨折全部愈合,无并发症发生,内固定取出后无再脱位的病例,关节功能均恢复良好.结论:锁骨钩钢板治疗锁骨远端骨折(NeerⅡ型)和肩锁关节脱位(TossyⅢ型)是一种可靠有效的方法.     

锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折

目的：探讨AO锁骨钩钢板对肩锁关节脱位和锁骨远端骨折的疗效。方法：回顾性分析39例应用AO锁骨钩钢板治疗Tossy Ⅲ型肩锁关节脱位和NeerⅡ型锁骨远端骨折的临床资料,其中肩锁关节脱位16例,锁骨远端骨折合并肩关节脱位5例,锁骨远端骨折18例。结果：39例均获随访,平均12个月。所有患者获得良好复位和固定,X线片未见肩锁关节半脱位或钢板断裂和松动,肩关节功能恢复良好。结论：AO锁骨钩钢板是治疗肩锁关节脱位和锁骨远端骨折的一种良好的方法。     

锁骨钩钢板治疗POST肩锁关节脱位Ⅲ和Ⅳ型疗效观察

目的介绍应用国产锁骨钩钢板(clavicular hook plate,CHP)治疗肩锁关节脱位与锁骨远端骨折的临床疗效。方法应用国产CHP固定治疗27例POSTⅢ、Ⅳ型肩锁关节脱位患者,所有病例均采用将钢板插入肩峰下关节囊外,复位后钢板置于锁骨上螺钉固定,仅修补肩锁韧带及肩锁关节囊,未做刻意的喙锁韧带修复。结果随访3-24个月,平均12.6个月,骨折全部愈合,术后9-12个月取出内固定,无再次骨折及脱位发生。采用Karlsson分级标准进行疗效评价:A级21例,B级4例,C级2例。结论锁骨钩钢板是治疗肩锁关节脱位和锁骨远端骨折的一种可靠方法。     

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.