改良颞下-经小脑幕入路显微手术切除岩斜区脑膜瘤

目的探讨改良颞下-经小脑幕入路显微手术切除岩斜区膜瘤瘤的显微手术技术。方法在传统颞下-经小脑幕入路的基础上，离断颧弓切除Labbe氏静脉前颞下回脑组织。采用显微外科技术切除岩斜区脑膜瘤7例。结果肿瘤全切除2例，次全切除3例，大部分切除2例。术后肢体轻瘫2例。面神经和动眼神经不全麻痹各1例，无手术死亡。随访8～36个月，2例恢复良好，4例生活自理，1例生活需要照顾。结论改良颞下-经小脑幕入路具有操作简单，创伤小，易于掌握，特别适用于中上斜坡脑膜瘤手术，是切除岩斜区脑膜瘤较理想的手术入路。     

岩斜区脑膜瘤显微手术入路的改良及疗效

目的探讨改良经岩骨乙状窦前入路显微手术切除岩斜区脑膜瘤的疗效及手术技巧.方法采用改良经岩骨乙状窦前入路显微外科切除岩斜区脑膜瘤11例并对其临床资料进行回顾性分析.结果肿瘤全切除8例,次全切除1例,大部切除2例.本组无死亡病例,术后昏迷 1 例,新出现暂时性颅神经障碍3例,无脑脊液漏发生.结论改良经岩骨乙状窦前入路简便、安全,可充分显露岩斜区,有利于提高肿瘤切除程度和术后疗效,是岩斜区脑膜瘤手术治疗的较佳入路,但对术者的手术技巧和经验要求较高.     

岩斜区脑膜瘤显微手术入路的改良及疗效

目的探讨改良经岩骨乙状窦前入路显微手术切除岩斜区脑膜瘤的疗效及手术技巧.方法采用改良经岩骨乙状窦前入路显微外科切除岩斜区脑膜瘤11例并对其临床资料进行回顾性分析.结果肿瘤全切除8例,次全切除1例,大部切除2例.本组无死亡病例,术后昏迷 1 例,新出现暂时性颅神经障碍3例,无脑脊液漏发生.结论改良经岩骨乙状窦前入路简便、安全,可充分显露岩斜区,有利于提高肿瘤切除程度和术后疗效,是岩斜区脑膜瘤手术治疗的较佳入路,但对术者的手术技巧和经验要求较高.     

乙状窦前入路切除岩斜区脑膜瘤

目的 探索岩斜区脑膜瘤的手术入路及手术方式,并评价其疗效.方法 采用乙状窦前入路,应用显微神经外科技术,将岩斜区脑膜瘤分块行全切或部分切除.结果 9例病例中肿瘤全切6例,占66.6%;次全切除2例,占22.2%;大部分切除1例,占11.2%.无手术死亡病例,术后7例随访,平均20个月.6例正常生活,1例生活自理.MRI随访5例,未见肿瘤复发或再生长.结论 采用乙状窦前入路、应用显微神经外科技术治疗岩斜区脑膜瘤,能提高该病治愈率,减少并发症.     

改良经岩骨乙状窦前入路显微外科治疗岩斜区肿瘤

目的探讨岩斜区肿瘤经改良岩骨乙状窦前入路显微外科治疗的手术特征及并发症。方法回顾性分析经显微手术治疗的9例岩斜区肿瘤,对肿瘤临床和影像学特征、手术入路、手术切除技巧及术后常见并发症的处理进行研究。结果肿瘤全切除7例,近全切除1例,大部切除1例。术后一过性失语1例,脑水肿2例,周围性面瘫1例,脑脊液耳漏1例,腰穿引流后好转。无死亡病例。结论改良经岩骨乙状窦前入路可充分暴露岩斜区肿瘤及其周围结构,是岩斜区肿瘤的较佳手术入路。     

改良颞下一经小脑幕入路显微手术切除岩斜区脑膜瘤

目的 探讨改良颞下一经小脑幕人路显微手术切除岩斜区膜瘤瘤的显微手术技术.方法 在传统颞下一经小脑幕人路的基础上,离断颧弓切除Labbe氏静脉前颞下回脑组织.采用显微外科技术切除岩斜区脑膜瘤7例.结果 肿瘤全切除2例,次全切除3例,大部分切除2例.术后肢体轻瘫2例.面神经和动眼神经不全麻痹各1例,无手术死亡.随访8～36个月,2例恢复良好,4例生活自理,1例生活需要照顾.结论 改良颞下一经小脑幕入路具有操作简单,创伤小,易于掌握,特别适用于中上斜坡脑膜瘤手术,是切除岩斜区脑膜瘤较理想的手术入路.     

大型岩斜脑膜瘤的显微手术治疗

目的　对 12例大型岩斜脑膜瘤行乙状窦前入路的显微手术治疗 ,探讨该入路治疗岩斜脑膜瘤的要点。方法　总结岩斜脑膜瘤的临床表现、神经影像学特征和术中要点。结果　肿瘤全切除 10例 ,次全切除 1例 ,大部切除 1例 ,术后好转率 83.3%。结论　大型岩斜脑膜瘤首选乙状窦前入路 ,掌握术中暴露要点和分离技巧可提高手术疗效     

岩斜区神经纤维瘤的颞下经岩骨入路显微手术治疗

目的：探讨岩斜区神经纤维瘤的手术治疗方法。方法：总结7例病例的临床表现，神经影像学特征，显微手术方法 和术后治疗。结果：全切除5例，次全切除2例，无死亡病例。除1例术后遗留动眼神经麻痹外，其余病例的颅神经损伤均在半年后基本恢复。结论：岩斜区巨大神经纤维瘤采用经颞下岩骨入路全切除率明显高于其它入路，掌握颅底解剖知识和熟练的显微外科技术是提高全切除率、降低死亡率和并发症的关键。     

大型、巨大型岩斜区脑膜瘤的手术策略*

目的:探讨大型、巨大型岩斜区脑膜瘤的手术效果,以提高和改善预后.方法:回顾性分析新疆医科大学第一附属医院神经外科2000年1月-2011年6月显微手术切除的32例岩斜区脑膜瘤的临床资料.结果:32例岩斜区脑膜瘤,肿瘤全切除12例,次全切除12例,大部分切除8例.全切除术后的近期和远期并发症最高(P<0.05),而次全切除与大部分切除相比,其术后的近期和远期并发症差异比较无统计学意义(P>0.05).结论:对于大型、巨大型岩斜区脑膜瘤,次全切除是一个合理的手术策略.     

岩斜区肿瘤外科治疗策略探讨

目的探讨岩斜区肿瘤的外科处理策略。方法回顾性分析经3种手术方式(岩骨乙状窦前入路、颞下经小脑幕入路、乙状窦后入路)配合神经内镜及电生理监测切除岩斜区肿瘤49例,观察其手术效果及术后并发症。结果岩骨乙状窦前入路11例,肿瘤全切8例,出现新的神经损伤4例,术后改善3例,症状同术前4例;颞下经小脑幕入路18例,肿瘤全切12例,出现新的神经损伤4例,原有神经损伤加重2例,术后改善5例,同术前7例;乙状窦后入路20例,肿瘤全切18例,原有神经损伤加重5例,术后改善8例,症状同术前7例;均无死亡病例。结论岩骨乙状窦前入路、颞下经小脑幕入路、乙状窦后入路是处理所有岩斜区肿瘤的3种首选的基本入路,扎实的显微解剖基本功、娴熟的显微手术技术配合使用神经内镜及术中电生理监测可以提高肿瘤的全切除率,减少并发症发生、降低死亡率。     

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.