腹腔镜辅助阴式子宫切除术及盆腔淋巴结清扫术治疗早期子宫内膜癌的临床疗效分析

目的 分析早期子宫内膜癌应用腹腔镜辅助盆腔淋巴结清扫术与阴式子宫切除术的临床疗效。方法 选取2018年1月至2021年3月本院收治的80例早期子宫内膜癌患者作为研究对象,依据不同手术方法分为对照组与观察组,各40例。对照组应用腹腔镜辅助盆腔淋巴结清扫术与子宫切除术治疗,观察组应用腹腔镜辅助盆腔淋巴结清扫术与阴式子宫切除术治疗。比较两组手术指标（手术时间、出血总量、淋巴结清扫个数）、术后恢复状况（引流管留置时间、住院时间）及术后并发症（淋巴囊肿、肠梗阻、尿潴留）发生情况。结果 观察组手术时间、住院时间、引流管留置时间均明显短于对照组（P<0.05）,观察组出血总量明显少于对照组（P<0.05）;观察组淋巴结清扫个数明显多于对照组（P<0.05）;观察组术后并发症发生率明显低于对照组,差异有统计学意义（P<0.05）。结论 应用腹腔镜辅助盆腔淋巴结清扫术与阴式子宫切除术治疗早期子宫内膜癌的手术时间较短,出血量较少,淋巴结清扫数量较多,可缩短引流管留置的拔除时间及住院时间,减少并发症发生。     

腹腔镜下保留盆腔自主神经的根治性子宫切除术效果观察

目的:探讨腹腔镜下保留盆腔自主神经的根治性子宫切除术的临床效果.方法:88例行腹腔镜下根治性子宫切除术的宫颈癌病人随机分为观察组和对照组,各44例.对照组病人给予传统的根治性子宫切除术,观察组病人行腹腔镜下保留盆腔自主神经根治性子宫切除术.比较2组病人的手术时间、术中出血量、阴道及宫旁切除长度、清扫淋巴数、术后拔除尿管的时间、术后残余尿量<100 mL的时间、术后肛门排气及排便时间等指标.结果:2组病人术后均无并发症发生.观察组病人的手术时间长于对照组(P<0.01);观察组病人术后拔除尿管时间、残余尿量<100 mL时间、肛门排气及排便时间均明显短于对照组(P<0.01).结论:腹腔镜下保留盆腔自主神经根治性子宫切除术治疗早期宫颈癌安全性高,有利于病人膀胱及直肠功能的恢复,临床效果显著,值得推广应用.     

腹腔镜辅助阴式全子宫切除术治疗早期宫颈癌患者的效果观察

目的:观察腹腔镜辅助阴式全子宫切除术治疗早期宫颈癌的临床效果。方法:选取68例早期宫颈癌患者作为研究对象,按随机数字表法将其分为观察组和对照组各34例。观察组行腹腔镜辅助阴式全子宫切除术、盆腔淋巴结清扫术治疗,对照组行传统开腹手术、盆腔淋巴结清扫术治疗。比较两组手术相关指标水平、术后并发症发生情况及随访病死率。结果:观察组术中出血量明显少于对照组,术后首次肛门排气、引流管拔除及住院时间均明显短于对照组,差异均有统计学意义(P<0.05);两组术后并发症及随访2年病死率比较,差异无统计学意义(P>0.05)。结论:与传统开腹手术相比,腹腔镜辅助阴式全子宫切除术治疗早期宫颈癌效果更好,有利于患者恢复。     

腹腔镜下宫颈癌根治术治疗早期宫颈癌的疗效观察

目的:探讨腹腔镜下宫颈癌根治术治疗早期宫颈癌的临床疗效。方法:选取130例早期宫颈癌患者,随机分为两组。对照组64例行常规开腹子宫切除术与盆腔淋巴结清扫术,观察组66例行腹腔镜下宫颈癌根治术与盆腔淋巴结清扫术,比较两组患者手术情况及治疗效果。结果:观察组术后肛门通气时间及住院时间均显著较对照组短,术中出血量较少,术后并发症发生率较低(P<0.05)。经随访,观察组无淋巴结转移与复发,对照组出现2例淋巴结转移,1例复发。结论:腹腔镜下宫颈癌根治术治疗早期宫颈癌效果显著,术后恢复快,值得在临床中推广。     

腹腔镜下广泛子宫切除术加盆腔淋巴清扫治疗早期宫颈癌的研究

目的:研究并分析腹腔镜下广泛子宫切除术加盆腔淋巴清扫治疗早期宫颈癌的效果。方法:选取201 1年1月-201 6年1月本院妇科收治早期宫颈癌患者200例,根据随机数字表法分为对照组和观察组,每组100例。对照组患者采取开腹广泛子宫切除术加盆腔淋巴清扫治疗方案,观察组患者采取腹腔镜下广泛子宫切除术加盆腔淋巴清扫治疗方案。对比观察两组患者手术时间、出血量、淋巴结清扫数量、住院时间及围术期并发症发生率。结果:观察组患者手术时间、出血量、住院时间均少于对照组,差异均有统计学意义(P0.05)。观察组淋巴结清扫数量显著多于对照组,差异有统计学意义(P0.05)。观察组围术期并发症总发生率为11.00%(11/100),显著低于对照组的28.00%(28/100),差异有统计学意义(P0.05)。结论:腹腔镜下广泛子宫切除术加盆腔淋巴结清扫治疗早期宫颈癌的效果理想,具有微创性、恢复速度快、并发症发生率低等优势,有临床推广实践的价值。     

腹腔镜下广泛子宫切除＋盆腔淋巴结清扫术治疗早期宫颈癌疗效分析

目的 探讨腹腔镜下广泛子宫切除＋盆腔淋巴结清扫术治疗早期宫颈癌疗效.方法 将2007年9月-2012年9月入住该院的100例早期宫颈癌患者按照抽签法随机地均分为对照组与观察组,对照组给予开腹广泛子宫切除＋盆腔淋巴结清扫术,观察组给予腹腔镜下广泛子宫切除＋盆腔淋巴结清扫术治疗.比较两组术中及术后情况、五年生存率、术后生存质量.结果 对照组术中出血量、手术时间、手术引流量、并发症发生率、切缘残留以及住院时间等均明显大于观察组,两组上述指标相比,差异有统计学意义（P＜0.05,P＜0.01）;观察组5年生存率均显著高于对照组,差异有统计学意义（P＜0.01）;根据患者生存质量评价标准,对照组生存质量得分明显低于观察组（P＜0.01）.结论 腹腔镜下广泛子宫切除＋盆腔淋巴结清扫术治疗早期宫颈癌疗效显著,患者生存质量明显提高,值得在临床上加以推广并应用.     

腹腔镜下广泛子宫切除和盆腔淋巴结清扫术治疗早期宫颈癌与经腹手术的对比分析

目的:对比分析经腹手术与腹腔镜下广泛子宫切除和盆腔淋巴结清扫术治疗早期宫颈癌的临床效果。方法:将我院接收的96例早期宫颈癌为对象,时间为2015年9月至2016年9月。依据接诊患者时间的先后分为对照组和观察组。对照组患者经腹广泛子宫切除与盆腔淋巴结清扫术治疗,观察组患者经腹腔镜下广泛子宫切除和盆腔淋巴结清扫术治疗。对照两组患者临床治疗效率。结果:统计分析两组患者手术时间、术中出血量、肛门排气时间、住院时间,观察组患者均显著优于对照组,差异符合统计学意义(P0.05);且观察组患者并发症发生率低于对照组,差异显著(P0.05)。结论:早期治疗宫颈癌,相对于开腹下子宫切除术,患者采用盆腔淋巴结清扫术联合腹腔镜下广泛子宫切除效果更显著,对提高患者生存质量具有促进性的作用。     

腹腔镜下与开腹广泛子宫切除术治疗子宫恶性肿瘤的临床疗效对比研究

目的：研究腹腔镜下广泛子宫切除术在治疗子宫恶性肿瘤中的临床疗效。方法：2008年6月至2012年8月于我院妇科行腹腔镜下广泛性子宫切除术和盆腔淋巴结清扫术(TLRH+LPL)57例(腹腔镜组)及行传统开腹手术的100例(开腹组)确诊为宫颈癌/子宫内膜癌患者的病历资料。比较两组的手术时间、术中出血量、术中清扫盆腔淋巴结数量,术后肛门排气时间、术后导尿管留置时间等手术情况、住院时间以及两组并发症的发生率。结果：腹腔镜组手术时间、术中出血量均显著长于对照组(P<0.01),清扫盆腔淋巴结数量显著多于对照组(P<0.01)。腹腔镜组术后肛门排气时间、术后住院时间明显短于对照组(P<0.01),两组术后导尿管留置时间无显著差异(P>0.05)。腹腔镜组并发症总发生率为14.0%,对照组并发症总发生率为18.0%,两组并发症总发生率差异均无显著性(P>0.05)。结论：腹腔镜下广泛性全子宫切除术和盆腔淋巴结清扫术较开腹手术比较具有创伤小、恢复快,在不增加手术风险的基础上其手术疗效肯定,可在临床上广泛开展应用。     

腹腔镜下广泛性子宫切除术联合盆腔淋巴结清扫术治疗宫颈癌的效果分析

目的探讨腹腔镜下广泛性子宫切除术联合盆腔淋巴结清扫术治疗宫颈癌的效果。方法选取濮阳人民医院2014年5月至2016年5月收治的56例宫颈癌患者,按照随机数表法分组,各28例,所有患者均接受广泛子宫切除术联合盆腔淋巴结清扫术,对照组常规开腹,观察组于腹腔镜下进行。比较两组手术情况、淋巴结摘除个数、并发症发生情况及术后两组癌症治疗功能总体评价量表(FACT-G)评分情况。结果观察组手术时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。治疗后,观察组FACT-G评分高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜下广泛性子宫切除术联合盆腔淋巴结清扫术治疗宫颈癌患者,术中出血量少,手术时间短,并发生症发生率低,能促进患者康复。     

腹腔镜与传统开腹手术治疗宫颈癌的疗效比较

目的:比较腹腔镜和传统开腹手术治疗宫颈癌的疗效。方法:收集老年ⅠA-ⅡB期宫颈癌患者93例进行研究,将其随机分为两组,即开腹根治术联合盆腔淋巴清扫为对照组(46例)和腹腔镜下根治性子宫切除术联合盆腔淋巴清扫为观察组(47例)。对比两组患者手术相关指标及治疗效果。结果:观察组手术时间明显长于对照组,术中出血量明显少于对照组,肛门排气时间和住院时间均明显短于对照组(P<0.05)。两组患者术中淋巴结切除总数、阳性淋巴结总数、髂血管旁淋巴结数目/阳性数目、闭孔淋巴结数目/阳性数目、腹股沟深淋巴结数目/阳性数目比较均无明显差异(P>0.05)。术后两组患者并发症发生率比较无明显差异(P>0.05)。结论:腹腔镜与开腹手术治疗宫颈癌的总体疗效相当。     

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.