小切口甲状腺切除术与传统甲状腺切除术治疗甲状腺结节的临床效果比较

目的评估及比较小切口甲状腺切除术与传统甲状腺切除术治疗甲状腺结节的临床效果。方法选取2015年1月~2016年1月于我院住院进行诊治的60例甲状腺结节患者,分为对照组30例和小切口组30例,对照组行传统甲状腺切除术,小切口组行小切口甲状腺切除术;统计并比较两组患者的手术时间、住院时间、切口长度及术中出血量等手术观察指标,并对比两组术后的并发症发生率。结果小切口组患者的手术时间为(41.5±11.6)min、术中出血量(42.3±12.5)mL,切口长度(4.61±1.13)cm,住院时间为(6.27±1.12)d,分别与对照组比较,小切口组患者的手术时间明显缩短,术中出血量明显减少,切口长度较小,住院时间明显缩短。两组上述各项手术观察指标比较,差异具有显著性(P0.05)。小切口组的并发症发生率显著低于对照组,两组并发症发生率比较差异具有显著性(P0.05)。结论小切口甲状腺切除术治疗甲状腺结节有较好的作用,较传统甲状腺切除术具有创伤小、切口小、术中出血少及并发症少等优势,值得广泛推广和应用。     

小切口甲状腺切除术的临床效果观察

目的探讨甲状腺腺瘤应用小切口甲状腺切除术治疗的效果。方法选取2011年8月至2015年8月惠城区小金口人民医院收治的甲状腺腺瘤患者88例,随机分成对照组与观察组,各44例。对照组给予传统甲状腺切除术治疗,观察组则使用小切口甲状腺切除术予以治疗。对比两组的术后住院时间、术中出血量、平均手术时间以及术后并发症发生情况。结果观察组的术后住院时间、术中出血量、平均手术时间均优于对照组(P<0.05);观察组的术后并发症发生率显著高于对照组(P<0.05)。结论甲状腺腺瘤应用小切口甲状腺切除术治疗具有出血量少、住院时间以及手术时间短等特点,并且安全可靠,值得推广。     

改良小切口与传统甲状腺切除术治疗甲状腺腺瘤的对比研究

目的：对比改良小切口与传统甲状腺切除术治疗甲状腺腺瘤的效果。方法整群选取该院2013年7月—2014年8月收治的76例甲状腺腺瘤患者随机分成两组,各38例。观察组采取改良小切口术,对照组采取传统甲状腺切除术,比较两组住院时间、手术时间、切口长度、术中出血量及术后并发症情况。结果观察组住院时间、手术时间、切口长度及术中出血量较对照组明显减少（P﹤0.01);观察组术后并发症发生率为15.79%,相对于对照组明显降低（P﹤0.05)。结论改良小切口术在甲状腺腺瘤治疗中效果显著,并发症少,值得应用。     

小切口改良甲状腺切除术与传统甲状腺切除术比较研究

目的探讨小切口改良甲状腺切除术与传统甲状腺切除术治疗甲状腺腺瘤的临床效果.方法将68例甲状腺腺瘤患者随机分为对照组和观察组,对照组采用传统甲状腺切除术治疗,观察组采用小切口改良甲状腺切除术治疗.分析两组的治疗效果及不良反应发生情况.结果观察组与对照组腺瘤大小差异无统计学意义(P>0.05).观察组手术时间、术中出血量、住院时间显著低于对照组,差异有统计学意义(P<0.05).结论小切口改良甲状腺切除术治疗甲状腺腺瘤,术中出血量少,手术时间短,患者恢复快,使用方便,值得临床推广应用.     

腔镜下辅助小切口甲状腺切除术治疗甲状腺腺瘤的临床研究

目的研究腔镜下辅助小切口甲状腺切除术治疗甲状腺腺瘤的优势。方法选择2014年1月-2016年1月我院住院治疗的52例甲状腺腺瘤患者作为观察对象,采用随机数字表法根据治疗方法不同随机分为研究组(腔镜下辅助小切口甲状腺切除术)和对照组(采用开放性手术)。每组26例,比较两组患者苕项手术观察指标及术后疼痛程度、并发症发生率。结果研究组的手术切口长度(2.5±0.3)cm,手术时间(40.5±11.2)min,术中出血量(41.2±17.3)mL,术后颈部恢复活动时间(39.+2±12.7)h,术后住院时间(6.4±1.3)d,分别与对照组开放性手术比较,差异具有统计学意义(P0.05)。研究组患者苏醒时VAS评分为(6.32±1.16)分、对照组患者苏醒时VAS评分为(8.78+2.11)分,研究组患者苏醒时VAS评分显著低于对照组,差异具有统计学意义(P0.05);研究组患者术后6、12、24h的VAS评分分别显著低于对照组、差异具有统计学意义(P0.05);研究组患者术后并发症发生率合计为7.69%、显著低于对照组患者术后并发症发生率,差异具有统计学意义(P0.05)。结论腔镜下辅助小切口甲状腺切除术治疗甲状腺腺瘤较开放性手术具有切口小、术后疼痛轻、并发症少、术后恢复快等优点、值得推广和应用。     

小切口甲状腺瘤切除术治疗甲状腺瘤的临床疗效观察

目的探讨小切口甲状腺瘤切除术治疗甲状腺瘤的临床疗效及手术安全性。方法将100例甲状腺瘤患者随机分为观察组和对照组,每组各50例,观察组行小切口甲状腺瘤切除术,对照组行传统切除术,统计分析比较两组患者术中情况、临床疗效及并发症。结果观察组手术时间、术中出血量、手术切口长度、住院时间、术后视觉模拟评分法(VAS)评分、并发症发生率显著低于对照组(P0.05);观察组术后切口美容评分显著高于对照组(P0.05)。结论小切口甲状腺瘤切除术治疗甲状腺瘤具有手术操作时间短、术中出血量少、切口长度短、美观、术后疼痛轻、恢复快、并发症少等优点。     

对比分析改良小切口与传统甲状腺切除术治疗甲状腺腺瘤的效果

目的比较分析改良小切口和传统甲状腺切除术分别在甲状腺腺瘤治疗中的效果。方法选取我院2015年3月-2016年3月收治的甲状腺腺瘤患者66例,分成各33例的甲组、乙组。甲组患者采用改良小切口手术治疗,乙组患者予以传统甲状腺切除术治疗,比较两组患者手术治疗效果。结果甲组患者的手术用时和住院时间均短于乙组,且乙组患者的手术切口长度和术中出血量均高于甲组(P0.05);甲乙组术后并发症发生率比较有显著差异(P0.05)。结论采用改良小切口手术治疗甲状腺腺瘤的临床疗效显著优于传统甲状腺切除术,术后并发症发生率下降明显。     

改良小切口手术与传统甲状腺切除术治疗甲状腺腺瘤临床疗效对比

目的对比改良小切口手术与传统甲状腺切除术治疗甲状腺腺瘤的临床疗效。方法采用分层抽样法抽选2014年9月至2020年7月我院耳鼻咽喉头颈外科收治的329例甲状腺腺瘤患者纳入本实验,并采用均等双盲划分法将其中164例纳入对照组,予以传统甲状腺切除术治疗,其余165例纳入观察组,予以行颈前小切口腔镜辅助下甲状腺手术治疗。比较两组手术相关指标(术中出血量、手术时间、切口长度及住院时间)、疼痛程度、手术疗效、并发症及满意度等。结果观察组的术中出血量显著少于对照组,手术时间、切口长度及住院时间显著短于对照组(P0.05)。观察组的手术优良率为95.76%,显著高于对照组的84.15%(P0.05)。术后3 d至7 d,两组VAS评分较术前均有所降低,其中观察组VAS评分在术后3 d、5 d、7 d明显低于对照组(P0.05),观察组的并发症发生率为3.64%,显著低于对照组的12.80%(P0.05);观察组对手术切口瘢痕的满意度为93.94%,显著高于对照组的73.17%(P0.05)。结论采用改良小切口手术治疗甲状腺腺瘤临床疗效更加显著,有操作简单、恢复快、创伤小和并发症较少等优点,能使患者早日康复,可在临床借鉴推广。     

改良小切口甲状腺切除术应用于甲状腺腺瘤的临床效果观察

目的:探讨改良小切口甲状腺切除术应用于甲状腺腺瘤的临床疗效。方法:选取我院2013年10月-2015年2月收治的甲状腺腺瘤患者38例,随机分为观察组和对照组各19例,观察组采取改良小切口甲状腺切除术,对照组采取传统甲状腺切除术,对比两组患者的手术切口长度、手术时间、术中出血量、住院时间及术后并发症。结果:观察组患者的切口长度、术中出血量、手术时间、住院时间均明显少于对照组,差异具有统计学意义(P0.05)。对所有患者进行3个月随访,观察组患者出现1例颈前区疼痛症状,并发症发生率为5.3%,对照组患者出现2例颈前区疼痛症状,3例吞咽困难症状,并发症发生率为26.3%,经对比差异具有统计学意义(P0.05)。结论:改良小切口甲状腺切除术治疗甲状腺腺瘤效果显著,对患者的创伤较小,有利于术后康复,值得临床推广应用。     

小切口甲状腺切除术与传统甲状腺切除术治疗甲状腺结节的疗效比较

目的探讨小切口甲状腺切除术治疗甲状腺结节的临床疗效,并与传统甲状腺切除术的临床疗效进行比较。方法选择我院2009年1月~2016年1月收治的80例甲状腺良性结节患者,应用随机数字表法随机分为小切口组和对照组(采用传统甲状腺切除术),每组40例,比较两组各项手术观察指标:包括手术时间、术中出血量、手术时间、住院时间。两组患者手术并发症发生率。结果小切口组患者的切口长度明显短于对照组,差异有统计学意义(P0.05)。小切口组患者的术中出血量(40.75±15.26)mL,明显少于对照组,差异有统计学意义(P0.05)。小切口组患者的手术时间(40.11±6.75)min,明显短于对照组,差异有统计学意义(P0.05)。小切口组患者的住院时间(6.11±1.34)d,明显短于对照组,差异有统计学意义(P0.05)。小切口组患者发生切口粘连、吞咽不适、术后皮下水肿的发生率显著低于对照组(P0.05)。结论小切口甲状腺切除术治疗甲状腺结节的临床疗效确切,其疗效明显优于传统甲状腺切除术的临床疗效,有利于提高患者的生活质量,值得推广和应用。     

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.