经尿道前列腺电切术与经尿道前列腺等离子双极电切术治疗良性前列腺增生症的效果分析

目的探讨经尿道前列腺电切术(TURP)与经尿道前列腺等离子双极电切术(PKRP)治疗良性前列腺增生症(BPH)的临床效果和安全性。方法选取95例具有可比性的BPH患者,按照手术方式分为TURP组和PKRP组,对比不同电切术式的手术疗效和安全性。结果 PKRP组手术时间、术中出血量和导管留置时间明显优于TURP组(P<0.01);PKRP组并发症发生率6.25%明显低于TURP组27.66%(P<0.05);PKRP组泌尿功能恢复情况明显优于TURP组(P<0.05)。结论 PKRP术治疗BPH患者疗效确切,具有手术时间短、术中出血量小、导管留置时间段、术后并发症发生率低和泌尿功能恢复快等优势,是一种较为理想的BPH治疗方法。     

经尿道前列腺等离子双极电切与电切术的疗效比较

目的:比较经尿道前列腺等离子双极电切术(PKRP)与经尿道前列腺电切术(TURP)治疗前列腺增生(BPH)的疗效。方法:将前列腺增生症患者160例随机分为两组各80例,分别行PKRP和TURP,并监测、记录患者围手术期和术后6个月复查的有关指标,并进行统计学分析。结果:术中或术后12h输血量、电切综合征发生率、术后平均膀胱冲洗时间、置管时间和住院时间、术后继发出血和感染,PKRP组明显TURP组(P<0.01);术后6个月,两组患者症状评分、生活质量分析、最大尿流率均比术前明显改善(P<0.01)。结论:PKRP治疗BPH与TURP疗效的相近;术中并发症发生率、恢复时间和术后并发症明显少于TURP,有望替代TURP法。     

经尿道双极等离子电切术与经尿道前列腺电切术治疗前列腺增生临床疗效比较

目的:比较经尿道双极等离子电切术(PKRP)与经尿道前列腺电切术(TURP)治疗良性前列腺增生的临床疗效。方法:选择2009年7月至2011年7月收治的130例良性前列腺增生患者,其中接受TURP治疗56例对照组,接受PKRP治疗观察组76例,比较两组手术情况及术后症状改善情况。结果:两组患者术前在年龄、残余尿量、国际前列腺症状评分、生活质量评分等方面比较,差异无统计学意义(P>0.05)。观察组与对照组比较,手术时间、术中出血量均减少(P<0.05)。治疗3个月后,两组IPSS评分、QOL评分、RUV较治疗前均明显降低,Qmax明显升高(P<0.05),但两组术后各项指标相比较差异无统计学意义(P>0.05)。结论:PKRP是一种治疗BPH的有效方法,具有手术时间短、术中出血少、并发症发病率低等优势,值得临床推广。     

经尿道前列腺电切术与双极等离子切除术治疗前列腺良性增生的疗效比较

目的比较经尿道前列腺电切术(TURP)和经尿道双极等离子前列腺切除术(PKRP)治疗前列腺良性增生(BPH)的临床疗效及安全性。方法将2009年10月至2013年2月解放军180医院泌尿外科收治的142例BPH患者根据随机数字表法分为TURP组70例和PKRP组72例,比较两组手术相关指标,国际前列腺症状评分(IPSS),术后尿流率峰值(Qmax)、生活质量评分(QOL)和剩余尿量(RUV)。结果 PKRP组术中出血量、膀胱冲洗时间、留管时间及住院时间均显著少于TURP组(P<0.05),两组手术时间及术后并发症发生率比较差异无统计学意义(P>0.05);两组治疗后IPSS、QOL、Qmax及RUV均较治疗前明显好转(P<0.05),且PKRP组IPSS、QOL、Qmax改善更为显著(P<0.05)。结论 PKRP与TURP均是治疗BPH的有效手术措施,但PKRP术中出血量较少,疗效更佳,值得临床推广应用。     

经尿道前列腺等离子体剜除术与电切术治疗前列腺增生

目的:比较经尿道前列腺等离子电切剜除术(PKEP)与经尿道前列腺电切术(PKRP)治疗良性前列腺增生(BPH)的安全性及临床疗效。方法:将82例BPH患者随机分成两组,分别行电切术(45例)和剜除术(37例),比较手术时间、术中出血量、前列腺切除量、术后膀胱冲洗时间和并发症发生率等指标,评价两种手术方式的安全性,通过比较术后6个月前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)和剩余尿量(PVR)等评价两种手术方式的疗效。结果:剜除术组的手术时间、术中出血量、术后恢复时间(术后冲洗时间、留管时间以及住院时间)以及并发症发生率明显低于电切术组,前列腺切除量明显高于电切术组,差异均具有统计学意义(均P<0.05);术后随访6个月,两组IPSS、QOL、Qmax和PVR术后与术前比较均明显改变(均P<0.05),但两组间改善程度比较差异无统计学意义(P>0.05)。结论:两种手术都是治疗BPH的有效方法,但经尿道前列腺等离子电切剜除术更省时、并发症更少、安全性更高。     

经尿道前列腺等离子电切术与传统电切术治疗前列腺增生的疗效比较

目的比较经尿道前列腺等离子切除术（transurethral plasma kinetic resection of prostate,PKRP）与经尿道前列腺电切术（transurethral resection of prostate,TURP）治疗前列腺增生（benign prostate hyperplasia,BPH）的疗效及安全性。方法按照知情同意及自主选择原则,收集符合入选标准684例,分为PKRP组和TURP组,每组各342例,比较两组手术前及手术后3个月国际前列腺症状评分（international prostate symptom score,IPSS评分）、最大尿流率(Q_max)、残余尿量（post-void urine volume,PVR）,比较两组手术后血红蛋白下降程度、血清钠变化程度、导尿管留置时间及手术并发症的发生率,并进行统计学分析。结论两组患者年龄、前列腺重量、术前IPSS评分、Q_max、PVR、血红蛋白水平、血清钠水平、住院时间、前列腺切除比例差异无统计学意义（P>0.05）。每组患者手术前后的IPSS评分、Qmax、PVR差异均有统计学意义（P<0.05）。PKRP组术后血红蛋白下降值、血清钠下降值低于TURP组,术后导尿管留置时间短于TURP组,术后出血发生率小于TURP组,前列腺电切综合征（transurethral resection syndrome,TURS）发生率低于TURP组,术中闭孔神经反射发生率PKRP组低于TURP组（均P<0.05）。两组术后感染、尿道狭窄发生率差异无统计学意义（P>0.05）。结论 PKRP治疗BPH与TURP疗效相近,但手术并发症发生率低,是一种安全有效的BPH手术方式。     

PKRP和TURP治疗良性前列腺增生的疗效比较

目的 比较经尿道前列腺等离子双极电切术(PKRP)和经尿道前列腺电切术(TURP)治疗良性前列腺增生的疗效.方法 选择在我院进行治疗的良性前列腺增生患者100例,随机将其分为2组各50例.PKRP组采用经尿道前列腺等离子双极电切术治疗,TURP组采用经尿道前列腺电切术治疗,比较2组患者的手术各项指标、术后疗效以及并发症发生情况.结果 TURP组患者的手术时间明显长于PKRP组,差异显著(P<0.05);2组患者的留置导尿管时间、Qmax、RUV、IPSS评分以及QOL评分比较均无明显差异(P>0.05);PKRP组的并发症发生率明显低于TURP组,差异显著(P<0.05).结论 PKRP和TURP治疗良性前列腺增生都具有良好的效果,PKRP术后并发症发生率低,具有更高的安全性.     

经尿道前列腺电切术与等离子双极电切术治疗前列腺增生疗效比较

目的:比较经尿道前列腺等离子双极电切术 (PKRP)与经尿道前列腺电切术 (TURP)治疗前列腺增生症 (BPH)的临床疗效。 方法:PKRP术治疗 BPH74例 ,TURP术治疗 BPH 12 7例 ,对两种术式的临床效果进行比较。 结果 :对于相同体积的前列腺腺体 ,采用两种方法所需的手术时间、IPSS减分率、尿流率及病人术中血压、血氧饱和度值的差异均无统计学意义 (P >0 .0 5 )。但行 PKRP术的病人术中出血量更少 ,术后无低钠血症及水中毒(TURS)等并发症的发生。 结论:两种经尿道手术都是治疗 BPH的有效方法。 PKRP具有安全性高、对机体生理功能影响小的优点 ,且治疗 BPH的适应证范围也较广。     

经尿道前列腺剜除术与电切术的疗效及安全性比较

目的比较经尿道前列腺剜除术(TUEP)与经尿道前列腺电切术(TURP)治疗前列腺增生症(BPH)的疗效及安全性。方法以TURP治疗BPH 193例,以TUEP治疗BPH 137例,通过比较其术中出血量、手术时间、手术完毕时低血钠发生率和术后并发症发生情况,评价两种方法治疗BPH的安全性;通过比较其前列腺增生腺体切除重量、术后导尿管留置时间、术后3个月最大尿流率(Qmax)、残余尿量(RUV)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、电切环消耗率,比较两种方法治疗BPH的疗效。结果 TUEP治疗组术中出血量、手术完毕时低血钠发生率、手术时间、术后导尿管留置时间、电切环消耗根数(率)均低(短、少)于TURP治疗组(P<0.05或0.01),前列腺切除重量高于TURP治疗组(P<0.01);术后3个月两组Qmax、RUV、IPSS、QOL较术前均明显改善(P<0.01),但两组间比较差异无显著性(P>0.05)。结论 TUEP术与TURP术相比较,TUEP术出血少,手术完毕时低血钠发生率低,手术时间短,电切环消耗根数(率)少,切除增生腺体更彻底,疗效确切,值得进一步推广应用。     

PKRP和TURP治疗良性前列腺增生的疗效观察

目的　比较经尿道前列腺等离子双极电切术(PKRP)与经尿道前列腺电切术(TURP)治疗前列腺增生症(BPH)的临床疗效。方法　PKRP术治疗BPH 6 0例,TURP术治疗BPH 6 0例,对两种术式的临床效果进行比较。结果　两组患者在手术后国际前列腺症状评分(IPSS) ,生活质量评分(QOL)、平均尿流率(AFR)较术前均得到显著改善(P <0 .0 1)。PKRP组在手术时间,术中失血量,术后留尿管时间,术后住院时间,暂时性尿失禁发生率均明显少于TURP组(P <0 .0 5 ) ,未发生电切综合征(TURS)。结论　PKRP比TURP并发症更少,恢复更快,更安全,是经尿道治疗BPH的理想方法之一。     

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.