腹腔镜术后辅助药物治疗子宫内膜异位症的效果观察

目的观察子宫内膜异位症患者腹腔镜术后辅助米非司酮、孕三烯酮和诺雷得治疗的临床效果、副作用及停药后对复发率、妊娠率的影响。方法将121例确诊为子宫内膜异位症的患者随机分为对照组、米非司酮组、孕三烯酮组和诺雷得组,对比分析各组的治疗总有效率、副作用和复发率、妊娠率。结果各用药组的治疗总有效率较对照组明显提高(P<0.05或0.01),复发率较对照组明显降低(P<0.05或0.01)。结论在腹腔镜术后加用抑制卵巢功能药物对提高子宫内膜异位症患者的妊娠率、降低复发率有重要作用。     

腹腔镜术后应用米非司酮治疗子宫内膜异位症临床研究

目的：研究子宫内膜异位症腹腔镜手术后联合米非司酮药物治疗的效果及安全性。方法：将232例子宫内膜异位症腹腔镜手术后的患者随机分为3组：米非司酮组（RU486）84例,孕三烯酮组78例,未用药组70例。比较3组术后疗效、术后复发、妊娠及用药不良反应等情况。结果：米非司酮组、孕三烯酮组复发率分别为5.95%、6.41%,低于未用药组45.71%（P〈0.05,P〈0.05）。米非司酮组不良反应发生率15.48%,低于孕三烯酮组46.15%（P〈0.05）。米非司酮组和孕三烯酮组的术后复发率没有显著性差异,对照组术后有效率明显较其它两组低,复发率亦较其他两组高,差异均具有统计学意义（P〈0.01）,3组术后妊娠率差异无统计学意义。结论：腹腔镜术后联合米非司酮或孕三烯酮治疗子宫内膜异位症较单纯手术复发率低、治疗效果可靠,而且米非司酮的价格低廉,不良反应显著小于孕三烯酮。     

子宫内膜异位症术后应用米非司酮与孕三烯酮临床疗效观察

目的:探讨米非司酮与孕三烯酮治疗子宫内膜异位症术后患者的临床疗效。方法:选取保守性或半保守性手术的子宫内膜异位症138例,随机分为3组:米非司酮组46例,给予米非司酮12.5 mg口服,每天1次;孕三烯酮组46例,给予孕三烯酮2.5 mg口服,每周2次,两组均于术后1周开始用药,疗程6个月;对照组46例,手术后不用药物巩固治疗,定期随访。结果:3组患者痛经症状均得到不同程度缓解,米非司酮组和孕三烯酮组总缓解率均明显高于对照组,差异有统计学意义(P<0.05);米非司酮组和孕三烯酮组复发率低于对照组(P<0.05)。结论:米非司酮与孕三烯酮用于子宫内膜异位症手术后巩固治疗,安全、有效,副作用小。     

腹腔镜手术联合药物治疗子宫内膜异位症的临床探讨

目的 探讨腹腔镜手术联合药物治疗子宫内膜异位症的临床效果.方法 选择98例子宫内膜异位症患者分为米非司酮组35例、孕三烯酮组33例和未用药组30例,均在腹腔镜下行保守手术治疗,米非司酮组于术后口服米非司酮10mg,每天1次,疗程为3个月;孕三烯酮组于术后口服孕三烯酮2.5mg,每周2次,疗程3个月.未用药组术后不用药.结果 米非司酮组和孕三烯酮组治疗后复发率相比差异无统计学意义(P>0.05),但两组复发率均显著低于未用药组(P<0.01);米非司酮组和孕三烯酮组疼痛缓解率差异无统计学意义(P>0.05),但明显高于对照组,差异均有统计学意义(P<0.01);三组妊娠率差异无统计学意义(P>0.05).结论 腹腔镜保守手术治疗后应用药物米非司酮或孕三烯酮,可有效治疗子宫内膜异位症患者,降低术后复发率,提高疼痛缓解率.     

腹腔镜保守性手术联合药物治疗子宫内膜异位症86例近远期疗效观察

目的:探讨腹腔镜保守性手术联合药物治疗子宫内膜异位症的临床疗效,为临床应用提供参考。方法:将我院收治的86例子宫内膜异位症患者随机分成A、B两组,每组43例,所有患者均行腹腔镜保守性手术治疗,术后A、B两组分别给予孕三烯酮和米非司酮治疗。结果:B组总有效率及妊娠率显著高于A组,且前者的不良反应发生率及复发率显著低于后者,两组比较差异显著具有可比性(P<0.01或P<0.05)。结论:子宫内膜异位症行腹腔镜保守性手术后辅以米非司酮联合治疗,疗效显著,不良反应小,复发率低,妊娠率高,值得临床广泛推广应用。     

米非司酮联合手术在子宫内膜异位症中的疗效研究

目的:探讨米非司酮联合手术治疗子宫内膜异位症的临床疗效。方法:将76例子宫内膜异位症患者随机分入孕三烯酮组与米非司酮组,两组患者均接受保守性手术治疗,术后分别给予两组患者孕三烯酮及米非司酮口服。比较两组临床疗效、1年内妊娠率、复发率及不良反应发生率。结果:米非司酮组治疗有效率显著高于孕三烯酮组(87.5%vs 66.7%,P0.05);米非司酮组及孕三烯酮组1年内妊娠率分别为43.8%和7.7%,差别具有统计学意义(P0.05);与孕三烯酮组相比,米非司酮组患者复发率显著降低(7.7%vs 33.3%,P0.05);米非司酮组患者关节酸痛、痤疮、肝功能损害及体重增加发生率显著低于孕三烯酮组(P0.05)。结论:与口服孕三烯酮相比,米非司酮联合手术治疗子宫内膜异位症临床疗效更为理想,妊娠率高,复发率低,且安全性好。     

不同药物应用于子宫内膜异位症腹腔镜术后的疗效及安全性

目的：对比分析子宫内膜异位症腹腔镜术后服用不同药物的临床疗效及安全性。方法选择江西九江市九江县妇幼保健院2012年3月～2013年10月行腹腔镜手术治疗子宫内膜异位症患者70例,随机均分为米非司酮组（给予米非司酮辅助治疗）与孕三烯酮组（给予孕三烯酮辅助治疗）（n=35）,比较2组的缓解率、复发率、妊娠率和不良反应。结果米非司酮组完全缓解率为82.9%,孕三烯酮组完全缓解率为85.7%,2组术后复发率均为2.8%,妊娠率均为66.7%,差异均无统计学意义。米非司酮组1例患者出现用药不良反应,孕三烯酮组9例出现不良反应,2组比较差异有统计学意义（P＜0.05）。结论子宫内膜异位症腹腔镜术后应用米非司酮辅助治疗疗效明显,不良反应少,安全性高,值得临床推广应用。     

子宫内膜异位症术后应用孕三烯酮和米非司酮的疗效观察

目的 比较重度子宫内膜异位症术后应用孕三烯酮与米非司酮的复发率及不良反应.方法 重度子宫内膜异位症术后51例患者随机分成两组,其中25例服用孕三烯酮2.5mg/次,2次/周,疗程6个月,26例服用米非司酮12.5mg,1日1次,于手术后第一次月经来潮5d内开始用药,疗程6个月,随访1～2年,观察临床症状、体征、激素水平、副反应及妊娠情况.结果 两种药物术后控制症状有效率达100%,术后应用孕三烯酮复发率为8%,而米非司酮复发率7.8%,米非司酮的不良反应较小.结论 子宫内膜异位症术后应用孕三烯酮与米非司酮能有效地控制子宫内膜异位症症状,减少复发,提高妊娠率,而米非司酮不良反应较小,使用方便.     

腹腔镜联合药物治疗中重度子宫内膜异位症的疗效观察

目的:探讨腹腔镜联合药物治疗中重度子宫内膜异位症的疗效。方法:以我院收治的内异症患者22例为治疗1组,以同期收治的内异症患者21例为治疗2组,以同期收治的内异症患者20例为对照组。所有患者均给予腹腔镜治疗,治疗1组给予米非司酮;治疗2组给予孕三烯酮;对照组不予口服任何药物,比较三组的疗效。结果:治疗1组与治疗2组比较,有效率及复发率的差异无统计学意义;治疗1组与治疗2组的有效率均高于对照组,差异具有统计学意义(P<0.05);治疗1组与治疗2组的复发率均低于对照组,差异具有统计学意义(P<0.05)。术后妊娠率的比较,治疗1组与治疗2组差异无统计学意义;治疗1组、治疗2组均高于对照组,差异具有统计学意义(P<0.05)。结论:腹腔镜联合药物治疗中重度子宫内膜异位症,可提高疗效及妊娠率,减少术后复发。     

米非司酮联合手术在子宫内膜异位症中的疗效研究

目的：探讨米非司酮联合手术治疗子宫内膜异位症的临床疗效。方法将76例子宫内膜异位症患者随机分入孕三烯酮组（n=36）与米非司酮组（n=40）,2组患者均接受保守性手术治疗,术后分别给予2组患者孕三烯酮及米非司酮口服。结果米非司酮组治疗有效率87.5%显著高于孕三烯酮组66.7%,差异有统计学意义（P<0.05）;米非司酮组及孕三烯酮组1年内妊娠率分别为43.8%和7.7%,2组差异有统计学意义(P<0.05);与孕三烯酮组33.3%相比,米非司酮组患者复发率7.7%显著降低（P<0.05）;米非司酮组患者关节酸痛、痤疮、肝功能损害及体重增加发生率显著低于孕三烯酮组（P<0.05）。结论与口服孕三烯酮相比,米非司酮联合手术治疗子宫内膜异位症临床疗效更为理想,妊娠率高,复发率低,且安全性好。     

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.