阴道镜在宫颈病变诊断中的临床价值

目的:评价阴道镜检查对宫颈上皮内瘤样病变的诊断价值.方法:回顾性分析326例外观有宫颈炎的患者行宫颈涂片、阴道镜检查及镜下定位取活组织病理检查.结果:阴道镜下诊断CIN 90例占27.61%,其中CINⅠ 45例,CINⅡ 27例,CINⅢ 18例.经病理确诊CINⅠ 34例,CINⅡ 23例,CINⅢ 14例.阴道镜检查对CIN的诊断准确性为78.89%.结论:阴道镜在宫颈病变的诊断中显著优于宫颈防癌涂片,对CIN筛查有重要价值,阴道镜检查可以避免不必要的宫颈活检,减少宫颈组织创伤及感染的发生率,与病理学检查结合,可以提高宫颈病变诊断的准确率.     

电子阴道镜诊断宫颈病变的临床价值

目的 探讨电子阴道镜检查对宫颈病变诊断的临床价值.方法 2005年9月至2009年11月111例疑有宫颈病变的患者,在门诊行电子阴道镜直视下宫颈活检,对电子阴道镜诊断与组织病理诊断结果进行分析.结果 电子阴道镜诊断:慢性宫颈炎48例;宫颈上皮内瘤样病变(CIN)Ⅰ17例,CINⅡ20例,CIN Ⅲ20例;宫颈浸润癌6例.组织病理确诊:慢性宫颈炎50例;CIN54例,包括CIN Ⅰ 16例、CINⅡ19例、CINⅢ19例;宫颈浸润癌7例.电子阴道镜诊断与组织病理学诊断在上述宫颈病变的符合率依次为92.0%、81.3%、84.2%、89.5%、85.7%.阴道镜诊断宫颈病变的总符合率为88.3%(98/111).结论 电子阴道镜检查对宫颈病变诊断符合率高,其配合组织学检查是早期诊断和治疗宫颈病变的重要手段,尤其在宫颈癌前病变和早期宫颈癌的诊断中有着较高的应用价值.     

阴道镜在宫颈病变诊断中的临床价值

目的:探讨阴道镜检查在宫颈病变诊断中的临床价值。方法:对2000年3月～2004年9月419例宫颈病变患者的阴道镜检查结果和病理检查结果进行分析总结。结果:419例患者全部进行了病理学检查,确诊宫颈上皮肉瘤(CIN)48例,CIN检出率为11.46%,其中CINⅠ26例,CINⅡ12例,CINⅢ10例,原位癌5例,浸润癌14例,湿疣34例,慢性宫颈炎318例。结论:阴道镜检查对宫颈病变的正确诊断和CIN筛查有重要价值,与病理学检查结合,可提高宫颈病变诊断的准确率。     

妇科特殊检查

051072阴道镜在宫颈病变诊断中的临床价值杨秀桃…∥海南医学院学报.—2005,11(1).—35～36探讨阴道镜检查在宫颈病变诊断中的临床价值。方法:对419例宫颈病变患者的阴道镜检查结果和病理检查结果进行分析总结。结果:419例患者全部进行了病理学检查,确诊宫颈上皮肉瘤(CIN)48例,CIN检出率为11.46%,其中CINⅠ26例,CINⅡ12例,CINⅢ10例,原位癌5例,浸润癌14例,湿疣34例,慢性宫颈炎318例。结论:阴道镜检查对宫颈病变的正确诊断和CIN筛查有重要价值,与病理学检查结合,可提高宫颈病变诊断的准确率。表1参3(原文摘要)051073阴道镜在子宫颈…     

阴道镜检查241例分析

目的 评价阴道镜检查在诊断宫颈上皮内瘤样病变中的价值。方法 对1999年9月—2001年12月在我院妇科就诊，因临床可疑或宫颈细胞学巴氏Ⅱ级以上而行阴道镜及病理检查的241例患者进行临床分析。结果 CIN病变的发生率在各年龄段之间无显著差异，241例阴道镜检查的患者175例做细胞学涂片，宫颈细胞学涂片为巴氏Ⅱ、Ⅱa级的患者85例，阴道镜检查定点活检病理结果为CIN病变者22例，阳性率为25．9％；宫颈细胞学涂片为巴氏Ⅱb级及以上的患者110例，阴道镜检查定点活检病理结果为CIN病变者37例，阳性率为33．6％，假阳性率为66．4％；临床可疑未涂片行阴道镜检查者66例，活检病理结果为CIN病变者21例，阳性率为31．8％。阴道镜图像为Ⅰ级者139例，病理诊断为CIN病变者7例，检出率为(5％)，均为CINⅠ；阴道镜图像为Ⅱ级者78例，病理诊断为CAN病变者51例，检出率为65．4％，其中CINⅠ为36例，CINⅡ14例，CINⅢ1例；阴道镜图像为Ⅲ级者24例，病理诊断为CIN病变者22例，检出率为91．7％，其中CINⅠ为4例，CINⅡ9例，CINⅢ9例。结论 防癌检查应从年轻患者开始，宫颈细胞涂片、阴道镜、病理活检三者有机地结合起来，以提高CIN的早期诊断率，对防止和减少子宫颈癌的发生具有重要意义。     

阴道镜检查宫颈病变78例临床分析

目的探讨阴道镜检查在诊断宫颈病变中的临床诊断价值。方法对2006年12月-2007年10月78例宫颈病变患者的阴道镜检查进行回顾性分析。结果阴道镜检查78例宫颈病变中，全部进行病理学检查，病理检查确诊为CINⅠ18例，CINⅡ6例，CINⅢ2例，原位癌3例，宫颈浸润癌3例，慢性宫颈炎46例。结论阴道镜检查对宫颈癌、宫颈癌前病变的早期诊断具有重要价值。     

宫颈上皮内瘤变的阴道镜评价

目的 探讨阴道镜检查对宫颈上皮内瘤变(CIN)的诊断价值.方法 2006年1月-2006年6月我院采用电子阴道镜对液基细胞学(TCT)检查阳性(≥ASC)及临床可疑宫颈病变的患者共315例进行检查,并在阴道镜下取活检送病理.结果 315例患者阴道镜诊断CIN共150例,其中高度病变41例,低度病变109例,经病理检查确诊的CIN为134例,其中CINⅢ14,CINⅡ25,CINⅠ 95,阴道镜对CIN的诊断符合率89.33%,对CINⅡ、CINⅢ的诊断符合率95.12%.结论 阴道镜检查对早期发现宫颈上皮内瘤变尤其是高度病变有重要价值.     

ASCUS在子宫颈病变诊断中的分析

目的 评价性质未定的不典型鳞状细胞(ASCUS)在子宫颈病变中的诊断价值. 方法 对328例宫颈液基薄层细胞学检查为ASCUS的患者进行阴道镜检查及组织活检,将结果进行对比. 结果 宫颈细胞学ASCUS患者中宫颈上皮内瘤样病变(CIN)阳性91例(27.7%),CINⅠ 58例(17.7%),CINⅡ 25例(7.6%),CINⅢ8例(2.4%),浸润癌0例.其中HPV阳性的106例ASCUS,组织病理学诊断为CIN 34例,其中CINⅡ及CINⅢ9例,占9%;HPV阴性112例ASCUS中,CINⅠ 8例,CINⅡ 1例. 结论 对ASCUS的患者应行阴道镜下活检,进一步明确诊断,以便能及时发现宫颈病变.     

宫颈疾病阴道镜与活组织病理检查的诊断结果比较

目的:探讨电子阴道镜检查在宫颈疾病诊断中的应用。方法:2007年3月～2011年3月宫颈病变门诊行电子阴道镜检查的1 600例患者中,1 210例行活组织病理检查,对阴道镜诊断与组织病理学检查结果进行比较分析。结果:活组织病理检查1210例中,病理诊断为宫颈炎553例,宫颈息肉15例,宫颈尖锐湿疣27例,宫颈上皮内瘤样病变(CIN)Ⅰ236例,CINⅡ～Ⅲ348例,宫颈癌(SCC)31例;诊断符合率分别为:宫颈炎及宫颈息肉97%,CINⅠ92.6%,CINⅡ93.2%,CINⅢ68.2%,高度病变(CINⅡ～Ⅲ)91.7%,SCC 80.6%。结论:电子阴道镜检查是诊断宫颈疾病,尤其CIN和宫颈癌的重要工具,但也存在一定局限性。     

TCT及阴道镜在宫颈病变诊断中的应用分析

目的 分析比较TCT及阴道镜在宫颈病变中的应用价值.方法 对310例TCT检查阳性的宫颈病变患者进行阴道镜检查,并在可疑病变区取多活检后送病理检查,比较TCT、阴道镜及病理组织学的诊断符合率.结果 TCT诊断的ASCUS、LSIL、HSIL、SCC结果与病理组织学的阳性符合率分别为38.9%、77.5%、97.5%、100%,1例SCC病例的病理组织学结果为CINⅡ,无漏诊病例;阴道镜诊断的CINⅠ、CINⅡ、CINⅢ、浸润癌与病理组织学的阳性符合率分别为69.8%、91%、100%、95.7%,阳性符合率为88.7%,有1例CINⅡ和4例CINⅢ过度诊断为宫颈癌,有11例宫颈癌被阴道镜诊断为CINⅠ、CINⅡ、CINⅢ,尚有1例宫颈癌被诊断为慢性炎症.结论 TCT与阴道镜在宫颈病变诊断中各有优劣,两者不能互相替代,而是互为补充,合理的联合应用可以提高宫颈病变的检出率.     

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.