笑气吸入性镇痛用于人工流产术50例疗效观察

目的观察笑气吸入性镇痛用于人工流产术的疗效。方法对50例早孕妇女在常规消毒的同时,采用笑气吸入作为观察组,同期采用利多卡因宫颈神经阻滞麻醉行人流术50例作为对照组。分别观察镇痛效果、镇痛起效时间、手术时间、出血量及人流综合征发生率。结果两组镇痛效果比较差异有显著性(P<0.01),两组镇痛起效时间比较差异有统计学意义(P<0.05),人流综合征发生与对照组比较(P<0.01)有显著性差异。两组手术时间、出血量无显著性差异(P>0.05)。结论笑气吸入性镇痛用于人工流产术镇痛效果好,镇痛作用起效快,病人不良反应少,适合人流手术需要。     

笑气吸入镇痛人工流产302例分析

目的观察笑气吸入镇痛人工流产的疗效。方法将604例早孕者随机分为观察组和对照组。观察组302例给笑气吸入人工流产术。对照组302例除不给笑气吸入外,其他处理与观察组相同。观察比较两组人工流产镇痛效果、手术时间、出血量、人流综合征发生率及不良反应情况。结果观察组镇痛效果明显高于对照组(P<0.01)。人流综合征发生率明显低于对照组(P<0.01)。笑气除有个体差异外无不良反应。手术时间和出血量无明显差异。结论 笑气吸入镇痛用于人工流产术,能减轻病人疼痛,降低人流综合征的发生。使用方法安全,简单易操作,是一种理想的人工流产镇痛方法。     

笑气吸入和心理护理在人工流产术中的护理观察

目的探讨笑气吸入性镇痛配合心理护理用于人工流产术的疗效。方法将200例孕妇随机分为实验组（n=100例）和对照组（n=100例）。观察组孕妇在术前2分钟自控吸入笑气，护士全程陪伴．给予孕妇心理护理。语言诱导病人放松至手术结束，对照组采用利多卡因宫颈旁神经阻滞麻醉。观察比较两组孕妇术中的镇痛效果，以及出血量、不良反应的发生率。结果观察组镇痛效果的总满意率为98％，面对照组总满意率为51％，P〈0.01，人工流产综合征发生率观察组为2％．对照组15％．P〈0.01.两组的阴道出血量无显著差异。结论笑气吸入与心理护理用于人工流产对减轻疼痛、降低人工流产综合征的发生率效果显著、且操作方便、绽用安全，受术者乐于接受，临床应用满意。     

笑气用于人工流产术的镇痛效果观察

目的：观察笑气用于人工流产术的镇痛效果。方法：将早孕妇女采用笑气吸入镇痛法行人工流产术315例作为观察组,随机选取同期早孕妇女未采用镇痛措施行人工流产206例作为对照组,观察笑气吸入用于人工流产术的镇痛效果、手术时间、出血量及人流综合征发生率。结果：观察组镇痛效果显著优于对照组,两组差异有非常显著性（P〈0.01）,人工流产综合征发生率较对照组小,而两者手术时间、出血量的差异无显著性（P〉0.05）。结论：笑气用于人工流产镇痛效果可靠,镇痛作用起效快,操作简便安全,患者不良反应少,值得推广应用。     

笑气吸入镇痛应用于人工流产300例分析

目的了解笑气吸入镇痛在人工流产中的镇痛疗效。方法选择300例人工流产孕妇随机分为试验组和对照组,观察两组患者疼痛程度、手术时间及人流综合征发生率的差异。结果两组镇痛效果比较有显著性差异(P<0.05),手术时间,术中出血量比较无显著差异(P>0.05)。结论笑气用于人工流产镇痛效果可靠,安全,有效,是一种简单,无创的镇痛方法。     

笑气在人工流产术中应用

目的寻找一种在人工流产术中镇痛作用好,操作简便、安全、患者易于接受的镇痛方法.方法将60例患者随机分为治疗组30例,面罩吸入笑气后进行人流.对照组30例,用传统人流术.结果笑气自动扩宫总有效率达90%,镇痛总有效率达97.7%,均比对照组高.笑气还能明显降低人工流产综合征的发生率(P＜0.01),术中出血量不增加,且操作简单、方便.结论面罩吸入笑气是人工流产术中较好的镇痛方法.     

笑气吸入在人工流产术中的观察及护理

目的 研究笑气在人工流产手术中的镇痛效果.方法 将150例行人工流产术者随机分为3组,I组:50例,笑气吸入组;Ⅱ组:50例,异丙酚静脉麻醉组,Ⅲ组:50例,普通人流组.观察3组在镇痛效果、宫颈松驰程度、人工流产综合征发生率、手术时间、离院时间、子宫收缩和出血量等方面的情况.结果 (1)在离院时间上,I组明显短于Ⅱ组,(p＜0.05).(2)I组和Ⅲ组相比,I组镇痛效果明显提高(P＜0.01)、宫颈松驰程度明显提高(P＜0.01)、人工流产综合征发生率明显降低(P＜0.01),在其他观察指标上,2组无明显差异,P＞0.05.结论 笑气在人流术中镇痛效果明显、可靠,显著降低人流综合征发生,值得在无痛人工流产中推广应用.     

笑气、缩宫素在无痛人流中效果观察

目的 探讨笑气缩宫素在无痛人流中的应用效果.方法 选择787例早孕人群,采用笑气吸入 缩宫素肌注为观察组A.2%利多卡因宫颈旁阻滞麻醉法为对照组B.结果 镇痛效果、宫颈松弛、人流综合征出现、平均出血量两组比较结果差异有显著性,P<0.05.结论 笑气吸入联合缩宫素肌注用于人工流产方法简便、安全,能有效减轻人工流产时的疼痛.预防人工流产并发症发生.     

3种无痛人工流产术376例效果分析

目的:探讨利多卡因宫颈注射、笑气吸入、芬太尼与异丙酚联合静脉麻醉下行人工流产术中镇痛效果及宫颈扩张效果。方法:将2003年1月～2005年12月在本院门诊要求行无痛人工流产的早孕妇女376例分三组:一组宫颈注射利多卡因后行人工流产,为利多卡因组。一组笑气吸入后行人工流产,为笑气组。一组芬太尼与异丙酚联合静脉麻醉后行人工流产,为异丙酚组。比较3种方式下人工流产时镇痛效果、宫颈扩张效果及人流综合征发生率。结果:利多卡因组术中镇痛有效率65.1%,宫颈扩张有效率82.5%,人流综合征发生率22.2%。笑气组术中镇痛有效率74.6%,宫颈扩张有效率87.3%,人流综合征发生率13.6%。异丙酚组术中镇痛有效率100%,宫颈扩张有效率96.9%,人流综合征发生率2.6%。结论:芬太尼与异丙酚联合静脉麻醉下行人工流产术中镇痛效果及宫颈扩张效果均优于宫颈注射、笑气吸入下行人工流产术,且人流综合征发生率明显降低。     

笑气联合利多卡因在无痛人工流产中的应用

目的探讨笑气、利多卡因联合应用于人工流产术(人流)的镇痛效果。方法选择自愿要求人工流产终止早孕而无禁忌证的健康妇女160例,观察组80例为笑气吸入及2%利多卡因宫颈旁阻滞麻醉,对照组80例为不用任何药物,而采用传统人工流产术。观察两组术中疼痛情况、人流综合征发生率、宫颈松弛效果和出血量。结果两组的镇痛效果总有效率,观察组为98.75%,对照组为18.75%,两组镇痛效果比较差异有显著性(P<0.05);人工流产综合征发生率:观察组为1.25%,对照组为40%,两组比较差异有显著性(P<0.05);宫颈松弛总有效率,观察组为98.75%,对照组为17.5%,两组比较差异有显著性(P<0.05)。两组出血量比较无明显差异(P>0.05)。结论笑气联合利多卡因在人流中的镇痛效果好,宫颈松弛满意,人流综合征发生率低,简便易行,安全可靠,值得推广。     

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.