通过对冠心病患者的健康教育,使其在疾病知识、态度、及行为上得以提高和改善,并能自觉地采纳健康的行为及生活方式。从而预防冠心病的发生,促进康复的进程。
INTRODUCTION:There is an increasing number of methods available for removing the uterus, but no multicentre, randomised, clinical trials are available to show which type of operation ensures the best outcome for the patient. The charts of 207 vaginal hysterectomies were reviewed in this descriptive study. The aim was to examine whether vaginal hysterectomy might be an alternative for a group of patients.MATERIAL AND METHODS:Only patients with a previous, vaginal birth were entered in the study (four patients had not given birth). A uterus weight of 500-600 g was the upper limit set by our group for the use of the vaginal route. Patient characteristics, data from the operations, complications, and histological examinations of the uterus were analysed.RESULTS:The mean operation time was 61 min (95% CI 58-64 min), range 25-115 min. The difference between preoperative and postoperative haemoglobin was 1.1 mmol/l (95% CI 1.0-1.2 mmol/l). The mean length of hospital stay was 2.9 days (95% CI 2.7-3.1 days). The complications were 1) febrile morbidity; 17 (8%) (95% CI 4-12%); 2) urinary tract injury, 3 (2%) (95% CI 0-3%); 3) unforeseen need for major surgery (including conversion to abdominal hysterectomy), 3 (2%) (95% CI 0-3%).DISCUSSION:In some patients, vaginal hysterectomy is a good alternative.
Objective To evaluate the advantages of intraoperative laparoscopy used in transvaginal hysterectomy (TVH).Methods Retrospectively analysis the clinical data of 306 patients who received TVH with intraoperative laparoscopy between April 2005 and February 2009 in the Department of Gynecology of the Second Hospital of Shanxi Medical University.Analyze the clinical effects by operative time,blood loss,postoperative hospital stay,intraoperative and post-surgery complications and surgical indications,particularly the size of the uterus,pelvic adhesion and adnexa cases. Results The proportion of the uterus size greater than 3 months gestational size is 28.1%,proportion of pelvic adhesions is 29.4%; all adhesion patients were treatment with adhesiolysis by laparoscope,37.2% and 4.2% patients were treated with adnexa surgeries and electrocautery respectively,2 cases were ransitted to abdominal hysterectomy after laparoscopy in that the situation were not suitable for vaginal hysterectomy; the clinical effects were good,all patients were discharged with good conditions.Conclusion Laparoscopy could expand the indications of TVH and enhance its security,also could promotes the utilization of TVH more broaderly.
Objective To study the expression of CD62P in the plasma of diabetic nephropathy, and investigate the role of CD62P in the pathogenesis of diabetic nephropathy. Methods 56 cases of diabetics are classified into three groups according to the UAE and changes of kidney functions: the Group with normal urinary proteins(Group I); the Group with continuous urinary proteins and normal kidney functions(Group II), and the Group with abnormal kidney functions(Group III). Meanwhile a control group(proup Ⅳ) is set up with the cases chosen from the adults and old people who come to our hospital for physical examination.Detect the CD62P with Flow Cytometry ; While letting blood, detect the levels of blood sugarand kidney functions and make detection to the platelet and its dispersion of distribution in the blood routine examination; assay UAE in each hour that day;record the blood pressure of the patients. Results Detection of the CD62P concentration in the plasma: Comparing Group I with Group Ⅳ, there are not outstanding differences, P=0.303, comparing Group I with II, there are outstanding differences, P=0.033, and comparing Group I with III, there are also outstanding differences, P 0.001; there are outstanding differences in the comparisons between Group II and the common control group, P 0.05, and comparing Group II with Group III, there are outstanding differences, P=0.001. In the detection of the platelet and its dispersion of distribution in the blood routine examination, there are not outstanding differences among the three groups, P0.05. Conclusions CD62P has expression of different extent in each period of onset of diabetic nephropathy and with the development of the state of diabetic nephropathy the expression of CD62P is more obvious. CD62P plays an import role in the occurrence and development of diabetic nephropathy.Higher expression of CD62P concers with higher level of blood sugar and other factors. Medium haematoblast、 monocyte and T lymphocyte, which gather in the glomerulus and mesenchyme, may play an important role in the DN attack.In the occurrence and development of diabetic nephropathy, the high expression of CD62P doesn’t depend on the changes of platelet in quantity.
The development of higher education and economy are closely linked.In order to make the medical institutions of higher learning have their own unique core competence in many similar institutions in the country,it is necessary to precisely position,run schools with our own characteristics,make rational analysis of market demand,have a correct view of the medical degree,guarantee the quality of personnel training and strive to cultivate local talent and innovative features.
Objective To explore the issue of postoperative pain study ano-rectal diseases. Methods 102 cases of ano-rectal diseases clinical data were analyzed retrospectively. Results The injection of methylene blue combined solution significantly reduced wound pain,or even essentially painless; this group of 102 patients with postoperative pain and pain in 85 cases of grade ,accounting for 83.33%; Ⅱ severe pain in 15 cases,accounting for 14.71%; Ⅲ degree of pain in 2 cases,accounting for 1.96%. Conclusion Methylene blue as a long-acting analgesic agents,the preparation of simple and easy to get drug source,cheap,simple operation easily mastered,efficacy sure,more and more being used in clinical.
Objectives To detect and compare the systolic tricuspid annular velocity and time intercal changes by Doppler tissue imaging(TDI) technique in patients with pulmonary hypertension,and to explore the value of tricuspid annular systolic velocity and time intervals for quantification of right ventricular Systolic function.Methods 62 pulmonary hypertension patients and 30 normal were observed.To detecte color doppler echocardiography which ventricular free wall thickness and end-diastolic area were observed.To measure right ventricular ejection fraction(RVEF) with double plane Simpson formula.To measure peak systolic velocity of tricuspid annular(anterior leaflet,posterio leaflet,septal leaflet) with tissue doppler.To measure right ventricular ejection time of the systolic wave(ET) and regional pre-ejection period(PEP) of anterior leaflet tricuspid annular.Results Compared with the control group,in moderate and severe PH groups,Sa of anterior tricuspid annular were lower than those of control group(P0.05).In severe PH groups,Sa of posterio tricuspid annular were lower than those of control group(P0.05).Compared with the control group,PET prolonged,ET shortened,PET/ET ratio increased in moderate and severe PH groups(P0.05).Conclusion Not only Sa,but also ET and PEP measured with pulsed TDI are promising indices for the quantitative assessment of right ventricular systolic dysfunction in patients with pulmonary hypertension.
Objective To explore the operating Methods and clinical effects of treating acromioclavicular joint dislocation with the ligament advancement reinforcement system (LARS) artificial ligaments. Methods From November 2007 to January 2009,8 patients(5 males and 3 females,with an average age of 35.3 years)with acute acromioclavicular joint dislocation were treated with the LARS artificial ligaments.Results All 8 patients were available for follow-up with an average of 15 months. No postoperative complications such as infection,ligament rupture,ligament loosening occurred. The clinical Results were graded as being excellent in 7 patients,good in 1 according to Oxford Standard of Shoulder Function. The excellent and good rate was 100%.Conclusion The anatomical reconstruction and the stability of acromioclavicular joint dislocation can be obtained after operation with LARS artificial ligaments.
Objective To investigate the effect of combined therapy and selective resection of the dorsal penile nerve on the ejaculatory latency of patients with premature ejaculation (PE), coitus satisfaction degree of patients, and study its influence on the clinical efficacy. Methods A total of 24 cases of PE patients were subjected to combined medicine therapy. 17 cases of PE patients subjected to selective resection of the dorsal penile nerve. After 4 weeks, patients in both groups were assessed with ejaculatory latency in vagina and the coitus satisfaction degree. The clinical efficacy was compared between the two groups. Results The ejaculatory latency in vagina before treatment in medicine therapy group and operation group is (0.93±0.35)min, (0.91±0.39) min, respectively. After treatment they are (4.27±1.51) min, (4.46±1.65) min. The ejaculatory latency in vagina after treatment increased significantly in two groups compared to that before treatment (P0.01). The coitus satisfaction degree are (1.39±0.68), (1.31±0.77) respectively before treatment and (4.45±0.88),(4.51±1.03) after treatment. A month after treatment, the effective rate of two groups was 79.17% and 82.35% respectively. There is no significant difference between two groups. Conclusion The combined medicine therapy and selective resection of the dorsal penile nerve were safe and efficient in treatment of PE.
Objective To explore the invasion reasons about schizophrenic patients,and to enhance its levels in dignosis and antidiastole.Methods We selected 157 persons,the final diagnostic schizophrenic in Dalian 7th hospital,male 97 persons,female 60 persons,age from 15 to 59,who pathogenetic conditions were stable.We applied electrophoresis method to detect glycohemoglobin(GHb),did normal comparison,and found out its dependablity.Results After statistical treatment,the difference had statistical significance(P0.01).We found that the value of GHb in schizophrenic patients was 7.39±3.25%,and its value was higher than 4.58±1.8% in the normal comparison whose blood glucose and urine glucose in schizophrenic were normal,and it had nothing to do with diabetes mellitus.Conclusions That the contents of GHb heightened is the characteristic of schizophrenic.so it could be one of the affiliated diadynamic criteria in schizophrenic.
Objective To study levels of thrombopoietin(TPO) and the relationships between TPO and peripheral blood platelet (Plt) counts in patients thrombocytopenia. Methods Levels of TPO and Plt counts were detected in 114 patients with thrombocytopenia 25 healthy volunteers(control group) by using a sand-ELISA procedure. Results The TPO levels in patients with hematological malignant patients were lower compared to those in control group(P0.05),but others were no significance. Conclu-sions The result will provide an important consultation in the study of the regulation of TPO in thrombocytopenia.
Objective To investigate the correlation between serum uric acid(SUA) in patients with multiple sclerosis and the action of the disease.Methods The MS patients were treated by high doses of intravenous methylprednisolone(IVMP),and a quantitative enzymatic assay according to the manufacture's protocol was adopted to detect SUA levels in 54 patients with MS and 49 non-inflammatory neurological disease(NIND) controls.Results The SUA levels in patients with MS was significantly lower in comparison with NIND group and those in remission(P0.05).The SUA levels of MS patients did not change obviously with age(P0.05).After treatment,the number of focal zone decreased with the increase of SUA levels.Conclusion The SUA levels in MS patients is low and it is related to the sex,and unrelated to the age.The lower SUA level is an independent risks factor to multiple sclerosis.The SUA levels can be potentially adopted as a marker of disease activity of MS and the therapeutic effect of IVMP treatment.
Objective it is to discuss the effect of umbilical cord entangle neck on perinatal infant.Methods 365 clinical records were retrospectively analyzed the correlation of umbilical cord length and umbilical cord entangle neck, the effect of the circle number of umbilical cord entangle neck on perinatal infant .Results there wasn't umbilical cord entangle neck in short umbilical cord group , The rate of umbilical cord in longer group were significantly higer than in normal group (p0.01).the incidence rate of fetal distress is 23.01% in umbilical cord entangle neck , and neonatal asphyxia is 7.67%. Conclusions umbilical cord entangle neck was related with umbilical cord length, umbilical cord in longer lead to umbilical cord entangle neck. umbilical cord entangle neck increased the incidence rate of fetal distress 、neonatal asphyxia and death.
Objective To analysis for the characteristic and significance of the ultrasound diagnosis of varicocele in children.Methods 19 children with primary varicocele patients were conducted bilateral spermatic vein and left renal vein ultrasonography,a comparative analysis was performed for other side varicose,diameters and the compilications of nutcracker phenomenon.Results Among 19 with varicocele,18 were found in the left side,1 case in the bilateral.Spermatic vein diameters were 2.2～3.4mm,the average of which was 2.7±0.4.All cases were complicated with nutcracker phenomenon.Conclusions The cause of varicocele children is mainly due to nutcracker phenomenon,which should be regarded as the routine inspection of renal vein and for which the treatment is done.Nutcracker phenomenon should be used as the census for children Varicocele.
Objective To investigate the expression of PTEN protein and the relationship with clinic characteristics of esophageal carcinoma.Methods To detect protein expression of PTEN in 68 cases of esophageal carcinoma and normal esophageal tissues closely adjacent to carcinoma by immunohistochemistry.Results The incidence of PTEN in esophageal carcinoma was 67.6%,while in normal esophageal tissue it was 100%.The difference is significant(p 0.05).The expression of PTEN was correlated with the degree of differentiafion of carcinoma,1ymph node metastasis and depth of invasion.Conclusion The decreased expression of PTEN may play an important role in the occurrence,delvlopment and clininal pathologic features of esophageal carcinoma.
Objective To eliminate Microspironema pallidum by studying the serological test and the message of epidemiology in syphilis. Methods The message of epidemiology in syphilis were provided by syphilis patients from 2005 to 2007 in our hospital. The three serological tests including TRUST ,ELISA and TPPA were employed to detect the serum antibodies. Results The morbidity of syphilis was 2.7% in 2005,4.0% in 2006 and 8.7% in 2007.The rate of each staging is 55.9%,33.8%,1.5% and 8.8% in 2005, 73.9%,20.4%,0.7% and 5.0% in 2006 and 61.3%, 32.1%,0.6% and 6.2% in 2007. The sensitivity and specificity were 77%and 82%for TRUST , 87% and 95%for ELISA and 68% and 100% for TPPA. The feature of epidemiology indicate that there was a significant difference in male female ratio, civilization, age distribution, occupation and marriage. Conclusion There were significant higher sensitivity for ELISA and higher specificity for TPPA among three .
Objective To evaluate the treatment of intertrochanteric and subtrochanteric fractures of femur shape anatomic plate.Methods From Jan 2003 to Aug 2007,29 patients(16males and 13 females) with intertrochanteric and subtrochanteric fractures of femur were treated by snakehead shape anatomic plate.Skin traction was performed following admission.3 dynamic condylar screws into femoral head or neck,and other compact bone screws for distal femoral shaft.Various data were analyzed for evaluating the characteristics and curative effect.Results All cases were followed-up for 1 year averagely.The mean incision length was 12 cm,the average duration of operation and intraoperative X-ray fluoroscopy was 70min and 0.20 min,respectively.The mean blood loss was 500 ml.The average femoral neck-shaft angle was 128.9 degrees.None of the complications occurred postoperatively,including nonunion and malunion,deep venous thrombosis,internal fixation loosening or infection of the incision etc.Conclusions With shape anatomic plate can achieve satisfying outcomes of different concerns,such as time-saving,small incision,few complications,quick recovery and so on,which indicates that it should be a good choice for the treatment of proximal femoral fractures.
Objective T0 study the occurrence and characteristic of Kawasaki disease in children. Methods The data of 56 cases with Kawasaki disease in children from June 2001 to January 2009 were retrospectively analyzed. Results According to the diagnosis criteria of Kawasaki disease,28 children met to 6 main symptoms which counted for 50%,21 children met to 5 main symptoms which counted for 37.5%,6 children met to 4 main sym ptoms which counted for 10.7%.1 children which counted for 1.8% only had fevers during the course of the disease and without any other clinical manifestation. 27 children which counted for 64.3% had the complication of coronary artery lesions.After treatment,48 children were cured,7 improved,1 gave up and no one died.Except for the one that gave up treatment ,all children received follow-up in the next 3 months to 3 years.Diameter of coronary artery dilatation (4mm)could return to normal in 3 months,while those diameters of cornary artery dilatation that were between 4-7mm could return to normal in 6 months.One children that diameter of cornary artery dialation was 9mm was still receiving the follow- up. Conclusion Most of the children with Kawasaki disease have typical symptoms and could be diagnozed correctly.high dosage IVIG could have a good therapeutic efficacy.The rate of coronary artery lesions is higher in incomplete Kawasaki disease,and it should be paid more attention to earlier diagnosis and earlier treatment.
<正>马尔尼菲青霉病(penicilliosism arneffei PSM)是由马尔尼菲青霉菌(penicillium m arneffei PM)引起的一种少见的深部真菌感染性疾病。PM是条件致病菌,免疫力低下患者易感染。感染后表现多样,常见症状为发热、咳嗽、肝脾肿大、淋巴结肿大、皮疹、呈坏死样丘疹、局部脓肿等[1]。由于PM具有侵犯血管的习性和潜能及
