Objective To investigate infertile inpatients hospitalized in Pingjin Hospital in Tianjin from 2008 to 2010, so as to provide baseline data for further research. Methods According to diagnosis criteria of WHO, we collected demographical characteristics, disease cause and cost constitution of infertility inpatients hospitalized in Pingjin Hospital in Tianjin from 2008 to 2010. The data of each patient were input into ACCESS database and SPSS 13.0 was used for statistical analysis. Results a) From 2008 to 2010, there were 1 452 infertile patients from 33 different areas of mainland China, 79.7% of which was from the north of China. b) The mean age was 31.2±4.3 years old. The percentage of patients aged 30 to 34 years accounted for the most (40.3%). Mental laborers (23.3%) were more than physical laborers (7.2%). 36.7% of patients received education from universities and 83.1% of patients had family income ranging from 20,000 yuan to 190,000 yuan. c) The mean age of the first sexual activity was 21.4±2.9 years old. 53.7% of patients had only one sexual partner and most couples had sexual activities twice every week. The mean age of husbands was 32.9±5.5 years old with the highest percentage of 30 to 35 years old (39.2%). The percent of intellectual work of husband was the highest (35.9%). 64.9% of patients had normal semen analysis results and 23.0% never took related examination. d) 29.9% of patients was primary infertility and 70.1% was secondary infertility, of which 57.6% had either induced or medical abortion. The mean duration of infertility was 5.2±3.5 years (range 1 to 21 year). e) 76.3% of infertile patients had pelvic adhesion and 88.6% suffered from tubal disease. Among the tubal infertile patients, 23.6% had uterine disease, 5.2% had ovarian disease, 5.0% had endometriosis, 6.7% had multiple problems, and 4.8% had unexplained infertility. In patients with tubal infertility, the incidence of distal fimbria atresia (45.8%) was higher than that of proximal block (32.9%). 24.7% of patients with fimbria atresia had hydrosalpinx and among of them, 21.1% had no hydrosalpinx. 15.2% had congenital tubal defects. f) The average hospital stay was 10.5 days and the cost was 14 253.3 yuan per person. The percentage of material cost was 29.1% and that of drugs was 18.2%. Conclusion a) The total number of infertile inpatients was 1 452 in gynecology department of Pingjin Hospital of Tianjin from 2008 to 2010. 79.7% of patient was from North China. Most of them were 30 to 34 years old and 44.3% had no job. The percentage of patients had university education and that of low-middle family income was the highest. Sexual activity was relatively traditional. Most husbands were 30 to 35 years old and intellectual workers, and 23.0% of them had never taken an examination of semen analysis. More patients were secondary infertile, and the duration of infertility was 1 to 21 years. b) 76.3% of patients had pelvic adhesion and 88.6% had tubal disease. The incidence of distal tubal fimbria atresia was higher than proximal tubal occlusion. c) The average hospital stay was 10.5 days and the cost was 14 253.3 yuan per person which was further lower than each cycle cost of assisted reproductive technology. The overall costs included materials and drugs (47.3%), which were mainly at patients’ own expense.
目的 探讨胰性脑病的可能的发病机制、发病情况及防治措施.方法 计算机检索中文科技期刊全文数据库(1989～2004),收集有关胰性脑病的临床研究,并进行统计分析.结果 共纳入43篇文献,435例患者.胰性脑病在重症急性胰腺炎中的发病率远高于轻症急性胰腺炎;发病年龄趋向中、老年;病死率为43.67%;病因仍以胆系疾病为主;伴发低氧的几率不高于未并发胰性脑病患者.结论 胰性脑病的发生可能是多因素共同作用的结果,仍需进一步探讨其发病机制.血清髓鞘碱性蛋白有望成为有价值的诊断指标.防治以治疗原发病急性胰腺炎为主,重在预防.胰酶抑制剂和早期营养支持有一定预防作用.
目的:了解疼痛门诊患者的一般情况,同时运用软组织外科学理论对疼痛门诊患者作病因分析,为进一步更好地服务疼痛患者提供临床依据。方法:3246例门诊疼痛患者作一般情况统计分析,同时应用软组织外科学理论根据疼痛部位寻找相应压痛点,符合软组织痛者给予相应治疗,其他诊断者按相应疾病治疗。结果: ①性别:男性1418例,占4368%,女性1828例,占5632%;②居住地:城镇居民1123例,占3459%,农村居民2123例,占6541%。③ 年龄:小于等于20岁183例,占565%,21岁到30岁278例,占763%,31岁到40岁728例,占2242%,41岁到50岁648例,占1995%,51岁到60岁700例,占2156%,61岁到70岁471例,占1452%,71岁到80岁206例,占636%,大于80岁62例,占191%。④ 疼痛时间:疼痛时间在小于30天1367例,占4214%,1个月到1年1015例,占3236%,大于1年不满3年388例,占1197%,大于3年不满10年350例,占1076%,大于10年90例,占276%。⑤ 病因:痛风、PHN、HZ、三叉神经痛、类风湿、股骨头坏死、强脊、残肢痛、面瘫、肋骨折、外伤、FBSS、压骨折、CA共255例,占786%。有相应压痛点,诊断为慢性软组织损害者共2991例,占9214%;⑥疼痛部位:其中头面痛278例,占856%,颈肩上肢痛609例,占1878%,胸背痛427例,占1315%,腰臀腿痛1666例,占5132%,全身痛172例,占529%,腹会阴痛94例,占29%。 结论: 门诊疼痛患者中女性患者多于男性患者,农村居民多于城镇居民,30岁到60岁年龄段疼痛患占大部分(6393%),发病时间在1年以内者占大部分(745%),慢性软组织损害占绝大部分(9214%),其中腰及下肢痛占1半以上(5132%)。
目的：探讨女性生殖道瘘的病因及预防措施。方法：回顾性分析我院妇产科2000年1月至2005年12月收治入院的57例女性生殖道瘘病例的病因。结果：产伤和妇科手术占女性生殖道瘘病因的前两位，分别占56.1%（32/57）和33.3%（19/57）。结论：产伤和妇科手术是引起女性生殖道瘘的主要原因。加强围产期保健、积极处理产科合并症以及提高妇科手术技术是降低女性生殖道瘘发生率的关键因素。
Objective To discuss the pathogeny， treatment and prophylactic measures of postcholecystectomy syndrome (PCS). Methods The clinical data of 150 patients with laparoscopic PCS in our department from October 2000 to March 2009 were analyzed. Results Etiological factors were found in 131 patients: one hundred and twelve cases were due to the reasons of biliary system, including bile duct residual stones after cystic resection， the injury bile duct stenosis， a long residual cystic canal， nipple benign stricture, bile duct tumor etc; Nineteen examples were due to other reasons, including gallbladder stone merger reflux gastritis, gastroduodenal ulcer， diverticulum beside duodenal nipple, and so on, which resulted in the symptoms un-release after cystic resection. Nineteen cases were not found organic lesion. In ones whose etiological factors were definite, 117 cases were treated with different surgeries according to different etiological factors; another 33 cases were treated with conservative treatment. Total 145 cases were followed up, and 139 cases in them were cured or relieved at different degrees. Conclusion Careful preoperative examination, normalized operation avoiding damaging bile duct and leaving behind bile duct stones can effectively prevent laparoscopic PCS.
原发性胆囊癌是胆道系统常见的恶性肿瘤，早期无特异临床表现，一经发现多属中晚期，疗效不佳，预后极差。随着分子生物学与现代影像学技术的发展，近20年来，对胆囊癌的诊治水平虽有较大的提高，但总体上仍不能令人满意。
目的探讨老年急性肠梗阻的临床特点及其治疗，寻找降低死亡率的有效方法。方法回顾性总结分析150例经手术证实的60岁以上的急性肠梗阻患者的病因、临床特点及其治疗方法。结果引起肠梗阻的病因中，肿瘤75例(50.0%)，肠粘连27例(18.0%)，腹外疝11例(7.3%)，肠扭转10例(6.7%)，其它原因导致梗阻27例（18.0%）。绞窄性肠梗阻34例，术后有并发症35例，死亡12例。结论老年急性肠梗阻的主要病因为肿瘤，加强围手术期处理、重视老年合并疾病、早期诊断及手术可有效减低术后死亡率。
Platelet aggregation test (PAgT), platelet adhesion test (PAdT), thromboplastic activity of factor Ⅷ (FⅧ∶c), antithrombin Ⅲ activity (AT-Ⅲ∶a), antithrombin Ⅲ antigen (AT-Ⅲ∶Ag), von willebrand factor (vWF) and fibrinogen (Fg) were measured in 33 patients with biliary tract diseases and 24 normal individuals. The results showed that there was no significant difference in PAgT, PAdT, AT-Ⅲ∶a and AT-Ⅲ∶Ag between the two groups (Ｐ＞0.05). Fg increased more significantly in biliary tract disease than in the controls (Ｐ＜0.01). FⅧ∶c increased more significantly in patients with obstructive jaundice than in that of nonjaundiced and the controls (Ｐ＜0.01). The levels of vWF increased higher and higher in the sequence of patients with no jaundice, obstructive jaundice due to benign diseases and obstructive jaundice due to malignancy(Ｐ＜0.01). In conclusion, Fg, FⅧ∶c and vWF increased in patients with biliary tract disease.
In a series of experiments on rats,we have observed that the tensile strength and hydroxyproline content of left colonic anastomosis presented the lowest level on the 3rd and 4th postoperative days. Aprotinin,dimethyl sulfoxide,superoxide dismutase and vitamin A could improve the early coures of healing of colonic anastomosis;hydroxycortisone could retard the early course of healing of anastomosis and vitamin A antaonize the deleterious effect as mentioned above. Perioperative chemotherapy did not impair the early coures of healing of colonic anastomosis. The primary rasection and anastomosis of left colon for complete obstruction could be safety done if colonic content was decompressed before performing anastomosis and abdominal cavity was irrigated with antibiotic solutions afterwards. The mechanism of some factors influencing the healing of colonic anastomosis is discussed.