铁缺乏状态学龄儿童视听整合持续操作测试分析

目的 探讨铁缺乏状态学龄儿童是否存在反应控制能力缺陷和注意力缺陷.方法 选择2005年5月～2006年6月在本院儿童保健门诊就诊的6～12岁铁缺乏状态儿童42例和健康儿童42例,分别设为铁缺乏组和对照组.应用视听整合持续操作测试软件,进行反应控制能力和注意力测试.对铁缺乏状态学龄儿童补充铁剂治疗8周后再进行反应控制能力和注意力测试.结果 铁缺乏状态学龄儿童各项反应控制能力商数和注意力商数均低于对照组,差异有显著性(P<0.05).铁缺乏组经过8周铁剂治疗后血清铁蛋白及各项反应控制能力商数和注意力商数均高于治疗前,差异有显著性(P<0.05).结论 铁缺乏状态学龄儿童反应控制能力和注意力均下降,经铁剂治疗后有效.     

ADHD儿童100例IVA-CPT测试结果分析

目的探讨视听整合连续执行测试（IVA-CPT）在临床诊断儿童注意力缺陷多动障碍（ADHD）中的应用。方法对2009年1月—2010年12月我院多动症门诊主诉以多动、注意力不集中的、符合ADHD诊断标准的100例儿童进行IVA-CPT测试,对其结果进行分析。结果男童中注意缺陷型占28%,多动型占45%,混合型占27%;女童中注意缺陷型占40%,多动型占25%,混合型占35%.差异有显著性（P〈0.005）。男童的综合反应控制商数和综合注意力商数分别为80.50±20.01和66.9±317.30;女童的综合反应控制商数和综合注意力商数分别为86.45±19.50和64.5±415.20,各项数值比较,差异均有显著性（P〈0.01）。结论 IVA-CPT是一种对儿童ADHD具有诊断价值的客观检查方法。     

脑电生物反馈仪测试和治疗儿童多动症的临床分析

目的 探讨视听整合连续性测试(IVA-CPT)对儿童多动症(ADHD)的诊断和脑电生物反馈治疗ADHD的疗效及临床价值.方法 ①采用IVA-CPT.测试法对129例临床疑似多动倾向的儿童进行测试,根据综合反应控制商数和综合注意力商数得分,确定ADHD儿童并分型;②对经IVA-CPT测试后确定为注意缺陷型ADHD 33例患儿进行脑电生物反馈治疗,并作治疗前后商数得分对比.结果 129例儿童IVA-CPT测试,30例综合反应控制商数和综合注意力商数得分均>85,不支持ADHD;25例两个商数均<85为混合型ADHD;17例综合反应控制商数<85为多动型ADHD;57例综合注意力商数<85为注意缺陷型ADHD.33例注意缺陷型ADHD儿童行脑电生物反馈治疗,综合注意力商数在治疗20次后,57.8%(19/33)转为正常;治疗40次后,75.8%(25/33)转为正常,综合注意力商数治疗后明显高于治疗前(P<0.01).结论 IVA-CPT测试可提供ADHD儿童的诊断及分型依据;脑电生物反馈治疗可改善ADHD儿童注意力集中水平,为提高注意力、改善行为问题和学习困难提供了良好的治疗方法.     

视听整合持续操作测试评价哮喘儿童持续注意力和反应控制力的临床研究

目的：应用视听整合持续操作测试（ IVA-CPT）评估哮喘患儿的持续注意力和反应控制力。方法90例哮喘患儿,其中哮喘完全控制组30例、部分控制组35例和未控制组25例,健康对照组儿童45例,应用IVA-CPT软件评估其反应控制力和持续注意力。结果（1）哮喘组的综合注意力商数（ FSAQ ）、视觉注意力商数（ VAQ ）、听觉注意力商数（AAQ）、视觉警醒商数（VIG-V）、听觉警醒商数（VIG-A）、视觉速度商数（SPE-V）、听觉速度商数（SPE-A）均低于对照组（P＜0．05）;哮喘组与对照组的反应控制力商数比较,差异均无统计学意义（P＞0．05）。（2）哮喘组儿童VAQ、SPE-A SPE-V、VIG-V和VIG-A异常率高于对照组儿童（ P ＜0．05）。（3）与健康组相比,哮喘未控制组的 FSAQ、VAQ、AAQ 低于对照组（P＜0．05）,哮喘部分控制组的FSAQ、VAQ低于对照组（P＜0．05）。与完全控制组比,哮喘未控制组儿童的FSAQ、VAQ、AAQ均低于完全控制组儿童（P＜0．05）,哮喘部分控制组的VAQ低于完全控制组儿童（P＜0．05）。结论哮喘患儿存在持续注意力损害,而且其损害程度与哮喘的控制水平相关联。     

注意力缺陷多动障碍儿童执行功能的分析

目的探讨注意力缺陷多动障碍儿童执行功能对学习的影响。方法采用南京伟思医疗科技有限公司生产的VBFB2000生物反馈系统中的视、听整合持续执行测试软件,对427例儿童进行执行操作功能测试,分析注意力缺陷多动障碍儿童和对照组儿童的测试结果。结果注意力缺陷多动障碍儿童的视觉警醒性商数(79. 61)、听觉一致性商数(83. 84)、多动商数(80. 73)均值低于一个标准差;听、视觉注意力集中商数(P=0. 000, 0. 019)、谨慎商数(P=0. 005, 0. 000)明显低于对照组。表现为大脑皮层警醒兴奋性低,对干扰识别的正确率低,长时间维持注意力的指向性、稳定性、一致性弱,易疲劳,并且自制冲动的控制能力低。此外,注意力缺陷多动障碍儿童的听、视觉在一致性商数、速度商数上有差异。结论注意力缺陷多动障碍儿童的视、听执行功能都有缺陷,在干预治疗时不仅要进行视—躯体操作执行能力的训练,同时也要重视听—躯体操作执行能力的训练。     

寿光地区儿童铁、锌缺乏情况分析

目的了解寿光地区儿童体内锌和铁的含量、分布状况及其可能的影响因素，为儿童合理补充微量元素提供参考。方法选择2007年12月～2009年10月来我院健康体检的353名儿童，按年龄分成婴儿期（0－）、幼儿期（1岁－）、学龄前期（3岁－）、学龄期（7—12岁）4组，采集空腹静脉血置于肝素钠抗凝管中，使用日立7600—020全自动生化分析仪检测血浆中锌、铁的含量。计算各年龄段儿童铁、锌元素分布情况，同时进行各年龄段性别间微量元素的差异比较。结果寿光地区儿童锌的缺乏率为28．05％，铁的缺乏率为29．18％，性别之间均无显著性差异（P〉0．05）；婴儿期组锌、铁缺乏率均较高，幼儿期组与学龄前期组锌的缺乏率高于铁，学龄期组铁缺乏率明显高于锌且铁缺乏率有性别差异（P〈0．05）；铁的缺乏在各年龄段有显著性差异（P〈O．05），而锌的缺乏在各年龄段间无显著性差异（P〉O．05）。结论寿光地区儿童铁、锌的缺乏均比较严重，尤其是婴幼儿时期更容易缺乏，年龄、性别不同微量元素含量也不同。     

益气养阴活血通络法联合弥可保治疗2型糖尿病周围神经病变的临床观察

目的 观察益气养阴活血通络法联合弥可保治疗2型糖尿病周围神经病变之疗效。方法 随机将65例患者分成治疗组（中西药组）和对照组（西药组），均在西药降血糖基本达标的同时，对照组单纯口服弥可保，治疗组在弥可保的基础上加用自拟方药内服，治疗8wk。结果 总有效率及治疗后证候积分比较，治疗组优于对照组p〈O．05，有显著性差异；治疗后肌电图比较，治疗组也优于对照组（p〈0．01或p〈O．05），有显著性差异。结论 益气养阴活血通络之自拟方联合弥可保治疗2型糖尿病周围神经病变疗效较单独使用弥可保好，是治疗该病的有效方剂之一。     

注意力缺陷多动障碍儿童执行功能的分析

目的探讨注意力缺陷多动障碍儿童执行功能对学习的影响.方法采用南京伟思医疗科技有限公司生产的VBFB 2000生物反馈系统中的视、听整合持续执行测试软件,对427例儿童进行执行操作功能测试,分析注意力缺陷多动障碍儿童和对照组儿童的测试结果.结果注意力缺陷多动障碍儿童的视觉警醒性商数(79.61)、听觉一致性商数(83.84)、多动商数(80.73)均值低于一个标准差;听、视觉注意力集中商数(P =0.000,0.019)、谨慎商数(P =0.005,0.000)明显低于对照组.表现为大脑皮层警醒兴奋性低,对干扰识别的正确率低,长时间维持注意力的指向性、稳定性、一致性弱,易疲劳,并且自制冲动的控制能力低.此外,注意力缺陷多动障碍儿童的听、视觉在一致性商数、速度商数上有差异.结论注意力缺陷多动障碍儿童的视、听执行功能都有缺陷,在干预治疗时不仅要进行视-躯体操作执行能力的训练,同时也要重视听-躯体操作执行能力的训练.     

应用IVA-CPT测试系统评价3.3.3.训练对小学生脑功能影响的研究

目的：应用视听整合连续执行测试系统（integrated visual and auditory continuous performancetest，IVA-CPT），评价3．3．3．训练后小学生的脑功能改变的程度。方法：本研究通过采用随机抽样分组方法，抽取武汉市某小学二年级两个班学生。一个班为实验组参与此实验，共30人；另一班为对照组25人。实验组进行3．3．3．训练，其他活动两组保持一致，干预前后对照的方法，训练前后两组皆使用IVA视听整合测试系统测试注意、记忆参数，通过参数前后变化进行分析评价。结果：①通过IVA测试系统所测得商数，进行干预前后组内差值均值的实验组与对照组组间比较，两组比较实验组控制力尺度中谨慎商数提高显著（P〈0．05）、注意力尺度的警醒商数提高显著（P〈0．05）听觉持续性商数差异显著（P〈0．05）、视觉持续性商数差异极显著（P〈0．001）。②短时记忆实验组提高显著有统计学意义。（p〈0．05）结论：“3．3．3”训练对学生的脑功能中注意力与记忆力某些指标有一定影响。     

静脉铁剂对维持性血液透析患者贫血、炎症反应及氧化应激的影响

目的探讨静脉铁剂蔗糖铁对维持性血液透析（MHD）患者贫血、炎症及氧化应激反应的影响。方法选择本院MHD患者90例,随机分为I组（静脉铁剂30例）,Ⅱ组（口服铁剂30例）,Ⅲ组（未补铁组30例）。三组均同时联合皮下注射重组人促红细胞生成素（rHuEPO）（8000—100HD0）IU/W,共观察24周。结果治疗24周后I组患者血红蛋白（Hb）与红细胞压积（Hct）水平显著高于Ⅱ组与Ⅲ组（P〈0．01）,同时rHuEPO用量明显减少（P〈0．05）,但是I组患者C反应蛋白（CRP）、血清白介素6（IL-6）、肿瘤坏死因子（TNF—α）、丙二醛（MDA）显著上升（P〈0．05）,谷胱苷肽过氧化物酶活性（GSH—Px）显著下降（P〈0．05）。结论静脉补铁可有效改善MHD患者贫血及铁缺乏状态,但可能诱发炎症反应及加重氧化应激反应。     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.