妊娠肝内胆汁淤积症104例胎儿监护的临床价值

目的 探讨妊娠肝内胆汁淤积症（ＩＣＰ）胎儿监护的临床价值。方法 对１０４例ＩＣＰ患者进行无负荷试验９ＮＳＴ）和脐动脉充Ｓ／Ｄ值测定。结果 ＮＳＴ这脐动脉充Ｓ／Ｄ值≥３者围产儿预后不良的发生率明显高于正常者,差异显著。结论ＮＳＴ和脐动脉血流Ｓ／Ｄ值测定,可作为了解ＩＣＰ患者胎儿胎盘功能和预测围产儿结局的指标,具有较高的临床价值。     

脐动脉多普勒血流测定与胎儿监护在诊断脐带异常中的应用

目的 探讨胎儿监护与脐动脉多普勒血流测定,预测脐带异常的临床价值。方法 选孕３７～４２＾＋周单胎头位妊娠的住院孕妇５８１例,进行ＮＳＴ初筛,其中可疑有脐带异常者１０５例,再行脐血流测定,以ＮＳＴ有脐带因素的异常图形与Ｓ／Ｄ值≥３和Ｓ／Ｄ值〈３为产前脐带异常的判断标准,并对围产儿结局进行比较。结果 Ｓ／Ｄ值≥３组羊水粪染,脐带绕颈和剖宫产率均高于Ｓ／Ｄ值〈３组（Ｐ〈０．０５）,Ｓ／Ｄ值≥３组中８３％     

彩色多普勒血流显像在脐绕颈及胎儿宫内窘迫中的应用

用彩色多普勒血流显像（ＣＤＦＩ）对晚期孕妇进行检查,用脉冲多普勒（ＰＷ）测定脐动脉收缩期与舒张期血流速度,计算两者比值（Ｓ／Ｄ）。结果显示,ＣＤＦＩ诊断胎儿脐绕颈的准确率为１００％,脐动脉Ｓ／Ｄ≥３与Ｓ／Ｄ〈３两组胎儿宫内窘迫发生率及围产儿死亡率有显著差异。结论：ＣＤＦＩ及脐动脉Ｓ／Ｄ≥３是检测脐绕颈与胎儿宫内窘迫的可靠方法。     

胎儿脐动脉血流测定与脐血血气分析预测新生儿预后120例

应用超声多普勒，对１２０例孕妇妊娠２６～２８周及妊娠３６～３８周各进行脐动脉血流测定１次，观察胎儿静脉血气分析，新生儿出生１ｍｉｎＡｐｇａｒ评分及羊水性状。结果：正常妊娠时，脐动脉血流速度比值（Ｓ／Ｄ）随孕周增加而减少。Ｓ／Ｄ≥３组的新生儿窒息、羊水混浊及酸中毒发生率明显率高于Ｓ／Ｄ＜３组。提示当脐动脉Ｓ／Ｄ≥３，妊娠结局将有改变     

胎儿脐动脉血流速度波形监测胎儿状况145例分析

应用彩色多普勒超声，检测正常妊娠妇女１０９例（正常妊娠组）胎儿宫内生长迟缓３６例（ＩＵＧＲ组），胎儿脐动脉血流速波，多普勒指标包括血流的收缩末期峰值（Ｓ）与舒张末期峰值（Ｄ）的比值（Ｓ／Ｄ），脉搏指数（ＰＩ），阻力指数（ＲＩ）。结果：ＩｕＧＲ组脐动脉血流各指标随妊娠进展逐渐下降，但与正常妊娠组相比则明显长高，差别有显著性意义（Ｐ〈０．０５）。当Ｓ／Ｄ≥３，ＰＩ〉１．０，ＲＩ〉０．６时，围产儿预捂不     

无刺激试验,声刺激试验及脐动脉血流参数的临床观察

报道孕满３６周至４２周的孕妇６１例同时接受无刺激试验（ＮＳＴ）、声刺激试验（ＶＳＴ）和脐动脉血流参数测定（Ｓ／Ｄ,ＲＩ,ＰＩ）的结果。指出,ＮＳＴ与ＶＳＴ结果无显著差异,Ｐ＞０．０５;ＮＳＴ与Ｓ／Ｄ结果相比,有显著差异,Ｐ＜０．０５。ＮＳＴ或ＶＳＴ异常组与Ｓ／Ｄ异常组中宫内窘迫发生率无显著差异,Ｐ＞０．０５。脐动脉血流参数与胎儿宫内窘迫、脐带缠绕关系密切,Ｐ＜０．０５。认为临床上可考虑以ＶＳＴ代替ＮＳＴ,且有缩短操作时间等优点。多普勒超声测定脐动脉血流参数对脐带缠绕等血流阻力增加因素的预测有重要参考价值,三者联合使用可提高对胎儿急慢性宫内窘迫诊断的准确性。     

脐动脉血流速度和无负荷试验产前监护高危妊娠的临床意义

本文对４８４例高危妊娠病人行多普勒测定脐动脉血流速度收缩期与舒张期的比值（Ｓ／Ｄ），无负荷试验（ＮＳＴ）产的监护，监护异常者１７８例。Ｓ／Ｄ异常组（１１１例）中ＣＳＴ异常的发生率（４１．４％）高于ＮＳＴ异常组（２６．２％）（Ｐ＜０．０５）；而新生儿１和５ｍｉｎＡｐｇａｒ低分的发生卒ＮＳＴ异常组较高（Ｐ＜０．０５）。在Ｓ／Ｄ异常同时伴有ＮＳＴ异常组（２５例）中。ＣＳＴ异常、Ａｐｇａｒｌ和５ｍｉｎ低分的发生率最高（Ｐ＜０．００１）。临床胎儿窘迫和分娩时羊水胎粪污染的发生率在监护异常的三组中无差异（Ｐ＞０．０５）。结果提示，应用脐动脉血流速度监护力这能较早地提供胎儿宫内危险信号。     

妊娠合并肝内胆汁淤积症的超声多普勒变化

对１１９例孕３６￣４０周妊娠合并肝内胆汁淤积症（ＩＣＰ）孕妇用脐动脉血流仪测出脐动脉血流收缩期峰值（Ｓ）与舒张期末峰值（Ｄ）的比值（Ｓ／Ｄ）、脉搏指数（ＰＩ）和阻力指数（ＲＩ）值，并与同期同孕周正常妊娠对照组比较。结果：单纯ＩＣＰ组与正常妊娠组比较，Ｓ／Ｄ、ＰＩ和ＲＩ无统计学意义，而ＩＣＰ并发胎儿宫内窘迫时与正常妊娠组比较，Ｓ／Ｄ有差异，ＰＩ和ＲＰ无统计学意义；ＩＣＰ脐动脉多普勒检查阻力升高者出现     

监测胎儿脑,脐血流阻力指标预测胎儿宫内缺氧

目的：预测胎儿宫内缺氧。方法：应用彩色多普勒超声对１４７例孕妇进行详细观察。结果：胎儿的大脑中动脉（ＭＣＡ）血流Ｓ／Ｄ值〈４、ＰＩ〈１．４、ＲＩ值〈０．６（Ｓ／Ｄ、ＰＩ、ＲＩ值简称阻力指标）;脐动脉（ＵＭＡ）血流Ｓ／Ｄ值〉３、ＰＩ值〉１．７、ＲＩ值〉０．８;ＰＩ、ＲＩＭＣＡ／ＰＩ、ＲＩＵＭＡ〈１时,提示胎儿宫内缺氧。妊高征组和伴ＩＵＧＲ的妊高征组缺氧发生率与正常组缺氧发生率比较差异有显著性（Ｐ〈０     

妊娠期肝内胆汗淤积症产前联合监护的临床意义——附120例临床分析

目的 探讨对妊娠期肝内胆汗淤积症（ＩＣＰ）患者进行产前联合监护的临床价值。方法 对１２０例ＩＣＰ患者进行尿雌三醇／肌酐比值（Ｅ／Ｃ）、胎心无负荷试验（ＮＳＴ）、超声脐Ａ血流分析（Ｓ／Ｄ）检查的监护,进行分析。结果 尿Ｅ／Ｃ、ＮＳＴ,Ｓ／Ｄ对了解患者胎盘功能,监测胎儿宫内状态和预测围生儿预后。是有较高临床价值的监护手段。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.