正常妊娠妇女血常规检测参考区间调查

目的研究妊娠妇女在不同孕期常用血常规指标的变化,并探讨其正常参考区间。方法分别对孕妇妊娠早期、中期以及晚期等3个时期的RBC、HGB、HCT、PLT、WBC和NEU进行测定。结果正常妊娠妇女血常规指标与非妊娠对照组相比,RBC、HGB、HCT随着孕期增加而降低,到中、晚孕降低较明显（P〈0.05）;PLT随着孕期增加而升高;WBC和NEU在妊娠期均升高,中、晚孕升高较明显（P〈0.05）。结论血常规各项指标随孕妇孕期的发展均产生不同程度的变化。本调查统计分析的参考区间可以作为妊娠妇女血常规检测临床应用的参考依据,以及用于评估正常妊娠妇女的孕期健康水平。     

论血常规标本临检前混匀静置时间对结果的影响

目的对血常规标本临检前混匀静置时间对检测结果的影响进行分析。方法选取2016年1月至2017年1月我院接收的150例血常规检查者作为观察对象,每人抽取外周静脉血,抗凝处理后静置10 min、30 min、1 h、2 h后行血常规检测,对比不同静置时间的检测结果,包括白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)、血小板(PLT)及红细胞压积(HCT)等指标,并对WBC分类指标中性粒细胞(NEU)、淋巴细胞(LYM)的比值进行对比。结果通过测定,静置30min内的WBC、RBC、Hb及HCT等指标水平无统计学差异(P0.05),但PLT计数会随时间延长而升高,差异有统计意义(P0.05),1 h、2 h相比无统计学差异(P0.05);不同留置时间的LYM比值无统计学差异(P0.05),但NE在30 min内处在最高,之后有所降低(P0.05)。结论在血常规检查中,血液标本检前静置时间对测定结果有一定影响,应加以重视。     

不同温度与时间条件下对血常规参数检测结果的影响

目的 研究不同温度与时间条件下对血常规参数检测结果的影响.方法 选择2014年7月—2015年7月在该院接受健康体检的人群的320份血液样本进行研究,根据保存温度的差异分成两组,各160份,A组置于室温保存,B组冷藏保存,对比两组血液样本不同时间段的MCH、WBC、Hb、RBC、PLT及HCT水平.结果 24 h后两组血液标本的MCH、WBC、Hb、RBC、PLT、HCT水平比较差异无统计学意义(P>0.05),但是PLT与HCT水平发生了明显变化.48 h后B组血液标本的Hb、PLT水平高于A组血液标本的Hb、PLT,差异有统计学意义(P<0.05).结论 血液标本置于不同的温度下保存,在不同的时间下血常规水平会出现一定程度的变化,提示临床上需要妥善保存血液标本,选择最佳的检验时间,从而保证血液标本检测结果的可靠性.     

影响血常规化验结果的相关因素分析

目的探讨影响血常规化验结果的相关因素。方法选择2013年1月—3月我院128例门诊健康体检者作为研究对象,采用全自动血细胞计数仪,真空采血法采血,静脉血取自肘静脉,末梢血取自左手环指内侧面。采血后0.5 h内及4 h检测白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)、血小板(PLT)。结果 0.5 h内测试WBC、RBC、Hb与4 h测试无显著性差异(P>0.05),4 h测试PLT低于0.5 h,差异有显著性(P<0.01);末梢血检测中WBC、RBC、Hb均高于静脉血检测,但PLT低于静脉血检测,差异有显著性(P<0.01)。结论不同时间、采血部位血常规检测结果有显著性差异,做血液检测时应选用静脉血,短时间内处理样本,以尽量减少偶然误差和系统误差。     

温度和时间对血常规检验结果的影响观察

目的:通过探讨温度和时间对血常规检验结果的影响,旨在为提高血常规检验的准确性,为疾病的诊断提供理论依据。方法:选择2013年6月-2013年12月在我中心接受血常规检查的健康体检者260例,随机分成室温保存组和冷藏保存组,测定结果进行对照,记录血常规参数检测结果变化情况。结果:室温保存24h血常规指标中WBC、RBC、Hb、MCH与对照组无显著差异,HCT、PLT指标与对照组差异显著,冷藏保存72 h血常规指标中WBC、RBC、MCH、Hb比较稳定,HCT、PLT在48 h内比较稳定,超过48h与对照组差异显著。结论:不同温度下保存血液样品随着时间的增加对血常规检验结果有一定影响,在临床应用时要结合保存条件在最优时间内进行检验。     

温度和时间对血常规检验结果的影响观察

目的：通过探讨温度和时间对血常规检验结果的影响，旨在为提高血常规检验的准确性，为疾病的诊断提供理论依据。方法：选择2013年6月-2013年12月在我中心接受血常规检查的健康体检者260例，随机分成室温保存组和冷藏保存组，测定结果进行对照，记录血常规参数检测结果变化情况。结果：室温保存24h血常规指标中WBC、RBC、Hb、MCH与对照组无显著差异，HCT、PLT指标与对照组差异显著，冷藏保存72 h血常规指标中WBC、RBC、MCH、Hb比较稳定，HCT、PLT在48 h内比较稳定，超过48h与对照组差异显著。结论：不同温度下保存血液样品随着时间的增加对血常规检验结果有一定影响，在临床应用时要结合保存条件在最优时间内进行检验。     

不同采血方法进行血常规检验在临床应用中的价值研究

目的:探讨分析不同采血方法进行血常规检验在临床应用中的价值。方法:选取2013年6月-2014年6月在我院接受血常规检验的患者300例,根据不同采血方式将其分为观察中和对照组各150例,对观察组患者进行静脉血采集,对照组患者进行末梢血采集。对两组患者的血常规结果进行统计学分析,比较白细胞计数(WBC)、红细胞计数(RBC)、红细胞比容(HCT)、血小板计数(PLT)及血红蛋白(Hb)等检查项目的差异。结果:末梢血中WBC、RBC、HCT、PLT、Hb的检测结果均低于静脉血的检测结果,比较差异均有统计学意义(P<0.05)。提示末梢血的稳定性低于静脉血和动脉血;其他检测结果比较差异无统计学意义(P>0.05)。结论:不同采血方法将对血常规的检测结果产生一定影响,建议临床应用静脉血采集来进行血常规检测,使检测结果更为客观准确,具有更高的应用价值。     

不同采血方法进行血常规检验在临床中的价值比较

目的:探讨不同采血方法进行血常规检验在临床中的应用价值。方法:选取2012年6-12月于本院接受血常规检查的患者200例,根据不同采血方法分为观察组和对照组各100例,观察组进行静脉血采集,对照组进行末梢血采集,对血常规结果进行统计学分析,并比较两组患者血常规检查结果中的白细胞计数(WBC)、红细胞计数(RBC)、血小板计数(PLT)、红细胞比容(HCT)、血红蛋白(Hb)、平均红细胞血红蛋白浓度(MCHC)等检查项目的差异。结果:两组血常规检测指标中WBC、RBC、PLT、HCT、Hb比较差异均有统计学意义(P0.05);MCHC、平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)比较差异均无统计学意义(P0.05)。结论:临床应用静脉血采集进行血常规检测结果更为客观准确,静脉血液采集具有更高的应用价值,值得临床推广应用。     

XS-1000i血细胞分析仪全血与末梢血模式检测结果比较

目的:观察XS-1000i血细胞分析仪全血与末梢血2种进样模式检测白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)、血小板(PLT)、平均血红蛋白含量(MCH)、红细胞比容(HCT)、平均红细胞体积(MCV)、平均血红蛋白浓度(MCHC)8项参数结果有无差异。方法:应用XS-1000i血细胞分析仪检测108例患者的全血与末梢血标本的WBC、RBC、Hb、PLT、MCH、HCT、MCV、MCHC 8项参数,并对结果进行统计分析。结果:HCT、MCV、MCHC的结果2种模式差异有统计学意义(P<0.01);WBC、RBC、Hb、PLT、MCH差异无统计学意义(P>0.05)。结论:末梢血进样模式测定的WBC、RBC、Hb、PLT、MCH这几个主要参数可信性强,适用于化疗的血液病患者反复采血及新生儿、婴幼儿。     

凝血四项和血常规在临产孕妇中的变化及临床价值

目的研究临产孕妇的血常规、凝血四项变化及临床价值。方法选取2015年12月至2016年12月在本院分娩的212例临产孕妇临床资料(设观察组),同期选取我院体检的非妊娠健康女性100例(设对照组),均行血常规、凝血功能检测,比较两组血常规及凝血功能指标的水平。结果观察组RBC、Hb含量及HCT均比对照组少,WBC含量比对照组多(P0.01);观察组aPTT、PT、TT指标值比对照组低,Fbg含量则多于对照组(P0.01)。结论临产孕妇通过血常规及凝血四项检测,有助于凝血功能异常的诊出,及早发现妊娠贫血或高血压疾病,预防血栓疾病,降低母婴不良结局。     

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.     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.