21482例新生儿苯丙酮尿症和先天性甲状腺功能低下筛查分析

目的通过对本地区新生儿苯丙酮尿症（PKU）和先天性甲状腺功能低下（CH）的筛查,了解本地区新生儿PKU、CH的发病率,做到早诊断、早治疗。方法新生儿于出生后48h,充分哺乳后采足跟血。PKU采用细菌抑制法,测定苯丙氨酸（phe）浓度;phe≥4μIU／ml即为阳性;CH采用时间分辨荧光免疫测量法（DELFIA法）测定促甲状腺素（TSH）浓度,≥20μIU／ml,即为疑似阳性,对疑似阳性患儿检测游离T3、T4、TSH确诊。结果1998年3月至2008年11月,共筛查新生儿21482例,确诊PKU患儿5例,发病率为1／4296;确诊CH患儿7例,发病率1／3068。结论开展新生儿疾病的筛查,早诊断、早治疗,对降低我国病残儿的发生有十分重要的意义。     

内蒙古地区28964例新生儿疾病筛查结果分析

目的：探讨内蒙古地区新生儿苯丙酮尿症（phenylketouria,PKU）及先天性甲状腺功能减低症（congenital hy-pothyroidism,CH）两种疾病的发病情况。方法：2007年7月至2012年11月在内蒙古妇幼保健院出生的全部新生儿28 964例,均在出生72 h后采集足跟血;PKU筛查采用荧光检测法测定血苯丙氨酸（phenylalanine,PHE）浓度,CH筛查采用时间分辨法检测促甲状腺激素（TSH）。结果：PKU初筛阳性123例、初筛阳性率0.42%,共确诊PKU患儿14名,其中高苯丙氨酸血症1名,未发现假阴性结果。CH初筛阳性233例、初筛阳性率为0.80%,确诊CH患儿4例。结论：内蒙古地区PKU患病率高于全国平均水平,CH患病率低于全国平均水平。     

高效液相色谱－荧光法测定新生儿血清Phe和Tye浓度的价值分析

目的：探讨高效液相色谱－荧光法测定新生儿血清Phe和Tye浓度在筛查新生儿苯丙酮尿症（PKU）的价值。方法：回顾21例确诊PKU新生儿的实验室资料作为观察组,选择同期22例健康新生儿作为对照组,全部采用高效液相色谱－荧光法测定Phe和Tye浓度,并计算Phe／Tye比值,分析测定对筛查新生儿PKU的价值。结果：观察组Phe浓度、Phe／Tye比值明显低对照组（P〈0．01）;观察组Tye浓度明显高于对照组（P〈0．01）。结论：通过高效液相色谱－荧光检测法能够快速、准确测定新生儿Phe和Tye浓度,在PKU的早期诊断、鉴别、评估疗效和评价预后等方面具有非常重要的意义。     

沈阳地区新生儿疾病筛查232258例回顾性分析

目的 了解沈阳地区新生儿先天性甲状腺功能低下(CH)和苯丙酮尿症(PKU)的发病率,为CH和PKU患儿的早期干预提供依据.方法 新生儿出生72小时后采集足跟血,用酶免疫荧光分析法、时间分辨免疫荧光分析法测定干血片中的促甲状腺激素(TSH),用荧光法测定苯丙氨酸(Phe)含量.结果 经对沈阳地区232 258例新生儿进行筛查,检出CH患儿64例,发病率为1∶3629;PKU患儿31例,发病率为1∶7492.结论 新生儿疾病筛查可作为预防出生缺陷的一个重要手段,加强实验的全程质量控制,提高新生儿疾病筛查率,使CH和PKU患儿得到早期诊断、早期治疗,防止智力、体能障碍的发生.     

盐城市2012-2014年新生儿遗传代谢病筛查结果回顾性分析

目的总结和分析盐城市2012--2014年新生儿苯丙酮尿症（PKU）、先天性甲状腺功能减低症（CH）和先天性肾上腺皮质增生症（CAH）疾病筛查情况,并对3种疾病的发病率进行探讨。方法对盐城市2012--2014年所有参与新生儿遗传代谢病筛查的对象在出生72h后,7d之内,充分哺乳,由医务人员采集足跟血,检测样品中苯丙氨酸（Phe）、促甲状腺素（TSH）、17α-羟孕酮（17α—OHP）的浓度,对可疑结果进行确诊检查。结果2012—2014年盐城市共筛查新生儿199612例,共检出苯丙酮尿症（PKU）24例,发病率为1：8317（％）,先天性甲状腺功能减低症（CH）121例,发病率为1：1650（％）,先天性肾上腺皮质增生症（CAH）9例,发病率为1：22179（％）。结论盐城市PKU发病率稍微高于全国平均水平,CH发病率明显高于全国平均水平,CAH发病率则稍微低于全国平均水平（1：10000—1：20000）。通过新生儿遗传代谢病筛查,使患儿得到早期的诊断和治疗,从而提高我国人口素质,减少残疾儿童的发生。     

镇江地区先天性甲状腺功能减低症的筛查及治疗效果分析

目的：总结分析镇江地区新生儿先天性甲状腺功能减低症（CH）的筛查和诊治经验。方法：对本地区近5年出生72h的111238例新生儿,采足跟血滴在专用滤纸上,用塑料袋封存送至筛查中心（镇江妇幼保健院）,采用时间分辨免疫法进行TSH的筛查。可疑标本复核后仍异常,召患儿回筛查中心进行血清促甲状腺激素（TSH）、游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）的测定。确诊者给予左旋甲状腺素片规范性治疗,定期监测其甲状腺功能,进行体格评估和智能测试。结果：筛查111238例新生儿,确诊CH患儿31例。其中2例筛查阴性,甲状腺功能检查后确诊。镇江地区CH发病率为1／33588。28例CH患儿智力水平及体格发育均达到同龄儿生长发育水平,骨龄正常,发育商（DQ）测试平均108（85-132）分,2例失访,1例智能发育落后。结论：新生儿疾病筛查是早期诊断及早期治疗CH的保障,应该推广普及。筛查阳性或筛查阴性而进一步确诊的CH患儿早期规范性治疗,定期随访,其体格和智力发育可与同龄儿相当。     

重庆市新生儿疾病筛查12年结果回顾性分析

目的 总结重庆市开展新生儿疾病筛查12年来先天性甲状腺功能减低症(CH)和苯丙酮尿症(PKU)的筛查结果和体会.方法 CH筛查先后采用放射免疫法、时间分辨免疫荧光法检测促甲状腺素(TSH)的浓度.PKU筛查先后采用细菌抑制法和荧光法测定血苯丙氨(PHE)浓度.结果 1996年10月至2008年12月共筛查本市25个区县的新生儿427 566例,共检出CH患儿295例,发病率为1/1 449,检出PKU16例,发病率1/26 723.结论 (1)本市CH发病率明显高于全国平均水平.(2)新生儿疾病筛查工作应在政府的领导和支持下,不断健全网络,规范管理,加强健康教育,才能有效提高筛查率和召回复查率,使患儿得到早期诊断和治疗,从而提高人口素质,减少残疾儿童的发生.     

潍坊市新生儿疾病筛查苯丙氨酸切值的探讨

目的探讨通过检测新生儿足跟全血干血片苯丙氨酸（Phe）水平筛查新生儿苯丙酮尿症（PKU）的切值。方法采用连续流动荧光分析仪测定新生儿72 h足跟全血干血片Phe水平。结果正常新生儿Phe频数呈正偏态分布,99%分位数为42.1 mg/L,共筛查40 096例新生儿,确诊5例典型PKU,1例高苯丙氨酸血症（HPA）。结论本地区筛查PKU切值以40.0 mg/L为宜。     

58338例新生儿疾病筛查结果分析

目的了解恩施州新生儿先天性甲状腺功能减低症（CH）、苯丙酮尿症（PKU）的发病率。方法 CH筛查指标为血中促甲状腺激素（TSH）,实验方法为时间分辨荧光免疫分析法;PKU筛查指标为血中苯丙氨酸,实验方法为荧光化学法。结果 2006年~2009年共筛查新生儿58 338例,确诊CH14例,发病率为1∶4 167,PKU确诊3例,发病率为1∶19 446。结论新生儿疾病筛查是CH和PKU早期诊断的有效措施,是减少出生缺陷,提高出生人口素质的重要措施。     

运城市新生儿“两病”筛查发病率分析

目的：了解新生儿先天性甲状腺功能低下和苯丙酮尿症的发病率,促进新生儿疾病筛查工作更好地开展。方法选取2012年1月—2015年6月运城市167423例接受先天性甲状腺功能减退症（CH）和苯丙酮尿症（PKU）筛查的新生儿,于出生72 h后采足跟血制成滤纸干血片,应用时间分辨免疫荧光法检测血片中促甲状腺激素（TSH）和茚三酮荧光法检测血片中苯丙氨酸（PHE）含量,Tsh值≥10μIU/mL或PHE值≥2.0 mg/dL的新生儿视为可疑阳性,召回复查并进一步确诊。结果所选新生儿中共确诊CH患儿77例,检出率为46.0/10万;PKU患儿28例,检出率为16.72/10万。运城市CH发病率与全国、山西平均水平一致,PKU发病率明显高于全国平均水平。结论新生儿“两病”我市是高发区,应加大宣传力度,加强新筛管理,提高血片质量,保证新生儿疾病筛查的覆盖率。新生儿“两病”的预防工作已卓有成效,应进一步增加新生儿疾病筛查新项目,降低新生儿出生缺陷发生率。     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.