Bllod Lead Dynamics of Lead—Exposed Pregnant Women and Its Effects on Fetus Development

The dynamics of blood lead(Pb-B) and blood zinc protoporphyrin(ZPP-B)of women in early pregnancy and parturient women with lead exposure and the effects on fetus development were investigated.Pb-B of lead-exposed women was high:0.984μmol/L(20.38μg/dl)and ZPP was 84.54μg/dl.Cord blood Pb-B was 0.896μmol/L(18.56μg/dl) and cord blood ZPP was 69.24μg/dl.In the control group,Pb-B was 0.261μmol/L(5.41μg/dl),ZPP-B,37.59μg/dl,cord blood,Pb-B0.34μmol/L(7.03μg/dl),and cord ZPP-B 49.0μg/dl.There was a significant correlation beteen blood lead and blood ZPP,maternal Pb-B and cord Pb-B,maternal Pb-B and cord ZPP-B.The significance of the consistency of high level Pb-B and the ffects on fetus development is discussed.     

Contribution of placental leptin to the serum levels in preeclampsia and the effect of hypoxia on synthesis of placental leptin

Objective: To investigate the contribution of placental leptin to the serum levels in preeclampsia and the effect of hypoxia on synthesis of placental leptin. Methods: Fifteen preeclamptic women and 20 normotensive pregnant women were recruited in present study. Leptin concentrations in peripheral venous blood samples and uterine venous blood samples were measured by radioimmunoassay. Eight cases of normal human term placental villi were cultured either in normaxia (21%O2) or in hypoxia (2%O2) followed by determining leptin in the culture medium by radioimmunoassay. Results: Leptin concentrations were significantly higher in preeclamptic women than in normotensive pregnant women, both in the peripheral vein ([23.29±12.87] μg/L vs [13.87±5.57] μg/L, P<0.01) and uterine vein ([16.44±8.62] μg/L vs [11.21±4.20] μg/L, P<0.05). Leptin concentrations were significantly higher in the peripheral vein than in uterine vein, both in the preeclamptic (P<0.01) and in normotensive pregnant women (P<0.01). Concentrations of leptin in the culture medium were significantly increased in hypoxia than in normoxia (P<0.05). Conclusion: The pathogenesis of preeclampsia may be associated with an increase of maternal serum leptin and placenta leptin, and hypoxia in placenta may be an important factor that results in preeclamptic placenta to produce more leptin. Placenta is not the principal source of the serum leptin in the preeclamptic women or normotensive pregnant women.     

Selenium supplement in the prevention of pregnancy induced hypertension.

The effect of selenium (Se) supplement on pregnancy was studied in 52 pregnant women with high risk factors of pregnancy induced hypertension (PIH). They were given natural Se dietetic liquid (100 μg / d) for 6-8 weeks during late pregnancy, and 48 controls were given placebo. They received similar routine prenatal care. The results revealed that Se supplement on the pregnant women prevented and decreased the incidence of PIH and gestational edema, and elevated the mother's blood Se level by 0.1008± 0.091 ppm in the treated group while decreased by 0.0402±0.046 ppm in the control group (P<0.01). The umbilical blood Se level was 0.2756± 0.100 ppm in the treated group and 0.1544 ± 0.051 ppm in the control (P<0.01). The differences of the neonatal birth weight and the amount of postpartum hemorrhage between the two groups were not significant.     

海南省三亚市新型冠状病毒感染孕妇所分娩核酸阴性新生儿临床特征

Objective To explore the clinical characteristics of nucleic acid negative newborns delivered by pregnant women infected with SARS-CoV-2 (Omicron variant BA. 5.1.3) in Sanya area, and to provide evidence for understanding its clinical characteristics. Methods A retrospective analysis was performed on 14 neonates with negative nucleic acid delivered by pregnant women who tested positive for SARS-CoV-2 (Omicron variant BA.5.1.3) in Sanya Central Hospital (the Third People's Hospital of Hainan Province) from June 2022 to September 2022 (observation group, n=14). The corresponding nucleic acid-negative newborns delivered by pregnant women detected negative with SARS-CoV-2 (Omicronon variant strain BA.5.1.3) were set as the control group (n=56), and the general data and clinical characteristics of neonates in the two groups were compared. Results There was no significant difference between the observation group and the control group in pregnancy diabetes, pregnancy induced hypertension, gestational pre-eclampsia, fetal intrauterine distress, premature rupture of membranes (P>0.05); there was no significant difference between the observation group and the control group in terms of sex, gestational age, birth weight, age, mode of delivery, birth Apgar score, heart screening, pulmonary disease, glucose 6-phosphate dehydrogenase (G6PD) deficiency, thalassemia, breast milk jaundice, hemolytic jaundice (P>0.05). The bilirubin level, blue light irradiation cases and the duration of blue light irradiation of the newborns in the observation group at 7 days after birth were higher than those in the control group (P<0.05); the ratio of blood oxygen saturation ≥ 90% in the observation group was lower than that in the control group (21.43% vs 89.29%, P<0.05), and the ratio of blood oxygen saturation occasionally<90% was higher than that in the control group (57.14% vs 10.71%, P<0.05). The ratio of blood oxygen saturation<90% had no significant difference compared with that in the control group (7.14% vs 0, P>0.05), and the ratio of blood oxygen saturation reduced to the required oxygen uptake was higher than that in the control group (14.29% vs 0, P<0.05). Conclusions The jaundice manifestation of the nucleic acid-negative newborns delivered by pregnant women infected with SARS-CoV-2 (Omicronon variant strain BA.5.1.3) in Sanya area is relatively obvious, with blood oxygen saturation easily lower than 90% and even requiring oxygen inhalation in severe cases. © 2023 China Tropical Medicine. All rights reserved.     

Urolithiasis in pregnancy: Survey in clinical epidemiology

This study examined the association of pregnancy with urolithiasis and provided new insights into urolithiasis in pregnancy. A total of 462 subjects were studied from January 2004 to December 2009 in Foshan Maternal and Child Health Hospital, China. Among the 462 subjects, 162 cases of urolithiasis during pregnancy (UPG) were selected as the observation group, 150 cases of no urolithiasis during pregnancy (NUPG) served as pregnancy control group, and 150 cases of no pregnancy (NPG) at reproductive age who took part in physical examination were randomly assigned into non-pregnant control group. At the same time, the patients in observation group were divided into the following sub-groups: no symptomatic urinary calculus (NSUC) and symptomatic urinary calculus (SUC) groups; SUC group was further divided into surgical intervention (SI) and conservative management (CM) groups. The general information and the data of blood and urine were collected and compared among the groups. The results showed that the incidence of urinary calculi in pregnant women was lower than that in non-pregnant women, the formation of urinary stone was associated with the change of metabolism of protein and sugar in pregnant women, and the surgical intervention was a practicable alternative to treat the clinical intractable symptomatic urinary calculi in pregnancy.     

Study of Coping-competence among Unmarried Pregnant Young Women in Three Big Cites in China

Objective To identify the coping-competence among unmarried pregnant young women. Methods A cross-sectional study was conducted in the setting of clinics-based. A total of 1 391 unmarried young women were recruited as the sample in Youth Clinics of 3 maternal care hospitals in Beijing, Jinan, and Guangzhou respectively in China. ＂Behavioral Attributes of Psychosocial Competence Scale-Condensed Form＂ was administered to identify the coping-competence of these women. All these women were aged 10-24 years old and were divided into three groups based on whether or not they had sex and pregnancy. The three groups were named as follows： pregnancy group with young women having had both sex and pregnancy, sex group with young women having had only sex but not pregnancy, and non-sex group with young women having no sex experience. Results Among the adolescents aged 10-19 years old, the coping-competence was different among the three groups （P=O.050）. Compared with the pregnancy group, the non-sex group were more inclined to active coping （P=0.026）. Among all the pregnant women aged 10-24 years old, the coping-competence was various by region （P〈0.001）： the women in Jinan were more inclined to active coping than the women in another two cites （P=0.009, P〈0.001）, and there was no difference between the women from Beijing and Guangzhou （P=0.324）. Conclusion This is the first study of coping among unmarried pregnant young women in China. The results supported the point of view that the pregnant adolescents were more inclined to passive coping, and the coping had regional differences.     

Effects of plasma ghrelin, obestatin, and ghrelin/obestatin ratio on blood pressure circadian rhythms in patients with obstructive sleep apnea syndrome

Background Obstructive sleep apnea syndrome （OSAS） is strongly associated with obesity and with cardiovascular disease.Ghrelin and obestatin are two peptides from the same source but have opposite roles.Both of them can affect feeding and regulate vascular tune.The aim of this study was to investigate the relationship between plasma ghrelin,obestatin,the ratio of ghrelin and obestatin （G/O） and sleep parameters and blood pressure circadian rhythms in patients with OSAS.Methods This study enrolled 95 newly diagnosed over-weight OSAS patients （OSAS group）,30 body mass index （BMI）-match non-OSAS adults （over-weight group） and 30 non-OSAS normal weight adults （control group）.Polysomnography （PSG） was performed in the OSAS group and over-weight group.Blood pressure of all subjects was monitored by means of 24-hour ambulatory blood pressure monitoring.The concentration of plasma ghrelin and obestatin was detected by enzyme-linked immunosorbent assay （ELISA）.Results Plasma ghrelin levels in the OSAS group and over-weight group were significantly lower than that of the control group （P ＜0.05）.Plasma obestatin levels were lower in the over-weight group and OSAS group,but there was no significant difference among the three groups.The blood pressure in OSAS patients was higher,and there was a significant difference in all blood pressure parameters compared to the control group,and in the daytime average diastolic blood pressure （DBP）,nocturnal average systolic blood pressure （SBP） and DBP,DBP variability values as compared to over-weight subjects.Furthermore,there were significantly more non-dipper patterns of blood pressure （including hypertension and normotension） in the OSAS group than in the other two groups （P ＜0.01）.Correlation analysis showed that ghrelin levels had a significant correlation with BMI and nocturnal average DBP but not with PSG parameters.In contrast,the G/O ratio had a negative correlation with apnea-hypopnea index （AHI） （P ＜0.05）,as well as a strong positive correlation with the blood pressure variability values （P ＜0.01）.In multivariate analyses,AHI （P ＜0.05） and G/O （P ＜0.05）were independently related to SBP variability changes,while AHI （P ＜0.05）,G/O （P ＜0.01） and BMI （P ＜0.05） were independently related to DBP variability changes.Conclusions Our data show plasma ghrelin and obestatin levels were related to obesity in OSAS.Sleep apnea in OSAS patients could have led to an imbalance in G/O in the basis of obesity.Moreover,the imbalance may promote nighttime blood pressure elevation and affect blood pressure circadian disorder.     

Surveillance of Childhood Blood Lead Levels in 14 Cities of China in 2004-2006

Objective To investigate the blood lead level in children aged 0-6 years in urban areas of China. Methods Fourteen cities were selected as sites under surveillance. A total of 44 045 peripheral blood specimens were collected from 2004 to 2006, during which 15 727, 14 737, and 13 584 specimens were tested in 2004, 2005, and 2006, respectively. Tungsten atomizer absorption spectrophotometer was employed to determine blood lead level. Results The geometric mean blood lead level in the tested children was 47.10 μg/L with 10.10% ≥100 μg/L, 46.17 μg/L with 7.78% ≥100 μg/L, and 47.03 μg/L with 7.30% ≥ 100μg/L in 2004, 2005, and 2006, respectively. The blood lead levels seemed to tend to rise in parallel with the increase of age of the children and were higher in boys （48.84 μg/L, 47.56μg/L, and 47.78 μg/L in the 3 respective years） than in girls （45.00 μg/L, 44.53μg/L, and 46.13 μg/L）. Conclusion The blood lead levels in children in cities of China are lower than those in previous national studies, but higher than those in developed countries. Childhood lead poisoning remains a public health problem in China.     

Up-regulated expression of Tim-3/Gal-9 at maternal-fetal interface in pregnant woman with recurrent spontaneous abortion

The relationship between T cell immunoglobulin domain and mucin domain protein 3（Tim-3）/Galectin（Gal）-9 pathway and recurrent spontaneous abortion（RSA） was studied. Thirty-one pregnant women with RSA and 27 normal early gravidas were investigated to detect the levels of Tim-3 and Gal-9 in villi and deciduas by Western blotting. Meanwhile, the concentration of interleukin（IL）-4 and IL-12 in peripheral blood plasma was determined by ELISA in 25 healthy fertile non-pregnant controls, the normal early gravidas and pregnant women with RSA mentioned above, respectively. It was found that the relative expression levels of Tim-3 and Gal-9 in villi and deciduas were significantly increased in pregnant women with RSA as compared with those in the normal early gravidas. The concentration of IL-4 in peripheral blood plasma of pregnant women with RSA was lower than that of the normal early gravidas（P〈0.05） and healthy fertile non-pregnant controls（P〈0.05）, but that of IL-2 in pregnant women with RSA was significantly higher than that of the normal early gravidas（P〈0.05） and healthy fertile non-pregnant controls（P〈0.05）. It was suggested that the overexpression of Tim-3/Gal-9 pathway may be related to the pathogenesis of RSA.     

Effect of Lipoxin A4 on IL-1β Production of Monocytes and Its Possible Mechanism in Severe Preeclampsia

This study examined in vitro effect of lipoxin A 4 (LXA 4) on interleukin-1β (IL-1β) production of monocytes and its possible mechanism in severe preeclampsia (PE).Peripheral venous blood was drawn from 15 patients with severe preeclampsia (PE group) and 20 normal pregnant women (control group) to prepare monocytes which were then treated with LXA 4 at different concentrations of 0,10,100 nmol/L respectively.IL-1β level in the supernatant of monocytes was detected by enzyme linked immunoassay.The [Ca 2+ ] i of monocytes was measured by laser scanning confocal microscopy.The results showed that the IL-1β level and the [Ca 2+ ] i of monocytes in the PE group were significantly higher than those in the control group.LXA 4 significantly decreased the generation of IL-1β in a dose-dependent manner in the PE group.After treatment with 100-nmol/L LXA 4,in the PE group,the [Ca 2+ ] i concentration of monocytes was significantly reduced.It was concluded that LXA 4 may inhibit the IL-1β production of monocytes from severe preeclampsia women by inhibiting extracellular calcium influx.     

冠心病与血清高敏C反应蛋白、尿酸及血脂水平的检测与结果分析

目的 探讨冠心病患者血清高敏C反应蛋白(hs-CRP)、尿酸(UA)及血脂水平变化及临床意义.方法 抽取冠心病与健康对照组清晨空腹静脉血,应用全自动生化分析仪对血清hs-CRP、UA、血脂进行检测.结果 冠心病组高密度脂蛋白胆固醇(HDL-C)、载脂蛋白AI(apoAI)含量低于健康对照组;hs-CRP、UA、甘油三酯(TG)、胆固醇、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apoB)浓度高于健康对照组.结论 血清hs-CRP、UA及血脂水平的联合检测对冠心病的诊断具有重要意义. Abstract： Objective Discussion coronary disease blood serum high sensitivity C-reactive protein (hs-CRP),the blood lipids and the uric level change and clinical significance. Methods Extraction coronary disease group with the healthy control group early morning the empty stomach venous blood, applied the whole blood to move the biochemistry analyzer to the blood serum hs-CRP, the uric acid, the blood lipids carries on the examination. Results The coronary disease group blood serum the high density lipoprotein cholesterol and carry the lipoprotein AI content were lower than that in the healthy control group. The hs-CRP, the uric acid, the triglyceride, the low density lipoprotein cholesterol, carry lipoprotein B were higher than that in the control group. Conclusions Combined determination of the patient blood serum hs-CRP, uric acid, blood lipids level is important for the diagnosis of coronary artery disease.     

妇科恶性肿瘤化疗患者262例血糖观察

目的 观察化疗对妇科恶性肿瘤患者血糖的影响.方法 回顾性分析我科收治的262例恶性肿瘤患者化疗前、中、后糖尿病的发生情况,对并发糖尿病患者进行随访.结果 化疗后空腹血糖升高24例,糖尿病8例,糖耐量减低11例,一过性血糖升高5例.PT方案化疗较PVB方案化疗更易引起血糖增高(P＜0.05).结论 恶性肿瘤患者化疗后可引起血糖增高,甚至发生糖耐量减低或2型糖尿病. Abstract： Objective To explore the effect of chemotherapy on glucose metabolism in patients with gynecological malignant tumor.Methods Two hundred and sixty -two patients with gynecological malignant tumor who treated with chemotherapy were analyzed retrospectively.The incidence of diabetes mellitus as analyzed.The occurrence of diabetes before, during and after chemotherapy for patients with malignant tumors was observed.Results Total 24 cases had elevated fasting blood glucose after chemotherapy.Among them ,8 cases were diagnosed as diabetes mellitus, 11 cases were diagnosed as impaired glucose tolerance.Significant difference of blood glucose was observed between patients treated with PT chemotherapy and those who treated with PVB chemotherapy(P ＜ 0.05).Conclusions Chemotherapy could make the blood glucose of patients with malignant tumor increase, and may result in decreased sugar tolerance or type 2 diabetes.     

全髋关节置换术中骨水泥对老年患者凝血功能的影响

目的 探讨全髋关节置换术中骨水泥对老年患者凝血功能的影响.方法 对2004年2月至2005年8月34例行骨水泥型全髋关节置换术患者的凝血功能相关指标进行检测,包括血浆凝血酶原时间(PT)、活化的部分凝血酶原时间(APTT)、血浆纤维蛋白原(FIB)及鱼精蛋白副凝固实验(3P试验),分别于注入骨水泥前5 min、注入骨水泥后30 min及3 h各检测1次.所有数据进行统计学处理.结果 注入骨水泥后30 min PT值较注入前5 min显著缩短(P＜0.05);而注入骨水泥后3 h PT值与注入后30 min比较,显著回升(P＜0.05).FIB含量在注入骨水泥后30 min较注入前5 min明显增高(P＜0.05);注入骨水泥后3 h与注入后30 min比较差异有统计学意义(P＜0.05).3P试验阳性率,注入骨水泥后30 min与注入前5 min比较差异有统计学意义(P＜0.05).APTT在该实验中影响不太明显,注入骨水泥3 h后各项指标基本恢复.结论 全髋关节置换术中注入骨水泥30 min后PT缩短,FIB增高,3P试验的阳性率升高,但在3 h后骨水泥对这些指标的影响基本消除,提示注入骨水泥后的3 h内是监测病情的重要时段,在注入骨水泥后,老年患者凝血系统虽有高凝倾向,但各相关指数仍在正常范围内. Abstract： Objective To assess the effects of bone cement implantation on coagulation functions during the total hip arthroplasty in elderly patients. Methods Thirty-four patients admitted to our hospital between February 2004 and August 2005 involved in this study. The relative parameters were observed in all patients, including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and plasma protamine paracoagulation test (3P test). Blood samples were measured 5 minutes before, 30 minutes and 3 hours after bone cement implantation. All data were analyzed with Medical Statistics Software. Results PT significantly decreased at 30 minutes after bone cement implantation, compared with 5 minutes before implantation ( P ＜ 0. 05), and significantly recovered at 3 hours after implantation (P ＜ 0.05). FIB significantly increased at 30 minutes after implantation compared with 5 minutes before implantation ( P ＜ 0.05), and significanlty decreased again at 3 hours after implantation (P ＜ 0.05 ). A higher rate of positive results in 3P test was observed at 30 minutes after implantation compared with 5 minutes before implantation ( P ＜ 0.05 ). There was no significant difference in APTT before and after implantation. Conclusions PT significantly decreased at 30 minutes after bone cement implantation, and FIB or positive rate of 3P test increased, but these parameters recovered at 3 hours after implantation. It showed we must monitor patients in 3 hours after implantation. And bone cement shows a tendency to activate blood coagulation, especially in elderly patients, but the relative indexes are still in normal range.     

替罗非班治疗不同时间拔除动脉鞘管的急性冠状动脉综合征患者的安全性

目的 探讨不同时间拔除动脉鞘管对经皮冠状动脉介入治疗(PCI)术后血管并发症的影响,并探讨其与术后替罗非班应用的关系.方法 将150例急性冠状动脉综合征患者随机分为观察组(A组)73例和对照组(B组)77例,A组于PCI术后即刻拔除动脉鞘管,B组于PCI术后留置4 h后拔除动脉鞘.观察两组出血及拔管后压迫止血15 min后出血率.结果 对照组出血率较观察组明显增高,差异有统计学意义(P＜0.05).拔管后压迫止血15 min后,对照组出血率较观察组明显增高,差异有统计学意义(P＜0.05).结论 PCI术后即刻拔除动脉鞘管可以预防和减少血管并发症的发生,尤其应用替罗非班更适合早期拔管. Abstract： Objective To investigate the effects of removing artery sheath catheter at different time points on blood vessel complications after PCI operation and evaluate whether tirofiban was associated with them. Methods The study was a parallel - group, randomized, controlled clinical trial, 150 patients with ACS who underwent selective PCI were randomly assigned to one of two treatment regimens , tirofiban was predominantly initiated in the catheter laboratory after the patients underwent selective PCI. In observation group of 73 patients, artery sheath catheter was removed immediate after PCI, while in control group of 77 patients, it was removed 4 h after PCI. The incidence of blood vessel complications in two groups were compared. Results There were more bleeding events happened in the control group compared with the observative group, and there was significantly differences between the two groups ( P＜0.05 ).Conclusions Immediate removal of the artery sheath catheter after PCI operation could prevent and reduce the occurrence of the blood vessel complications and is more suitable for patients treated with tirofiban.     

胎盘、脐血及外周血造血干细胞免疫原性初步比较

目的 初步比较胎盘、脐血和外周血来源的造血干细胞的免疫原性.方法 应用单向混合淋巴细胞培养的方法将胎盘、脐血和外周血三种来源单个核细胞的增殖情况进行比较.结果 单向混合淋巴细胞培养中胎盘、脐血和外周血来源的细胞的增殖比较差异有统计学意义(P＜0.01).结论 胎盘较脐血和外周血来源的造血干细胞的免疫原性低,更适合用于异基因造血干细胞移植. Abstract： Objective To compare phenotypic characteristics and immunog- genicity of hematopoietic stem cell(HSC)from placenta(PT), from cord blood(CB)and from peripheral blood(PB).Methods Comparing cell proliferation of PT, CB and PB using mixed - lymphocyte reactions(MLR).Results There was a difference in proliferation of PT, CB and PB(P ＜ 0.01).Conclusions Immunogenicity of HSC from PT are lower than that what from CB and PB.HSC of PT are more suitful for transplant of allogen hematopoietic stem cell.     

无创正压通气对慢性阻塞性肺疾病致慢性肺源性心脏病合并全身水肿患者尿量的影响

目的 观察无创正压通气治疗对慢性阻塞性肺疾病致慢性肺源性心脏病合并全身水肿患者尿量的影响.方法 2007年1月至2008年8月入住我科的慢性阻塞性肺疾病致慢性肺源性心脏病合并全身水肿患者55例,均给予氧疗、抗感染、化痰、扩张气道治疗.除上述治疗外,其中19例(A组)接受无创正压通气治疗每天16 h以上;16例(B组)给予口服利尿剂氢氯噻嗪25 mg/d加螺内酯40 mg/d(B组);其余20例(C组)患者未接受无创正压通气或口服利尿剂.观察入选患者住院期间尿量,计算出每例患者的日平均尿量并做记录(单位ml/24 h).将三组记录作比较.结果 A组尿量为(1972±110)ml/24 h,B组为(1750±125)ml/24 h,C组为(1408±117)ml/24 h,三组结果相比差异有统计学意义(P＜0.01).结论 无创正压通气治疗能明显增加慢性阻塞性肺疾病致慢性肺源性心脏病合并全身水肿患者的尿量,达到减轻水肿的目的 ,较口服利尿剂效果更明显. Abstract： Objective To observe the effect of noninvasive positive pressure ventilation (NPPV)on urinary volume in patients with chronic cor pulmonale combined with general dropsy caused by chronic obstructive pulmonary disease.Methods From January 2007 to August 2008,55 patients with chronic cor pulmonale combined with general dropsy caused by chronic obstructive pulmonary disease were enrolled in this study.All patients received oxygen therapy,anti-infection,dissipate phlegm and to airway dilation,and they were randomly divided into three group. Patients in group A(19 cases)received noninvasive positive pressure ventilation for more than 16 hours per-day;Patients in group B(16 cases)were given hydrochlorothiazide 25 mg/d and spironolactone 40 mg/d.Patients in group C(20 cases) didn't received NPPV or oral diuretics.Observe urinary volume of all the enrdled patients,and daily mean urinary volume of each patient was calculated and recorded(ml/24 hour).Compare the records between three groups.Results The wrinary volume in group A was(1972±110)ml/24 h,(1750±125)ml/24 h in group B and(1408±117)ml/24 h in group C.There were significant differences between the three groups(P＜0.01).Conclusions NPPV may increase urinary volume obviously of the patients with chronic cor pulmonale combined with general dropsy caused by chronic obstructive pulmonary diseaes,so can lessen edema,and the effect is more obvious than oral diuretic.     

单侧颈动脉重度狭窄或闭塞CEA围术期的综合治疗

目的 探讨单侧颈动脉重度狭窄甚至闭塞的患者的围术期处理,寻找使患者安全平稳度过围术期的措施.方法 选择我院自2008年1月至2009年3月收治自康复科和神经内科转入我科并伴有神经功能缺陷的患者,按指定标准选入34例行颈内动脉内膜剥脱术(CEA)手术.结合脑血流监测,探讨围术期对血压控制、转流管应用、抗凝及脱水治疗等方面的综合处理措施,注意全程脑保护.结果 34例患者中,除1例术中血压波动较大,估计远处栓子脱落,术后CT及MRI证实术侧多发梗死灶,1例患者未使颈内动脉再通,余患者术后恢复满意,NIHSS评分均有所下降.结论 病情稳定患者,越早手术干预颈动脉重度狭窄甚至闭塞的患者,可能对患者带来越大的收益.围术期平稳控制血压是全程脑保护的中心问题,对颈动脉重度狭窄甚至闭塞的患者尤为重要. Abstract： Objective To explore the perioperative management of patients with unilateral carotid artery severe stenosis or occlusion in order to carry the patients through the perioperative period safely.Methods In our hospital from January 2008 to March 2009,patients were treated in Rehabilitation Division and department of Neurology and transferred to our department, accompanied by neurological dysfunction in patients selected according to specified standards into the thirty-four cases CEA surgery. Combination of cerebral blood flow monitoring, to explore perioperative blood pressure control and shunt applications, anticoagulation and dehydration treatment in a comprehensive treatment measures and pay attention to whole brain protection.Results Thirty-four patients, except one case of intraoperative blood pressure fluctuations, the estimated distance off emboli, postoperative CT and MRI confirmed the surgery side of multi-infarct foci, one patient did not make the internal carotid artery recanalization, the rest patients after satisfactory recovery, NIHSS scores have been reduced.Conclusions The patients in stable condition, the earlier the surgical intervention of severe carotid artery stenosis or occlusion in patients may bring greater benefits for patients. Perioperative control of blood pressure is stable throughout the central issue of cerebral protection, right carotid artery severe stenosis or occlusion in patients is particularly important.     

家庭无创正压通气在慢性阻塞性肺疾病稳定期患者中的疗效

目的 研究稳定期慢性阻塞性肺疾病并慢性呼吸衰竭患者家庭氧疗加用无创正压通气与单独应用家庭氧疗治疗的疗效.方法 慢性阻塞性肺疾病稳定期并慢性呼吸衰竭患者使用家庭氧疗加无创正压通气与单纯长期家庭氧疗患者比较在治疗1年中的病情恶化次数、住院次数、住院时间以及治疗前与治疗12个月后的血气指标和肺功能参数的变化和症状、体征.结果 随访12个月后,家庭氧疗加用无创正压通气治疗组病情恶化次数和住院次数均较单纯氧疗组明显减少.在治疗12个月随访时,家庭氧疗加用无创正压通气治疗组的动脉血氧分压(PaO2),动脉血二氧化碳分压(PaCO2),血液pH与单纯氧疗组比较均有显著改善,差异有统计学意义(P<0.05).结论 无创正压通气是慢性阻塞性肺疾病稳定期并慢性呼吸衰竭患者积极和有效的治疗措施. Abstract： Objective To study the clinical value of home non-invasive positive pressure ventilation(NIPPV) in patients with stable-phase chronic obstructive pulmonary disease(COPD)and chronic respiratory failure.Methods Stable COPD patients complicated with chronic respiratory failure received Bi-level positive airway pressure ventilation.The frequency of acute exacerbation,admissiontimes-admission expending,blood gas analysis were compared in these patients with those received long term oxygen therapy. Results After one year home non-invasive positive pressure ventilation,PaCO2,HCO-3 were decreased,while pH and PaO2 increased.Compared with patients received long term oxygen therapy,PaCO2 was greatly ameliorated and the frequency of acute exacerbation,admission times and admission expending declined.Conclusions Home non-invasive positive pressure ventilation will do good to COPD patients with hypercapnic respiratory failure during stable phase.     

肺腺癌患者外周血及肿瘤浸润性淋巴细胞中Fas分子的表达及意义

目的 检测Fas分子在肺腺癌患者肿瘤浸润淋巴细胞(TILs)和外周血淋巴细胞(PBLs)中的表达,探讨Fas/FasL在肿瘤局部与全身免疫反应中的作用及临床意义.方法 用流式细胞术(FCM)对50例肺腺癌患者PBLs及TILs中Fas的表达进行定性定量分析,以48例正常人的PBLs为对照组.结果 Fas分子在肺腺癌患者TILs和PBLs中的表达率分别为16.8%和8.0%,对照组PBLs为12.6%,前者表达率明显高于后两者(P<0.05);而肺腺癌患者PBLs的Fas分子表达率明显低于对照组PBLs(P<0.05).结论 Fas分子在肺腺癌患者PBLs与TILs及其亚群中的表达不同,Fas/FasL在机体肿瘤局部及全身水平的免疫反应中起着重要作用. Abstract： Objective To study the Fas expression in tumor infiltrating lymphocytes (TILs)and peripheral blood lymphocytes(PBLs) from patients with pulmonary adenocarcinoma, and to investigate the clinical significance and the role of the Fas/FasL in local and systemic immune responses. Methods By flow cytometery(FCM),the expression of Fas molecule were detected on TILs and PBLs in 50 cases of lung adenocarcinoma and in 48 cases of normal healthy PBLs. Results Expression rate of Fas molecule on TILs and PBLs of lung adenocarcinoma patients was 16.8% and 8.0% respectively,and on PBL of normal controls was 12.6%. The former was significantly higher than the two latters(P<0.05). Expression rate of Fas molecule on PBLs of lung adenocarcinoma patients was significantly lower than the control group (P<0.05). Conclusions Expression of the Fas molecul on TILs and PBLs of lung adenocarcinoma patients is different. Fas/FasL pathway plays a major role in the fighting between immune system and tumor not only at local tumor site but also at systemic level.     

低分子量肝素在胸部肿瘤合并高凝血状态病人围术期的临床应用

目的 使用低分子量肝素(LMWH)预防胸部肿瘤合并高凝血状态病人的围术期血栓性疾病的发生.方法 对2006年1月至2007年10月我科收治的合并高凝血状态的食管癌、贲门癌、肺癌病人,在围术期皮下注射低分子量肝素,每日1次,从术前3～5 d开始直至病人下床,观察术中出血量及术后胸液量,并统计血栓性疾病发生率.结果 该组病人围术期血栓性疾病发生率得到了明显控制.结论 低分子量肝素对预防胸部肿瘤合并高凝血状态病人的围术期血栓性疾病的发生有明显效果,安全可靠. Abstract： Objective To evaluate the efficacy of low molecular weight heparin for preventing thromboembolism disease in perioperative of thoracic tumor with blood hypercoagulabale state. Methods From January 2006 to October 2007, we diagnosed and treated 72 patients with lung cancer and carcinoma of esophagus and cardia. All the patients were treated with LMWH qd from the 3 -5 days before operation until ambulation after operation. To observe the postoperative total amount effusion and to statistic of incidence of thromboembolism disease. Results Incidence of thromboembolism disease decreased more significantly of this group than usual. Conclusions Application of LMWH for preventing thromboembolism disease in periopetive of thoracic tumor with blood hypercoagulabale state is an effective, safe and reliable treatment.