近红外光谱检测宫内窘迫新生儿缺氧性脑损伤的研究

目的探讨近红外光谱技术对宫内窘迫新生儿脑组织氧合评价及缺氧缺血性脑损伤评判的价值,为临床评价脑损伤提供客观、量化依据。方法对46例宫内窘迫新生儿,根据出生后是否合并新生儿缺氧缺血性脑病（HIE）分为HIE组及无HIE组,应用近红外光谱技术测定其脑组织氧饱和度（rSO2）,并与对照组比较。ROC曲线分析rSO2,评判新生儿缺氧缺血性脑病的价值。结果HIE组患儿产程中胎头剥露时及出生后5min两个时间点rSO2（38%±5%;53%±5%）均明显低于正常对照组（46%±4%;60%±4%）及宫内窘迫无合并HIE组（44%±3%;57%±4%）新生儿（P〈0.01）。分别以胎头剥露时脑rSO2〈40%、出生后5min脑rSO2〈53%为界点,评判新生儿缺氧缺血性脑病的敏感度及特异度分别为66%、88%及67%、86%。结论近红外光谱测定脑组织rSO2能客观评价宫内窘迫新生儿脑氧合状态,尚可提示新生儿缺氧缺血性脑损伤的存在。     

胎儿窘迫后新生儿脑组织氧饱和度研究

目的探讨胎儿窘迫与新生儿脑组织氧饱和度(rSO2)的关系及围生期缺氧并发脑损伤时新生儿脑组织rSO2的变化。方法将胎儿窘迫后娩出的足月新生儿135例根据缺氧缺血性脑病(HIE)诊断标准分为HIE组(62例)和无HIE组(73例),无胎儿窘迫娩出的30例足月新生儿为对照组,在新生儿出生后2～8 h及第2天、第3天、第5天、第7天应用TSAH-100型近红外组织血氧参数无损监测仪测量脑组织rSO2。结果HIE组新生儿出生后2～8 h、第2天、第3天、第5天、第7天脑组织rSO2均低于对照组(P<0.05);无HIE组新生儿出生后2～8 h、第2天、第3天脑组织rSO2均低于对照组(P<0.05);HIE组新生儿出生后2～8 h、第2天、第3天脑组织rSO2低于无HIE组(P<0.05)。胎儿窘迫后剖宫产组新生儿出生后第2天脑组织rSO2较顺产组低(P<0.05),其余各组间比较差异无显著性意义(P>0.05)。结论HIE患儿在宫内缺氧时间较长,有脑内氧合及细胞代谢异常;无HIE组的新生儿宫内缺氧程度轻,新生儿没有因严重缺氧导致脑损伤。胎儿窘迫的分娩方式与新生儿脑组织rSO2无直接关系,熟练的钳产手术不增加胎儿脑损伤。     

过期产与新生儿缺氧缺血性脑病

目的探讨过期产与新生儿缺氧缺血性脑病的关系。方法2006年-2007年在我院出生新生儿1208例，对发生宫内窘迫、新生儿窒息、新生儿缺氧缺血性脑病者生后72h和1个月时的头颅CT表现进行统计分析。结果过期产儿与足月儿相比，发生宫内窘迫、出生窒息、缺氧缺血性脑病者比例较高，两者对比差异非常显著（P〈0．01）。结论过期产对新生儿危害大，应对过期妊娠采取干预措施，适时终止妊娠，以降低过期产对新生儿的损伤。     

新生儿窒息的抢救

新生儿窒息（asphyxiaofthenewbom）是指新生儿因缺氧发生宫内窘迫及娩出过程中引起呼吸、循环障碍，在生后1分钟内，无自主呼吸，但心跳仍存在，也是新生儿死亡及伤残的主要原因，因此，治疗改善窒息，是生存的质量。一、病因：1．母体与胎儿间血液气体交换障碍，供血不足或供血中断而引起缺氧，使中枢受抑以致发生窒息。2．胎盘气体交换障碍、前置胎盘、胎盘早期剥离3．胎盘灌注不足、糖尿病、妊娠高血压、严重贫血、慢性心肺肾疾病或分娩过程中使用麻醉、镇静药物等。     

足月儿呼吸窘迫综合征28例临床分析

目的:通过对足月新生儿进行临床观察,找出足月儿呼吸窘迫综合症(RDS)的危险因素。方法:以新生儿科诊断RDS的足月儿为临床观察对象组,对比同一时期住院未合并RDS的足月儿;对两组足月儿的胎龄、分娩方式、出生体重、宫内窘迫、窒息、脐带缠绕、产妇糖尿病、多胎等高危因素进行单因素方差分析和多因素Logistic回归分析。结果:两组对比中胎龄、产妇糖尿病、多胎脐带缠绕颈部差异无统计学意义(P>0.05),观察组[(2 698±403)g]的体重低于对照组[(2 997±426)g],观察组出生男婴比例和剖宫产率(69.3%和97.01%)高于对照组(53.9%和68.6%),观察宫内窘迫率(17.9%)低于对照组(30.89%),差异有统计学意义(P<0.05),多因素Logistic回归分析显示,婴儿体重、剖宫产、男婴、窒息、宫内窘迫、产妇糖尿病多胎与足月儿的发生相关性(P<0.05)。结论:剖宫产、男婴、窒息、产妇糖尿病是足月儿RDS发生的危险因素,高出体重、宫内窘迫、多胎是足月儿RDS发生的保护因素。     

新生儿颅内出血16例误诊分析

男11例，女5例。出生后6小时～18天。足月儿5例，早产地11例。误诊疾病有吸人性肺炎并败血症、生活能力低下、新生儿肺炎、硬肿症、呼吸窘迫综合征等。经尸体解剖证实，16例均为颅内出血。出血都位在脑室内、硬脑膜下、蛛网膜下胜、脑实质。及早做头颅B超或CT扫描，可减少误诊。新生儿颅内出血16例误诊分析@马宁生     

足月新生儿不明原因高胆红素血症相关因素分析

目的探讨导致足月新生儿不明原因高胆红素血症的可能危险因素。方法选择2007年7月～2009年10月经临床确诊的112例足月原因不明的高胆红素血症新生儿（病例组）,以及同期137例正常足月新生儿（对照组）,比较两组新生儿孕周、出生身高、性别、出生体重、出生体温、喂养情况、排便情况、孕母年龄、家族黄疸发病史、是否多胎、妊娠合并症高血压、糖尿病及胎盘钙化等情况,分析上述影响因素与新生儿高胆红素血症的相关性。结果两组新生儿孕周、出生体温、出生体重、出生身高、孕母年龄、胎盘钙化、多胎史方面差异均无统计学意义（P〉0．05）：病例组新生儿开奶时间及开始排便时间均较对照组晚,生后2d喂养总量及生后2d排便总量均较对照组少,差异均有统计学意义（P〈0．01、P〈0．05）;两组新生儿性别、分娩方式、母妊娠高血压、妊娠糖尿病、家族黄疸发病史差异均有统计学意义（P〈0．05）。结论开奶时间晚及排便时间延迟、生后2d喂养量不足及生后2d排便量少是足月新生儿不明原因高胆红素血症的危险因素;剖宫产、孕母有妊娠高血压、妊娠糖尿病及家族中有黄疸发病史是足月新生儿不明原因高胆红素血症的高危因素。     

Netrin-1在急性胎儿宫内窘迫胎盘中的表达及其意义研究

目的急性胎儿宫内窘迫是导致围产儿死亡的主要原因,大多系胎盘及脐带因素导致胎儿缺氧所致。通过检测晚期正常妊娠及急性胎儿宫内窘迫的胎盘表达神经轴突导向因子．1（neurontowardsaxonguidancefactor．1,Netrin-1）水平、相应脐带情况及患者娩出新生儿出生状况,从而探讨Netrin-1在急性胎儿宫内窘迫中发病的可能机制。方法选取2012年10月1日—2013年9月30日间剖宫产终止妊娠孕妇共27例。其中15例正常足月妊娠孕妇为对照组,12例急性胎儿宫内窘迫患者为研究组。检测所有人选病例胎盘中Netrin．1表达水平,观察2组胎儿娩出时脐带情况,测定相应新生儿出生体重及出生后1minApgar评分。结果2组患者胎盘Netrin-1表达水平、新生儿出生体重及出生后1rainApgar评分差异均无统计学意义（P〉0．05）。对照组未见明显脐带异常。12例胎儿宫内窘迫10例存在脐带绕颈,1例脐带螺旋。10例脐带绕颈中3例脐带绕颈两周;7例脐带绕颈1周,脐带绕颈1周新生儿患者中3例存在脐带水肿。但所有娩出胎盘均未见明显异常。与对照组相比,急性胎儿宫内窘迫组脐带异常明显（P〈0．05）。结论Netrin-1在急性胎儿宫内窘迫胎盘维持功能过程中作用较小。孕晚期急性胎儿宫内窘迫发生多因脐带因素所致。     

新生儿窒息与相关因素的关系(附266例临床分析)

新生儿窒息为新生儿出生后呼吸衰竭的表现,是新生儿主要死亡原因之一,其发生因素约有三分之二是胎儿宫内窘迫的延续,另一部分为新生儿出生后的影响因素所致,了解新生儿窒息诱因,减少新生儿窒息发生对降低围产儿并发症及死亡率将有重要意义。1临床资料1.1一般资料:对我院1989年1月至2000年1月新生儿出生后窒息226例病因进行分析,并与同期足月妊娠分娩之正常新生儿260例进行对比分析。诊断标准按美国芝加哥大学产科医院规定:出生后1minAPgar评分代表新生儿出生后抑制状态最严重阶段,重度抑制0～2min,中度抑制3～4min,轻度抑制5～6min。本组正…     

新生儿窒息与缺氧缺血性脑病的护理

新生儿窒息是指胎儿缺氧、宫内窘迫以致出生后呼吸抑制，严重时呼吸功能障碍，导致血氧浓度降低，二氧化碳滞留，并引起脑血流减少或血流暂停而导致胎儿和新生儿脑损伤。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.