100例癫痫患者夜间自然睡眠脑电图分析

目的　观察癫痫患者夜间自然睡眠与痫样放电的关系 ,分析癫痫患者睡眠时相和睡眠结构的改变。方法　对10 0例癫痫患者 (癫痫组 )的 2 4h动态脑电图检查进行清醒和夜间睡眠脑电图分析 ,比较痫样放电的阳性率 ,分析睡眠结构 ,并与正常对照组进行比较。结果　癫痫组有 84例出现痫样放电 ,睡眠中出现的痫样放电率为 83 .3 3 % ,明显高于清醒期 (5 1.19% ) ,P <0 .0 1;其中 70例痫样放电分布于浅睡期 (NREMⅠ～Ⅱ期 ) ,与NREMⅢ～Ⅳ、REM、NREM -REM时相比较差异有高度显著性 (P均 <0 .0 1)。非动眼睡眠过程中各时相变化与正常对照组比较差异有高度显著性 (P均<0 .0 1)。结论　睡眠过程大大提高了痫样放电率 ,且痫样放电主要出现于浅睡期 (NREMⅠ～Ⅱ期 )。癫痫患者的睡眠时相明显发生改变 ,以至睡眠结构破坏 ,深睡期减少 ,其睡眠质量下降。     

老年癫痫患者夜间自然睡眠脑电图分析

目的 观察老年癫痫患者夜间自然睡眠与痫样放电的关系,探讨老年癫痫患者睡眠时相的改变.方法 对64例老年癫痫患者(癫痫组)的24小时动态脑电图进行清醒和夜间睡眠脑电图分析,比较痫样放电的检出率,分析睡眠时相,并与健康对照组比较.结果 老年癫痫患者夜间自然睡眠状态中痫样放电的检出率为68.75%,清醒状态中痫样放电的检出率为40.62%;痫样放电分步于NREMⅠ～Ⅱ期者占86.36%,明显高于NREMⅢ～Ⅳ期、REM期及NREM-REM期(P均＜0.01).癫痫组NREM各时相所占时间比例与健康对照组比较差异有高度显著性(P均＜0.01),癫痫组睡眠纺锤波破坏者明显高于对照组(P＜0.01).结论 老年癫痫患者夜间自然睡眠状态中痫样放电检出率明显高于清醒期,痫样放电主要分布于NREMⅠ～Ⅱ期.老年癫痫患者睡眠时相明显发生改变,睡眠纺锤波破坏,睡眠质量下降.     

癫痫患者发作间期常规清醒脑电图与睡眠脑电图的对比研究

目的:探讨自然睡眠诱发脑电图(EEG)对癫痫(EP)的诊断价值。方法:对112例临床诊断为EP的患者发作间期行常规清醒EEG和自然睡眠EEG检查,并对两次检查结果的异常率和癫痫放电检出率进行对比分析。结果:常规EEG有30.36%出现痫样放电,而自然睡眠诱发EEG有75.89%出现痫样放电,两者比较具有统计学意义(P<0.01)。痫样放电检出率与患者年龄、睡眠周期有关,痫样放电检出率在睡眠的入睡期及浅睡期(NREM～期)最高,少儿较成年人检出率高,各发作类型之间的睡眠EEG中痫样放电检出率无统计学差异(P>0.05)。结论:自然睡眠诱发EEG可显著提高痫样放电的检出率,对EP的诊断与鉴别诊断有重要的参考价值。     

电视录像脑电图在小儿发作性疾病中的应用

目的评价电视录像脑电图(VEEG)监测在小儿发作性疾病临床诊断中的应用价值。方法对656例具有发作性症状的病儿进行3~4 h包括清醒、睡眠及诱发试验的VEEG监测。结果656例病儿中,132例(20.1%)监测到临床发作,其中86例(65.2%)伴有发作期痫样放电,证实为癫痫性发作;46例(34.8%)发作期无痫样放电,为非癫痫性发作。656例病儿中共监测到痫样放电398例,检出率60.7%。210例(52.8%)确定了癫痫发作类型,74例监测后发作分类得到修正。痫样放电多见于NREMⅠ~Ⅱ期。结论VEEG监测可提高痫样放电的检出率,有助于癫痫发作与非癫痫发作的鉴别及癫痫的分型。     

动态脑电图监测对癫痫的诊断价值

目的:观察和评估动态脑电图在癫痫诊断中的应用价值。方法:将160例癫痫患者的常规脑电图(REEG)、动态脑电图(AEEG)痫样放电检测的结果进行相关分析,并对动态脑电图觉醒期和睡眠期痫样放电的分布情况及痫样放电部位进行分析。结果:REEG对癫痫患者痫样放电检出率为25.6%,AEEG检出率为72.5%,两者相比差异有显著性(P<0.05);痫样放电多出现于NREM第I、II期,且NREM第I、II期明显延长,而第III、IV期相对缩短;AEEG检测对癫痫病灶定位诊断有重要的意义。结论:睡眠期痫样放电检出率明显高于觉醒期,睡眠期痫样放电主要出现于NREMⅠ、Ⅱ期,AEEG有助于癫痫的诊断。     

癫痫200例动态脑电图分析

目的探讨动态脑电图（AEEG）在癫痫诊断中的应用价值。方法对200例临床拟诊癫痫患者的24h动态脑电图与常规脑电图结果进行比较分析,观察痫样放电情况。结果200例患者中检出痫样放电164例,在清醒及睡眠期同时出现有7例,仅在清醒期出现25例,睡眠期出现132例,因此,清醒期共出现32例（占16％）,睡眠期共出现139例（占85．8％）。其中出现在非快速眼动睡眠期（NREM）Ⅰ-Ⅱ期的痫样放电102例（占73．38％）。结论睡眠期痫样放电检出率明显高于觉醒期,且痫样放电主要在NREMⅠ-Ⅱ期,AEEG对癫痫的临床诊断有重要意义。     

24小时动态脑电图在癫痫诊断中的价值探讨

目的观察24h动态脑电图对癫痫的诊断价值。方法回顾性分析临床拟诊的283例癫痫患者24h动态脑电图,分析清醒状态和自然睡眠诱发脑电图痫样放电的发放频率和痫样波的发放时间。结果在283例中,有75例除外癫痫的诊断,另有208例患者检出痫样放电,确诊为癫痫,总检出率为73.5%。208例中有14例在清醒期出现痫样放电,占6.73%;93例只在睡眠中出现痫样放电,占44.71%;101例患者在清醒和睡眠中出现痫样放电,占48.56%。睡眠中痫样放电主要见于睡眠Ⅰ～Ⅱ期。结论动态脑电图可以显著提高癫痫患者痫样放电的检出率,有助于癫痫的鉴别诊断,癫痫患者睡眠中痫样放电主要出现于睡眠Ⅰ～Ⅱ期。     

24h动态脑电图在小儿癫痫诊断中的应用研究

目的:探讨小儿动态脑电图(Ambulatory Eletroencephalography:AEEG)的睡眠时相与癫痫的关系及其对小儿癫痫的诊断价值。方法:对52例常规脑电图(Routine Eletroencephalography:REEG)无痫样放电患儿进行24 h AEEG检测,并观察觉醒期和睡眠期AEEG痫样放电的分布情况。结果:AEEG痫样放电发生率为46.1%,痫样放电多见于非快速动眼睡眠Ⅰ～Ⅱ期(NREMⅠ～Ⅱ期)。结论:小儿癫痫痫样放电主要发生于NREMⅠ～Ⅱ期,AEEG可提高小儿癫痫痫样放电的检出率,对小儿癫痫的诊断有重要意义。     

癫痫患者24小时动态脑电图分析

目的分析癫痫患者的24 h动态脑电图,研究动态脑电图对癫痫应用价值。方法对116例癫痫患者的24 h动态脑电图和常规脑电图结果进行分析,观察痫样放电的情况。结果24 h动态脑电图痫样放电检出率明显高于常规脑电图,差异有显著性(P<0.01)。自然睡眠期痫样放电检出率明显高于清醒期,差异有显著性(P<0.01),其中76.1%出现于NREMⅠ~Ⅱ期。结论24 h动态脑电图对癫痫的诊断和睡眠关系的研究有重要意义。     

同步录像脑电图对癫痫及可疑癫痫的诊断价值

目的 探讨同步录像脑电图(Video-EEG)对癫痫及可疑癫痫的诊断价值.方法 对临床确诊为癫痫的43例患者和35例可疑癫痫患者进行Video-EEG监测,并对结果进行分析.结果 癫痫组痫样放电检出率为58.1%,可疑癫痫组检出率为8.6%.差异有极显著性.96.3%的痫样放电出现在睡眠NKEM Ⅰ、Ⅱ期.10例癫痫患者通过Video-EEG修正了发作类型.8例确诊为颞叶癫痫,4例确诊为额叶癫痫.结论 Video-EEG可显著提高癫痫诊断的阳性率,区别癫痫发作与非癫痫发作,确定癫痫发作类型,有助于局灶性癫痫的定位诊断及抗癫痈药物疗效评估,提高疗效.     

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…     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.