袋鼠式护理在早产儿护理中的研究进展

随着围产医学和新生儿医学的迅速发展,早产儿的存活率得到极大提高,早产儿成为当今研究的重要内容之一.有关早产儿护理干预的研究也很多,现就袋鼠式护理在早产儿护理中的研究进展综述如下.     

纤溶酶原激活物抑制剂-1在冠状动脉疾病时表达的变化

目的：研究纤溶酶原激活物抑制剂（PAI）-1分子在吸烟患者中的表达以及与冠状动脉粥样硬化病变的关系。方法：入选冠心病患者98例,根据吸烟时间和吸烟支数分为：强吸烟组（45例）和弱吸烟组（53例）;又根据冠脉造影分为：单支病变组（56例）和多支病变组（42例）,比较各组血清PAI-1分子含量。结果：强吸烟组患者血清PAI-1含量明显高于弱吸烟组[（41．17±8．5）mol／L比（34．26±7．8）,mol／L,P〈0．055;多支病变组PAI-1含量明显高于单支病变组[（43．21±8．3）mol／L比（31.16±6．4）mol／L,P〈0．05]。结论：冠状动脉病变严重程度与纤溶酶原激活物抑制剂-1含量有关,吸烟可破坏机体的内环境平衡,对纤溶起到明显的抑制作用。     

一个同时携带线粒体DNA A1555G突变和GJB2235delC单杂合突变家系的基因型与听力表型

目的 调查一个同时携带线粒体DNA A1555G突变和GJB2 235delC突变的非综合征型耳聋家系,分析其基因型和听力表型的关系.方法 对家系成员进行临床听力测试,收集家系中8名成员的外周静脉血样本,从白细胞中提取DNA,聚合酶链反应扩增GJB2基因和线粒体DNA(mitochondric DNA,mtDNA)目的 片段,对扩增片段直接测序进行GJB2基因、mtDNA 12S rRNA及tRNASer(UCN)基因突变分析.结果 此家系先证者存在mtDNA A1555G突变和GJB2 235delC杂合突变,听力表型为极重度感音神经性耳聋.其他母系成员携带mtDNA A1555G突变,未发现tRNASer(UCN)基因突变,家系中其他母系成员听力表型为双侧对称高频下降或听力正常.结论 GJB2 235delC单杂合突变可能参与了mtDNA A1555G的听力损害.     

继发性噬血细胞性淋巴组织细胞增多症57例患者的早期诊断和临床分析

目的 探讨NK细胞活性、可溶性白细胞介素-2受体(sCD25)及糖化铁蛋白在继发性噬血细胞性淋巴组织细胞增多症(HLH)早期诊断中的意义.方法 收集2005年6月至2008年5月继发性HLH疑似病例57例,根据HLH-2004诊断标准分为初诊确诊组、复诊确诊组及排除组,另有正常健康人员25例为正常对照组.采用乳酸脱氢酶释放法检测外周血NK细胞活件,酶联免疫吸附试验检测血sCD25的水平,植物血凝素吸附法检测血糖化铁蛋白水平,比较上述指标在各组中的差异,并比较各项诊断指标在疾病确诊前后的阳性发生率情况.结果 NK细胞活性在初诊确诊组(18.3±5.6)%,复诊确诊组(16.7±6.7)%,明显低于排除组(33.4±6.8)%及对照组(36.6±5.0)%.糖化铁蛋白中位百分比在初诊确诊组(15.4±2.0)%及复诊确诊组(16.9±3.4)%明显低于排除组(40.4±3.0)%和对照组(45.2±2.2)%.而sCD25水平在初诊确诊组(12 916±4328)ng/L、复诊确诊组(12 117±5465)ng/L,明显高于排除组(4728±1482)ng/L及对照组(3841±993)ng/L.初诊确诊组及复诊确诊组患者的NK细胞活性、sCD25、糖化铁蛋白比例在疾病早期即100%出现异常.结论 NK细胞活性减低、糖化铁蛋白比例降低及sCD25水平升高在早期诊断继发性HLH中具有重要意义.     

一进行性肌营养不良中国家系相关基因Dystrophin的突变的检测

目的 对进行性肌营养不良(duchenne muscular dystrophy,DMD)中国家系致病基因Dystrophin基因多态位点及突变位点的研究.方法 收集进行性肌营养不良家系临床资料,采用聚合酶链反应及直接测序法对此家系进行Dystrophin基因突变检测,同时对150名家系外健康对照者的该位点进行限制性核酸内切酶(restriction endonuclease)分析.结果 在进行性肌营养不良家系中发现了一个纯合变异,即Dystrophin基因21号外显子上发现一个错义变异(A2851G),导致代表天冬氨酸的882位密码子变化为甘氨酸(D882G),通过测序及限制性核酸内切酶(RELP)等方法,其家系中有6名(包括先证者)均有此位点的改变.结论 在中国人进行性肌营养不良患者的Dystrophin基因上发现了一个尚未报道的错义多态位点.     

国产与进口复方甘草酸苷片在健康人体的生物等效性

目的 建立快速、灵敏的液相色谱-串联质谱法(LC-MS/MS)测定人血浆中甘草次酸(治疗慢性肝病药物)的浓度,评价国产与进口复方甘草酸苷片在健康人体的生物等效性.方法 22名中国健康男性志愿者随机分为试验组和对照组,采用双交叉设计和单剂量口服方式,以LC-MS/MS法测定血浆中甘草次酸浓度,经DAS 2.0统计软件计算主要药代动力学参数.结果 线性范围0.50～800.00 ng·mL-1,最低定量浓度为0.50 ng·mL-1,日内精密度(RSD)<10.60%,日间精密度(RSD)<8.80%.受试制剂或参比制剂的主要药动学参数:t1/2分别为(13.1±8.5)和(10.3±5.6)h;tmax分别为(13.5±6.0)和(16.7±7.2)h;Cmax分别为(288.0±249.0)和(287.0±160.0)ng·mL-1.试验制剂相对生物利用度为(117.4±79.8)%.结论 试验制剂与参比制剂具有人体生物等效性.     

Role of voltage-gated potassium channels in pathogenesis of chronic pulmonary heart disease

The influence of hypoxia on the activity of voltage-gated potassium channel in pulmonary artery smooth muscle cells （PASMCs） of rats and its roles in the pathogenesis of chronic pulmonary heart disease were investigated. Eighty male Sprague-Dawley rats were randomly allocated into control group （n=10）, acute hypoxic group （n=10）, and chronic hypoxic groups （n=60）. The chronic hypoxic groups were randomly divided into 6 subgroups （n=10 each） according to the chronic hypoxic periods. The rats in the control group were kept in room air and those in acute hypoxic group in hypoxia envi- ronmental chamber for 8 h. The rats in chronic hypoxic subgroups were kept in hypoxia environmental chamber for 8 h per day for 5, 10, 15, 20, 25, and 30 days, respectively. The mean pulmonary arterial pressure （mPAP）, right ventricular hypertrophy index （RVHI）, and the current of voltage-gated potas- sium channel （IK） in PASMCs were measured. Results showed that both acute and chronic hypoxia could decrease the IK in PASMCs of rats and the I-V relationship downward shifted to the right. And the peak Ir density at ＋60mV decreased with prolongation of hypoxia exposure. No significant difference was noted in the density oflK （at ＋60 mV） and I-V relationship between control group and chronic hy- poxic subgroup exposed to hypoxia for 5 days （P〉0.05）, but there was a significant difference between control group and chronic hypoxic subgroup exposed to hypoxia for 10 days （P〈0.05）. Significant dif- ferences were noted in the IK density （at ＋60 mV） and I-V relationships between control group and chronic hypoxic subgroups exposed to hypoxia for 20 days and 30 days （P〈0.01）. Compared with con- trol rats, the mPAP and RVHI were significantly increased after chronic exposure to hypoxia for 10 days （P〈0.05）, which were further increased with prolongation of hypoxia exposure, and there were signifi- cant differences between control group and chronic hypoxic subgroups exposed to hypoxia for 20 days and 30 days （P〈0.01）. Both the mPAP and the RVHI were negatively correlated with the density OflK （r---0.89769 and -0.94476, respectively, both P〈0.01）. It is concluded that exposure to hypoxia may cause decreased activity of voltage-gated potassium channel, leading to hypoxia pulmonary vasocon- striction （HPV）. Sustained HPV may result in chronic pulmonary hypertension, even chronic pulmonary heart disease, contributing to the pathogenesis of chronic pulmonary heart disease.     

氧减指数在判断儿童阻塞性睡眠呼吸暂停低通气综合征低氧程度的作用分析

目的了解氧减指数与小儿阻塞性睡眠呼吸暂停低通气综合征（OSAHS）低氧血症严重程度的关系和重要性,进一步探讨4,JL呼吸事件发生的特点。方法通过对57例3～6岁OSAHS患儿的PSG监测数据分析,将反映低氧血症的三个指标：最低血氧饱和度（LSa02）、最低血氧饱和度持续的时间、≥3％氧减指数（≥3％ODD与呼吸暂停／1氐通气指数（AHI）进行相关性分析,并对AHI轻、中、重三组的LSa02、最低血氧饱和度持续的时间、≥3％ODI进行组间两两对比。结果AHI与≥3％ODI和最低血氧饱和度持续的时间有相关性（r=0．686,0．643,P〈0．05）;而与LSa02无相关性（r=0．174,P〉0．05）。AHI轻、中、重三组的≥3％ODI组间比较,差异有显著性（P〈0．05）;而三组的LSa02组间比较,无显著差异性（P〉0．05）。结论儿童OSAHS严重程度目前仍以AHI为主要判断指标,≥3％ODI在辅助判断儿童阻塞性睡眠呼吸暂停低通气综合征严重程度上,具有一定的指导性,符合儿童睡眠时呼吸事件的特点。     

Effect of Chinese drugs combining with chemotherapy on quality of life in 146 children with solid tumor

Objective:To explore the effect of Chinese drugs for supporting essence and strengthening Pi(脾, SESP) combining with chemotherapy on the quality of life(QOL) in the children with solid tumor.Methods:Using a digital table,146 children with solid tumor were randomized into two groups,77 in the control group and 69 in the treated group.They received conventional chemotherapy,but to the patients in the treated group,SESP were administered additionally.The patients' scores of QOL and adverse reaction occurred...     

彰显儒家仁爱思想 构建和谐护患关系

在医疗卫生市场的运行过程中,作为护患关系利益主体的病人、护理人员都有自身的权利和义务,理想的和谐护患关系是找到两方利益的平衡点,最终实现"以人为本"的多赢局面。护患关系紧张固然与医院管理不完善、病人对护理工作的特殊性缺乏应有的认同等有关,但更重要的是与护患关系的主要承担