^18F-fallypride-新型多巴胺受体显像剂在脑神经疾病研究中的临床应用

^18F-Fallypride是一种新型安全的多巴胺D2受体PET显像剂,具有亲和力高、亲脂性适宜、半衰期短等特点,本文综述^18F-Fallypride用于精神分裂症、癫痫、抽动秽语综合征、兴奋剂成瘾性等的多巴胺D2/D3受体变化的研究。     

学龄前儿童心理行为问题与健康教育状况研究

【目的】了解南京市学龄前儿童行为问题及健康教育状况。【方法】随机抽取二个区九所托幼机构1 141名儿童作为调查对象,应用Achenbach儿童行为量表及托幼机构心理卫生健康教育状况问卷,了解儿童行为问题及健康教育状况。【结果】南京市学龄前儿童心理行为问题检出率为9.20%,儿童行为问题男女检出比例为1∶2,女童行为问题发生高于男童,5岁以下女童行为异常高于5岁以上女童。儿童行为问题与父母文化程度、父母有心理卫生培训证书、父母经常责骂子女、父亲对儿童的关心程度、家长较凶、家庭和睦密切相关。家长希望通过专业人员、报纸(电视)获得心理卫生知识,希望在医院、托幼机构、保健部门得到心理卫生服务。托幼机构儿童心理卫生服务较薄弱。【结论】儿童行为问题的发生是环境、社会、家庭、教养等多因素综合作用结果,对学校、家长、儿童开展健康教育活动至关重要。     

Preoperative tramadol combined with postoperative small-dose tramadol infusion after total abdominal hysterectomy: a double-blind,randomized, controlled trial

This double blind, randomized, controlled trial investigated whether a single preoperative intravenous (iv) dose of tramadol (100 mg) given 30 min before abdominal hysterectomy resulted in improved analgesic efficacy, reduced postoperative morphine patient-controlled analgesia (PCA) use and reduced side effects when combined with a postoperative small-dose tramadol infusion. Two-hundred twenty-four patients undergoing elective abdominal hysterectomy were randomly allocated to one of two groups: the tramadol group (n = 113) received iv tramadol (100 mg) 30 min before surgery, and the control group (n = 111) received an equivalent volume of normal saline. Upon awakening from general anesthesia, all patients received a loading dose of 0.5 mg/kg of tramadol and a small-dose infusion of tramadol (0.1 mg/kg/h) for 48 h. In addition, all patients were connected to morphine PCA delivering a morphine bolus of 0.02 mg/kg with a 6-min lock-out. Data on pain intensity at rest and during movement, morphine consumption, side-effects and overall patient satisfaction were recorded. A total of 189 patients completed the study. Preemptive tramadol was associated with superior analgesia at rest and with movement in the first 24 h after surgery (p < 0.01), a longer interval to first morphine PCA request (p = 0.019), and reduced morphine PCA use (p = 0.017). The tramadol group had reduced nausea (p = 0.015), dizziness (p = 0.001) and drowsiness (p = 0.0001), while other side-effects were similar. In conclusion, a single dose of iv tramadol (100 mg) 30 min prior to abdominal hysterectomy improves analgesia, and reduces morphine PCA requirements, nausea, dizziness and drowsiness when combined with a postoperative small-dose tramadol infusion and morphine PCA when compared to the same analgesic regimen that omitted the preemptive tramadol.     

基于OCTA分析妊娠期高血压患者产后视网膜微循环的变化

目的：利用光学相干断层扫描血管成像技术(OCTA)定量分析产后6mo以上妊娠期高血压综合征(PIH)患者的视网膜微循环变化。

方法：分别测量19例PIH患者、23例正常妊娠女性(HPW)及19例未妊娠女性(CNPW)的屈光度、最佳矫正视力及眼轴长度,并使用OCTA测量三组视乳头及黄斑区血流参数、神经纤维层厚度和脉络膜厚度。所有妊娠患者数据均采集自分娩6mo以后。运用统计软件SPSS20.0,单因素方差分析比较三组间视网膜微循环相关参数的组间差异。

结果：PIH组的黄斑区无灌注区面积(FAZ)明显大于HPW组和CNPW组(均P<0.05); 三组间的黄斑区各区域视网膜浅层血管密度无差异; PIH组的视乳头各区域浅层血管密度,其中视乳头整层6mm区域、外层、下外侧、鼻外侧高于HPW组和CNPW组; 视神经纤维层平均厚度三组间无差异,但PIH组的视神经颞侧纤维层厚度明显低于HPW组和CNPW组(均P<0.05); PIH组的黄斑中心区视网膜厚度明显低于HPW和CNPW(均P<0.05); 中心凹下脉络膜厚度三组间无差异。

结论：PIH患者产后视网膜部分区域血管密度、黄斑中心区厚度及颞侧视神经纤维层厚度与HPW及CNPW组间均存在差异,提示PIH对视网膜微循环的影响可能在产后仍持续存在。     

儿童食物皮肤点刺试验结果分析与过敏控制

目的:分析皮肤点刺试验(skin prick test,SPT)阳性结果,指导家长在喂养过程中控制由食物引起的过敏反应。方法:随机收集2009年6月～2010年10月在南京市妇幼保健院儿保门诊接受健康体检的6个月～2岁儿童195例(排除各种急性期疾病及中、重度湿疹),进行牛奶、鸡蛋、鱼、虾、小麦5种常见食物的SPT,对其阳性结果进行分析。结果:轻微湿疹儿童对食物过敏的有50.75%,正常儿童对食物过敏的有11.47%,轻微湿疹患儿食物过敏发生率高于正常儿童,两者有显著差异(P<0.05)。不同食物过敏原阳性率在各月龄组儿童均表现为鸡蛋>虾>鱼>牛奶>小麦,且随着年龄增长食物过敏阳性率有降低趋势。结论:食物过敏在儿童中发生率较高,尤其是患有轻微湿疹的儿童,根据儿童过敏的特点,应早期避免接触食物过敏原,在辅食添加的过程中逐一添加、循序渐进,从而有效控制食物过敏的发生。     

新医改下大型综合医院新型住院难问题研究

目的:观察系统健康教育对妊娠期糖尿病孕妇的干预效果,进一步探索对妊娠期糖尿病患者科学?便捷?经济?有效的饮食治疗和健康促进方法?方法:120名妊娠期糖尿病孕妇按1∶1随机分为实验组和对照组,实验组接受系统健康教育,对照组接受传统健康教育?观察两组相关知识的认知情况?态度及饮食习惯等方面的改变?结果:系统教育组和传统教育组均可使知识调查总分上升,但系统教育组要优于传统教育组;而态度总分仅在系统教育组干预后上升,且饮食习惯系统教育组优于传统教育组?结论:妊娠期糖尿病孕妇系统健康教育在相关知识的认知情况?态度及饮食习惯等方面的改变有一定意义?     

围产期下肢深静脉血栓形成的彩色多普勒超声诊断

目的：探讨围产期下肢深静脉血栓形成（DVT）彩色多普勒超声的诊断价值。方法：对31例疑诊DVT的声像图表现进行回顾分析。结果：深静脉回流障碍28例,其中DVT 9例,超声可表现为静脉管腔完全或不完全闭塞;彩色多普勒示管腔内无血流信号或充盈缺损。结论：彩色多普勒超声检查是诊断孕产妇DVT最理想、最安全、最有效的方法。     

Proteomic Mechanism of Myocardial Angiogenesis Augmented by Remote Ischemic Training of Skeletal Muscle in Rabbit

Aims: This study was designed to evaluate the proteomic mechanism of myocardial angiogenesis augmented by a remote ischemic training (RIT) of skeletal muscle in a controlled myocardial ischemia model. Methods: The rabbits were grouped by RIT, myocardial ischemia without RIT (MI), and sham‐operation (Sham). Controlled myocardial ischemia was modeled by a balloon constrictor implanted on their left ventricular branch (LVB) in a New Zealand rabbit. RIT was induced by four cycles of 10‐minute ischemia followed by 10 minutes of reperfusion using tourniquets on the hind limbs of the myocardial ischemia models for 4 weeks. The myocardial samples were subjected to two dimensional electrophoresis and MALDI TOF for protein identification. The angiogenesis was documented by using microspheres to measure the relative regional blood flow, immunohistochemistry to assess capillary density (Factor VIII), and Western blotting to measure the vascular endothelial growth factor (VEGF) levels. Results: Thirty‐eight differentially expressed protein spots between RIT and MI were separated by two‐dimensional gel electrophoresis, and of those, 22 proteins were identified by mass spectrometry. The regional blood flow, capillary density and VEGF in RIT were 35%, 49% and 28% higher than MI (p < 0.01). The increase of regional blood flow and capillary density were highly correlated with VEGF (r= 0.74 and r= 0.67, respectively; p < 0.01). Both RIT and MI groups exhibited stronger angiogenesis than sham treatment (p < 0.01). Conclusions: Augmentation of angiogenesis in ischemic myocardium by RIT has identical identified proteomic findings with differentially expressed proteins.     

高血压家族史儿童血压水平的研究

目的：了解有高血压家族史儿童的血压水平。方法：对167例有高血压家族史的儿童测量血压,以175例无高血压家族史的健康儿童作为对照。结果：与对照组比较,有家族史的儿童收缩压和舒张压明显增高,高血压检出率明显增高（2．57％：15．13％,P〈0．01）。有早发高血压家族史的儿童与非早发家族史儿童比较,收缩压和舒张压更高,高血压检出率更高（21．54％：12．94％,P〈0．01）。结论：有高血压家族史儿童血压水平较无高血压家族史儿童高,以有早发高血压家族史儿童更明显,提示成年后发生高血压的危险性显著升高。