早期环境刺激对婴儿行为发育的影响分析

目的探讨分析早期环境刺激对婴儿行为发育的影响。方法选择于2011年5月至2012年8月在我院妇产科分娩的的婴儿162例,随机将其分成对照组和研究组各81例,对研究组婴儿实施早期环境刺激,对照组婴儿未施行早期环境刺激,比较两组婴儿在50d和100d行为发育的状况。结果结果发现研究组婴儿在50d和100d时智力发育指数以及运动发育指数显著优于对照组,两组比较差异显著(P<0.05),具有统计学意义。结论本次研究发现早期环境刺激对婴儿行为发育具有显著的影响,能够促进婴儿的智力、运动等方面的发育,具有十分重要的临床意义。     

Catalpol improves cholinergic function and reduces inflammatory cytokines in the senescent mice induced by d-galactose

The neuroprotective effects of catalpol, an iridoid glycoside isolated from the fresh rehmannia roots, on the cholinergic system and inflammatory cytokines in the senescent mice brain induced by d-galactose were assessed. The results showed that acetylcholinesterase (AChE) activity increased in senescent mice brain and choline acetyltransferase (ChAT) positive neurons, detected by immunohistochemical staining, decreased remarkably in the basal forebrain of senescent mice. Simultaneously, muscarinic acetylcholine receptor M1 (mAChR1) expression declined in senescent mice brain by western blotting method. We also found that the contents of tumor necrosis factor (TNF-α), interleukin-1β (IL-1β) and advanced glycation endproducts (AGEs) increased in senescent mice brain by ELISA method. However, administration of catalpol for 2-weeks significantly reversed the biochemical markers mentioned above. These results suggest that catalpol can exert protective effects on senescent mice brain induced by d-galactose and this effect may be due to its protective effects on cholinergic and immune impairment in mice brain. Thus catalpol is worth testing for further preclinical study aimed for senescence or neurodegenerative diseases such as Alzheimer’s disease.     

输尿管镜下钬激光碎石治疗输尿管中上段结石1200例报告

目的评估输尿管镜钬激光碎石治疗输尿管中上段结石的安全性和有效性。方法对2005年1月～2010年12月输尿管镜下钬激光碎石治疗的1 200例输尿管中上段结石患者的临床资料进行回顾性分析。结果一次性结石清除率95.4%（1 145/1 200）,其中,第三腰椎下缘以上结石为75.7%（28/37）,第三腰椎下缘至骶髂关节上缘结石为92.6%（486/525）,骶髂关节段结石为98.9%（631/638）。3.6%（43/1 200）患者因碎石移位改行ESWL术。9例出现输尿管穿孔,除2例改开放手术外,7例成功留置双＂J＂管3月后再次行输尿管镜钬激光碎石获成功。本组手术时间20～90min,平均（45.6±17.4）min,术中未发生大出血、输尿管撕脱、断裂等,术中输尿管黏膜撕裂4例,黏膜下假道形成8例,均顺利留置双＂J＂管,随访1～6月无尿囊肿和输尿管狭窄形成。术后患侧肾绞痛57例、腹部胀痛24例、发热28例,予以抗感染、对症治疗后好转。术后2～3d拔除导尿管,术后住院天数3～7d,平均（4.3±1.2）d。结论输尿管镜钬激光碎石术,具有微创、高效、并发症少、恢复快等优点,在掌握一定输尿管镜技巧的基础上处理中上段输尿管结石可取得比较好的疗效。但对L3水平以上且直径大于1.0cm的结石不建议使用输尿管镜处理。     

孕妇血清内早期血清妊娠相关激素与胚胎停育的相关性

探讨孕早期血清妊娠相关蛋白-A(PAPP-A) 和整合素-金属蛋白酶12分泌期蛋白(ADAM12-s)、催乳素(PRL)和孕酮(P)水平变化及其与胚停育的相关性。应用时间分辨荧光免疫分析法测定患者血清中 PAPP-A、ADAM12-s、PRL和孕酮P表达水平,并对测定结果及孕妇妊娠结局进行统计分析。与正常妊娠组孕妇PAPP-A、ADAM12-s、PRL和孕酮P水平相比,胚胎停育组患者PAPP-A、ADAM12-s、PRL和孕酮P平均中位数水平显著降低,差异具有统计学意义(P<0.05)。正常妊娠组和胚胎停育组孕妇血清内PAPP-A、ADAM12-s、PRL和孕酮P水平与患者的孕周数存在显著的直线相关关系,Person相关系数为正值,(P<0.05)。孕早期孕妇血清 PAPP-A、ADAM12-s、PRL和孕酮(P)含量随孕周数增加而显著上升,可以作为预测胚胎停育的有效临床指标。     

Outcomes following ipsilateral great saphenous vein bypass for lower extremity arterial injuries

ObjectiveUse of autologous great saphenous vein (GSV) grafts for repair of extremity arterial injuries is well established. Contralateral great saphenous vein (cGSV) is traditionally used in the setting of lower extremity vascular injury given the risk of occult ipsilateral superficial and deep venous injury. We evaluated outcomes of ipsilateral GSV (iGSV) bypass in patients with lower extremity vascular trauma.MethodsPatient records at an ACS verified Level I urban trauma center between 2001 and 2019 were retrospectively reviewed. Patients who sustained lower extremity arterial injuries managed with autologous GSV bypass were included. Propensity-matched analysis compared the iGSV and cGSV groups. Primary graft patency was assessed via Kaplan-Meier analysis at 1-year and 3-years following the index operation.ResultsA total of 76 patients underwent autologous GSV bypass for lower extremity vascular injuries. 61 cases (80%) were secondary to penetrating trauma, and 15 patients (20%) underwent repair with iGSV bypass. Arteries injured in the iGSV group included popliteal (33.3%), common femoral (6.7%), superficial femoral (33.3%), and tibial (26.7%), while those in the cGSV group included common femoral (3.3%), superficial femoral (54.1%), and popliteal (42.6%). Reasons for using iGSV included trauma to the contralateral leg (26.7%), relative accessibility (33.3%), and other/unknown (40%). On unadjusted analysis, iGSV patients had a higher rate of 1-year amputation than cGSV patients (20% vs. 4.9%), but this was not statistically significant (P = 0.09). Propensity matched analysis also found no significant difference in 1-year major amputation (8.3% vs. 4.8%, P = 0.99). Regarding ambulatory status, iGSV patients had similar rates of independent ambulation (33.3% vs. 38.1%), need for assistive devices (58.3% vs. 57.1%), and use of a wheelchair (8.3% vs. 4.8%) compared cGSV patients at subsequent follow-up (P = 0.90). Kaplan-Meier analysis of bypass grafts revealed comparable primary patency rates for iGSV versus cGSV bypasses at 1-year (84% vs. 91%) and 3-years post-intervention (83% vs. 90%, P = 0.364).ConclusionIpsilateral GSV may be used as a durable conduit for bypass in cases of lower extremity arterial trauma where use of contralateral GSV is not feasible, with comparable long-term primary graft patency rates and ambulatory status.     

肝硬化合并原发性肝癌患者CT动态增强扫描变化及诊断价值

目的 观察肝硬化（HC）合并原发性肝癌（PLC）患者CT动态增强扫描变化,分析其诊断价值。方法 回顾性分析2020年4月—2022年7月我院125例HC患者资料,所有受试者均行病理组织学检测及CT动态增强扫描,统计所有患者病灶大小及分布情况,CT动态增强扫描动脉期、静脉期、延迟期病灶检出情况,以病理检查为金标准,分析CT动态增强扫描对HC患者PLC的诊断价值、HC患者与HC并PLC患者血流灌注参数大小及不同肝功能CTP分级下血流灌注参数变化。结果 125例HC患者共检出161个病灶,其中直径<1 cm 8个,1～3 cm 53个,4～5 cm 63个,>5 cm 37个,肝右前叶、肝右后叶者居多,分别为45及69个;CT动态增强扫描动脉期检出病灶149个,检出率92.55%;门脉期检出病灶134个,检出率83.23%;延迟期检出病灶142个,检出率88.20%;125例HC患者中病理学检查显示75例PLC阳性,50例PLC阴性,CT动态增强扫检测HC并PLC的敏感度为94.67%,特异度为94.00%,准确率为94.40%,阳性预测值为95.95%,阴性预测值为92.16%,Kappa值为0.884,具有较高的一致性;HC组HAP、HPI值均显著低于HC并PLC组,PVP、TLP值均显著高于HC并PLC组（P<0.05）;125例HC并PLC患者中CTP A级41例,CTP B级46例,CTP C级38例,CTP A级HAP、HPI值显著低于CTP B、C级（P<0.05）,PVP、TLP值均显著高于CTP B、C级（P<0.05）,CTP B级HPI值与CTP C级比较,差异均无统计学意义（P>0.05）。结论 CT动态增强扫描可多方位多角度显示HC病灶情况,且对PLC具有较好的诊断价值,其中肝脏血流灌注参数具有一定的特征性,可为PLC诊断和肝功能分级提供参考     

老年亚临床甲状腺功能减退症患者心电图改变及血清Hcy、25-(OH)D变化的临床价值

目的 探讨老年甲状腺功能减退症(SH)患者心电图改变及血清同型半胱氨酸(Hcy)、25-羟维生素D[25-(OH)D]变化的临床意义。方法 选取2019年6月—2021年6月核工业四一六医院收治的158例老年SH患者为研究对象,根据冠脉造影结果将患者分为动脉粥样硬化组(n=72)和动脉正常组(n=86),比较两组受试者心电图变化及Hcy、25-(OH)D水平,并分析血清Hcy、血清25-(OH)D及心电图变化与SH患者冠状动脉粥样硬化的关系。结果 动脉粥样硬化组患者的高脂血症构成率、BMI、TC、TG、Hcy、促甲状腺激素(TSH)水平高于动脉正常组(P<0.05),HDL-C、25-(OH)D水平低于动脉正常组(P<0.05);动脉粥样硬化组中窦性心动过缓、QRS低电压、矫正QT间期延长、ST-T改变、不完全性右束支阻滞构成比高于动脉正常组(P<0.05);多因素Logistic回归分析结果显示,Hcy≥12.16μmol/L、25-(OH)D<21.28 mg/L、心电图异常等均是SH患者冠状动脉粥样硬化的独立危险因素;血清Hcy、25-(OH)D评估患者动...     

谷参肠安胶囊长期毒性试验

本文报告谷参肠安胶囊大鼠长期毒性试验,结果表明,谷参肠安胶囊对动物的一般状况,体重增长、外周血象、肝肾功能及病理组织学检查等未见明显毒性。     

鲎试验测定复方氨基酸(15)双肽(2)注射液中的细菌内毒素

目的:检测复方氨基酸(15)双肽(2)注射液中的细菌内毒素。方法:供试品干扰试验后,采用凝胶鲎试验对样品中的细菌内毒素进行检测。结果:三批复方氨基酸(15)双肽(2)注射液稀释至28倍时对细菌内毒素的检测无干扰作用,所测样品的细菌内毒素含量均小于7 EU.ml-1。结论:所建立方法检查复方氨基酸(15)双肽(2)注射液中的细菌内毒素可行。     

团体认知行为治疗对医学毕业生心理健康的影响

目的探讨团体认知行为治疗对求职阶段医学专科毕业生心理健康水平的作用。方法对23名具有明显心理问题的医学专科毕业生进行团体心理治疗,并使用症状自评量表(SCL-90),贝克焦虑量表(BA I),及贝克抑郁量表(BD I)对其进行治疗前后的评估。结果团体治疗后,23名大学生的症状自评量表(SCL-90)(t=3.313,P=0.002),贝克焦虑量表(BA I)(t=5.471,P<0.001),及贝克抑郁量表(BD I)(t=6.038,P=0.001)总分得分与治疗前相比,均有显著下降,同时SCL-90各项因子评分较治疗前亦有明显降低(P<0.01)。结论团体认知行为治疗可以明显缓解毕业生求职阶段的焦虑抑郁状态,改善其心理健康水平。