固肾安胎丸治疗早期先兆流产临床疗效观察

目的:观察固肾安胎丸治疗早期先兆流产的临床疗效。方法:将225例早期先兆流产患者按就诊顺序采用随机数字法分为2组,治疗组115例给予固肾安胎丸治疗,对照组110例给予维生素E及黄体酮胶丸口服,2周为1个疗程。观察2组治疗前后阴道出血、腰酸胀痛、小腹坠痛症状减轻情况及B超、血孕酮值,并随访至12周以后。结果:总有效率治疗组为93.04%(107/115),对照组为88.18%(97/110),2组比较,差异有统计学意义(P<0.05)。治疗后2组平均血清孕酮值(P)水平较治疗前均升高,与治疗前相比,差异有统计学意义(P<0.05),说明2组药物均能改善机体血清P水平。结论:固肾安胎丸治疗早期先兆流产疗效显著,并且为纯中药制剂无不良反应、服用方便,值得推广应用。     

慢性心力衰竭患者窦性心律震荡现象及临床意义

目的探讨慢性充血性心力衰竭伴室性早搏患者窦性心率震荡（HRT）的变化及临床意义。方法选择伴室性早搏的慢性充血性心力衰竭患者（观察组）和无器质性心脏病的室性早搏患者（对照组）各30例。记录24h动态心电图,计算其震荡起始（TO）和震荡斜率（TS）。结果慢性充血性心力衰竭组震荡起始明显高于对照组[（0.05±0.58）%VS（-2.22±1.01）%,P〈0.001],震荡斜率明显低于对照组[（5.89±2.65）ms/RR VS（7.36±1.34）ms/RR,P〈0.01]。结论慢性充血性心力衰竭患者窦性心率震荡（HRT）减低,故窦性心率震荡可用于慢性心力衰竭患者病情程度的判断。     

血浆D-二聚体与肌钙蛋白T联合检测对心肌梗死的诊断价值

目的:评价联合检测血浆D-二聚体(DD)与肌钙蛋白T(TnT)在诊断急性心肌梗死(AMI)中的临床价值。方法:选择66例AMI患者,采用乳胶凝集法及酶联免疫吸附法(ELISA)检测血浆DD及心肌TnT(cTnT),计算DD及cTnT阳性率,并与44例非心血管疾病患者(对照组)进行比较。结果:AMI患者发病后,血液中cTnT、DD阳性率分别为87.88%、77.76%,与对照组比较,差异有统计学意义(P<0.05或P<0.01)。AMI组cTnT单独检测时,灵敏度和特异性分别为90.91%、90.96%。DD单独检测时,灵敏度和特异性分别为92.31%、86.27%。而联合检测时,灵敏度和特异性分别为99.30%、98.75%,临床诊断正确性优于各项指标单独检测。结论:联合检测血浆DD与cTnT对早期诊断AMI有较高的敏感性和特异性,有助于提高AMI的诊断率。     

1083例妇女HPV感染状况分析

目的:分析西安地区HPV感染亚型的分布情况及各年龄段与感染状况之间的关系。方法:采用HPV-RDB方法对1083例西安妇女进行HPV分型检测;分别统计19种亚型检出例数分布情况。将受检人群分为6个年龄阶段,分别计算其阳性检出率,分析各检出率与年龄之间的关系。结果:1083例样本中,检出HPV阳性402例,总阳性率为37.12%。亚型感染率相对较高的3个型别依次为16、52和58型,分别占检出总例数的38.06%、16.42%和14.43%。按年龄分组,以<20组和>60岁组检出率最高(75.00%和70.00%)。剩下的4个年龄段组,以20～29岁和40～49岁年龄段检出率较高(P<0.05)。结论:西安地区HPV阳性检出率较高,应加强对宫颈癌的早期预防和早期治疗;HPV基因分型检测能同时进行多种亚型的检测,可为临床防治宫颈癌提供可靠依据。     

负荷剂量阿托伐他汀对非ST段抬高急性冠状动脉综合征患者PCI围术期的影响

目的探讨负荷剂量阿托伐他汀对非ST段抬高急性冠状动脉综合征(NSTEACS)患者PCI围手术期的影响。方法将160例NSTEACS患者随机分为负荷剂量治疗80例为观察组和标准治疗80例为对照组。观察组PCI术前3~5d给予负荷剂量阿托伐他汀40mg/d,对照组PCI术前3~5d给予常规剂量阿托伐他汀10mg/d,两组其余药物治疗均相同,PCI治疗相同。主要检测指标为术前、术后6h、12h、24h肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白(cTnI)水平变化,随访术后30d内主要不良心脏事件(MACE)发生率。结果与PCI术前比较,观察组术后8h、24hCK-MB、cTnI升高水平均明显低于对照组,两组比较差异具有统计学意义(P<0.05);观察组术后30d内MACE的发生率明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论 NSTEACS患者PCI术前应用负荷剂量阿托伐他汀能减少PCI术对患者造成的心肌损伤,降低PCI术后不良心脏事件的发生率,安全有效,临床可广泛应用。     

Polysomnographic quantification of bioelectrical maturation in preterm and fullterm newborns at matched conceptional ages

We analyzed the relationship between normal neonatal EEG features and gestational age and conceptional age, and evaluated the normal aspects of EEG maturation in preterm babies compared to term babies. We report 46 newborns, divided into two groups. Group I consisted of 11 newborns with gestational age between 30 and 32 weeks, followed with weekly polysomnograms until they reach 42 weeks' conceptional age. Group II (control) consisted of 35 newborns with gestational ages of 34 weeks (n = 5), 36 weeks (n = 10), 38 weeks (n = 10) and 40 weeks (n = 10) evaluated with one polysomnogram in their first 24–48 h of life. In each examination one 5 min epoch in REM and NREM sleep was analyzed to quantify the number of delta brushes, the presence of frontal and temporal sharp transients, the presence of delta frontal rhythmic activity, the grade of concordance between EEG patterns and sleep stages, the percent of interhemispheric synchrony and the duration of interburst interval. The age dependent variability of the EEG patterns was evaluated during the subsequent weeks with group comparisons at weeks 34, 36, 38 and 40. Our results show that the number of delta brushes and the duration of the interburst interval decrease as gestational and conceptional age increase. The percent of interhemispheric synchrony increases with gestational and conceptional age. The presence of frontal sharp transients and delta frontal rhythmic activity suggest that the newborn is fullterm. The presence of temporal sharp transients suggest a preterm newborn. The degree of concordance between behavioral sleep patterns and EEG was more helpful in recognizing sleep stages than in estimating gestational or conceptional age. Although the EEG patterns were comparable between the groups at the same age, analyses of the behavioral patterns of concordance in NREM sleep showed that newborns in Group I had a more immature behavior than newborns in Group II. Our results also suggest that extrauterine life of preterm babies does not seem to accelerate EEG maturation but may influence the acquisition of behavioral patterns during NREM sleep.     

雷公藤多苷联合免疫抑制剂治疗难治性肾病综合征的远期疗效及对氧化应激指标的影响

目的 探究雷公藤多苷联合免疫抑制剂治疗难治性肾病综合征(RNS)的远期疗效及对氧化应激指标的影响.方法 选择2016年2月至2019年2月在本院接受治疗的68例RNS患者作为研究对象,采用随机数字表法将其分为对照组[34例,常规对症处理+吗替麦考酚酯(MMF)]和观察组(34例,常规对症处理+MMF+雷公藤多苷).比较...     

Inflammatory cytokines in the brain: Does the CNS shape immune responses?

Immune responses in the central nervous system (CNS) have traditionally been regarded as representing the intrusion of an unruly, ill-behaved mob of leukocytes into the well-ordered and organized domain of thought and reason. However, results accumulated over the past few years suggest that, far from being an immunologically priviledged organ, T lymphocytes may be regular and frequent visitors to the CNS, for purposes of immune surveillance. Here, Trevor Owens and colleagues propose that the brain itself can regulate or shape immune responses therein. Furthermore, given that the immune cells may be subverted to autoimmunity, they suggest that the study of inflammatory autoimmune disease in the brain may shed light on the ability of the local environment to regulate immune responses.     

冠状动脉支架植入术后患者320排减影冠状动脉CT血管造影图像质量的影响因素

目的 观察冠状动脉支架植入术后患者320排减影冠状动脉CT血管造影(Sub-CCTA)图像质量的影响因素。方法 前瞻性纳入40例冠状动脉支架植入术后冠心病患者,获取320排冠状动脉血管造影(CCTA)及Sub-CCTA,评估图像质量;观察患者基本信息、心率、心脏解剖结构参数和支架情况与Sub-CCTA图像质量的相关性,分析其影响因素。结果 Sub-CCTA图像质量评分与患者性别(r=-0.326,P<0.01)、平均心率(r=-0.328,P<0.01)、心脏左横径(r=0.319,P<0.01)及支架位置(r=0.410,P<0.01)相关。将上述因素纳入logistic分析,结果显示平均心率、心脏左横径及支架位置为Sub-CCTA图像质量的影响因素;基于上述各项建立的模型评估Sub-CCTA图像质量的敏感度、特异度、阳性预测值及阴性预测值分别为89.21%、63.34%、76.73%及81.00%。结论 冠状动脉支架植入术后患者平均心率、心脏左横径及支架位置为其Sub-CCTA图像质量的影响因素。