胆红素对新生豚鼠蜗核损伤的动态研究

目的　探讨听性脑干反应 (ABR)在胆红素所致听力损伤中的监测价值。方法　 2 0只新生 5日豚鼠随机分为胆红素组和对照组 ,胆红素组腹腔注射胆红素 (2 0 0 μg/ g) ,对照组腹腔注射相应体积的生理盐水 (0 1ml/g) ,于腹腔注射前和后 4h、 8h分别记录ABR并观察神经行为状况 ,每组各取 5只于腹腔注射后 4h、 8h分别行蜗核形态学观察。结果　注射胆红素后 ,ABR波潜伏期、波间期呈逐渐延长趋势 ,振幅呈逐渐下降趋势 ,其中波Ⅱ改变出现最早且最明显。用药后 4h ,无明显神经系统症状和形态学改变时 ,Ⅰ -Ⅱ波间期延长及波Ⅱ振幅下降与对照组及用药前比较差异有显著性 (P <0 0 1) ;用药后 8hABR改变更明显 ,同时伴有神经症状和镜下形态学改变 ,蜗核体积及大椭圆细胞截面积显著性减小 (P <0 0 1)。结论　ABR是监测胆红素所致听力损害早期的敏感指标 ,优于耳蜗电图和耳声发射等主要反映周围听觉系统功能状态的电生理技术 ,加强高胆红素血症新生儿的ABR动态监测有非常重要的临床意义     

脑活素治疗新生儿缺氧缺血性脑病27例疗效分析

本文对27例新生儿缺氧缺血性脑病(HIE)在常规治疗基础上加用脑活素与常规治疗相比较,发现两组治疗结果在统计学上比较差异有显著性(P<0.05),提示脑活素对治疗HIE有一定疗效,可提高治愈率,减少后遗症的发生。     

胆汁中提取胆红素的最佳实验条件探讨

从胆汁中提取胆红素，所得成品，其含量和收率受许多因素的影响。本文通过正交表实验选择，结果表明，最主要因素为醇析酸化ｐＨ值，其次为乙醇浓度、乙醇用量和抗氧剂用量等。     

产褥期脑病62例临床分析

目的研究产褥期脑病的临床特征、治疗方法及预后。方法选择62例产褥期突发精神症状并有全脑受累体征病人的临床资料进行回顾性分析。结果发现产褥期脑病的临床表现酷似病毒性脑炎,但病前无明显感染灶,病程较长,疗效和预后较差。结论对产褥期精神异常病人应进行神经病学方面检查,尽早诊治。病初要控制和缩短脑水肿期,防止和减轻脑细胞的变性和脱鞘;恢复期要耐心而持久地进行各种康复治疗,以便病人恢复到最佳健康水平。     

两种检测血清结合胆红素方法的结果比较

[目的]比较2，4-二氯苯胺重氮法（DCA）和钒酸盐氧化法检测血清结合胆红素的结果。[方法]根据NCCLS（EP6-P）评价方案，评估两种方法的相关性和偏倚。[结果]两种方法的检测结果相关性良好（r=0．9985），Ⅰ、Ⅱ、Ⅲ组检测结果无差异，Ⅳ组结果有差异。[结论]应建立与方法学相对应的血清结合胆红素参考值范围。     

Surgical Treatment of an Early Epileptic Encephalopathy with Suppression-Bursts and Focal Cortical Dysplasia

Summary: A case of early epileptic encephalopathy (EIEE) with suppression-bursts or Ohtahara's syndrome, associated with focal cortical dysplasia is reported. Infantile spasms and brief tonic unilateral seizures began on the fifth day of life. Interictal EEG demonstrated an asymmetrical "suppression-burst" pattern with no wake or sleep cycling. Seizures were refractory to all antiepileptic drug (AED) and steroid therapy. Magnetic resonance imaging (MRI) showed right frontotemporal cortical thickening. After three weeks of an ineffective medical treatment a preoperative evaluation with single photon emission computed tomography (SPECT) and electrocorticography (ECoG) was performed to characterize epileptogenic focus. Surgical resection of the precentral area was performed at age 1 month. Neuropathologic examinations confirmed diagnosis of focal cortical dysplasia by identifying cytoarchitectural disarray and ectopic neurons located deep in subcortical white matter. During follow-up, 1-year postoperative the child had a single febrile seizure. Neurologic examination showed minor developmental delay and slight left-sided weak ness.     

颅脑超声对高原新生儿缺氧缺血性脑病观察及探讨

本文对西宁地区新生儿缺氧缺血性脑病（ＨＩＥ）颅脑超声诊断分析脑缺氧缺血产生的原因、脑实质损伤程度及预后评估。提出对围产期窒息导致脑缺血性损害的预防措施。     

"Chronic painter''s syndrome". A reanalysis of psychological test data in a group of diagnosed cases, based on comparisons with matched controls

Twenty solvent-exposed workers, most of them painters, had been diagnosed as cases of toxic encephalopathy in 1978/79. Two years later they were re-examined with an extensive battery of neuropsychological tests. Their performance was unchanged on retesting. We have now compared their test results with those of non-exposed control subjects. Previous impressions of significant intellectual impairment in the solvent-exposed patients could not be confirmed when the influence of age, education, and intelligence was taken into consideration. The present group with presumed toxic encephalopathy is assumed to be representative of other patients who were similarly diagnosed in our department. The presently reanalyzed cases had been diagnosed as brain damaged and reported as such in the literature. Thus, they may have contributed to the formation of the concept of the "chronic painters' syndrome" with dementia.     

生物标志物联合检测在脓毒症相关急性肝损伤患者中的应用价值

目的:探讨生物标志物联合检测对脓毒症相关急性肝损伤患者的早期诊断和预后评估的价值。方法:收集内蒙古科技大学包头医学院第一附属医院重症医学科(ICU)2019年11月-2022年1月收治的104例脓毒症患者临床资料,按照入ICU时是否发生急性肝损伤分为脓毒症相关急性肝损伤组(n=42)和非肝损伤组(n=62),将脓毒症相关急性肝损伤患者按28 d是否存活分为存活组(n=16)和死亡组(n=26),记录104例患者入ICU 6 h内血清正五聚蛋白3(PTX-3)、C-反应蛋白(CRP)、降钙素原(PCT)、总胆红素(TBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、凝血酶原时间国际标准化比值(INR值)、凝血酶原时间(PT)、凝血酶原活动度(PTA)、血小板(PLT)、入ICU 24 h内急性生理与慢性健康状况评估量表II(APACHEII)评分最差值及序贯器官衰竭评估(SOFA)评分;同时记录脓毒症相关急性肝损伤患者28 d预后。PTX-3的相关性采用Spearman相关分析;绘制受试者工作特征曲线(ROC曲线),计算ROC曲线下面积(AUC),分析各指标单独检测以及联合检测对脓毒...     

极低体质量近存活期分娩儿一例的出生后早期管理

近存活期分娩（PVB）儿各组织系统发育极不成熟,易发生各种器官功能损害和并发症,预后常不佳。目前关于PVB儿出生后早期管理的报道不多,诸多尚待解决的问题仍是围产医学所面临的挑战。经有效的新生儿复苏和呼吸循环支持、积极的营养支持和喂养、防治感染、内分泌和代谢性疾病管理、积极处理早产儿相关并发症,以及发育支持护理、家庭参与式护理等一系列个体化管理和精细化护理,四川省医学科学院·四川省人民医院成功救治了1例胎龄23周,出生体质量（BW）为450 g的PVB儿。本文通过总结1例PVB儿的出生后早期管理,并结合文献复习进行归纳总结,以期为提高BW<500 g的PVB儿存活率并获得良好预后提供经验及借鉴。