36例慢牲肾功能不全患者血浆心钠素水平的观察

报告３６例慢性肾功能不全患者的血浆心钠素、肾素、血管紧张素Ⅱ、醛固酮水平及其相互关系。结果表明：①慢性肾功能不全患者的血浆心钠素水平明显高于对照组值（Ｐ＜０．０ｌ）；②慢性肾功能不全患者中并发高血压者与血压正常者血浆心钠素水平相近，但均高于对照组（Ｐ＜０．０１）；③慢性肾功能不全患者肾素—血管紧张素—醛固酮系统（ＲＡＡＳ）活性增高，但心钠素与醛固酮无明显相关。提示血浆心钠素测定在慢性肾功能不全的诊断中有重要意义。     

Increase of prolactin mRNA in the rat hypothalamus after intracerebroventricular injection of VIP or PACAP

Vasoactive intestinal peptide (VIP), the structurally homologous pituitary adenylate cyclase-activating peptide (PACAP) and the pituitary hormone, prolactin (PRL) enhance rapid eye movement sleep (REMS). VIP and PACAP are both inducers of PRL gene expression and release in the pituitary gland. Little is known about PRL regulation in the brain although it is hypothesized that the REMS-promoting activity of i.c.v. administered VIP may be mediated via the activation of cerebral PRL. To test whether VIP or PACAP in fact increase intracerebral mRNA, the peptides (VIP: 30 or 300 pmol; PACAP: 220 pmol) were injected i.c.v. into rats at dark onset. 1 h later, cDNA was synthesized from purified hypothalamic mRNA. Standardized amounts were analysed for PRL using the polymerase chain reaction followed by Southern blotting and hybridization. Compared with β-actin mRNA levels, both VIP and PACAP increased PRL mRNA levels in a dose-dependent fashion though VIP was more effective on a molar basis. The previously reported alternatively spliced PRL mRNA (lacking exon 4) was not detected. The data support the hypothesis that the REMS-promoting activity of central VIP and PACAP might be mediated by cerebral PRL.     

Release of heat-loss responses in paradoxical sleep by thermal loads and by pontine tegmental lesions in cats

Thermoregulatory heat-loss responses at high ambient temperatures were studied in intact cats and those with bilateral electrolytic lesions in the pontine tegmentum during wakefulness (W), slow-wave sleep (SWS), paradoxical sleep (PS) and PS without atonia induced by the lesions. Panting (respiratory rate 90/min) was present W, SWS, and in some cases, during PS. The percentage of the PS episodes with panting was directly related ambient temperature. In intact cats at 30 °C, panting occurred in 8% of the PS episodes; at 35 °C, in 52%, and at 40 °C, in 77%. The percentage of PS episodes with panting higher in the pontine-lesioned cats (90% at 35 °C), probably another indication of the altered thermoregulation of such animals. Thermoregulatory responses to heat load, and thermoregulation in general, have previously been shown to be suppressed in PS. Because hypothalamic thermosensitive neurons lack thermal responses during PS, the partial activation of heat-loss responses observed here may depend upon the function of extrahypothalamic brainstem areas.     

Endothelin-1 in children with chronic renal failure

Endothelin-1 (ET-1) was meansured after extraction from plasma of normal adults (5.9±1.9 pg/ml,n=22), normal children (7.1±1.86 pg/ml,n=29), nonhaemodialysed children with chronic renal failure (CRF) (11.1±1.8 pg/ml),n=10), renal graft recipients (9.5±3.4 pg/ml,n=37), haemodialysed children 24 h after a haemodialysis session (20.02±10.9 pg/ml,n=26) and haemodialysed children before and after a haemodialysis session (15.31±10.6 and 13.8±8.5 respectively,n=14). A sensitive and specific radioimmunoassay was used. ET-1 was significantly higher in non-haemodialysed CRF children and in renal graft recipients than in normal children (P<0.001 andP<0.01, respectively) and significantly higher in haemodialysed children when compared with normal children, non-haemodialysed CRF children and renal graft recipients (P<0.001). ET-1 concentrations were similar in normal children and normal adults. ET-1 was inversely correlated with glomerular filtration rate in non-haemodialysed CRF children (r=–0.39,P<0.01) and positively correlated with extracellular volume in haemodialysed children (r=0.435,P<0.03). After haemodialysis, ET-1 increased in 6 and decreased in 8 of the 14 children studied before and after a haemodialysis session.     

5地市720名高中学生睡眠状况相关因素分析

目的了解省级示范高中学生睡眠状况及相关因素对学生睡眠的影响，为相关部门制订针对性改进措施提供依据。方法采用睡眠状况自评量表（self-rating scale of sleep，SRSS）对省级示范高中学生进行睡眠状况问卷调查，用SPSS 10．0 FOR WINDOWS进行数据的统计与分析。结果发现720名省级示范高中学生睡眠状态异常者占65．42％，显著高于全国常模（45．6％）。其中轻度睡眠问题占57．36％，显著高于全国常模（35．6％）。学业负担过重、缺乏良好的学习习惯、住宿条件差、家庭状况不好、家校距离远和心理问题是导致省级示范高中在校学生睡眠状态异常的主要因素。结论应促进高中生身心健康，提高其学习能力，改善其睡眠状况。     

The effect of oral appliance therapy on blood pressure in patients with obstructive sleep apnea

The objective of the study was to investigate the effects of oral appliance (OA) therapy on ambulatory blood pressure in patients with obstructive sleep apnea (OSA). Eleven OSA patients who received OA therapy were prospectively investigated. Ambulatory blood pressure was measured for 20 h from 4:00 p.m. to 12:00 noon the next day using an ambulatory blood pressure monitor. The Respiratory Disturbance Index (RDI) was measured in the pretreatment and posttitration periods. The OA was titrated to reach a therapeutic jaw position over 2 to 8 months, and posttitration measurements were repeated. At posttitration, the RDI was significantly decreased from a mean (SD) of 24.7 (20.1) to 6.1 (4.5). Significant reductions in diastolic blood pressure (DBP) and mean arterial pressure (MAP) were found for the 20-h periods, and systolic blood pressure (SBP), DBP, and MAP while asleep. The mean values were 79.5 (5.5) to 74.6 (6.0) for DBP and 95.9 (5.4) to 91.2 (5.9) for MAP, for over a 20-h period, and 118.4 (10.0) to 113.7 (9.1) for SBP, 71.6 (8.0) to 67.2 (7.9) for DBP, and 88.4 (8.0) to 83.9 (7.5) for MAP, while asleep. This study suggests that successful OSA treatment with an OA may also be beneficial to lower blood pressure in OSA patients, as previously suggested for nasal continuous positive airway pressure therapy. This study was conducted in the Division of Orthodontics, The University of British Columbia, Canada     

下肢静脉机能不全的应变容积描绘仪检查

本文报告我院外科1985～1987年,使用应变容积描绘仪检查下肢深静脉机能不全30例。其中28例同时行Doppler超声检查,27例行静脉造影检查。介绍了测量最大静脉输出量,最大静脉逆流量和静脉再充盈时间的方法和结果,叙述了该技术的原理,在诊断下肢静脉机能不全时,应变应变容积描绘仪是较好的无损伤检查技术。     

恩必普软胶囊改善慢性脑供血不足患者认知功能的临床分析

目的:探讨dl-3-正丁基苯酞软胶囊(恩必普软胶囊)治疗慢性脑供血不足的临床疗效及对慢性脑供血不足病人认知功能改善的影响。方法:将60例慢性脑供血不足病人随机分为治疗组和对照组,每组30例,治疗组口服dl-3-正丁基苯酞软胶囊,每次200毫克,每日3次;对照组口服复方丹参片,每次4片,每日3次,疗程为8周,治疗前后进行疗效评价和P300数据采样,同时给予同步MMSE、HDS量表评分。结果:治疗组总有效率为70%,对照组总有效率为53.3%,2组治疗后比较差异有显著意义(P<0.05);治疗组治疗前、后MMSE和HDS量表得分情况比较,均有明显改善(P<0.01),与对照组治疗后比较差异有显著意义(P<0.05);治疗组治疗前、后P300波潜伏期及P300波幅差异均有显著意义(P<0.05),与对照组治疗后比较均有显著差异(P<0.05)。结论:dl-3-正丁基苯酞软胶囊对慢性脑供血不足病人安全有效。     

两种不同术式治疗下肢静脉功能不全的近期疗效对照研究

目的 评价腔内射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全的疗效. 方法 150例下肢静脉功能不全患者(150条患肢)随机分为A、B两组,每组75例.A组行大隐静脉射频闭合术联合曲张浅静脉TriVex刨吸术,B组行大隐静脉高位结扎抽剥术联合曲张浅静脉TriVex刨吸术.比较两组手术情况、术后4周患者对手术的自身评价、手术前后CEAP(clinic,etiologic,anatomic and pathophysiological classification)分级和临床严重程度计分(venous clinical severity score,vcss)的变化.结果 A、B两组手术时间分别为(67±11)min和(69±9)min(P＞0.05),A组术后疼痛轻、下地时间早、住院天数少、皮下血肿发生率低,但皮下硬结发生率高于B组;对手术的评价A组为(11.21±2.00)分优于B组(10.52±2.08)分,差异有统计学意义(P＜0.05);两组手术前后CEAP分级和VCSS计分变化差异均有统计学意义(P＜0.01),A、B两组手术前后VCSS分差为(4.6±2.5)分和(4.3±2.7)分(P＞0.05).结论 利用射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全有效,且微创、并发症少.CEAP临床分级和VCSS临床记分可用于其疗效评价.