焦虑大鼠内脏敏感性评估

目的:探讨慢性情绪应激导致的焦虑对大鼠直结肠敏感性的影响。方法:实验于2003-09/2004-07在郑州大学第一附属医院消化内科实验室完成。将32只Wistar大鼠随机分为对照组和焦虑组,每组16只,每天两次定时饮水,持续1周。定时饮水训练后,焦虑组在每天2次定时饮水期随机给予1次空瓶刺激10min,对照组在每天2次定时饮水期自由饮水,均持续14d。焦虑组大鼠即为以焦虑为主要表现的慢性情绪应激模型。应激期间,观察两组大鼠的攻击、探究和修饰行为,行为出现即为1分,否则为0分。空瓶刺激10min内平均4次观察的总分为0～4分之间。造模结束后,以腹部回缩反射评分为指标观察两组大鼠对直结肠气囊扩张的反应性,大鼠接受的扩张压力依次为20,40,60,80mmHg(1mmHg=0.133kPa),分别维持压力不变2min,评估内脏敏感性,0～4分分别为大鼠在结肠扩张时无行为学反应到身体呈弓形,骨盆抬起。结果:进入结果分析大鼠保持为2组,每组16只,无脱失。①大鼠的情绪性行为反应:应激期间,焦虑组主要表现为明显的探究和攻击行为,修饰行为很少,与对照组相比差异有显著性意义犤(2.61±0.25,3.29±0.31,0.33±0.17);(0.24±0.18,0.00±0.00,1.83±0.17),(t=24.648～42.028,P<0.01)犦。对照组则没有攻击行为的表现。②在大鼠的腹部回缩反射评分20,40,60和80mmHg的扩张压力下焦虑组均显著高于对照组(犤2.00,3.00,4.00,4.00);(0.00,1.25,2.25,3.50),(T=136.0～172.0,P<0.01)犦。结论:空瓶刺激能诱发出明显的以焦虑为主的情绪性行为反应,而应激所致的焦虑能够增加大鼠的内脏敏感性。     

丁卡因咽喉喷雾联合硝酸甘油滴鼻在高血压病人气管插管时的应用

目的 研究对比1%丁卡因咽喉喷雾与鼻腔滴入硝酸甘油对高血压病人气管插管时心血管反应的影响.方法 将40例高血压病择期手术患者随机分两组(A,B)每组20例.麻醉诱导前均给1%丁卡因咽喉喷雾,A组诱导后鼻腔滴入硝酸甘油1 mg,再行气管插管,两组诱导药均为咪唑安定、芬太尼、丙泊酚和琥珀胆碱,麻醉维持采用静吸复合.记录两组病人诱导前(T1),诱导后(T2)、插管即刻(T3)和插管后5 min(T4)的SBP、DBP与心率(HR)变化.结果 与T1时比较,T2时两组患者的收缩压(SBP)、舒张压(DBP)均明显下降,HR明显减慢(P＜0.01);与T2比较,T3时SBP、DBP明显升高,HR明显增快(P＜0.01);与T3比较,T4时SBP、DBP明显下降,HR明显减慢,两组间比较T3时,B组SBP、DBP比A组明显升高(P＜0.05),A组比B组HR明显升高(P＜0.05).结论 两组插管后都产生心血管反应,但A组比B组心血管反应轻.     

Graves病药物治疗停药复发相关因素分析

Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs.     

经颅多普勒与脑CT检查在有机磷中毒中的应用价值

对32例有机磷中毒患者行双侧大脑中动脉(MCA)血流频谱形态和血流动力学检查及脑CT检查。结果显示经颅多普勒(TCD)与脑CT比较能够更早、更敏感地反映有机磷农药中毒所致的脑损害,可以提供更加丰富的脑血流资料,为中毒后早期治疗脑水肿,改善预后提供理论依据。     

245例药物性肝损伤病例的临床流行病学特征描述

目的描述性分析245例药物性肝损伤(DILI)患者临床流行病学特点。方法回顾性分析DILI患者年龄、性别、药物、病理、预后等临床资料。采用SPSS 12.0统计软件,计数资料比较采用χ2检验,计量资料比较采用t检验。P≤0.05为差异有统计学意义。结果 245例DILI患者,男性151例、女性94例(P=0.877);肝细胞型160例(65.30%),胆汁淤积型27例(11.02%),混合型58例(23.67%);G2级87.50%,G3级12.50%;S0级12.50%,S2级50.00%,S3级25.00%,S2~3级12.50%。伴发的基础疾病前3位分别为心血管疾病68例(27.75%)、呼吸系统疾病54例(22.04%)、内分泌疾病30例(12.24%);引起DILI药物最多见的是中药61例(24.90%),其次为心血管药物34例(13.88%)。根据病情停用致病药物或减低致病药物用量及相应保肝对症治疗,治疗后肝功能完全恢复83例(33.88%),好转159例(64.90%);5例重症肝病经综合治疗后,2例治愈,3例因病情较重或其他原因转其他医院进一步治疗,预后不详。结论 DILI临床发病率高,以肝细胞型多见,伴发基础疾病多,中药是最常见致病药物,根据病情停用致病药物或减低致病药物用量及相应保肝对症治疗效果好。     

Graves病药物治疗停药复发相关因素分析

Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs.     

维持性血液透析HIV/AIDS患者的认知功能调查

目的　评估维持性血液透析（maintenance hemodialysis, MHD）HIV/AIDS患者认知功能,分析其相关影响因素。 方法　收集2014年1月—2018年12月南宁市第四人民医院MHD 3个月及以上且合并HIV 感染的73例患者的临床资料,以国际人类免疫缺陷病毒相关性痴呆量表评分评估MHD HIV/AIDS患者认知功能,根据有无认知功能障碍分为正常组及认知功能障碍组,分析其可能影响因素。结果　73例MHD HIV/AIDS患者中,认知功能障碍发病率为83.56%。认知功能障碍组年龄、透析龄均高于正常组（P均＜0.05 ）;受教育年限、高效抗反转录病毒治疗（highly active antiretroviral therapy, HAART）时程、CD4+ T淋巴细胞计数基线、尿素清除指数（Kt/V）均低于正常组（P均＜0.05 ）。结论　MHD HIV/AIDS患者具有较高的认知功能障碍发病率,年龄、透析龄、受教育年限、HAART时程、CD4+ T淋巴细胞计数基线、Kt/V是其可能影响因素。     

患儿颈外静脉采血体位摆放与人文关怀的效果探讨

目的探讨患儿颈外静脉采血的体位摆放与人文关怀对采血效果的影响。方法将门诊200例患儿随机分为对照组和观察组各100例。对照组采用传统方法采血;观察组采用改进方法,即给予人文关怀,并根据不同年龄、体型患儿采取单纯侧卧头后仰位和侧卧颈部垫枕头后仰位。结果观察组一针穿刺成功率,患儿舒适、安全度及家属满意度均显著高于对照组(P<0.01,P<0.05),皮下瘀血发生率低于对照组(P<0.01)。结论改进的颈外静脉采血体位摆放方法为一种科学、有效的小儿采血方法,而人性化服务是其保证。