防哮饮早期干预对哮喘小鼠血清白细胞介素-10水平影响的实验研究

目的观察中药防哮饮早期干预对哮喘小鼠血清白细胞介素10(IL-10)水平以及支气管肺泡灌洗液(BALF)中嗜酸性粒细胞百分比(EOS%)的影响。方法将60只健康昆明小鼠随机分为6组:正常对照组、哮喘模型组、防哮饮小剂量组、防哮饮中剂量组、防哮饮大剂量组、布地奈德组各10只,用卵蛋白致敏激发造模。中药防哮饮组从致敏第1天起,将中药防哮饮按小剂量(含生药0.5 g/mL)、中剂量(含生药1.5 g/mL)、大剂量(含生药2.5 g/mL)灌胃给药,每日1次,每次0.4 mL,共27 d。在最后1次激发后24 h(第28 d)处死小鼠,采用双抗夹心酶联免疫吸附试验检测小鼠血清IL-10的含量,并镜检BALF中EOS%。结果哮喘模型组小鼠BALF中EOS[(2.9±1.4)%]较对照组[(1.3±0.9)%]明显升高(P<0.01);血清IL-10的含量[(7.6±3.0)ng/mL]较对照组[(44.9±33.0)ng/mL]降低(P<0.05)。防哮饮小、中、大剂量组均能显著提高哮喘小鼠血清IL-10水平,与哮喘模型组比较差异有统计学意义(P<0.01),与布地奈德组比较差异无统计学意义(P>0.05)。防哮饮大...     

小儿遗尿症的中医传统外治疗法及治疗经验

遗尿症是小儿常见病,治疗难点主要是易反复。对于难治性遗尿症单纯采用中药口服治疗,疗效不明显;中医传统外治疗法的加入,不仅能有效提高治愈率,还能缩短疗程,巩固疗效,减少复发。     

轻度胃肠炎伴婴幼儿惊厥患儿粪便及脑脊液轮状病毒及诺沃克病毒的检测及意义

目的 探讨轻度胃肠炎伴婴幼儿惊厥常见感染病原及轮状病毒(RV)、诺沃克病毒(NoV)导致惊厥发生的差异.方法 用RT-PCR方法对30例轻度胃肠炎伴婴幼儿惊厥患儿的大便及脑脊液中RV、NoV进行检测,分析两种病毒所导致惊厥发作频率的差异.结果 30例中,RV粪便阳性17例(56.7%),脑脊液阳性3例(17.7%);NoV粪便阳性6例(25.0%),脑脊液阳性1例(16.7%).NoV感染患儿惊厥的发生次数为(4.33±1.75)次,明显高于RV感染患儿[(2.53±1.12)次],差异有非常显著性(P＜0.01).脑脊液中病毒阳性患儿的惊厥发生次数为(4.75±1.71)次,明显高于阴性患儿[(2.63±1.21)次](P＜0.01).结论 RV、NoV是导致轻度胃肠炎伴婴幼儿惊厥的常见病原;NoV感染对中枢神经系统的影响程度可能大于RV感染;脑脊液中病毒存在可能与惊厥的频繁发生有关,其具体机制有待进一步研究.

Abstract：

Objective To explore the common pathogen of infantile convulsions associated with mild gastroenteritis, and to study the differences between the seizures caused by the two kinds of virus.Methods RT-PCR was used to detect Rotavirus (RV) and Norwalkvirus (NoV) in stool and cerebrospinal fluid of 30 cases with infantile convulsions associated with mild gastroenteritis. The differences between the frequency of seizures caused by two kinds of virus were analyzed by statistical methods (two-sample t-test).Results 17/30 (56. 7%) were RV-positive in stool and 3/17 (17. 7%) in cerebrospinal fluid; 6/30 (25.0%) were NoV-positive in stool and 1/6 (16. 7%) in cerebrospinal fluid. The seizure frequency with NoV infection was (4. 33 ± 1.75) times, and RV infection patients was (2. 53 ± 1.12) times (P ＜ 0. 01).The seizure frequency of CSF virus-positive children was (4. 75 ± 1.71) times compared to (2. 63 ± 1.21)times in virus-negative children (P ＜ 0.01). Conclusion The common pathogens causing infantile convulsions associated with mild gastroenteritis were RV and NoV. The degree of NoV infection affecting the central nervous system may be greater than RV. The presence of the virus in cerebrospinal fluid may lead to higher incidence of seizures,but their exact roles related to the occurrence of seizures remain to be further studied.     

焦虑症及抑郁症在多囊卵巢综合征和体质量指数相匹配对照组妇女中发生风险的评估

焦虑症与抑郁症普遍存在于多囊卵巢综合征（PCOS）妇女中。PCOS的发生与许多心理因素有关,影响PCOS妇女的心理健康及其生活质量。研究发现,确诊患有PCOS妇女的精神状态比患其他疾病的妇女要差。本研究旨在探讨焦虑症与抑郁症在PCOS妇女中的发生率及其危险因素。     

妊娠合并心脏病孕产妇的风险评估和管理

妊娠合并心脏病是产科常见合并症,是导致孕产妇和围产儿死亡的重要原因之一。由于妊娠和分娩期间血流动力学改变,心脏病孕产妇发生心力衰竭、血栓形成、心律失常甚至死亡等并发症的风险上升。本文从孕产妇心功能、临床病史、体格检查、实验室辅助检查等方面,对心脏病孕产妇的妊娠风险评估作一综述,并在此基础上进行危险分层管理,确保心脏病孕产妇良好的妊娠结局。     

内质网应激激活与依托泊甙和放线菌素D耐药绒癌相关性研究

目的探讨内质网应激激活与拓扑异构酶Ⅱα介导的依托泊甙(etoposide,VP16)和放线菌素D(actinomy-cin-D,Act-D)耐药绒癌的关系。方法采用间断诱导法诱导人绒癌细胞系JEG-3,分别建立绒癌ActD耐药细胞系JEG-3/ActDB1和VP16耐药细胞系JEG-3/VPC1。细胞计数法(cell counting kit-8,CCK-8)观察敏感细胞和耐药细胞的生长增殖规律和耐药指数;流式细胞仪检测细胞周期比例和染色体倍性变化;荧光定量PCR技术分别检测两种不同药物诱导的JEG-3耐药株中拓扑异构酶Ⅱα(TopoⅡα)和内质网应激(ERS)各个通路相关的基因mR-NA的表达水平。结果 (1)成功建立了绒癌耐药细胞系JEG-3/ActDB1和JEG-3/VPC1。其耐药指数分别为50.64±10.68和65.87±3.19。耐药株生长速度均较亲本细胞减慢,三者的染色体倍性差异无统计学意义。(2)在两种不同的耐药株中,TopoⅡα的表达水平均明显低于亲本细胞,而与ERS各个通路相关基因均有不同程度的激活。结论成功建立了针对ActD和VP16耐药的绒癌细胞系JEG-3/ActDB1和JEG-3...     

围产期子宫切除术后再次行腹腔探查术患者的临床特点分析

目的 探讨产后出血围产期子宫切除术后再次腹腔探查手术的原因及临床特点.方法 回顾性分析1999年1月至2009年7月广州市重症孕产妇救治中心收治的88例产后出血致围产期子宫切除病例,其中14例为再次探查手术组,74例为非再次探查手术组.比较两组的如下各项指标:分娩方式、子宫切除指征及方式、再次探查手术的间隔时间及手术方式、并发症、失血量、输血量、格拉斯哥评分、呼吸机辅助呼吸率、重症监护病房入住率、重症监护病房入住时间、住院时间及结局等.结果 88例围产期子宫切除患者中再次探查手术者14例,发生率为15.91%,均因子宫切除后腹腔内出血行再次探查手术.再次探查手术组患者并发弥漫性血管内凝血的比例显著高于非再次探查手术组(92.9%与43.2%,x2=11.598,P=0.001),同时羊水栓塞比例也显著增高(28.6%与2.7%,x2=8.663,P=0.003).再次探查手术止血方式:宫颈残端切除(5例),残端缝扎止血(8例)和右附件切除及腹膜后血肿清除(1例).再次探查手术组比非再次探查手术组患者具有更高的出血量、输血量、重症监护病房入住率及呼吸机辅助呼吸率[(8752.9±4593.0)ml与(3742.4±2689.9)ml,P=0.000;(8163.6±3903.1)ml与(2958.8±2323.0)ml,P=0.000;100.0%与41.9%,P=0.000;100.0%与24.3%,P=0.000];同时格拉斯哥评分≤8分比例及多器官功能障碍综合征比例显著增高(71.4%与25.7%,x2=9.179,P=0.002;71.4%与14.9%,x2=17.735,P=0.000);且ICU入住时间及住院时间明显延长[ICU入住时间:(11.4±10.0)d与(1.3±2.3)d;住院时间:(24.0±13.1)d与(12.7±7.0)d,P均=0.000].14例患者均临床痊愈出院.结论 围产期子宫切除术后再次探查手术的发生率不低,腹腔内出血是再次探查手术的主要原因.再次探查手术可能与凝血功能障碍及子宫切除方式选择不当等有关.再次探查手术患者并发症严重.

Abstract：

Objective To analyse the causes and clinical characteristics of re-exploration after peripartum hysterectomy due to postpartum hemorrhage. Methods Clinical data was analysed retrospectively including 88 critically ill obstetric patients who underwent peripartum hysterectomy due to postpartum hemorrhage in the Obstetric Critical Care Center of Guangzhou from January 1999 to July 2009, which were divided into re-explored group (n= 14) and non-re-explored group (n=74)depending on whether the patient underwent re-exploration after peripartum hysterectomy. The main demographic data and clinical details were compared between the two groups, including mode of delivery, indication and type of hysterectomy, interval from hysterectomy to re-exploration, surgical intervention, complications, blood loss, blood transfusion,Glasgow Coma Score(GCS), the need for mechanical ventilation, intensive care unit stay and hospital stay. Results Fourteen out of the 88 (15.91%) patients underwent re-exploration due to internal bleeding after peripartum hysterectomy.Removal of cervical stump was performed in five patients and stump hemostasis in eight cases.Significant difference was found between the re-exploration and non-re-explored group on thepercentage of patients complicated with disseminated intravascular coagulation(92.9% vs 43.2%,x2=11.598,P=0.001) and amniotic fluid embolism (28.6% vs 2.7%, x2 =8.663, P=0.003).0.000], blood transfusion [(8163.6± 3903.1 ) ml vs (2958.8± 2323.0) ml, P = 0.000], intensive care unit admission rate (100.0% vs 41.9%, x2 = 15.909, P= 0.000), the need for mechanical ventilation (100.0% vs 24.3%,P=0.000), the number of patients with GCS≤8 score (71.4% vs 25.7% ,x2 = 9.179, P = 0.002 ), the number of multiple organ dysfunction syndrome ( 71.4% vs 14.9%, x2 = 17.735, P = 0.000), intensive care unit stay [ ( 11.4 ± 10.0 ) d vs ( 1.3 ± 2.3 ) d, P =0.000] and hospital stay[(24.0±13.1) d vs (12.7±7.0) d, P=0.000]. Allof the 14 cases were clinical recovered before discharge. Conclusions The rate of re-exploration after peripartum hysterectomy is not low, and internal bleeding is the most common causes. The re-exploration after peripartum hysterectomy might be associated with coagulopathy and the mode of hysterectomy, and patients may experience more severe complications.     

积水输卵管液对精子形态及运动的影响

目的:通过体外实验研究积水输卵管液对精子运动及形态学的影响,分析输卵管积水造成不孕的部分原因,对临床治疗提供科学依据。方法:以输卵管积水患者的输卵管液为观察组,以人类输卵管液(HTF培养液)为对照组,将精子优化处理后在体外分别与两组输卵管液共同孵育,分别观察培育2h、6h、21h后精子的形态和各项运动参数。结果:①培育2h、6h、21h后两组精子的形态无统计学差异(P>0.05);②观察组精子的平均曲线运动速度(VCL)、平均直线运动速度(VSL)、平均路径运动速度(VAP)均慢于对照组(P<0.05)。结论:输卵管积水对精子的形态影响不大,但降低了精子的活性,是造成不孕的重要原因。     

移植8cell胚胎个数与妊娠率的关系

目的:探讨体外受精-胚胎移植(IVF-ET)周期中第三天移植8cell胚胎数量与临床结局的关系。方法:以2009年1月至2010年12月在本中心接受IVF-ET治疗625个周期为研究对象。将所有移植周期按移植8cell胚胎个数分为三组,分析三组的临床妊娠率、胚胎种植率、多胎率有无差异。结果:移植两个8细胞胚胎组(C组)的临床妊娠率(59.5%)显著高于无8细胞胚胎移植组(A组)和含一个8细胞组(B组)(P<0.05),A、B两组临床妊娠率无显著性差异;C组种植率(39.8%)显著高于其他两组,A组和移植胚胎中含一个8细胞组(B组)种植率比较有显著性差异,;多胎率分析,C组明显高于其他两组。结论:在IVF-ET周期中第3天移植8cell胚胎个数对妊娠率及种植率、多胎率有影响,在挑选胚胎时移植一个8cell胚胎搭配一个其他细胞数的胚胎也能得到较好的妊娠率并有效降低多胎率。     

脑梗死伴睡眠障碍患者应用综合睡眠护理的效果观察

目的:探究在对脑梗死伴睡眠障碍患者护理中实施综合睡眠护理的临床效果。方法:选取2017年7月至2019年3月福建医科大学附属泉州第一医院收治的脑梗死伴睡眠障碍患者68例作为研究对象,按照随机数字表法分为对照组和观察组,每组34例。对照组行常规护理,观察组在常规护理基础上行综合睡眠护理,比较2组患者睡眠质量改善情况、入睡时间、护理满意度。结果:护理后观察组的PSQI评分低于对照组,入睡时间短于对照组,护理满意度高于对照组,差异有统计学意义(P 0. 05)。结论:在为脑梗死伴睡眠障碍患者护理中,实施综合睡眠护理干预,可以帮助患者缩短入睡时间,改善睡眠质量,提升护理满意度,值得推广。