Changes of hepatic and systemic haemodynamics following somatostatin administration in patients with hepatitis B-related cirrhosis

Abstract Somatostatin has been used to effectively control acute variceal haemorrhage, with conjectured mechanisms on portal hypertension. We, therefore, evaluated the effects of somatostatin on hepatic and systemic haemodynamics in 15 patients with hepatitis B-related cirrhosis and portal hypertension. All patients received an intravenous, continuous infusion of somatostatin 250 μg/h, following a bolus injection of 250 μg. In systemic haemodynamics, the mean arterial pressure (MAP) increased ( P < 0.05), associated with a reflex bradycardia within 3 min following bolus injections, compared with basal values. The right atrial pressure, pulmonary capillary wedge pressure, inferior vena cava pressure, cardiac index, and systemic vascular resistance remained unaffected after drug infusion. In hepatic haemodynamics, the wedge hepatic vein pressure remained unchanged after drug administration. However, there was an increase in free hepatic vein pressure (FHVP; P < 0.05), and a trend toward a decrease in the hepatic vein pressure gradient (HVPG; P = 0.063), within 3 min after bolus injection. Furthermore, the hepatic blood flow decreased significantly at 10 and 30 min after somatostatin infusion ( P < 0.05). The effective sinusoidal perfusion assessed by indocyanine green infusion also decreased progressively at 10 min ( P = 0.057) and 30 min ( P < 0.05). We concluded that somatostatin, at the dose used in this study, caused a transient and bolus-related vasoconstrictive effect, resulting in increases in MAP and FHVP, a decrease in heart rate, and a trend toward lower HVPG. In addition, somatostatin reduced the hepatic blood flow and effective sinusoidal perfusion which may be hazardous to cirrhotic patients during variceal haemorrhage.     

25例晚期及复发子宫内膜癌紫杉醇联合化疗分析

[目的]评价紫杉醇联合化疗治疗晚期、复发子宫内膜癌的近期疗效及毒副作用.[方法]25例Ⅲ、Ⅳ期或复发的子宫内膜癌行紫杉醇 卡铂(或顺铂)化疗,紫杉醇135mg/m2～150mg/m2,卡铂AUC 4～5,或顺铂70mg/m2.[结果]有可测肿瘤或CA125/CA199升高16例,共进行63个疗程化疗,完全缓解37.5%,部分缓解25.0%,总有效率62.5%.完全缓解者无进展期平均5.3个月.无肿瘤监测指标9例,进行29个疗程化疗,中数随诊11.5个月无复发.3、4级白细胞下降40.0%,3级血小板下降11.4%.[结论]紫杉醇 卡铂或顺铂联合化疗对晚期、复发的子宫内膜癌有较好疗效.     

如何有效地提高护理专业生理学教学质量

通过在教学过程中不断改善教学方式,采用多种教学方法相结合的形式,有效地提高生理学教学质量.这样不仅可以为学生学习后续学科打下坚实的基础,而且提高了护理专业学生的临床应变能力.     

Routine Blastocyst Culture and Transfer: 201 Patients' Experience

Purpose: The purpose was to compare the outcomes betweenday-5 blastocyst and day-2 embryo transfers. Methods: Infertile women who accepted the ovarian hyperstimulationand oocyte retrieval were divided: Group 1, day2 embryo transfer, group 2, cultured to day 5 in serum-freesequential culture medium and transfer. Early embryoquality and growth, blastocyst formation and quality,implantation rate (IR) and pregnancy rates (PR) weredetected. Results: Total blastocyst formation rate was 49.4%. Betterearly embryo quality (days 2, 3) and higher day 3 blastomerenumber possess higher blastocyst formation rate. The IR forday 2 and day 5 embryos were 10.8% and 22.2%, respectively.The PR in both groups were comparable (37.3% vs. 41.8%). Conclusions: Blastocyst transfer has higher IR and comparablePR as those of day 2 embryo transfer. Early embryoqualities and day 3 blastomere number are useful in predictingthe final blastocyst formation. Blastocyst formationrate is not related to maternal age, infertile causes, inseminationmethods, and early embryo number.     

景颇族和汉族小学生同伴冲突应对与父母教养方式的关系

目的 探讨景颇族、汉族小学生同伴冲突应对方式和父母教养特点及相互关系.方法 采用小学生同伴冲突应对方式问卷和父母养育方式评价量表,对301名3～6年级景颇族和汉族小学生进行测查.结果 景颇族小学生的攻击[(2.45±0.78)分]、幻想[(2.71±0.70)分]分值均显著高于汉族,而退避分值[(2.49±0.61)分]明显低于汉族[(2.64±0.62)分];景颇族父母比汉族父母更多采用干涉、拒绝否认、偏爱等教养方式;父/母亲的温暖理解对子女问题解决、求助和退避等应对具有一定的预测作用,而母/父亲的偏爱可在一定程度上预测子女的攻击性应对.结论 小学生同伴冲突应对方式与父母教养方式密切关联,需要改进不良的家庭教养方式.     

间接喉镜下刮除术和鼻内镜下切吸术治疗腺样体肥大的手术效果比较

目的比较间接喉镜下腺样体刮除术和鼻内镜直视下腺样体切吸术治疗腺样体肥大的效果。方法118例患者分为A组(64例)和B组(54例),全身麻醉,用导尿管悬吊软腭,分别行间接喉镜下腺样体刮除术或鼻内镜直视下腺样体切吸术。结果所有患者术后打鼾症状明显改善,显效率分别为A组93.8%(60/64),B组94.4%(51/54);78例伴有渗出性中耳炎或复发性中耳炎,术后A、B组平均听阈提高分别为16±4.2dB和15±5.8dB;伴有鼻窦炎的患者,术后症状改善率分别为A组78.3%(18/23),B组88.9%(24/27)。术中平均出血量分别为A组20m1,B组25m1;平均手术时间分别为A组9分钟,B组7分钟。所有患者均无术后并发症发生。A组的手术费用明显低于B组。结论间接喉镜下腺样体刮除术和鼻内镜直视下腺样体切吸术均为安全、有效术式,但间接喉镜下腺样体刮除术简单易行、经济实惠。