小儿支原体肺炎临床分析

目的进一步提高对小儿肺炎支原体肺炎的认识,减少误诊误治。方法对我院儿科2005年1月至2008年1月收治诊断明确的60倒小儿肺炎支原体肺炎进行回顾性临床分析。结果学龄前儿童多发（60％）,次为学龄儿童（40%）;有地方性和流行趋势,春冬多发,全年可见。以发热咳嗽起病,多为持续剧烈干咳,X线检查有一定特征,出现早,可与体征不相一致（体征轻而胸片阴影显著）。全部均有延误诊治情况。大环内酯类药治疗均敏感。结论正确评估肺炎支原体感染在地区小儿呼吸道感染疾病中的地位非常必要,并且提高认识,借助X线检查和其他病原学方法检查是减少延误诊治的关键。     

小儿肺炎支原体肺炎临床诊治体会

目的总结小儿肺炎支原体（MP）肺炎诊治经验。方法对2011年6月—2012年5月在我院住院68例肺炎支原体肺炎患儿的临床资料进行回顾性分析。结果发病年龄多为学龄儿童,6—13岁占67%,5岁以下占33%。68例均有发烧,部分为刺激性咳嗽及气喘,大部分肺部体征不明显,部分有湿性罗音,所有患儿MP-IgM均为阳性,X线胸片有明显改变。结论小儿肺炎支原体肺炎的诊断要结合临床表现及化验结果、X线胸片检查。对确诊患儿大环内酯类抗生素要足疗程,联用其他类抗生素可缩短疗程。     

小儿肺炎支原体感染的临床诊治及疗效评价

目的分析小儿肺炎支原体（MP）感染的临床特点及诊治方法,为提高肺炎支原体感染的诊治水平提供依据。方法对2005年9月至2009年9月我院确诊的132例支原体肺炎患儿临床资料进行回顾性分析。结果 36例患者合并肺外并发症,所有患儿治疗后体温均于1周内降至正常,咳嗽减轻。18例患儿有轻微胃肠道反应,均采用对症治疗缓解。未发现严重不良反应。结论小儿肺炎支原体感染应尽早进行X线检查,对怀疑有心功能损害的患儿进行心肌酶谱检查,以达到早期诊断和治疗的目的。     

小儿支原体肺炎30例临床分析

目的：探讨小儿支原体肺炎的临床特点及转归。方法：回顾性分析30例小儿肺炎支原体肺炎的临床表现、辅助检查、肺外并发症及治疗转归。结果：发病年龄〈5岁的占43．3％．5-14岁的占56．7％。检测肺炎支原体IgM（MP-IgM）均阳性。胸部X线检查改变多且出现早,病变可累及两下肺,以右下肺为多,与体征不一致;红霉素治疗有效。结论：小儿支原体肺炎发病率有低龄化趋势,几乎都有发热、咳嗽症状,肺部体征可不明显,一部分合并其他系统的损害。血常规白细胞总数可正常,但单核细胞多数增高,CRP多数轻度增高．可疑病例应做X线检查及MP-IgM检测．大环内酯类抗生素疗效满意。     

小儿肺炎支原体肺炎20例诊治分析

目的探讨小儿肺炎支原体肺炎的临床特点和诊治方法。方法回顾性分析笔者自2005年至2008年诊治的20例肺炎支原体肺炎的临床特点、实验室检查、X线特点及应用阿奇霉素治疗的效果。结果小儿肺炎支原体肺炎临床表现以不规则发热,顽固性剧烈咳嗽为主,有时伴喘憋,肺部体征少、X线表现多为单侧病变,病变以右肺中下肺野多见,也可为间质性肺炎的改变。肺炎支原体肺炎也可发生肺外脏器受损,应用阿奇霉素治疗可获治愈。肺外疾病需要对症治疗。结论肺炎支原体肺炎临床症状重,但体征较轻微,X线胸片阴影明显,是本病的特点。对临床上出现剧烈咳嗽而肺部体征少,X线阴影明显的患儿应及时寻找肺炎支原体感染的证据。本病对大环内酯类抗生素治疗有效,尤其是阿奇霉素疗效可靠,且副作用少,可作为治疗肺炎支原体肺炎的首选用药。     

小儿肺炎支原体肺炎诊治体会

目的探讨小儿肺炎支原体肺炎的相关临床特点及诊治效果。方法选取在我院接受小儿肺炎支原体肺炎患者28例,对患者的临床特点、患者实验室检查以及对患者的治疗及其治疗效果进行相关分析。结果本组患者主要的临床表现为发热、咳嗽,并且刺激性咳嗽为主,患者表现出的肺部体征不明显,患者的血白细胞比较正常,红细胞以及C反应蛋白显示正常或者稍微升高,X线胸片改变比较明显,而且还伴随着血液、肝功能、心肌、肾脏等会有损害情况。结论小儿肺炎支原体肺炎相对于学龄儿童处于一个多发年纪,而且患者的临床表现症状明显,经过X线胸片显示有阴影,而阴影则是肺炎的明显特点。对肺炎支原体肺炎的主要手段为血清学检测,而治疗肺炎支原体肺炎的首选药物是大环内脂类抗生素。     

小儿肺炎支原体肺炎107例临床分析

肺炎支原体（MP）是小儿呼吸道感染的主要病原之一,全年均有散发感染,甚或在局部地区造成小范围的流行,肺炎支原体肺炎（MPP）临床症状轻重不一,易导致多系统、多器官损害,常被误诊而延误治疗。近年来,MP感染呈逐年增加趋势。现将我院儿科2007年10月～2008年9月明确诊断并治愈出院的107例MPP患儿的临床资料进行分析,以提高对小儿肺炎支原体肺炎的临床认识和诊治水平。     

小儿肺炎支原体肺炎52例临床分析

目的:探讨小儿肺炎支原体肺炎合理的临床诊治及预防措施。方法:选择收治的52例小儿肺炎支原体肺炎患儿,分析患儿的临床表现、并发症、辅助检查结果、治疗和预后。结果:小儿肺炎支原体肺炎主要临床表现为咳嗽伴发热,主要肺部体征为中细湿啰音及干啰音,肺外表现包括消化系统症状、血液系统症状、心血管系统症状等;血白细胞正常占76.9%;痰菌培养检查肺炎支原体阳性占5.8%,但肺炎支原体IgM阳性率为100%;胸部X线检查发现大片絮状阴影;经综合治疗2周后,所有患儿均痊愈出院,出院后随访1个月,发现无复发。结论:小儿肺炎支原体肺炎的临床诊治要采取综合治疗方案,才能有效提高治疗效果,避免复发。     

小儿肺炎支原体感染临床探析

目的探讨小儿肺炎支原体（MP）感染的发病特点及诊治措施。方法回顾性分析2010年1月-2012年1月我院确诊的128例肺炎支原体感染患儿临床资料。结果婴幼儿是小儿肺炎支原体肺炎的高发群体,春冬季多发。患儿主诉咳嗽,以阵发剧咳、刺激性咳嗽为显著,肺部体征明显,X线片示小斑点。应用红霉素联合阿奇霉素治疗效果良好,未发现耐药情况。随访1—2个月病例无复发,未见明显后遗症。结论MP是小儿呼吸道感染的重要病原体之一,春冬季多发,婴幼儿为高危人群,临床表现不典型,以肺部表现明显且重,常伴肺外合并症,易被漏诊,临床应广泛重视。给予红霉素和阿奇霉素治疗后症状改善,效果显著,值得推广。     

146 例小儿肺炎支原体感染临床分析简

目的：探讨小儿肺炎支原体感染的临床特征、诊断要点及治疗效果.方法：对咸宁市妇幼保健院2008年1月至2012年2月收治的146例肺炎支原体感染患儿的临床资料进行回顾性分析和总结.结果：146例肺炎支原体感染患儿发病年龄在6个月~3岁75例,占51.37%.患儿表现为发热、咳嗽、血清肺炎支原体特异IgM抗体（Mp-IgM）均为阳性,胸部X线检查表现多样性.并发症累及消化系统,泌尿系统,心血管系统,皮肤黏膜及中枢神经系统,有12例（8%）出现心肌酶谱异常,MP患者合并心肌损害.所有病例通过正规使用大环内脂类抗生素10-14d达到临床治愈效果.结论：小儿支原体肺炎,通过X线早期明确诊断是基础,进行IgM抗体检测是诊断的关键环节,大环内脂类抗生素是治疗小儿肺炎支原体感染最有效的方法.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.