小儿肺炎支原体肺炎86例临床诊治分析

目的 总结小儿肺炎支原体肺炎的临床诊治经验.方法回顾性分析本院86例感染肺炎支原体(Mp)小儿的临床表现、辅助检查、治疗及转归.结果 86例患者中均有咳嗽症状,发热78例,血清Mp-IgM 效价大于1:160的62例,大于1:80的24例.经阿奇霉素治疗后,患儿均痊愈出院.结论 小儿支原体肺炎临床表现多样化,可用血清学方法明确诊断,阿奇霉素可作为Mp感染治疗的首选抗生素.     

71例小儿肺炎支原体肺炎临床分析

目的 探讨小儿肺炎支原体(MP)感染的临床特点,并通过分析以期提高肺炎支原体感染的治疗水平.方法 对本院2010年3月到2011年6月住院的小儿肺炎支原体肺炎进行分析.结果 同期呼吸道感染中小儿支原体肺炎占20％,其中男42例,女29例,小于3岁12例(占16.9％),3～6岁26例(占56.6％),大于6岁33例(占46.4％).发病高峰期为11月到3月.结论 肺炎支原体(MP)在呼吸道感染中十分常见,并容易造成肺外感染,应值得注意.     

小儿肺炎支原体感染132例的临床分析

目的 探讨小儿肺炎支原体(mycoplasma pneumoniae,MP)感染的临床特点,并通过分析以期提高肺炎支原体感染的治疗水平.方法 对本院2006年9月～2009年7月住院的小儿肺炎支原体感染患者132例的临床资料进行回顾式分析.结果 小儿肺炎支原体感染患者率占到同期就诊的呼吸道感染患儿的17%.其中小于3岁55例(占41.7%),大于3 岁77例(占58.3%) ;伴肺外症状者55例(占41.7%) ;出入院符合诊断者58例(占43.39%) .结论 MP感染在呼吸道感染中极为多见,因其发病年龄不受限,造成MP感染后肺外损害较多,初入院误诊率较高,值得重视.本文所有患儿用阿奇霉素,疗程2～3周,效果较好.     

280例儿童支原体肺炎的诊治分析

目的 探讨临床小儿肺炎支原体感染临床治疗方法与效果.方法 对笔者所在医院2007年11月～2010年11月收治的280侧小儿肺炎支原体感染患儿进行血常规、血培养、红细胞沉降率和胸部x线片等相关检查,所有患儿给予阿奇霉素治疗.结果 280例患儿经过治疗后,痊愈214例,显效46例,好转20例,无效0例,总有效率为92.8%.结论 对于小儿支原体肺炎的诊治来说,要把握其临床表现,采用阿奇霉素序贯治疗可以获得满意的临床效果.     

肺炎支原体感染80例临床分析

目的:探讨肺炎支原体感染的诊断和治疗。方法:分析肺炎支原体感染80例患儿临床特点。结果:在80例肺炎支原体(MP)感染患儿中,肺炎60例,中枢神经系统受累8例,过敏性紫癜2例,心肌受损5例,泌尿系统损害2例,川崎病1例,急性胃肠炎1例,过敏性荨麻疹1例。经用红霉素、阿奇霉素1~3个疗程后,均在3~4周痊愈。结论:肺炎支原体感染可引起肺内及肺外多系统感染,应用大环内酯类抗生素有效。     

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。     

儿童肺炎支原体感染合并过敏性紫癜11例临床分析

目的探讨小儿肺炎支原体(MP)感染合并过敏性紫癜的临床特征。方法对ELISA方法检测到MP-IgM≥1:80,临床诊断均为支原体感染合并过敏性紫癜的11例患儿进行回顾性分析。结果11例均有紫癜,其中单纯皮肤紫癜3例,紫癜伴关节肿痛3例,紫癜伴消化道症状5例,紫癜伴肾损害3例,具有2种以上表现2例。伴肺炎4例,脑炎1例,支气管哮喘发作1例。在过敏性紫癜常规治疗的基础上,全部给予阿奇霉素10mg/(kg.d)静脉点滴2周,再口服2周及其他相应对症治疗,均痊愈。结论肺炎支原体感染可并发过敏性紫癜,伍用阿奇霉素抗感染,预后良好。     

86例儿童肺炎支原体感染的临床分析

目的分析儿童肺炎支原体感染的临床特点。方法对确诊肺炎支原体肺炎的86例儿童病例进行回顾性分析,总结支原体肺炎的临床特点及并发症特点及治疗效果。结果经阿奇霉素治疗,全部发热病儿用药3～5天后体温恢复正常,平均4.2天退热,4～7天后咳嗽症状明显改善,肺部啰音消失,疗程结束后呼吸道症状基本消失。8周后复查MP-IgM,其中阴转65例(75.58%),仍呈阳性21例(24.42%)。12周后复查,阳性患者中18例转阴,仍有3例(3.49%)阳性患者,均无临床症状。结论肺炎支原体是小儿肺炎重要病原,且患儿有年轻化趋势。支原体肺炎有肺外多系统并发症可能。大环内酯类(阿奇霉素)对支原体肺炎疗效明显。     

中西医结合治疗小儿肺炎支原体感染50例疗效分析

目的 观察中西医结合治疗小儿肺炎支原体感染的疗效,探讨小儿肺炎支原体感染的有效治疗方法.方法 对2008年2月~2010年2月本科收治的100例肺炎支原体感染患儿随机分为两组,对照组(n=50)患儿给予阿奇霉素间隙性治疗,观察组(n=50)在上述治疗基础上加用中药治疗,以7 d为一个疗程,治疗两个疗程后评价临床疗效,随访3个月观察复发情况.结果 治疗2个疗程后,检查患儿的临床症状及体征,观察组患儿的治疗总有效率为94.0%,明显高于对照组的80.0%,差异有统计学意义(P<0.05);所有患儿均获得3个月随访,其中对照组复发8例(16.0%),观察组复发1例(2.0%),两组比较差异有统计学意义(P<0.05).结论 中西医结合治疗小儿肺炎支气管感染的疗效满意,能够快速、有效地缓解临床症状及体征,降低短期复发率,具有临床推广价值.     

阿奇霉素与小儿百部止咳糖浆联合治疗小儿肺炎支原体肺炎的临床疗效

<正>小儿肺炎支原体肺炎是小儿肺炎的一种,也是目前临床较为常见的肺炎类型。多发于低龄幼儿,除有呼吸道感染的临床症状外,X线片所见表现明显。该疾病患儿往往伴有咽痛或头痛等症状~([1])。病程和治疗一般在2～3周,有迁延不愈者,也往往带来严重不良影响。治疗该疾病的西医对症支持治疗是阿奇霉素,但往往许多患儿在治疗中,胃肠道反应较大。且阿奇霉素往往为序贯联疗法,使用3～5 d后必须停药,故中医治疗提升治疗效果,特联合小儿百部止咳糖浆治疗。为了研究阿奇霉素与小儿百部止咳糖浆联合治疗小儿肺炎支原体肺炎的临床疗效,选取我院2015年11月至2016年1月收治的58例小儿肺炎支原体肺炎患儿,分别采取阿奇霉素静     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.