儿童上腹反复疼痛与幽门螺旋杆菌感染的关系

目的 探讨儿童反复性腹痛与幽门螺旋杆菌(helicobacter pylori HP)感染的关系.方法 选择2007年2月-2009年2月期间在我院就诊的反复慢性腹痛患儿82例.无反复腹痛史的儿童30例作为对照组.利用C13-尿素呼气实验儿童的HP感染情况.结果 82例反复性腹痛儿童中,HP感染阳性率为40.2%,与对照组比较差异有显著性(P<0.01).1-3岁组HP感染阳性率为21.4%,4-6岁组HP感染阳性率为33.3%,7-10岁组HP感染阳性率为45.8%,11-14岁组HP感染阳性率为48.3%,感染率随着年龄增长而增高.男女组差异无显著性(P＞0.05).结论 反复性腹痛儿童与HP感染关系密切.利用C13-UBT诊断HP感染,具有无创、快速和准确的优点,已被临床广泛应用.     

幽门螺杆菌感染与小儿复发性腹痛的相关性研究

目的研究幽门螺杆菌（Hp）感染与小儿复发性腹痛（RAP）的相关性：方法采用^13C—尿素呼气试验（^13C—UBT）检测60例健康儿童和187例RAP儿童的Hp感染率，观察Hp根除后RAP患儿的腹痛缓解率，并对RAP儿童在性别、年龄、病程、腹痛方式等方面进行比较，结果RAP儿童和对照组的Hp感染阳性率分别为31.4％，15.0％，两组比较差异有显著性（P〈0．05），Hp阳性的RAP儿童进行抗Hp治疗后，Hp已根除和未根除的腹痛缓解率分别为78．5％、37．5％，两组比较差异有显著性（P〈0．05）。3个年龄组的Hp感染率差异无显著性（P〉0．05）。Hp感染与RAP儿童的性别、病程及腹痛方式之间进行比较，差异亦无显著性（P〉0．05）。结论Hp感染与RAP有密切的相关性．可能为RAP的主要致病因素，根除Hp治疗可缓解RAP儿童的腹痛症状。     

14C-尿素呼气试验在诊断幽门螺杆菌感染中的价值

目的探讨14C-尿素呼气试验（14C—UBT）对幽门螺杆菌（Hp）的诊断价值。方法对120例我科住院患者早晨空腹行14C—uBT测定Hp，同时经胃镜检查并夹取组织进行快速尿素酶试验测定Hp，其检测结果两组进行对比。结果14C—UBT测定Hp阳性为98例，阳性率为81．67％，快速尿素酶试验阳性为108例，阳性率为90．00％，两组比较差异无显著性（P〉0．05）。结论14C—UBT不需通过胃镜获取标本，具有简便，易操作的优点。     

小儿再发性腹痛与幽门螺杆菌感染的关系探讨

目的 对87例再发性腹痛患儿进行幽门螺杆菌（HP）的检测，探讨小儿再发性腹痛与幽门螺杆菌感染之间的关系。方法 87例患儿均接受^14C-尿素呼气试验（^14C—UBT）检测，其中63例行血清幽门螺杆菌-IgG抗体检查，42例做胃镜检查及快速尿素酶试验。42例无症状者作为对照组仅做^14C—UBT及血清幽门螺杆菌-IgG抗体检查。如检查中有2项或2项以上阳性者则诊断为幽门螺杆菌感染。结果 再发性腹痛患儿HP阳性45例，阳性率51．7％。对照组阳性10例，阳性率23．57％，两组比较，差异有显著性（P〈0，05）。胃镜结果：慢性胃炎32例，十二指肠球部渍疡8例，胃渍疡1例，正常1例。病变检出率达99％。结论 小儿再发性腹痛与幽门螺杆菌感染有关，慢性胃炎和十二指肠部溃疡是其主要致病原因。     

三联疗法治疗儿童幽门螺杆菌感染

目的探讨泮托拉唑、克拉仙、阿莫仙三联短程疗法根除儿童幽门螺杆菌（Hp）现症感染的疗效。方法经^13C尿素呼吸试验（^13C—UBT）及血清Hp-IgC；测定两项阳性的反复疫痛患儿63例，分为治疗组36例与安慰剂组27例。治疗组接受泮托拉唑、克拉仙、阿莫仙三联治疗，安慰剂组口服安慰剂；疗程均为1周。结果停药后4周门诊复诊并复查^13C-UBT。治疗组与安慰剂组临床总有效率分别为100％和22．2％，Hp根据除率分别为83．3％和11．1％。结论部分小儿反复腹痛与Hp现症感染密切相关，泮托拉唑、克拉仙、阿莫仙三联1周短程疗法根除反复腹痛儿童Hp现症感染临床效果好，Hp根除率高，副作用少。     

^14C－尿素呼气试验检测幽门螺杆菌感染

目的：评价^14C-尿素呼气试验（UBT）检测幽门螺杆菌（HP）感染的价值。方法：36例受试口服37kgbq^14C-尿素胶囊后收集呼气进行试验。结果：十二指肠溃疡，胃溃疡和慢性浅表性胃炎的阳性率分别为70．00％（7／10），62．50％（5／8），22．22％（4／18）。结论：^14C－尿素呼气试验可为临床提供可靠的HP感染的即时状态。     

复发性腹痛儿童血清幽门螺杆菌抗体检测及临床研究

目的：在复发性腹痛儿童中进行血清HP－IgG抗体检测。探讨复发性腹痛与幽门螺杆菌感染的关系，方法：对156例2－14岁因反复腹痛在儿科门诊就诊或住院病人的血清中检测HP－IgG抗体。结果：检测156例复发性腹痛儿童HP抗体阳性患儿125例，阳性率80．1％，其中男性患儿阳性率85．1％，女性患儿阳性率72．6％，发病1月内就诊阳性率72．2％，半年内84．8％，1年87．2％，2年内86．4％，结论：复发性腹痛儿童与HP感染关系密切，HP抗体的存在与HP活动性感染具有较高的一致性，并认为HP抗体的检测对于儿童不仅可用于流行病学调查，亦可用于HP感染的临床诊断。     

韶关市曲江区2006年人群麻疹免疫水平监测分析

目的了解人群麻疹免疫状况，考核及评价麻疹疫苗的接种质量和效果，为制定和调整免疫策略提供依据。方法用统计学方法对不同性别、乡镇和年龄组的人群麻疹免疫水平监测结果进行统计学分析。结果人群平均抗体水平3556.78mlu／ml，阳性率为91．81％；男、女两性之间麻疹抗体阳性率差异无统计学意义（X^2=2．0，P=0.1573）；不同年龄组之间阳性率差异有统计学意义（X^2=18．0，P=0．0012），2-4岁组阳性率为93．10％，6-8岁组阳性率为85．19％，13-15岁组阳性率为96．61％；不同乡镇之间人群阳性率差异无统计学意义（X^2=1.0，P=0．3173）。结论曲江区麻疹IgG抗体阳性率为91．81％，但6-8岁抗体阳性率较低，说明该年龄段接种情况较差，需加强此年龄段的免疫接种工作。     

口腔幽门螺杆菌感染与胃幽门螺杆菌感染的相关性研究

目的：探讨口腔幽门螺杆菌感染与胃幽门螺杆菌感染的关系,评价根除幽门螺杆菌治疗对口腔幽门螺杆菌感染及胃幽门螺杆菌感染的影响。方法：采用唾液测定幽门螺杆菌抗原技术（HPS）与^14C尿素呼气试验（^14C—UBT）同时测试的方法,选取有上消化道症状来消化科门诊初诊的患者、经证实有胃Hp感染且根除治疗后4周复查的患者及无任何消化道症状的健康志愿者分别进行检测。结果：上述三组入选对象均有较高HPS阳性检出率,分别为78．57％、79．83％和76．74％,三组比较差异无统计学意义（X2=0．46,P〉0．05）,^14C—UBT阳性检出率,三组患者分别为51．79％、34．45％、23．26％,三组比较差异有统计学意义,初诊患者高于抗Hp治疗后患者和健康志愿者,（,=8_32,X2=9．18,P〈0．05）;在^14C—UBT阳性患者中HPS阳性检出率,三组患者分别为82．76％、90．24％、90．00％,三组间比较差异无统计学意义（P〉0．05）。结论：VI腔中有较高的Hp检出率,胃Hp感染患者中大多存在13腔Hp感染。Hp根除治疗对杀灭胃内Hp有一定疗效,对口腔Hp感染几乎无效。     

幽门螺杆菌与小儿反复性腹痛关系的研究

目的 :探讨幽门螺杆菌 (HP)与小儿反复性腹痛的关系 ,为小儿反复性腹痛的诊断、治疗提供依据。方法 :采用福建兰波生物制剂厂生产的HP抗体药盒 ,用金标法测定 2 31例反复性腹痛患儿HP IgM ,HP IgG ,80例健康儿童作对照。结果 :反复性腹痛患儿HP IgM阳性率 6 6 .2 3% ,HP IgG阳性率为 6 1.0 4 % ;对照组HP IgM阳性率为 4 2 .5 % ,HP IgG阳性率为 38.92 % ,两组比较有显著性差异 (P <0 .0 0 5 )。 结论 :小儿反复性腹痛与幽门螺杆菌的感染密切相关     

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.     

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.     

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.