尿激酶联合低分子肝素钙治疗进展性脑梗死60例临床观察

目的观察尿激酶联合低分子肝素钙治疗进展性脑梗死患者的临床疗效。方法将60例患者随机分为两组,对照组采用常规缺血性脑血管病治疗;治疗组采用小剂量尿激酶30万U溶于生理盐水100 ml,30 min滴完,1次/d,7 d为1个疗程,低分子肝素钙5000 U皮下注射,1次/d,10 d为1个疗程。结果治疗组患者治疗3周后基本治愈率、显著进步率均高于对照组。结论低分子肝素钙联合小剂量尿激酶治疗进展性脑梗死安全、有效。     

小剂量尿激酶联合低分子肝素钙治疗急性进展性脑梗死的临床研究

目的探讨进展性脑梗死的有效治疗措施。方法将180例急性进展性脑梗死患者随机分为4组:联合治疗组45例,采用尿激酶20万u+0.9%氯化钠溶液100 ml静滴,每日2次,连5 d,同时低分子肝素钙0.4 ml腹部皮下注射,每日2次,连用7 d,余治疗同对照组;尿激酶组45例,采用尿激酶20万u+0.9%氯化钠溶液100 ml静滴,每日2次,连5天,余治疗同对照组;抗凝组45例,低分子肝素钙5000IU腹部皮下注射,每日2次,连用7 d,余治疗同对照组;对照组45例,血栓通300 mg+0.9%氯化钠溶液250 ml静滴,每日1次,共14 d。结果联合治疗组疗效明显优于抗凝组和对照组P<0.01(91.1%、77.8%、68.9%),抗凝组疗效高于对照组P<0.05。结论应用小剂量尿激酶和低分子肝素治疗急性进展性脑梗死均有明显的疗效,两者具有协同作用。     

低分子肝素加奥扎格雷钠治疗进展性卒中200例疗效观察

目的：观察低分子肝素联合奥扎格雷钠治疗进展性缺血性脑卒中的近期疗效。方法：将病情进展在48小时内的200例缺血性进展性脑卒中患者．随机分为低分子肝素（LMWH）加奥扎格雷钠治疗组及常规治疗对照组，治疗组在对照组治疗基础上．加用奥扎格雷钠注射浪80mg加入5％葡萄糖250ml内静滴．LMWH2500IU．2次/d，腹壁皮下注射，于治疗前、治疗后14d分别进行神经功能缺损评分和疗效评定。结果：治疗后14d治疗组神经功能较治疗前显著恢复，且与对照组相比有显著差异（P〈0．05）；治疗组总显效率80％，与对照组相比有显著差异（P〈0．01）．且无明显不良反应。结论：在严格掌握适应症的基础上，LMWH加奥扎格雷钠治疗治疗进展性缺血性脑卒中的效果较好。且较为安全。     

小剂量尿激酶与肝素联合治疗不稳定型心绞痛疗效观察

目的：探讨小剂量尿激酶与肝素联合治疗不稳定型心绞痛（UAP）的疗效及安全性。方法：常规抗心绞痛用药的基础上，应用尿激酶30万U加生理盐水100ml静脉滴注1小时，每日1次，连用3天；普通肝素6250U加5％葡萄糖溶液（或生理盐水）250ml静滴，每日2次，连用7天。用药前后对比观察凝血指标、心电图及心绞痛发作情况。结果：23例UAP患者治疗总有效率91．3％，其中显效47．8％；心电图总改善率78．1％，恢复正常者26％；凝血酶原时间（PT）、凝血时间（TT）、激活的部分凝血活酶时间（APTT）均延长，纤维蛋白原（FiB）降低，但无出血等并发症，无一例急性心脏事件发生。结论：小剂量尿激酶与肝素联合治疗UAP安全、有效。     

大剂量尿激酶溶栓治疗急性脑梗塞的临床研究

目的 探讨早期应用大剂量尿激酶溶栓治疗脑梗塞的临床疗效。方法 将80例急性脑梗塞病人分为溶栓组、对照组。溶栓组应用生理盐水200ml加尿激酶150万U，在20～30min内滴完，溶栓12h后用低分子肝素7500U皮下注射，1次／24h，共5～7d。对照组1次／d皮下注射低分子肝素0．4ml，连用7d。溶栓前、溶栓后24h及溶栓后14d进行神经功能缺损评分、疗效评定及治疗前后血流变检测。结果 溶栓组疗效明显优于对照组。结论 只要严格掌握溶栓治疗的时间窗、适应症及禁忌症，应用大剂量尿激酶在急性脑梗塞的超早期进行静脉溶栓治疗是安全的、有效的。     

溶栓抗凝疗法治疗急性脑梗死76例临床效果分析

目的观察急性脑梗死患者在尿激酶溶栓后给予低分子肝素持续抗凝治疗的效果。方法将152例患者，随机分成二组，对照组常规予低分子右旋糖酐、胞二磷胆碱、维脑路通、20％甘露醇静脉滴注，并调整血压、控制血糖、防治感染、脑保护治疗等；研究组在对照组治疗方案基础上，加用国产尿激酶50～100万u加入生理盐水100ml中，于30min内滴注，8～12h后给予低分子肝素（速避宁）5000U，2次／d，皮下注射，连续10d。用治疗神经功能缺损评分评价疗效。结果研究组在首次溶栓治疗后、治疗后7d、28d的神经功能缺损评分与治疗前比较、每次与前次评分的差异均有统计学意义（P〈0．01）。对照组首次评分较治疗前高，治疗后第7天、第28天评分较治疗前低，差异有统计学意义（P〈0．01），第7天评分较首次评分低，差异有统计学意义（P〉0．05），而第28天的评分与第7天的评分差异无统计学意义（P〈0．01）；研究组显效率为78．9％，明显高于对照组的28．9％。结论急性脑梗死患者在尿激酶溶栓后给予低分子肝素持续抗凝治疗，有较快改善患者神经功能缺损症状，疗效持续，安全性好。     

静脉溶栓治疗急性脑梗死的临床观察

目的观察大剂量尿激酶治疗脑梗死超早期的静脉溶栓效果。方法对40例符合溶栓条件的急性脑梗死病人在发病6h内给予尿激酶100万U静滴,辅以低分子右旋糖酐500ml／d,内加脉络宁针20ml,连用15d,溶栓有效者,次日起给予低分子肝素2500U,Bid,iH连用5—7d。对照组不用尿激酶,只用低分子右旋糖酐、脉络宁及低分子肝素等药物,用法及用量同溶栓组,适当给予甘露醇脱水降颅压治疗。结果溶栓治疗40例,第21d基本痊愈12例,占30．0％,显著进步21例,占52．5％,总显效率为82．5％（33／40）。对照组42例,基本痊愈10例,显著进步10例,各占23．8％,总显效率为47．6％。两组间比较差异有统计学意义（P〈0．05）,溶栓组出血率为10％（4／40）,脑内出血占5％（2／40）,对照组出血率为5％（2／40）,全为颅内出血。结论大剂量尿激酶超早期（6h以内）静脉溶栓治疗急性脑梗死有效。     

低分子肝素钙治疗进展性脑梗死临床观察

目的：探讨低分子肝素钙对进展性脑梗死的预后的影响。方法：124例进展性脑梗死患者分为治疗组（64例）和对照组（60例）,2组均给予常规治疗（尼达尔40 m g,3次/d;肠溶阿司匹林0.1,1次/d;辛伐他汀20 mg,每晚1次;灯盏花素20 ml静滴,1次/d;疗程均为7 d）。治疗组在常规治疗的基础上加用低分子肝素钙0.4 ml,每隔12h 1次,腹部皮下注射,疗程7 d。结果：低分子肝素钙组与对照组治疗前后神经功能缺损恢复情况比较,差异有显著性（t′=10.832,P〈0.001）。结论：低分子肝素钙可显著改善进展性卒中的预后,值得临床进一步研究及推广。     

低分子肝素联合依达拉奉治疗进展型脑梗死的疗效观察

目的观察低分子肝素联合依达拉奉治疗进展型脑梗死的疗效。方法治疗组采用低分子肝素4100U皮下注射，每12小时1次，连用10d，依达拉奉30mg＋生理盐水250ml静脉滴注，每日2次，连用14d；对照组仅用同剂量、疗程的低分子肝素。两组患者治疗前及治疗结束时均进行临床神经功能缺损程度评分及临床疗效评定。结果治疗组的治愈率、显效率及治疗后神经功能缺损程度评分与对照纽比较，差异均有统计学意义（p均〈0．01）。结论低分子肝素联合依达拉奉对进展型脑梗死有较好的疗效。     

基层医院应用低分子肝素钙治疗急性进展型脑梗死的疗效观察

目的：观察低分子肝素钙治疗急性进展型脑梗死的疗效。方法：将68例急性进展型脑梗死患者随机分为两组,给予两组患者相同的常规治疗,治疗组在常规治疗的基础上加用低分子肝素钙0．4ml（4100U）腹壁皮下注射,2次／d,连用14d。观察两组患者的神经功能缺损程度及疗效。结果：治疗后第3、7、14、30d分别用欧洲卒中评分评定两组患者的临床神经功能缺损程度,30d加用Barthel指数评定日常生活能力,治疗组患者的恢复均优于对照组,差异有统计学意义（P〈0．01）。治疗组患者有效率为94．1％,日常生活能力达到大部分自理以上者占91．2％,优于对照组患者的52．9％、11．2％,差异有统计学意义（P〈0．01）。结论：低分子肝素钙治疗急性进展型脑梗死安全有效,值得在基层医院应用。     

1，5-脱水山梨醇的性质及其临床应用

1，5-脱水山梨醇（1，5-anhydro-D-glncitol；1，5-AC）是一种存在于人类血液中的正常化合物，由于其代谢稳定，在血液中波动范围小，可反映血糖短期的变化．具有空腹血糖、果糖胺和糖化血红蛋白所不具有的优点，在糖尿病诊断与治疗中具有很高的价值和意义。     

颞浅动脉旁注射护理服务项目的成本核算

目的探讨颞浅动脉旁注射(以下简称颞浅注射)护理成本核算方法。方法根据项目成本核算有关公式完成颞浅注射护理成本核算,并与当前收费作比较。结果根据实际情况核算出颞浅注射护理成本。结论提供了较为科学的核算方法,为更合理地制定价格提供了依据。     

Differentiation of CD3-4-8- human fetal thymocytes in vivo: characterization of a CD3-4+8- intermediate

Human thymocyte differentiation was examined by injecting fetal thymic progenitor populations into human thymic xenografts in SCID-hu mice. Thymic progenitors were fluorescently labeled with the lipophilic dye PKH2. The phenotypes of their progeny could be identified by flow cytometric analysis of cells with a very high fluorescent PKH2 signal. Intrathymic injection of purified triple negative (TN) CD3-4-8- thymocytes resulted in the sequential appearance of CD3-4+8-, CD3-4+8+, and CD3+4+8+ cells, with the subsequent appearance of small numbers of phenotypically mature CD3+4+8- and CD3+4-8+ cells over a 4-d period. Sorted CD3-4+8- thymocytes injected intrathymically rapidly differentiated to CD4+8+ cells. CD4+8+ fetal thymocytes in cell cycle differentiated into phenotypically mature CD3+4+8- and CD3+4-8+ populations, whereas nondividing CD4+8+ cells failed to differentiate after intrathymic transfer. The number of cell divisions that occurred between the injection of TN thymocytes and their progeny at different time points was estimated based on the decrease in the intensity of the PKH2 label. The average length of the cell cycle for the TN population was calculated to be 24 h. The SCID-hu model thus provides a useful tool for studying the kinetics of cell division and differentiation of human thymocytes in vivo.     

Pharmacokinetics of (+/-)-, (+)-, and (-)-gossypol in humans and dogs

Pharmacokinetic parameters of (+/-)-, (+)-, and (-)-gossypol were determined in humans and dogs after a single oral or intravenous dose. Mean (+/- SD) oral bioavailability of (+/-)-gossypol in dogs was 30.9% +/- 16.2%. Studies in dogs who received single intravenous injections revealed that the elimination t1/2 and volume of distribution of (+)-gossypol were five and six times those of (-)-gossypol, respectively, whereas total body clearance and the AUC of the two enantiomers were similar. Data from men receiving the compounds orally show that the average peak plasma concentration and the AUC of (+)-gossypol are significantly greater than those of the (-)-isomer. The rate constants of alpha, beta, ka, k21, and k10 for (-)-gossypol are significantly greater than those for (+)-gossypol, indicating higher rates of mass transfer of the (-)-species. In humans the elimination t1/2 of (+)-gossypol was 29 times as that of (-)-gossypol, a difference that is more striking than that found in dogs. The elimination t1/2 of (+/-)-gossypol in humans averages 286 +/- 179 hours.     

健脾益肾方对慢性肾衰患者肾保护的疗效观察

目的 :观察中药健脾益肾方治疗慢性肾衰患者对蛋白尿、肾功能、血清白蛋白的影响。方法 :随机将 4 7例慢性肾衰患者分为两组。治疗组 2 6例 ,予以健脾益肾方每日 1剂 ,每日 2次和对症治疗。对照组 2 1例 ,予以一般对症治疗。疗程 8周 ,治疗前后检测两组 2 4h尿蛋白定量、肾功能、血清白蛋白。结果 :健脾益肾方治疗组能降低慢性肾衰患者蛋白尿及血清肌酐、尿素氮水平 ,明显升高血清白蛋白水平 (P <0 0 5 ,P <0 0 1)。结论 :健脾益肾方对慢性肾衰患者有较好的肾保护作用     

5-4-3-2-1 Go! Standardizing Nutrition and Physical Activity-Related Counseling

Providers at an urban pediatric clinic lacked a standardized protocol for counseling parents and children when addressing the problem of obesity. Providers were trained to implement the 5-4-3-2-1 Go! evidence-based intervention. The electronic medical record was revised for documentation of counseling. Adherence to the protocol was monitored through observation and chart reviews. Providers found the protocol to standardize care and enhance the patient’s ability to set goals and develop plans for change. The rate with which providers recommended follow-up visits for this purpose increased significantly. 5-4-3-2-1 Go! was successfully used to standardize obesity-related follow-up visits.     

Ferroelectric performance of nylons 6-12, 10-12, 11-12, and 12-12

Nylons have great potential for electrical applications requiring high polarizability and low dielectric loss. Recently, the narrow single hysteresis loop with relaxor ferroelectricity and the double hysteresis loop due to antiferroelectricity have been reported in nylon random copolymers, terpolymers, and common even-numbered nylons. Although several studies of ferroelectric nylons have been reported, even–even-numbered and odd–even-numbered nylons have not been sufficiently explored. Here, the ferroelectricity of spin-coated even–even-numbered and odd–even-numbered nylons was investigated. A series of even–even-numbered nylons, including nylons 6-12, 10-12, and 12-12, and an odd–even-numbered nylon, nylon 11-12, were polymerized with 1,10-dodecanedicarboxylic acid (12) and four aliphatic diamines with various methylene units, 1,6-hexanediamine (6), 1,10-decanediamine (10), 1,11-undecanediamine (11), and 1,12-dodecanediamine (12). The obtained nylon polymers were spin coated and then subjected to melt-quenching or thermal annealing followed by quenching. From the X-ray diffraction and the electrical hysteresis loop data, the correlation between the ferroelectricity and the crystal parameters of crystallinity and crystallite size of the γ crystal phase was investigated. Furthermore, the free volume of the nylon samples was estimated to correlate with the ferroelectricity. Temperature-dependent ferroelectricity was investigated for nylon 10-12. At a high temperature, the nylon samples showed a narrow polarization–electric field hysteresis loop and a rhombus-shaped polarization current–electric field hysteresis loop due to the relaxor ferroelectricity. This behaviour was caused by electrically rotating the nanodomains with weakened hydrogen bonds at higher temperatures.

Nylons have great potential for electrical applications requiring high polarizability and low dielectric loss.     

儿童疑似肺炎支原体感染者血清、支气管灌洗液、胸腔积液、脑脊液MP-Ab-IgM检测的结果分析

目的 分析肺炎支原体肺炎(MPP)患儿血清、支气管灌洗液、胸腔积液及脑脊液的肺炎支原体(MP)MP-Ab-IgM检测结果。方法 选取2013年3月～6月在首都医科大学附属北京儿童医院疑似MP感染的278例住院患儿的血清、支气管灌洗液、胸腔积液及脑脊液标本,采用颗粒凝集的方法检测MP-Ab-IgM。结果181例患儿(男孩104例,女孩77例)的不同标本中MP呈阳性反应。278例患儿均进行了血清标本检测,共检出阳性血清标本170例,总检出率为61.2%(170/278),144例同时进行了支气管灌洗液检测,检出阳性62例,检出率为43.1%(62/144); 19例同时进行了胸腔积液标本检测,检出阳性13例,检出率为68.4%(13/19); 15例同时进行了脑脊液标本检测,检出阳性1例,检出率为6.7%(1/15)。各年龄组间检出率分别为:6个月～1岁组29.0%(9/31),～3岁组51.0%(25/49),～5岁组56.1%(23/41),～16岁组79.0%(124/157),6个月～1岁组与其他年龄组比较差异有统计学意义(P<0.05); ～3岁与～5岁组间差异无统计学意义(P>0.05),而与～16岁组间差异有统计学意义(P<0.05)。在6个月～1岁,～3岁,～5岁,～16岁四个年龄组中,同一患儿检测的不同类型MP-Ab-IgM阳性标本,其对应结果为A:血清类(111例)7,21,13和70; B:血清-支气管灌洗液类(45例)0,2,5和38; C:血清+胸腔积液类(7例)0,1,2和4; D:血清+脑脊液(1例)0,0,0和1; E:血清+支气管灌洗液+胸腔积液类(6例)0,0,2和4; F:支气管灌洗液类(11)2,1,1和7。结论 MP感染多种多样,有低龄化趋势,且有逐年增多的趋势。不同年龄组间血清阳性检出率随年龄增长逐渐增加,婴幼儿阳性检出率明显升高,重症患儿多发于年龄较大的患儿。