早产儿非营养性吸吮对外周血Leptin含量及体重的影响

目的探讨非营养性吸吮（NNS）对早产儿外周血中Leptin含量及体重的影响。方法将66例早产儿随机分为观察组和对照组各33例。对照组给予静脉营养和胃管鼻饲，观察组在此基础上增加非营养性吸吮．即在清醒及安静状态下于每次喂奶前15min给予吸吮未开孔橡皮奶头5min．然后按医嘱鼻饲喂早产儿配方奶。2周后采用酶联免疫吸附法测定两组早产儿外周血中Leptin含量及NNS前后体重。结果观察组2周后外周血Leptin含量显著低于对照组（P〈0．01），体重显著高于对照组（P〈0．01）。早产儿外周血浆中Leptin含量水平与体重呈显著负相关（P〈0．01）。结论早产儿非营养性吸吮有利于外周血中Leptin含量的降低，并促进早产儿体重增长。     

抚触与非营养性吸吮对早产儿食欲及体重的影响

目的探讨抚触、非营养性吸吮对早产儿食欲和体重的影响.方法将70例早产儿随机分为观察组(40例)与对照组(30例).两组均接受常规综合治疗及微量喂养;观察组在此基础上实施抚触,2次/d,非营养性吸吮每2小时1次.结果观察组每天增加的奶量和体重显著高于对照组,平均睡眠时间显著长于对照组(P＜0.05,P＜0.01),而并发症发生率显著低于对照组(P＜0.05,P＜0.01).结论抚触与非营养性吸吮有助于增加早产儿的食欲,加速体重增长,减少并发症的发生,有利于早产儿的生长发育.     

非营养性吸吮对早产儿血ghrelin表达水平的影响

目的探讨非营养性吸吮对早产儿血ghrelin表达水平的影响。方法将64例早产儿随机分成观察组和对照组各32例。对照组仅予鼻胃管喂养和静脉营养,观察组在此基础上加用非营养性吸吮,即在每次喂养前15min给予吸吮未开孔橡皮奶头10min。2周后用ELISA测定早产儿血ghrelin表达量,同时测量其体重。结果观察组血ghrelin表达量及体重显著高于对照组（P〈0.05,P〈0.01）。早产儿血ghrelin表达量与体重呈显著正相关（P〈0.01）。结论非营养性吸吮可促进早产儿血ghrelin表达,ghrelin表达与患儿体重增加有关。     

采用鸟巢式护理降低低体重儿并发症效果观察

目的有效降低低体重早产儿并发症发生率，促进其生长。方法将98例低体重早产儿随机分为观察组（50例）和对照组（48例），两组患儿入院后均置辐射式抢救台或暖箱中保暖，观察组采用鸟巢式护理，对照组实施常规护理。结果观察组呼吸暂停、硬肿症、喂养不耐受发生率显著低于对照组（均P〈0．05），恢复出生体重时间、体重增长显著优于对照组（均P〈0．01）。结论采用鸟巢式护理能有效降低低体重早产儿并发症，促进其生长发育。     

早产儿非营养性吸吮对外周血Leptin含量及体重的影响

目的 探讨非营养性吸吮(NNS)对早产儿外周血中Leprin含量及体重的影响.方法 将66例早产儿随机分为观察组和对照组各33例.对照组给予静脉营养和胃管鼻饲,观察组在此基础上增加非营养性吸吮,即在清醒及安静状态下于每次喂奶前15 min给予吸吮未开孔橡皮奶头5 min,然后按医嘱鼻饲喂早产儿配方奶.2周后采用酶联免疫吸附法测定两组早产儿外周血中Leptin含量及NNS前后体重.结果 观察组2周后外周血Leptin含量显著低于对照组(P<0.01),体重显著高于对照组(P<0.01).早产儿外周血浆中Leptin含量水平与体重呈显著负相关(P<0.01).结论 早产儿非营养性吸吮有利于外周血中Leptin含量的降低.并促进早产儿体重增长.     

非营养性吸吮对早产儿血ghrelin表达水平的影响

目的 探讨非营养性吸吮对早产儿血ghrelin表达水平的影响.方法 将64例早产儿随机分成观察组和对照组各32例.对照组仅予鼻胃管喂养和静脉营养,观察组在此基础上加用非营养性吸吮,即在每次喂养前15 min给予吸吮未开孔橡皮奶头10 min.2周后用ELISA测定早产儿血ghrelin表达量,同时测量其体重.结果 观察组血ghrelin表达量及体重显著高于对照组(P＜0.05,P＜0.01).早产儿血ghretin表达量与体重呈显著正相关(P＜0.01).结论 非营养性吸吮可促进早产儿血ghrelin表达,ghrelin表达与惠儿体重增加有关.     

音乐疗法在早产儿护理中的应用

目的 探讨音乐疗法在早产儿护理中的应用效果。方法 将50例出生体重1000～2000g早产儿随机分为观察组和对照组各25例。对照组予以常规护理，观察组在此基础上于出生后72h内实施音乐干预，3次／d，15min／次，直至出院前。其他治疗两组相同。观察比较两组体重增长、对疼痛刺激即针刺足跟采血前后心率、呼吸、血氧饱和度的变化恢复时间及住院时间。结果 观察组每日体重增长显著高于对照组（P〈0．05）；针刺足跟采血后心率、呼吸及血氧饱和度恢复至刺激前的时间显著短于对照组（均P〈0．01）；住院时间短于对照组（P〈0．05）。结论 音乐疗法能促进早产儿体重的增长，缩短机体疼痛刺激阈及住院时间，有利于早产儿的生长发育。     

早期腹部抚触促进新生儿胆红素排泄的研究

目的探讨预防新生儿黄疸有效安全的干预方法。方法将足月行剖宫产的60例新生儿随机分为观察组和对照组，各30例。两组均行常规护理和母乳喂养，观察组在此基础上于新生儿出生后第2、3、4天进行腹部抚触。结果新生儿出生后第2～5天观察组血清胆红素上升幅度显著低于对照组（P〈0．05，P〈0．01）；第3、5天粪胆素显著高于对照组（均P〈0．01）。结论早期腹部抚触能有效促进胆红素的排泄，预防新生儿黄疸的发生。     

血液灌流辅助抢救急性重度有机磷农药中毒的疗效观察

目的探讨血液灌流（HP）辅助抢救急性重度有机磷农药中毒（ASOPP）疗效。方法根据时间段将ASOPP患者分为观察组（46例）和对照组（20例），两组均常规采用内科抢救治疗方法，观察组在此基础上加用HP治疗。结果观察组治愈率显著高于对照组（P〈0．05），而病死率、并发症发生率及阿托品总用量显著低于对照组（P〈0．01，P〈0．05）；患者昏迷时间、住院时间显著较对照组短（P〈0．01．P〈0．05）。结论系统内科治疗辅助HP，可提高ASOPP患者治愈率，降低病死率及并发症发生率；严密的病情观察及护理是抢救成功的关键。     

联合非药物干预方法减轻新生儿操作性疼痛的研究

目的探讨联合使用几种非药物干预方法在临床上减轻新生儿操作性疼痛的效果。方法将63例新生儿随机分成四组,在新生儿接受操作性疼痛刺激时,干预Ⅰ、Ⅱ、Ⅲ组分别采用体位干预＋抚触、口服24％蔗糖水＋非营养性吸吮、口服24％蔗糖水＋非营养性吸吮＋体位干预＋抚触。对照组在穿刺的全过程不给予任何缓解疼痛的干预措施。采用新生儿疼痛量袁（N1PS）比较四组疼痛程度。结果与对照组比较,干预Ⅰ组NIPS评分差异无统计学意义（P〉0．05）,但干预Ⅱ组、干预Ⅲ组差异有统计学意义（均P〈0．01）;与刺激后1min比较,刺激后5min及刺激后10min各组的NIPS评分均迅速下降。结论联合干预方法Ⅱ、Ⅲ均有协同镇痛作用,干预方法Ⅲ减轻新生儿操作性疼痛效果最好。     

Hazards and complications of endoscopic transurethral ureterolithotripsy and lithoextraction and means of prevention

Complications related to ureterolithotomy and ultrasonic ureterolithotripsy performed under the control of visual endoscope were analyzed in 86 ureterolithiasis patients, methods of their prevention discussed. All the aforementioned complications were distributed into three groups: inapplicability of surgery due to anatomic and functional defects of lower and upper urinary tracts, intraoperative, and postoperative complications. The commonest ones were ureteral abruption and perforation, acute pyelonephritis, temporary vesicoureteral reflux. Their control measures were considered as relative methods of treatment: immediate surgical intervention in case of ureteral abruption, renal catheterization in patients with insignificant ureteral perforation or acute pyelonephritis. Adequate ureteroscopy, careful consideration of pro- and contraindications, catheterization of renal pelvis and urinary bladder performed within 2-3 days after the surgery and adequate antibacterial therapy are the most decisive steps in the control of aforementioned complications.     

牙体牙弓颌骨阻力中心及其临床意义

牙体、牙弓及颌骨的阻力中心在正畸矫治力系统中具有重要的意义,也是正畸学领域争论较多的一个问题。Dermaut等研究表明,当力作用于物体阻力中心时,物体将发生平动,否则将发生平动和转动的复合运动。目前,国内外多数学者认为牙体、牙弓及颌骨存在阻力中心,但其位置存在争议。本文就牙体、牙弓及颌骨的阻力中心及其临床意义作一综述。     

Characterisation and differentiation of chondroblastomas and chondromyxoidfibromas - presence and expression of collagen types I and II

AIM: Chondroblastomas and chondromyxoidfiibromas are rare benign skeletal neoplasms with reported overlapping histology. Aim of this study was to analyse the biochemical composition of the matrix of these tumour entities in order to further characterise the cellular phenotypes of these neoplasms using typical cell biological marker genes. METHODS: The matrix compositions of chondroblastomas and chondromyxoidfibromas were analyzed by HE-histology, histochemistry, and immunolocalization techniques. Cellular gene expression patterns were detected by mRNA in situ hybridization. RESULTS: Chondroblastomas are rich in collagen type I and show foci of an osteoid-like matrix, whereas collagen type II as a typical marker of chondrocytic differentiation was not detected in any of the specimens. Chondromyxoidfiibromas had foci of chondroid appearance with chondroblastic cellular differentiation characterised by collagen type II expression. CONCLUSION: These results characterise chondroblastomas and chondromyxoidfiibromas as skeletal neoplasms that have a different biology and which can be distinguished by matrix protein expression products: collagen type II, the typical marker of chondroblast differentiation, could only be detected in chondromyxoidfibromas, but not in chondroblastomas. Thus, both neoplasms are clearly different on the cell biological level.     

Histochemical and contractile properties of striated muscles of urethra and levator ani of dogs and sheep

AIMS: To understand their possible importance in long- and short-term control of continence, some properties of the striated muscles of the urethra and pelvic floor (levator ani) of dogs and sheep were investigated, especially fiber types and contractile characteristics. MATERIALS AND METHODS: Striated muscles of urethra and levator ani of 29 male and 6 female dogs and 11 male and 6 female sheep were removed and cut into strips. Some strips were frozen and stained for ATPase at pH 9.4 and 4.3 for fiber typing; others were set up in an organ bath to study contractile responses to nerve stimulation. RESULTS: All muscles contained both type I (slow) and type II fibers, ranging from 97% type II in female greyhound urethra to 60% in female sheep levator ani. For each muscle, there were fewer type II muscles in sheep than in dog. The diameters of the urethral fibers were about 60% of the levator ani in dogs and 34% in sheep. Contraction of the urethral muscle was faster than for levator ani and declined to about 80% of the peak, 500 msec after the beginning of stimulation at 20 Hz. The levator ani contraction rose to a steady level as long as stimulation continued. CONCLUSIONS: Both the levator ani and urethral striated muscles contain slow and fast fiber types. The levator ani muscles are capable of sustained contraction with rapid onset which will produce long-term closure of the urethra. The circular urethral muscle contraction was faster but less well maintained.     

Incorporation and release of85Sr and14C-proline-hydroxyproline in mineral and collagen of bone and incisor teeth of growing rats

The extent to which exchange and reutilization processes of mineral tracers affect skeletal mineral accretion and resorption measurements was evaluated by comparing the rates of appearance and disappearance of⁸⁵Sr and¹⁴C-proline-hydroxyproline in bones and teeth in growing rats for 12 days following simultaneous parenteral injection of these tracers. Expressions for the relative rates of collagen synthesis and breakdown, which unlike mineral metabolism are considered not to be complicated by exchange phenomena, were based on¹⁴C-proline conversion to¹⁴C-hydroxyproline; the specific activity of the latter was determined. Both the mineral and the collagen specific activities reflected the rates and patterns of growth of the samples assayed; rapid growth and a short interval of time between formation and resorption of tissue in themetaphyseal bone which contains the cartilagineous growth plate, slow growth and an interval of time between formation and resorption of tissue indiaphyseal bone and incisor teeth which is longer than the 12 days of the experiment. However, in metaphyseal bone the specific activity collagen/mineral ratio dropped by one half during the 4–12 day interval in contrast to diaphyseal bone and incisor teeth in which no change in this ratio was observed during this period of time. The data indicate that collagen in the metaphyseal growth zone is removed by resorption before it has become fully mineralized, and that exchange is a relatively unimportant factor in the long term kinetics of bone mineral.

---

Zusammenfassung Das Ausmaß, bis zu welchem Austausch- und Wiederverwendungsprozesse der mineralen Tracer die Messungen des mineralen Skelett-Auf- und Abbaues beeinflussen können, wurde ausgewertet; zu diesem Zweck wurde die Geschwindigkeit des Auftretens und Verschwindens von⁸⁵Sr und von¹⁴C-Prolin-Hydroxyprolin in Knochen und Zähnen von wachsenden Ratten während der 12 auf die simultane parenterale Injektion dieser Tracer folgenden Tage verglichen.Der Ausdruck für die relative Geschwindigkeit des Kollagen-Auf- und Abbaues, bei welchem im Gegensatz zum Mineralmetabolismus kein Mitwirken des Austauschphänomens vermutet wird, basiert auf der Umwandlung von¹⁴C-Prolin zu¹⁴C-Hydroxyprolin; die spezifische Aktivität des letzteren wurde bestimmt.Aus der spezifischen Aktivität des Minerals sowie jener des Kollagens konnten die Geschwindigkeit und die Art des Wachstums der untersuchten Proben ersehen werden, d.h.schnelles Wachstum und ein kurzes Zeitintervall zwischen Bildung und Resorption des Gewebes imKnochen der Metaphyse, die auch die knorpelige Wachstumsplatte enthält, und andererseitslangsames Wachstum und längeres Zeitintervall (länger als die 12 Tage des Experimentes) zwischen Bildung und Resorption des Gewebes imKnochen der Diaphyse und in den Schneidezähnen. Immerhin fiel die spezifische Aktivität des Kollagen/Mineral-Anteils im Knochen der Metaphyse während dem 4–12tägigen Zeitintervall auf die Hälfte, im Gegensatz zum Knochen der Diaphyse und der Schneidezähne, bei welchen während dieser Zeitspanne kein Unterschied in diesem Verhältnis beobachtet wurde.Diese Ergebnisse zeigen, daß Kollagen in der Wachstumszone der Metaphyse durch Resorption verschwindet, bevor es ganz mineralisiert ist, und daß der Austausch ein relativ unwichtiger Faktor in der Kinetik auf lange Sicht des Knochenminerals ist.