微生态制剂用于早产儿治疗60例的临床观察

目的 探讨微生态制剂用于早期早产儿的治疗.方法 将120例早产儿随机分为治疗组和对照组,每组60例.均给予肠道喂养.治疗组在此基础上,于出生24小时内予口服或经胃管微生态制剂双歧杆菌四联活菌片0.5/次,3次/天,连用28天.观察二组喂养不酎受发生率,达全胃肠喂养时间及体重恢复至出生体重所需时间等.结果 治疗组早产儿喂养不耐受率低于对照组(P<0.01),治疗组达全胃肠喂养时间及恢复至出生体重所需时间短于对照组(P<0.01).在微生态制剂用于治疗过程中,未发现不良反应.结论 微生态制剂用于早期早产儿的治疗,降低喂养不耐受发生率、缩短达全胃肠喂养时间及恢复至出生体重所需时间,有利于早产儿的生长发育.     

早期微生态干预对早产儿黄疸的预防作用及机制研究

目的探讨早期应用微生态调节剂金双歧对早产儿黄疸的影响及作用机制。方法将符合条件的早产儿150例随机分为对照组和试验组,对照组给予常规治疗,试验组在此基础上给予双歧杆菌、乳杆菌、嗜热链球菌三联活菌片治疗,0.5 g/次,3次/d,观察2组患儿喂养及排便情况,监测胆红素,采集第3、7天肠道粪便标本,通过实时PCR技术对新生儿粪便中的双歧杆菌属进行定量检测。结果与对照组相比,试验组喂养不耐受发生率低(P<0.01),达全胃肠喂养所需时间提前(P<0.01),温盐水灌肠次数减少(P<0.01),生后第3天血清胆红素水平降低(P<0.01),高胆红素血症发生率降低(P<0.01),黄疸持续时间缩短(P<0.01)。第3、7天肠道双歧杆菌的数量均明显高于对照组(P<0.01),第3天血清胆红素水平与肠道双歧杆菌数量的对数值呈明显负相关(r=-0.810,P<0.01),且无益生菌相关性败血症发生。结论早产儿早期应用微生态调节剂金双歧,可以促进肠道益生菌定植,从而改善消化道症状、避免高胆红素血症发生、促进黄疸消退。     

双歧杆菌三联活菌散联合早期微量喂养在早产儿喂养不耐受治疗中的效果研究

目的 分析双歧杆菌三联活菌散联合早期微量喂养在早产儿喂养不耐受治疗中的临床效果。方法 选取2018年1月至2022年6月杭州市妇产科医院收治的82例喂养不耐受早产儿为研究对象，根据随机数字表法将其分为对照组和观察组，每组各41例。对照组患儿接受早期微量喂养干预，观察组患儿使用双歧杆菌三联活菌散联合早期微量喂养干预。比较两组患儿的临床疗效、出生后恢复情况及不良事件发生情况。结果 观察组患儿的总有效率显著高于对照组（97.56% vs. 78.05%，χ2=7.288，P=0.020）。观察组患儿恢复出生体质量时间、达全胃喂养时间、腹胀与呕吐消失时间、住院时间均显著短于对照组（P<0.05），体质量增长速率显著大于对照组（P<0.05）。观察组患儿的胆汁淤积、低血糖发生率均显著低于对照组（P<0.05），两组患儿的坏死性小肠结肠炎、高胆红素血症、院内感染发生率比较，差异均无统计学意义（P>0.05）。结论 双歧杆菌三联活菌散联合早期微量喂养可有效提高喂养不耐受早产儿的临床疗效，促进出生后快速恢复，降低不良事件发生率，缩短住院时间，值得临床推广应用。     

胃肠动力药物联合微生态制剂防治早产儿喂养不耐受的疗效观察

目的:评价胃肠动力药物联合微生态制剂防治早产儿喂养不耐受的临床疗效。方法:将448例早产儿分为A组(常规组)104例、B组(微生态制剂组)173例、C组(微生态制剂+胃肠动力药物组)171例。A组患儿予常规护理和治疗,B组在A组的基础上于出生6 h内开始口服(或经胃管)微生态制剂酪酸梭菌-婴儿型双歧杆菌二联活菌散剂,每次0.5 g,每天2次。C组在B组治疗基础上加用胃肠动力药物莫沙必利,每次0.2 mg/kg,每天3次。观察和记录3组早产儿喂养不耐受发生率、出生后体质量下降幅度、恢复至出生体质量时间、达到全胃肠喂养时间、体质量增长速度及住院时间等情况。结果:B组和C组喂养不耐受发生率均低于A组(P0.01),喂养不耐受持续时间均短于A组(P0.01),出生后体质量下降幅度均低于A组(P0.01),恢复至出生体质量时间、达到全胃肠喂养时间和住院时间均短于A组(P0.05～P0.01),体质量增长速度均大于A组(P0.01);C组与B组喂养不耐受发生率差异无统计学意义(P0.05),C组喂养不耐受持续时间、恢复至出生体质量时间、达到全胃肠喂养时间和住院时间均短于B组(P0.05～P0.01),体质量下降幅度低于B组(P0.01),体质量增长速度大于B组(P0.01)。胃肠动力药物及微生态制剂应用过程中均未见不良反应。结论:胃肠动力药物联合微生态制剂可有效防治早产儿喂养不耐受,较单一使用微生态制剂效果更好,可促进早产儿早期生长发育,缩短达到全胃肠喂养的时间。     

小剂量红霉素联合双歧杆菌三联活菌散治疗早产儿喂养不耐受的疗效观察

目的 探究小剂量红霉素联合双歧杆菌三联活菌散治疗早产儿喂养不耐受的疗效。方法 选取我院2016年3月～2018年5月喂养不耐受早产儿64例,按随机数字表法分为试验组(n=32)、对照组(n=32)。常规治疗基础上,对照组采取小剂量红霉素治疗,试验组采取小剂量红霉素联合双歧杆菌三联活菌散治疗,均治疗5～7 d。对比2组疗效、临床症状消失时间、住院时间、恢复出生体重时间、可完全肠道营养时间、每日进奶量及不良反应发生情况。结果 经治疗,试验组总有效率90.63%(29/32)较对照组68.75%(22/32)高(P＜0.05);试验组胃潴留、呕吐、腹胀消失时间与住院时间、恢复出生体重时间、可完全肠道营养时间较对照组短,每日进奶量较对照组高(P＜0.05);试验组不良反应发生率9.38%(3/32)与对照组6.25%(2/32)相比,差异无统计学意义(P＞0.05)。结论 喂养不耐受早产儿给予小剂量红霉素联合双歧杆菌三联活菌散治疗可增强疗效,减轻临床症状,促进患儿康复,且具有安全性。     

双歧杆菌对早产儿早期喂养的影响分析

目的:总结双歧杆菌对早产儿早期喂养的影响。方法:将90例早产儿随机分组,对照组采用常规治疗,观察组在常规治疗的基础上口服或鼻饲双歧杆菌。结果:观察组早产儿平均体重较对照组有明显升高,观察组喂养耐受能力较对照强,两组比较差异有统计学意义(P<0.05)。结论:双歧杆菌不仅能加速早产儿的追赶性生长,还能增进早产儿的胃肠功能的发育和完善,利于肠道微生态的建立和益生菌的定植,更有利早产儿的健康成长。     

双歧杆菌三联活菌胶囊治疗早产儿喂养不耐受疗效观察

目的 观察口服双歧杆菌三联活菌胶囊治疗早产儿喂养不耐受的疗效.方法 将56例喂养不耐受早产儿随机分为治疗组和对照组各28例,对照组给予常规护理、补液、胃肠内外营养,治疗组在常规治疗的基础上加服双歧杆菌三联活菌胶囊观察两组患儿的疗效.结果 治疗组有效率(92.9 %)优于对照组(60.7 %),二者比较差异有统计学意义 (P<0.05).结论 双歧杆菌三联活菌胶囊治疗早产儿喂养不耐受疗效显著.药价便宜,使用方便,值得临床推广应用.     

鼻塞式气道正压通气治疗早产儿早期微生态干预的前瞻性研究

目的：探讨应用气管插管－使用肺表面活性物质－拔管使用经鼻塞式气道正压通气（intubation surfactant-extubation,INSURE）策略的早产儿早期肠道内添加益生菌制剂金双歧的临床价值。方法将符合条件的给予 INSURE 策略治疗的患有呼吸窘迫综合征早产儿86例随机分为对照组42例和试验组44例,对照组给予常规治疗,试验组在此基础上给予口服双歧杆菌乳杆菌三联活菌片治疗,0．5 g／次,3次／d,对治疗效果进行统计学分析。结果与对照组相比,试验组喂养不耐受发生率低（χ2＝4．693,P ＜0．05）,达全胃肠喂养所需时间早（t ＝2．385,P ＜0．05）,温盐水灌肠次数减少（t ＝2．925,P ＜0．05）,更早恢复出生体质量（t ＝4．541,P ＜0．05）,发生胆汁淤积比率降低（χ2＝4．671,P ＜0．05）。2组坏死性小肠结肠炎发生率差异无统计学意义,试验组无益生菌相关性败血症发生。结论对 INSURE 策略治疗早产儿进行更为积极的保护性喂养策略,即早期微量喂养同时添加肠道益生菌,对胃肠功能恢复、促进生长发育、减少胆汁淤积并发症等方面效果良好,无明显不良反应,值得临床推广。     

双歧杆菌制剂预防早产儿坏死性小肠结肠炎328例

目的:观察应用双歧杆菌制剂预防早产儿坏死性小肠结肠炎(NEC)的临床床效果。方法:将2011年1月-2012年1月在本院住院的328例早产儿按病例对照研究分成2组(预防组、对照组),2组除病因治疗、合理喂养外,预防组在24h内加双歧杆菌制剂164服。应用X2检验或确切概率法比较2组不同胎龄、不同出生质量早产儿NEC患病率的差异。结果:预防组164例中5例诊断为NEC,患病率为3.05%;对照组164例中21例诊断为NEC,患病率为12.80%。预防组早产儿的NEC患病率明显低于对照组(X2=8.60,P0.05)。胎龄32周早产儿,2组NEC患病率比较差异无统计学意义(X2=0.36,P0.10)。2组极低出生体质量早产儿NEC患病率比较差异无统计学意义(P=0.62);2组低出生体质量早产儿NEC患病率比较差异有统计学意义(X2=11.48,P0.05)。结论:预防性应用微生态制剂双歧杆菌制剂可明显降低早产儿NEC的患病率,可能与双歧杆菌制剂可促进早产儿肠道正常菌群的定植和优势化有关。微生态制剂预防性保护作用随胎龄减小有渐减趋势。     

微生态疗法对低体重儿感染的早期干预

目的:探讨微生态疗法对低体重儿感染的早期干预作用。方法:治疗组30例低体重儿于生后开始服用或胃管注入微生态制剂金双歧(高效双歧杆菌活菌制剂),观察院内感染发生情况,并于对照组30例低体重儿比较。结果:治疗组感染发生率(6·7%),显著低于对照组感染发生率(30%);两组病情平稳天数比较,5天治疗组病情平稳24例(80%),对照组13例(45%),10天治疗组病情平稳29例(96·7%),对照组22例(73·3%),治疗组病情平稳天数明显短于对照组,具有显著性差异。观察期间未见有任何不良反应。结论:早期使用微生态疗法可有效降低低体重儿的感染发生率,提高生存率具有重要的意义。     

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.