发作性疾病临床发作与24小时脑电图异常脑电发放的关系

分析了１８０例发作性疾病患者临床发作与２４ｈ动脉脑电图异常脑电发放的时相关系，存在三种情况，异常放电与临床发作时相一致；时相不一致及发作与发作间期均无异常放电，９３．３％的虱明确了诊断类别；９３％的癫痫确定了发作类型。讨论了动态脑电图对发作性疾病的诊断２价值及异常放电、癫痫及非癫痫之间的相互关系。     

长程视频脑电监测在诊断癫痫中的应用分析

目的:分析和研究癫痫患者视频脑电图表现,评价视频脑电监测技术在癫痫的诊断价值.方法:对2008年6月-2010年11月我科接收的248例发作性疾病患者视频脑电图2、6、12、24h监测结果进行回顾分析.分析临床发作与癫痫样异常放电之间的关系、异常放电出现的时相,癫痫分型与异常放电的关系,临床发作前脑电图的改变以及临床发...     

动态脑电图对儿童癫痫与非癫痫发作的诊断和鉴别诊断

目的 :探讨动态脑电图对小儿癫痫及非癫痫发作的诊断和鉴别诊断意义。方法 :对 10 3例临床确诊为癫痫及 47例可疑癫痫儿童进行 2 4h动态脑电监测。结果 :15 0例中脑电图总异常率为 6 8.6 %。癫痫组脑电异常率 77.7% ,痫样放电检出率 70 .9% ,可疑癫痫组脑电异常率为 40 .4% ,痫样放电检出率 19.1%。两组之间的异常率及痫样放电检出率均有显著性差异 (P<0 .0 1)。结论 :动态脑电图对小儿癫痫及非癫痫发作性疾病的诊断、鉴别诊断具有重要作用     

动态脑电图监测在诊断癫痫和某些发作性疾病中的应用

目的 探讨动态脑电图(AEEG)对发作性疾病的诊断及鉴别诊断价值。方法采用MB8000／MB8500(8道／16道)动态脑电图监测系统对812例发作性疾病患者行24h AEEG监测的资料作回顾性分析。结果812例发作性疾病患者中,AEEG异常者496例(61．08％),其中有痫样放电344例(69．35％),睡眠期痫样放电率84．88％(292例);496例AEEG异常者中在确诊癫痫及怀疑癫痫组为458例(92．34％),其它组异常者为38例(7．66％)。结论AEEG可提高痫样放电的检出率,对发作性疾病的诊断和鉴别诊断有重要的临床价值。     

视频脑电图监测对癫痫的临床应用价值

目的:探讨视频脑电图(Video-EEG)对癫痫的临床应用价值。方法:对975例发作性疾病患者进行连续90 min~24 h监测,其中包括清醒、睡眠期,分析临床发作和异常放电的关系。异常放电出现的时相,癫痫分型与异常放电的关系,临床发作前脑电图的改变,以及临床发作间期和发作期异常脑电图的不同表现。结果:975例监测到临床发作568例,期中同时伴异常放电者为443例,975例检出异常放电741例,确诊的443例中403例明确了发作类型,其中125例修正了发作类型,55例更换了药物治疗,16例适时停用了药物,76例难治性癫痫监测到发作前脑电图的异常改变,确定了致痫灶的位置,进行了手术治疗。结论:视频脑电图监测可提高痫样放电的检出率,有助于癫痫的诊断及分型,指导临床用药及术前致痫灶的定位。     

150例发作性疾病动态脑电图的诊断价值

目的分析150例发作性疾病24h动态脑电图（AEEG）,以评估其对发作性疾病的诊断价值。方法对150例发作性疾病常规脑电图（REEG）无痫样放电的患者行24h AEEG检查。结果150例发作性疾病患者中,85例初诊癫痫性发作,经24h AEEG监测60例出现痫样放电（70.58%）,非特异性异常7例（8.23%）,65例初诊非癫痫性发作中,经24h AEEG监测,12例显示痫样放电（18.46%）,6例有非特异性异常（9.23%）,150例中共72例有痫样放电（48%）。结论24h动态脑电图对发作性疾病的诊断和鉴别诊断有较高的临床价值。     

315例儿童发作性疾病24小时脑电图监测

监测３１５例各类反复发作性症状的患儿２４ｈ脑电图（ＡＥＥＧ）。结果表明：动态脑电图异常２２４例（７１．１１％）；其中１４２例（４５．０８％）记录到痫性放电，以惊厥发作和失神发作症状者阳性率最高。提示ＡＥＥＧ对儿童癫痫的诊断率高于常规脑电图，对儿童发作性疾病有独特的诊断价值。     

145例癫痫与发作性疾病24h动态脑电图分析

癫痫为短暂性、发作性疾病,常规脑电图(EEG)因描记时间短,患者脑电图痫样放电常不易被捕捉。本文通过对145例患者24h动态脑电图(AEEG)监测资料进行分析发现,AEEG因其监测时间长,使痫样放电的检出率得到较大提高。对于癫痫及非癫痫性发作性疾病的诊断、鉴别诊断具有重要意义。     

315例儿童发作性疾病24小时脑电图监测

监测３１５例各类反复发作性症状的患儿２４ｈ脑电图（ＡＥＥＧ）。结果表明：动态脑电图异常２２４例（７１．１１％）；其中１４２例（４５．０８％）记录到痫性放电，以惊厥发作和失神发作症状者阳性率最高。提示ＡＥＥＧ对儿童癫痫的诊断率高于常规脑电图，对儿童发作性疾病有独特的诊断价值。     

363例发作性疾病动态脑电图监测分析

癫痫的临床特点之一是发作性，而临床上还有许多其他疾病也表现为发作性，且发作形式多种多样，有些发作表现形式与癫痫十分相似，临床诊断困难，极易引起误诊。为探讨动态脑电图对癫痫与其他发作性疾病的诊断及鉴别诊断价值，现对我院利用动态脑电图对发作性疾病患者检查的结果进行分析如下。     

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.     

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.     

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.