对64例急性一氧化碳中毒迟发性脑病的脑电图观察分析

目的分析急性一氧化碳中毒迟发性脑病的临床表现与脑电图（EEG）异常改变,为判定和指导治疗提供依据。方法对64例脑电图（EEG）及临床表现进行回顾性分析。结果 64例患者急性一氧化碳中毒昏迷清醒后不久出现迟发性脑病特有的神经精神症状与体征,全部病例EEG均表现为异常,脑电图主要特征为广泛性不规则高波幅慢活动（δ、θ）连续性出现,以额、中央、颞区占优势,严重者可呈平坦波及爆发-抑制波。患者意识状态分为清醒、混浊、昏迷,脑电图结果分别是轻、中、重度异常。结论 EEG检查对急性一氧化碳中毒迟发性脑病的预防、临床治疗指导康复、降低迟发性脑病的发生率等方面具有重要指导意义。     

高压氧治疗一氧化碳中毒迟发性脑病52例

目的：探讨高压氧治疗一氧化碳中毒迟发性脑病的疗效。方法：对52例一氧化碳中毒迟发脑病患者进行高压氧治疗,治疗前、后分别对患者进行脑电图、临床疗效分析。结果：高压氧治疗后临床症状明显改善,脑电图也较治疗前明显改善。临床症状的改善与疗程和脑电图的好转呈平行关系。结论：高压氧治疗一氧化碳中毒迟发性脑病疗效显著;疗效与治疗疗程有关,脑电图对临床治疗和疗效的判定有指导意义。     

一氧化碳中毒后迟发性脑病20例临床分析

目的探讨一氧化碳中毒后迟发性脑病临床特点,脑电图及MRZ表现,治疗和预后。方法对20例一氧化碳中毒后迟发性脑病患者病因、临床表现、脑电图、MRZ表现、治疗及预后进行统计学分析。结果一氧化碳中毒迟发性脑病可发生于任何年龄,临床表现多样,头MRZ可有特征性“虎眼征”及大脑白质对称长T1、长T2信号,脑电图表现不规则慢波,经高压氧治疗及对症治疗,临床症状可有不同程度改善。结论只要有一氧化碳中毒就有一氧化碳中毒迟发性脑病的可能,高压氧治疗是影响预后的关键。     

急性一氧化碳中毒后迟发性脑病的临床特点及护理干预

目的 探讨急性一氧化碳中毒后迟发性脑病的临床特点及护理措施.方法 对2010年1月-2011年12月我院收治的22例急性一氧化碳中毒患者的临床资料进行回顾性分析,总结其临床特点,探讨护理干预方法.结果 急性一氧化碳中毒后迟发性脑病中老年人的发病率较高,其临床表现复杂,CT、MRI及脑电图检查可见异常表现.经治疗和护理干预后22例患者中痊愈16例,显效4例,好转2例,无效0例,显效率为90.9%.结论 针对急性一氧化碳中毒后迟发性脑病的临床特点,采取积极的护理干预措施,可显著提高临床疗效.     

CT、MRI对急性一氧化碳中毒后迟发性脑病的预后评估价值分析

目的研究分析CT、MRI对急性一氧化碳中毒后迟发性脑病的预后评估价值。方法选取2014年8月-2016年12月期间在我院进行诊治的一氧化碳中毒患者进行回顾性分析,一共120例,随机将全部患者分成研究组与对照组,每组患者60例,其中对照组患者在发病48小时内进行CT检查,研究组患者在发病48小时内进行MRI检查,观察两组患者的临床情况。结果 CT和MRI检查中的腔隙性脑梗死和脑白质疏松对于急性一氧化碳中毒后迟发性脑病的发生有着关联性,而且进行检查预后,迟发性脑病的发生率得到了降低。结论 CT和MRI检查图像能清晰显示一氧化碳中毒患者的脑病情况,为迟发性脑病的临床治疗和预后判断提供了参考依据,对急性一氧化碳中毒后迟发性脑病的预后评估和诊断价值高。     

急性一氧化碳中毒后迟发性脑病的脑电图分析

目的 探讨急性一氧化碳中毒后迟发性脑病(DEACMP)的脑电图特征.方法 选择35例急性一氧化碳中毒后迟发性脑病患者分别在入院首日、治疗后7天、15天以及25天后行脑电图检查和动态观察.结果 入院首日、治疗后7天、15天以及25天后脑电图的异常率分别为100％、97％、71％、23％,脑电图异常主要特征为弥漫性慢活动增多.结论 动态观察脑电图α波和δ、θ活动对DEACMP病情判断具有不可忽视的价值.     

高压氧治疗一氧化碳中毒迟发性脑病52例

目的:探讨高压氧治疗一氧化碳中毒迟发性脑病的疗效。方法:对52例一氧化碳中毒迟发脑病患者进行高压氧治疗,治疗前、后分别对患者进行脑电图、临床疗效分析。结果:高压氧治疗后临床症状明显改善,脑电图也较治疗前明显改善。临床症状的改善与疗程和脑电图的好转呈平行关系。结论:高压氧治疗一氧化碳中毒迟发性脑病疗效显著;疗效与治疗疗程有关,脑电图对临床治疗和疗效的判定有指导意义。     

肌苷注射液治疗急性一氧化碳中毒后迟发性脑病93例临床观察

目的：观察肌苷在急性一氧化碳（CO）中毒后迟发性脑病预防性治疗中的作用。方法：在给予高压氧、脑细胞活化荆等治疗的基础上加用肌苷注射液治疗急性CO中毒48例，与同期采用安慰剂治疗45例进行比较，观察两组疗效。结果：在急性CO中毒后迟发性脑病患者的临床症状改善和患者脑CT或MRI检查改善情况，治疗组优于对照组（P〈0．05）。结论：肌苷注射液对预防急性CO中毒后迟发性脑病的发生有一定的疗效。     

急性一氧化碳中毒后迟发性脑病24例护理体会

目的:总结急性一氧化碳中毒后迟发性脑病的有关临床特征及护理方法.方法:对48 例急性一氧化碳中毒后迟发性脑病患者临床护理资料进行回顾分析.结果:48 例均有意识障碍(主要表现为意识改变,少数表现为意识水平受损)大部分有精神症状锥体外系功能障碍,部分病例有锥体系功能障碍,脑电图均有异常,本组痊愈32 例,好转16 例.结论:急性一氧化碳中毒后迟发性脑病主要表现为精神意识障碍、锥体外系和锥体系功能障碍,一旦发生经过合理的治疗和精心的护理,大多数患者预后良好.     

一氧化碳中毒迟发性脑病20例临床分析

急性一氧化碳中毒是常见急症，虽然经抢救治疗，绝大多数病人得以康复，但由于一部分人治疗不彻底易继发迟发性脑病，尤其是50岁以上老年人。一氧化碳中毒迟发性脑病是指急性一氧化碳中毒患者经治疗后临床症状消失，经过一段时间的假愈期后又出现神经精神症状。现将收治的20例报告分析如下：     

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.     

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.