脐血胆红素对新生儿黄疸早期干预的意义

目的研究脐血胆红素值对新生儿黄疸早期干预的意义。方法对本院240例足月健康新生儿,测定脐血胆红素值,监测每日经皮胆红素值(TCB),将新生儿按脐血胆红素浓度分<30μmol/L;30～40μmol/L;40～50μmol/L;>50μmol/L,共4组。比较4组新生儿TCB值及病理性黄疸例数,对脐血胆红素浓度预测新生儿黄疽进行分析。比较黄疸组新生儿和非黄疸组新生儿临床特征。结果随着脐血胆红素水平的升高,各组新生儿TCB、TSB值增高,病理性黄疸例数增高,脐血胆红索浓度用于预测新生儿黄疽发生率有统计学意义黄疽组新生儿脐血胆红素值显著高于非黄疸组(χ2=45.28,P<0.01)。经皮胆红素值与脐血胆红素值有高度相关性,(r=+0.871,P<0.01)。结论脐血胆红素能够对新生儿生前已具潜在原因引起的病理性黄疸予以早发现、早诊断、早治疗。     

经皮胆红素联合脐血胆红素检测预测新生儿病理性黄疸的价值

目的:研究经皮胆红素联合脐血胆红素检测预测新生儿病理性黄疸的价值。方法:采集100例新生儿脐血进行总胆红素测定,分别在出生后24h、48h及72h用经皮胆红素检测仪检测胆红素值;在出生后第3天检测血清胆红素浓度,判断新生儿病理性黄疸发生情况。结果:脐血总胆红素水平越高新生儿病理性黄疸的发生率越高;且当脐血总胆红素水平≥35μmol/L时,新生儿病理性黄疸发生率明显增高(P<0.05);病理性黄疸组新生儿生后3d内检测经皮胆红素日均值均较高,与非病理性黄疸组新生儿相比较,差异均有统计学意义(P<0.05)。结论:经皮胆红素联合脐血胆红素检测能够有效地预测新生儿病理性黄疸。     

脐血胆红素增加预测新生儿黄疸的价值

早期诊断新生儿黄疸对防治核黄疸具有重要意义。本文测定了166例足月正常新生儿脐静脉血清胆红素浓度．并用日本产无创伤经皮胆红素测量仪．动态检测新生儿经皮胆红素水平。结果表明：新生儿病理性黄疸发生率为34．94％，当脐血胆红素浓度<20μmol/L时．黄疸率为12．50%．而≥45μmol/L时．黄疸率高达81．82％．即随着脐血胆红素浓度的增加。新生儿病理性黄疸的发生率相应增高。提示：脐血胆红素测定能够更早地预测新生儿病理性黄疸，为早期诊断和治疗提供了可靠的理论依据。     

新生儿黄疸与窒息的关系探讨

目的分析新生儿窒息程度与高胆红素血症的关系。方法选择足月新生儿黄疸105例,包括无窒息者40例,轻度窒息者40例,重度窒息者25例,进行血清胆红素水平的测定。结果无窒息组、轻度窒息组、重度窒息组胆红素血症发生率分别为47.5%、27.5%、12.0%,3组的血清胆红素平均值分别为(206.5±49.6)μmol/L(、110.3±45.8)μmol/L、(58.7±24.3)μmol/L,3组之间有显著性差异(P<0.05)。结论新生儿窒息程度越重,其血清胆红素水平越低。     

脐血胆红素早期预测新生儿病理性黄疸的价值

目的：探讨脐血微量胆红素早期预测新生儿病理性黄疸的意义，方法：对130例足月新生儿采用脐血微量胆红素测定及经皮测胆红素测定（TCB），了解两者的相关性，并每日用TCB动态监测胆红素变化，在黄疸高山箕鹞 股静脉血进行血清胆红素测定以了解黄疸程度。结果：脐血胆红素与TCB呈正的直线相关（P＜0．01）。当脐血胆红素＜20μmol/L时，病理性黄疸发生率为0；当脐血胆红素21－34μmol/L时，黄疸发生率为32．84％，当脐血胆红素＞35μmol/L时，黄疸发生率为69．23％，随着脐血胆红素浓度增加，亲手儿病理性黄疸的发生率相应增加，结论：脐血胆红素测定能够早期预测新生儿病理性黄疸，并为早期诊断和治疗提供可靠依据。     

广西正常足月新生儿血清胆红素的测定及其相关因素分析

目的 制定广西正常足月新生儿(1～7 d)生理性黄疸血清胆红素的动态变化值,为临床诊断奠定基础.方法 (1)用微量法测定560例正常足月新生儿血清胆红素,记录围产期可能与新生儿黄疸有关的因素.(2)将研究对象按血清胆红素水平分为正常组和高胆红素组,比较两组间各种围产因素对血清胆红素的影响.结果 (1)正常足月新生儿出生后第二、三天出现黄疸,第四天到达高峰,峰值为(186.46±34.23)μmol/L,≥220.5 μmol/L者占28.68%,峰值的95%区间的上限为253.55μmol/L;男性与女性、汉族与壮族血清胆红素值的比较差异无统计学意义(P＞0.05).(2)在围产期因素中,正常组与高胆红素组的婴儿出生体重、母亲孕次的比较差异无统计学意义(P＞0.05),高胆红素组母亲年龄、孕周小于正常组(P＜0.05).结论 正常足月新生儿黄疸出现的时间及峰值与国内外报告相似,将本地区正常足月新生儿出生后峰值的95%区间的上限作为生理性黄疸的上限值,当血清胆红素值≥253.55 μmol/L,可作为新生儿高胆红素血症的诊断依据.     

金双歧治疗新生儿高胆红素血症34例疗效观察

为观察金双歧治疗新生儿高胆红素血症的疗效,将68例患儿随机分为两组,治疗组在常规治疗的同时加用金双歧治疗,疗程5~7d,观察血清胆红素下降水平及平均住院天数。结果,出院时治疗组血清胆红素含量为(61.06±35.75)μmol/L,明显低于对照组(89.38±49.98)μmol/L(P<0.05);平均住院天数治疗组为(5.08±1.34)d,明显低于对照组(6.67±1.66)d(P<0.05);治愈率治疗组为93.80%,明显低于对照组56.25%(P<0.01)。金双歧治疗新生儿黄疸,可迅速降低血清胆红素水平,明显缩短住院天数,提高治愈率。     

新生儿病理性黄疸的预防干预时间窗探讨

目的:探讨早期干预对新生儿病理性黄疸的预防效果。方法:对2012年3月至2014年12月分娩的302例足月新生儿脐静脉血进行肝功能检测,并分别在生后24 h、48 h及72 h给予脐血总胆红素浓度 >50.1μmol/L或脐血总胆汁酸测量值 >11.295μmol/L的新生儿进行提早干预治疗。结果:干预组新生儿病理性黄疸的发生率为23.65%,明显低于对照组的58.44%(P<0.01)。生后24 h干预组和生后48 h干预组及72 h干预组新生儿病理性黄疸发生率差异均无统计学意义(P>0.05)。结论:脐血总胆红素浓度>50.1μmol/L或脐血总胆汁酸测量值 >11.295μmol/L的新生儿于生后进行干预治疗能有效预防病理性黄疸,值得临床推广。     

妈咪爱治疗新生儿黄疸的疗效评价

目的观察妈咪爱在新生儿黄疸治疗中的临床疗效。方法50例新生儿黄疸患儿随机分为治疗组和对照组两组,每组25例。对照组进行常规治疗;治疗组在常规治疗基础上,加服妈咪爱,通过检测血清胆红素浓度观察其疗效。结果治疗组胆红素日均下降值为(61.22±28.63)μmol/L,明显高于对照组(39.87±23.11)μmol/L,P<0.01。平均治疗天数,治疗组为(4.1±2.4)d,明显比对照组(7.1±3.2)d短,P<0.01。结论妈咪爱用于新生儿黄疸治疗,可迅速降低血清胆红素水平,明显缩短治疗时间。     

南宁市足月新生儿胆红素动态观察

目的:了解本地足月新生儿黄疸的临床流行病学资料.方法:同时测定91例新生儿的经皮胆红素指数与血清总胆红素浓度值,求两者相关关系.用经皮胆红素仪测定227例足月健康新生儿的生后1～8天的经皮胆红素指数.结果:经皮胆红素指数与血清总胆红素浓度值存在相关关系.Y=0.76X+10.6(r=0.918,t=21.89,P＜0.001).黄疸在生后第4～5天达最深,均值为(180.9±45.0)μmol/L(10.6±2.6mg/dl).22.7%足月新生儿其总胆红素浓度大于12.9mg/dl,11.01%大于15mg/dl.结论:根据统计学原则将本地区正常新生儿生后第4～5天时的第95个百分位数作为生理性黄疸的上限,当血清胆红素浓度值≥271.9μmol/L(15.9mg/dl)为新生儿高胆红素血症的诊断标准.     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.