动态脑电图对儿童血管性头痛和头痛型癫痫的诊断作用

目的探讨儿童的头痛是血管性头痛所致还是头痛型癫痫引起.方法对54例经常头痛的患儿均作动态脑电图检查,并对脑电图结果进行分析.结果16例患儿脑电图正常,38例脑电图异常,其中3例出现特异性异常,可见棘波、尖波和棘慢波;35例非特异性异常,出现慢波、阵发性θ活动和δ活动.结论动态脑电图在儿童血管性头痛和头痛型癫痫方面有帮助诊断作用.     

失神癫痫儿童28例动态脑电图分析

目的 探讨儿童失神癫痫的动态脑电图特.方法 收集儿童失神癫痫患儿28例,记录其性别、年龄、起病年龄、发作频率、癫痫家族史、MRI检查等一般资料和临床特征,行24 h动态脑电图(AEEG)监测,分析失神癫痫儿童动态脑电图特征.结果 28例患儿AEEG均有特征性异常(异常率100%):26例(93%)出现发作期双侧对称同步的高波幅3 Hz棘慢复合波暴发,间歇期脑电图背景活动正常; 2例(7%)出现发作期广泛性1.52 Hz慢棘慢复合波或不规则的棘慢复合波发放,间歇期脑电图背景活动异常.结论 动态脑电图的阵发性全导联高波幅3 Hz棘慢复合波节律暴发或广泛性1.5～2.5 Hz的慢棘慢复合波、不规则棘慢复合波、慢波发放特征可作为儿童失神癫痫诊断和分型的依据.     

数字化脑电图对偏头痛与头痛型癫痫的对比研究

目的探讨数字化脑电图仪应用在偏头痛与头痛型癫痫患者中的检查效果。方法选择120例典型偏头痛患者及30例头痛型癫痫患者进行脑电图检测，并进行对比研究。结果典型偏头痛患者与头痛型癫痫患者脑电图有明显差异，尤其以青少年人群表现更加明显。结论成人偏头痛患者的脑电图异常率略低，而青少年期病人的异常率较高，有慢波活动。头痛型癫痫患者的脑电图则存在明显发作波。     

634例头痛患儿的脑电图分析

目的:通过对本组634例临床上大多诊断为头痛型癫痫患儿脑电图的分析,对头痛型癫痫这一诊断有进一步的认识。方法:对634例头痛患儿进行常规脑电图检查,并分析脑电活动的特点。结果:脑电图非特异性异常259例(40.5%),其中捕捉到痫样放电15例(2.36%),痫样放电多见于过度换气诱发时出现。结论:头痛型癫痫之诊断虽然可能存在,但为数甚少,须强调临床症状,结合脑电图之痫样放电,才能明确。     

71例以头痛为主诉的癫痫脑电图分析

目的:通过对71例儿童以头痛为主诉的癫痫脑电图分析,提出脑电图对该病的诊断意义.方法:采用光电脑电图检查仪及康泰脑电图仪,按国际脑电图学会的建议描记.结果:通过常规检查和诱发试验大多数显示阵发性两侧半球或两侧前额、额部对称同步性中至极高波幅4-7 c/sθ节律、阵发性或散发性棘波、棘-慢波、棘-慢综合波、尖波;少数局限于颞,顶枕部的棘-慢波异常放电波.结论:脑电图对诊断以头痛为主诉的癫痫有着特殊的意义.     

头痛型癫痫与脑电图诊断30例报告

头痛型癫痫是癫痫的特殊类型 ,酷似偏头痛 ,常可误诊。我院 1995年 3月至 1999年 10月对 90 0例头痛患者进行了脑电图检查。现将脑电图显示痫样放电 (棘波、尖波、尖 -慢综合波、棘 -慢综合波、爆发性高波幅δ节律波等 ) ,并经抗癫痫药治疗有效 ,而确诊为头痛型癫痫的 30例报告如下。1　临床资料本组 30例确诊为头痛型癫痫 ,男 14例 ,女 16例。年龄最小 6岁 ,最大 4 0岁 ,其中青少年期发病患者居多。病程半年至 2 0年。临床表现主要为发作性剧烈头痛 ,其性质多为胀痛、刺痛或跳痛 ,大部分位于前额和两颞区 ,也有累及全头部。持续时间数分钟…     

头痛型癫痫206例分析

目的 明确头痛型癫痫的临床特点和诊断方法。方法 对确诊的206例患者资料进行回顾性分析。结果 头痛型癫痫的头痛部位以额区、颞区居多,同时多伴有头晕、恶心、呕吐等症状;在异常脑波中128例（86．48％）为暴发性高幅（80－300μV)慢活动,20例（13．51％）出现棘波、尖波或棘／尖慢综合波,52．43％的病人对HV产生慢高化反应。确诊后给予苯妥英钠、丙戊酸钠及卡马西平等治疗效果良好。结论 头痛型癫痫的头痛为发作性,可伴有头晕、恶心、呕吐、腹痛等植物神经症状,抗癫痫治疗有效等有助于诊断。     

小儿癫痫临床及脑电图特点

探讨脑电图在小儿癫痫诊断上的意义。方法：277例癫痫儿童均采用脑电图检查，比较临床及脑电图结果。结果：临床上怀疑癫痫者，其脑电图异常219例（约79％），表现为应该出现的波不出现，或者其波幅降低或增高，脑波发展延迟，出现与年龄不符脑电图波型。只有部分病例 出现发作性棘波、尖波、棘慢波综合、尖慢波综合等特殊病理波。结论：脑电图检查是小儿癫痫诊断的重要依据。     

33例儿童头痛性癫痫随访分析

目的：探讨头痛性癫痫的诊断及与偏头痛的鉴别诊断。方法：分析由基层医院诊断为头痛性癫痫的33例患儿的临床资料．经详细询问病史，进行仔细的体格检查，复查脑电图（EEG）2～5次后，重新确定诊断，实施治疗并进行临床随访。结果：在此33例患儿中，14例纠正诊断为偏头痛，16例纠正诊断为神经性头痛。复查EEG结果显示大部分在正常范围，部分异常EEG中以弥漫波增多为主，仅有3例EEG显示有散在痫样波，结合临床表现符合头痛性癫痫的诊断。结论：头痛性癫痫临床少见，单纯以头痛表现诊断为癫痫是不可靠的，必须依靠临床表现、EEG检查结果综合判断，并和偏头痛进行鉴别。以头痛为主诉的儿童不应轻易诊断为癫痫。     

剥夺睡眠对头痛型癫痫的诊断

２４例头痛型癫痫的脑电图特征，主要表现来各区可见散在性棘波或尖波；两侧同步，阵发性发放３－４Ｈｚ高波幅慢波棘慢综合本病以突发性剧裂头痛为主要特征。服用止痛药无效，应用抗癫痫药物治疗有特效。常规脑电图检查仅有４５．８％，呈异常改变，异常漏检率达４７．８％。     

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.