肺表面活性物质结合一氧化氮吸入治疗新生儿持续肺动脉高压的护理

新生儿持续肺动脉高压是新生儿时期危重症之一,其特点是持续肺高压和右向左分流.引起持续性肺高压的主要因素是肺血管痉挛,常见病凶有窒息、呼吸窘迫综合征(RDS)、胎粪吸入和肺炎等.一氧化氮(NO)作为一种选择性肺血管扩张剂,近年来已广泛应用于治疗各种原因引起的新生儿持续肺动脉高压,并获得较好疗效.     

新生儿持续肺动脉高压60例临床分析

目的 探讨新生儿持续肺动脉高压(PPHN)的临床特点.方法 对2007年1月至2010年12月收治的60例PPHN患儿的原发疾病、治疗及转归情况进行分析.结果 经心脏超声确诊的60例PPHN新生儿原发疾病包括:围生期窒息、胎粪吸入综合征、细菌性肺炎、吸入性肺炎、湿肺、新生儿呼吸窘迫综合征、先天性膈疝、新生儿败血症等.在治疗原发疾病的同时,给予硫酸镁、吸氧或机械通气治疗,轻中度肺动脉高压患儿均临床治愈,18例重度肺动脉高压中有10例患儿死亡.结论 PPHN病因复杂,早期诊断和及时治疗是改善预后的关键.     

肺表面活性物质结合一氧化氮吸入治疗新生儿持续肺动脉高压的护理

新生儿持续肺动脉高压是新生儿时期危重症之一，其特点是持续肺高压和有向左分流。引起持续性肺高压的主要因素是肺血管痉挛，常见病因有窒息、呼吸窘迫综合征（RDS）、胎粪吸入和肺炎等。一氧化氮（NO）作为一种选择性肺血管扩张剂，近年来已广泛应用于治疗各种原因引起的新生儿持续肺动脉高压，并获得较好疗效。多年来国外临床及动物实验证实，加用肺表面活性物质治疗对多种新生儿严重肺部疾病，如RDS、     

高频振荡通气治疗新生儿持续肺动脉高压的研究

目的研究高频振荡通气治疗新生儿持续肺动脉高压的效果。方法选取我院2015年1月~2017年1月收治的80例新生儿持续肺动脉高压患儿,依据治疗方法将这些患儿分为高频振荡通气组(n=40)和常频机械通气组(n=40)两组,对两组患儿的原发病、血气指标、血压指标、并发症发生情况进行统计分析。结果高频振荡通气组患儿的胎粪吸入性肺炎、吸入性肺炎比例均显著高于常频机械通气组(P0.05),急性呼吸窘迫综合征、肺炎、湿肺比例均显著低于常频机械通气组(P0.05),PaO_2显著高于常频机械通气组(P0.05),FiCO_2、SPAP均显著低于常频机械通气组(P0.05),并发症发生率5.0%(2/40)显著低于常频机械通气组20.0%(8/40)(P0.05)。结论高频振荡通气治疗新生儿持续肺动脉高压的效果较常频机械通气好。     

感染与新生儿呼吸窒迫综合征相关因素的探讨

目的:探讨新生儿呼吸窘迫综合征的相关高危因素。方法:对68例呼吸窘迫综合征新生儿和70例无急性呼吸窘迫综合征的患儿进行相关因素的Logistic回归分析,探讨其相关的高危因素。结果:经回归分析后筛选出高危因素包括:感染、窒息缺氧、胎粪吸入以及择期剖宫产;其中对发生急性呼吸窘迫综合征影响最大的为感染因素,其次依次为缺氧窒息、胎粪吸入和择期剖宫产。结论:感染与新生儿呼吸窘迫综合征密切相关,是新生儿发生新生儿呼吸窘迫综合征的高危因素之一,应引起临床的足够重视。     

妊娠期肝内胆汁淤积症对围产儿的影响

目的:探讨妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)对围产儿结局的影响.方法:选择2000年1月～2002年12月以剖宫产分娩结束妊娠的ICP孕妇72例(病例组),观察其羊水胎粪污染、胎儿窘迫、早产、新生儿窒息、新生儿吸入性肺炎的发生率,与同期行剖宫产分娩的70例正常孕产妇(对照组)的妊娠结局和新生儿结局进行对比分析,并行胎盘组织超微结构的电镜检查.结果:病例组羊水胎粪污染、胎儿窘迫、早产、新生儿窒息、新生儿吸入性肺炎发生率分别为30.56%、23.61%、16.67%、5.56%、16.67%,与对照组相比差异有统计学意义(P＜0.05～0.01),病例组胎盘组织的超微结构有明显的异常改变.结论:ICP可导致羊水胎粪污染、胎儿窘迫、早产、新生儿窒息、新生儿吸入性肺炎.ICP胎盘的病理改变与围产儿结局有着密切的关系.     

高频振荡通气辅助治疗新生儿持续肺动脉高压效果

新生儿持续肺动脉高压(persistent pulmonarv hypertension of newborn,PPHN)是由多种原因引起的以新生儿肺循环压力和阻力持续增高,导致在动脉导管和卵圆孔水平出现右向左分流,表现为全身发绀,吸入高浓度氧后发绀不易缓解的循环性疾病。引起PPHN的常见原发病有新生儿胎粪吸入综合征、新生儿呼吸窘迫综合征、先天性膈疝及新生儿湿肺等。作者观察了PPHN患儿分别行常频机械通气和高频振荡通气(high frequency oscillatory ventilation,HFOV)治疗后的疗效,报道如下。     

胎粪吸入综合征的治疗进展

胎粪吸入综合征(MAS)是由于胎儿宫内窘迫或产时窒息排出胎粪,吸入后发生的肺部疾病.国外统计,活产儿中羊水胎粪污染率为10%～15%,羊水胎粪污染的新生儿只有5%发生MAS;30%的MAS患儿需行机械通气,病死率为3%～5%[1].MAS的特点是气道阻塞半阻塞导致肺不张、肺气肿,从而出现通气/血流比例紊乱及气漏.吸入胎粪所致呼吸道炎症反应导致酸中毒、低血氧、高碳酸血症,肺表面活性物质(PS)被抑制.窘迫导致肺血管重塑及肺动脉高压和肺损伤.MAS是引起新生儿呼吸衰竭的主要原因之一[2].     

不同孕周选择性剖宫产新生儿湿肺临床分析

新生儿湿肺症（wet lung syndrome of the new-born）,又称暂时性呼吸困难（transient tachypnea）或II型呼吸窘迫综合征（type II RDS）,是因肺内液体积聚和清除延迟引起的轻度自限性呼吸系统疾病。国外研究表明,剖宫产特别是选择性剖宫产出生的足月儿中易发生新生儿湿肺,一旦发生,容易产生并发症如肺气漏、持续性肺动脉高压（PPHN）等[1]。     

胎粪吸入综合征的治疗进展

胎粪吸入综合征(MAS)是由于胎儿宫内窘迫或产时窒息排出胎粪,吸入后发生的肺部疾病。国外统计,活产儿中羊水胎粪污染率为10%~15%,羊水胎粪污染的新生儿只有5%发生MAS;30%的MAS患儿需行机械通气,病死率为3%~5%[1]。MAS的特点是气道阻塞半阻塞导致肺不张、肺气肿,从而出现通气/血流比例紊乱及气漏。吸入胎粪所致呼吸道炎症反应导致酸中毒、低血氧、高碳酸血症,肺表面活性物质(PS)被抑制。窘迫导致肺血管重塑及肺动脉高压和肺损伤。MAS是引起新生儿呼吸衰竭的主要原因之一[2]。1吸出胎粪、支气管灌洗国内报道活产儿中羊水胎粪污染率约9%…     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.