小儿肺炎支原体肺炎抗生素序贯疗法的临床观察

目的探讨抗生素序贯疗法对小儿肺炎支原体肺炎的治疗效果。方法将68例肺炎支原体肺炎住院患儿分为2组,34例为序贯治疗组(A组),开始以红霉素30 mg.kg-1.d-1静脉滴注,1次/d,连用3 d,病情较重者,连用5 d,改口服阿奇霉素10 mg.kg-1.d-1,1次/d,连服3 d停4 d。34例为常规治疗组(B组),采用单纯红霉素30 mg.kg-1.d-1静脉滴注,1次/d,连用10 d。10 d疗程结束后根据疗效评定标准比较2组疗效及不良反应。结果临床有效率:序贯治疗组为97.1%,常规治疗组为67.6%,2组间有显著性差异(P<0.05),不良反应在开始治疗前3 d无显著性差异(P>0.05),在治疗后7 d有显著性差异(P<0.05)。结论小儿肺炎支原体肺炎采用抗生素序贯疗法优于单纯用红霉素治疗,不良反应发生率低,且安全、有效、方便、依从性好,可缩短住院时间,减少住院费用,减少患儿家长的陪伴时间,减轻家长的精神负担。     

红霉素、阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的价值分析

目的:分析红霉素、阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的临床价值。方法:抽取我院2017年1月—2018年3月收治的92例肺炎支原体肺炎患儿作为观察对象,将其分为对照组和观察组,各46例。对照组接受阿奇霉素治疗方法,观察组接受红霉素、阿奇霉素序贯疗法,对比分析两组临床效果和不良反应发生情况。结果:观察组总有效率(97. 83%)高于对照组(91. 30%),其不良反应发生率(2. 17%)则低于对照组(17. 39%),组间比较差异有统计学意义(P <0. 05)。结论:红霉素、阿奇霉素序贯疗法在小儿支原体肺炎治疗中能够提高临床疗效,降低不良反应发生率,值得推广和应用。     

3种方案治疗小儿肺炎支原体肺炎的成本-效果分析

目的 评价3种方案治疗小儿肺炎支原体肺炎的成本-效果.方法 A组:乳糖红霉素每日2次,静脉滴注5 d.热退、症状控制后改用阿奇霉素,连服3 d,停4d,如此服用3个周期.B组:阿奇霉素静脉滴注,一日一次,连续使用5d;热退、症状控制后改用阿奇霉素连服3 d,停4d,如此服用3个周期.C组:乳糖红霉素每日2次,静脉滴注10d.结果 A组(红霉素+阿奇霉素序贯治疗方案)成本最低.结论 红霉素+阿奇霉素序贯治疗方案是治疗小儿肺炎支原体肺炎的最佳方案.     

阿奇霉素三种方案治疗小儿支原体肺炎疗效观察

目的 探讨阿奇霉素不同给药方案治疗小儿肺炎支原体肺炎的疗效.方法 94例支原体肺炎患儿随机分成A、B、C三组,A组32例、B组31例、C组31例.A组应用阿奇霉素10mg/(kg·d)静滴,连用5～7d;B组先应用阿奇霉素10mg/(kg·d)静滴,连用3d,然后改用阿奇霉素10mg/(kg·d)口服,连用3～4 d;C组应用阿奇霉素10mg/(kg·d)口服,连用5～7d.结果 A、B、C三组均有良好治疗效果,三组之间治愈率没有显著差异(P＞0.05).结论 治疗轻、中型小儿支原体肺炎,口服阿奇霉素治疗效果良好,值得推广应用.     

阿奇霉素治疗小儿支原体肺炎的临床疗效观察

目的　探讨小儿肺炎支原体肺炎 (MP)的治疗方法。方法　将诊断为MP的 174例患儿随机分成 2组 ,治疗组 88例给予阿奇霉素粉针剂 6～ 10mg·kg- 1 ·d- 1 ,溶于 5 %葡萄糖溶液 2 5 0ml中 ,60min内静脉滴注 ,每日 1次 ,疗程 3～ 5天 ;对照组给予红霉素粉针剂 2 0～ 3 0mg·kg- 1 ·d- 1 ,溶于 5 %葡萄糖溶液中 ,静脉滴注 ,疗程 7～ 14天。结果　阿奇霉素治疗肺炎支原体肺炎退热时间、3个月时随访复发率与红霉素对照组无显著性差异 (P >0 .0 5 ) ,咳嗽消失时间、肺部罗音消失时间、X线吸收消散时间 ,治疗组均明显短于对照组 ,两组比较有显著性差异 (P <0 .0 1或 <0 .0 5 )。结论　阿奇霉素治疗小儿肺炎支原体肺炎疗效确切 ,值得推广。     

阿奇霉素与红霉素治疗肺炎支原体肺炎的比较

目的:探讨小儿支原体肺炎的临床治疗方法及疗效。方法:将确诊为肺炎支原体肺炎的84例患儿随机分为治疗组和对照组各42例,治疗组采用阿奇霉素10 mg/(kg·d)静脉滴注,1次/d,3⁵ d为一个疗程,后口服阿奇霉素分散片10 mg/(kg·d)序贯治疗,服3 d停4 d,连用25 d为一个疗程,后口服阿奇霉素分散片10 mg/(kg·d)序贯治疗,服3 d停4 d,连用2³个疗程;对照组采用红霉素203个疗程;对照组采用红霉素20³0 mg/(kg·d)静脉滴注,1次/d,730 mg/(kg·d)静脉滴注,1次/d,7¹4 d为一个疗程,后口服阿奇霉素分散片序贯治疗214 d为一个疗程,后口服阿奇霉素分散片序贯治疗2³个疗程。两组均给予对症治疗,比较两组临床疗效和症状、体征消失时间、住院天数及不良反应。结果:治疗组和对照组总显效率分别为97.61%和95.23%,两组比较差异无统计学意义。治疗组的体温复常时间、咳嗽消失时间、啰音消失时间及平均住院天数比对照组明显缩短,存在的差异有统计学意义(P<0.05);且治疗组的局部静脉疼痛、胃肠道反应等不良反应发生率较对照组明显减低(P<0.05)。结论:阿奇霉素序贯治疗小儿支原体肺炎具有临床疗效确切、安全、经济方便、依从性好等优点,值得临床推广使用。     

阿奇霉素三种方案治疗小儿支原体肺炎疗效观察

目的探讨阿奇霉素不同给药方案治疗小儿肺炎支原体肺炎的疗效。方法94例支原体肺炎患儿随机分成A、B、C三组,A组32例、B组31例、C组31例。A组应用阿奇霉素10mg/(kg·d)静滴,连用5～7d;B组先应用阿奇霉素10mg/(kg·d)静滴,连用3d,然后改用阿奇霉素10mg/(kg·d)口服,连用3～4d;C组应用阿奇霉素10mg/(kg·d)口服,连用5～7d。结果A、B、C三组均有良好治疗效果,三组之间治愈率没有显著差异(P>0.05)。结论治疗轻、中型小儿支原体肺炎,口服阿奇霉素治疗效果良好,值得推广应用。     

采用阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎40例的疗效与安全性分析

目的：分析采用阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的疗效与安全性。方法：于2014年9月至2015年9月期间选取小儿肺炎支原体肺炎患者80例,随机分为对照组和观察组两组,分别采取红霉素、阿奇霉素序贯疗法治疗,后比较两组患者的临床疗效。结果：观察组患儿的住院时间、疾病症状消失时间、不良反应发生率等均优于对照组,P ＜0．05。结论：采取阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎,疗效显著且安全性较好。     

阿奇霉素和红霉素治疗儿童支原体肺炎用法和疗效比较

目的:比较红霉素序贯阿奇霉素与阿奇霉素治疗儿童支原体肺炎的疗效.方法:符合诊断标准的支原体肺炎患儿58例,依先后分为两组,30例采用红霉素30mg/㎏·d,分2次静脉滴入,连用3天,改用阿奇霉素10mg/㎏·d,静脉滴入5天,停4天,以静滴量再口服3天.28例采用阿奇霉素10mg/㎏·d,静脉滴入5天,停4天,以静滴量再口服3天停药.结果:红霉素序贯阿奇霉素组的痊愈率93.3%,明显高于阿奇霉素组85.7%(P＜0.05),症状、体征消失较快.结论:儿童支原体肺炎时应首选红霉素控制支原体血症,然后再用新一代大环内酯类抗生素阿奇霉素序贯治疗,比开始采用阿奇霉素的疗效好,显效快,值得推广.     

红霉素和阿奇霉素治疗小儿肺炎支原体肺炎疗效比较

目的:对红霉素和阿奇霉素治疗小儿肺炎支原体肺炎疗效和不良反应进行比较。方法:把确诊为肺炎支原体肺炎的患儿分成A、B两组,分别用红霉素静脉滴注和阿奇霉素序贯疗法进行治疗。结果:A组的治愈率为85.4%,不良反应发生率为29.2%;B组治愈率为100.0%,不良反应发生率10.4%,差异有显著性。结论:用阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎比红霉素有较高的治愈率和较低的不良反应发生率。     

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.