硫酸镁与大环内酯类联合治疗毛细支气管炎43例疗效观察

目的:探讨硫酸镁与大环内酯类联合治疗毛细支气管炎的疗效。方法:将78例毛细支气管炎住院患儿随机分为两组。治疗组应用25%硫酸镁(0.2~0.3)ml/kg,用10%葡萄糖注射液稀释至浓度为0.25%0.5%缓慢静脉点滴,每日1次,连用3 d5 d;联合应用大环内酯类抗生素静脉点滴。对照组未用硫酸镁,抗生素应用青霉素或头孢菌素静脉点滴。其他治疗两组相同。结果:观察喘憋消失时间、呼吸急促缓解时间、咳嗽及肺部音消失时间,治疗组较对照组均明显缩短。结论:应用硫酸镁联合大环内酯类抗生素治疗毛细支气管炎安全、有效。     

婴幼儿肺炎青霉素类药物静滴给药方法的探讨

青霉素类抗生素仍是治疗婴幼儿肺炎的首选药物,且静脉给药是可靠的给药途径.但青霉素类抗生素静脉给药的间隙时间问题并未引起部分临床医师的足够重视,使抗生素未能发挥应有的疗效,影响了治疗效果,为此,我们对婴幼儿肺炎青霉素类抗生素静滴给药方法进行探讨.     

婴幼儿肺炎青霉素炎药物静滴给药方法的探讨

青霉素类抗生素仍是治疗婴幼儿肺炎的首选药物,且静脉给药是可靠的给药途径.但青霉素类抗生素静脉给药的间隙时间问题并未引起部分临床医师的足够重视,使抗生素未能发挥应有的疗效,影响了治疗效果,为此,我们对婴幼儿肺炎青霉素类抗生素静滴给药方法进行探讨.     

289例药疹临床分析

目的：探讨临床应用药物与药疹发生的关系以及药疹的防治。方法：对我院皮肤科自2000年1月-2006年12月间因药疹到门诊就诊或住院的患者的临床资料进行分析。结果：289例患者中有196例可明确为1种致敏药物，占67．8％（196／289）。由青霉素类引起的药疹共有71例，占36．2％（71／196），其中阿莫西林45例，安西林21例，苄星青霉素G5例。磺胺类引起的药疹共有36例，占18．4％（36／196）。解热镇痛药引起的药疹共有56例，占28．6％（56／196），其中扑热息痛24例，吲哚美辛26例。青霉素类及解热镇痛药引起的药疹中重症药疹分别占8．5％（6／71）及8．9％（5／56）。巴比妥类引起的药疹共13例，占6．6％（13／196），其中重症药疹占38．5％（5／13）。治疗所需的糖皮质激素控制剂量多为80—120mg／d，病程较长。结论：青霉素类、解热镇痛类及磺胺类药物是引起药疹最常见的药物。引起重症药疹的药物主要为青霉素类、解热镇痛药以及巴比妥类。     

药疹80例临床分析

随着新药的不断出现,药疹的发生率愈来愈高。对致敏药物种类和药疹类型作统计分析,无论对药疹的诊断还是防治都具有指导意义。本文选取我院１９９８年１月至２０００年４月住院药疹患者８０例作致敏药物及药疹类型统计分析,报告如下。１临床资料１．１一般资料 ８０例药疹患者中,男４３例,女３７例,年龄３～７３岁。用药到症状出现,潜伏期半小时～１２夭,首次用药潜伏期４～１２天,再次或多次应用者潜伏期为半小时～４８小时。１．２药物与类型 致敏药物与药疹类型见表１。引起药疹的致敏药物中,青霉素类有青霉素钠盐、氨苄青霉素…     

药物性皮炎152例临床探讨

目的：分析药疹的临床特征。方法：采取回顾性分析方法对152例住院药疹患者的临床资料进行分析,内容包括性别、年龄、疹型、致敏药物、潜伏期、药物反应史、并发症、治疗转归。结果：年龄以40-49岁组最多,药疹类型以发疹型最常见,致敏药物青霉素类、解热镇痛类、头孢菌素类最常见,平均潜伏期5.6d,既往有药物过敏史的病例占32.6%。合并肝功能损害18例,肾功能损害13例。所有病例痊愈及好转出院,无死亡病例。结论：临床医师在应用易引起药疹药物时要特别警惕药疹的发生。     

国产氨苄青霉素所致小儿药疹的临床观察

用国产氨苄青霉素治疗小儿感染性疾病440例,其中引起药疹者38例,药疹率为8.6%。药疹与病种、性别无关,年龄以3岁以后多见,季节以7～9月份为多。经用抗组胺药等处理,药疹消退时间平均12.5d,无其它不良反应。     

中西医结合治疗药物性皮炎30例临床观察

药物性皮炎是药物通过口服、注射、吸入等途径进入人体后引起皮肤粘膜的反应。在致敏药物中抗菌素占有较大比例，其中以青霉素为多见。在临床中很多患者由于各种感染而应用抗菌素治疗，在感染未能完全控制时，又出现药物性皮炎。自1983年至1993年我们采用清热凉血解毒法配合抗组织胺药、激素治疗药物性皮炎合并感染30例,取得了较好的疗效，现报告如下:临床资料30例患者中男12例，女18例；年龄最小18岁，最大65岁，平均年龄40．5岁；其中红斑类药疹24例，水疱类药疹4例，皮炎类药疹2例。全部病例均有高热，白细胞总数增高或中性增高等不同程…     

1例青霉素过敏抢救不当引起死亡的教训

青霉素类药物是临床使用率最高的药物 ,由于其抗菌谱广 ,疗效好 ,除过敏反应外 ,一般很少报导其它不良反应。过敏反应抢救及时 ,措施得力 ,成功率很高 ,无后遗症。过敏抢救不及时 ,措施不得力往往引起病人在短时间内因心源性休克或喉头水肿死亡。最近某院 1例因静脉点滴青霉素钠盐、氧哌嗪青霉素引起过敏死亡的病例。1　临床资料　　患者陈×× ,男 ,76岁 ,宜春市人 ,因咳嗽、上感在门诊给予对症治疗 ,一般情况尚好 ,曾有冠心病史。给予5 %葡萄糖加青霉素钠盐 480万单位 ,5 %葡萄糖生理盐水5 0 0ｍｌ加氧哌嗪青霉素 4ｇ静脉点滴 ,每日一次 ,…     

氨基苄青霉素所致药疹的临床观察

氨基苄青霉素（简称氨苄）是临床上常用的广谱合成青霉素，对革兰阴性杆菌效能较强，对伤寒疗效甚佳。其主要的副作用为引起药疹，据有关资料报道药疹率高达２４％，多数为８％左右。１９９５～２０００年期间，我们对应用氨苄治疗的２７８例患者进行了这方面的观察，现报道如下。 １ 资料与方法： 1.1 对象：住院患者２７８例。年龄１６～７０岁，男１２２例，女１５６例。患者既往均无青霉素过敏史，治疗前青霉素皮试均阴性。多数单用氨苄抗感染治疗，少数用两种抗菌药物联合治疗。以静脉给药为主，少数采用肌注，剂量为每天２～４克的３…     

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.