489例智力低下儿童病因分析

目的　探讨儿童智力低下的病因及其影响因素的关系。方法　对 489例智能低下儿童采取询问出生史、家族史、行智力测验和染色体、内分泌、TORCH感染检查等方法。结果　 489例病儿中轻度智力低下 136例 ,中度 16例 ,重度191例。其中生物医学因素占 6 5 .2 4% ( 319/489) ,社会文化心理因素占 2 .0 4% ( 10 /489) ,原因不明占 32 .72 % ( 16 0 /489)。结论　保持生殖健康 ,做好产前诊断及围生期保健工作是预防儿童智力低下的重要措施。     

90例窦性心动过缓食道调搏分析

目的　探讨在门诊和住院患者中经心电图证实 ,心率在 4 0～ 5 5次 分的窦性心动过缓 (窦缓 )病人中窦房结起搏功能低下和迷走神经张力变化所起的作用。方法　对 90例心率在 4 0～ 5 5次 分的窦缓病人行食道调搏和药物阻滞试验 ,测定窦房结恢复时间 (SNRT)及迷走神经张力 ,对其结果进行回顾性分析。结果　 90例窦缓病人中迷走神经张力增高者占 6 5 6 % ;窦房结功能低下者占 34 4 %。 4 5岁以下组迷走神经张力增高明显多于窦房结功能低下 ,分别为 83 3%和 16 7%。而 4 5岁 (包括 4 5岁 )以上组情况正相反 ,分别为 2 6 2 %和 73 8%。结论　在心率为 4 0～ 5 5次 分的窦缓病人中窦房结功能低下和迷走神经张力增高所起的作用随年龄组的不同而不同。年龄较大者 (≥ 4 5岁 )窦房结起搏功能低下起主要作用 ,相反 (<4 5岁 )迷走神经张力增高起主要作用。窦房结功能低下在两组中有显著差异 (P <0 0 1)。     

949例学习成绩不良儿童智力测试结果分析

1994年 3月～ 2 0 0 1年 12月于我院儿保门诊以学习成绩不良就诊的在校中小学生达 94 9例 ,我们对其进行韦克斯勒智力测验 ,并对结果进行分析与讨论。1　材料和方法1.1　资料来源　本组 94 9例中男 6 6 4例 ,女 2 85例。 6～ 10岁男 4 98例 ,女 2 85例 ,11～ 12岁男 86例 ,女 35例 ,13～ 14岁男 80例 ,女 35例。1.2　方法　采用韦克斯勒学龄儿童智力量表 (WISC R)进行测验 ,用总智商 (FIQ)代表智力总水平 ,同时分测出语言智商(VIQ)与操作智商 (PIQ) ,全部测验由专人经严格培训负责 ,所有测试都是在特定的智力测试房按要求进行。1.3　…     

结节性硬化症6例临床分析

结节性硬化症（TuberoussclerosisTS）是一种常染色体显性遗传性神经皮肤综合征。癫病和智力低下是患儿就诊的主要原因。近2年来，我们对以上述原因就诊的患儿进行脑CT检查时发现6例给节性硬化症患儿，报道如下。1临床资料本组6例，男2例，女各冽；年龄4个月、7个月、4岁各1例、9个月3例。6例均无产伤及产时窒息史。抽搐形式表现为婴儿痉挛者5例，癫痫大发作反倒。从出现抽搐到就诊时间为1天～3年。6例中除1例4个月患儿无明显智力低下外，其余5例中，4岁1例表现明显智力低下，4例均有智力发育落后和运动发育落后。全部患儿均可见到皮肤脱…     

新生儿惊厥120例病因分析

新生儿惊厥是由各种原因引起的新生儿时期常见急症 ,反复发作往往影响脑发育 ,常常留下脑瘫、癫痫、智力低下等不同程度的后遗症。为研究新生儿惊厥的病因及脑功能损伤的预防 ,现将我院 1997～ 1999年 12月收治的 12 0例新生儿惊厥病例分析如下。1　临床资料1 1　一般资料 :12 0例均为住院患儿 ,其中男 73例 ,女 4 7例。日龄 1～ 2 8天 ,<4天 4 9例 (40 8% ) ,～ 8天 31例(2 5 8% ) ,～ 2 8天 4 0例 (33 3% )。在城市医院出生的 39例 (32 5 % ) ,乡卫生院出生的 5 3例 (44 1% ) ,家庭出生的 2 8例 (2 3 3% )。早产儿 6 1例 (5 0 8% ) ,…     

智力低下儿童病因特征分析及护理措施

目的:探讨智力低下儿童的病因特征并制定出高效的护理措施。方法:选取1542户进行访问调查,接受调查的儿童共1380人。筛查方法视儿童年龄决定。研究采集受调查儿童父母的一般资料,通过神经科/遗传科以及儿科等方法进行病因特征分析。1380例儿童中0~8岁儿童621例,9~14岁儿童759例。农村儿童725例,占52﹒5%;城市儿童655例,占47﹒5%。研究分析儿童智力低下的病因特征,并进行相应的护理干预。结果:1380人中智力低下者15例,占1﹒1%,其中7例为轻度智力低下,占46﹒7%;4例为中度智力低下儿童,占26﹒7%;2例为重度智力低下,占13﹒3%;剩余2例为极重度智力低下,占13﹒3%。0~8岁儿童621例,其中智力低下儿童有8例,占1﹒29%;9~14岁儿童759例,其中存在智力低下儿童7例,占0﹒92%,0~8岁儿童出现智力低下的概率显著高于9-14儿童(P0﹒05);农村儿童725例,其中智力低下儿童有9例,占1﹒24%;城市儿童655例,发现智力低下儿童有6例,占0﹒92%,农村儿童出现智力低下的概率显著高于城市儿童(P0﹒05)。病因特征调查显示:出生前病因6例;出生时因素4例;出生后病因4例;病因不明者1例。结论:儿童智力低下受到多种因素干扰,要加强健康知识的宣传以及进行必要的护理干预以减少智力低下儿童的发生概率。     

头部外伤观察期迟发性外伤性颅内血肿的诊治经验

我科自 1994年 1月至 2 0 0 1年 6月 ,在头部外伤患者住院观察治疗期间 ,经CT复查共发现迟发性外伤性颅内血肿共 6 4例 ,现报告如下。1　临床资料1 1　一般资料　本组男 5 0例 ,女 14例 ,年龄 18～ 73岁。入院时GCS记分 :13～ 15分 16例 (2 5 % ) ,9～ 12分 36例(5 6 % ) ,8分以下 12例 (19% )。致伤原因 :车祸伤 4 3例 (6 7% ) ,坠落伤 14例(2 2 % ) ,棍击伤 3例 (5 % ) ,其他 4例(6 % )。受伤部位 :额部 2 0例 (31% ) ,颞顶部 2 8例 (4 4 % ) ,枕部 16例 (2 5 % )。首诊时应用甘露醇等脱水剂 2 8例(4 4 % ) ,应用镇静剂 13例 (2 0 % )。…     

老年人外伤性颅内血肿115例分析

198 5年 1月～ 2 0 0 0年 12月 ,我们收治老年人外伤性颅脑外伤 180例 ,其中经ＣＴ或手术证实颅内血肿的为 115例 ,现将结果总结报告如下。1　临床资料1.1　一般资料　本组男 72例 ,女 43例。年龄 6 0～ 92岁 ,平均6 9 .7岁。 6 0岁～ 6 1例 ,70岁～ 46例 ,80岁以上 8例。致伤原因有跌伤 5 3例 ,交通事故伤 42例 ,打击伤 7例 ,其他致伤原因13例。1.2　临床表现　本组入院时意识按格拉斯哥昏迷积分 (ＧＣＳ)评分 ,13～ 15分 48例 (41.7% ) ,9～ 12分 2 0例 (17.4% ) ,6～ 8分 2 4例 (2 0 .9% ) ,3～ 5分 2 3例 (2 0 .0 % )。头痛 47例 ,恶心 …     

广元地区0～6岁智力低下儿童的致残危险因素分析

目的 分析四川省广元地区0～6岁儿童智力低下的主要致残因素,为预防和降低MR发病率提供重要依据.方法 用丹佛智力筛查量表-DDST和韦氏儿童智力量表-CWYCSI,对广元地区的46839例儿童进行智力筛查和测试,对确诊为智力低下(MR)的儿童进行分析,探讨其致残原因.结果 广元地区0～6岁MR儿童的发病率为10.82‰,其中严重智力障碍发病为203例(4.33‰),轻度智力障碍发病为304例(6.49‰),高于文献报道的发达国家发病率(2‰～4‰).躯体因素中各种围生期因素(早产、窒息、缺血缺氧性脑病等)、重度脑瘫和社会心理因素占主要地位,相应比例为27.42%、22.29%和17.16%;农村和城市的病因分布存在显著差异(P＜0.01).多数农村儿童的双亲受教育水平低于同类的城市水平.结论 维生期因素是影响儿童智力发育的重要原因;宫内感染、出生后的脑部感染、脑损伤及营养不良等均可以独立影响到患儿的智力发育;父母文化水平的差异也是影响儿童智力发育的原因之一.     

男子乳腺癌14例

我院 1997年 3月— 2 0 0 1年 5月门诊共接诊 14例男子乳腺癌患者 (均无外源性激素应用史 ) ,现分析报告如下。1　临床资料1.1.　发病年龄　 14例男子乳腺癌年龄最小 6 0岁 ,最大 76岁 ,平均年龄 6 8.2岁 ,6 0～ 70岁发病 12例 ,占本组发病率的85 .7% ,为高发病年龄组。1.2.　临床分期　均采用 1988年TNM分期的修订方案。Ⅰ期 (T1N0 M0 ) 4例 ( 2 8.6 % ) ,Ⅱ期 (T2 N1M0 ) 8例 ( 5 7.1% ) ,Ⅲ期 (T3 N2 M0 ) 2例 ( 14 .3% ) ,本组均为首诊病例。1.3.　婚姻状况　先天智力低下终生未婚 2例 ( 14 .3% ) ,已婚丧偶寡居 9例 ( 6 4 .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.