早期干预对高危新生儿智能发育的影响

目的:探讨早期综合教育对高危新生儿智能发育的影响。方法:采用早期干预方法,对高危儿干预组(29例)进行综合干预,用CDCC婴幼儿发育量表进行早期智能发育监测,并与高危对照组(31例)和正常对照组(33例)进行比较。结果:高危儿干预组各能区发育商(DQ)和总DQ均大于对照组;但与正常对照组无显著性差异。结论:早期综合干预对高危新生儿智能发育有一定的促进效果。     

早期干预训练联合皮肤抚触对高胆红素血症高危儿的应用效果

目的分析早期干预训练联合皮肤抚触对高胆红素血症高危儿的应用效果。方法选取2017年1月至2018年7月郑州大学第三附属医院收治的214例高胆红素血症高危儿,按体检顺序分为观察组和对照组,每组107例。对照组接受常规护理干预,观察组接受早期干预训练联合皮肤抚触干预。对两组患儿发育商(DQ)、智力指数(MI)异常率、不良反应发生率、护理工作满意度情况进行比较。结果干预后观察组患儿DQ、MI总异常率为9.35%(10/107),低于对照组的24.30%(26/107),差异有统计学意义(P<0.05);观察组患儿不良反应发生率为5.61%,低于对照组的22.42%,差异有统计学意义(P<0.05);观察组护理工作满意度为84.11%(90/107),高于对照组的72.90%(78/107),差异有统计学意义(P<0.05)。结论早期训练干预联合皮肤抚触可促进高红胆素血症高危儿智力发育,降低不良反应发生率,提升护理工作满意度。     

1096例0～3岁儿童智能发育筛查结果分析

对2010年1月—2012年6月在本儿童保健门诊进行智能发育筛查0³岁婴幼儿的筛查资料进行整理分析,受检的1096例婴幼儿中,正常942例,可疑和异常154例(14.05%),男女童间差异无统计学意义。早产、低体重儿、窒息、高胆红素血症是影响DST结果的主要因素,出生有无存在高危因素儿童智能发育比较差异有统计学意义(χ2=20.094,P<0.05);父母亲文化程度高低对婴幼儿智能发育影响差异有统计学意义(χ2=12.860,P<0.05)。     

6 288例儿保门诊婴幼儿发育商水平及其影响因素分析

目的：了解儿童保健（儿保）门诊婴幼儿的发育商水平及其影响因素,为婴幼儿的干预指导提供一定的科学依据。方法：回顾性收集2018年1月至2020年4月在武汉大学人民医院儿保门诊就诊,并首次经小儿神经心理发育检查表评估的0～3岁婴幼儿的发育商资料,进行比较分析。结果：共纳入婴幼儿6 288例,男婴3 657名,女婴2 631名;早产儿1 277例,足月儿4 983例,过期产儿28例。足月产婴幼儿各月龄总发育商（DQ）均高于早产儿组。早产组DQ异常率达39.6%,DQ评估结果中正常、聪明及优秀的比例显著低于足月胎龄组(P<0.05)。早产儿直至24月龄时才达到同龄足月儿的发育水平,且女婴早产儿追上足月儿的速度显著快于男婴早产儿(P<0.05)。孕次、产次和体检月龄是DQ异常的高危因素,胎龄、性别、出生体质量、体检身高以及体检体质量是DQ异常的保护因素。结论：儿保门诊婴幼儿的DQ水平差别较大,早产儿直至24月龄时才达到同龄足月儿的发育水平,女婴早产儿追赶速度快于男婴早产儿。早产、性别、母亲孕次/产次、出生体质量以及体检身高/体质量是DQ异常的影响因素。加强早产儿的随访管理,积极促进生...     

207例婴幼儿丹佛智能筛查及其智能发育相关因素分析

目的了解婴幼儿智能发育状况,探讨影响智能发育的相关因素。方法采用丹佛发育筛查(DDST)法对婴幼儿进行智能发育筛查,并对生产方式,有无高胆红素血症,母孕期高危因素,家族史等影响智能发育的因素进行调查。结果 207例婴幼儿中,正常婴幼儿188例,异常或可疑婴幼儿19例,占9.18%。丹佛发育筛查结果与早产、母孕期高危因素、出生窒息及病理性黄疸、新生儿缺氧缺血性脑病有关(P<0.05)。结论早产、母孕期高危因素、出生窒息及病理性黄疸、新生儿缺氧缺血性脑病是影响婴幼儿智能发育的相关因素。     

儿童发育筛查测验结果分析

目的通过探讨儿童发育筛查测验（以下简称DST）在评估婴幼儿智能发育中的价值,监测高危儿,及早干预。方法将588例4个月龄和干预后再追踪的558例9个月龄婴儿分为两组进行统计观察。采用上海医科大学编制的DST对儿童进行运动、社会适应性和智力等3个能区检测,对各年龄段的发育商（DQ）进行统计,并作男女对比。结果各能区原始分值随年龄增长而增加。高危儿DQ明显低于正常儿童,干预后9个月龄儿童DQ值有所提高,效果良好。婴儿期发育商无男女差异。结论通过DST检查,体会儿童认知方式,揭示个体儿童心理功能,早期发现神经发育落后儿童,及早干预,全面促进儿童健康成长。     

神经行为发育监测及早期干预对高危儿智能发育影响的研究

目的 探讨神经行为发育监测及早期干预对高危儿智能发育的影响,提高高危儿的生存质量.方法 将46例高危儿随机分为干预组和对照组,同时选取20例正常对照组进行随访观察.对干预组的高危儿定期进行神经行为发育监测和早期干预.各组均在3月、6月和1岁时用Gesell婴幼儿发育量表进行发育商的测评.结果 ① 3月时高危干预组和高危对照组5个能区的发育商（developmental quotient,DQ）均低于正常对照组 （P＜0.01）;高危干预组和高危对照组比较,各能区的DQ无差异（P＞0.05）.② 6月时高危干预组各能区的DQ均高于高危对照组,差异有统计学意义（P＜0.01和P＜0.05）;高危干预组和正常对照组4个能区的DQ无差异（P＞0.05）.③ 1岁时高危干预组各能区的DQ均明显高于高危对照组,差异有高度统计学意义（P＜0.01）;高危干预组与正常对照组比较,各能区的DQ无差异（P＞0.05）.结论 神经行为发育监测及早期干预可以促进高危儿的智能发育,到1岁时能赶上正常儿童,有效减少残障的发生.     

高危儿早期规范化干预的临床效果研究

目的:探讨早期规范化干预对高危儿生长发育及智能发育的影响。方法:将108例高危儿按家长的意愿分为干预组和对照组,干预组实施在医生指导下的家庭干预与医院综合康复治疗相结合的干预模式,对照组只实施家庭干预。测量身高、体重等体格发育指标,使用婴幼儿智力发育测量表(CDCC量表)进行智能测评。结果:(1)干预组高危儿1岁时身高、体重高于对照组,差异有统计学意义(P<0.05);(2)干预组在发育商(DQ)、精细动作、认知能力、语言、社会交往能力方面的发育水平均明显好于对照组,差异有统计学意义(P<0.01)。结论:早期进行规范化管理对高危儿体格及智能发育可以起到积极作用。     

不同喂养方式对婴幼儿智力及行为发育的影响

目的探讨不同喂养方式对婴幼儿智力及行为发育的影响。方法采用自制婴幼儿问卷调查表对145名婴幼儿的喂养方式进行了调查，采用《0～6岁发育筛查测验》（DST）和《贝利婴幼儿发展量表）（BSID）来评定婴幼儿的发育状况。结果母乳喂养47名（占32．4％），混合喂养48名（占33．1％），人工喂养50名（占34．5％）。母乳喂养组MI、DQ、PDI、MDI评分均高于混合喂养组和人工喂养组，差异有统计学意义（P〈0．05）；而混合喂养组和人工喂养组之间差异无统计学意义（P〉0．05）。结论母乳喂养有利于婴幼儿智力及行为各项指标的健康发育。     

2~5岁高危儿童语言发育迟缓MRI表现及诊断

目的探讨2~5岁高危儿童语言发育迟缓的MRI表现及诊断价值。方法从2016年1月至2018年11月在本院儿童保健门诊就诊并确诊为语言发育迟缓的高危患儿中选出120例作为研究对象,进行回顾性研究,所有患儿均行MRI检查,分析不同程度的语言发育迟缓高危患儿的MRI表现。结果高危患儿语言发育迟缓的头颅MRI检查结果显示:正常患者19例,占比15.83%,异常患者101例,异常率84.17%,其中皮质发育异常27例,占比22.50%,颅内白质髓鞘化延迟21例,占比17.50%,胼胝体发育不良13例,占比10.83%,脑室周围脑白质软化32例,占比26.67%,脑畸形8例,占比6.67%;120例高危患儿的DQ评估结果显示,轻度语言发育迟缓33例,中度49例,重度38例,其中轻微语言发育迟缓MRI异常显示率69.70%(23/33),中度语言发育迟缓MRI异常显示率83.67%(41/49),重度语言发育迟缓MRI异常显示率97.37%(37/38),不同程度语言发育迟缓检出率比较差异具有统计学意义(P<0.05)。结论皮质发育异常、颅内白质髓鞘化延迟、脑室周围脑白质软化是高危患儿语言迟缓常见的MRI表现,对于中、重度高危语言发育迟缓患儿的异常显示率较高,具有较高的诊断价值。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.