早期护理干预对新生儿缺氧缺血性脑病患儿智力和运动功能及预后的影响

目的探讨早期护理干预对新生儿缺氧缺血性脑病（HIE）患儿的智力和运动功能及并发症的影响。方法90例新生儿HIE随机分为护理干预组和常规护理组。常规护理组予以常规护理干预,护理干预组予以早期护理干预,两组均干预24个月。结果随访6、12个月,护理干预组患儿MDI和PDI均明显高于常规护理组（P〈0．05）;随访24个月．护理干预组患儿适应能力、大运动能力、精细运动能力、语言能力和社交能力均明显优于常规护理组（P〈0．05）;同时护理干预组神经系统后遗症发生率明显低于常规护理组（x2=5．07,P〈0．05）。结论早期护理干预可提高新生儿HIE患儿运动发育和智力发育水平,减少神经系统后遗症发生率。     

早期康复干预对缺氧缺血性脑损伤患儿智力发育水平及预后影响

目的 探讨早期康复干预对缺氧缺血性脑损伤（HIBD）患儿智力发育水平及预后的影响。方法 选取2014年1月~2016年3月于我院就诊的病情稳定的HIBD患儿80例,采用抛硬币法分为干预组和对照组各40例。对照组患儿给予常规干预措施,干预组患儿予以早期康复干预措施,两组均干预24个月。于干预12、24个月后比较两组患儿智能发育商评分变化,并比较神经系统后遗症发生率。结果 干预12、24个月后,干预组患儿精细运动、适应、语言、社交和大运动等智能发育商各能区评分均明显高于对照组,差异有统计学意义（P<0.05）。干预24个月后,干预组患儿在神经系统后遗症发生率方面低于对照组,差异有统计学意义（χ2=4.11,P<0.05）。结论 早期康复干预用于HIBD患儿的效果肯定,能显著改善智力发育水平,并能减少或预防神经系统后遗症发生,从而改善预后。     

早期康复干预对缺氧缺血性脑损伤患儿智力发育水平及预后的影响

目的探讨早期康复干预对缺氧缺血性脑损伤(HIBD)患儿智力发育水平及预后的影响。方法选取2014年1月~2016年3月于我院就诊的病情稳定的HIBD患儿80例,采用抛硬币法分为干预组和对照组各40例。对照组患儿给予常规干预措施,干预组患儿予以早期康复干预措施,两组均干预24个月。于干预12、24个月后比较两组患儿智能发育商评分变化,并比较神经系统后遗症发生率。结果干预12、24个月后,干预组患儿精细运动、适应、语言、社交和大运动等智能发育商各能区评分均明显高于对照组,差异有统计学意义(P0.05)。干预24个月后,干预组患儿在神经系统后遗症发生率方面低于对照组,差异有统计学意义(χ~2=4.11,P0.05)。结论早期康复干预用于HIBD患儿的效果肯定,能显著改善智力发育水平,并能减少或预防神经系统后遗症发生,从而改善预后。     

新生儿缺氧缺血性脑病早期干预的临床观察

目的探讨早期综合干预方法对新生儿缺氧缺血性脑病(HIE)患儿智力及运动发育的影响,最大限度地改善患儿的预后。方法将HIE患儿46例随机分为干预组和常规育儿组,对干预组从生后3天开始接受早期干预;对照组常规治疗,育儿指导。两组均接受常规的HIE综合治疗,并在3、6、12、18和24个月进行智力、运动发育检测。结果干预组在12、24个月的智力发育指数(MDI)、运动发育指数(PDI)比常规育儿组高(P<0.01)。干预组康复93%,常规组仅为72%。结论对HIE患儿进行适宜的早期干预,能显著减少脑瘫、智能发育迟滞等后遗症的发生。     

早期家庭干预模式对新生儿缺氧缺血性脑病的影响

目的探讨早期家庭干预模式对新生儿缺氧缺血性脑病预后的影响;方法将90例出院HIE出院患儿随机分为干预组和对照组,每组45例,干预组接受为期2年的早期家庭干预模式,对照组实施常规的护理模式,比较患儿后遗症发生情况、干预前后体格和智力发育情况;结果:在后遗症发生率方面,干预组患儿后遗症的发生率(8.89%)明显低于对照组(22.22%),在智力发育方面,干预前两组患儿的DQ值无明显差异,在干预12个月及24个月时,干预组的DQ值均明显高于对照组(P0.01);结论早期家庭干预模式是一种有效的干预模式,可促进受伤大脑功能的代偿,降低后遗症的发生率,值得进一步推广。     

早期康复护理对新生儿缺氧缺血性脑病预后的影响

目的探讨早期康复护理对新生儿缺氧缺血性脑病（HIE）预后的影响。方法选择64例HIE患儿,随机分为常规护理组和康复护理组,分别予以常规护理和早期康复护理干预,干预时间12个月。比较两组患儿出生后3、6、12个月的智力发育指数（MDI）和运动发育指数（PDI）的变化及后遗症发生率。结果两组患儿出生后6、12个月的MDI和PDI均较出生后3个月明显升高（P〈0．05）,且康复护理组升高的幅度明显高于常规护理组（P〈0．05）。康复护理组发生后遗症3例,常规护理组发生后遗症10例,康复护理组后遗症的发生率明显低于常规护理组（X2=4．73。P〈0．05）。结论早期康复护理干预能明显促进HIE患儿智能和运动发育,减少后遗症的发生率,改善预后。     

早期干预对新生儿缺氧缺血性脑病神经行为预后的观察

目的:探讨早期干预对新生儿缺氧缺血性脑病(HIE)神经行为预后的影响。方法:将同期住院的48例中重度HIE患儿随机分为干预组28例、对照组22例。对干预组采用医院和家庭相结合的方式系统的早期干预,对照组按常规育儿随访18个月,使用Gesell发育量表进行评定。结果:干预组6个月、12个月精神运动发育商(DQ)均显著高于对照组(P<0.01),神经系统后遗症发生率明显低于对照组。结论:早期干预能改善HIE的预后,降低脑瘫及智能发育落后。     

早期综合治疗对中重度新生儿缺氧缺血性脑病预后的影响

目的 探讨早期综合治疗对中重度新生儿缺氧缺血性脑病（HIE）预后的影响。方法 将92例中重度HIE患儿随机分为观察组46例和对照组46例，观察组在常规治疗基础上加用高压氧、促神经细胞代谢药物和早期干预治疗，对照组给予一般常规治疗，比较两组治疗后的疗效。结果 观察组在6，12，24个月时测定智力发育指数、运动发育指数均比对照组高，差异有显著性意义(P < 0.01)；复查头颅CT观察组正常率78.3%，对照组正常率45.7%，差异有显著性意义（P < 0. 05）；观察组后遗症发生率10.9%，对照组为26.1%，差异有显著性意义(P < 0.05)。结论 早期采用积极综合治疗，可促进中重症HIE患儿的智能发育，减少神经系统后遗症的发生率，有效地改善预后。     

早期康复干预对缺氧缺血性脑病患儿神经功能的影响及疗效

目的探讨早期康复干预对缺氧缺血性脑病患儿神经功能的影响及疗效。方法选取2015年4月~2016年6月我院儿科住院治疗的新生儿HIE患者68例,采用抛银币法分为观察组(n=43)与对照组(n=43)。两组患儿均予以HIE常规治疗。对照组与观察组患儿分别予以常规干预和早期康复干预,干预时间12个月。观察两组患儿干预12个月后神经行为和发育商(DQ)的变化,并比较其临床效果。结果干预12个月后,观察组患儿鲍氏NBNA评分显著改善(P0.05),且观察组改善幅度更明显(P0.05);观察组患儿DQ评分水平显著高于对照组(P0.05);同时观察组患儿总有效率较对照组更佳(χ~2=4.22,P0.05)。结论早期康复干预用于新生儿HIE患者的效果较确切,能显著提高其神经功能,开发患儿其潜能,提高治疗效果。     

早期干预护理对新生儿缺氧缺血性脑病后遗症效果观察

目的观察早期综合干预护理(高压氧、新生儿抚触游泳、新生儿运动训练、脑经络导平治疗等)对新生儿缺氧缺血性脑病(HIE)患儿部分指标前后变化,探讨其对HIE后遗症的影响。方法对同期发生的HIE患儿分为干预组与对照组进行对照观察。结果干预组的运动发育指数和智力发育指数比对照组高(P<0.05)。结论早期干预可促进HIE患儿智力发育,有效地防治后遗症。     

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.     

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…     

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.     

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.