高压氧联合早期护理干预对新生儿缺氧缺血性脑病预后的影响

目的 探讨高压氧联合早期护理干预对新生儿缺氧缺血性脑病(HIE)预后的影响.方法 将124例诊断为HIE的患儿随机分成治疗组(高压氧联合护理干预)70例和对照组54例进行治疗,并行NBNA20项神经行为评分、精神运动发育商(DQ)评估和伤残率比较,判断疗效.结果 新生儿期NBNA评分两组比较差异无统计学意义(P>0.05),后期DQ评分和伤残率比较治疗组优于对照组,差异有统计学意义(P<0.05).结论 高压氧联合早期护理干预综合治疗HIE,疗效确切,能明显改善HIE患儿的预后.     

早期干预对新生儿缺氧缺血性脑病预后影响的临床研究

目的 探讨早期干预对新生儿缺氧缺血性脑病(HIE)预后的影响.方法 对32例NBNA加分法评分基础分＜35分的HIE患儿自恢复期起随机分成干预组和对照组,于0～2岁时进行智能发育随访.结果 干预组发育商(DQ)明显高于对照组,其后遗症发生率低.结论 早期干预治疗能有效地促进HIE患儿的智能发育,是降低其后遗症发生率的有效手段.     

单唾液酸四己糖神经节苷脂治疗新生儿缺氧缺血性脑病29例

目的:观察单唾液酸四己糖神经节苷脂(GM1)静脉滴注与脑活素静脉滴注治疗新生儿缺氧缺血性脑病(HIE)的近期及远期疗效比较。方法:将HIE55例分为GM1治疗组(n=29)和对照组(脑活素治疗组,n=26)。新生儿期采用NBNA评分,随访期每3个月采用Gesell量表法对其进行发育评价直至生后15个月,对出现神经系统异常者给予相应的康复训练。结果:两组在新生儿期NBNA评分上差异无统计学意义(P>0.05),两组Gesell在总均值、精细运动和语言方面差异有统计学意义(P<0.05)。结论:早期应用GM1治疗新生儿HIE对改善HIE所致的远期神经系统发育障碍有较好的疗效。     

58例新生儿缺氧缺血性脑病恢复期治疗的预后分析

目的探讨新生儿缺氧缺血性脑病(HIE)恢复期治疗对预后影响.方法 86例中、重度HIE患儿分成治疗组、对照组两组.治疗组在恢复期给予脑活素、高压氧治疗,10次为一疗程,每月1疗程,共4～5疗程.两组均定期随访,比较两组神经系统后遗症发生率、智能发育商数方面的情况.结果①治疗组神经系统后遗症发生率明显低于对照组,两组比较X2=4.93,P《0.05,差异有显著性.②治疗组智能发育商数(DQ)值明显高于对照组,P《0.01,有显著性差异.结论恢复期对新生儿缺氧缺血性脑病的治疗,能促进受损脑细胞、神经细胞的修复,明显改善预后,降低伤残儿童发生率有重要意义,值得提倡开展应用.     

促红细胞生成素治疗重度新生儿缺氧缺血性脑病效果观察

目的观察促红细胞生成素对新生儿缺氧缺血性脑病(HIE)的治疗效果。方法用促红细胞生成素治疗重度HIE 20例,同时设对照组20例,两组均给予三项支持、两项对症治疗。观察治疗前后血清超氧化物歧化酶(SOD)和丙二醛(MDA)的水平、脑CT的改变、NBNA评分及生后1个月至12月龄时精神运动发育商(DQ)以评价疗效。结果观察组治疗后血清SOD和MDA的水平、脑CT、NBNA评分及DQ检测结果均明显优于对照组,各项指标经统计学处理,差别无统计学意义(P<0.05,P<0.01)。结论应用促红细胞生成素治疗重度HIE确有明显疗效。     

早期康复干预对新生儿缺氧缺血性脑病患儿智力和运动功能的改善作用

目的探讨早期康复干预对新生儿缺氧缺血性脑病患儿智力和运动功能的改善作用。方法 70例新生儿HIE患儿随机分为观察组与对照组。两组患儿予以吸氧、预防感染、降颅内压及抗惊厥、保持水电解质酸碱平衡等治疗。对照组与观察组患儿分别予以常规干预与早期康复干预,干预时间24个月。观察两组患儿干预12、24个月后智力、运动发育指数及发育商(DQ),并比较神经系统后遗症的发生率。结果干预12、24个月后,观察组患儿MDI、PDI和DQ各项水平均高于对照组(P0.05)。干预24个月后,观察组神经系统后遗症的发生率低于对照组(χ2=4.18,P0.05)。结论早期康复干预用于新生儿HIE的疗效较常规干预更佳,有利于提高患儿智力和运动发育水平,开发患儿其潜能,减少或预防神经系统后遗症发生。     

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。     

早期针对性护理干预在缺氧缺血性脑病患儿护理中的应用

目的探讨早期针对性护理干预对缺氧缺血性脑病(HIE)患儿认知功能、运动功能和神经后遗症发生率的影响。方法选取2016年8月至2017年8月通许县人民医院收治的78例HIE患儿,根据就诊顺序分为对照组和观察组,各39例,给予对照组患儿常规护理,给予观察组患儿早期针对性护理干预。对比两组患儿不同时间点MDI和PDI评分,统计两组患儿神经系统后遗症发生率。结果干预后3、6、12个月,两组MDI和PDI评分均高于干预前,且观察组同时期MDI和PDI评分均高于对照组,差异有统计学意义(P<0.05)。对照组神经系统后遗症发生率为20.51%(8/39),高于观察组的5.12%(2/39),差异有统计学意义(P<0.05)。结论早期针对性护理干预可有效提高患儿认知功能和运动功能发育,且能降低神经系统后遗症发生率,具有临床推广价值。     

神经生长因子与脑蛋白水解物治疗新生儿缺氧缺血性脑病的临床效果

目的:观察神经生长因子与脑蛋白水解物治疗新生儿缺氧缺血性脑病(HIE)的临床效果。方法:选取接受治疗的150例HIE患儿为研究对象,按随机数字表法将其分为对照组、神经生长因子治疗组和脑蛋白水解物治疗组,每组50例。对照组予基础综合治疗,其他两组在基础综合治疗上分别予神经生长因子及脑蛋白水解物治疗,比较三组新生儿行为神经测定(NBNA)评分,血清超氧化物歧化酶(SOD)、血清内皮生长因子(VEGF)水平及临床疗效。结果:神经生长因子治疗组中度患儿及重度患儿NBNA评分、治疗总有效率、SOD及VEGF水平均高于对照组和脑蛋白水解物治疗组,差异有统计学意义(P<0.05)。结论:相比于脑蛋白水解物,使用神经生长因子治疗HIE,能更好地缓解患儿的神经系统临床症状,提高疗效。     

早期干预对改善新生儿缺氧缺血性脑病预后的影响

目的：探讨早期干预对新生儿缺氧缺血性脑病（HIE）预后的影响。方法：将120例HIE患儿随机分为对照组和干预组,两组均分为轻度、中度、重度HIE组,通过将各种感知觉刺激、视听刺激、主动及被动肢体训练与药物治疗相结合的方法对干预组进行系统的早期干预,对其智能发育进行随访。结果：中度和重度HIE组患儿的发育商（DQ）明显优于对照组（P〈0.01）,轻度HIE组患儿的DQ与对照组比较无明显差异（P〉0.05）;干预组患儿脑瘫和智力低下的发生率明显低于对照组（P〈0.05,P〈0.01）,癫痫的发生率与对照组比较无明显差异（P〉0.05）。结论：早期干预不仅能提高中、重度HIE患儿的DQ,而且可降低其后遗症的发生率,这对改善患儿的预后、全面提高其生存质量有重要的意义。     

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.