36例极低出生体重儿部分静脉营养临床分析

目的:了解部分静脉营养对极低出生体重儿体重增长及降低并发症所起的作用.方法:将70例极低出生体重儿分成治疗组(36例)和对照组(34例).治疗组均经外周静脉用微电脑输液泵24 h内均匀输入静脉营养液,对照组仅给予葡萄糖及一般综合治疗,两组均给予早期微量喂养.结果:治疗组平均每天体重增长(19.5±6.52)g;对照组平均每天体重增长(12.24±4.65)g,两组比较,有显著性差异(P＜0.05).治疗组并发症发生率为22.2%(8/36),对照组为82.3%(28,34),两组比较,有显著性差异(P＜0.05).结论:部分静脉营养对极低出生体重儿非常重要,能很好地促进体重增长,降低其并发症的发生率,提高生存质量和存活率.     

早期微量喂养联合静脉营养对早产极低出生体重儿的临床效果观察

目的 观察早期微量喂养联合静脉营养对早产极低出生体重儿的临床疗效.方法 对60例早产极低出生体重儿随机分为观察组(n=30)和对照组(n=30),观察组自生后1～3天开始微量喂养,对照组采用静脉补充能量.生后3天再喂养经口喂养.根据肠道耐受情况渐增奶量,期间能量不足部分由静脉营养补充.观察两组体重增长、呕吐、腹胀、胃内潴留发生情况及达到全程喂养时间.结果 观察组体重增长优干对照组,达到完全胃肠喂养需要时间短,呕吐、腹胀、胃内潴留发生情况少,两组比较有显著性意义(P<0.05).结论 早期微量喂养联合静脉营养能提高早产极低出生体重儿对喂养的耐受性改善胃肠道动力,能尽早适应胃肠喂养,有利于疾病的康复.     

静脉营养在低出生体重儿中的临床应用

目的 静脉营养对低出生体重儿体重增长及预防并发症发生的作用.方法 将70例低出生体重儿分成观察组(35例)和对照组(35例),治疗组于出生后第1～2天开始全静脉营养(TPN)或部分静脉营养(PPN),对照组以常规方法进行治疗.结果 观察组出生后5～6天体重开始增长,每天增长10～30 g,平均(21.66±5.31)g,对照组出生后10～14天起体重开始增长,每天增加9～15 g,平均(11.31±4.69)g,两组比较有显著性差异(p＜0.05),观察组并发症发生率11.4%(4/35),对照组并发症发生率54.3%(19/35),两组并发症发生率经统计学处理有显著性差异(p＜0.05),观察组治愈率82.9%,对照组治愈率48.6%,经统计学处理两组有显著性差异(p＜0.05).结论 静脉营养对低出生体重儿非常重要,可促进体重增长,降低并发症发生率,提高存活率,提高生存质量,促进生长发育.     

早期微量喂养在极低出生体重儿营养支持中的应用

目的 探讨早期微量喂养在极低出生体重儿营养支持中的作用.方法 根据研究目的和临床操作的可行性,将符合入选标准的80例极低出生体重儿,随机分成观察组和对照组各40例.两组患儿基础治疗相同,观察组实施早期微量喂养干预策略,对照组按照传统方法进行喂养,观察两组达完全胃肠喂养时间、恢复至出生体重时间;观察胃肠喂养不耐受的情况及例数、每日摄入热卡、第10天胆红素值及肠外营养达足量水平的例数;记录每日体重,计算其平均增长速度.结果 观察组喂养不耐受发生率、过渡到全胃肠喂养所需时间、恢复至出生时体重所需时间、第10天胆红素值及肠外营养达足量水平的比率,较对照组有显著性差异.观察组体重增长速度与对照组比较,差异有显著性.结论 早期微量喂养是极低出生体重儿营养支持策略的重要内容,可有效降低极低出生体重儿喂养不耐受发生率,缩短静脉营养时间.     

肠外营养和胃肠喂养治疗极低出生体重早产儿的临床观察

目的:探讨出生后早期全肠外营养(TPN)和胃肠喂养(EN)对极低出生体重早产儿的疗效.方法:将35例患儿随机分为2组.TPN组20例经静脉给予全营养混台液;EN组15例,经管饲间歇母乳或早产儿配方乳喂养.观察两组患儿7 d内体重变化、血浆蛋白、微量元素、血.脂、胆红素等指标.结果:TPN组3 d～7 d每日热能供给低于EN组,两组患儿7 d后恢复出生体重者分别占53.3%、80%(P＜0.05),平均每日体重增长18.5 g/kg±5.7 g/kg、25.5 g/kg±9.4 g/kg(P＜0.05).患儿7 d的前白蛋白、白蛋白、总蛋白及微量元素等均较出生时明显改善,两细.之间比较无统计学意义.结论:早期营养可为极低出生体重早产儿提供能量和氮量,但早期胃肠道喂养优点明显,可替代TPNT和部分静脉营养.     

肠外营养支持对极低出生体重儿的生长发育疗效观察

目的探讨早期肠外营养对极低出生体重儿(VLBW)体重增长的疗效.方法 将初生体重＜1500g的极低体重儿按比例随机分为治疗组和对照组,每组32例,对照组给予普通能量合剂,治疗组患儿出生24小时即应用"全合一"营养液,并辅以少量的胃肠喂养和非营养性吸允,营养液经外周静脉中心静脉置管(PICC),滴注时间维持在20h/d,...     

极低出生体重儿40例实施早期微量喂养的体会

目的：探讨极低出生体重儿实行早期微量喂养的耐受性、体重增长情况。方法：极低出生体重儿40例随机分为两组。在常规静脉营养基础上治疗组25例生后24～72小时内予以微量喂养,对照组15例于生后1周内予以喂养。对照喂养中胃肠不耐受发生率、体重达到或超过出生体重。结果：两组相比,早期微量喂养组缩短了达到全胃肠道喂养的时间,体重增长优于对照组。结论：早期微量喂养是极低出生体重儿最理想的喂养方式。     

35例早产儿静脉营养临床观察

目的探讨早产儿、低出生体重儿的营养疗法。方法35例早产儿、低出生体重儿均采用单纯胃肠喂养，并与同期入选条件相似的30例早产儿、低出生体重儿采用单纯胃肠喂养患儿作对照，比较两种方法在早产儿、低出生体重儿营养支持方面的差异。结果经胃肠喂养辅助静脉营养支持的早产儿、低出生体重儿体重增长速度明显优于对照组，两组存在显著性差异。结论早产儿各系统功能不成熟，喂养困难，单纯喂养辅助静脉营养支持治疗能更好促进早产儿体重的增长，减少并发症的发生。     

极低出生体重儿营养与支持治疗50例临床分析

目的：对极低出生体重儿的营养与支持治疗进行探讨。方法将极低出生体重儿50例作为研究对象,按数字奇偶法分为两组,每组25例,两组患儿均给予常规治疗,对照组行全静脉营养支持,研究组行早期微量喂养营养支持联合静脉营养支持;对比两组患儿喂养不耐受情况以及肠外营养监测、生长发育情况。结果研究组极低出生体重儿胆红素水平显著低于对照组,肠胃营养达到标准的概率显著高于对照组,差异有统计学意义（ P＜0.05）。研究组极低出生体重儿体重恢复至出生的时间以及达到完全胃肠喂养的时间比对照组明显缩短,体重增长的速度明显快于对照组,差异有统计学意义（ P＜0.05）。研究组极低出生体重儿喂养不耐受概率比对照组明显较低,差异有统计学意义（ P＜0.05）。结论对极低出生体重儿早期微量喂养营养支持可提高患儿治疗效果,降低不耐受情况,减少黄疸发生,缩短其恢复至出生体重时间,对其生长发育起着促进的作用,值得临床应用推广。     

机械通气时极低出生体重儿营养支持的回顾分析

目的探讨机械通气时极低出生体重儿有效的营养支持方法。方法28例接收机械通气治疗的极低出生体重儿随机分为两组,实验组采用早期微量鼻胃管喂养联合外周静脉营养,对照组采用单纯的静脉营养,对两组患儿体重开始增长日龄,恢复出生体重日龄,达到足量喂养日龄进行比较分析。结果应用早期微量鼻胃管喂养联合外周静脉营养组的患儿体重开始增长日龄、恢复出生体重日龄、达到足量喂养的日龄缩短比单纯静脉营养组相应指标明显缩短(P<0.001)。结论早期微量鼻胃管喂养联合外周静脉营养是供给机械通气中的极低出生体重儿营养支持的较理想途径,使极低出生体重儿体重开始增长、恢复出生体重的时间缩短,并尽快达到完全胃肠道营养。     

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.