婴幼儿期反复呼吸道感染与维生素D缺乏性佝偻病的关系研究

目的:探讨研究婴幼儿期反复呼吸道感染与维生素D缺乏性佝偻病的关系。方法:选择110例反复呼吸道感染的婴幼儿患者作为试验组,选择同期来我院门诊体检的110例健康婴幼儿作为对照组。所有患儿均详细的询问病史、系统的体格检查并取指尖血进行BALP的检查,结合BALP检验结果,明确诊断。结果:试验组大于250μ/L的患儿有30例,占27.2%;对照组大于250μ/L的患儿有6例,占5.4%,两组婴幼儿BALP测定的含量差异明显。试验组排除佝偻病患儿有48例,亚临床诊断22例,明确诊断佝偻病的有34例,占总数的30.9%;对照组排除佝偻病诊断患儿有88例,亚临床诊断14例,明确诊断佝偻病的有8例,占总数的7.2%。结论:婴幼儿期反复呼吸道感染与维生素D缺乏性佝偻病有密切的关系,防治维生素D缺乏性佝偻病对预防婴幼儿反复呼吸道感染有重要帮助。     

佝偻病简易诊断与骨X线及实验性诊断的相关性

目的 探讨婴幼儿佝偻病的简易诊断与骨X线、实验性诊断的相关性。方法 对简易诊断为佝偻病的166例小儿全部作骨X线、骨碱性磷酸酶（BALP）,血生化检查。结果 经骨X线确诊为佝偻病78例（47．0％）。BALP检测结果与X线检查结果符合率最高。夜惊、多汗、乒乓头、枕秃在佝偻病患儿中发生率较高。结论 简易诊断具有一定的实用价值,可应用于我国基层卫生机构,若有条件应用骨X线、BALP、血生化测定则可提高佝偻病诊断的准确性。     

骨碱性磷酸酶检测在小儿佝偻病诊断中的作用

目的：探讨骨碱性磷酸酶（BALP）检测诊断小儿佝偻病的临床意义。方法：应用BALP检测技术和简易诊断标准对乌鲁木齐市0－6岁的散居婴幼儿352例进行佝偻病筛查。结果：BALP检出可疑者（BALP≥250U／L）127例,占36％;佝偻病（BALP≥300U／L）97例,占28％,总异常检出224例,占64％,简易诊断佝偻病85例,占24％,与BALP检测比较临床符合率82％,佝偻病发生与性别或种族无关（P＞0．05）与幼儿年龄呈负相关,与患儿既往病史肺炎,上呼吸道感染发生关系密切（P＜0．05）,结论：BALP检测诊断佝偻病优于简易诊断法,且对早期佝偻病的诊断具有重要的临床价值。     

婴幼儿反复上呼吸道感染与佝偻病相关性探讨

目的 :探讨婴幼儿反复上呼吸道感染与佝偻病的关系。方法 :对 2 0 0 0年 1月至 2 0 0 2年7月门诊就诊的 14 3例反复上呼吸道感染婴幼儿和 173例对照组婴幼儿进行骨碱性磷酸酶(BALP)检测 ,结果研究组BALP阳性 6 7例 (4 6 .85 % ) ,可疑阳性 2 4例 (16 .78% ) ,对照组BALP阳性 33例 (19.0 7% ) ,可疑阳性 2 6例 (15 .0 3% ) ,反复上呼吸道感染组佝偻病患病率明显高于对照组(P <0 .0 1) ,使用维生素D及钙剂治疗佝偻病及可疑佝偻病患儿 ,并进行半年随访。结果 :在反复上呼吸道感染组婴幼儿中未发生上呼吸道感染 4 3例 (4 7.2 3% ) ,发生 (1～ 2 )次为 34例 (37.36 % ) ,上呼吸道感染的患病率比治疗前明显减少。结论 :婴幼儿反复上呼吸道感染与佝偻病的发生有密切临床相关性     

骨碱性磷酸酶与血清中碱性磷酸酶、钙、磷的相关性及佝偻病诊疗中的应用

我国目前用于佝偻病临床诊断的主要依据为1986年制订综合诊断标准，临床病史、症状、血生化（Ca、P、AIP）和影象学诊断。而BALP来源于成骨细胞，它是反映成骨细胞活性和骨形成的敏感指标之一。近年来随着临床生化检验技术的发展BALP在早期诊断佝偻病的应用较为广泛，我科对BALP阳性、阴性幼儿进行血清Ca、P、AIP测定的探讨，并对临床疑似佝偻病患儿进行BALP检测。现报告如下：     

110例婴幼儿佝偻病血清25羟维生素D水平检测分析

目的 通过对0～3岁婴幼儿血清25羟维生素D水平测定,了解广州地区婴幼儿血清25羟维生素D水平,探讨婴幼儿维生素D缺乏性佝偻病诊断指标的意义.方法 对2010年6月-12月在我院保健门诊就诊的婴幼儿佝偻病110例为研究组,随机选择同一时期来我科进行常规保健的健康婴幼儿90例为对照组,分别检测血清25羟维生素D水平及血微...     

α-D3治疗维生素D缺乏性佝偻病的效果

①目的观察α-D3治疗婴幼儿维生素D缺乏性佝偻病的效果.②方法选择维生素D缺乏性佝偻病病儿78例,随机分为两组,α-D3组40例,应用α-D3 0.125～0.375 μg/d口服治疗,疗程30 d; Vit D3组38例,应用Vit D3 15～20万单位行一次性肌肉注射治疗,观察两组病儿相关临床症状、血BALP变化、血清钙均值变化.③结果两组病儿治疗前后相关临床症状、血BALP变化、血清钙磷均值变化差异均无显著意义(χ2=0.03～0.39,t=0.28,P>0.05).④结论α-D3治疗维生素D缺乏性佝偻病效果可靠、安全.     

血骨碱性磷酸酶检测在佝偻病诊断中的应用

目的：探讨血骨碱性磷酸酶（BALP）水平检测对佝偻病诊断的临床意义。方法：对来我院体检的0—4岁儿童550例进行血BALP检测，并按1986年卫生部颁发的“婴幼儿佝偻病防治方案”对本组儿童进行佝偻病体征筛查，对31名可疑儿童进行手腕关节X线检查。结果：BALP阳性率19．82％，其中以0～1岁组的阳性率最高；31名有佝偻病临床体征儿童BALP与性别没有显著性关联。结论：在佝偻病的早期诊断中，早期检测BALP水平是较为敏感可靠的方法，结合其他临床诊断技术对早期发现并及时纠治佝偻病具有重要的指导作用。     

骨碱性磷酸酶测定指导佝偻病维生素D治疗的探讨

使用维生素 D治疗维生素 D缺乏性佝偻病 ,分普通治疗和大剂量突击治疗 ,剂量、疗程、疗效常依据患儿的症状、骨 X线及血生化检查来予以判定。为探讨一种较简单且适应基层医院开展的方法 ,我们对 110例婴幼儿佝偻病进行了骨碱性磷酸酶 (BAL P)测定 ,并同时进行骨 X线观察 ,用来指导维生素 D治疗 ,经临床应用 ,效果满意 ,现报告如下。1　资料与方法1.1　对象　 1998年 9月至 1999年 10月门诊就诊的佝偻病患儿 ,按卫生部婴幼儿佝偻病防治方案诊断标准 [1 ] ,依据症状、骨骼改变 ,并经 BAL P及骨 X线检查 ,选择活动期佝偻病 110例 ,男 6 1…     

6例佝偻病活动期25-羟维生素D3等指标的临床报道

佝偻病是由于缺乏维生素D引起的钙、磷代谢失常的慢性营养性疾病,其主要特征为生产中的长骨矿不全或骨软化症.25-羟维生素D3,由于其半衰期3-4周,在血浆含量多稳定,可代表机体维生素D的贮备,常作为测定维生素D营养状态的指标.诊断维生素D缺乏性佝偻病血生化指标主要是：25-羟维生素D3、血钙、血磷下降;骨碱性磷酸酶、血碱性磷酸酶升高.而根据笔者的临床观察发现患者25-羟维生素D3维生素D3值正常,引发笔者思考,25-羟维生素D3是否是诊断佝偻病的金标准.     

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.