百日咳及百日咳综合征吸入性肺部病变的探讨

报道经摄片证实有肺部并发症的百日咳及百日咳综合征287例。其中右肺炎及右肺不张90例，发生率在24d～组为50．0％，4个月～组为33．3％，13个月～组为17．7%，4岁～9岁组为l6．7％，4组间差异极显著。前两组发生率与憋气率有统计学上的联系。频发憋气的尸检资料见喉头充血水肿，小支气管内有挂子，肺部病变以右下肺为重。提示：1岁以下尤其是3个月以下的患儿易发生喉头水肿导致憋气，进而引起高发生率的吸入性肺部病变。     

婴儿百日咳及百日咳综合征之憋气与肺部并发症的关系（附384例分析）

分析３８４例婴儿百日咳及百日咳综合征临床表现和Ｘ线检查。结果：憋气组肺部并发症发生率高于无憋气组（Ｐ＜０．０５）。憋气有肺部并发症组憋气次数多于憋气无肺部并发症组（Ｐ＜０．０５），前组憋气Ａｐｇａｒ评分低于后组（Ｐ＞０．００１）。有吸收组原憋气Ａｐｇａｒ评分高于无吸收组（Ｐ＜０．０５），前组憋气Ａｐｇａｒ评分减轻Ｉ度的天数短于后组（Ｐ＜０．００１），前组憋气消失天数也短于后组（Ｐ＜０．０５）。提示憋气与肺部并发症存在联系。     

婴儿百日咳及百日咳综合征之憋气与肺部并发症的关系：附384例分析

分析３８４例婴儿百日咳及百日咳综合征临床表现和Ｘ线检查。结果：憋气组肺部并发症发生率高于无憋气组（Ｐ〈０．０５）。憋气有肺部并发症组憋气次数多于憋气无肺部并发症组（Ｐ〈０．０５），前组憋气Ａｐｇａｒ评分低于后组（Ｐ〈０．００１）。有吸收组原憋气Ａｐｇａｒ评分高于无吸收组（Ｐ〈０．０５），前组憋气Ａｐｇａｒ评分减轻Ｉ度的天数短于后组（Ｐ〈０．００１），前组憋气消失天数也短于后组（Ｐ〈０．０５）。提示     

婴儿百日咳及百日咳综合征血钙与憋气的关系（附107例分析）

观测婴儿百日咳或百日咳综合征血钙１０７例。结果：＜２．２５ｍｍｏｌ／Ｌ４４例（憋气２７例）为低血钙组，≥２．２５ｍｍｏｌ／Ｌ６３例（憋气３０例）为正常血钙组。抽搐率前组高于后组（Ｐ＜０．０１）。憋气Ａｐｇａｒ评分前组低于后组（Ｐ＜０．０５）。憋气冲Ａｐｇａｒ评分减轻１度的天数，低血钙钙剂治疗组短于其对照组（Ｐ＜０．０５）；正常血钙钙剂治疗组与其对照组无明显差异（Ｐ＞０．０５）；憋气消失天数，四组间无明显差异（Ｐ＞０．０５）。提示：低血钙提高肌肉兴奋性，加重憋气程度，静注钙剂能改善之，但憋气的最终消失有待于基础病变的消除。     

不同年龄儿童百日咳及百日咳综合征临床特征分析

目的 对2月至11岁儿童鉴别百日咳及百日咳综合征提供临床特征参考。方法 回顾性分析我院住院治疗的196例百日咳患儿和228例百日咳综合征患儿临床资料，比较两组差异。结果 两组患儿性别、年龄比较差异无统计学意义，两组5岁以上儿童人数占比均为最多，百日咳组中≤6月人数占比(32.1%)较百日咳综合征组占比(15.3%)增多，而7月～5岁人数占比(26.5%)较百日咳综合征组(42.6%)减少，差异均有统计学意义(P<0.05)。百日咳组发热人数、WBC总数、淋巴细胞计数、血小板计数、FeNO均较百日咳综合征组升高，潮气肺功能水平下降，差异有统计学意义(P<0.05)。其他临床特征差异均无统计学意义。结论 6月以下和5岁以上儿童更易感染百日咳杆菌，百日咳患儿易出现血常规和气道炎性指标异常，婴幼儿患儿还容易出现肺功能下降，应密切关注各项指标，积极进行防治。     

婴儿百日咳及百日咳综合征血钙与憋气的关系：附107例分析

观测婴儿百日咳或百日咳综合征血钙１０７例。结果：〈２．２５ｍｍｏｌ／Ｌ４４例（憋气２７例）为低血钙组，≥２．２５ｍｍｏｌ／Ｌ６３例（憋气３０例）为正常血钙组。抽搐率前组高于后组（Ｐ〈０．０１）。憋气Ａｐｇａｒ评分前组低于后组（Ｐ〈０．０５）。憋气Ａｐｇａｒ评分减轻１度的天数，低血钙钙剂治疗组短于其对照组（Ｐ〈０．０５）；正常血钙钙剂治疗组与其对照组无明显差异（Ｐ〉０．０５）；憋气消失天数，四组间无     

乌鲁木齐市健康人群百日咳抗体水平调查

目的：了解乌鲁木齐市健康人群及产妇针对百日咳的血清特异性IgG抗体水平，为制定免疫策略和防治措施提供科学的依据。方法：随机选取乌鲁木齐市505人作为检测对象，根据年龄分为9个组：0-5个月龄（50例）、6～11个月龄f47例1、12。17个月龄（53例）、18～23个月龄（60例）、2～3岁（56例）、4-6岁（60例）、7-11岁（60例）、12-14岁f59例）、≥15岁（60例）；此外还随机选取了各60例的配对脐血组和产妇组。取检测对象血清，应用酶联免疫吸附试验（ELISA）测定特异性百日咳IgG抗体。结果：百日咳IgG抗体水平2～3岁最高，0～5月龄最低，12-14岁组及≥15岁组处于较低水平；同时，配对脐血及产妇组的百日咳IgG抗体水平存在很好的关联性（rs=0．79，P〈0．05）。结论：应该对年长儿及成人进行百日咳疫苗的加强免疫，从而根除低龄儿童百日咳的主要传染源。     

百日咳患儿血清心肌酶水平变化及意义

百日咳是由百日咳嗜血杆菌引起的儿童时期常见的呼吸道传染病 ,常于冬春季流行 ,其特征为阵发性痉挛样咳嗽 ,较易引起肺部、脑部并发症。为了解百日咳患儿的心肌受累情况 ,笔者对我院１９９６年５月～２０００年５月间收治的５０例百日咳患儿进行血清心肌酶水平测定 ,现将结果报道如下。１．对象观察组５０例 ,均符合实用儿科学中百日咳诊断标准［１］(有百日咳接触史、典型的阵发性痉挛样咳嗽、外周血白细胞升高、以淋巴细胞升高为主 ) ,发病前无肺部疾病、先天性心脏病、心肌炎、肝肾疾病及肌肉疾病史。男性３１例 ,女性１９例 ,年龄５０…     

乌鲁木齐市健康人群百日咳抗体水平调查

目的:了解乌鲁木齐市健康人群及产妇针对百日咳的血清特异性IgG抗体水平,为制定免疫策略和防治措施提供科学的依据。方法:随机选取乌鲁木齐市505人作为检测对象,根据年龄分为9个组:0～5个月龄(50例)、6～11个月龄(47例)、12～17个月龄(53例)、18～23个月龄(60例)、2～3岁(56例)、4～6岁(60例)、7～11岁(60例)、12～14岁(59例)、≥15岁(60例);此外还随机选取了各60例的配对脐血组和产妇组。取检测对象血清,应用酶联免疫吸附试验(ELISA)测定特异性百日咳IgG抗体。结果:百日咳IgG抗体水平2～3岁最高,0～5月龄最低,12～14岁组及≥15岁组处于较低水平;同时,配对脐血及产妇组的百日咳IgG抗体水平存在很好的关联性(rs=0.79,P<0.05)。结论:应该对年长儿及成人进行百日咳疫苗的加强免疫,从而根除低龄儿童百日咳的主要传染源。     

甘肃省2004年健康儿童白喉、百日咳和破伤风抗体水平结果分析

目的 了解甘肃省健康儿童白喉、百日咳和破伤风抗体水平。方法 采用间接血球凝集试验法、微量凝集试验法对3个县的302名l～14岁健康儿童进行了白喉、百日咳和破伤风抗体水平监测。结果 在监测的5个年龄组中，白喉、破伤风抗毒素抗体阳性率均〉95％，百日咳抗体阳性率为98．58％，保护率仅为62．06％，保护率除7～8岁组〉75％外，其余年龄组均〈75％。结论 我们要重视加强免疫工作。     

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.