大鼠异位辅助性肝移植肝的形态及功能变化

目的 :观察大鼠异位辅助性肝移植后的自体肝及辅助肝 (两肝 )的形态及功能改变。　方法 :建立大鼠异位辅助性肝移植模型 ,行 (血流动力学 )核素显像、电镜观察及光镜检测 ,评价术后大鼠生存以及移植肝功能状况。　结果 :大鼠异位辅助性肝移植模型切实可行 ,手术成功率较高 (93.3% )。术后 1周存活率达 80 % ,并能长期存活(>3个月 )。术后行相关检查 ,表明供肝随移植时间延长逐渐萎缩 ,功能逐渐丧失 ,4 5天后已基本无功能。　结论 :异位辅助性肝移植中 ,两肝共存时 ,自体肝的功能基本不受影响 ,随着移植时间延长 ,辅助肝逐渐萎缩。     

黄芪注射液对婴儿先天性心脏病体外循环术后肾损伤的干预作用

目的 探讨黄芪注射液对婴儿先天性心脏病(先心病)体外循环(cardiopulmonary bypass, CPB)术后肾损伤的干预效果,为先心病婴儿CPB术后肾损伤的保护提供新方法。     

准分子激光原位角膜磨镶术术后屈光回退及欠矫再手术32例临床分析

目的 观察准分子激光原位角膜磨镶术(LASIK)术后屈光回退及欠矫再手术的治疗效果.方法 对2004年5月～2009年8月在我院行LASIK术后发生屈光回退和欠矫的32例(46眼),在条件允许及患者自愿的前提下,原角膜瓣下再次行激光切削,随访1年,观察术后裸眼视力、屈光度变化及并发症发生情况.结果 32例(46眼)术后...     

王今觉教授治疗肝硬化临床用药浅析

探讨王今觉教授临床治疗肝硬化用药经验,即审因论治,善用行气活血、化湿软坚之品,强调虚实兼顾,重视运用药物的性味归经及临证加减,通过探析王老师临床治疗经验,促进名老中医临床经验的学术继承。     

原发性睾丸非霍奇金淋巴瘤1例合并文献分析

目的提高对原发性睾丸非霍奇金淋巴瘤(PTL)的全面认识,从而选择更合适的治疗方法,提高患者生存率。方法回顾性分析1例经病理活检证实为原发性睾丸非霍奇金淋巴瘤的临床资料,并结合文献进行分析。结果 PTL患者对R-CHOP方案耐受性较好,需继续观察追踪治疗效果。结论原发性睾丸非霍奇金淋巴瘤较为罕见,有明显的结外侵犯趋势,预后较差。对PTL R-CHOP方案是较佳的选择,治疗疗效尚需大样本的临床试验进一步确定。     

室内不良装修诱发儿童哮喘的探讨

[目的]探讨儿童哮喘IgE、IgA、IgG、IgM、C3、C4、外周血嗜酸性细胞与室内装修关系及室内甲醛、苯、氨浓度与儿童哮喘关系. [方法]在哮喘儿童中房屋装修30例,对照组非房屋装修30例,于入院时抽血检测IgE,IgAIgG,IgM,C3,C4外周血嗜酸性细胞进行对照研究.在室内装修(小于5年)中哮喘儿童61例,对照组非哮喘儿童61例,测量室内甲醛、苯、氨浓度进行对照研究.[结果]装修组30例哮喘儿童IgE,IgA,外周血嗜酸性细胞明显高于对照组,差异有统计学意义(P<0.05).IgG,IgM,C3,C4,差异无统计学意义(P>0.05).哮喘儿童室内甲醛、苯、氨浓度与对照组差异有统计学意义(P<0.05).非参数相关分析甲醛、苯和氨与儿童哮喘呈正相关性.[结论]室内装修导致室内空气不良可诱发儿童哮喘并加重哮喘.装饰材料中主要污染物-甲醛、苯、氨对哮喘儿童健康危害较大,应加强该方面的调查研究加快装饰材料立法和标准的制定.     

儿童先天性心脏病血清Apelin水平与肺动脉压关系的初步探讨

目的 初步探讨先天性心脏病患儿血清Apelin 水平与肺动脉压的关系.方法 手术治疗的先心病患儿126 例,检测患儿术前及术后第7 天的血清Apelin 水平.建立体外循环前检测并计算肺动脉收缩压/体循环收缩压(Pp/Ps)的比值,依据Pp/Ps 分组:无肺动脉高组压(PAH)组、轻度PAH 组、中度PAH 组和重度PAH 组;术后第7 天超声心动图估测肺动脉平均压(PAMP).结果 无PAH,以及轻、中、重度PAH 各组术前及术后的血清Apelin 水平依次降低,差异有统计学意义(PPr=-0.51,-0.54,P结论 先心病患儿并发肺动脉高压及其发展与血清Apelin 水平降低有关系,血清Apelin 对诊断先心病患儿是否并发肺动脉高压及其程度的意义值得深入研究.     

Does a reduced glucose intake prevent hyperglycemia in children early after cardiac surgery? a randomized controlled crossover study

Introduction

Hyperglycemia in children after cardiac surgery can be treated with intensive insulin therapy, but hypoglycemia is a potential serious side effect. The aim of this study was to investigate the effects of reducing glucose intake below standard intakes to prevent hyperglycemia, on blood glucose concentrations, glucose kinetics and protein catabolism in children after cardiac surgery with cardiopulmonary bypass (CPB).

Methods

Subjects received a 4-hour low glucose (LG; 2.5 mg/kg per minute) and a 4-hour standard glucose (SG; 5.0 mg/kg per minute) infusion in a randomized blinded crossover setting. Simultaneously, an 8-hour stable isotope tracer protocol was conducted to determine glucose and leucine kinetics. Data are presented as mean ± SD or median (IQR); comparison was made by paired samples t test.

Results

Eleven subjects (age 5.1 (20.2) months) were studied 9.5 ± 1.9 hours post-cardiac surgery. Blood glucose concentrations were lower during LG than SG (LG 7.3 ± 0.7 vs. SG 9.3 ± 1.8 mmol/L; P < 0.01), although the glycemic target (4.0-6.0 mmol/L) was not achieved. No hypoglycemic events occurred. Endogenous glucose production was higher during LG than SG (LG 2.9 ± 0.8 vs. SG 1.5 ± 1.1 mg/kg per minute; P = 0.02), due to increased glycogenolysis (LG 1.0 ± 0.6 vs. SG 0.0 ± 1.0 mg/kg per minute; P < 0.05). Leucine balance, indicating protein balance, was negative but not affected by glucose intake (LG -54.8 ± 14.6 vs. SG -58.8 ± 16.7 μmol/kg per hour; P = 0.57).

Conclusions

Currently recommended glucose intakes aggravated hyperglycemia in children early after cardiac surgery with CPB. Reduced glucose intake decreased blood glucose concentrations without causing hypoglycemia or affecting protein catabolism, but increased glycogenolysis.

Trial registration

Dutch trial register NTR2079.