气管插管冲洗抢救婴幼儿重症肺炎痰堵20例临床分析

目的:探讨气管插管冲洗在抢救婴幼儿重症肺炎痰堵的治疗效果。方法:在治疗肺炎的基础上,对痰液黏稠,痰堵致呼吸困难的20例婴幼儿重症肺炎行气管插管冲洗、吸痰,开通气道,解除呼吸道阻塞。结果:20例患儿中痊愈19例,1例因就诊时间过晚,插管成功后因多脏器功能衰竭而死亡。结论:气管插管冲洗可迅速开通气道,解除呼吸道痰堵,清理上、下呼吸道分泌物,是改善通气功能,纠正呼吸衰竭和进行辅助呼吸的有效方法。     

Influence of exclusive breastfeeding on hippocampal structure,satiety responsiveness,and weight status

Longer exclusive breastfeeding duration has been associated with differences in neural development, better satiety responsiveness, and decreased risk for childhood obesity. Given hippocampus sensitivity to diet and potential role in the integration of satiety signals, hippocampus may play a role in these relationships. We conducted a secondary analysis of 149, 7–11‐year‐olds (73 males) who participated in one of five studies that assessed neural responses to food cues. Hippocampal grey matter volume was extracted from structural scans using CAT12, weight status was assessed using age‐ and sex‐adjusted body mass index (%BMI_p85), and parents reported exclusive breastfeeding duration and satiety responsiveness (Children''s Eating Behaviour Questionnaire). Separate path models for left and right hippocampus tested: (1) the direct effect of exclusive breastfeeding on satiety responsiveness and its indirect effect through hippocampal grey matter volume; (2) the direct effect of hippocampal grey matter volume on %BMI_p85 and its indirect effect through satiety responsiveness. %BMI_p85 was adjusted for maternal education, yearly income, and premature birth while hippocampal grey matter volume was adjusted for total intercranial volume, age, and study from which data were extracted. Longer exclusive breastfeeding duration was associated with greater bilateral hippocampal grey matter volumes. In addition, better satiety responsiveness and greater left hippocampal grey matter volume were both associated with lower %BMI_p85. However, hippocampal grey matter volumes were not associated with satiety responsiveness. Although no relationship was found between breastfeeding and child weight status, these results highlight the potential impact of exclusive breastfeeding duration on the hippocampal structure.     

风湿平胶囊对大鼠生殖功能及胚胎发育的影响

目的:观察风湿平胶囊对大鼠生殖功能及胚胎发育的干扰和影响.方法:采用SD大鼠对风湿平胶囊进行一般生殖毒性试验.雄鼠从交配前9周至交配成功,雌鼠从交配前2周到妊娠后第8 d,连续经口灌胃给药,每天1次.交配结束后处死雄鼠,进行精子畸形检查及睾丸组织病理学检查.交配成功的雌鼠于妊娠第20 d解剖,记录胎儿总重、黄体数、着床腺数、吸收胎数、活胎数、死胎数等指标.计算雌雄大鼠交配率及妊娠率.各取一半存活胎鼠进行内脏及骨骼检查.结果:223 mg/kg、304 mg/kg、446 mg/kg、608 mg/kg的风湿平胶囊可导致雄性大鼠睾丸生精细胞发育不良、精子减少及精子畸形等.1216 mg/kg的风湿平胶囊可致雌鼠体重增长缓慢,304 mg/kg以上剂量的风湿平胶囊可降低雌性大鼠妊娠率,608 mg/kg和1216 mg/kg的风湿平胶囊可降低雌鼠黄体数及着床腺数,1216 mg/kg的风湿平胶囊可致胎鼠骨骼发育迟缓.结论:风湿平胶囊可导致雄鼠睾丸生精细胞发育不良、精子减少及精子畸形等,影响雌鼠受精卵着床及引起胎鼠骨骼发育缓慢.     

高压氧对链脲佐菌素大鼠糖尿病性心肌病变的治疗作用

目的 研究高压氧治疗(HBOT)是否可改善STZ(链脲佐菌素)大鼠的糖尿病性心肌病变。方法 STZ大 鼠造模成功3月,电镜证实有心肌病变后,随机分为3组:(1)HBOT组(n=30):每天接受0.15 MPa、HBOT 1 h,连 续20 d。(2)糖尿病对照组(n=32):不做治疗。(3)正常对照组(n=20):腹腔注射生理盐水的无糖尿病的正常大 鼠。分别在疗程5、10、20 d后处死治疗组及同期对照组大鼠,取心脏进行HE染色病理学观察和电镜观察。结果 HBOT治疗20 d后STZ大鼠的糖尿病性心肌病变明显好于同期糖尿病对照组,电镜观察显示肌丝排列整齐、Z线 明显、线粒体排列规则、结构紧凑。结论 HBOT可改善STZ大鼠糖尿病性心肌病变。     

巨大心脏瓣膜置换术的临床研究

目的:总结合并巨大心脏瓣膜病行心脏瓣膜置换术的疗效,探讨影响手术疗效的高危因素,手术适应症,围手术期处理.方法:1999年6月至2004年6月共为16例合并巨大心脏(CTR＞0.7)的瓣膜病行心脏瓣膜置换术,其中双瓣置换术12例、二尖瓣置换术2例、主动脉瓣置换术2例,同时行三尖瓣Devega成形术2例,均选用机械瓣.结果:术后早期死亡2例,1例并发肾功能衰竭,多器官功能衰竭死亡.1例并发恶性室性心律失常死亡,死亡率为12.2%,14例生存,术后6个月时心功能明显改善.结论:提高手术疗效,降低手术并发症及死亡率的关键是把握手术时机、完善的围手术期处理.     

肝癌患者血清和腹水可溶性肿瘤坏死因子受体-p55的测定

目的 进一步了解肝癌患者的异常免疫状态,探讨血清、腹水中可溶性肿瘤坏死因子受体-p55（sTNFR-p55）检测的临床意义。方法　以双单抗夹心酶免疫吸附法检测了25例肝癌患者和25例肝硬化患者的血清、腹水中血清sTNFR-p55水平并以正常人为对照。结果肝癌病人血清sTNFR-p55浓度[（0.74±0.50）ng/ml]显著高于正常人[（0.37±0.03）ng/ml]和肝硬化患者和[（0.35±0.02）ng/ml],P<0.01。肝癌病人腹水sTNFR-p55浓度[（1.11±1.25）ng/ml]亦显著高于肝硬化患者[（0.33±0.03）ng/ml],P<0.01。肝癌、肝硬化患者血清与腹水的sTNFR-p55水平显著相关。肝癌患者血清sTNFR-p55水平与外周血TBil和AFP呈正相关（r=0.524,P=0.01和r=0.234,P=0.03）。结论　sTNFR-p55的检测对反映肝癌患者的异常免疫状态和肿瘤诊断具有实用价值。     

过量运动对健康大鼠肾脏结构与功能的影响

目的：观察过量运动对健康大鼠肾脏结构与功能的影响并探讨其可能机制。方法：将30只健康Sprauge-Dawley(SD)大鼠按照随机数字表随机分为安静对照组和过量运动组,每组15只。安静对照组在鼠笼内安静饲养,过量运动组进行16周高强度跑台力竭运动。实验后,测定24 h尿蛋白（UP）、血尿素氮（BUN）和血清肌酐（SCr）含量评价肾功能;分别行HE、Masson染色观察肾脏组织病理学改变,同时获取肾小球和肾小管损伤评分以及纤维化指数（FI）;免疫印迹测定转化生长因子-β1(TGF-β1)、基质金属蛋白酶-9(MMP-9)、α-平滑肌肌动蛋白（α-SMA）和E-钙黏蛋白（E-CA）蛋白表达量。结果：与安静对照组比较,过量运动组肾脏结构异常,肾小球损伤评分、肾小管损伤评分、FI、UP、BUN和SCr增加（t分别为-6.895、-7.365、-9.234、-4.964、-7.753、-16.444,均P<0.05）,MMP-9蛋白表达下调（t=5.077,P<0.05）,而TGF-β1、α-SMA和E-CA蛋白表达差异无统计学意义（t分别为-1.801、-1.129、1.585,...     

Pre-treatment waking cortisol response and vulnerability to interferon α induced depression

Depressive disorder is a common consequence of interferon α treatment. An understanding of the aetiological processes involved is evolving. HPA axis abnormalities are clearly described in community depressive disorder and represent vulnerability to depression development. We explored whether pre-treatment HPA axis abnormalities influence depression emergence during interferon α treatment. We examined waking HPA axis response via salivary cortisol sampling in 44 non-depressed, chronic hepatitis C infected patients due to commence standard interferon α treatment. Hamilton depression scales and the structured clinical interview for DSM-IV major depressive disorder status were administered monthly during treatment. Major depressive disorder developed in 26 of 44 subjects during interferon-α treatment. The pre-treatment waking cortisol response over 1 h was significantly greater in the subsequent switch to depression group (F=4.23, p=0.046). The waking cortisol response pre-treatment with interferon α appears greater in those subsequently switching to depressive disorder during treatment. This waking response may join other vulnerability factors for depression emergence in this group. This model could prove a valuable tool in understanding non-iatrogenic depressive disorder in the general population and notably the role of cytokines.     

不同吡喹酮给药方案治疗日本血吸虫感染小鼠的结果比较

目的:观察吡喹酮不同给药时间、不同给药剂量对日本血吸虫感染小鼠生存状况的影响,以及对小鼠血清中可溶性虫卵抗原(SEA)特异性抗体水平的影响。方法:90只BALB/c小鼠随机分成5组,感染和治疗1、2、3组,各20只小鼠,以腹部贴壁法感染日本血吸虫尾蚴;剩余10只小鼠作为阴性对照组(Ns)。治疗1、2组均在感染6周时开始治疗,给药剂量分别是300mg.kg-1和150 mg.kg-1,连续给药3 d;治疗3组在感染5周开始治疗,给药剂量150 mg.kg-1,连续给药3 d;治疗2和治疗3组于感染后8周进行第二次治疗,剂量300 mg.kg-1,连续给药3 d。整个实验过程对小鼠进行每周进行称重,观察小鼠生存状态的变化。感染后12周、14周、17周对各组小鼠采血,检测血清中SEA特异性IgG抗体的变化。结果:感染日本血吸虫6周后,感染和治疗组BALB/c小鼠体重均显著降低;其中感染5周开始给药的治疗3组小鼠体重恢复最快,感染后7周体重就恢复到阴性组水平,小鼠的生存率为100%,治疗后血清SEA特异性IgG值也最低;感染6周开始治疗的两组中,高剂量的治疗1组体重恢复略快于低剂量的治疗2组,但是治疗1组小鼠生存率仅为30%,明显低于治疗2组的65%。治疗1、2组的小鼠血清IgG值比较接近,高于治疗3组。结论:小鼠感染日本血吸虫后,最佳治疗时间应不晚于感染5周,在感染5周之前给予治疗能大大降低感染小鼠的死亡数量,治疗效果最显著;对于感染6周后的小鼠,应该采用首次低剂量服药治疗,可明显改善感染小鼠的生存率。治疗时间提前有助于鼠血清抗体水平回落。