中国脑性瘫痪康复指南(2015):第七部分

正第四章脑性瘫痪的康复治疗第三节康复治疗技术(下)六、言语治疗(一)构音障碍治疗证据脑瘫患儿进行构音训练后,口、舌、唇、下颌的运动和控制能力得到提高,解决流涎问题,同时吞咽和咀嚼能力得到改善,对声响声调及速率节律异常、肌肉紧张度有明显改善[245](1个Ⅳ级证据)。90%以上的患儿言语清晰度和发音能力提高,错误的构     

心率变异性检测临床应用的建议

近十年来的大量研究，已充分肯定了自主神经活动与多种疾病有关系，特别是与某些心血管疾病的死亡率，尤其与猝死率有关。同时，也公认心率变异性（ｈｅａｒｔｒａｔｅｖａｒｉａｂｉｌｉｔｙ，ＨＲＶ）分析是判断自主神经活动的常用的定量指标。ＨＲＶ降低是预测心脏病人...     

急性非静脉曲张性上消化道出血诊治指南(2009,杭州)

[编者按]急性非静脉曲张性上消化道出血一直是临床最常见的危重急症,自从2005年<中华内科杂志>编委会组织国内部分著名专家进行多次专题讨论,并于2005年颁布了<急性非静脉曲张性上消化道出血诊治指南(草案)>[1]以来,对临床内、外科医师处理消化道出血患者起到了很好的规范和指导作用.4年以来,医疗技术日新月异,随着对本病的病因学、诊断认识的加深和治疗技术的进步,2005年颁布的指南已不能适应目前临床实际工作的需要.有鉴于此,<中华内科杂志>编委会联合<中华消化杂志>、<中华消化内镜杂志>编委会组织国内消化相关领域知名专家再次进行讨论,结合近年来国内外循证医学证据及参考更新的国外指南,对2005年颁布的指南修订如下.     

急性非静脉曲张性上消化道出血诊治指南(2009,杭州)

一、定义 急性非静脉曲张性上消化道出血(acute nonvariceal upper gastrointestinal bleeding,ANVUGIB)系指屈氏韧带以上消化道非静脉曲张性疾患引起的出血,包括胰管或胆管的出血和胃空肠吻合术后吻合口附近疾患引起的出血,年发病率为50/10万～150/10万,病死率为6%～10%~([1-2]).     

Dietary risk markers that contribute to the aetiology of hypertension in black South African children: the THUSA BANA study

Although clinical hypertension occurs less frequently in children than in adults, ample evidence supports the concept that the roots of essential hypertension extend back to childhood. Since little is available in the literature on causal dietary factors of hypertension in children, this study hypothesised that certain dietary factors can be identified as risk markers that might contribute to the aetiology of hypertension in black children. Children aged 10-15 years were randomly selected from 30 schools in the North West Province from 2000 to 2001. These children comprised 321 black males and 373 females from rural to urbanised communities, of which 40 male and 79 female subjects were identified with high-normal to hypertensive blood pressure. Blood pressure was measured with a Finapres apparatus and data were analysed with the Fast Modelflo software program to provide systolic, diastolic and mean blood pressure. A 24-h dietary recall questionnaire and weight and height measurements were taken. In a stepwise regression analysis, the following variables were significantly associated (P < or = 0.05) with blood pressure parameters of hypertensive males: biotin, folic acid, pantothenic acid, zinc and magnesium. Energy, biotin and vitamin A intakes were significantly associated with blood pressure parameters of hypertensive females. No significant dietary markers were indicated for any of the normotensive groups. Dietary intakes of all of these nutrients were well below the dietary reference intakes. In conclusion, the dietary results coupled with the cardiovascular parameters of this study identified folic acid and biotin as risk markers that could contribute to the aetiology of hypertension in black persons. The low intakes of these nutrients, among others, is a matter of serious concern, as is the increasing tendency towards urbanisation.     

兰地洛尔临床应用中国专家共识

兰地洛尔是新一代速效、超短效、高选择性β 1受体阻滞剂,对心脏抑制作用弱且较少引起低血压。国内医师对兰地洛尔的认识和用药经验相对匮乏。为使临床医师更充分了解和合理使用兰地洛尔,中国医师协会心力衰竭专业委员会组织国内该领域专家制定了本共识。本共识从兰地洛尔的药代动力学和药理作用,以及在快速心律失常、急性冠状动...     

大鼠离体心脏缺血-再灌注过程的功能变化

目的 建立大鼠离体心脏缺血-再灌注(I/R)损伤模型,观察I/R过程心脏舒缩功能与冠脉流量变化. 方法 大鼠离体心脏采用Langendorff法灌流,对照组(n=8)心脏连续灌流80 min;I/R组(n=8)心脏缺血40 min再灌注40 min.实验过程实时动态检测心率(min-1)、心肌收缩幅度(g)与最大收缩速度(dT/dtmax,g/ms)、最大舒张速度(-dT/dtmax,g/ms)、心肌静息张力(g)、冠脉流量(液滴,min-1). 结果 与对照组比较,I/R组心脏缺血后心搏停止,20 min后心肌静息张力上升(P＜0.05);再灌注后心肌张力仍高;心搏恢复但心率、心脏收缩幅度、最大收缩速度、最大舒张速度均降低(P＜0.05～0.001);再复灌注初冠脉流量恢复正常,10 min后呈下降性变化(P＜0.05～0.001). 结论 大鼠离体心脏缺血40 min再灌注40 min导致I/R损伤,该模型制备及功能评价方法简便可靠.     

肝脏疾病

肝脏是全身代谢和营养的中心器官，碳水化合物、蛋白质／氨基酸、脂肪的合成和分解主要通过肝脏完成。同时，有多种维生素通过肝脏进行合成、活化和储存。此外，肝脏还具有生物转化功能，大部分内源性和外源性代谢终末产物需要通过肝脏转化后方能以安全的形式排出体外。