三七总苷治疗进展性脑梗死的疗效和安全性

目的:观察三七总苷对进展性脑梗死的疗效及安全性.方法:640例起病24h内的急性脑梗死患者随机分为两组.对照组320例采用常规治疗,根据病情应用20%甘露醇、706代血浆、舒血宁、川芎嗪、维脑路通、胞磷胆碱、尼莫地平、阿司匹林等,试验组320例在常规治疗基础上给以三七总苷0.4～0.8 g加入氯化钠注射液500 mL,静滴,qd,14 d为1个疗程.观察两组治疗后进展性脑梗死的发病率,检测治疗前后进展性脑梗死全血高切还原黏度、全血低切还原黏度、血浆黏度、红细胞聚集指数、红细胞压积、红细胞变形指数、纤维蛋白原及神经功能缺损评分.结果:试验组进展性脑梗死发生率为10.63%(34/320),对照组进展性脑梗死发生率为28.75%(92/300)(P＜0.05).试验组进展性脑梗死神经功能缺损评分明显低于对照组[进展高峰值:(22±4)vs.(26±6);治疗d20时:(13±8)vs.(18±3),均为P＜0.01].试验组全血高切还原黏度、全血低切还原黏度、血浆黏度、红细胞压积明显低于治疗前(P＜0.05),不良反应轻.结论:三七总苷治疗进展性脑梗死安全有效.     

柴莪退热栓治疗急性病毒性上呼吸道感染临床研究

目的观察柴莪退热栓治疗急性病毒性上呼吸道感染中医辨证属卫分证、卫气同病证的临床疗效,并探讨外感高热卫分证、卫气同病证证候与疗效间的关系.方法将患者 80例随机分为治疗组与对照组,分别予柴莪退热栓和消炎痛栓塞肛,并进行安全性评价.结果两组总体疗效相当,且未发现明显毒副作用.结论 柴莪退热栓治疗急性病毒性上呼吸道感染疗效满意.     

Examining the effects of lipopolysaccharide and cholecystokinin on water ingestion: comparing intake and palatability

Lipopolysaccharide (LPS) and cholecystokinin (CCK) have been shown to have anorectic properties in a variety of species. The present study examined the effects of LPS and CCK, both alone and in combination, on two different aspects of water ingestion, water intake and palatability. On test days, animals were first injected intraperitoneally (i.p.) with either LPS (200 microg/kg) or NaCl vehicle, and 2 h later received a second injection of either CCK (8 microg/kg) or NaCl vehicle. In Experiment 1, water intake was monitored for 1 h on 3 separate test days 72 h apart; while in Experiment 2, water palatability was assessed using the taste reactivity test (TRT), on two separate test days 72 h apart. Both LPS and CCK significantly (p<0.05) reduced water intake, with the effects of combined LPS with CCK being more pronounced than either agent injected alone. Rats developed a rapid tolerance to the effects of LPS on water intake on subsequent exposures to LPS. Results from the TRT indicated that LPS enhanced water palatability (p<0.05), as evidenced by a high level of ingestive responding, whereas CCK produced a pattern of responding indicative of satiety. LPS plus CCK reduced ingestive responding on the first test day, but these responses were significantly increased on the second test day (p<0.05). These results demonstrate that although LPS reduces water intake, it enhances water palatability. The results further underscore the necessity for examining palatability changes in addition to intake measures when studying the regulation of feeding and drinking.     

儿童急性白血病患者血浆止凝血分子标志物检测的临床意义

目的　了解三种止凝血分子标志物在不同类型 ,不同出血程度的儿童急性白血病 (AL)患者中的变化并探讨其临床意义。方法　用ElISA方法检测了 56例初诊AL患儿血浆中的凝血酶调节蛋白 (TM) ,可溶性纤维蛋白单体复合物 (SFMC) ,D-二聚体 (D -D)含量 ,并用常规方法检测了 56例AL患儿的血小板 (BPC)、血浆凝血酶原时间 (PT)、活化部分凝血活酶时间 (APTT)、凝血酶时间 (TT)、鱼精蛋白副凝试验( 3P)及纤维蛋白原定量 (Fg)。结果　 56例AL患儿的SFMC、D -D均值高于正常对照组儿童的均值 ,两组比较有显著差异 (P <0 0 5)。急性非淋巴细胞白血病 (ANLL)与急性淋巴细胞白血病 (ALL)比较 ,ANLL患儿组的SFMC、D -D的血浆含量显著高于ALL组。高白细胞性急性白血病 (HLAL)与其它初诊时白细胞数低于 1 0 0× 1 0 9/L的AL患儿比较 ,TM、SFMC、D -D均有显著差异 (P <0 0 5)。无出血组与正常对照比较 ,SFMC、D -D及BPC有显著差异 (P <0 0 5) ,其它项目无显著差异 ,轻度出血组与无出血组比较 ,BPC减低有显著差异 (P <0 0 5) ,而其它项目无显著差异 ,重度出血组与轻度出血组相比较 ,TM、SFMC、D -D、3P试验、Fg均有显著差异。结论　 1、儿童AL患儿存在不同程度凝血、纤溶紊乱 ,以HLAL患儿最严重。 2、血管内皮细胞受损 ,?     

Acute-onset nontraumatic paraplegia in childhood: fibrocartilaginous embolism or acute myelitis?

Fibrocartilaginous embolus causing acute spinal cord infarction is a rare cause of acute-onset paraplegia or quadriplegia. Few cases of survivors have been reported in the neurosurgical literature, with most reports involving post-mortem or biopsy findings. There is little information on MRI findings in such patients. We present the youngest patient ever reported, and discuss the important differences between fibrocartilaginous embolus and acute myelitis of childhood. A 6-year-old girl with a history of back pain presented with sudden-onset nontraumatic paraplegia, with a clinical anterior spinal artery syndrome. Initial MRI scan revealed intervertebral disc disease at L1–2 and an incidental thoracic syrinx, but no cause for her acute-onset paraplegia was identified. Cerebrospinal fluid and other investigations were all negative. Sequential MRI scans revealed development of spinal cord expansion from T10 to the conus medullaris, with increased cord signal in the anterior aspect of the spinal cord. The intervertebral disc disease was unchanged. The imaging and clinical findings were caused by fibrocartilaginous embolus, which meant there was no need for spinal cord biopsy. The report describes the clinical and imaging criteria for diagnosis of fibrocartilaginous embolus, highlighting the case for avoiding an unnecessary biopsy. The clinical pattern in the paediatric group is discussed, with features differentiating it from acute myelitis of childhood. Received: 4 January 2000     

P-选择素在急性冠脉综合征中的研究进展

P-选择素可反映体内血小板的功能状态,间接反映体内血管炎症及免疫状态,而炎症与免疫可能是导致斑块不稳定的主要因素,观察及干预P-选择素可能对急性冠脉综合征的预测和防治有帮助。     

肺保护性通气策略在儿童急性呼吸窘迫综合征中的应用价值

Objective To assess the effect of lung protective ventilation on outcome of children with acute respiratory distress syndrome(ARDS).Methods Between January 1999 and December 2007,43 children with ARDS were enrolled from PICU of Shanghai Children's Medical Center and assigned to the protective-ventilation group(group A) or the conventional-ventilation group(group B).The patients in group A (from January 2004 to December 2007)received lower tidal volume(6～7 ml/kg) and high levels of positive end-expiratory pressure(PEEP),and optimal oxygenation was achieved by adjusting FiO2 and PEEP.The patients in group B(from January 1999 to December 2003) received relatively higher tidal volume(8～12 mL/kg) with lower PEEP(2～6 cm H2O),and optimal oxygenation was achieved by adjusting FiO2.Tidal volume,PEEP,arterial blood gas,mortality and the number of ventilator-free days were compared between the two groups.Results Since protective ventilation was adopted after 2004,tidal volume was significantly lower in group A[(7.09±1.66)ml/kg]as compared with that in group B[(9.82±2.31) ml/kg](P=0.001).PEEP was significantly higher in group A[(7.15±2.08) cm H2O]as compared with that of group B[(5.40 + 1.84) cm H2O](P=0.021).The mortality was 30.3% in group A and 60.0% in group B.The number of ventilator-free days were(10.88±8.84) d in group A and(8.40±10.86) d in group B.Although mortality was lower and number of ventilator-free days was greater in group A,no significant differences were found between the two groups(P＞0.05).Conclusion Lung protective ventilation may improve the outcome for pediatric patients with ARDS,however,larger trials are required before a definite conclusion can be reached.     

纳洛酮治疗急性酒精中毒46例疗效观察

目的:总结纳洛酮(naloxone)治疗急性酒精中毒的疗效和经验。方法:对用纳洛酮治疗的46急性酒精中毒患者的临床资料进行分析。结果:纳洛酮治疗轻、中度患者症状消失时间为(0.6±0.1)小时,重度中毒患者神志清醒时间为(3.0±0.3)小时,与传统的治疗相比有明显的优势。结论:纳洛酮是治疗急性酒精中毒的有效药物,使用简单,疗效快速可靠。     

内皮素在急性胰腺炎中的标志物作用

目的　本实验旨在观察ANP时ET在腔静脉血和门静脉血中的浓度变化。方法　将 10 8只大鼠随机分成仿手术组 (A )、损伤对照组 (B)、DA给药一组 (C)和二组 (D )。采用 4 5%牛磺胆酸钠逆行胆胰管逆行注射建立大鼠ANP模型 ,并于 1h、 6h、 2 4h采集尾静脉和下腔静脉、门静脉血液 ,用放免法测定ET含量 ,取胰腺组织作病理切片检查和评分。结果　对照组大鼠外周血、门脉血和腔静脉血ET水平明显高于假手术组和给药组 ,其胰腺病理学改变也明显加重 ,DA一组和DA二组的ET水平及病理改变也有统计学差异。结论　ET能有效反映胰腺病变程度 ,检测门脉血指标比外周血更灵敏、准确 ,经腹主动脉给药比外周静脉注射更有效     

Acute hyperglycemia attenuates nerve conduction velocity and nerve blood flow in male Sprague–Dawley rats: reversal by adenosine

Hyperglycemia is implicated to play a major role in development of diabetic neuropathy. Since most of the diabetics are hyperglycemic much before they develop full-blown diabetes, we felt, it would be very important to know the effects of acute hyperglycemia on nerve function so that early pathophysiological events could be understood and appropriate therapeutic intervention can be made. Moreover, effect of acute hyperglycemia on motor nerve conduction velocity (MNCV) and nerve blood flow (NBF) is not known. Hence, we studied the effects of acute hyperglycemia on sciatic MNCV and sciatic NBF in healthy male Sprague-Dawley (SD) rats. Three different animal models of acute hyperglycemia (50% glucose (3 g kg(-1), i.v. (intra-venous) or i.p. (intra-peritoneally)) or 24 h post-streptozotocin (STZ) injected rats were used. Acute hyperglycemia but not mannitol or sucrose significantly attenuated MNCV and NBF. Adenosine (10 mg kg(-1), i.p.) prevented the acute hyperglycemia-induced attenuation of MNCV and NBF in all the three rat models of acute hyperglycemia. Adenosine effects were blocked by theophylline (50 mg kg(-1), i.p.) suggesting the role of adenosinergic receptor mediated mechanisms in acute hyperglycemia-induced neuropathy. Acute glucose administration in 8 weeks, STZ diabetic rats did not further affect MNCV or NBF. Adenosine (10 mg kg(-1), i.p.) did not produce any adverse effects on the blood pressure and heart rate. From the results, we conclude that acute hyperglycemia attenuates MNCV and NBF via an adenosinergic receptor-dependent mechanism.