丙戊酸静脉制剂治疗儿童癫痫持续状态的疗效及安全性

目的探讨丙戊酸静脉制剂治疗儿童癫痫持续状态的疗效和安全性.方法对25例采用传统一线药物安定及苯巴比妥治疗无效的惊厥性癫痫持续状态住院患儿,改用丙戊酸静脉制剂以15 mg/kg负荷量,1～2 mg/kg维持量治疗,观察疗效及不良反应.结果丙戊酸静脉制剂治疗儿童癫痫持续状态总有效率92%,有7例患儿出现嗜睡,未见其他不良反应.结论丙戊酸静脉制剂治疗传统一线药物无效的儿童癫痫持续状态安全、有效.     

Responsiveness of the renin-aldosterone system during exercise in young patients with essential hypertension

Abstract. The effect of exercise of gradually increased intensity, i.e. 75 W for 20 min followed by 100 W for 20 min, on plasma renin concentration (PRC) and plasma aldosterone concentration (PAC) was studied in young patients with essential hypertension and normotensive control subjects. During exercise without previous sodium loading PRC and PAC increased to the same degree in both hypertensives and normotensives during light exercise; PRC increased further significantly in the normotensives (63 to 72 μIU/ml (medians), P < 001) but not in the hypertensives (46 to 51 μIU/ml) during heavy exercise. PRC and PAC were significantly correlated during both 75 W (p = 0–633, P<005) and 100 W (p = 0–635, P<005) exercise in the normotensives, but not in the hypertensives. During exercise after loading with 500 ml sodium chloride (0–85 mol/1) PRC and PAC increased in both hypertensives (28 to 42 μIU/ml, P< 0.01; 0.11 to 0.53 nmol/1, P < 001) and normotensives (22 to 33 μIU/ml, P<002; 012 to 0–34 nmol/1, P<00), although to a considerably lower degree than without previous loading. PRC and PAC were, however, significantly higher in the hypertensive than in the normotensive group after exercise. It is suggested that the responsiveness of the renin-aldosterone system is abnormal during exercise in young patients with mild essential hypertension, both without and with previous intravenous sodium loading.     

关节腔冲洗配合醋酸曲安缩松及玻璃酸钠治疗膝骨性关节炎的临床研究

目的探讨关节腔冲洗配合醋酸曲安缩松及玻璃酸钠关节腔内注射治疗膝关节骨性关节炎的疗效。方法生理盐水1500—2500ml加20％甘露醇注射液250ml关节腔冲洗。冲洗完毕后，关节腔内注射醋酸曲安缩松5mg。1次／周，共3次，最后一次术后3d开始关节腔内注入玻璃酸钠注射液2．5ml，1次／周，连用5次，以后每隔3个月均注射玻璃酸钠1次。结果经13～25个月随访，总显效率为90．2％，总有效率为96．8％。结论本方法是一种治疗膝关节骨性关节炎安全有效的方法。     

枯草杆菌、肠球菌二联活菌多维颗粒剂联合鲁米那钠治疗母乳性黄疸临床观察

目的:观察枯草杆菌、肠球菌二联活菌多维颗粒剂联合鲁米那钠治疗母乳性黄疸的疗效。方法:将60例母乳性黄疸患儿随机分为Ⅰ、Ⅱ组,各30例患儿。两组均维持母乳喂养,Ⅰ组同时给予枯草杆菌、肠球菌二联活菌多维颗粒剂及鲁米那钠治疗;Ⅱ组仅用鲁米那钠治疗。两组患儿均治疗7至14天,观察其黄疸消退情况、治疗前及治疗7天后血清胆红素水平变化。结果:服药后3天两组患儿黄疸均开始减轻,7天时I组33%、Ⅱ组20%的患儿黄疸消失;第14天时Ⅰ组93%、Ⅱ组63%的患儿黄疸消失。用药前,两组患儿血清胆红素水平无明显差异(P>0.05),用药7天后Ⅰ组胆红素水平较Ⅱ组明显降低(P<0.05)。结论:对母乳性黄疸患儿,联合使用枯草杆菌、肠球菌二联活菌多维颗粒剂及鲁米那钠,对改善症状和降低血清胆红素水平优于单用鲁米那钠,疗效显著。     

苯溴马隆联合碳酸氢钠治疗高尿酸血症合并原发性高血压

目的探讨苯溴马隆联合碳酸氢钠治疗高尿酸血症合并原发性高血压的临床疗效。方法选择高尿酸血症伴原发性高血压患者126例,按照随机数字表方法分为A组、B组和C组,各42例。A组为苯溴马隆给药组,B组为碳酸氢钠给药组,C组为苯溴马隆加碳酸氢钠给药组。比较治疗前后3组患者的的血肌酐、血尿酸（UA）、24 h尿UA、尿素氮、甘油三酯、24 h平均收缩压与舒张压等指标的变化。结果治疗5周后,3组患者的血UA、24 h收缩压与舒张压均低于治疗前（P<0.05）,尿UA高于治疗前（P<0.05）;且治疗后C组患者的血UA、24 h平均收缩压与舒张压低于A组和B组（P<0.05）,尿UA高于A组和B组（P<0.05）,以上均差异有统计学意义。结论苯溴马隆联合碳酸氢钠治疗高尿酸血症合并原发性高血压,能有效降低患者的血UA、24 h平均收缩压和舒张压,增加尿UA的排泄,临床效果显著,值得推广应用。     

Synthesis of Geopolymer from a Novel Aluminosilicate-Based Natural Soil Precursor Using Electric Oven Curing for Improved Mechanical Strength

Natural soil (NS)-based geopolymers (GPs) have shown promise as environmentally friendly construction materials. The production of ordinary Portland cement is known to release significant amounts of greenhouse gas (CO₂) into the atmosphere. The main objective of this work is to synthesize a geopolymer (GP) from an uncommon aluminosilicate-based NS and a sodium silicate (SS) activating solution that would not only minimize the emission of harmful gases, but also offer improved mechanical strength. Samples of different compositions were produced by varying the wt.% of NS from 50% to 80% and adding a balancing amount of SS solution. The drying and curing of the samples were carried out in an electric oven at specific temperatures. The degree of geopolymerization in the samples was measured by Fourier transform infrared spectroscopy, and microstructural analysis was performed using a scanning electron microscope. Mechanical tests were conducted to evaluate the range of compressive strength values of the prepared GP samples. A minimum compressive strength of 10.93 MPa at a maximum porosity of 37.56% was observed in a sample with an NS to SS ratio of 1:1; while a ratio of 3:1 led to the maximum compressive strength of 26.39 MPa and the minimum porosity of 24.60%. The maximum strength (26.39 MPa) was found to be more than the reported strength values for similar systems. Moreover, an improvement in strength by a factor of three has been observed relative to previously developed NS-based GPs. It may be inferred from the findings that for the given NS, with almost 90% aluminosilicate content, the extent of geopolymerization increases significantly with its increasing proportions, yielding better mechanical strength.     

The Combined Use of Medium- and Short-Chain Fatty Acids Improves the Pregnancy Outcomes of Sows by Enhancing Ovarian Steroidogenesis and Endometrial Receptivity

Fatty acids play important roles in maintaining ovarian steroidogenesis and endometrial receptivity. Porcine primary ovarian granulosa cells (PGCs) and endometrial epithelial cells (PEECs) were treated with or without medium- and short-chain fatty acids (MSFAs) for 24 h. The mRNA abundance of genes was detected by fluorescence quantitative PCR. The hormone levels in the PGCs supernatant and the rate of adhesion of porcine trophoblast cells (pTrs) to PEECs were measured. Sows were fed diets with or without MSFAs supplementation during early gestation. The fecal and vaginal microbiomes were identified using 16S sequencing. Reproductive performance was recorded at parturition. MSFAs increased the mRNA abundance of genes involved in steroidogenesis, luteinization in PGCs and endometrial receptivity in PEECs (p < 0.05). The estrogen level in the PGC supernatant and the rate of adhesion increased (p < 0.05). Dietary supplementation with MSFAs increased serum estrogen levels and the total number of live piglets per litter (p < 0.01). Moreover, MSFAs reduced the fecal Trueperella abundance and vaginal Escherichia-Shigella and Clostridium_sensu_stricto_1 abundance. These data revealed that MSFAs improved pregnancy outcomes in sows by enhancing ovarian steroidogenesis and endometrial receptivity while limiting the abundance of several intestinal and vaginal pathogens at early stages of pregnancy.     

术后首次MELD评分及其衍生评分对肝衰竭患者肝移植术后早期生存率的预测价值

目的  探讨术后首次终末期肝病模型(MELD)评分及其衍生评分MELD联合血清钠(MELD-Na)评分、MELD联合血乳酸(MELD-Lac)评分对于肝衰竭患者肝移植术后早期生存率的预测能力。方法  回顾性分析135例肝衰竭肝移植受者的临床资料,根据术后28 d的生存情况分为早期生存组(110例)和早期死亡组(25例),比较两组患者的临床资料,采用受试者工作特征(ROC)曲线确定MELD评分、MELD-Na评分与MELD-Lac评分对肝衰竭患者肝移植术后早期生存率预测的最佳截取值,以评价不同评分预测肝衰竭患者肝移植术后早期生存率的能力。结果  两组患者术后首次MELD评分、MELD-Na评分、MELD-Lac评分比较,差异均有统计学意义(均为P < 0.05)。术后首次MELD评分、MELD-Na评分、MELD-Lac评分预测肝衰竭患者肝移植术后早期生存率的AUC分别为0.653 [95%可信区间(CI) 0.515~0.792]、0.648(95% CI 0.514~0.781)、0.809 (95% CI 0.718~0.900),最佳截取值分别为18.09、18.09、19.97,约登指数分别为0.398、0.380、0.525,灵敏度分别为0.680、0.680、0.840,特异度分别为0.720、0.700、0.690。MELD-Lac评分预测肝衰竭患者肝移植术后早期生存率的AUC大于MELD评分和MELD-Na评分,差异均有统计学意义(均为P < 0.05)。结论  术后首次MELD评分及MELD-Na评分对于肝衰竭患者肝移植术后早期生存率预测能力一般,而术后首次MELD-Lac评分是肝衰竭患者肝移植术后早期生存率更为可靠的预测指标。     

Posterior chamber intraocular lens implants in children: Report of a series

Posterior chamber lenses were implanted in ten eyes of nine children under 18 years of age. Visual results and complications are discussed.