经后囟穿刺部分换血治疗新生儿红细胞增多症

因新生儿周围血管细，血液淤滞粘稠、外周静脉穿刺成功率低，加之抽血量大，在抽血过程中易发生凝固等因素，而难以一次换血达到预定值，在临床实践中我们探索经后囟穿刺部分换血治疗新生儿红细胞增多症，取得满意疗效，现将方法报告如下：     

Effect on peripheral nerve vivo with human insulin-like regeneration by transgene in growth factor-1

BACKGROUND: Human insulin-like growth factor (hIGF-1) has been successful in treating peripheral nerve injury, but it is still unclear whether hIGF-1 after transgene in vivo has the effect on promoting the regeneration of peripheral nerve. OBJECTIVE: To observe the effect of hIGF-1 on the regeneration of peripheral nerve by transgene in vivo with electrophysiology, histological morphology and ultromicro morphology. DESIGN: A univariate design. SETTINGS: Jilin Institute of Surgery, China-Japan Friendship Hospital Affiliated to Jilin University; School of Basic Medical Sciences, Jilin University. MATERIALS: Thirty male adult Wistar rats of grade Ⅱ, weighing 200-250 g, were provided by the Animal Experimental Center of Jilin University [certification number: SCXK-(Ji)20030001]. The rats were raised in the environment at the temperature of 25 ℃ and humidity of 70%. All the rats were randomly divided into hIGF-1-treated group, treatment control group and blank control group, 10 rats in each group. Positive liposomes (mass concentration of 2 g/L) and pcDNA3.1 (mass concentration of 1 g/L) were purchased from Beijing Yuanpinghao Company; pcDNAhIGF-1 (mass concentration of 1 g/L) was provided by Dr. Shen from the School of Public Health of Jilin University. The liposomes were mixed with plasmids with the mass ratio of 1.5 to 10.Operative microscope was made by Jiangsu Zhenjiang Microsurgical Instrument Factory; EMB-5304K electromyogram (EMG) evoked potential meter by Nihon Kohden Corporation. HPIAS-1 000 high-acuity color pathological imaging analytical system (Japan) and JEM-1200EX transmission electron microscope (Japan) were also used. METHODS: The experiments were carried out in Jilin Institute of Surgery from April to June in 2004. ① All the rats were anesthetized, and the right sciatic nerve was exposed, and it was clipped with a clip at 5 mm below the piriform muscle for 3 times, 10 s for each time. The pressed width was 3 mm, and formed as membrane under operating microscope (×6). Rats in the hIGF-1-treated group were subepineurially injected with the mixture of pcDNAhIGF-1 and positive liposomes (10 μL) immediately, those in the treatment control group were injected with the mixture of pcDNA3.1, positive liposomes and distilled water (10 μL), and those in the blank control group were not given any injection. ② The sciatic nerve functional indexes (SFI) were measured within 56 days postoperatively according to the methods used by Shen et al. ISFI=0 was taken as normal, and ISFI=-100 as completely damaged. EMG evoked potential meter was used to record the electrophysiological changes of the regenerated nerve fibers. The indexes of histological morphology in 5 randomly selected sights were determined with the color pathological imaging analytical system, and the ultrostructures of the regenerated nerve fibers were also observed. MAIN OUTCOME MEASURES: ① Comparison of the SFI within 56 days postoperatively; ② Comparison of the electrophysiology, histological morphology and ultrastructure of the regenerated nerve fibers 56 days postoperatively. RESULTS: All the 30 Wistar rats were involved in the analysis of results. ① SFI: The SFI values were gradually increased as time prolonged in all the three groups, and the changes were more obvious after 24 days, the SFI values recovered better at each time point in the hIGF-1-treated group than in the other two groups. ② Eelectrophysiological results of right sciatic nerve: The latency of motor evoked potential (MEP) was close between the treatment control group and the blank control group [(2.55±0.36), (2.65±0.55) ms, P > 0.05], but higher in the hIGF-1-treated group [(2.14±0.22) ms] than in the blank control group (P < 0.01). The amplitude and conduction velocity of MEP in the treatment control group [(6.67±0.69) mV, (29.57±4.06) m/s] were close to those in the blank control group [(6.60±0.59) mV, (29.22±3.20) m/s, P > 0.05], but those in the hIGF-1-treated group [(7.81±0.84) mV, (36.91±4.37) m/s] were larger or faster than those in the blank control group (P < 0.01). ③ Results of the pathological image analysis of the regenerated nerve fibers: The axonal diameter, thickness of myelin sheath of the regenerated nerve fiber and the number of myelinated nerve fiber in the treatment control group [(2.28±0.33) μm, (1.08±0.18) μm2, (71.80±8.25) fibers] were close to those in the blank control group [(2.18±0.29) μm, (1.03±0.15) μm2, (68.60±8.55) fibers] (P > 0.05), and those in the hIGF-1-treated group [(3.03±0.35) μm, (1.65±0.24) μm2, (88.20±8.82) fibers] were obviously larger or more than those in the blank control group (P < 0.01). ④ Ultrastructure of the regenerated nerve fibers of sciatic nerve: In the hIGF-1-treated group, the regenerated fibers of sciatic nerve were more and mature, manifested by thicker nerve fibers, thicker and evener myelin sheath, which were better than those in the other two groups. CONCLUSION: The results of the quantitative parameters of the electrophysiology, gross histological morphology and ultrostructural changes in the process of repairing damaged peripheral nerve indicate that transgene in vivo with hIGF-1 can promote the neural regeneration after peripheral nerve injury.     

两种股静脉采集血标本方法的比较

股静脉穿刺采血是临床上常用的一种采血方法，从刚出生的婴儿至不同年龄的儿童均适用，特别是危重病人和婴幼儿，还有一些肥胖患儿和长期输液患儿，由于外周血管血液循环差，常不易找到充盈的血管，在外周静脉采血很困难，这时就需选用股静脉采集血标本，为病人的诊断和治疗提供依据。为了提高穿刺成功率。减少患儿的痛苦，提高工作效率，笔者通过对60例患儿采用两种不同股静脉穿刺方法，并对其临床效果进行比较，现报道如下：     

外周动静脉同步换血治疗新生儿高胆红素血症20例

20 0 1～ 2 0 0 2年我院儿科对 2 0例溶血性高胆红素血症行外周动静脉同步换血治疗 ,效果显著 ,现报告如下。1　临床资料1.1　一般资料 :2 0例中足月儿 18例 ,36周早产儿 2例 ,出生体重平均为 (2 986± 4 6 8) g,男 12例 ,女 8例 ,入院时日龄平均为 (3± 1.5 ) d。 2 0例患儿入院时均有黄疸 ,肝脾增大 3例 (15 % ) ,无呼吸困难及青紫 ,无神经症状。入院时血清胆红素浓度平均为 (4 2 9± 5 5 ) μmol/ L,血红蛋白量平均为 (174±30 ) g/ L。 2 0例母亲 ,与患儿 ABO血型不同者 14例 ,患 G- 6 -PD中度～重度缺陷 6例 ,产母 Rh血型均为阳性…     

外周导入中心静脉置管术在老年患者中的应用

目的:探讨外周导入中心静脉置管术(PICC)的安全性及应用。方法:对我科2002年￣2004年施行的经外周导入中心静脉置管术30例进行回顾性分析。结果:28/30例(93.3%)成功置管,平均置管时间为10￣120d,其中出现塞管2例(6.7%),外周静脉炎3例(10%),导管末端细菌培养阳性2例(6.7%)。结论:PICC置管术操作简单,安全性高,有效置管时间较长,出现并发症易于处理。不仅能减轻老年病人每日受静脉穿刺和药物对周围静脉刺激的痛苦,而且为病情恶化病人的抢救赢得了时间,值得临床推广使用。     

长航对艇员外周血红细胞及粒细胞系统的影响

红细胞是外周血的主要有形成分，不仅有重要的运输O2和CO2的作用，而且与血液酸碱平衡等重要生理功能有密切关系。粒细胞最易受环境因素的影响而导致机体抵御病原体的能力改变。长航时艇员长期处在一个密封的特殊环境，常出现胸闷气短、头痛头晕、口唇紫绀，甚至黄疸等不适症状和体征及呼吸系统、皮肤和口腔等炎症，可能是其所处环境与正常环境不同，     

高血压性左室肥厚与外周淋巴细胞内β-肾上腺素能受体激酶-1(βARK1)的关系

高血压的左室肥厚(LVH)与心血管危险性提高和交感调节改变有关联。     

外周神经动作电位记录中刺激伪迹的消除方法

<正> 记录外周神经动作电位的实验中往往有难以克服的刺激伪迹。特别所记录的外周神经比较短时,此问题更为突出。一般常用的消除刺激伪迹方法亦不易奏效。通过摸索,我们找到一种简单的消除方法。现介绍如下:     

经外周静脉置入中心静脉导管在恶性肿瘤化疗中的应用

静脉化疗是恶性肿瘤的主要治疗途径之一 ,反复多次的静脉给药可使血管内膜损伤 ,弹性下降 ,管径缩小 ,严重者可影响下一疗程治疗。而许多化疗药物常导致静脉炎 ,若渗漏皮下又可引起局部组织坏死。我们自 2 0 0 2年 10月～ 2 0 0 3年 10月对42例中晚期恶性肿瘤患者 ,采用经外周静脉置入中心静脉导管(peripherallylnsertedcentralcatheter ,PICC )注入化疗药物 ,效果满意 ,现总结如下。1　资料与方法1.1　临床资料本组 42例患者均经细胞学和 (或 )病理组织学检查证实为恶性肿瘤 ,按美国癌症 (AJCC)临床分期标准进行分期 ,均属Ⅲ～Ⅳ期 ,有…     

心脏保护性药物治疗与外周动脉疾病患者生存率改善相关

目的:研究心脏药物治疗对外周动脉疾病(PAD)患者远期死亡率的影响。背景:PAD与心血管疾病的患病率和死亡率升高相关。治疗指南推荐积极控制危险因素和改善生活方式。然而PAD患者接受心脏药物治疗的潜在获益尚未明确。方法:在此前瞻性队列研究中,入选2420例连续的PAD(踝臂指数≤