Physiological regulation in cigarette exposed infants: an examination of potential moderators

The primary purpose of this study was to examine pathways from prenatal cigarette exposure to physiological regulation at 2 months of age. Specifically, we explored the possibility that any association between prenatal cigarette exposure and infant physiological regulation was moderated by fetal growth, prenatal or postnatal environmental tobacco smoke (ETS) exposure or maternal depressive symptomatology during pregnancy. We evaluated whether exposed infants who were also exposed to ETS after birth, were small for gestational age (SGA) or had mothers with higher depressive symptoms during pregnancy had the highest levels of physiological dysregulation. Respiratory sinus arrhythmia (RSA) was obtained from 234 (166 exposed and 68 nonexposed) infants during sleep. As expected, cigarette-exposed infants had significantly lower RSA than nonexposed infants. This association was not moderated by prenatal or postnatal ETS exposure, or maternal depressive symptomatology during pregnancy. However, small for gestational age status did moderate this association such that nonexposed infants who were not small for gestational age had a significantly higher RSA than nonexposed small for gestational age infants and exposed infants. These findings provide additional evidence that prenatal cigarette exposure is directly associated with dysregulation during infancy.     

鼻内镜鼻窦手术后患者治疗依从性的护理干预

目的 探讨护理干预对鼻内镜鼻窦手术后患者治疗依从性的方法和疗效,为临床护理提供指导.方法 总结分析本院于2010年1-6月收治入院的80例鼻内镜鼻窦手术后患者.采用随机抽取法分为2组,实验组40例,行综合护理干预.对照组40例,行普通护理干预.随访6个月～1年,对比2组患者护理后认知和行为变化,并统计依从性改变.结果 ...     

筛窦恶性黑色素瘤术后胃转移1例分析

目的恶性黑色素瘤临床较为罕见,而转移至胃的病例更为罕见。为探讨其病理特征提高临床诊断而避免误诊,报道1例筛窦恶性黑色素瘤术后胃转移。方法行CT检查提示右筛窦占位性病变,进一步检查,未见转移到其他组织,于外院手术切除,术后病理证实为右筛窦恶性黑色素瘤,术后进行化疗。结果于该院行胃镜检查,两处病灶分别取活检,病理及免疫组化均证实恶性黑色素瘤胃转移。结论恶性黑色素瘤根据其发生部位分为皮肤及黏膜恶性黑色素瘤两类,以皮肤的多见,而原发于筛窦者罕见。恶性黑色素瘤的胃转移多发生于胃底、胃体。     

稳心颗粒治疗窦性心动过缓合并室性早搏的临床观察

目的 观察稳心颗粒治疗窦性心动过缓合并室性早搏的疗效与安全性.方法 选择窦性心动过缓合并室性早搏患者60例,给予稳心颗粒9 g/次,3次/d口服,4周后复查心电图1次及24 h动态心电图(Holter).观察治疗前后室早次数、心率、临床症状改善情况及药物不良反应情况.结果 治疗后临床症状明显改善、早搏明显减少.结论稳心颗粒治疗窦性心动过缓合并室性早搏安全有效且无明显不良反应.     

胺碘酮对慢性阻塞性肺病急性加重并窦性心动过速的疗效分析

目的 探讨胺碘酮在慢性阻塞性肺病急性加重期(AECOPD)并窦性心动过速中的疗效.方法 AECOPD患者43例,经合理氧疗、抗感染、纠正酸碱失衡及电解质紊乱、解痉平喘、祛痰等综合基础治疗2 h后心率仍超过120次/min,心电图确诊窦性心动过速,以随机数字法分为治疗组(A组,23例)及对照组(B组,20例);监测患者使用胺碘酮或西地兰前,使用后24 h、72 h、7 d及14 d时的心率、呼吸次数、二氧化碳分压及血氧分压、血压及心电图,必要时调整用量或停药.结果 A组及B组所有患者均能按计划完成治疗,未出现严重的心率失常;A组予胺碘酮治疗后24 h、72 h、7 d及14 d时心率、呼吸次数均有改善,并具有统计学意义;血氧分压及血二氧化碳分压也有所改善但差异无统计学意义;B组予西地兰治疗后24 h及72 h心率、呼吸次数无显著性改善;而治疗后7 d及14 d心率、呼吸次数改善具有统计学意义;监测血氧分压及血二氧化碳分压逐步改善,但差异无统计学意义.结论 胺碘酮可安全有效地降低AECOPD窦性心动过速患者的心率及呼吸频率.     

鼻腔冲洗对功能性鼻内窥镜手术疗效的影响

目的：探讨鼻腔冲洗对功能性鼻内窥镜鼻窦手术疗效的影响。方法：将183例慢性鼻窦炎、鼻息肉患者术后随机分为对照组和实验组,对照组采用滴鼻、上颌窦穿刺冲洗。实验组在滴鼻、上颌窦穿刺冲洗的基础上,配合鼻腔冲洗。结果：对照组（92例）,1期愈合50例,延期愈合21例,迁延炎症15例,无变化6例;实验组（91）例,1期愈合68例,延期愈合13例,迁延炎症8例,无变化2例。实验组疗效优于对照组,差异有统计学意义（19〈0．05）。结论：鼻腔冲洗可清除术腔血痂和分泌物,减少术后黏膜黏连,减轻黏膜充血水肿,加快黏膜纤毛摆动,促进黏膜的正常生理功能的恢复,提高疗效。     

Sinus pericranii: diagnostic and therapeutic considerations in 15 patients

INTRODUCTION: Sinus pericranii (SP) is a rare, usually asymptomatic condition characterized by a large communication between the intra- and the extracranial venous drainage pathways in which blood may circulate bidirectionally through dilated veins of the skull. We describe our diagnostic and therapeutic experience with SP, with a special focus on the vascular analysis of digital subtraction angiography (DSA). METHODS: DSA images of 15 patients were evaluated with regard to the delay in opacification of the scalp vessels, the absence or distortion of the superficial cortical veins in the vicinity of the SP, the drainage patterns of the superior sagittal sinus, and the degree of maturation of the venous outlets of the brain. SP were classified either as "dominant", if the main stream of contrast flow used the SP to drain the brain bypassing usual venous outlets, or as "accessory", if only a small part of the venous outflow occurred through the extradiploic vessels. RESULTS: All patients presented with a nonpulsatile, soft-tissue mass. The lesion was on the midline in 14 of 15 patients, frontal in 12 patients, and parietal in 2 patients. In 13 patients, associated intracranial venous anomalies were present, eight of which were developmental venous anomalies. Seven patients had a dominant SP, and eight an accessory SP. CONCLUSION: SP can be considered the cutaneous sign of an underlying venous anomaly. If treatment is contemplated, analysis of the drainage pattern of the SP has to be performed. Treatment should be avoided in dominant SP or if its accessory role constitutes the only collateral pathway of an underlying venous anomaly.