妥泰预防热性惊厥的临床及实验研究

目的观察妥泰(topiramate, TPM)单药在预防动物及儿童热性惊厥发作的疗效、价值与毒副反应.方法挑选60只对热惊厥敏感的Wistar大鼠和90例符合 CFC诊断的儿童使用妥泰后,观察其热性惊厥敏感性改变情况和毒副反应.结果①Wistar大鼠用药后,入热水浴后发生惊厥的时间明显推迟(t=3.07～3.59,P<0.01);而惊厥持续的时间则明显缩短(t=3.33～4.18,P<0.01);同时热惊厥发生的程度也明显减轻(t=4.89～6.65,P<0.01).②90例CFC儿童服用妥泰前后热惊发作次数分别为(8.72±11.07)次,(0.24±0.72)次,差异非常显著(t=7.25,P<0.01);用药前后脑电图比较也有明显改善(χ2=20.63,P<0.01).③Wistar大鼠和CFC儿童服用TPM后出现神萎、纳差、消瘦等不良反应者分别为65%(39/60),13.3%(12/90),两者分别相比差异非常显著(χ2=42.83-12.82,P<0.01).结论 TPM用于预防动物和儿童热性惊厥的发生具有临床疗效高,使用剂量较小,副作用较少等优点,因而具有较好的临床使用价值.     

妥泰防治复杂型高热惊厥复发的疗效观察

目的 探讨妥泰(TPM)单药预防复杂型高热惊厥(CFC)复发的疗效。方法 定期随访记录26例CFC患儿服用TPM后惊厥复发情况、TPM用量和用药期间出现的不良反应。结果 TPM完全控制发作的患儿占73．08％，患儿出现不良反应和事件约46.2％，主要为食欲下降，体重减轻(11／12，91．7％)，可能的复发危险因素为发作持续时间(P＝0.0057)。结论 TPM可作为预防CFC复发的药物长期服用，副作用能耐受，安全性高。     

热性惊厥复发危险因素与预后82例分析

目的研究热性惊厥患儿的复发危险因素及预后情况。方法结合82例热性惊厥患儿的临床及脑电图资料,研究其复发、转为癫痫和出现智力障碍及行为异常的情况。结果复发共43例。其中,各种危险因素的例数分别为:惊厥家族史20例、初次发作年龄<1岁8例,初发体温<38.5℃8例,复杂型热性惊厥19例,围产期异常11例(P<0.01或0.05)。热性惊厥转为癫痫共10例;转为癫痫的各种危险因素分别为:初次发作年龄<1岁5例,热性惊厥反复发作9例,复杂型(CFC)6例,惊厥家族史7例(P<0.01或0.05);发生智力障碍及行为异常2例(2.44%)。结论热性惊厥复发危险因素与惊厥家族史、初次发作体温、初次发作年龄、复杂型热性惊厥及围产期异常有关;热性惊厥转为癫痫的危险因素与复杂型热性惊厥、初次发作年龄、热性惊厥反复发作和惊厥家族史有关。     

托吡酯、丙戊酸钠、苯巴比妥预防动物反复热性惊厥脑损伤的作用

目的:探讨托吡酯(TPM),丙戊酸钠(VPA),苯巴比妥(PB)对大鼠反复热性惊厥(CFC)脑损伤的保护作用,并比较它们之间的差异.方法:清洁级SD大鼠,采用热水浴升高大鼠体温的方法,制备CFC大鼠模型.实验分为TPM组、PB组、VPA组、生理盐水(NS)组和正常对照组.在对TPM组,PB组,VPA组,NS组实行药物干预的同时,每2 d使大鼠热性惊厥(FC)1次,观察大鼠对FC的反应情况,并对CFC后大鼠脑海马组织进行电镜观察和血清神经元特异性烯醇化酶(NSE)水平检测,以了解脑损伤的发生情况;采用水迷宫方法观察大鼠学习记忆的改变情况.结果:大鼠血清NSE浓度TPM组,PB组,VPA组,正常对照组分别为(2.0±0.26),(2.5±0.35),(2.3±0.24),(1.52±0.24)mg/L,以NS组(3.30±0.31)mg/L的浓度最高,与其他各组比较,差异具有统计学意义(P<0.05).水迷宫实验结果以NS组潜伏期(53.0±35.0)s最长,正常对照组潜伏期(12.1±12.6)s最短,与PB组VPA组比较,差异具有统计学意义(P<0.05);TPM组(22.8±29.0)s与正常对照组间差异无统计学意义(P0.05).脑组织超微结构表现NS组海马CA1区及门区神经元细胞核为中-重度肿胀,神经元出现坏死现象,同时伴有线粒体肿胀,嵴模糊不清,甚至消失.而TPM组,PB组,VPA组表现为海马CA1区及门区神经元基质多均匀,细胞核为轻.中度肿胀,少量线粒体出现嵴模糊不清,肿胀.结论:TPM,VPA,邝对CFC造成的大鼠脑损伤均具有保护作用,可以改善FC性脑损伤的程度,以TPM预防和减轻CFC所导致的惊厥性脑损伤的效果最好.     

儿童热性惊厥发作的昼夜分布特点及相关影响因素

目的 探讨儿童热性惊厥发作的昼夜分布特点及相关影响因素。方法 回顾性分析河北大学附属医院儿科2014年1月至2019年12月收住院的443例热性惊厥患儿发作次数的昼夜分布特点,并分析性别(男/女)、初发年龄(≤3岁/>3岁)、胎龄(早产/足月)及出生方式(剖宫产/顺产)对热性惊厥发作昼夜分布的影响作用。结果 热性惊厥发作次数的昼夜分布差异有统计学意义(χ²=5.411,P=0.020);单因素分析结果显示,不同性别、初发年龄、胎龄的患儿发作的昼夜分布差异均有统计学意义(均P<0.05);Logistic回归分析发现,初发年龄、胎龄是儿童热性惊厥发作昼夜分布的影响因素,差异均有统计学意义(均P<0.05)。结论 儿童热性惊厥发作的昼夜分布有一定特点,且受初发年龄、胎龄的影响。     

小儿复杂性热性惊厥与血清钙、铁、镁的相关性探讨

目的 观察和分析小儿复杂性热性惊厥与血清钙、铁、镁的相关性.方法 选择45例小儿复杂性热性惊厥患儿为研究对象.同期选择本院门诊体检正常儿童60例作为对照组.通过对复杂性热性惊厥患儿进行微量元素钙、铁、镁测定,对比分析发现复杂性热性惊厥与微量元素钙、铁、镁密切相关.结果 实验组患儿的血清钙含量为(1.58±0.34)μmol/L,血清铁含量为(7.55±2.54)μmol/L,对照组患儿的血清钙含量为(2.00±0.19)μmol/L,血清铁含量为(9.31±2.76)μmol/L,实验组显著低优于对照组,差异具有统计学意义(P<0.05);实验组患儿的血清镁含量为(2.77±0.34)μmol/L,对照组患儿的血清镁含量为(2.86±0.12)μmol/L,两组差异无统计学意义.结论 小儿复杂性热性惊厥的发作和血清钙、铁含量密切相关,而和血清镁含量无显著关系,为临床治疗复杂性热性惊厥提供可靠的依据,造福于广大患儿,提高患儿的生活质量,值得参考.     

热性惊厥患儿485例的临床特征和脑电图分析

目的探讨热性惊厥患儿的临床特征和脑电图特点。方法对485例热性惊厥患儿临床资料和脑电图进行回顾性分析。结果 485例热性惊厥患儿≤3岁者395例(81.4%);惊厥时体温在38℃以上者469例(96.7%),其中≥39℃者326例(67.2%),有家族史者216例(44.5%);首次发作1-3 d内脑电图异常299例(61.6%),惊厥发作后10-14 d脑电图异常171例(39.3%)。脑电图异常171例,其中>3岁58例(58/88,占65.9%),体温≤38℃者11例(11/16,占68.8%),发作次数>2者62例(62/83,占74.7%)。结论热性惊厥患儿的发作与年龄、体温、惊厥家族史有关;脑电图异常与年龄、体温、发作次数有关。     

热性惊厥临床和脑电图分析

热性惊厥是小儿惊厥中最常见的一种,热性惊厥多在原发疾病的初期体温骤然升高时发生。但惊厥严重程度并不与发热程度完全一致。单纯性热性惊厥(SFC)与复杂性热性惊厥(CFC)在临床上表现不同。脑电图(EEG)异常程度与预后有一定的关系。我们收集本院1999年1月至2005年1月间177例临床诊断为热性惊厥患儿的临床及EEG资料,现分析如下。1资料与方法1.1一般资料:本组177例患儿中男性105例,女性72例,年龄4个月￣10岁,平均3.36岁,病程1d至4年,临床表现体温升高时出现突发性意识丧失,两眼凝视或眼睑、面肌、口周抽动,多数是全身发作,表现为强直或…     

托吡酯添加治疗儿童癫痫临床疗效观察

目的 观察托吡酯(TPM)添加治疗儿童癫痫的疗效.方法 采用不同剂量(3.2-12.0mg.kg-1·d-1 )的托吡酯添加治疗35例儿童部分性和或全身性癫痫(基线发作次数的中位值6次/月)的开放性研究.TPM治疗的平均时间为(447±142) d (范围28～582d),TPM持续治疗3个月和6个月的平均剂量为6.75mg.㎏-1·d-1.结果 >70%的患儿发作频率减少≥50%,38%(13/34)的患儿无发作持续3个月以,43% (14/32)的患儿无发作持续6个月以上.接受不同剂量TPM的治疗反应大致相同(p>0.05).而最常见的不良反应为中枢神经系统的表现.经过2年的治疗,26%的患儿因不良反应和发作未得到有效的控制而未继续用药.结论 TPM添加治疗儿童癫痫具有良好的耐受性和安全性,并可作为基础抗癫痫药物失败后长期控制癫痫发作的广谱癫痫药.     

小儿热性惊厥复发的相关因素分析

目的研究小儿热性惊厥复发的影响因素及其预防措施。方法回顾性分析2009年3月至2012年3月佛山市南海区第四人民医院儿科收治的290例小儿热性惊厥首发患儿的临床资料,应用单因素分析复发情况的影响因素,分析热性惊厥患儿复发的影响因素。结果首次发作患儿160例,复发患儿130例,热性惊厥患儿复发的影响因素单因素分析显示,剖宫产、女性、复杂热性惊厥、有直系亲属发病史、首次发作年龄为6个月至2岁、首次发病体温<39.5℃的患儿复发率高于顺产、男性、单纯热性惊厥、无直系亲属发病史、首次发作年龄为2~6岁、首次发病体温≥39.5℃的患儿[50.6%(79/156)比19.4%(26/134)、44.4%(59/133)比29.3%(46/157)、34.2%(83/155)比16.3%(22/135)、51.3%(80/156)比18.6%(25/134)、48.7%(74/152)比22.5%(31/138)、47.8%(76/159)比22.1%(29/131)],差异有统计学意义(P<0.05)。分娩方式、惊厥首次发作类型、直系亲属发病史、患儿首次发作年龄以及首次发作体温是患儿复发的影响因素(P<0.05)。结论了解热性惊厥的复发影响因素,有助于筛查小儿热性惊厥重点对象。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.