尿钙/肌酐比值预测妊娠高血压综合征的意义

测定127例子24～34周正常健康妇女的尿钙/肌酐比值,结果尿钙/肌酐比值≤0.049的41例,21例发生妊娠高血压综合征(妊高征),其敏感性、特异性、准确性、阳性及阴性预测值分别为58.33％、78.0295、72.44％、51.22％及82.56％。2～5周后该127例中有53例作了第二次测定,比值≤0.049约22例,17例发生了妊高征,其敏感性、特异性、准确性、阳性及阴性预测值分别为80.95％、84.38％、83.02%、72.27%及87.10%,均较前明显提高。尿钙/肌酐比值可作为预测妊高征的客观指标,连续动态观察价值更高。     

血β-HCG、血钙、红细胞压积及平均动脉压联合预测妊娠高血压综合征

目的测定孕中期血β-HCG、血钙、红细胞压积、平均动脉压联合预测妊娠高血压综合征的发生,寻求一种简便、易行并具有临床价值的预测方法。方法采用放射免疫方法测定血β-HCG值,生化分析方法测定血钙,自动血细胞计数仪测定红细胞压积,同时测量平均动脉压进行研究。结果妊高征孕妇在孕16~20周血β-HCG明显高于正常妊娠者(P<0.01);血钙水平明显下降(P<0.01)。以血β-HCG≥50 632 IU/L,血钙≤2.18 mmol/L,红细胞压积≥35%,平均动脉压≥85 mmHg为联合预测指标,阳性预测值81.82%,阴性预测值97.30%,敏感度84.38%,特异度96.77%。结论孕中期联合检测血β-HCG、血钙、红细胞压积、平均动脉压对预测妊高征有较高的敏感性和特异性,方法简单易行,值得临床推广应用。     

平均动脉压测定阳性在预测妊高征的发生及预防性治疗中的价值

目的 :探讨平均动脉压测定阳性预测妊高征发生及预防性治疗的价值。方法 :对 97、98两年郑州市妇幼保健院围产门诊系统管理的 5 5 1例 2 2 - 2 6周孕妇进行平均动脉压 (mABP)测定 ,测出阳性 12 5例。对阳性组中 5 5例进行预防性治疗 ,包括指导饮食、左侧卧位、补充活性钙制剂 ,有水肿者加用维生素B1。结果 :阳性组妊高征发生率为 49.6 % ,阴性组发生率为 8.9% ,通过比较二者有明显差异 (P <0 .0 0 5 )。mABP阳性预防性治疗组妊高征发生率为 32 .73% ,未预防组发生率为 6 2 86 % ,通过比较二者有明显差异 (P <0 .0 0 5 )。结论 :平均动脉压测定可有效地预测妊高征的发生 ;对mABP测定阳性进行预防性治疗可明显降低妊高征的发生率。     

服镁后血镁钙及24小时尿钙和钙/肌酐比值变化

研究服镁后，血镁钙及24h尿钙和钙／肌酐比值变化及与妊高征发生的关系。方法：采用前瞻性随机双盲的方法，对治疗组52例（治疗1组24例和治疗2组28例）孕妇自孕28周起，连续服用葡萄糖酸镁，每日3g。结果：治疗组血钙明显高于对照组；治疗2组的尿钙和钙／肌酐明显高于对照2组，且妊高征发生率3．57％，明显低于对照2组（30．77％）；治疗组和对照组尿钙与钙／肌酐比值分别呈正相关关系。结论：服镁后，调节体内钙平衡，使妊高征发生率降低。     

尿微量白蛋白／肌酐比值预测妊高征的临床研究

２４８例孕妇在妊娠２０～２４周时留晨尿，用放射免疫方法（ＲＩＡ）测定尿微量白蛋白（ＵＡｂ）生化自动分析仪测定尿肌酐，尿钙。尿白蛋白／肌酐比值（ＵＡｌｂ／Ｃｒ）≥１０（ｍｇ／ｇ）作为临界值，预测妊高征。其敏感性，特异性，阳性和阴性预测率分别为７７．８％，９７．０％，６６．７％和９８．２％，与尿钙／肌酐比值（ＵＣａ／Ｃｒ）红细胞压积（ＨＣＴ）孕中期平均动脉压（ＭＡＰ－２）等预测方法相比，各项指标均优于     

服镁后血镁钙及24小时尿钙和钙／肌酐比值变化

目的：研究服镁后，血镁钙及２４ｈ尿钙和钙／肌酐比值变化及与妊高征发生的关系。方法：采用前瞻性随机双盲的方法，对治疗组５２例（治疗１组２４例和治疗２组２８例）孕妇自孕２８周起，连续服用葡萄糖酸镁，每日３ｇ。结果：治疗组血钙明显高于对照组；治疗２组的尿钙和钙／肌酐明显高于对照组２组，且妊高征发生率３．５７％，明显低于对照２组（３０．７７％）；治疗组和对照组尿钙与钙／肌酐比值分别呈正相关关系。结论：服镁     

妊高征孕妇血脂水平和红细胞压积检查的临床意义

目的:探讨妊高征孕妇血脂水平和红细胞压积检查的临床意义。方法:选择妊高征孕妇136例,根据妊高征程度的分级标准,分为重度妊高征组和轻度妊高征组,每组各68例。选择同期接受体检的68例健康孕妇作为对照组。分别检测并比较3组孕妇的血脂水平(指标为:TC、TG、HDL-C、LDL-C、Apo A1、Apo B)和红细胞压积。结果:与对照组相比,重度妊高征组和轻度妊高征组孕妇的血脂水平均显著升高,差异均有统计学意义(P<0.05);其中,重度妊高征组孕妇的血脂水平显著高于轻度妊高征组(P<0.05);重度妊高征组和轻度妊高征组孕妇的红细胞压积显著低于对照组,差异均具有统计学意义(P<0.05)。结论:血脂水平升高和红细胞压积下降,其程度可反映妊高征孕妇的严重程度。     

Ca^2＋检测在妊娠高血压综合征早期诊断中的临床意义

目的：评价血、尿钙含量在妊娠高血压综合征（妊高征）早期诊断中的临床意义。方法：收集296例孕22－29周健康孕妇的晨尿并同时采血,采用自动生化仪测定血和尿中的钙含量。其中24例至妊娠晚期发展为妊高征的设为妊高征组,其余272例为正常妊娠组,至分娩前或孕晚期再复测上述指标。结果：妊高征组在妊娠26周左右尿钙的排出量及血钙较正常妊娠对照组明显下降,有显著性差异,其中尿钙含量界限值为3．23mmol.L^-1,Ca^2 /Cr之值界值为0．42。结论：妊高征的发生与血清钙有关。妊娠期尿钙的排除量与尿钙比值的降低早于妊高征,这一特征可作为妊高征早期诊断的指标。     

妊高征预测及预防的临床探讨

选择孕期为２２～２６周的２１０例孕妇，以平均动脉压≥１２ｋＰａ，翻身试验阳性，体重指数≥０．２４，红细胞压积≥０．３５为预测妊高征的敏感指标。将预测为阳性的１６８例分为４组，自孕２８周起进行药物预防治疗，结果：治疗１～３组妊高征发生率为２．３８％，无系统治疗的第４组为２６．１９％（Ｐ〈０．０１）。治疗对母婴无不良影响。     

重度妊娠高血压综合征患者脑灌注压变化及其临床意义

目的 :通过检测重度妊娠高血压综合征 (妊高征 )脑灌注压变化 ,探讨脑灌注压变化与头痛症状的关系。方法 :选择重度妊高征 6 9例为实验组 ,正常晚期妊娠妇女 10 0例为对照组 ,采用Aaslid评估脑灌注压方法检测脑灌注压 ,评价妊高征患者脑灌注压变化及与头痛症状的关系。结果 :重度妊高征患者中异常脑灌注压患者明显多于正常脑灌注压患者 (P <0 .0 5 )。严重头痛和轻中度头痛患者脑灌注压均异常 ,且均以脑灌注压增高为多 (P<0 .0 5 )。在脑灌注压增高组中 ,严重头痛组脑灌注压明显高于轻中度头痛组 (P <0 .0 5 ) ;而在脑灌注压减低组中 ,严重头痛组脑灌注压又显著低于轻中度头痛组和无头痛症状组 (P <0 .0 5 )。 3组重度妊高征间平均动脉压比较无显著差异 (P >0 .0 5 )。无头痛症状组有脑灌注压正常和脑灌注压轻度降低 2种状态。结论 :高脑血流灌注状态和低脑血流灌注状态均可导致妊高征脑损害。高脑灌注压和低脑灌注压均是妊高征患者头痛发生的病理生理机制。高脑灌注压是妊高征头痛症状的主要原因 ,高脑灌注压患者更有发生子痫的危险     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…