浅议独生子女发展问题及研究对策

目的:探讨林格氏液短时间快速静脉滴注行宫内复苏时改善胎儿宫内窘迫、减轻新生儿窒息程度的效果。方法:将2015年11月-2017年1月在本院足月分娩的100例胎儿宫内窘迫的产妇按照随机数字表法分为观察组和对照组,各50例。观察组采取宫内复苏治疗,静脉滴注乳酸林格氏液;对照组给予葡萄糖溶液加维生素C静脉滴注治疗。观察两组胎心率恢复情况、最终分娩方式、新生儿Apgar评分及胎儿娩出时的羊水性状。结果:观察组治疗后胎心率为(139.43±11.28)次/min,显著优于对照组的(129.94±10.46)次/min(P<0.05)。两组产妇分娩方式比较,差异无统计学意义(P>0.05),两组剖宫产比例均较高。观察组新生儿窒息程度显著优于对照组(P<0.05),重度窒息新生儿例数显著少于对照组(P<0.05)。观察组羊水粪染程度显著轻于对照组(P<0.05)。结论:林格氏液能够有效改善胎儿心率,减轻窒息程度和羊水粪染程度,改善新生儿生存质量,且操作简单,值得临床推广应用。     

网络图书管理系统及其关键技木探讨

目的:探讨腹腔镜术后联合应用促性腺激素释放激素激动剂(Gn RH-a)和孕三烯酮巩固治疗子宫内膜异位症患者的临床效果,并分析其对患者卵巢功能及复发和再次妊娠的影响。方法:选取2012年1月-2014年3月在本院妇产科行腹腔镜手术治疗的子宫内膜异位症患者164例,按随机数字表法分为四组,分别为联合组38例(术后应用Gn RH-a联合孕三烯酮治疗),Gn RH-a组43例(术后仅应用Gn RH-a治疗),孕三烯酮组47例(术后仅应用孕三烯酮治疗),对照组36例(术后应用安慰剂治疗)。比较四组的症状缓解情况、用药前后性激素水平的变化、复发及再次妊娠情况。结果:联合组、Gn RH-a组、孕三烯酮组患者症状明显缓解率比较差异均无统计学意义(P>0.05),但三组均明显高于对照组,与对照组比较差异均有统计学意义(P<0.05);联合组、Gn RH-a组、孕三烯酮组用药治疗后血清雌二醇(E2)、促黄体生成素(LH)、卵泡生成素(FSH)均较治疗前明显降低,治疗前后比较差异均有统计学意义(P<0.05),联合组、Gn RH-a组上述血清性激素水平下降幅度比较差异无统计学意义(P>0.05),但均明显小于孕三烯酮组,差异有统计学意义(P<0.05);联合组、Gn RH-a组、孕三烯酮组随访期间累计复发率比较差异均无统计学意义(P>0.05),但均明显低于对照组,与对照组比较差异均有统计学意义(P<0.05);联合组、Gn RH-a组、孕三烯酮组妊娠率及良好妊娠结局率均明显高于对照组,三组与对照组比较差异均有统计学意义(P<0.05);联合组与Gn RH-a组妊娠率及良好妊娠结局率比较差异无统计学意义(P>0.05),但均明显高于孕三烯酮组,两组与孕三烯酮组比较差异均有统计学意义(P<0.05)。结论:腹腔镜术后应用Gn RH-a联合孕三烯酮治疗与单用Gn RH-a和孕三烯酮临床疗效及预防复发效果相当,对卵巢功能的影响和促进良好妊娠结局的效果与单用Gn RH-a相当,但优于单用孕三烯酮。     

如何提高小组合作学习的有效性

目的:观察人工髋关节置换术联合活血通络汤治疗股骨头坏死患者的临床效果。方法:选取ONFH患者73例,按随机数字表法分组,对照组36例采用人工髋关节置换术治疗,研究组37例采用活血通络汤与人工髋关节置换术联合治疗,持续治疗3个月。分析比较两组髋关节功能(Harris)及生活质量(SF-36)评分。结果:研究组治疗前Harris评分与对照组比较,差异无统计学意义(P>0.05),研究组治疗后Harris评分明显高于对照组,差异有统计学意义(P<0.05);两组治疗前SF-36评分比较,差异无统计学意义(P>0.05),研究组治疗后SF-36评分明显高于对照组,差异有统计学意义(P<0.05);研究组临床效果优于对照组,差异有统计学意义(P<0.05)。结论:对ONFH患者予以活血通络汤与人工髋关节置换术联合治疗效果较好,可明显促进其术后髋关节功能恢复及改善其生活质量,值得临床推广应用。     

Fogarty导管在血透患者前臂动静脉内瘘失功再次手术中的应用

为了探讨Fogarty球囊导管在前臂动静脉内瘘失功再次手术的应用效果,本研究将40例急性自体动静脉内瘘失功患者分为2组:观察组和对照组,每组20例。观察组行Fogarty球囊导管取栓术。对照组行原位动静脉内瘘重建术。观察2组患者术后透析时血流量、内瘘3、6、12个月通畅率及再次血栓、肿胀手综合征发生率的情况。结果观察组3个月内瘘透析时血流量、内瘘通畅率与对照组比较差异均无统计学意义(均P>0.05),观察组再次血栓、肿胀手综合征发生率均与对照组比较差异均无统计学意义(均P>0.05)。组间总有效率比较,观察组较对照组有显著性差异(P<0.05)。观察组6个月与12个月时间点和对照组相比具有显著性差异(P<0.05)。应用Fogarty球囊导管处理失功动静脉内瘘效果满意,长期通畅率较常规手术组有明显优势。     

中小学校园安全问题的研究

目的:观察丹参酮胶囊联合激光射频治疗外耳道疖的临床疗效。方法:选取外耳道疖患者90例,随机分为对照组和治疗组,各45例,对照组给予头孢丙烯分散片联合激光射频治疗,治疗组给予丹参酮胶囊联合激光射频治疗,比较两组间的疗效,症状及体征消失时间和不良反应情况。结果:对照组有效率达87%,治疗组总有效率达100%,差异具有统计学意义(P<0.05);对照组的症状及体征消失时间长于治疗组,差异具有统计学意义(P<0.05),对照组治疗中出现3例不良反应,治疗组无不良反应,差异无统计学意义(P>0.05)。结论:丹参酮胶囊联合激光射频治疗外耳道疖疗效较好,治疗后不易复发,无明显不良反应,值得临床推广应用。     

中期引产230例分析

中期引产适用于因各种疾病不能继续妊娠,胎儿畸形及计划外妊娠者。其方法有多种。本文对我院1993.1—1998.11月间用利凡诺、水囊及米索前列醇三种方法引产的230例病例进行分析发现,利凡诺组妊娠合并症较多;水囊组次之;米索前列醇组无妊娠合并症。三组引产成功率差异无显著性(P<0.05),平均排胎时间米索前列醇最短(24.8h);水囊次之(33.1h);利凡诺组最长(43.4h)。产后出血的发生率,米索前列醇较其它两组少(2.6％)(水囊及利凡诺两组无明显差异。胎盘残留,产后清宫,三组比较差异有显著性(P<0.05);而发热三组比较差异无显著差异性(P>0.05)。结论:三种引产方法各有其优缺点,在实际工作中要根据病人的具体情况而选用。     

从细节做起,转化数学学困生

目的:对妊娠高血压综合征与胎儿宫内发育迟缓的关系进行探讨。方法:选取2012年1月-2013年12月山东省庆云县人民医院妇科收治的妊娠高血压综合征孕妇150例作为研究对象,设为观察组,选取同期非妊娠高血压综合征孕妇150例作为对照组,统计两组胎儿宫内发育迟缓的发生率及不同程度妊娠高血压综合征对胎儿宫内发育迟缓的影响,并统计不同体重新生儿与胎儿宫内发育迟缓的关系。结果:观察组迟缓儿的发生率为59.33%,对照组仅为9.33%,两组比较差异有统计学意义(字2=83.16,P<0.05);且随着血压程度的增高,出现发育迟缓比率显著升高,比较差异有统计学意义(字2=26.46,P<0.05)。随访观察组对象至出生,体重<2000 g的新生儿中出现发育迟缓比率为73.91%,体重2000~2500 g的新生儿中出现发育迟缓比率为55.93%,体重>2500 g的新生儿中出现比率为48.89%,随着新生儿体重的增加,出现发育迟缓的比率显著降低,比较差异有统计学意义(字2=6.37,P<0.05)。结论:妊娠高血压综合征孕妇的病症情况和胎儿宫内发育迟缓之间的关系密切,呈正比关系。     

浅谈课外阅读在小学语文教学中的作用

目的:观察中西医结合治疗多囊卵巢综合征合并胰岛素抵抗的无排卵型不孕症的临床疗效。方法:选取90例多囊卵巢综合征(PCOS)合并胰岛素抵抗(IR)的无排卵型不孕症患者为研究对象,随机分为对照组和研究组各45例。对照组采用西药常规治疗并加入行为治疗;研究组在对照组基础上联合自拟中药方进行治疗。观察组对比两组治疗效果。结果:研究组临床疗效明显优于对照组(P<0.05),研究组周期排卵率和排卵率均明显高于对照组(P<0.05);两组治疗前监控指标差异无统计学意义(P>0.05),治疗后,研究组空腹血清和黄体生成素水平均明显高于对照组,血清胰岛素及OGTT 2h胰岛素水平均明显低于对照组,其差异均具有统计学意义(P<0.05)。结论:中西医结合治疗多囊卵巢综合征合并胰岛素抵抗的无排卵型不孕征,其疗效较好,具有临床应用推广价值。     

创设情境,让语文课堂诗意流淌——儿童诗《风》教学策略

目的:分析集束化护理在降低胸腰骶骨折术后患者腹胀便秘发生率的效果。方法:将2015年2月-2016年9月至本院骨科胸腰骶骨折进行手术治疗的患者93例作为研究对象,所有患者均符合试验标准且自愿参与。运用摸球法分为对照组46例和试验组47例。对照组施以常规护理,试验组在对照组基础上加以实施集束化护理。比较并评估两组术后腹胀便秘发生情况及满意度情况。结果:试验组无腹胀率为89.36%,高于对照组的65.22%,差异有统计学意义(P<0.05);且两组轻度腹胀者数量比较,差异也有统计学意义(P<0.05);两组中度及重度腹胀者比较,差异均无统计学意义(P>0.05)。试验组首次排便时间为(15.21±3.13)h,短于对照组的(27.15±4.93)h,差异有统计学意义(P<0.05);试验组肠鸣音(5.41±0.35)次/min,对照组(3.08±0.31)次/min,两组比较差异有统计学意义(P<0.05);试验组持续腹胀时间为(2.19±0.93)h,短于对照组(4.62±1.29)h,差异有统计学意义(P<0.05)。试验组满意度为93.62%,高于对照组的71.74%,差异有统计学意义(P<0.05)。结论:运用集束化护理能够有效减少胸腰椎患者术后的腹胀便秘发生率,提高患者满意度。     

中西医结合治疗早期糖尿病肾病临床观察

目的:观察加味金匮肾气丸合卡托普利治疗早期糖尿病肾病临床疗效。方法:将66例患者分成三组,Ⅰ组(对照组20例)、Ⅱ组(卡托普利组23例)、Ⅲ组(加味金匮肾气丸合卡托普利组23例),三组治疗后F检验两两比较。结果:Ⅰ组治疗后比治疗前无显著性差异(P>0.05)、Ⅱ和Ⅲ组治疗后比治疗前有非常显著性差异(P<0.01),MAPⅢ组治疗后比Ⅱ组治疗后无明显差异(P>0.05)、观察指标除MAP外Ⅲ组治疗后比Ⅱ组治疗后有显著性差异(P<0.05).结论:中西医结合治疗早期糖尿病肾病临床疗效好。     

镍铬合金烤瓷冠修复对患者头发和血液中镍铬元素含量的影响

目的:观察镍铬合金烤瓷冠修复后头发和血液中镍铬元素含量的变化,探讨镍铬合金长期存在于口腔中的安全性。方法:选取60名经体检合格的健康人作为正常对照组;60名上、下颌前牙有任意三颗行镍铬合金烤瓷冠修复的患者作为实验组。实验组修复后半年及一年和对照组均采用火焰原子吸收光谱法测定头发镍铬元素含量,采用石墨炉原子吸收光谱法测得其血清中镍铬元素含量。结果:头发镍含量:实验半年组与对照组比较无显著性差异(P>0.05);实验一年组与对照组相比较有显著性差异(P<0.05);实验一年组与半年组比较无显著性差异(P>0.05)。头发铬含量:各组之间比较均无显著性差异(P>0.05)。血清镍含量:实验半年组与对照组比较无显著性差异(P>0.05);实验一年组与对照组相比较有显著性差异(P<0.05);实验一年组与半年组比较无显著性差异(P>0.05)。血清铬含量:各组之间比较均无显著性差异(P>0.05)。结论:镍铬合金烤瓷冠修复后会在口腔环境中释放一定的镍、铬,且释放的量与时间有关,但量很微小,头发和血液中镍铬元素含量呈正相关。     

Allograft rejection-related gene expression in the endothelial cells of renal transplantation recipients after cytomegalovirus infection

Objective: To explore the effects of cytomegalovirus (CMV) infection on rejection-related gene expression in the endothelial cells of renal transplantation recipients. Methods: Endothelial cells (ECs) were cultured and stimulated by a variety of factors: A, normal control group; B, inactivated human cytomegalovirus (HCMV) infection group; C, HCMV infection group; D, HCMV supematant infection group; and E, ganciclovir HCMV group. Expression of intercellular adhesion molecule-1 (ICAM-1) and major histocompability complex (MHC) class Ⅰ and class Ⅱ antigens was detected by flow cytometry (FCM) and immuno-histochemistry. Results: We found characteristic CMV-infected ECs in this study. There were no significant differences among groups A, B and D (P>0.05). Although the expression levels of ICAM-1 were not significantly different between groups C and E (P>0.05), the ICAM-1 expression in these two groups was significantly higher than that in group A (P<0.05). ICAM-1 expression was detected in groups C and E, while there was no expression in groups A, B and D. Furthermore, there was no significant difference of ICAM-1 mRNA expression between groups C and E (P>0.05). Human leucocyte antigen (HLA)-ABC expression was detected in all the groups, while HLA-DR expression was only detected in groups C and E. There were no significant dif-ferences of HLA-ABC and HLA-DR expression among groups A, B and D (P>0.05). However, the HLA-ABC and HLA-DR expression levels in groups C and D were higher than those of the remaining groups previously reported (P<0.05). Meanwhile, the HLA-ABC and HLA-DR expression levels in group E were lower than those of group C (P<0.05). Conclusion: CMV could up-regulate the expression levels of ICAM-1 and MHC antigens, which was closely related to allograft rejection.     

血清镍铬元素含量检测用于镍铬合金烤瓷冠修复的研究

目的：研究镍铬合金烤瓷冠修复后血清中镍铬元素含量的变化，探讨镍铬合金长期存在于口腔中的安全性。方法：选取60名经体检合格且无任何病史的健康人作为正常对照组，采用石墨炉原子吸收光谱法测得其血清中镍铬元素含量；再从我院修复科选取60名上、下颌前牙有任意三颗行镍铬合金烤瓷冠修复后半年和一年的血清中镍铬元素含量作为实验组，并对实验组和对照组的镍铬元素含量进行分析。结果：血清镍含量：实验半年组与对照组比较无显著性差异（P〉0．05）；实验一年组与对照组相比较有显著性差异（P〈0．05）；实验一年组与半年组比较无显著性差异（P〉0．05）。血清铬含量：各组之间比较均无显著性差异（P〉0．05）。结论：镍铬合金烤瓷冠修复后会在口腔环境中释放一定的镍和铬，但量很微小，远低于对人体产生毒副作用的水平。     

Anticoagulation therapy in intra-aortic balloon counterpulsation: Does IABP really need anti-coagulation?

INTRODUCTIONTheintra aorticballoonpump(IABP)isthemostwidelyusedofallcirculatoryassistdevicestodayandisroutinelyusedinawiderangeofse riouscardiovascularconditions,rangingfromhe modynamicinstabilityinpatientssufferingfromcomplicationsofacutemyocardialinfarc…     

Evaluation of recombinant endostatin in the treatment of atherosclerotic plaques and neovascularization in rabbits

Objective:Atherosclerotic plaques and neovascularization play an important role in the course of coronary atherosclerosis.This study evaluated the effect of recombinant endostatin on experimental atherosclerotic plaques and neovascularization in rabbits.Methods:Eighteen healthy male rabbits were divided into three groups:control group,atherosclerotic model group,and recombinant endostatin treated group.The atherosclerotic model was established via a high-cholesterol diet after balloon catheter injury.The subject weights,serum total cholesterol,creatine kinase-myocardial band fraction(CKMB),and matrix metalloproteinase-2(MMP-2)were measured.Six weeks after treatment,the aortic roots were taken for pathological assay.The thickness ratio of the intima to media was measured by hematoxylin and eosin(HE)staining,and the number of neovessels was measured by immunohistochemistry via monoclonal antibody CD31 staining.Results:The weight,plasma total cholesterol,and CKMB were not significantly different between the atherosclerotic model group and the recombinant endostatin treated group,but much higher than those of the control group(P<0.05).The thickness ratio of the intima to media in the recombinant endostatin treated group was distinctly less than that in the atherosclerotic model group(P<0.05).The number of neovessels decreased dramatically(P<0.05)and the content of MMP-2 decreased slightly without statistical difference(P>0.05)in the recombinant endostatin treated group,compared to the atherosclerotic model group.Conclusions:Recombinant endostatin is able to inhibit the growth of neovascularization in the atherosclerotic plaque and the development of plaque.     

腹腔镜阑尾切除术与传统阑尾切除术疗效对比

目的:比较腹腔镜阑尾切除术(laparoscopic appendectomy,LA)与传统剖腹阑尾切除术(open appendectomy,OA)的临床疗效。方法:将156例阑尾炎病例随机分成两组,一组72例行LA,另一组84例行OA,比较两种术式的手术时间、平均住院费用、住院时间,切口长度、术后镇痛剂应用、术后6h开始下床活动、术后24h内肛门排气例数、放置引流管率、切口感染等指标。结果:LA组的术后24h内肛门排气时间、放置引流管率、切口感染、平均住院时间、切口长度、粘连性肠梗阻、镇痛剂应用例数、术后6h开始下床活动例数与OA组比较,差异均有统计学意义(P<0.05);而两组手术时间比较差异无统计学意义(P>0.05);LA组住院费用较OA组明显增高(P<0.05)。结论:LA与OA比较,有手术损伤小、疼痛轻、恢复快、住院时间短、并发症少等优点,可作为大多数阑尾炎的首选手术方式。     

急性脑损伤患者血清LDH的检测研究

目的:探讨急性脑损伤患者血清乳酸脱氢酶变化的临床意义.方法:AbbottAeroset(2000)全自动生化分析仪测定乳酸脱氢酶(LDH).结果:2组病人在急性脑损伤后LDH明显高于对照组(P＜0.01),组间比较差异不明显(P＞0.05).结论:测定血清乳酸脱氢酶可在一定程度上反应脑损伤的程度,对预后和治疗有一定的指导意义.     

2型糖尿病合并高血压对血脂及心脑血管疾病的影响

[目的]探讨糖尿病合并高血压对血脂及心脑血管疾病发生的影响.[方法]将172例门诊2型糖尿病患者,按是否合并高血压分为糖尿病合并高血压组和单纯糖尿病组,每组各为86人.研究各组间血脂水平及心脑血管疾病的发生情况,进行统计分析.[结果]两组间血脂水平存在显著差异,表现为糖尿病合并高血压组总胆固醇、甘油三脂、低密度脂蛋白明显高于单纯糖尿病组;两组间心脑血管疾病发生率也有显著性差异,表现为糖尿病合并高血压组心脑血管疾病发生率明显高于单纯糖尿病组.[结论]糖尿病合并高血压会加重脂代谢紊乱及心脑血管疾病的发生.     

有机硒和硼联用对肉鸡血清生理指标的影响

研究日粮中添加有机硒和硼对肉鸡血液生理指标的影响。选用健康1日龄AA肉鸡1200羽随机分成5组:对照组和试验Ⅰ、Ⅱ、Ⅲ、Ⅳ组,每组6个重复,每个重复40羽。对照组饲喂基础日粮,试验Ⅰ-Ⅳ组在基础日粮中添加0.4%的有机硒和硼(添加量分别为0、5、10、15 mg/kg),试验期42 d。结果表明,在21日龄,试验Ⅰ和Ⅱ组RBC、WBC、HGB和HCT均不同程度高于对照组,其中试验Ⅱ组最为明显,但差异不显著(P0.05),而试验Ⅱ和Ⅲ组MCV均显著低于对照组(P0.05),且试验Ⅳ组PLT也显著低于对照组和试验Ⅱ组(P0.05)。在42日龄,试验Ⅰ和Ⅱ组RBC、WBC、HGB和HCT均不同程度高于对照组,其中试验Ⅱ组HCT显著高于对照组(P0.05),而试验Ⅰ组PLT也显著高于试验Ⅳ组(P0.05)。以上结果表明,日粮中补充有机硒或有机硒和适量的硼联用均可改善肉鸡血液生理学指标,其中以补充0.4%有机硒和5 mg/kg硼效果更为明显。     

Study on the neurotoxic effects of low-level lead exposure in rats

Objective: To investigate effects of developmental lead exposure on nitric oxide synthase (NOS) activity in different brain regions and on N-methyl-D-aspartate (NMDA) receptor mRNA expression in the hippocampus of rats. On the basis of these observations, we explored possible mechanisms by which lead exposure leads to impaired learning and memorizing abilities in children. Methods: A series of rat animal models exposed to low levels of lead during the developing period was established (drinking water containing 0.025%, 0.05% and 0.075% lead acetate). NOS activities in the hippocampus, the cerebral cortex, the cerebellum and the brain stem were determined with fluorescence measurement and levels of mRNA expression of the NMDA receptor 2A (NR2A) subunit and NMDA receptor 2B (NR2B) subunit in the rat hippocampus were measured with Retro-translation (RT-PCR). Results: There were no differences in the body weight of rat pups between any of the groups at any given time (P>0.05). The blood lead level of Pb-exposed rat pups showed a systematic pattern of change: at 14 d of age, it was lower than that at 7 d of age, then rising to the peak level at 21 d and finally falling to lower levels at 28 d. The hippocampal NOS activities of lead-exposed groups were all lower than that of the control group on the 21st and 28th day (P<0.01). NOS activities in the cerebellum of lead-exposed groups were all lower than that of the control group on the 21st and 28th day (P<0.001) and the NOS activity of the 0.025% group was significantly lower than that of the 0.05% and 0.075% groups on the 28th day (P<0.05). NOS activity in the cerebral cortex of the 0.075% group was significantly lower than that of the control, 0.025% and 0.05% groups on the four day spans (P<0.001). There was no significant difference of NOS activity in the brain stem between any lead-exposed group and the control group on the four day spans. In the 0.05% and the 0.075% groups, the level of NR2A mRNA expression was higher than that in the control group at 7 d and 14 d of age (P<0.05). In the 0.025% group, the level of NR2A was found to be higher than that in the control group at 7 d of age only (P<0.05). No significant differences were found for the levels of NR2B mRNA expression between any of the groups at any given time. Conclusions: NOS activity in the hippocampus, the cerebral cortex and the cerebellum are inhibited by lead exposure. The degree of the inhibitory effect depends on the time span of exposure and the lead concentration. Developmental low-level lead exposure was found to raise the level of NR2A mRNA expression in the hippocampus of rats. Developmental low-level lead exposure does not affect the level of NR2B mRNA expression in the hippocampus.