Relationship between Growth Hormone and Cytokines in Short Children Undergoing Growth Hormone Stimulation Testing

Background: The relationship between growth hormone (GH) and cytokines remains unclear. Several studies have suggested that GH increases tumor necrosis factor (TNF)-α production in both children and adults. However, a number of studies have demonstrated a negative correlation between GH and TNF α. The aim of this study is to explore the relationship between endogenous GH secretion and certain pro and anti-inflammatory cytokines in short children undergoing GH stimulation testing for evaluation for GH deficiency. Methods: Plasma growth hormone, TNF α, CRP, IL-6, IL1-β, IL-4 and IL-10 levels are obtained at baseline and every 30 minutes for 150 minutes following two provocative agents (clonidine, and either arginine or glucagon). Results: Among the 23 children, 7 are found to be GH deficient. No significant differences in baseline TNF α levels are found between GH deficient and GH sufficient children. No correlation is identified between TNF α levels and GH levels during stimulation testing. Furthermore, no relationship is found between GH and pro-inflammatory cytokines or GH and anti-inflammatory cytokines. Conclusion: Our results do not demonstrate an acute relationship between endogenous GH secretion and the cytokines examined.

Early electrical field stimulation prevents the loss of spinal cord anterior horn motoneurons and muscle atrophy following spinal cord injury

Our previous study revealed that early application of electrical field stimulation（EFS） with the anode at the lesion and the cathode distal to the lesion reduced injury potential, inhibited secondary injury and was neuroprotective in the dorsal corticospinal tract after spinal cord injury（SCI）. The objective of this study was to further evaluate the effect of EFS on protection of anterior horn motoneurons and their target musculature after SCI and its mechanism. Rats were randomized into three equal groups. The EFS group received EFS for 30 minutes immediately after injury at T_（10）. SCI group rats were only subjected to SCI and sham group rats were only subjected to laminectomy. Luxol fast blue staining demonstrated that spinal cord tissue in the injury center was better protected; cross-sectional area and perimeter of injured tissue were significantly smaller in the EFS group than in the SCI group. Immunofluorescence and transmission electron microscopy showed that the number of spinal cord anterior horn motoneurons was greater and the number of abnormal neurons reduced in the EFS group compared with the SCI group. Wet weight and cross-sectional area of vastus lateralis muscles were smaller in the SCI group to in the sham group. However, EFS improved muscle atrophy and behavioral examination showed that EFS significantly increased the angle in the inclined plane test and Tarlov＇s motor grading score. The above results confirm that early EFS can effectively impede spinal cord anterior horn motoneuron loss, promote motor function recovery and reduce muscle atrophy in rats after SCI.

Does a combined intervention program of repetitive transcranial magnetic stimulation and intensive occupational therapy affect cognitive function in patients with post-stroke upper limb hemiparesis?

Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-r TMS and i OT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient＇s Trail-Making Test part B（TMT-B） performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-r TMS to the contralesional hemisphere and 2 sessions of i OT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-r TMS to the contralesional hemisphere combined with i OT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.

Therapeutic benefit of repetitive transcranial magnetic stimulation for severe mirror movements A case report

Congenital mirror movements retard typical hand functions, but no definite therapeutic modality is available to treat such movements. We report an 8-year-old boy with severe mirror movements of both hands. His mirror movements were assessed using the Woods and Teuber grading scale and his fine motor skills were also evaluated by the Purdue Pegboard Test. A 2-week regimen of repetitive transcranial magnetic stimulation produced markedly diminished mirror movement symptoms and increased the fine motor skills of both hands. Two weeks after the completion of the regimen, mirror movement grades had improved from grade 4 to 1 in both hands and the Purdue Pegboard Test results of the right and left hands also improved from 12 to 14 or 13. These improvements were maintained for 1 month after the 2-week repetitive transcranial magnetic stimulation regimen. After 18 months, the mirror movement grade was maintained and the Purdue Pegboard test score had improved to 15 for the right hand while the left hand score was maintained at 13. This occurred without any additional repetitive transcranial magnetic stimulation or other treatment. These findings suggest that repetitive transcranial magnetic stimulation for this patient had a therapeutic and long-term effect on mirror movements.

Clinical observation of acupoint injection combined with nerve electrical stimulation in the treatment of post-stroke dysphagia

Background:Post-stroke dysphagia is one of the common clinical symptoms in the rehabilitation department of primary hospitals,which seriously affects the quality of life of patients and their families.Majority of medical workers have comprehensively studied post-stroke dysphagia as it easily induces inhalation pneumonia,asphyxia,and many other complications.At present,many methods for post-stroke dysphagia have been proved to be effective.With regard to comprehensive treatment effect,patient compliance,technology promotion difficulty,grassroots hospital operability,and other factors,we found that acupoint injection combined with nerve electrical stimulation is a good method worthy of promotion.Methods:A total of 130 patients with dysphagia after stroke were randomly divided into nerve electrical stimulation group(n=41),acupoint injection group(n=40),and comprehensive treatment group(nerve electrical stimulation plus acupoint injection,n=49).The therapeutic effect in each group was evaluated before treatment and 20 days after treatment using the improved water swallow test,video fluoroscopic swallowing study,and standardized swallowing assessment.Results:After 20 days of treatment,significant differences were noted in each group.The scores of improved water swallow test decreased from 4.10±0.74 to 2.12±0.95 in the nerve electrical stimulation group,4.00±0.78 to 2.28±1.04 in the acupoint injection group,and 4.16±0.77 to 1.73±0.79 in the comprehensive treatment group;video fluoroscopic swallowing study scores increased from 3.71±2.16 to 5.05±2.111 in the nerve electrical stimulation group,3.80±1.94 to 5.20±1.942 in the acupoint injection group,and 3.73±2.22 to 6.24±2.21 in the comprehensive treatment group;and standardized swallowing assessment scores of the three groups also decreased from 35.13±3.38 to 28.17±3.42,34.66±3.46,and 34.48±3.26 to 26.39±3.86,respectively.The overall scores of each group after treatment were significantly different from those before treatment(P<0.05),indicating that both nerve electrical stimulation and acupoint injection were effective for post-stroke dysphagia;the scores of nerve electrical stimulation group and acupoint injection group were similar,but those of the comprehensive treatment group were significantly better than the single treatments(P<0.05).It shows that the two treatment methods have synergistic effect,and combined treatments have more benefits.Conclusion:Nerve electrical stimulation and acupoint injection have a synergistic therapeutic effect on post-stroke dysphagia.The combined treatment is more beneficial to patients with post-stroke dysphagia than the single treatments.

Tail nerve electrical stimulation-induced walking training promotes restoration of locomotion and electrophysiology in rats with chronic spinal cord injury

Functional recovery is the final goal in the treatment of spinal cord injury. However, to date, few treatment strategies have demonstrated significant locomotor improvement in animal experiments. By using tail nerve electrical stimulation (TANES) as an open-field locomotor training method combined with glial scar ablation and cell transplantation, we have successfully promoted locomotor recovery in rats with chronic spinal cord contusion injury. The purpose of the present study is to further investigate the mechanism of TANES and its effect on electrophysiology. Spinal cord segment T10 of female, adult Long-Evans rats was contused using the NYU impactor device with 25 mm height setting. After injury, rats were randomly divided into three groups. Group I was used as a control without any treatment, group II and group III were subjected to basic treatment including glial scar ablation and transplantation of olfactory lamina propria 6 weeks after injury, and group III received TANES-induced open-field locomotor training weekly after basic treatment. All animals were allowed to survive 22 weeks, except some rats which were transected. Basso, Beattie, and Bresnahan (BBB) open-field locomotor rating scale, horizontal ladder rung walking test, and electrophysiological tests were used to assess the restoration of functional behavior and conduction. Results showed that TANES significantly improves locomotor recovery and spinal cord conduction, reflex, as well as significantly reduces the occurrence of autophagia. Additionally, after transection, trained rats still maintained higher BBB score than that of control rats. This may be related to the activity-dependent plasticity promoted by TANES-induced locomotor training.

CAN LONG-TERM POTENTIATION BE INGVCED BY ACUPOINT STIMULATION?

Longterm potentiation (LTP ) is usually induced by direct brain stimulation. An attempt has been made to evoke LTP in dentate granule cells of hippocampus by acupoint stimulation in anesthetized rats. Assuming a gradual increasing course, LTP rose to 146% at the end of one hour. After applying such stimulation to the awake rats for six days (once everyday), their discriminative learning capacity in Y maze test markedly improved as compared with that of the control.

卡洛芬注射液安全性研究

为了研究卡洛芬注射液的安全性,选用新西兰白兔,采用皮下注射方法进行刺激试验,选用豚鼠进行皮肤致敏试验和全身致敏试验,观察卡洛芬注射液对白兔和豚鼠的安全性。结果表明,白兔每天皮下注射卡洛芬注射液(10 mg/kg)1次,连续7 d,受试物组和参比品组注射部位均出现发红和溃烂,组织病理学观察可见注射部位溃疡、真皮/皮下/肌肉炎症伴纤维化、表皮增生,恢复期末未见完全恢复,但受试物组恢复程度比参比品组略好;受试物组和参比品组的卡洛芬注射液激发豚鼠皮肤致敏试验和全身致敏试验中均未引起蓝斑等过敏症状。综上所述,受试物和参比品的卡洛芬注射液对动物注射部位均有明显的刺激性,但不会产生皮肤过敏反应,两者安全性基本一致。

单时相GnRH激发试验对不同体重指数女童中枢性性早熟诊断价值的研究

目的 探讨单时相促性腺激素释放激素(gonadotropin-releasing hormone,GnRH)激发试验对不同体重指数(body mass index,BMI)女童中枢性性早熟(central precocious puberty,CPP)的诊断价值。方法 回顾性分析2017年1月—2023年8月在郑州大学第三附属医院就诊的7.5岁前出现乳房发育的760例女童数据。根据GnRH激发试验结果和临床表现综合诊断,分为CPP组(n=297)和非CPP组(n=463)。再根据体重指数(body mass index,BMI)分为正常体重组(n=540)、超重组(n=116)及肥胖组(n=104)。采用受试者操作特征曲线分析单时相GnRH激发试验对不同BMI女童CPP的诊断价值。结果 GnRH激发后30 min黄体生成素(luteinizing hormone,LH)/卵泡刺激素诊断CPP的曲线下面积为0.985,高于0、60、90 min LH/卵泡刺激素的曲线下面积(P<0.05)。30 min与60 minLH诊断价值相当(P>0.05)。30 min LH与BMI及BMI-Z值呈负相关(P<0.05)。30 min LH在正常体重、超重、肥胖女童中诊断CPP的曲线下面积分别为0.952、0.965、0.954 (P<0.05)。结论 30 min GnRH激发试验对不同BMI女童CPP均有较好的诊断价值,有望替代传统的GnRH激发试验,但应注意BMI对LH水平的影响。

人绒毛膜促性腺激素激发试验在性发育异常儿童中的诊断作用评估

目的探讨人绒毛膜促性腺激素(human chorionic gonadotrophin,hCG)激发试验在诊断不同分型性发育异常(disorder of sexual development,DSD)患儿中的价值。方法回顾性分析132例DSD患儿,按染色体核型分为46,XX组(n=10)、46,XY组(n=87)、性染色体异常组(n=35),比较各组患儿hCG激发试验前后的性激素水平,分析形态学上是否存在睾丸组织对hCG激发试验结果的影响。结果3组患儿激发试验后睾酮(testosterone,T)增加倍数比较差异无统计学意义(P>0.05)。46,XY组中,5α-还原酶2缺乏症患儿激发试验后的T与双氢睾酮(dihydrotestosterone,DHT)比值高于其他46,XY DSD患儿(P<0.05)。形态学上,有睾丸组织的DSD患儿激发试验后T增加倍数高于无睾丸组织患儿(P<0.05)。结论hCG激发试验对于评估不同类型的DSD患儿的睾丸间质细胞存在和功能均具有重要价值,对于性腺性质不明确的DSD患儿,均建议行hCG激发试验。

百合地黄汤对抑郁症大鼠肠道菌群的影响

目的:探究百合地黄汤对抑郁症大鼠肠道菌群的影响。方法:采用孤养和慢性不可预知性温和应激刺激制备大鼠抑郁症模型,经百合地黄汤给药后,采用糖水偏好试验和旷场试验进行药效学评价,并对大鼠的结肠进行病理学检测;收集大鼠粪便,应用16S rRNA高通量测序技术对大鼠肠道菌群多样性进行分析,并进行功能预测。结果:与正常组比较,模型组大鼠体质量明显降低;给药后,各剂量组大鼠体质量均有增加的趋势。糖水偏好实验结果显示,与正常组比较,模型组大鼠糖水偏爱度明显减弱(P<0.01);给药后,各剂量组糖水偏爱度均有增强的趋势,且中剂量组和低剂量组差异有统计学意义(P<0.01)。在旷场实验中,与正常组比较,模型组大鼠自主活动显著减弱(P<0.01);给药后,各剂量组大鼠自主活动均有增强的趋势,且低剂量组与模型组比较差异有统计学意义(P<0.05)。病理结果显示,模型组大鼠结肠黏膜遭到破坏,经百合地黄汤给药后,各给药组结肠黏膜损伤均有不同程度的恢复。在菌群多样性方面,经百合地黄汤治疗后,在门水平上,厚壁菌门的丰度明显增加,拟杆菌门、疣微菌门、变形菌门及蓝藻门的丰度明显降低,其中变形菌门和蓝藻门改变具有统计学意义(P<0.05)。在属水平上,降低了norank_f__Muribaculaceae、瘤胃球菌属及粪球菌属等菌属的丰度,升高了乳酸菌属、罗姆布茨菌属、Turicibacter及芽孢杆菌属等菌属的丰度,其中norank_f__Muribaculaceae、罗姆布茨菌属、Turicibacter、norank_f__Eubacterium_coprostanoligenes_group、Prevotellaceae_UCG-001及Prevotellaceae_UCG-001的改变有统计学意义(P<0.05)。京都基因和基因组百科全书(KEGG)功能预测显示,差异菌群的功能与氨基酸代谢、能量代谢、神经系统以及神经退行性疾病等相关。结论:百合地黄汤能够调节抑郁症大鼠的肠道菌群进而改善抑郁症大鼠的抑郁样行为。

重复经颅磁刺激结合多重吞咽刺激对脑卒中后吞咽障碍患者吞咽功能 营养指标的影响

目的观察重复经颅磁刺激结合多重吞咽刺激对脑卒中后吞咽障碍患者吞咽功能、营养指标的影响。方法选取四川大学华西医院2020-03—2022-04收治的152例脑卒中后吞咽障碍患者作为研究对象,分为观察组和对照组。对照组75例采用多重吞咽刺激治疗,观察组77例采用重复经颅磁刺激结合多重吞咽刺激治疗。比较2组患者治疗效果、吞咽功能、营养指标。结果观察组总有效率97.40%,高于对照组的89.33%(P<0.05)。2组患者干预前视频荧光造影检查(VFG)及饮水试验(WST)评分对比,差异无统计学意义(P>0.05),干预后2组VFG评分比干预前升高且观察组[(6.77±1.25)分]高于对照组[(5.65±1.03)分](P<0.05),干预后2组WST评分低于干预前且干预后观察组[(1.81±0.44)分]低于对照组[(2.63±0.40)分](P<0.05)。干预前2组患者吞咽波幅及吞咽时程对比差异无统计学意义(P>0.05),干预后2组吞咽时程比干预前下降且观察组[(1.48±0.21)s]低于对照组[(1.65±0.26)s](P<0.05),干预后2组吞咽波幅比干预前升高且观察组[(0.40±0.11)mV]高于对照组[(0.35±0.09)mV](P<0.05)。干预前2组血清白蛋白、血红蛋白等营养指标比较差异无统计学意义(P>0.05),干预后2组血清各营养指标高于干预前且干预后观察组血清白蛋白[(35.59±7.12)g/L]、血红蛋白[(125.64±9.21)g/L]、血清总蛋白[(67.26±7.34)g/L]高于对照组[血清白蛋白(32.67±6.94)g/L,血红蛋白(121.29±8.54)g/L,血清总蛋白(62.86±6.94)g/L](P<0.05)。结论对脑卒中后吞咽障碍患者采用重复经颅磁刺激结合多重吞咽刺激治疗效果明显,能有效改善患者吞咽障碍,提高患者营养指标水平。

重复经颅磁刺激联合同步工作记忆训练对改善老年脑卒中患者认知功能的研究

目的探究重复经颅磁刺激联合同步工作记忆训练对脑卒中患者记忆力、注意力、执行能力等认知功能的影响。方法选取2022年1月至2023年5月于牡丹江医学院附属红旗医院康复医学科住院和门诊治疗的100例脑卒中患者,采用随机数表法将其分为同步组、重复经颅磁刺激组、工作记忆训练组、对照组,每组25例。针对认知功能,同步组同时进行重复经颅磁刺激和工作记忆训练,重复经颅磁刺激组进行重复经颅磁刺激治疗,工作记忆训练组进行工作记忆训练,对照组进行假性磁刺激治疗。治疗前后分别给予4组患者Stroop测试、Rivermead行为记忆测试、蒙特利尔认知评估量表(MoCA)测试、改良Barthel指数(MBI)测试、Fugl-Meyer测试。结果治疗前,4组Stroop、Rivermead、MoCA、MBI、Fugl-Meyer测试成绩比较,差异无统计学意义(P>0.05);治疗后同步组Stroop测试基线阶段正确率、冲突阶段正确率显著高于其他3组(P<0.05),基线阶段用时显著短于工作记忆训练组、对照组[(1043.76±260.38)ms vs(1299.36±468.86)ms、(1418.68±412.25)ms,P<0.05],冲突阶段用时显著短于对照组(P<0.05)。同步组Rivermead行为记忆测试、MoCA测试、MBI测试、Fugl-Meyer测试成绩显著高于其他3组(P<0.05)。结论重复经颅磁刺激联合同步工作记忆训练能有效改善脑卒中患者的认知功能。

经皮穴位电刺激对行脊柱开放性手术的老年患者围术期神经认知障碍及临床预后的影响

目的:探讨经皮穴位电刺激(TEAS)合谷、内关二穴辅助全身麻醉对老年脊柱开放性手术患者围术期神经认知障碍(PND)及临床预后的影响。方法:选取2020年8月至2022年3月北京中医药大学东直门医院骨科脊柱开放性手术患者为研究对象。采取随机对照原则,将符合纳入标准的64例患者随机分为单纯全身麻醉组(对照组)和穴位电刺激复合全身麻醉组(实验组),每组32例。实验组在麻醉诱导前30 min直至手术结束时选择合谷穴、内关穴与神经刺激仪连接,给予电刺激。对照组在合谷和内关两穴贴电极片并与神经刺激仪连接,但不给予电刺激,其余治疗同实验组。观察术后7 d谵妄(POD)的发生率,在排除POD的情况下30 d内神经认知恢复延迟(DNR)的发生率,在麻醉前、气管插管时、切皮时、置入椎弓根钉时、术毕时患者脑电双频谱指数(BIS)值的变化,以及30 d内术后并发症(切口感染、恶心呕吐)发生情况。结果:64例患者均顺利完成手术。两组患者的基线值差异无统计学意义(P>0.05)。术毕时,实验组BIS值高于对照组(P<0.05);实验组术后30 d内的DNR发生率低于对照组(P<0.05);术后30 d内呕吐例数实验组低于对照组,差异有统计学意义(P<0.05)。结论:TEAS与静脉全身麻醉结合用于老年人脊柱开放性手术可降低PND的发生率及术后呕吐发生率,加快苏醒,改善患者预后。

基于AdmiTest的CTCS-3级列控系统自动测试平台

根据CTCS-3级列控系统的特点,结合欧洲列车运行控制系统(ETCS)测试经验,研发基于通用测试平台AdmiTest的CTCS-3级列控系统自动测试平台CARSTool。CARSTool采用激励-反馈机制实现单系统或多系统的闭环测试,包含测试对象、仿真系统、链路、消息、激励、响应和测试序列等基本元素,具有线路工程数据配置、通信链路配置、站场线路配置、PI Object、仿真系统、列车运行仿真和自动测试序列7个功能模块。以郑西客运专线列控数据为例,采用CARSTool对CTCS-3级列控系统进行仿真测试。测试结果表明:通过规范化语法严格卡控测试步骤,根据CTCS-3级列控系统测试案例库以及激励-反馈信息判断测试项目的执行状态,CARSTool实现了测试计划、执行过程和测试结果的闭环处理;说明CARSTool能够实现CTCS-3级列控系统的自动测试。

声诱发反应在胎膜早破胎儿听力监测中的应用

目的探讨声诱发反应(acoustic stimulation test,AST)在胎膜早破(prelabor rupture of membranes,PROM)胎儿听力监测中的可行性。方法选取2018年6月—2021年12月宁德师范学院附属宁德市医院妇产科收治的2725例PROM孕妇作为PROM组,根据PROM发生时阴道分泌物病原体检测结果分为生殖道感染(reproductive tract infections,RTI)组(阳性)918例和无RTI组(阴性)1807例;再根据胎龄进一步划分为足月组(孕期≥37周)1792例和早产组(28周≤孕期<37周)933例,为以上受试者行AST检测和新生儿听力筛查及诊断。同时,选取无PROM受试者600例作为对照组,最后将各组结果进行对比。结果RTI组足儿和早产儿的AST阳性率均明显低于无RTI组和对照组,差异有统计学意义(P<0.05);3月龄时,PROM组足月儿和早产儿的声导抗和畸变产物耳声发射(DPOAE)与对照组比较,差异无统计学意义(P>0.05),但其V波阈值明显高于无PROM组;6月龄时,PROM组足月儿和早产儿的声导抗、DPOAE及V波阈值与对照组比较,差异均无统计学意义(P>0.05);在听力损失随访幼儿中,起初超过一半患儿的声导抗异常,而DPOAE通过率低、V波阈值差。随着月龄增加,各组患儿(PROM组足月儿除外)的声导抗异常率、DPOAE通过率及V波阈值均出现明显改善;在阳性AST,PROM组及对照组患儿听力损失多为轻、中度;在阴性AST,PROM组患儿听力损失多为单或双耳中、重度,而对照组则多为同时双耳;AST对筛查胎儿听力损失的曲线下面积(Area under the curve,AUC)为0.821,联合DPOAE的AUC则为0.915,高于单独使用AST或DPOAE,对重度和极重度者具有很好的敏感度。结论AST可以较好地反映与预估PROM宫内胎儿听力,可供临床选择/联合使用;尤其是RTI阴性者,其听力损失率较高,应加强此类患儿的听力跟踪与随访。

皮肤外用桑白皮水提物安全性研究

目的评估皮肤外用桑白皮水提物的安全性。方法选取豚鼠进行皮肤急性毒性试验,观察豚鼠14 d内的体质量变化、毒性反应和死亡情况;进行皮肤致敏试验,观察72 h内皮肤致敏情况并评分。选取新西兰兔,采用自身对比法进行单次、多次皮肤刺激,观察72 h内完整及破损皮肤刺激性反应并评分。结果经低、中、高剂量(6.0,12.0,24.0 mg/mL)桑白皮水提物处理后,豚鼠均正常生长,完整皮肤、破损皮肤均未见急性毒性反应,且破损皮肤处结痂正常;各组豚鼠用药前及用药后7,14 d的体质量无显著差异(P>0.05);未出现局部皮肤红斑、水肿或站立不稳、呼吸困难和过敏性休克等全身性症状,豚鼠未发生皮肤致敏反应。试验兔完整皮肤、破损皮肤均未出现刺激性反应。结论在外用质量浓度不超过24 mg/mL桑白皮水提物作用下,豚鼠无皮肤急性毒性、致敏性表现,试验兔无刺激性反应。

矮小症患儿胰岛素生长激素激发试验血糖检测的临床价值

目的探讨矮小症患儿胰岛素生长激素激发试验血糖检测频次,促进激发试验准确、顺利完成。方法322例矮小症患儿,行胰岛素生长激素激发试验,于注射胰岛素前及30 min、60 min、90 min、120 min采血标本检测生长激素,(测末梢血糖0 min、10 min、15 min、20 min、30 min、60 min、90 min、120 min),末梢血糖低于2.8 mmol/l,或基础值一半时,为有效血糖值。比较8次末梢血糖(测末梢血糖0 min、10 min、15 min、20 min、30 min、60 min、90 min、120 min)与5次末梢血糖(测末梢血糖0 min、30 min、60 min、90 min、120 min)达有效血糖值有效性。结果179例末梢血糖15 min内达有效血糖值,其中27例30 min时升至有效血糖值以上;136例末梢血糖15 min-30 min之间达有效血糖值,其中19例30 min时升至有效血糖值以上;17例末梢血糖未达有效血糖值。8次末梢血糖达有效血糖值占94.72%(305/322),5次末梢血糖达有效血糖值占80.4%(259/322),两者比较差异有统计学意义(P<0.01)。结论胰岛素生长激素激发试验是诊断矮小症的重要部分,是诊断生长激素缺乏症的确诊条件,达到有效血糖值是试验成功的必需条件,常规检测0 min、30 min、60 min、90 min、120 min末梢血糖,可导致有效血糖值的错失,可加强检测末梢血糖的频次,提高试验准确性,避免部分试验的失败,减少经济损失。

测试压力曲线在海拉尔油田压裂选层中的应用

海拉尔油田压裂后约44%试油层为低产层或干层,改造有效率低,需要建立一套适用该区块的压裂选层评价方法。统计103口地层测试施工后的压裂试油井资料,进行测试压力曲线形态与压裂效果的相关性研究,分析储层信息与压裂增产潜力的关系。根据测试开井流动曲线、关井压力恢复曲线反映的地层渗流能力、污染程度、压力系数、能量衰竭等信息,将测试压力曲线分为常压高渗型、污染堵塞型、特低渗透型、能量衰竭型(低压型)四类,制定测试压力曲线分类图版,指导压裂选井选层。经37口井压裂选层现场应用,综合符合率达到92%以上。该方法适用于试油方案优化、老井复查、压裂选层等方面,显著提高海拉尔油田储层改造有效率。

精氨酸与可乐定生长激素激发试验在矮小症儿童中的应用比较

目的分析比较精氨酸与可乐定生长激素(GH)激发试验在儿童矮小症中的临床应用价值。方法回顾性分析温州市人民医院2018年6月至2021年6月住院诊断为矮小症的162例患儿的临床资料,给予精氨酸、可乐定激发试验,比较分析试验0 min、30 min、60 min、90 min生长激素值。结果162例患儿中,14例(8.64%)患儿表现为GH完全缺乏,58例(35.80%)患儿表现为GH部分缺乏。采用可乐定激发试验的阳性率为48.15%(78例),高于采用精氨酸激发试验的阳性率21.60%(35例),差异具有统计学意义(P<0.05)。联合采用精氨酸与可乐定激发试验的阳性率高达55.56%(90例)。可乐定激发试验的GH峰值为(10.35±4.96)μg/L,精氨酸激发试验的GH峰值为(7.26±5.85)μg/L,两者比较,差异无统计学意义(P>0.05)。可乐定峰值时间主要集中于60 min,达60.49%;精氨酸峰值时间分别集中于30 min,60 min,分别达到40.1%、32.1%。结论精氨酸联合可乐定激发试验可作为儿童GH缺乏的诊断性试验。可乐定激发试验的阳性率高于精氨酸试验结果,两种药物联合诊断的价值要优于单种药物。